Care of The Pulp Flashcards
what are the 3 components of pulp?
- cells
- nerves
- blood vessels
what cells are in pulp?
odontoblasts
what is the nerve plexus in pulp called?
plexus of Raschkow
what types of nerves are in pulp?
- Alpha fibre (myelinated)
- C-fibres (unmyelinated)
is pulp a vital tissue?
yes has a blood supply
what is pulp apart of?
dentine-pulp complex
- closely related
procedures in dentine will have effect of treatment of pulp and dentine
- don’t consider in isolation
what are the 4 main functions of pulp?
- nutrition
- sensory (temperature, pressure, pain)
- protective (tertiary dentine formation)
- formative
why is it hard to diagnose pulp issues?
poor correlation between clinical symptomatology and pulpal histopathology
- due to misaligned symptoms and histopathology to what is happening in the tooth
more negative tests mean….
more likely a disease process
possible injuries to pulp
- caries
- cavity/crown preparation
- dehydration of dentine
- cutting odontoblast processes
- direct injury to pulp
- remaining dentine thickness too small
- restorations
- trauma
- tooth-wear
- periodontal pathology
- orthodontic treatment
- radiation therapy
how can cavity/crown prep injure the pulp?
- Heat generation- use coolant!
- Type of bur used (Size, speed, sharpness, force, vibration)
how can dehydration of dentine injure pulp?
air or water infiltrating???
how can cutting odontoblast processes injure the pulp?
Odontoblast trail through tooth leaving trail of cell – cut them will damage the pulp
why is it important to keep in mind remaining dentine thickness?
Keep in mind potential remaining dentine thickness RDT (top of pulp to base of cavity)
- larger = less chance of pulp damage
how can restorations damage the pulp?
Restoration materials can be highly chemical and toxic • Toxicity • Water absorption • Heat of reaction • Poor marginal adaptation/ seal • Cementation of restoration • Microleakage etch
how can trauma lead to pulp injury
teeth are in vulnerable area of body
- exposed to external onslaught
how can periodontal pathology lead to pulp injury?
close relationship to perio tissue around the pulp
microtubules that go through dentine to periodontal ligament
how can radiation injure the pulp?
X rays can kill pulp cells
describe dentine permeability
Dentine tubules increase in number and diameter as they approach the pulp
- Tubules more numerous and wider the deeper in dentine
- Easier for substance to enter and exit pulp
therefore, the deeper the cavity the greater the dentine permeability
what bacteria substances can enter the pulp via the dentine?
- enzymes
- peptides
- exotoxins
- endotoxins (e.g. LPS)
what substances can enter the pulp via the dentine?
- bacterial substances
- polysaccharides
- antibodies
- immune complexes
- complement proteins
- tissue destruction products
what are a key factor in causing pulp problems?
micro-organisms
- causes inflammatory process
- manifests as clinical pain in patient
what are the fibres responsible for the 2 types of pain/
Alpha fibres
- sharp
C fibres
- dull/aching
are alpha fibres myelinated?
yes