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www.petesmif.org.uk Pete Smith Senior Lecturer in Oral Biology / Physiology 1st BDS Teaching Lead School of Dentistry SCHOOL OF DENTISTRY Ingestion of a meal • • • • Mastication Salivary glands and salivation Deglutition Salivary gland pathology SCHOOL OF DENTISTRY Muscles of Mastication Temporalis: arises from the temporal fossa and inserts onto the coronoid process of the mandible temporal maxilla mandible temporalis hyoid Masseter: arises from the zygomatic process of the maxilla and inserts into the angle and ramus of the mandible Muscles for closing the mouth SCHOOL OF DENTISTRY Muscles of Mastication Lateral pterygoid: arises from the sphenoid and inserts onto the condyloid process of the mandible temporal maxilla mandible hyoid temporalis lateral pterygoid Muscles for opening the mouth All of the muscles of mastication are innervated by the mandibular branch of the trigeminal nerve SCHOOL OF DENTISTRY Digastric: posterior: arises from the mastoid notch; anterior arises from lower border of the mandible. Insert onto the hyoid Infrahyoid: (4 pairs if muscles) arise from hyoid insert onto clavicle (ish). Control of Mastication • • • • Voluntary Reflexes: Jaw opening reflex; Jaw-jerk reflex Brain stem pattern generator Fine tuning via sensory feedback through periodontal ligaments and proprioceptors • A change in occlusion (e.g. following dentistry) will alter the chewing pattern. • There are 3 main movements of mastication SCHOOL OF DENTISTRY Movements of Mastication The temperomandibular joint (TMJ) allows three movements of mastication: open/close; protrusion/retraction; lateral SCHOOL OF DENTISTRY Salivation mastication taste smell anticipation Superior (pons) + - vomiting fear Salivary Nuclei Inferior (medulla) SCHOOL OF DENTISTRY VII submandibular sublingual IX Salivary glands parotid Functions of Saliva • Tooth maintenance rampant caries • Lubrication: allows speech, mastication and deglutition • Antibacterial/antifungal candida infection • Digestive: salivary amylase; lingual lipase SCHOOL OF DENTISTRY Functions of Saliva • Tooth maintenance: dilution, clearance and buffering Stephan Curve 7 rampant caries Plaque pH 6.5 6 Critical pH teeth demineralise 5.5 5 0 20 Time (seconds) SCHOOL OF DENTISTRY 40 Functions of Saliva • Lubrication: salivary glycoproteins are sticky SCHOOL OF DENTISTRY Functions of Saliva • Antibacterial/antifungal: protective barrier; IgA; lysozyme etc. Much more detail available in: Many copies available in the library Saliva and Oral Health 3rd Edition Saliva and Oral Health 4th Edition ISBN: 9780956566836 Paperback: £25.00 SCHOOL OF DENTISTRY Salivary Secretion mucous minor glands serous Parotid mucous sublingual mixed submandibular All salivary glands secrete both protein and fluid. The constituency of saliva is determined by the nature of the secreted protein SCHOOL OF DENTISTRY Serous acinus Mucous acinus myoepithelia cell Serous demilune Intercalated duct Striated duct Excretory duct SCHOOL OF DENTISTRY basolateral or blood side endoplasmic reticulum nucleus secretory vesicles SCHOOL OF DENTISTRY apical or lumenal side parasympathetic nervous system sympathetic nervous system acetylcholine noradrenalin cyclic adenosine StimulusSecretion Coupling monophosphate cAMP Ca2+ protein fluid SCHOOL OF DENTISTRY CHOH.CH2.NH2 b adrenergic receptor OH OH noradrenaline G-protein NH2 adenylate cyclase cyclic AMP C PO4 OH Protein Secretion SCHOOL OF DENTISTRY cAMP stimulates gene transcription, glycosylation and formation of secretory vesicles and exocytosis IgA R Transcellular translocation of serum IgA Polymeric immunoglobulin receptor PIgR R SCHOOL OF DENTISTRY M3 muscarinic receptor CH3 CH3 N.CH2.CH2.O.CO.CH3 CH3 acetylcholine G-protein inositol 1,4,5 trisphosphate IP3 Fluid Secretion SCHOOL OF DENTISTRY phospholipase C NaCl Ca2+ release receptor activation IP3 increased [Ca2+]i Na+ ClSCHOOL OF DENTISTRY ion channel activation CH3 CH3 N.CH2.CH2.O.CO.CH3 CH3 osmotic gradient K+ fluid & electrolyte secretion Deglutition • • • Oral/buccal: voluntary: the bolus is pushed to the back of the mouth by the tongue. The teeth are brought together. The soft palate elevates to close the nasal cavity. The larynx rises to close the airways (inspiration is inhibited) Pharyngeal: involuntary (reflex): cricopharyngeal sphincter relaxes to open the oesophagus. The epiglottis steers the bolus over the trachea and the peristalsis starts Oesophageal: peristalsis; all of the above reverse…. SCHOOL OF DENTISTRY Salivary gland pathology • • • What causes xerostomia? Drugs Disease • Sjogren’s syndrome : an autoimmune condition that causes salivary gland dysfunction and atrophy Much more detail available via: www.petesmif.org.uk SCHOOL OF DENTISTRY rampant caries