學習目標 口腔胚胎及組織學 Oral embryology & histology 能了解頭臉部及口腔之發育、結構與功能， 並發展能有效吸收與傳播相關資訊之辭彙， 將胚胎及組織學上之基本概念，應用於臨 床上之診斷與治療 Salivary Gland 臺北醫學大學 牙醫學系 張維仁醫師 [email protected] 1 參考資料 2 Summary 1.Illustrated Dental Embryology, Histology, and Anatomy: Mary Bath-Balogh, Margaret J. Fehrenbach, 2nd Edition, Elsevier Saunders,2006 2.Esstential of Oral Histology and Embryology--A clinical approach: James K Avery, Denial J Chiego,Jr 3rd Edition, Elsevier Mosby, 2006 3.Ten Cate's Oral Histology: Development, Structure, and Function: Nanci Anatonio, 6th ed. Mosby, 2003 提供學生探討頭臉部及口腔之發育，認識 牙齒及口腔組織之正常顯微結構，並了解 其功能與結構之關係，進而對生理、病理 與臨床牙科學上之問題能做比較與思考， 為各牙科臨床科目之重要基礎課程 3 Distribution of Salivary Gland 4 Secretion Unit 5 Alveolus or acinus Mucous cell Serous cell Serous demilunes Collecting by intercalated duct 6 1 Serous cell Pyramidal cell Oval to round nucleus Secret most protein Secretion containing zymogen granule --Æ amylase Organelles on apical area 7 8 9 10 11 12 Mucous cell Cubidal to pyramid Oval to spindle nucleus High carbonhydrate secretion Secretion product --- mucin 2 Serous demilunes On the terminal alveolus of mucous cell A serous cells cap 13 14 15 16 17 18 Duct system Acinus Intercalated duct –low cuboidal cell Straited duct ----columnar columnar cell exchange ions with nearby blood vessel Na resorption and K secretion Intralobular duct Interlobular duct 3 19 Major Salivary Gland 20 Parotid Gland Parotid glands Submandibular glands Sublingual gland Largest Anterior ear Serous 25% secretion Stenson’s duct Opening over upper 2nd molar 21 Submadibular gland 22 Sublingual gland Intermediate Angle of mandible Mixed serous demilune Whartson’s duct 60% secretion 23 Smallest Anterior floor of mouth Mucous Bartholin’s duct 5% secretion 24 4 Minor Salivary Gland Buccal and labial gland Palatine gland --- mucous gland Glossopalatine gland --- mucous gland Lingual anterior middle ---serous posterior ---- mucous von Ebner’s gland posterior tongue --Serous 25 26 Saliva 1) 2) 3) Composition pH Quantity resting stimulated Viscosity Antibacterial properties Buffer capacity Pure Saliva Mixed Saliva 27 28 Salivary flow Seruous Mucin M i fluid Resting male: 0.51 cc/min female: 0.35 cc/min Stimulated fl fluid id 29 male: 1.41 cc/min female: 1.07 cc/min 30 5 Salivary pH Resting Stimulated Mucous – secreting cells small amount protein, high content of complex carbohydrates Serous – secreting cells large amount protein 6.6-7.5 7 7.3-7.9 379 31 Mucins large mucin : lubricating smaller mucin : antibacterial and antiviral actions 32 Secretion of saliva Parasympathetic stimulation 33 34 Striated duct parasympathetic stimulation – high fluid volume – low l protein t i sympathetic stimulation – low fluid volume – high protein Isotonic saliva to hypotonic sliva p Na+ and Cl– Reabsorption – Secrete HCO3- 35 36 6 Saliva contains histatin : antifungal proteins SIgA : antivirus Cystatin : active against herpes virus Digestive enzymes – Amylase Growth factors – Epidermal growth factor – nerve growth facter – mesodermal growth factor – hepatocyte factor 37 – β-glucuronidase – Lysozyme – Acid phosphatase – Alkaline phosphatase – Aliesterase – Lipase p – Acetylcholinesterase – Perioxidase – Succinic dehydrogenase – Carbonic anhydrase – Aldolase 38 Anticarcinogens Proline-rich proteins bind tannin-rich foods 40 Parameter Urea Uric U c ac acid d Volume 14-75 mg ﹪ Rate of flow 0 0.5-4.0 5 0 mg g ﹪ Unstimulated saliva Mixed saliva Plasma 500-1500 ml/day 4.3﹪ of BW 0.6(0.1-1.8) ml/min pH 6.7(5.6-7.9) 7.4 Water( ﹪) 98(97-99.5) 91.5(90-93) Total protein (g/100ml) 0.3(0.15-0.64) Albumin (g/100ml) Mucin (g/100ml) 7.3(6-8) 4.5(4-5) 0.27(0.08-0.6) 41 7 Parameter Amino acid (mg/100ml) Electrolytes (mmole/l) Potassium Sodium Calcium Phosphate Chloride Cholesterol Dry sulistance (g/l) Mixed saliva Plasma 0.1-40 0.98 8-40 5-100 1.5-2 5.5-14 5-70 7.5 (3-15) 6 3.5-5.5 135-155 4.5-5.2 1.2-2.2 100-106 150-300 80 Saliva is important 1) 2) 3) 4) Wash food debris and plaque to prevent decay and periodontitis Limit growth of bacteria and fungus Bathe the teeth allow remineralization of cavities Lubricate food to swallow easily 44 Saliva is important 5) 6) 7) 8) Providing enzyme the aid in digestion Help tasting process Moisten the mucosa and diminish trauma to make chewing and speaking easier Supply buffering oral condition 45 8
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