Additional oral-cavity structures of clinical interest are the zygomatic and parotid salivary papillae and their associated
ducts. Palatal repositioning of the papillae is necessary in most cases to achieve closure of the mucoperiosteal flap following
extraction of the maxillary first molar in the dog (Photo 17).
Lateral and ventral to the tongue are the lingual folds. These folds, when excessive, become traumatized during mastication
producing sublingual traumatic granulomas otherwise known as "gum chewer's syndrome" (Photo 18). The tongue is secured to
the floor of the oral cavity rostrally by the lingual frenulum.
The lingual frenulum should not be confused with the mandibular labial frenulum (Photo 19), an extension of unattached mucosa
vestibular to the mandibular first premolar. This structure may require surgical alteration in cases where its presence is
a contributing factor to periodontal disease associated with the mandibular canine teeth.
Maxillary, mandibular landmarks
Several anatomical structures of clinical importance exist in the maxillary and the mandibular bone. Landmarks for the regional
nerve blocks of the oral cavity are as follows (Photos 20, 21 and 22):
- Infraorbital block = infraorbital foramen,
- Maxillary block = distal to the maxillary second molar,
- Inferior alveolar block = mandibular foramen,
- Mental block = middle mental foramen.
The infraorbital neurovascular bundle courses in a rostral direction as it exits the infraorbital canal. It can be palpated
as a large band beneath the vestibular mucosa. Divisions of the arteries and nerves are found throughout the deeper tissue
of the upper lip and must be avoided when preparing mucoperiosteal flaps for extractions and oronasal fistula repair.
Although not as prominent as the infraorbital structures, the nerves and arteries emanating from the caudal, middle and rostral
mental foramina should be avoided or ligated if surgical exposure is required in the soft-tissue region of the rostral mandible.
As a note of clarity, the proper nomenclature describing the horizontal portion of the mandible is the mandibular body. There
is no horizontal ramus. The vertical portion of the mandible is the ramus. There is no vertical ramus.