Radya Agna Nugraha

1610211011
• At the end of the fourth week, facial prominences consisting primarily of
neural crest-derived mesenchyme and formed mainly by the first pair of
pharyngeal arches appear. Maxillary prominences can be distinguished
lateral to the stomodeum, and mandibular prominences can be
distinguished caudal to this structure (Fig. 15.21). The frontonasal
prominence, formed by proliferation of mesenchyme ventral to the
brain vesicles, constitutes the upper border of the stomodeum. On both
sides of the frontonasal prominence, local thickenings of the surface
ectoderm, the nasal (olfactory) placodes, originate under inductive
influence of the ventral portion of the forebrain (Fig. 15.21).
• During the fifth week, the nasal placodes invaginate to
form nasal pits. In so doing, they create a ridge of tissue
that surrounds each pit and forms the nasal prominences.
The prominences on the outer edge of the pits are the lateral
nasal prominences; those on the inner edge are the medial
nasal prominences (Fig. 15.22)
• During the following 2 weeks, the maxillary prominences
continue to increase in size. Simultaneously, they grow
medially, compressing the medial nasal prominences toward
the midline. Subsequently the cleft between the medial nasal
prominence and the maxillary prominence is lost, and the two
fuse (Fig.15.23). Hence, the upper lip is formed by the two
medial nasal prominences and the two maxillary prominences.
The lower lip and jaw form from the mandibular prominences
that merge across the midline.
Intermaxillary segment

• As a result of medial growth of the maxillary prominences,

the two medial nasal prominences merge not only at the
surface but also at a deeper level. The structure formed by
the two merged prominences is the intermaxillary segment.
It is composed of (a)a labial component, which forms the
philtrum of the upper lip; (b) an upper jaw component,
which carries the four incisor teeth; and (c)a palatal
component, which forms the triangular primary palate (Fig.
15.24)

Secondary plate

• Although the primary palate is derived from the

intermaxillary segment (Fig. 15.24), the main part of the
definitive palate is formed by two shelf like outgrowths from
the maxillary prominences. These outgrowths, the palatine
shelves, appear in the sixth week of development and are
directed obliquely downward on each side of the tongue
(Fig. 15.25).
• In the seventh week, however, the palatine shelves
ascend to attain a horizontal position above the tongue
and fuse, forming the secondary palate (Figs. 15.26 and
15.27).
Tongue
• The tongue appears in embryos of approximately 4 weeks in the
form of two lateral lingual swellings and one medial swelling,
the tuberculum impar (Fig. 15.17, A and C).
• These three swellings originate from the first pharyngeal arch. A
second median swelling,the copula, or hypobranchial eminence,
is formed by mesoderm of the second, third, and part of the
fourth arch. Finally, a third median swelling, formed by the
posterior part of the fourth arch, marks development of the
epiglottis.
• As the lateral lingual swellings increase in size, they overgrow the
tuberculum impar and merge, forming the anterior two-thirds, or
body, of the tongue (Fig. 15.17, B and D). Since the mucosa
covering the body of the tongue originates from the first
pharyngeal arch, sensory innervation to this area is by the
mandibular branch of the trigeminal nerve. The body of the
tongue is separated from the posterior third by a V-shaped groove,
the terminal sulcus (Fig. 15.17, B and D).
• The posterior part, or root, of the tongue originates from the
second, third, and part of the fourth pharyngeal arch. The fact that
sensory innervation to this part of the tongue is supplied by the
glossopharyngeal nerve indicates that tissue of the third arch
overgrows that of the second.
• The epiglottis and the extreme posterior part of the tongue are
innervated by the superior laryngeal nerve, reflecting their
development from the fourth arch. Some of the tongue
muscles probably differentiate in situ, but most are derived
from myoblasts originating in occipital somites. Thus,
tongue musculature is innervated by the hypoglossal nerve.
• The general sensory innervation of the tongue is easy to
understand. The body is supplied by the trigeminal nerve,
the nerve of the first arch ; that of the root is supplied by the
glossopharyngeal and vagus nerves, the nerves of the third
and fourth arches, respectively. Special sensory innervation
(taste) to the anterior two thirds of the tongue is provided by
the chorda tympani branch of the facial nerve, while the
posterior third is supplied by the glossopharyngeal nerve.
Teeth
• Teeth themselves arise from an epithelial-
mesenchymal interaction between overlying oral
epithelium and underlying mesenchyme derived
from neural crest cells.
• By the sixth week of development, the basal
layer of the epithelial lining of the oral cavity
forms a C-shaped structure, the dental lamina,
along the length of the upper and lower jaws 
This lamina subsequently gives rise to a number of
dental buds (Fig. 15.31A), 10 in each jaw, which
form the primordia of the ectodermal components
of the teeth.
• Soon the deep surface of the buds invaginates,
resulting in the cap stage of tooth development
(Fig. 15.31B). Such a cap consists of an outer layer,
the outer dental epithelium, an inner layer, the
inner dental epithelium, and a central core of
loosely woven tissue, the stellate reticulum. The
mesenchyme, which originates in the neural crest
in the indentation, forms the dental papilla (Fig.
15.31B).
• As the dental cap grows and the indentation
deepens,the tooth takes on the appearance of a bell
(bell stage) (Fig. 15.31C). Mesenchyme cells of the
papilla adjacent to the inner dental layer
differentiate into odontoblasts, which later produce
dentin
• With thickening of the dentin layer, odontoblasts
retreat into the dental papilla, leaving a thin
cytoplasmic process (dental process) behind in the
dentin (Fig. 15.31D). The odontoblast layer persists
throughout the life of the tooth and continuously
provides predentin. The remaining cells of the
dental papilla form the pulp of the tooth (Fig.
15.31D).
• In the mean time,epithelial cells of the inner dental
epithelium differentiate into ameloblasts (enamel
formers). These cells produce long enamel prisms
that are deposited over the dentin (Fig.15.31D).
Furthermore,a cluster of these cells in the inner
dental epithelium forms the enamel knot that
regulates early tooth development (Fig. 15.31B).
• Formation of the root of the tooth begins when
the dental epithelial layers penetrate into the
underlying mesenchyme and form the
epithelial rootsheath (Fig. 15.31D). Cells of the
dental papilla lay down a layer of dentin
continuous with that of the crown (Fig. 15.32).
As more and more dentin is deposited, the
pulp chamber narrows and finally forms a
canal containing blood vessels and nerves of
the tooth.
• Mesenchymal cells on the outside of the
tooth and in contact with dentin of the root
differentiate into cementoblasts (Fig.
15.32A). These cells produce a thin layer of
specialized bone, the cementum. Outside of
the cement layer, mesenchyme gives rise to
the periodontal ligament (Fig. 15.32), which
holds the tooth firmly in position and
functions as a shock absorber.
• With further lengthening of the root,the
crown is gradually pushed through the
overlying tissue layers into the oral cavity
(Fig. 15.32B). The eruption of deciduous or
milk teeth occurs 6 to 24 months after birth.
• Buds for the permanent teeth, which lie on the lingual aspect of the milk teeth, are
formed during the third month of development. These buds remain dormant until
approximately the sixth year of postnatal life (Fig. 15.33) Then they begin to grow,
pushing against the underside of the milk teeth and aiding in the shedding of them. As
a permanent tooth grows, the root of the overlying deciduous tooth is resorbed by
osteoclasts
 Molecular Regulation of Tooth
Development
Tooth development represents a classic example of an epithelial-mesenchymal interaction, Regulation of tooth patterning
from incisors to molars is generated by a combinatorial expression of HOX genes expressed in the mesenchyme. Signals for
development in volve growth factors including :
WNTs,
bonemorphogenetic proteins(BMPs),and
fibroblast growth factors(FGFs);the secreted factor sonic hedgehog(SHH);and transcription factors,such as MSX1 and 2 that
inter actin acomplex pathway to produce cell differentiation and patterning for each tooth.

Teeth also appear to have a signaling center that represents the “organizer” for tooth [Link] organizer region is
called the enamel knot, and it appears in a circumscribed region of the dental epithelium at the tips of the tooth buds. While it
is present, it expresses FGF-4, SHH, and BMP2 and 4. FGF-4 may regulate outgrowth of cusps much as it participates in limb
outgrowth produced by the apical ectodermal ridge (AER); while BMP-4 may regulate the timing of apoptosis in knot cells.
Anatomi
Taste buds are microscopic barrel-shaped
epithelial structures which contain chemosensory
cells. They are numerous on all types of lingual
papillae (except filiform papillae).
Histology
LIDAH
 Massa otot rangka
ditutupi membran
mukosa
 Permukaan dorsal lidah
berstruktur irregular,
ditutupi tonjolan kecil yg
disebut papilla.
Papilla Filiformis
 Jumlah banyak
 Kerucut memanjang
 Banyak lapisan tanduk -> terlihat keabuan / keputihan
 Tidak ada kuncup kecap
 Peran : menyediakan permukaan kasar -> mempermudah pergerakan
makanan saat mengunyah.
Papilla Fungiformis
 Jumlah sedikit
 Sedikit bertanduk
 Berbentuk jamur -> berinti jaringan ikat
 Sebaran kuncup kecap di permukaan atas
 Tersebar acak di antara papilla filiformis
Papilla Foliata
 Terdiri atas rigi (ridge) dan beralur parallel
 Terdapat kuncup kecap
Papilla Vallata / Circumvallata
 Jumlahnya paling sedikit
 Papilla tersebar di lidah
 Lebih dari separuh kuncup kecap
Kuncup Kecap
 Berstruktur ovoid, di dalam epitel berlapis lidah dan mukosa mulut
 Terdapat sel gustatorik (kecap), sel penyangga, dan sel punca
 Dasar tiap kuncup kecap di lamina basal dan disusupi akson sensorik
aferen membentuk sinaps di sel-sel gustatorik
 Kuncup kecap mendeteksi :
 Ion logam (asin)
 Ion hydrogen (asam)
 Gula dan senyawa organic (manis)
 Alkaloid & toksin (pahit)
 Asam amino (gurih)
FARING
 Rongga peralihan antara rongga mulut, system pencernaan dan system
pernafasan.
 Daerah komunikasi antara hidung dan laring
 Dilapisi epitel berlapis gepeng tak bertanduk yang berlanjut ke
esophagus
 Mengandung tonsil dan mukosa faring mengandung banyak kelenjar
liur dan mukosa kecil dalam lamina propria, terdiri atas jaringan ikat
padat
GIGI
 32 gigi permanen
 8 gigi : 2 insivisus, 1 kaninus, 2 premolar, 3 molar tetap
 20 gigi dari gigi desidua (gigi susu) sisanya adalah gigi molar tetap
yang tidak memiliki prekursos desidua.
 Setiap gigi memiliki : Mahkota, Leher, dan Akar Gigi.
 Foramen apikal -> lubang tempat Pembuluh darah, pembuluh limfe
dan saraf keluar masuk gigi
Dentin
 Terdiri atas 70% kalsium hidroksiapatit sehingga lebih kuat dari tulang.
 Matriks organic mengandung serat kolagen tipe 1 dan
glikosaminoglikan yang disekresi oleh odontoblas.
 Pulpa banyak mengandung serabut saraf dan sejumlah serabut saraf
tidak bermielin yang menjulur ke dalam tubulus dentis di dekat rongga
pulpa.
Email
 Komponen tubuh manusia yang paling keras
 Terdiri atas 98% mineral dan materi organic lainnya yaitu 2 protein
unik amelogenin dan enamelin
 Terdiri atas batang atau kolom panjang -> batang email / prisma ->
berfungsi untuk menentukan ketebalan lapisan email dan sifat
mekanisnya
 Gigi yang sedang berkembang, matriks email disekresi oleh ameloblas
 Prosesus ameloblas -> mengandung sejumlah besar granul sekresi
berisi protein yang membentuk matriks email
Pulpa
 Terdiri dari jaringan ikat longgar yang menyerupai mesenkim
 Komponen utama : lapisan odontoblas, fibroblast, serabut kolagen
halus, dan substansi dasar
 Banyak Pembuluh Darah dan Saraf
 PD & Saraf bermielin masuk melewati foramen apical yang bercabang-
cabang
 Sebagian serabut saraf kehilangan mielinnya dan terjulur ke dalam
tubulus dentis
 Serat pulpa sensitive terhadap nyeri
Periodonsium
 Mempertahankan gigi di dalam tulang maksila dan mandibula.
 Sementum -> menutupi dentin akar gigi dan zat nutrisinya berasal dari jaringan
eksternal
 Ligamen Periodontal -> jaringan ikat dengan berkas kolagen (serat) yang
menghubungkan sementum dengan tulang alveolar pada saku gigi. Berfungsi
sebagai suportif, protektif, sensorik dan nutrisi.
 Tulang alveolar -> berkontak langsung dengan ligament periodontal sebagai
periosteumnya.
 Gingiva -> membrane mukosa yang melekat erat di periosterum tulang maksila dan
mandibula. Terdiri dari epitel berlapis gepeng dan lamina propria banyak papil
jaringan ikat.
 Epitel pertautan -> melekat pada email gigi melalui kutikula.
 Sulkus gingiva -> suatu lekukan yang mengelilingi leher gigi di antara email dan
epitel.
KELENJAR LIUR
 Kelenjar eksokrin dalam mulut menghasilkan liur yang berfungsi untuk
digestif, pelumas, dan pelindung
 PH normal 6,5 – 6,9 -> saliva penting untuk pendinginan evaporative
 Saliva dari parotis bersifat serosa dan encer
 Kelenjar submandibular dan sublingual -> menghasilkan secret seromukosa
 Sel-sel serosa -> penghasil protein terpolarisasi, berbentuk pyramid
 Sel-sel mukosa -> berbentuk kuboid / kolumner sampai silindris dengan inti
yang terdesak ke basal sel. Bersifat penghasil mucus -> musin glikoprotein
hidrofilik -> fungsi liur membasahi dan melumasi
 Sel-sel mioepitel -> mencegah pelebaran bagian ujung ketika lumen berisi
saliva dan kontraksinya mempercepat sekresi produk kelenjar
KELENJAR LIUR
 Pada kelenjar liur utama, jaringan ikat memiliki banyak limfosit dan sel
plasma.
 Sel plasma melepaskan IgA -> menahan pencernaan enzimatik dan
membentuk mekanisme pertahanan imunologis terhadap pathogen di
rongga mulut.
 Kapiler yang mengelilingi ujung sekresi liur dirangsang oleh system
saraf autonom.
 Kelenjar liur utama :
 Kelenjar Parotis
 Kelenjar Submandibula
 Kelenjar Sublingual
Kelenjar Parotis
 Berada di pipi dekat telinga
 Kelenjar asinar bercabang dengan bagian sekresi yang hanya terdiri
atas sel-sel serosa di sekeliling lumen yang sangat kecil
 Sel serosa mengandung granula sekretori dengan sejumlah besar alfa-
amylase dan protein yang kaya akan prolin -> berperan atas
kebanyakan hidrolisis karbohidrat yang dimakan.
 Protein yang kaya akan prolin -> antimikroba & membantu
mempertahankan permukaan email.
Kelenjar Submandibula
 Kelenjar tubuloasinar bercabang dengan bagian sekresi mengandung
sel-sel mukosa dan serosa
 Sekresi enzim lain seperti lisozim -> hidrolisis dinding bakteri
Kelenjar Sublingual
 Sel mukosa mendominasi
 Produk utama saliva adalah mucus, namun sel demilum serosa di
kelenjar ini menyekresi amylase dan lisozim