3. Detine-Pulp Complex

Question 1

Definition of pulp

Answer 1

CT core of the tooth

Question 2

What does pulp contain (5)

Answer 2

Cells (odontoblasts, fibroblasts, defence cells)
EC components (fibres, matrix)
Nerves (sensory, autonomaitc)
BVs
Lymphatics

Question 3

Functions of pulp (4)

Answer 3

Nutrition to BVs
Dentine growth and repair
Defence
Neural (sensory, control of dentinogenesis)

Question 4

Pulp and dentine are intimately associated through (3)

Answer 4

Developmental links (dental papilla)
Structural links (plural elements extend into dentine) 
Functional links (dentine formation)

Question 5

Causes of tooth wear (6)

Answer 5

Abrasion
Attrition (Bruxism)
Erosion
Abfraction
Caries
Operative procedures

Question 6

Types of tertiary dentine (2)

Answer 6

Reactionary

Reparative

Question 7

Features of reactionary tertiary dentine (2)

Answer 7

In response to mild stimulus

Laid down by primary odontoblasts

Question 8

Features of reparative tertiary dentine (2)

Answer 8

In response to intense stimulus that destroys primary odontoblasts
Laid down by secondary odontoblasts

Question 9

Pulp nerves are branches of

Answer 9

Alveolar nerves

Question 10

How do neuromuscular bundles enter the pulp

Answer 10

Via apical foramen and pass along root canal in centre of pulp towards coronal pulp chamber

Question 11

Definition of Raschow’s plexus

Answer 11

When the nerve branches in the coronal pulp chamber fan out in a sub-odontoblastic layer

Question 12

Where do terminal pulp nerve branches enter (2)

Answer 12

Odontoblastic layer

Some enter dentinal tubules

Question 13

What nerve fibres are activated by hydrodynamic stimuli (2)

Answer 13

A-beta

A-delta

Question 14

How are C-fibres activated

Answer 14

Directly by stimuli and respond to most forms of intense stimulation

Question 15

Function of C-fibres

Answer 15

Mediate pain associated with pulp inflammation

Question 16

Pulp blood flow is controlled by (4)

Answer 16

Local factors (metabolites)
Nerves 
Circulating hormones (adrenaline)
Drugs (LA with vasoconstrictors)

Question 17

Function of pulp nerves (4)

Answer 17

Sensory pain mediation
Control of pulp BVs
Promote neurogenic inflammation
Promote dentine formation

Question 18

Dentine-pulp responses to injury (7)

Answer 18

Immediate
After 1 min
After 10 mins
After 100 mins
After 1 day
After 1 week
Variable

Question 19

Immediate dentine-pulp response to injury

Answer 19

Nociceptor activation - pain

Question 20

After 1 min dentine-pulp response to injury (2)

Answer 20

Early inflammatory response Involves kinins, PGs, NP and vasodilation

Question 21

After 10 mins dentine-pulp response to injury (4)

Answer 21

Nociceptor sensation Extravasation of fluid
Oedema
Polymorph migration

Question 22

After 100 mins dentine-pulp response to injury (3)

Answer 22

Enzyme activation
Nerve growth factor
Monocyte presence

Question 23

After one day dentine-pulp response to injury (3)

Answer 23

Nerve sprouting (NGF)
Increased axonal transport
Altered excitability of CNS

Question 24

After one week dentine-pulp response to injury (2)

Answer 24

Repair

Tertiary dentine formation

Question 25

Variable dentine-pulp response to injury

Answer 25

Completion of repair and recovery

Question 26

Definition of pulpitis

Answer 26

Acute inflammation in the dental pulp

Question 27

Problems with pulpitis

Answer 27

Pulp cannot swell as it is confined within the pulp chamber

Question 28

Increase in pulp pressure is caused by

Answer 28

Oedema

Question 29

Effect of oedema due to pulpitis (2)

Answer 29

Variable effect in blood flow

Variable effect on nerve excitability