Dental Pulp

Question 1

Dental pulp contains a variety of cells and connective tissues:

Answer 1

• loose connective fibrous tissue
• neuromuscular elements (blood vessels, lymph vessels, nerves)
• cell types (odontoblasts, mesenchymal cells, fibroblasts)

Question 2

odontoblasts vs mesenchymal cells

Answer 2

Odontoblasts- produce primary and secondary dentin

Mesenchymal cells- can differentiate into secondary odontoblasts to produce tertiary dentin in response to injury

Question 3

primary vs secondary dentin

Answer 3

Primary dentin- BEFORE complete root formation

Secondary dentin- AFTER complete root formation

Question 4

Why does the pulp have difficulty fighting infection?

Answer 4

lack of collateral circulation

Question 5

Has limited expansion ability, this creating an increase in pressure when pulpal infection occurs

Answer 5

dentin

Question 6

secondary vs tertiary dentin

Answer 6

Secondary dentin/reactionary dentin- produced in response to minor damage

Tertiary dentin/reparative dentin- produced in response to major damage

Question 7

calcification of dentinal tubules due to aging or a response to slowly advancing caries

Answer 7

sclerotic dentin

Question 8

occurs in rapid caries or severe damage

Answer 8

pulp necrosis

Question 9

5 histological zones of the pulp:

Answer 9

1) Predentin- unmineralized inner dentin layer, directly adjacent to the pulp
2) Odontoblastic layer- location of odontoblasts, considered part of the pulp
3) Cell-free zone of Weil- no nuclei/cells present, often seen with nerve bundles
4) Cell-rich zone- nuclei and cells present
5) Pulp core- central part of the pulp

Question 10

abnormal increase in sensitivity

Answer 10

hyperalgesia

Question 11

numbness

Answer 11

anesthesia

Question 12

unpleasant, abnormal sensation

Answer 12

dysasthesia

Question 13

pain due to stimulus that does not normally cause pain

Answer 13

allodynia

Question 14

pain perceived to come from a location other than where it actually originates

Answer 14

referred pain

Question 15

Referred pain from mandibular molars is often felt where?

Answer 15

pre-auricular region (both have V3 innervation)

Question 16

Pain vs pulpitis vs pain from dentin

Answer 16

Pain from pulpitis
- pain conducted from C-fibers
- dull, throbbing, lingering pain
- sensitive to heat
- travel centrally through the pulp

Pain from dentin
- pain conducted from Aδ-fibers
- sensitive to cold
- sharp, transient pain
- travel coronally in the pulp, hence more easily provoked for pain sensation than central C-fibers