Presentation covers all the current topics and advances regarding saliva and salivary glands.

1. 1

2. SALIVARY GLANDS AND
SALIVA
PRESENTED BY:-
Nilesh R.Vaidya
1st yr PG.
Dept. Of Conservative Dentistry &
Endodontics.KIMSDU,SDS.
2

3. CONTENTS
INTRODUCTION
SALIVARY GLANDS
•Embryology
•Development
•Classification
•Structure
•Parotid Gland
•Submandibular Gland
•Sublingual Gland
•Age Changes
SALIVA
•Definition
•Composition Of Saliva
•Properties Of Saliva
•Functions Of Saliva
3

4. • Formation Of Saliva
• Regulation Of Salivary Secretion
• Saliva As A Biomarker
• Conditions Affecting Salivation
• Methods Of Collecting Saliva
•Artificial Saliva
Applied aspects
Neoplasms of salivary glands
Importance of saliva in dentistry
Caries activity tests
Conclusion
References
4

5. 5
Saliva is a complex fluid produced by salivary glands,whose
important role is to maintain well being of mouth.
Saliva is multifunctional helping in swallowing, digestion and
protecting the oral cavity from desciccation.
Saliva circulating in mouth at any given time is termed WHOLE
SALIVA.
Saliva reflects the physiological state of the body and is also known
as THE BODY’S MIRROR.
INTRODUCTION

6. SALIVARY GLANDS
6

7. EMBRYOLOGY
.
7

8. 8
Mesenchyme
Oral Epithelial Buds
Ectoderm Endoderm
Parotid and
Minor Salivary
Glands
Submandibular
and Sublingual
Glands
Salivary glands are a group of compound exocrine glands
secreting saliva.

9. Bud Formation
Growth &
Formation of
Epithelial chord
Branching of
chords
Formation of
Lobules
Canalization
Cytodifferentiation
DEVELOPMENT
9

10. 10
According to
anatomical size:
• Major salivary
glands (Parotid,
Submandibular and
Sublingual)
• Minor salivary
glands (labial,
buccal,
glossopalatine,
palatine, lingual and
Von Ebner’s)
According to
location:
Labial
Lingual
According to
Histochemical
nature of secretory
products:
• Serous (Parotid)
• Mucous
(Glossopalatine,
Palatine and posterior
part of tongue)
• Mixed
(Submandibular and
Sublingual)
CLASSIFICATION

11. It contains:
 Ducts
 Acini
 Myoepithelial Cells
11
STRUCTURE OF SALIVARY GLAND

12. • Lined by single layer of low cuboidal
cells
• Contribute- Lysozymes and lactoferin.
Intercalated Ducts
• Largest portion of the ductal system
• Lined by layer of tall columnar cell,
with large centrally placed nuclei
• Site of electrolyte reabsorption of Na,
Cl, K & bicarbonates
Striated Ducts
• Two layers : mucosa and outer
connective tissue
• Connective tissue allow passive
stretching of the duct to accomodate
varying volumes of saliva.
Excretory Ducts
12

13. 13

14. ACINI
SEROUS CELL
-Pyramidal in shape
-Nucleus is spherical
MUCOUS CELL
-Pyramidal in shape
-Nucleus is flattened
14

15. MYOEPITHELIAL
CELLS
 Located between basal
lamina and acinar cells.
 Consists of myofilaments
similar to those found in
smooth muscle cells.
 Contraction -sudden
release of secretory granules
from acinar cells.
15

16. PAROTID GLAND
16

17. •Largest
•Weighs – 15gms.
•Situated- below external acoustic
meatus between ramus of
mandible & sternocleidomastoid.
•Accessory parotid gland-
forward extension
lies b/w zygomatic arch
and parotid duct.
17

18. PAROTID CAPSULE
Derived from investing layer
of deep cervical fascia.
Superficial lamina- thick
closely adherent-sends fibrous
septa into the gland.
Deep lamina- thin-attached
to styloid process.
Stylomandibular ligament –
separates gland from
submandibular salivary gland.
18

19. External Features of Gland:
Resembles a inverted 3 sided pyramid.
Four surfaces: Superior
Superficial
Anteromedial
Posteromedial
Patey’s Faciovenous Plane:-
Gland divided into 2 parts-
-Large superficial
-Small deep part
2 Parts are connected by Isthmus. 19

20. Superior Surface:
Cartilagenous part of external
acoustic meatus
Posterior aspect of TMJ
Auriculotemporal nerve
Superior temporal vessels
Superficial Surface:
Covered by
Skin
Superficial fascia
Parotid fascia
20
Relations

21. Anteromedial Surface:
Lateral surface of TMJ
Posterior border of ramus of
mandible
Masseter and Medial Pterygoid
Posteromedial Surface:
Mastoid Process
Styloid Process
21

22. •BORDERS:
Anterior- Separates superficial
surface from anteromedial surface.
Posterior- Separates superficial
surface from posteromedial surface.
Overlaps sternocleidomastoid.
Medial - Separates anteromedial
surface from posteromedial and is
related to pharynx.
22

23. •Structures Within Parotid Gland:
Arteries Veins
23

24. Nerves
24

25. 25
•Parasympathetic - secretomotor and reach the gland
through the auriculotemporal N.

26. 26
•Sympathetic-
•Derived from plexus
around Middle Meneingeal
Artery
• Sensory-
Auriculotemporal N.
•Lymphatic drainage-
First to Parotid nodes

upper deep cervical nodes

27. • Thick walled, 5 cm long
• Runs forwards and downwards
on masseter
• Lies between upper and
lower buccal branches of facial N.
• Because of its oblique course,
inflation of the duct is prevented during blowing.
• It runs forwards between buccinator and oral mucosa
and finally opens in the vestibule opposite the maxillary
2nd molar crown
PAROTID DUCT
27

28. SUBMANDIBULAR GLAND
28

29. •Situated in the anterior part of digastric
triangle.
•Wt: 15-20gms.
•Roughly J shaped.
•Indented by post. border
of mylohyoid which divides it into:
•1.Superficial part
•2.Deep part
29

30.  Superficial part:
-Fills the diagastric triangle.
-Extends superiorly deep to the
mandible upto the mylohyoid line.
-It has 3 parts-1)Inferior 2.Lateral
3)Medial
30
 Deep part:
-Small in size.
-Lies deep to mylohyoid and
superficial to hyoglossus and
styloglossus.

31. • RELATIONS
INFERIOR SURFACE
• The inferior surface is covered
by
1. Skin
2. Platysma
3. Cervical branches of facial N.
4. Deep fascia
5. Facial V.
6. Submandibular lymph nodes
31

32. LATERAL SURFACE
• Related to
1. Submandibular fossa
2. Insertion of medial pterygoid
3. Facial A.
32

33. MEDIAL SURFACE
• Related to
1. Mylohyoid, hyoglossus
and styloglossus from
anterior to posterior.
2. Overlaps stylohyoid
and post.belly of
digastric inferiorly.
33

34. •Arterial:
Facial Artery, Lingual
Artery.
•Venous:
Common Facial Vein
/Lingual Vein.
•Lymphatic:
Submandibular Lymph
nodes.
VASCULAR , NERVE SUPPLY, LYMPHATIC
34

35. •Nerve Supply:
Parasympathetic
fibers from chorda
tympani.
Sensory fibers from
linugal branch of
mandibular nerve.
Sympathetic from
plexus on facial
artery .
35

36. • Also known as Wharton’s duct.
• 5 cm long.
• Emerges at the anterior
deep part of the gland.
• Runs forwards on hyoglossus
b/w lingual & hypoglossal N.
• Opens in the floor of the mouth at the side of the
frenulum.
SUBMANDIBULAR DUCT
36

37. Submandibular Ganglion:
•It is parasympathetic
peripheral ganglion.
•Relay station for
secretomotor fibres to the
submandibular &
sublingual glands.
•Topographically related to
lingual nerve.
•Functionally related to
chorda tympani branch of
facial nerve.
37

38. SUBLINGUAL GLAND
38

39. •It is the smallest of the 3 glands.
•Almond shaped, weighs:3-4 gms.
•Lies above mylohyoid, below
mucosa of the floor of the mouth.
•Duct - Bartholin’s Duct.
•About 15 ducts emerges from the
gland and most of them opens into the
floor mouth on the summit of
sublingual fold.
39

40. •Front- Meets opposite side
gland.
•Behind- Comes in contact with
deeper part of submandibular
gland.
•Above- Mucous membrane of
mouth & Mylohyoid muscle.
•Lateral- Sublingual fossa.
•Medial- Genioglossus muscle.
Relations:
40

41. •Arterial: Lingual and
Submental Arteries.
•Venous: Lingual Vein.
•Lymphatic: submental
lymph nodes.
41
VASCULAR , NERVE SUPPLY, LYMPHATIC

42. •Nerve Supply:
Similar to the
innervation of
submandibular glands
i.e. through the lingual
nerve, chorda tympani
and sympathetic fibres
from the plexus on
facial artery.
42

43. •Numerous minor salivary glands in oral cavity.
•Ranges between 600 to 1000.
•Present throughout most of oral cavity.
•Not seen in gingiva and anterior part of hard palate.
•Continuous slow secreting glands, have important role in
protecting and moistening oral mucosa, especially when major
salivary glands are inactive.
MINOR SALIVARY GLANDS
43

44. Labial:
•Mixed.
•Consists of mucous tubules with
serous demilunes.
•Intercellular canaliculi observed b/w
mucous cells.
Buccal:
•Mixed
•Continuation of the labial glands with
similar structure.
Glossopalatine:
•Pure mucous.
•Principally localised to the region of
the isthmus in glossopalatine fold.
44

45. Palatine:
•Pure mucous
•Situated at hard and soft palate and
uvula.
•The openings of the ducts on palatal
mucosa often large and easily
recognizable.
Lingual :
•2 parts-
•Anterior (glands of Blandin & Nuhn)
located near apex of the tongue.
Chiefly mucous.
• Posterior- mixed-located lateral and
posterior to the vallate papillae and in
association with lingual tonsil.
45

46. Von Ebner’s Glands:
•Are posterior lingual serous
glands.
•Located b/w muscle fibers of
tongue below vallate papillae.
•Duct opens into the trough of
vallate papillae and at
rudimentary foliate papillae on
the sides of tongue.
46

47. •Decrease in amount of glandular tissue (over 50 years).
•Increase in amount of fibrous tissue, fat cells, inflammatory
cells and oncocytes.
•Increase in amount of duct volumes which may be due to
shrinkage of acini.
•With such significant loss of parenchyma there would be a
reduction in amount of saliva in aged population, giving rise
to the clinical condition like xerostomia.
AGE CHANGES
47

48. 48

49. 49
“Clear, tasteless, odorless, slightly acidic (pH 6.8) viscid fluid
consisting of secretion from the parotid, sublingual
submandibular and the mucous glands of the oral cavity”
- Stedman’s medical dictionary, 26th Ed

50. 50

51. COMPOSITION OF SALIVA
51

52. VOLUME- 1000 ml to 1500 ml of saliva is secreted per day
and is approximately 1ml/min.
(Parotid-25%,
Submandibular-70%,
Sublingual-5%)
REACTION-Mixed saliva from all the glands is slightly
acidic with Ph of 6.35 to 6.85
SPECIFIC GRAVITY- Ranges between 1.002 to 1.012
TONISITY- Saliva is HYPOTONIC
PROPERTIES OF SALIVA
52

53.  Preparation of food for swallowing
 Appreciation of taste
 Digestive functions - salivary amylase , maltase and lingual
lipase enzymes
 Cleansing and Protective Functions
 Role in speech
 Excretory function
 Regulation of body temperature
 Regulation of water balance
 Mucous membrane integrity
FUNCTIONS OF SALIVA
53

54. 1st stage: Production of primary saliva
from secretory end pieces which is an
isotonic fluid.
2nd stage: Primary saliva is modified
as it passes through striated and
excretory ducts mainly by
reabsorption and secretion of
electrolytes.
FORMATION OF SALIVA
Two
Stages
54

55. The fluid formation in salivary glands
occurs in the end pieces (acini).
Initiated by binding of neurotransmitters
(acetylcholine or norephinephrine).
This leads to opening of K+ and Cl-
channels and influx of sodium and calcium.
Due to high permeability of acinar tissue to
water, water enters into lumen.
This results to formation of primary saliva
which is isotonic.
55

56. From the lumen it passes through the
ductal system where it is further
modified.
Most of the modification occurs
in the striated ducts where
reabsorption of sodium and
chloride takes place and the
secretion is changed from an
isotonic solution to a
HYPOTONIC one.
56
Edgar M, Dawes C, Mullane D, Saliva and Oral
Health, Dental Tribune Middle East & Africa
Edition, 2014 Jan, 14-16

57. TWO STAGE HYPOTHESIS
57

58. 58

59. REGULATION OF SALIVARY SECRETION
 PARASYMPATHETIC NERVE SUPPLY:-
•Arise from the superior and the inferior salivatory nuclei, situated
in the pons (to submaxillary and sublingual glands) and medulla
(parotid gland), respectively.
59

60. 60

61. Parasympathetic fibers stimulated
Profuse and
watery saliva with
less organic
constituents
Activates acinar
cells, Dialate
blood vessels of
gland
Neurotransmitter -
Acetylcholine
61

62. • The sympathetic preganglionic fibres to salivary glands
arise from 1st and 2nd thoracic segments of spinal cord.
• The postganglionic fibres from this ganglion are
distributed to the salivary glands along the nerve plexus
around the arteries supplying the glands.
 SYMPATHETIC NERVE SUPPLY:-
62

63. Sympathetic fibers stimulated
Thick and rich in
mucous, Less
secretion
Activate acinar
cells, Causes
vasoconstriction
Neurotransmitter-
Noradrenaline
63

64. REFLEX REGULATION OF SALIVARY SECRETION
CONDITIONED REFLEX UNCONDITIONED REFLEX
64

65. SALIVA AS A BIOMARKER
65

66.  Cardiovascular disease:
•Elevated salivary lysozyme levels, shown a
significant association with hypertension, an
early stage of CVD.
 Diabetes:
•It is relatively easy to measure salivary
glucose, due to the multiple sources of this
material in the oral cavity.
66

67.  Renal disease
•Salivary phosphate -clinical biomarker for hyperphosphatemia.
• Evaluation of phosphate levels in saliva are correlated positively
with serum creatinine and the glomerular filtration rate.
 Psychological research:
• Typical markers that have been identified include salivary
amylase, cortisol, lysozyme and secretory IgA.
•Salivary testosterone levels have been associated with increased
aggressive behaviour and also with athletic activities.
67

68.  Forensics:
•Salivary tests have been used for a wide variety of forensic
studies.
•Samples can be obtained from
• drinking glasses,
•cigarette buds,
•Envelopes.etc.
68

69. Journal of Clinical And Diagnostic
Research,2018 Sep,vol.12.
69

70. 70

71.  Periodontium:
• The potential salivary gland markers for periodontal
diseases include immunoglobulins, enzymes, gingival
crevicular fluid, bacterial components, volatile
compounds, and phenotypic markers.
•Decreased lysozyme levels-risk factor for periodontal
diseases.
Blood Group Antigens:
•Blood group substances are soluble antigens i.e A, B
and H can be found in salivary secretios.
71

72.  Wound Healing:
•The EGF in saliva-angiogenic and proliferative
effects,enhances wound healing.
•Increased level of salivary kallikrein has a major role in
vasodilatation around mucosal injuries- facilitate defence and
healing of injured areas.
 Autoimmune Disorders:
•Sjogren’s Syndrome: Autoantibodies of IgA class are secreted by
the salivary gland which are then secreted into the saliva much
before it is secreted in the serum.
72

73.  Oral Cancer:
• Research studies proved the importance of 3 tumour
markers i.e. Cyfra 21-1,Tissue Polypeptide Antigen(TPA) and
Cancer antigen that were found to have high levels in saliva
in patients having oral cancer.
 Alzheimer And Other Neurodegenerative Disorders:
•Existance of Ab,a-Syn and DJ-1 in human saliva can be
considered related to Alzheimer’s and Parkinson’s disease.
73

74.  Lung Cancer:
•16 potentially biomarkers have been discovered
that can efficiently contribute to the salivary
diagnosis.
•3 of the most important markers are –Hepatoglobin
, Calprotectin and Zinc-a-2 glycoprotein which
have high sensitivity and excellent specificity.
A New Approach for the Diagnosis of Systemic
and Oral Diseases Based on Salivary
Biomolecules. By AlexandraRoi,Laura Rusu
and Simina Boia. Disease Markers VOL.2019
74

75.  Hypersalivation:
• Excess secretion of saliva
• ptyalism, sialorrhea, sialism, sialosis
 Drolling:
• Excessive secretion of saliva outside of
the mouth
 Hyposalivation:
• Reduced secretion of saliva in oral caviy
–leads to xerostomia
CONDITIONS AFFECTING SALIVATION
75

76.  PHYSIOLOGIC:-
•Age
•Sex
•Diet
•Source
•Diurnal Variation
•Type of stimulus
76

77. Pathologic Conditions
that increase salivation
• Digestive tract infection
• Ill fitting dentures
• Vitamin deficiency
• Trauma from Surgery
Pathologic Conditions
that decrease salivation
• Senile atropy
• Radiation Therapy
• Diseases of Brain stem
• Diabetis
mallitus/incipidus
• Diarrhoea
• Acute infectious
diseases
77

78. Drugs increasing
salivation
• Cholinesterase
inhibitirs.eg-
Prostigmine
• Adrenergic drugs.eg-
Epinephrine
• Sialogaugs.eg-
Pilocarpine
Drugs decreasing
salivation
• Antihistamines
• Antihypertensives
• Antipsychotics
• Antianxiety
• Antidepressants
• Diuretics
78

79. 79
SALIVARY IMMUNOGLOBULINS
Predominant immunoglobulin in saliva is
IgA, derived from plasma cells in salivary
glands.
Parotid gland derived IgA is the
predominant immune defence mechanism in
saliva.
2 isoforms-A1 and A2.
A2 isoform predominates in saliva.

80. 80
Sialography (also termed
radiosialography) is the radiographic
examination of the salivary glands.
 It usually involves the injection of a
small amount of contrast medium into
the salivary duct of a single gland,
followed by routine X-ray projections.
 The resulting diagram is called a
sialogram.
SIALOGRAPHY

81.  Carlson-Crittendon cannula- Parotid saliva
 A Segregator -Submandibular and Sublingual glands
 Most commonly used techniques for measuring
unstimulated salivary flow rate are :1) Draining method
2) Spitting method
3) Suction method
4) Swab method
 To determine stimulated salivary flow rate :
 1) Masticatory method
2) Gustatory method
METHODS OF COLLECTING SALIVA
81

82. Artificial saliva is a product that is used by people who have
too little of their own naturally occurring saliva (a condition
known as dry mouth).
Its pH buffering capacity is similar to normal saliva and has
excellent caries preventive effect.
They do not contain the digestive and antibacterial enzymes
and other proteins or minerals present in real saliva.
Contents: Carboxymethyl cellulose,Sorbitol,Potassium
chloride,Sodium chloride,Magnesium
chloride,Calcium chloride,
Dipotassium hydrogen phosphate
ARTIFICIAL SALIVA
82

83. APPLIED ASPECTS
83

84. • Developmental
1. Aberrant salivary glands
2. Atresia
3. Aplasia
• Obstructive Conditions
1. Sialolithiasis
2. Mucocele
3. Necrotizing sialometaplasia
• Inflammatory Diseases
 VIRAL
1. Mumps
2. HIV
BACTERIAL
1. Sialadenitis
84

85. • Degenerative Conditions
• Sjogren’s syndrome
• Ionizing Radiation
• Frey’s Syndrome
• Infectious Mononucleosis
• Xerostomia
• Neoplastic Diseases
• Benign and Malignant
• Epithelial and Mesenchymal
85

86.  ABERRANCY:
• Situation in which salivary glands
are found farther than their normal
location.
 ATRESIA:
• Congenital occlusion or absence of
one/more major gland ducts.
 APLASIA:
• Absence of one or more glands.
DEVLOPMENTAL
86

87. SIALOLITHIASIS:
• Also known as salivary stones
• Calcified organic matter forming
within the secretory system of the
major salivary gland.
• Etiology: unknown
• Submandibular gland- most common
site.
• Treatment-Surgical excision
OBSTRUCTIVE CONDITIONS
87

88.  MUCOCELE:
• It is a swelling caused by the accumulation
of saliva at the site of a traumatized or
obstructed minor salivary gland duct.
• 2 types:
1. Extravasation(etiology- trauma to minor
salivary gland duct)
2. Retention(etiology- obstruction of minor
salivary gland duct)
• Treatment-Surgical excision
88

89.  RANULA
Latin - Rana = frog ; ranula =
frog’s underbelly
• A large mucocele on the floor
of the mouth.
•Deep lesion that herniates
through mylohyoid and extend
along facial plane is called
plunging ranula.
•Treatment:Surgical excision
89

90.  NECROTISING
SIALOMETAPLASIA:
• Benign ulcerative lesion usually
located towards the junction of hard
and soft palate.
Treatmet:
•Self limiting lasting approximately
6weeks.
•No specific treatement
90

91.  MUMPS:
• An acute viral infection caused by
RNA virus- paramyxovirus.
• Symptoms: Salivary gland inflammation &
enlargement, Preauricular pain ,Fever,
Malaise,Headache,Myalgia
• Treatment- Symptomatic ,Vaccination
• Complications: Testicular swelling,
Meningitis ,Encephalitis ,
Pancreatitis ,Hearing loss 91
INFLAMMATORY CONDITIONS
VIRAL

92. 92
 HIV Infections:
•HIV-found in saliva.
•Neutralizing effects of salivary enzymes and HIV
antibodies make HIV difficult to isolate from saliva and
makes its possible infectiousness hard to estimate.
•Recent studies found that infectious HIV can be detected
at high levels in saliva during early weeks of HIV
infection i.e. Window Period ,but that levels fall rapidly
after this point .

93.  SIALADENITIS:
•Inflamation of salivary glands.
•Parotid gland-mostly affected
•2Types=Acute and Chronic
•Causes:
•Infective-viral or bacterial
•Salivary stones
•Malignancy
•Autoimmune incuding sarcoidosis , sjogren’s
syndrome etc.
•Idiopathic
•Treatment:Conservative with hydration,Artificial
saliva,Antibiotics for bacterial infection
93
BACTERIAL

94.  Sjogren’s Syndrome:
• Chronic autoimmune disease
• Characteristics – oral and ocular dryness, exocrine
dysfunction and lymphocytic infiltration and
destruction of exocrine glands
• Etiology: unknown
• Features:
Xerostomia
Dryness of eyes
(Keratoconjunctivitis sicca)
Angular chelitis
Increased caries incidance
Difficulty in wearing dentures etc.
DEGENERATIVE CONDITIONS
94

95. • Treatment:
• Salivary substitutes/ spray
• Cholinergic
drugs(eg.pilocarpine)
• Corticosteroids, cytotoxic drugs
and immunosuppressive therapy
are effective.
95
Ionizing Radiation:
•There is high levels of cell death , vascular
damage and loss of parenchymal cells.
•This leads to degeneration of the salivary
glands and there is decreased salivary flow
leading to conditions like mucositis and
xerostomia.

96. •Postoperative phenomenon following
salivary gland surgery due to injury to
auriculotemporal nerve.
•Sweating and flushing in preauricular
area in response to mastication or
salivary stimulus.
•Treatment:
Supportive
Use of neurotoxins
96
Auriculotemporal or Frey’s Syndrome

97. •Due to hyposalivation or aptyalism
•Causes :
•Dehydration- Excess sweating, diarroea.
•Sjogren’s syndrome
•Radiotherapy
•Trauma to gland or their ducts
•Absence of glands
•Drugs
•Shock
•Systemic diseases- HIV, Diabetes
mellitus, Sarcoidosis
XEROSTOMIA
97

98. •Treatment:
•Symptomatic
•Salivary stimulants.eg-Pilocarpine ,
Bromhexine, etc
•Salivary substitutes.eg- Carboxymethyl
and Hydroxyethyl cellulose , Mucine
•Sialogauges -Xylitol,Biotene chewing
gum
98

99. 99
Diseases Spreading Through Saliva
Caused by the Epstain-Barr Virus.
Spreads through saliva hence also called as
‘Kissing Disease’
Usually occurs in children and teenagers .
Symptoms:-fever, sore throat, swollen tonsils,
fatigue, headache, muscle weakness etc.
Treatment:- Rest, staying hydrated, gargling
salt water, medications etc.
Complications:- Enlargment of spleen, liver
inflamation, anemia, thrombocytopenia etc.
Infectious Mononucleosis

100. HISTOLOGICAL CLASSIFICATION OF SALIVARY GLAND
TUMOURS(WHO 1991)
 ADENOMAS
• Pleomorphic adenoma
• Myoepithelioma (myoepithelial adenoma)
• Basal cell adenoma
• Warthin’s tumour (adenolymphoma)
• Oncocytoma (oncocytic adenoma)
• Canalicular adenoma
• Sebaceous adenoma
• Ductal papilloma
• Cystadenoma
 CARCINOMAS
• Mucoepidermoid carcinoma
• Acinic cell carcinoma
• Adenoid cystic carcinoma
• Polymorphous low grade adenocarcinoma (terminal duct
adenocarcinoma)
• Epithelial – myoepithelial carcinoma
NEOPLASMS OF SALIVARY GLANDS
100

101. • Basal cell adenocarcinoma
• Sebaceous carcinoma
• Papillary cystadenocarcinoma
• Mucinous adenocarcinoma
• Oncocytic carcinoma
• Salivary duct carcinoma
• Adenocarcinoma
• Malignant myoepithelioma (myoepithelial carcinoma)
• Carcinoma in pleomorphic adenoma (malignant mixed tumour)
• Squamous cell carcinoma
• Small cell carcinoma
• Undifferentiated carcinoma
• Other carcinomas
 NONEPITHELIAL TUMOURS
 MALIGNANT LYMPHOMAS
 SECONDARY TUMOURS
 UNCLASSIFIED TUMOURS
 TUMOUR LIKE LESIONS
• Sialadenosis
• Oncocytosis
• Necrotizing sialometaplasia (salivary gland infarction)
• Benign lymphoepithelial lesion
• Salivary gland cysts
• Chronic sclerosing sialadenitis of submandibular gland (Kuttner tumour)
• Cystic lymphoid hyperplasia in AIDS
101

102. IMPORTANCE OF SALIVA IN DENTISTRY
 Saliva maintains tooth integrity by demineralization and
remineralization process.
Critical pH of saliva is 5-5.5
Acid diffuses through the plaque and pellicle into the enamel
and crystalline dissolution occurs at this critical pH which leads
to the progression of dental caries.
The strong buffering capacity of saliva greatly influence the
pH of plaque surrounding the enamel ,thereby inhibiting caries
progression. 102

103. 103

104. Endodontic Considerations:
•Hyposalivation -Leads to development of caries.eg.Radiation Caries
•Hypersalivation -Causes problems in isolation bonding of adhesive
and restorative materials to the tooth.
Prosthodontic Considerations:
•Hypersalivation –problem in impression making
•Hyposalivation-reduced retention of denture and also causes cheeks and
lips to stick to denture base.
•Moderate flow of saliva-helps in retention of denture by Adhesion and
Cohesion
104
CLINICAL CONSIDERATIONS

105. 105
Periodontal Considerations:
• Saliva is double edged sword-It is benificial against protecting
from periodontal diseases and also promotes the formation of
Biofilms which further leads to periodontal diseases.
Pedodontic Considerations:
• Hyposalivation  Xerostomia  Leads to the formation of
Rampant Caries.

106. 106
Orthodontic Considerations:
•Saliva contamination should be avoided during the bonding as
It affects the bond strength.
Oral Surgery Considerations:
•Radiation therapies on oral cancer greatly affects the salivary
flow which lead to the conditions like Xerostomia.

107. •Synder’s Test
•Lactobacillus colony test
•Reductase test
•Buffer capacity test
•Forsdick Calcium Dissolution test
•Dewar test
•Mutant group of streptococci screening test
•Saliva/tongue blade method
•S.mutans adherence test
•S.mutans dip slide method
•S.mutans replicate technique
•Cariostat
CARIES ACTIVITY TESTS
107

108. •Saliva is a secretion that helps maintenance
of the balance of the oral environment.
•It helps ensure optimum conditions for teeth to
stay mineralized and healthy apart from being
the first line of defense.
•In modern times saliva is used as biomarker of
many diseases helping in Diagnosis.
CONCLUSION
108

109. 1) Textbook of Medical Physiology By Guyten & Hall
South East Asia Edition.
2) Orban’s Oral Histology and Embryology, 12th Edition,
2007, Pg 258-262.
3) Essentials of Medical Physiology,K.Sembulingham,6th
Edition.
4) BD Chaurasia, Human Anatomy Vol 3, 4th ed, 2004, Pg
133-37
REFERENCES
109

110. 6)Burket’s Oral Medicine-11th Ed
7)Sindhu S, Jagannathan N ,-Saliva:A Cuting Edge in
Diagnostic Procedures, Journal of Oral Diseases
Vol.2014
110
8)A New Approach for the Diagnosis of Systemic and Oral
Diseases Based on Salivary Biomolecules. By
AlexandraRoi, Laura Rusu and Simina Boia. Disease
Markers VOL.2019
5)Shafer’s Textbook of Oral Pathology – 7th Ed

111. 9)Journal of Clinical and Diagnostic Research,2018
Sep.Vol.12
111
10)Edgar M, Dawes C, Mullane D, Saliva and Oral Health,
Dental Tribune Middle East & Africa Edition, 2014 Jan, 14-
16
11)Ole Fejerskov and Edwina Kidd, Dental Caries, the disease
and its management, 2nd ed, 2008, Pg189-206

112. 112

113. 113
Next Presentation :- Dr. Riddhi Mahalle
(Dept.of OSMF),SDS
Topic:-Blood Supply To Oral And Para-oral
Region.