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Endo > Bio and Histo of Pulp > Flashcards

Bio and Histo of Pulp Flashcards

1
Q

What is the pulpal organ?

A

Central mass of a tooth consisting of soft tissue that is densely innervated by afferent (sensory) fibers, sympathetic fibers, vascular structures, lymphatics and specialized cells such as odontoblasts (characteristic cells of pulp) and fibroblasts (most common/prevalent cell type in pulp)

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2
Q
A

dental lamina

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3
Q
A

bud stage

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4
Q
A

bell stage

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5
Q
A

cap stage
- arrow points to dental papilla

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6
Q
A
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7
Q

What does the cell-free zone (of Weil) do?

A

reduces the metabolic activity of the pulp

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8
Q

What is the function of odontoblast?

A
  • Responsible for DENTINOGENESIS
  • Important in amelogenesis
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9
Q

Primary Dentin secreted ________ root formation

A

before

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10
Q

Secondary Dentin formed ______ root formation

A

after

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11
Q

What do odontoblasts produce?

A
  • Produces collagen fiber and proteoglycan matrix which becomes mineralized . Pre-Dentin
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12
Q

Where do odontoblast processes extend into?

A

tubules

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13
Q
A

odontoblasts

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14
Q
A

odontoblasts

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15
Q

What do fibroblasts arise from?

A

arises from undifferentiated ectomesenchymal cell

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16
Q

What do fibroblasts do?

A

WOUND HEALING- FORMS TERTIARY DENTIN

  • Elaborates Type I & III Collagen fibers and ground susbtance (important for pulp regeneration)
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17
Q

What is the most prevalent cell in the pulp organ?

A

fibroblasts

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18
Q
A

fibroblasts

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19
Q
A
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20
Q

What are the primary functions of the pulp?

A

*INDUCTION
*FORMATIVE

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21
Q

What are the secondary functions of the pulp?

A

*PROTECTION
*DEFENSE AND REPAIR
*NUTRITION

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22
Q

What are the principle sensory innervations of the pulp in max and mand?

A

Trigeminal nerve (V2 and V3)

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23
Q

Additional PM innervation comes from what nerve (especially in premolar area)?

A

mylohyoid nerve

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24
Q

Sympathetic (motor) innervation for the pulp is from…

A

T1 and T2 via superior ganglion

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25
Q

Why might you have to innervate the pulp and have knowledge on it?

A

IA block alone may provide insufficient anesthesia

26
Q

The dental pulp is supplied by both…

A

myelinated and non-myelinated n. axons

27
Q

What are the characteristics of A fibers?

A

sharp, pricking

28
Q

What are the characteristics of C fibers?

A

dull, aching and more diffuse less bearable pain

29
Q

Which fibers have relatively high stimulation threshold, slow in
onset (late)?

A

C fibers

30
Q

Which fibers have relatively low stimulation threshold, quicker response, pain?

A

A fibers

31
Q

Which fibers are associated with early sharp pain (acute)?

A

A fibers

32
Q

Which fibers are associated with dull, diffuse pulpal pain (chronic)?

A

C fibers

33
Q

What type of fibers are associated with reversible pulpitis?

A

A fibers

34
Q

What type of fibers are associated with irreversible pulpitis?

A

C fibers

35
Q

About 90% of the fibers are…

A

A delta fibers

36
Q

What is Branstromm’s “Hydrodynamic Theory”?

A

Anything that causes movement of the fluid w/in the dentinal tubules causes pain inthe pulp

37
Q

Many of the etiologies of
pulpal damage are…

A

IATROGENIC

38
Q

The pulp amazingly resilient if covered by at least _____ mm of healthy dentin

A

.5mm
*reasonable trauma can be survived if bacteria are minimized or eliminated

39
Q

What are the common etiologies of pulp irritation?

A
  • Microbiological
  • Mechanical
  • Chemical
  • Trauma
40
Q

What are the portals of acess of microbiological irritants to the pulp?

A
  • Cracked or fractured tooth
  • Cemental defect @ CEJ
  • Open dental tubules
  • Perio invasion into apex
  • Pulpal invasion in P/A
  • Lateral or Accessory Canal
41
Q

What is the most common cause of access of microbiological irritants to the pulp?

A

caries/leaking restoration

42
Q

How big are bacteria compared to the tubules?

A

Bacteria are 0.2 to 5 um
Tubules are 50 um

43
Q

What is the central goal of RCT?

A

to SEAL ALL PORTALS of ACCESS

44
Q

The #1 threat to health of the dental Pulp is…

A

DENTAL CARIES

45
Q

Without microbes & their products, LEOs (Lesions of Endodontic Origin)…

A

do NOT occur

46
Q

What is this?

A

pulp polyp
(hyperplastic pulpitis)
*doesn’t hurt- can’t heal

47
Q

Most operative procedures are accompanied by significant opportunity for…

A

iatrogenic and irreversible damage to the pulp

48
Q

What does cutting with insufficient coolant cause?

A

Aspiration of odontoblasts into tubules

49
Q

What is the hottest temp that the pulp can get before it is beyond repair?

A

42 C

50
Q

What happens if the pulp gets damaged beyond repair by a mechanical irritant?

A

Pulp Necrosis

51
Q

What are different types of mechanical irritants to the pulp?

A
  • Excessive air drying of exposed dentin: aspiration
  • Application of desiccants: alcohol, chloroform, Cavit, etc.
  • Polishing
  • Use of laser
52
Q

What is the response of the dental pulp to injury in the immediate area of the injury?

A

fibroblasts lay down tertiary (reparative) dentin

  • general form of the pulp is altered
53
Q

What is a chemical irritant?

A

Application of any irritating or toxic element to the pulp or dentinal tubules may cause pulpal injury

54
Q

What are the different chemical irritants for the pulp?

A
  • Direct Pulp Cap or Indirect Pulp Cap (CaOH has pH of 12)
  • Disinfecting agents
  • Acidic preparations
  • Composites
55
Q

What are types of external trauma to the pulp?

A

Falls & Sports Accidents

56
Q

What are types of internal trauma to the pulp?

A

Para-Normal Habits (Bruxism)

57
Q

What is calcific metamorphosis?

A
  • Pulp sclerosis or Dystrophic calcification
  • Probably a combination of 2ndary and Tertiary dentin formation in response to extensive and chronic injuries before the pulp became necrotic. (no deposition unless pulp is vital)
    *also comes with age
58
Q

How much calcified material is deposited when the pulp is vital?

A

NONE

59
Q

What is the typical response of the Dental Pulp to Aging & Injury?

A

Calcific Metamorphosis

60
Q

The uniform deposition of ___________ __________ reducing the general size of the pulp but retaining the general form as the tooth matures

A

SECONDARY DENTIN

61
Q

What is the function of odontoblasts?

A

create tooth structure

Endo (5 decks)

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