Biology and Histology of Pulp and PA Tissues Flashcards
Central mass of a tooth consisting of soft tissue that is densely innervated by afferent sensory fibers, s
Pulpal tissue
_____ secretes type 1 and 3 collagen, repair connective tissue by digesting collagen, and form and repair connective tissue
Fibroblasts
______ forms tooth structure, produce collagen fiber and matrix, can’t divide, forms predentin that can become mineralized; in close relation with a-delta nerve
Odontoblasts
What is the primary cell in pulpal tissue?
Fibroblasts
________:
Anything that causes movement of fluid w/in dentinal tubules that causes pain in pulp
Branstromm’s “Hydrodynamic Theory”
______ is cortical bone that surrounds the roots of a tooth
Lamina dura
Function of _____ is to create tooth structure
Odontoblasts
The odontoblasts produce ______ while the tooth develops
Primary dentin
The odontoblasts produce _____ once the tooth is fully developed
Secondary dentin
The fibroblasts produce ______ in response to injury or trauma
Tertiary dentin
Which forms of dentin lack dentinal tubules?
Tertiary dentin
Do younger or older people have less pulp due to secondary dentin causing pulp chambers to shrink?
Older people
____ changes shape of pulp chamber: is deposited over time in the immediate area of the injury by fibroblasts in an attempt to repair, protect or insulate the pulp from further injury. General FORM of PULP is altered.
Tertiary dentin
•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)•This canal is not negotiable by normal means: nerves of dentin are injured: odontoblasts and fibroblasts lay down 2nd and 3o dentin; pulp is chronically inflamed but not dead or necrotic yet
Dystrophic calcification
1 reason for dental pulp injury is ________
Microbiological
The pulp amazingly resilient if covered by at least _____ mm of healthy dentin. Reasonable trauma can be survived if bacteria are minimized or eliminated
.5 mmm
The #1 threat to health of the dental pulp is :
DENTAL CARIES
Without _____ & their products, LEOs (Lesions of Endodontic Origin) do NOT occur and dentistry would not exist as the profession we know today.
MO
What is the #2 reason for pulpal injury?
Fracture/Cracks
How are
Caries
Crack
Foramen
Open dentinal tubules
____ occurs when old burs are used or inssuficient water used in an operative proceudre causing aspiration of tubules
Necrosis
-Minimal insult
-Healthy pulp
•Minimal odontoblast damage
•Blood vessels engorge
•Intrapulpal pressure increases
•Exaggerated pain to thermalstimuli
•Pain sharp and short lived
•A delta fibers
•Not lingering*
•Not spontaneous*
•Generally capable of Healing
Use Desensitizing agents GLUMA
Reversible pulpitis
•Extensive odontoblast damage •Blood vessels greatly engorge •Intrapulpal pressure increases greatly •Exaggerated pain to thermalstimuli•Pain Intense (Acute Pulpitis) •C fibers •Lingering *•Spontaneous * •Incapable of Healing * -Throbbing pain
Irreversible pulpitis
Which 2 types of nerve fibers are present in pulp?
A-delta and C fibers
____ fibers produce throbbing, lingering pain; associated with dull, diffuse pulpal pain (think CHRONIC damage) IP
C fibers
_____ fibers: associated with early sharp pain (think ACUTE) maybe RP
A delta fibers
_______: the pulp is symptom free and positive response to sensibility testing
Normal
________: subjective or objective findings indicating the inflammation should resolve on its own and the pulp return to normal (A delta fibers)
Reversible Pulpitis
Is dystrophic calcification SIP, RP, or AiP?
AIP
Is internal root resorption SIP, RP, or AiP?
AIP
inflamed pulp is not capable of healing(usually C fibers)–-lingering thermal pain, spontaneous pain, referred pain
SymptomaticIP
inflamed pulp is not capable of healing(usually C fibers)–-no clinical symptoms but inflammation produced by caries, caries excavation, trauma, etc
AIP
:(Death of the pulp) No response to pulp tests
Pulp Necrosis
: Previously obturated
Previously Treated
:Tooth previously treated by partial endodontic therapy (i.e. pulpotomy, pulpectomy)
Previously initiated therapy
________: is very richly supplied with collateral circulation as well & has a nearly unlimited source of undifferentiated cells for inflammation and repair. Therefore capable of both exudative (fluid) & formative(cellular) defense mechanisms; can be healed via rich blood supply
Peri-Apical Tissue
: When the defense mechanism (Pulp or P/A) is overwhelmed, an exudative response results with production of fluids = pain = symptomatic. (Rapid Swelling + Systemic Response – Fever, etc.)
Acute Inflamm
_____ INflam: When the progress of the disease is of lesser intensity over a longer time, aproliferative or cellular response results (lymphocytes, macrophages & plasma cells. etc.) = a “standoff” between the body’s immune system and infection. usually evolve some type of drainage: Draining Sinus Tract (DST) etc.). As a result, symptoms minimal or none (due to release of pressure/purulence). DST is important in the DX of Chronic Apical Per
Chronic inflam
What is the term for a reversible inflammation that has gone from chronic to acute?
Recrudescent Abscess.
An inflammatory reaction to pulpal infection characterized by rapid onset, spontaneous pain, tenderness of the tooth to pressure, pus formation and SWELLING of associated tissues
Acute Apical Abscess: (AAA)
An inflammatory reaction to pulpal infection and necrosis characterized by gradual onset, little or no discomfort and the intermittent discharge of pusThrough associated DRAINAGE *(DST Draining Sinus Tract or via Sulcus).
Chronic Apical Abscess:(CAA)
: Diffuse increased trabecular radiopaque lesion representing a localized reaction to a low-grade inflammatory stimulus. Pulp may be vital and inflamed or necrotic. P/A radiolucent inflammatory lesion may or may not be present at apices. Treatment varies depending upon pulpal conditions and symptoms.Older terms: focal sclerosing osteomyelitis & a variant of chronic asymptomatic apical periodontitis)
Condensing Osteitis (CO)
, (schlerotic bone) which is dense (but normal bone), homogenious, defined radiopacity devoid of pathosis (no treatment req.) Other terms: Enostosis, Osteosclerosis, Periapical Condensing Osseous Dysplasia (PCOD),
Ideopathic Osteosclerosis
:Teeth w normal periradicular tissues that will not be abnormally sensitive to percussion or palpation. The LD (Lamina Dura) surrounding the root is intact and the PDL space is uniform.
Normal Apical Tissues
What cells are prevalent in microabscesses in pulp?
Neutrophils
Inflammation of the apical periodontium, producing clinical symptoms including painful response to biting and percussion.It may or may not be associated with an apical radiolucent area
Symptomatic Apical Periodontitis(SAP)
Inflammation and destruction of apical periodontium that is of pulpal origin, appears as an apical radiolucent area and does not produce clinical symptoms
Asymptomatic Apical Periodontitis: (AAP)
: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)
*Primary Function: Formative: odontoblasts – dentin (with dental epithelium) ameloblasts – enamel
Secondary Functions:Supportive Protection, Sensation, Defense
Pulpal organ
