2. Pulp Biology Flashcards
• RCT is essential
○ In 60’s - half of population had no teeth
○ Now, we don’t have complete denture exams - things have cahnged
• Contributions to preservation
○ Root canal work
• Endo is not just RCT, there’s a ____ component > RCT may fail bc of the different branches containing bacteria
○ Endo is 90%, if fails > ____
• Implant has no comparison to actual tooth
○ Short life span
surgery
microsurgery
• 1 year follow up has PA abcess > surgical approach
• Alveolar bone regens better than cortical bone
○ 6 month left > bone ____ w/o infection
○ Microsurgery!
• Shouldn't touch \_\_\_\_ if you can • Do less on a tooth > small filling is better than a whole crown • \_\_\_\_ knowledge ○ Is required or else you're a plumber
regen
pulp
biological
• Once dentin is infected > PA lesion > can be solved with RCT; but if cystic lesion, RCT won’t work > ____ procedure
• Pain is important, but it’s a good model to study inflammation (tooth pulp)
○ Tooth is completely isolated > microcirculation, encased in rigid structure (enamel and dentin) > ____ compliance system (like brain and bone marrow)
§ Tooth will not ____ > gives crazy reactions
surgery
low
expand
- Finger connected to brain, all the material is coming in
* ____ > revascularization > creation of new pulp cell tissue
stem cell
Injurious agents (mechanical/chemical/bacterial)
> >
____ degranulation
disruption of blood vessels
____ damage
stimulation of sensory nerve
> >
histamine, 5-HT, PGs, BK, SP, CGRP, and NKs
> >
to nerves: ____
to arterioles: ____
to venules: ____
to lymphocytes: ____
mast cell
cell
pain
vasodilation
leakage
chemotaxis
The dentin/pulp complex a functional unit!
• LEFT IS DENTIN • RIGHT IS OB RICH LAYER • Drilling teeth > this area becomes crazy if you don't \_\_\_\_ the tooth while drilling ○ Tooth doesn't become necrotic
cool
Dentin is an important barrier in the ____ of the pulp
Normally highly ____
• Asymptomatic > can take care of \_\_\_\_ pulp capping > will most likely need RCT • Keep natural teeth as long as you can ○ Implants do not last for as long as you'd like § Esp not in the aesthetic zone • Dentin is permeable
immune defense
indirect/diret
- CS of tooth
- Tubular at the peripheral > holes are ____; 3 mm in pulp dentin junciton
- Fluid from pulp tissue pushes outside
- Anything placed on outside, will not be able to get into ____ tissue
- But if you prep ____ between > will have the chance higher chance getting into pulp tissue
- Remaining dentin ____ is very important
smaller
pulp
halfway
thickness
dentinal tubules
• OB Process into dentinal tubule
○ ____um into dentinal tubule; not all the way to 3mm
○ Why pain? Enamel peel > pain > ____ theory > fluid is filled w dentinal tubule > any ____ in fluid, rapid movement > exert on ____ tissue and experience pain
100
hydrodynamic
pressure
nerve
Dentinal tubules
dentin surface area
vs
surface area covered by the tubules
• Deep prep > leaving less half of dentin > won't expect the pulp to be \_\_\_\_
healthy
• Iodine131
• Circulation is good, peel enamel and place iodine into one side of dentin > will travel into ____ tissue
• Opposite side > empty space > ____ fluid
• Take venous blood out > if showing iodine, you can see it and it’s transferring
• Vasoconstrict after epi
○ Communicating
○ ____ are communicating [???]
131 Iodine collection
• Iodine cxn of plasma
• Iodine is inc with time
• Iodine in pulp tissue and circulation and removed
• Epinephrine injection > lingual chmaber increases > compeltely ____
• Dentin is permeable
pulp
collect
tubules
permeable
DENTIN (rate of solute permeation) PULP (rate of removal solute by microcirculation)
DENTIN:
- molecular ____, charge
- degree of ____
- dentin ____
- dentin ____
- proximity to the ____
PULP:
- number of ____
- rate of ____
- ____ pressure
- colloid ____ pressure
- pre vs postcapillary ____
size occlusion surface area thickness pulp
capillaries capillary flow perfusion osmotic resistance
• Restoration > there are gaps full of bacteria
○ None of the material is ____
○ All of it is hydrophobic; now we’re going hydrophilic
§ Production of bioceramic (not gutta percha)
○ Take restoration out > can smell the bacteria
• Dynamic events
hydrophilic
Dentin-pulp complex
* Cut tooth in half > leaving a little bit of the dentin; and placed different materials > slowly push (16 mmHg - inflam pressure) > what happens in restoration > is it sealed or leaking * All the materials \_\_\_\_
leaked
Constituents of the normal pulp
- ____
- vessels
- ____
- ground substance
- ____
Goldner’s ____ stain
(primate pulp, premolar)
cells
nerves
fibers
trichrome
Pulpal microcirculation
Vascular structure
•Arteriole - φ < \_\_\_\_ μm - \_\_\_\_ into the pulp •Capillaries - φ \_\_\_\_ μm - transport \_\_\_\_ and metabolites •Venule - φ up to \_\_\_\_ μm - thin \_\_\_\_ coat
100 multi-entry 8-10 fluid 200 muscular
• Control of microcirc is based on the ____
• Big vessels ○ Cannot tell whether one is vasodilating or constricting - it's all a \_\_\_\_ experience
sphincter
dynamic
- ____ into the tooth
- A lot of BV at the ____ junction
- And connecting the ____ ligament
- Perio and endo problems
- Dilated BV in a tooth pulp
- At the end are small fibers and vessels
india ink
dentin-pulp
perio
- Red is dentin
- Light is ____ zone
- Hemostasis is maintained if the insult is mild
- Vessel cast
- Infused BV > get rid of hard tissue
cell-rich odontoblastic
• Large magnification
* All BV on a young tooth * At the end are \_\_\_\_ branches
capillary
- All capillary beds are where ____ are located
- In middle are trasnferring blood
Coronal pulp
____ ml/min100g
• If fluid is in between vessels > inflammation
○ Can analyze inflam based on these studies
• Can measure blood flow based on unit volume of tissue
○ And ____ and ____
odontoblast
125
osmotic
capillary
Apical pulp
____ ml/min/100g
• BF is smalelr in \_\_\_\_ area • Configuration is different ○ Coronal BV is \_\_\_\_, apical is \_\_\_\_
22
apical
dense
fish net type
