Die ontwikkeling van die epiteel en keratien in die menslike mondholte: In histologiese, elektronmikroskopiese en histochemiese studie
Histological observations revealed that oral epithelium originated from a single ectodermal layer. As the ectoderm grew so it differentiated into squamous epithelium. The first features of squamous differentiation were noticed at 8 weeks in utero in areas where keratinized mucosae were developing, and these were the changing of cuboidal to cylindrical basal cells and the subsequent growth of prickle cells from these cylindrical basal cells. The prickle cells merged with the existing primitive cells and at no stage could a separate squamous epithelial layer I such as the stratum tritermedium of the epidermis I be observed inside the mouth. At 12 weeks in utero squamous differentiation had reached a stage where acidophilic layers appeared in certain regions on the epithelial layer. The time of appearance of these layers varied from case to case. At this stage most of the primitive characteristics had disappeared from the keratinizing epithelium. Unlike the periderm of the skin which was shed into the amniotic fluid, shedding of primitive epithelial cells from the keratinizing squamous epithelium was not noticeable. Thence, the growth of keratinizing epithelium was followed by an increase of acidophilic layers, the appearance of keratohyaline granules in cells and, in some instances, full keratinization. The latter I however I was almost exclusively confined to the vermilion border of the lip. The squamous epithelium of the lining mucosa, which is unkeratinized I developed at a much slower tempo. It retained its cuboidal-shaped basal cells and the primitive features of the overlying cells were lost only at about 4- 5 months in utero I when squamous differentiation set in. At no stage was the squamous differentiation a prominent feature. At junctions between keratinized and unkeratinized epithelia and epidermis the epithelium exhibited features of both types of epithelia that were being joined. This was especially noticeable at the junction between vermilion epithelium and epidermis, where part of the vermilion epithelium displayed a prominent intermediate type of layer. Similarly, acidophilic layers of keratinizing epithelium merged imperceptibly with the walls of cells of unkeratinizing epithelium, creating a small region of an unkeratinizing type of epithelium with keratinized cells. Thus the development of the oral epithelium is through differentiation and renewal of epithelial cells: the ectodermal layer developes into an epithelial layer which is recognised by its squamous appearance. The subsequent growth is by constant renewal of this differentiated epithelium. The pattern of epithelial development I the appearance of the junctional epithelia and the manner in which acidophilic layers merge with unkeratinized epithelial cells I indicate a unity between these epithelia. According to these developmental features, the epithelium of the mouth and epidermis can be classified into less differentiated and better differentiated, but with a commonbackground for these epithelia. When the formation and the established appearance of keratin in the mouth and on the skin was compared histologically I ultrastructurally and histochemically I a unity between these features became apparent. Ultrastructurally it appeared that keratin consisted basically of 2 cytoplasmic constituents: tonofilaments and a fine granular substance. The tonofilaments were gathered at first into bundles and then broken up into finer tonofibrils. These finer fibrils mixed with a granular ground substance to form a homogenous granular filamentous material. This product can be regarded as a pre-keratin. With the addition of a keratohyaline layer to the process I keratin was formed, Apart from the keratohyaline granules several additional changes took place in cells concerned in this process I whether keratin was formed or not. These changes were flattening of cells, extensive interdigitation between cell walls, disappearance of micro-villi I loss of structure in desmosomes I thickening of cell walls and the disappearance of glycogen from cells. Some of these features were displayed in each of the types of epithelium examined here.