Beruflich Dokumente
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CAVITY
Introduction
Oral mucous membrane
Saliva
Gingival crevicular fluid
Teeth
Hypersensitivity reactions
Conclusion
Refrences
Introduction:
Oral cavity is the only area in the body in which hard
tissues break through the epithelial surface, implying
that periodontal tissue surrounding the tooth acquire a
specialization to form an effective attachment & seal
around each structure
Keratin:
Squames:
At the junction of granular & keratinized layer sudden
change in their appearance occurs.
All organelles including nulceus & keratohyaline
granules disappears
Cells dehydrate & become packed with filaments
cross linked by disulfide bonds, which facilitate their
dense packing
Cells assume the form of hexagonal disks called
squames
Squames are lost --- desquamation --- programmed
enzymatic breakdown of lipids & proteins
Stimulated lymphocyte produce gamma interferon --stimulate keratinocyte to express HLA-DR antigen
Basement membrane:
Lamina propria adjacent to basement membrane --lymphoid cells --- combat microorganisms that has
penetrated to this depth
These intraoral lymphoid aggregations function
together with extraoral lymph node
Capillaries in CT carry adhession molecules like --endothelial cell leucocyte adhesion molecule,
intercellular adhesion molecule & vascular cell
adhesion molecule --- facilitate trafficking of leucocytes
from the blood
Lingual tonsil:
Lie on either side of tongue,
distal to circumvallete papillae
Palatine tonsils:
Paired
Glossopalatine &
pharyngeopalatine arches
Lymphoid tissue contains
both B & T cells
Pharyngeal tonsil:
Mass of lymphoid tissue
under nasopharyngeal
mucosa
DENTIN
Dentinal sclerosis:
In cases of caries, attrision, abrasion, erosion or cavity preparation
--- stimuli is generated --- cause collagen fibers & apatite crystals
compactly arranged in dentinal tubules
Gradually entire dentinal tubule gets filled with such highly calcified
dentin & dentinal tubule gets obliterated
Reduces the permeability of the dentin & prolong the pulp vitality.
PULP
1.
2.
Oral fluids
Saliva
GCF
SALIVA
Saliva bathes the oral tissues and is responsible for the health status
of the oral cavity
Hypotonic to plasma
COMPOSITION OF SALIVA
Proteins Small Organic molecules Electrolytes
Albmin
Amylase
B-glucuronidase
Carbohydrates
Cystatins
Epidermal growth factor
Esterases
Fibronectin
Gustin
Histatins
Immunoglobulin A
Immunoglobulin G
Immunoglobulin M
Kallikrein
Lactoferrin
Lipase
Lactic acid dehydrogenase
Lysosyme
Mucins
Nerve growth factor
Parotid aggregins
Peptidases
Phosphatases
Proline rich proteins
Ribonucleases
Salivary peroxydases
Secretory component
Secretory IgA
Serum protiens
Amino acids
Creatinine
Glucose
Lipids
Nitrogen
Sialic acid
Urea
Uric acid
Ammonia
Bicarbonate
Calcium
Chloride
Fluoride
Iodine
Magnesium
Phosphates
Potassium
Sodium
Sulphates
Thiocyanate
Proteins:
Salivary mucins:
I.
II.
.
.
The mucins coating the oral mucosa, interact with the epithelial
surfaces through specific membrane receptors.
Histatins:
Alpha - amylases
Lysozyme / muramidsae:
Bactericidal --- splits the bond between N-acetyl glucosamine & Nacetyl muramic acid in mucopeptide component of bacterial cell wall
Lactoferrin:
Peroxidase:
Catalyses the oxygenation of thiocyanate to hypothiocyanate --reduces the bacterial growth by blocking essential metabolic process
Fibronectin:
Adhesive glycoprotein
Salivary buffer:
1.
2.
Saliva pH:
IgA:
Secretory IgA
90% --- total parotid IgA, 85% --- whole saliva IgA, 30-35% --- minor
salivary glands
Functions:
Inhibits bacterial colonization by agglutination
Binds to specific bacterial antigen involved with adherance
Affects specific enzymes which are essential for bacterial metabolism
IgA complex with protein covering the oral epithelium --- provide
protective immunoglobulin coating
Epithelium:
Egelberg
Attstrm
Skapski & Lehner
Wilton et al.
Kowolik & Raeburn
Charon et al.
Sandholm
Saito et al.
Kennett et al.
98.6%
97.0%
91.5%
91.2%
98%
89.9%
9198%
89.7%
7080%
1.4%
1.0%
8.5%
8.8%
0.4%
10.2%
2-9%
1.7%
5.0%
2.0%
0.8%
2.3%
10-20%
Immunoglobulins in GCF:
Dentogingival junction:
DEFENSE CELLS:
Leucocytes
Langerhans cells
Mast cells
Leukocytes
Two types:
Granulocytes
Neutrophils
Eosinophils
Basophils
Agranulocytes
Monocyte
Lymphocyte
Mononuclear Phagocytes:
Monocytes circulating in blood & macrophages in tissue
During hematopoiesis in bone marrow, G-M progenitor cell --promyocytes --- enter blood & differentiates into mature
monocytes.
Phagocytosis:
Macrophages are capable of ingesting & digesting
exogenous antigens --- microbes & endogenous matter --injured/dead host cell, debris
Adherance of antigen to cell membrane initiates
phagocytosis
Complex antigens like bacterial cell, viral particles --- adhere
well & are readily phagocytosed
Encapsulated bacteria --- adhere poorly & less readily
phagocytosed
Neutrophils:
Most common leucocyte --- 50 to 70%
multilobed nucleus
Cytoplasm --- granulated
Lymphocyte:
20 to 50 % of leucocyte in circulation
Most circulating lymphocytes measure 6-9m --- small
lymphocyte
3% large lymphocyte --- 9-15m
Lymphocytes leave bone marrow, circulate in blood &
lymphatic system & reside in various lymphoid organs
Cell surface --- antigen binding receptors
1.
2.
Two population
B lymphocytes (B cells)
T lymphocytes (T cells)
B lymphocyte:
. Mature in bone marrow
. Stimulated B cells mature into plasma cell
. Plasma cells synthesize large amount of antibody (Ig)
. Unique antigen binding receptor on its membrane --- B cell receptor
. B cell receptor --- membrane bound antibody molecule
When B cell comes in contact with antigen for the first time
--- primary immune response
Binding of antigen to antibody cause cell to divide rapidly
Few cells mature to become memory B cells --- long lived
circulating lymphocytes which respond to quickly on
exposure to same antigen --- secondary immune response
Antibody production is more rapid & produce IgG & not IgM
Thus there is life time immunity
T lymphocytes:
Arise in bone marrow
Immature T cells migrate from marrow to thymus
where they develop into mature T cell
Mature T cells then populate secondary lymphoid
tissue & from here they circulate via bloodstream in
quest of antigen
Cytotoxic T cell:
Interaction with T helper cells, they become activated
& proliferate
Kill virus infected cells & some cancer cells
Supressor T cells:
Supress the immune responsiveness to self antigen
Switch off the response when antigen is removed.
Memory T cell:
Subsequent exposure to same antigen
Rapid reaction force
Eoisnophils
75
Basophils
81
Langerhans cells:
Mast cells:
Immunoglobulins:
Glycoproteins
Structure of Ig:
The smaller chains are called as Light chains (L) & longer chains as
Heavy chains (H)
IgA
s
Second most abundant class
sIgA is dimeric form & composed of two basic four chain units (2
light & 2 heavy chains) & J chain --- secretory component
Hypersensitivity reactions
1.
.
.
2.
.
.
Conclusion:
Oral cavity is characterized by various functions,
which contribute to the protective purpose and favour
the establishment of regulated equilibrium between
health and disease.
Refrences: