SALIVARY GLANDS

Oral Histology Dent 205 Summer semester 2005/2006

Salivary Glands


Characteristics
   

Compound more than one tubule entering the main duct Tubuloacinar morphology of secreting cells Merocrine only secretion of the cell is released Exocrine secretion onto a free surface StimulantsStimulants-taste and mastication Autonomic nervous system Afferent nerves Salivary centre Autonomic nervous system Efferent nerves Secretion

Physiology
    

Classification of Salivary Glands



Size


Major
  

Parotid Submandibular Sublingual

Minor: scattered throughout the oral mucosa

 

Labial, buccal, palatoglossal, palatal, and lingual mucosae Not present in gingivae and dorsum of anterior 2/3 of the tongue

Secretion
  

Mucous Serous Mixed

Saliva


Constituents
 

WaterWater-99% Organic
  

Proteins Glycoproteins Enzymes Minerals

Inorganic


Saliva


Functions


Lubrication
 

Mucin Physical protection of oral mucosa

 

Taste Antibacterial and immunity

 

Lysozyme IgA produced by plasma cells Amylase Minerals Helps in maintaining the integrity of enamel Epidermal Growth Factor produced and secreted by the submandibular salivary glands Kallikrein

Digestion


Buffering
 

Wound healing and upper GI mucosal integrity



Blood coagulation


Salivary Glands


Main tissue elements



Glandular secretory tissue

  

Parenchyma Ectodermal Acini and duct epithelium Stroma Mesodermal

Supporting Connective tissue

 

Macro-toMacro-to-microscopic levels
   

Gland Lobe Lobule Secretory units Acini

The Secretory Units - ACINI



A grape-like cluster of grapeparenchymal cells around a lumen Types

  

Serous Mucous Mixed



Serous demilunes capping mucous cells

Myoepithelial cells around the acini



Contactile cells with several processes Synonyms: basket cells

The Duct System



IntraIntra-lobular
Acinus lumen  Intercalated ducts  Striated duct * In intra-lobular system, intracomposition is affected

  

Plasma cells in stroma Electrolytes Epidermal GF and Kallikrein

InterInter-lobular
Collecting ducts *The inter-lobular system is inert, interdoes not affect the composition


Stroma
  

Connective tissue Mesenchymal origin Macro-toMacro-to-microscopic levels

   

Capsular InterInter-lobar InterInter-lobular InterInter-acinous

Capsular, inter-lobar, and interinterinterlobular septa contain blood vessels and nerves Constituents
  

Collagen fibers Fibroblasts Fat cells



With age, there is a decrease in parenchyma and an increase in stroma (esp. far cells)

Synthesis of Saliva
  

Active secretory process Not a blood ultra-filtrate ultraSerous cells



Watery proteinaceous fluid contains amylase Proteins linked to a greater amount of carbohyrates IgA

Mucous cells


Plasma cells


Secretion of Saliva


Throughout the day

 

Low level in general Periodic large addition from major glands 0.3 ml/min 500500-700 ml/day

Average flow rate (90% from Major SG)

 

 

Contribution of gingival fluids Secretion



Spontaneous


Small amounts from sublingual and minor SGs The bulk of saliva from all glands Parotid and Submandibular SGs do not secret spontaneously

Stimulated (nerve-mediated) (nerve 

Anaesthesia ceases secretion as it is nerve-mediated nerve-

Serous cells


Light Microscopy


Basophilic because of Rough Endoplasmic Reticulum Characteristic granular appearance with H & E Round prominent nuclei located at the basal third of the cell WedgeWedge-shaped outline Basal lamina separates from stroma Luminal part contains zymogen granules Microvilli Desmosomes, gap and tight junctions

UltraUltra-structure
  

 

Mucous cells
  

Appear pale in H & E stains BasallyBasally-compressed nuclei Acini may be surrounded by crescent-shaped serous crescentdemilunes Debate whether demilunes are connected with the lumen Mucin granules

Acinus lumen

Serous demilunes

Mucous cells

Myoepithelial cells
 

Lie between basal lamina and basal membranes of acinar cells and ICD Around acinar cells
 

Dendritic Long tapering processes Longitudinal Few short processes Parasympathetic Sympathetic Flattened nucleus Desmosomes with parenchymal cells Gap junctions and hemidesmosomes with basal lamina

Around ICD
 

Contracttion
 

UltraUltra-structure
  

Intercalated ducts
    

Drainage from several acini Compressed between the acini Cuboidal epithelial cells Prominent nuclei In Parotid, they are long, narrow, and branching

Striated ducts
    

 

Larger and longer than ICD Simple columnar epithelium Cells have large centrally-located nuclei centrallyLuminal surfaces have microvilli Basal surfaces separated from connective tissue by basal lamina Striation (in light microscopy) corresponds to multiple infoldings of the basal membrane of the cells Desmosomes Electrolyte re-absorption (active) and resecretion Secretion of Epidermal GF and Kallikrein

Collecting ducts


Bi-layered epithelium (lacks Bistriation)

 

Columnar epithelial layer Basal layer

As it enlarges, it gets a connective tissue adventitia Terminated as stratified epithelium to merge with the oral mucosa

Parotid gland
   

The largest Serous Acini Adult PG vs. Infants PG Fat cells vs. age

Submandibular gland
 

2nd largest Mixed serousserousmucous secretion (7:3) Intercalated ducts are short and difficult to locate Striated ducts are long and obvious

Sublingual glands


2 segments all empty to the sublingual fold

 

Major sublingual gland 8 - 30 mixed minor SGs

Mixed gland, mucous outnumber serous cells Most of the serous cells are in demilunes Lacking striated ducts

Minor Salivary glands

 

Primarily mucous Labial, buccal, palatal, palatoglossal, and lingual Lingual glands


Anterior glands
 

Embedded in muscle near the ventral surface of the tongue Mucous glands At the root of the tongue Mucous glands Serous Associated with the Circumvallate papillae

Posterior glands
 

Von Ebner glands

 

Clinical Considerations


Dry Mouth (xerostomia)



Causes
 

Ageing Parenchymal tissue < Stroma Drugs

 

Central action on the salivary centre Diuretics, sedatives, hypnotics, antihistamines, antihypertensives, antipsychotics, antidepressants, anticholinergics, and appetite suppressants Radiotherapy Autoimmune disorders


Loss / destruction of salivary tissue

 

Sjogrens syndrome destruction by lymphoid tissue (autoimmune disease)

Salivary gland surgery Diabetes Hyperthyroidism

Endocrine disorders
 

Clinical Considerations


Dry mouth (xerostomia)



Signs and symptoms

   

 

Dry, red, glossy atrophic mucosa Difficulty chewing, swallowing, or speaking Altered / diminished taste ability Dental caries  Saliva contains re-mineralising minerals rePeriodontal disease Candidal infection

Treatment
   

Consider stopping offending medication Commercial saliva substitute Fluoride Supplementation Scrupulous dental care

Clinical considerations


Obstructive disorders


Sialolithiasis (salivary calculi)



80% in submandibular SG Minor SGs Retention of mucous outside the duct Submandibular and sublingual SGs
http://www.fo.usp.br/estomato/patobucal/images/mucocele.jp g

Mucoceles and cysts

 

Ranula


Inflammatory disorders (Sialadenitis)



Viral


http://www.infocompu.com/adolfo_arthur/images/ranula.jpg

Mumps Suppurative parotitis

Bacterial uncommon


Autoimmune diseases


Sjogrens syndrome

Salivary gland tumours