Care of the Pulp Flashcards
what cells are in the pulp?
odontoblasts
what nerves are in the pulp?
alpha and C fibres
what does it mean if the pulp is a vital tissue?
responds to stimuli and has regenerative potential
what are the nerves of the pulp also called?
plexus of Raschkow
what are the functions of the pulp?
nutrition, sensory, protective, formative
what type of sensations can the pulp feel?
temperature, pressure, pain
what type of protective functions does the pulp have?
tertiary dentine formation for reparative healing
what is the formative function of the pulp?
secondary dentine production
name some injuries that can occur to the pulp
caries, cavity preparation, restorations, trauma, tooth wear, periodontal pathology, orthodontic treatment, radiation therapy
how can restoration materials damage the pulp?
toxicity, water absorption, heat of reaction, poor marginal adaptation/seal, cementation of restoration
where happens to dentine tubules closer to the pulp?
they increase in number and diameter
where is dentine permeability the greatest?
at the pulp
what types of cells can pass through dentine tubules?
bacterial substances, polysaccharides, antibodies, immune complexes, complement proteins, tissue destruction products
what is the key part of pulpal and periradicular pathology?
micro-organisms
what types of pain does alpha fibres feel?
sharp pains
what type of pain does C fibres feel?
dull/aching pain
what are alpha fibres stimulated by?
electric pulp test
what are c fibres stimulated by?
increased pulpal blood flow and increased pulpal pressure
what are the two AAE classifications?
pulpal diagnosis, periapcial diagnosis
what are the types of pulpal diagnosis?
healthy pulp, reversible pulpitis, irreversible pulpitis (symptomatic/asymptomatic), necrotic pulp, previously treated, previously initiated therapy
what are the different types of periapical diagnosis?
normal, periapical periodontitis (symptomatic, asymptomatic), acute apical abscess, chronic apical abscess, condensing osteitis
what does a healthy pulp mean?
vital and free of inflammation
when are healthy pulps removed?
for elective/prosthetic purposes, for traumatic pulp exposure
is a pulp with reversible pulpitis vital or non-vital?
vital
what is reversible pulpitis?
inflamed pulp which can be reversed back to health
what sort of response to reversible pulpitis pulps have to sensibility test
regular response
are pulps with irreversible pulpitis vital or non-vital?
vital
what is irreversible pulpitis
inflamed pulp which cannot be reversed back to normal
what are the treatment options for irreversible pulpitis
pulpectomy then RCT or extraction if the tooth is unrestorable and patient would prefer this
how do you know if a pulp has irreversible pulpitis?
if investigations suggest that pulpal inflammation cannot heal
what are the clinical symptoms of reversible pulpitis?
pain to cold, lasts a short time (A fibres), , hydrodynamic expression (microleakage) no change in blood flow
what are the clinical symptoms of irreversible pulpitis?
spontaneous pain, intermittent, sleep disturbance, pain to hot (C fibres), increase in pulpal blood flow
what is the vitality of a necrotic pulp?
non-vital
what is a necrotic pulp?
partial or total necrosis
what are the treatment options for mature teeth with a necrotic pulp?
root canal treatment or extraction
what are the treatment options for immature teeth with a necrotic pulp?
pulpotomy, pulpectomy then full RCT, extraction