vermilion border histology

Geographic tongue is a condition where filiform papillae on the dorsal surface of the tongue become non-uniformly hyper-keratinized, giving some filiform papillae a more white-ish appearance. Furthermore, the keratinocytes in the vermilion border synthesize a clear protein (Eleidin), which allows the reddish color of hemoglobin in the capillaries of the dermis and muscle tissue to be more visible in the vermilion zone than in the more highly keratinized neighboring regions of skin. The vermilion border of neonatal lips J Pedod. Since it is no longer attached to the tooth, the probe can likely be inserted over 3mm. Black hairy tongue occurs when filiform papillae shed epithelial cells more slowly, thus the papillae become enlarged. Related Content: GIT Development Lecture | GIT Development Practical | Salivary Gland Development However, the dental hygienist should ask if the patient has any surgical repair history or if any complications have resulted from the notch. The border between the red area of the lip and the skin is called the vermilion border. Higher-than-normal levels of keratinization are clinically relevant when they indicate bruxism, tobacco use, or other health-related issues. Excess gingival tissue can be removed using a scalpel or a laser tool. However, its layers get different names and are classified differently. Medical Mcqs Medical Mcqs for Exams preparation of Medical Students and professionals. It is are also more permeable, having fewer desmosomes between cells. Unlike proteins, these molecules are not synthesized on the rER, modified in the Golgi apparatus nor secreted from vesicles. Chronic inflammation within the pockets leads to damage to nearby tissue, such as alveolar bone. One unfortunate difference is the names we use for the skin are not the same names we use for oral mucosa. Image credit: Really bad gingivitis by D. Rosenbach, is licensed CC BY 3.0. Figure 3.14: Example of healthy human gingival coloration. Image credit: “Pre-operative view and Maxillary pigmentation removal using scalpel surgical technique” by Rehab A.Abdel Moneim et al is licensed under CC BY-NC-ND 4.0. Epidermis includes the following layers: 8. Sheldahl's histology, embryology, anatomy and physiology. vermilion border (prolabium) - only a small part, area of transition from skin to oral mucosa. Connective tissue grafts are relatively common in dentistry and maxillofacial surgery, but these technologies are starting to generate changes in tissue grafting below the neck, too. Under the microscope, the absence of dermal papillae and rete pegs indicates this tissue gets very little abrasion. It includes edema in the ECM of connective tissues in the lamina propria and sub-mucosa, as well as inside the epithelial cells of the oral mucosa. Image credit: “Extracrevicular GCF collection” by Zeyad Nazar Majeed et al is licensed under CC BY 4.0, During an inflammatory response, the gingival sulcus fills with gingivo-crevicular fluid (GCF). There are other pigments that cause color changes to the gingiva, and they are classified as either endogenous (produced by human cells) or exogenous (environmental). It is often caused by occlusal trauma. They may discharge directly to the surface of the skin, but are mostly associated with hair follicles. Look at this picture of the lip, and identify the vermilion border, accessory salivary glands, hairs, oral mucosa (mucosa lining the mouth), and muscle. Winter 1987;11(2):158-63. It is the proximity of these vessels to the surface of the epithelium which gives the prolabium it's red appearance. This is not to be mistaken for an endorsement of taking up an e-cigarette habit, nor maintaining one, we are discussing relative risk here. Yellow-white, asymptomatic, floral appearing 1 - 3 mm papules that remain constant throughout life May be hyperplastic and nodular … Labial mucosa and buccal mucosa both have a non-keratinized stratified squamous epithelial layer. Table 3.4: Turnover time of the various regions of oral mucosa and skin. This current page provides background support information for Medicine phase 1 BGD Histology Practical Virtual Slides and is not part of the BGDB practical class virtual slides. Figure 3.13: Alveolar mucosa. There were no cervical lymph nodes. Table 3.2: Summary of the layers of the skin compared to the layers of the oral mucosa, Figure 3.8: Increased amounts of keratin in the oral mucosa obscure underlying pigments. Scattered across the dorsal and lateral surfaces are four different shapes of bumps called lingual papillae. Based on that information, should I classify the vermilion zone as an extension of the labial mucosa, or as part of the skin and lips? Melanin protects tissues against damage from abrasion. The number of mast cells decreases with age in all … If the increase in keratinization is localized, it is referred to as leukoplakia. Ideally, an inflammatory response limits the spread of the initial damage and set the stage for regeneration. In Fig 58, the upward-pointing dermal papillae meet downward-pointing rete pegs of the epidermis. Image credit: “Intraoperative view showing hand sewn polytetrafluoroethylene bicuspid pulmonary valve in situ with transannular pericardial patch being sutured” by Prashant Ramdas Wankhade et al is licensed under CC BY-NC-SA 4.0. Even 1 mm of vermilion misalignment could be noticeable. Melanocytes are derived from neural crest cells that migrate from the CNS to the deepest layer of the epidermis. It has no sebaceous glands, sweat glands, or facial hair. Hyperplasia is a side-effect of certain medications, such as phenytoin and cyclosporine. Image credit: “Pitting edema” by James Heilman, MD is licensed under CC BY-SA 3.0. Figure 3.11: Histology of border between the labial mucosa (left side) and the vermilion zone (right side). Figure 3.27: The fluids that cause edema in a tissue are easily compressible. Image credit: V-shaped gingival recession by Ana Suzy Jati et al, is licensed CC BY 3.0. Connective tissue papilla extend deep into the epithelium and are heavily vascularized. [3], The lips are composed wholly of soft tissue. Similar to increased levels of keratin in the attached gingiva, increased levels of melanin may obscure underlying healthy level of hemoglobin. Image credit: Gingiva of the human mouth by John Crawford is licensed CC BY 3.0 / arrows added. Vermilion: The red part of the lips (Fig. Vermilion border The two images on the left show the oral mucosa lining the maxillary (above) and the mandibular (below) regions. Confusingly, the vermilion itself is also often referred to as the lips. As with all oral mucosa, there are no hair follicles, but in places sebaceous glands may be present, forming Fordyce spots. Figure 3.28: C Collection of Gingivo-Crevicular Fluid (GCF). They are not anchored to keratinocytes, and their shape more closely resembles neurons or glia than they do epithelial cells. Lips that have good volume can be highlighted by defining them and injecting a, Sunlight exposure can blur the junction between the vermilion border and the skin. a) before, b) laser incisions, c) immediately after surgery, d) 2-week post-operative. Figure 3.32: Gingival pigmentation, before and during pigment removal surgery. Ultimately, the patient’s own epithelial stem cells migrate over the scaffold to regenerate the oral mucosa. Image credit: “Dermal perivascular lymphoeosinophilic infiltrate – very low mag” by Nephron is licensed under CC BY-SA 3.0. Gingivitis also increases the risk of developing Alzheimer’s Disease and heart disease, making it all the more important to intervene as early as possible. The sub-mucosa is also produced by cells derived from mesoderm. It contains less keratin, no hair follicles and few or no sebaceous glands. Figure 3.26: Migration into an injured area by leukocytes (identified as masses of purple nucleusses in the dermis) during an inflammatory response. Coating a dental implant with Hyaluronic Acid helps grafted tissue adhere to the implant. Image credit: Ventral tongue by the NIH is in the Public Domain CC 0. Figure 3.40: Bleeding on probing (BoP). Enlargement of the gingival margin, whether by mitosis or fluid buildup, deepens the measurement of a pocket, but does not share the same harmful loss of the epithelial attachment. In the right image the lips have been pulled open to show the anterior teeth The redness, swelling, heat and pain symptoms indicate the body has likely suffered trauma, and is undergoing a response to that trauma. of sebaceous glands C. It contains less number of sebaceous glands D. It contains less number of sweat glands. Histology categorizes tissues based on what the cells look like in adulthood. Keratin has no color, but it can obscure the visibility of the deeper pigment hemoglobin. By Roger Shore at the School of Dentistry, University of Leeds. This allows white blood cells from the underlying vascular sub-mucosa to migrate through junctional epithelium and enter the gingival sulcus. Without stem cells generating new cells, chronic stress allows everyday wear on a tissue to accumulate. Figure 3.4: Histology of the vermilion border using Azan stain, at the border between the oral mucosa (left side) and the red zone of the lip (right side). A sub-epithelial connective tissue graft (SECT graft) may be performed to repair gingival recession. The vermilion border is the area of transition from the skin to the oral mucosa. The thin-ness gives these surfaces a more reddish-appearance than other lining mucosa. At the time we are writing this, there is no evidence that nicotine gum causes hyper-keratosis of the oral mucosa, and the link between vaping and hyper-keratosis is not strong, despite both containing nicotine. Other triggers exist, including pregnancy, hormonal disturbances, or it may even be a hereditary condition (Hereditary Gingival Fibromatosis). Figure 3.21; Junctional epithelium (red bracket). The increase in the size of the gingiva, even if not caused by poor oral hygiene, may make maintaining oral hygiene difficult, and should therefore be addressed. We cover adverse effects of nicotine when we discuss PDL loss in chapter 11. Surgeries and treatments to remove gingival pigment exist, often advertising what is found in textbooks: healthy gingiva should be pinkish or whitish in color (try a google search for gingival hyperpigmentation if you are skeptical). Image credit: “Lip (human), region between red zone (vermilion border) and mucosa inner surface” by Poels, Lambert G. is licensed under CC BY-NC-ND 3.0. The soft palate is lined by a non-keratinized stratified squamous epithelium, with a very thin layer of sub-mucosa deep to it. It received that name for having finger-like dermal papillae on the apical surface, compared to the smoother transition between the papillary and the reticular layer. Parafunctional habits can cause regions of the buccal mucosa to undergo hyper-keratosis. Histology of Skin Epidermis Dermis Hypodermis 7. The time it takes to replace all of the cells within the epithelial layers of the skin and oral mucosa is shown in Table 3.4. In subsequent chapters on the teeth, pay attention to how the lineage of tooth tissues is different from that of oral mucosa, as well as to how their basic pattern is similar. A third function of melanin is its ability to bind free radicals. New glandular cells are produced from stem cells in the basal portion of the gland. Chapter 2 * Table of Contents * Chapter 4, For further reading on dental biomaterials, “7x speed timelapse video of fish melanophores responding to 200uM adrenaline”, “Lentigo simplex or simple lentigo or lentiginous melanocytic naevus”, “Lip (human), region between red zone (vermilion border) and mucosa inner surface”, “Preoperative picture of 25-year-old female complaining of black-colored gums”, “Dermal perivascular lymphoeosinophilic infiltrate – very low mag”, half of American adults over the age of 30 suffer from periodontal disease, Gingival enlargement due to S – amlodipine, “Pre-operative view and Maxillary pigmentation removal using scalpel surgical technique”, “Smoker’s melanosis in oral mucosa with brown black pigmentation”, Class II gingival recession on the left maxillary canine and lateral incisor, “Retrieval of the subepithelial connective tissue graft from the palate and placement at the recipient site”, “Intraoperative view showing hand sewn polytetrafluoroethylene bicuspid pulmonary valve in situ with transannular pericardial patch being sutured”, Free gingival graft placed around the implants. • The vermilion border is red because the epithelium layer is thin and there are connective tissue papillae projecting into the epithelium, which are loaded with blood vessels and nerve endings. 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