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oral histology > Dental pulp > Flashcards

Dental pulp Flashcards

1
Q

what is the Dental Pulp

A

A soft connective tissue to support the dentin

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2
Q

how is the dental pulp unique

A

vascular

Not calcified

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3
Q

Embyronic origin of the dental pulp

A

Ectoderm (neural crest ectomesenchyme)- dental papilla

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4
Q

what makes up the dental pulp

A

Cells and cellular elements
Blood and lymphatic vessels
Extracellular matrix

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5
Q

Functions of the Pulp in the mature tooth

A

Hydrates Dentin
Protective: sensory, barrier
Defensive: Immune
Reparative: formation of new dentin & pulp

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6
Q

why are the pulps sensative

A

Keeps person from using that side of the mouth on the side of an injury

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7
Q

what is the inductive roll of the Pulp

A

Induces the bud to go to a cap

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8
Q

Formative Function of the Pulp

A

Dentinogenesis (odontoblasts)

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9
Q

Roll of odonotoblasts

A

Secrete organic amtrix of dentin

Participate in mineralization

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10
Q

what is the major component of dentin

A

Collagen as a scaffold

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11
Q

Roll of Odonotoblasts in mineralization

A

Transport Ca ions that make the HAP cystals

secreted proteins for controllling mineralization

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12
Q

protein important for mineralization for dnetin

A

Dentin phosphoprotein (DSPP gene)

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13
Q

how specific is Dentin Phosphoprotein

A

RElatively specific to dentin

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14
Q

How prominant is Dentin Phosphoprotein

A

Greater than 50% of the Non-collagenous proteins

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15
Q

How is DEntin Phosphoprotein made

A

Binding sites for Collagen
Highly phosphorylated
High in serine/aspartic acid
Acidic/anionic

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16
Q

Action of Dentin Phosphoprotein

A

Binds to collagen in forming dentin matrix

Attracts Ca ions to initiate mineralization

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17
Q

what protein initiates dentin mineralization

A

Dentin Phosphoportein

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18
Q

when does Dentinogenesis begin

A

At the bell stage

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19
Q

What exists right before dentinogenesis

A

4 layers of the dental organ present
Crown outline is present
No odontoblasts or ameloblasts

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20
Q

what happens in the Late bell stage

A

Inner enamel epithelial cells (ameloblasts)
Undiffferentiated mesenchymal cells/dental papilla: odontoblasts
Dentin secreted
Enamel secreted

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21
Q

How does Dentinogenesis travel through the tooth

A

Cusp tips to cervix

Periphery to pulp center

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22
Q

when does Odontoblast differentiation begin

A

when the cells in the outer layer of the papilla stop dividing near the DEJ

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23
Q

How do Odontoblasts differentiate

A 
Odonotoblasts stop devidining
elongate
nucleus moves to the periphery
processes elongate to the DEJ and begin to Deposite predentin
grow down to the pulp
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24
Q

what induces odontoblast differentiation

A

Secreted moleucles from the enamel organs from the inner enamel organs/ secondary enamel knows
(epithelial-mesenchymal interactions)

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25
Q

what are the signals that induces odontoblast differentiation

A

BMP’s (bone morphogeneitc portein)

Wnt’s

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26
Q

How did we detect the role of Wnt10a in odontoblast differentation

A

Stained for Wnt10a and Dentin sialophosphoprotein (a sign of odontoblast differentiation)
expressed first at enamel knots
Then pre-odonotoblasts
then successively more cervical parts of teeth

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27
Q

what immediately precedes the wave of odonotblasts differentiation

A

Wnt10a

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28
Q

what does Wnt10a bind to

A

binds to GSK to inactivate it (GSK is an inhibitory effect on transcption)
Beta Catenin released and travels to nucleus and initiates transcription

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29
Q

How did we figure out the importance of GSK inhibitor

A

compared how fast dentin repared using a collagen sponge alone, mta with sponge, and GSK inhibiots and sponge. The gsk showed the greatest amount of repearative dentin

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30
Q

Gross parts of the pulp

A 
Pulp horns
Pulp chamber/coronal pulp
Root canal/radicular pulp
accessory lateral foramina
Apical foramen
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31
Q

as you age how does the pulp chagne

A

less cells and more collagen

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32
Q

what type of dentin buldes into the pulp

A

Tertiary dentin

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33
Q

pulp calcifactions

A 
Pulp stones (Chamber) 
Diffuse calcifactions (cannals)
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34
Q

How common are pulp calcifications

A

They are common

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35
Q

do we know what causes pulp stones

A

Not really sure

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36
Q

what are the zones of the pulp

A

Odontogenic zone

central core

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37
Q

Zones of the odontogenic zone from outside to inside

A

Odontoblast layer
Cell free zone
Cell rich zone

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38
Q

what makes up the pulp core

A

Fibroblasts (mainly)
Capillaries/blood vessles
Nerves (perineural sheaths)

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39
Q

Cells of the pulp

A

Odontoblasts
Fibroblasts
Immune system cells
stem cells

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40
Q

roll of fibroblasts in the pulp

A

confined to the pulp to secrete ecm

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41
Q

resident immune system cells of the pulp

A 
Macrophage
T lmphocytes
eosinophils
Dendritic cells
pmn's
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42
Q

Inflammation cells of the pulp

A

B lymphocytes
Plasma cells
Mast cells

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43
Q

roll of stem cells in the pulp

A

Source for replacement of odontoblasts or fibroblasts

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44
Q

what makes up the Extracellular matrix of the pulp

A

Proteoglycans and associates
Glycoproteins (fibronectin)
Collagen (I and III)

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45
Q

function of PG’s and associates of the EXM of the pulp

A

Matrix for diffusion
Collagen fibrillogenesis
Water retention

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46
Q

what would you want the EXm of the pulp to hold water

A

Pressurized the pulp to resist compressive forces

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47
Q

Function of glycoproteins(fibronectin) in the ECM of the pulp

A

Cell adhesion to ECM

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48
Q

function of collagen I and III in the pulp

A

Tensile strength

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49
Q

differences of collagen in the pulp and the dentin

A

both contain type I, but dentin has no type III(b/c it is a hard connective tissue

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50
Q

what protein does the mature pulp not contain that is esential to dentin

A

DSPP

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51
Q

what are two of the major components of stem cells

A

high capacity for self-renewal

Plastic (can generate multiple cell types)

52
Q

Importance of Adult stem cells

A

Ready source for repair or correction of genetic defects (non-fetal, non-immunogenic)

53
Q

Multipotent adult stem cells

A

derived from bone marrow, brain, muscles, testes, and dental pulp

54
Q

what all can dental pulp stem cells differentiate into

A

Odontoblasts
adipocyte
Glial-like cells

55
Q

what happens when dentin-like tissues are transported subcutaneously into immunocompromised mice

A

what looks like a tooth made of dentin and pulp forms

56
Q

what successes have we had with dnetal stem cells

A

Creating tooth buds or reparing tooth strucutre in animal models
Treating other conditions like Multiple sclerosis or spinal cord injury

57
Q

limitations of dental stem cells

A

Size and shape of engineered teeth poorly controlled
How to integrate an engineered tooth into the jaw
human teeth take months-years to form

58
Q

what would be a practical use of Dental stem cells

A

Repair (regenerating pulp tissues lost to carries) - this is moden focus

59
Q

what is the canine model of total pulp regeneration

A

Isolate stem cell from max canines for autologous impants
Remove pulp from insiors
Implanted stems cells, G-CSF in combo or separating using a collagen matrix
Performed fucntion test, removed teeth, analyzed histogy
showed that good repair took place

60
Q

what is important for stem cell regeneration of dentin/pulp

A

The combo of stem cells and G-CSF

61
Q

what is G-CSF

A

functions in transforming leukocyte precursors into granulocytes (netrophils)

62
Q

how many tissues produce G-CSF

A

Lots

63
Q

Functions of G-CSF

A

Chemotactic for many types of stem cells, including DPSCs
Promotes neurogenesis and angiogenesis
Anti-apoptotic

64
Q

Can DPSC’s become many different cells

A

Yes, multipotent,

65
Q

Function of DPSCs

A

PRovide raw material for new pulp tissues
anti-inflammatory
secrete trophic factors promoting angiogenesis and neurogenesis

66
Q

how does G-CSF promote the processes of DPSCs

A

Keeps DPSC’s in the area, because DPSC’s have G-CSF receptors
Attracts other stem cells from surrounding tissues
Anti-apoptotic and proliferative effects

67
Q

Use of DPSC’s to treat pulpitis

A

Small clinical trial, with not definitive but promising results

68
Q

what is the Odontoblast unique to

A

Unique to the pulp

69
Q

how common is the odontoblast

A

2nd most numerous cell type in pulp

70
Q

Functions of odontoblasts

A

Dentinogenesis
Nuetrients to dentin
Immune

71
Q

Cell body dimensions of Odontoblasts

A

Crown: 25-50uX5-7u
Root: more cuboid

72
Q

Roll of Cytoskeletal elements in odontoblasts

A

PRotein transport and structural integrity

73
Q

Junctions between Odontoplasts

A

Desmosomes and Adherens junctions
Gap Junctions
Tight junctions

74
Q

roll of desmosomes and adherens

A

Sticky to help maintina position and polarity

75
Q

Roll of Gap junctions

A

Channels betwen cells to coordinate dentiogeneis

76
Q

what proteins are used in Adherens

A

Actin:Catenin:Cadherins:catenin:actin

77
Q

what makes up a gap junction

A

Connexin

78
Q

what does a desmosome connect

A

Intermediate filaments

79
Q

Rolll of tight junctions

A

Apical to weld membranes

80
Q

what can Tight junctions create

A

depending on proteins, can form an inter-cellular barrier

81
Q

what can pass through a tight junction

A

only smaller molecular weight substances

82
Q

what distinguishes the pulp from other

A

Highly vascularized

Lymphatic tissue/vessels

83
Q

How do blood vessels enter and leave the pulp

A

Through the apical foramen and accessory foramina

84
Q

how do blood vessels devide in the pulp

A

Become more diffuse and smaller as they go to the perifery and near the edge of the dentin towards the crown and lateraly

85
Q

What controls the blood flow

A

Sympathetic

Sensory nerves

86
Q

how does the sympathetic system control the blood flow in the pulp

A

constricts via norepinepthrine and alpha adrenergic receptors

87
Q

what is the roll of the lymphatic vessels in the pulp

A

Healing by draining proteins accumulated during inflammation

88
Q

what fibers innervate the pulp

A

Small A delta and C fibers

A beta fibers

89
Q

what is the roll of A delta nerve fibers

A

Sensory pain fibers

90
Q

what is the roll of c fibers

A

Sensory painn fibers

also smypathetic

91
Q

roll of A beta fibers

A

Sensory pain fibers

92
Q

what is the main sensation arising from activating nerve fibers innervating the pulp and dentin

A

PAIN

93
Q

when does tooth innervation begin

A

At the bell stage

94
Q

For how long does sensory innervation increase

A

increases until eruption and then slows until a few years after

95
Q

when does Innervation of the tooth decrease

A

with aging

96
Q

what dentintion is innervated

A

Primary and seconday

97
Q

where do nerves travel in the pulp

A

enter through the apical foramen and terminate in pulp dentin border zone and dentin

98
Q

how far do nerve processes extend into the dentin

A

Only up to about the inner 1/3

99
Q

how did we figure out that Nerve processes only go 1/3 up into the dentin

A

Used a fluorescent dye that was lipophilic and was then taken up by the nerves to show it only went like 1/3 in

100
Q

Do odonotblasts reach the outer dentin

A

Yes, due to dentinogenesis, but then seem to retract

101
Q

what dentinal tubules are most highly innervated

A

Those in the crown

102
Q

where is Rashhow’s plexus

A

at the border of the cell free zone and the cell rich zone

most likely in the pulp horns

103
Q

what zone do nerve fibers profusely innervate

A

The pulp-dentin border zone

104
Q

How does the Hydrodynamic theory of dental pain work

A

Mechanically activated ion channels in the nerve fibers ends of A delta and A belta fibers in the pulp/dentin border regeion
upon deformation, ion channels open
Na+ flows in
Depolarization and AP

105
Q

what are the mechanoreceptors used for Hydrodynamic theory of dentin

A

PIEZO2 (stretch sensitive ion channels used for touch and proprioception throughout the body

106
Q

why is there not direct stimulation of dental pain

A

Nerve endings don’t reach that far

107
Q

why is there not a synapse on odontogenesis for pain

A

Does not form that synapse for pain

108
Q

does the Odonotblast do nothing for dental pain

A

Yes, due to crowding and proximity in tubule, so it affects the fluid dynamic around the nerve process

109
Q

is hydrodynamic motion the only way of getting pain

A

Direct stimuli of the pulp(hydrodynamic fluid flow not required)

110
Q

What nerve fibers are responsible for pain due to direct stimulation of the pulp

A

C fibers(other recetpors on them)

111
Q

what receptor type is neccessary for pulp sensitivity to inflammation and thermal stimuli

A

TRP receptors

112
Q

what are TRP receptors

A

Famility of transmembrane receptors for thermal and inflammatory pain throughout the body

113
Q

what can activate TRPA1 rectpors

A

reactive oxygen species
Prostaglandings
Bradykinin

114
Q

How to tell a difference between Hydrodynamic pain or inflammation

A

Hydrodynamic: sharp pain (responds to hot, cold, electric pulp tests)
Inflammation: dull pain (less response)

115
Q

what fibers are used for the Hydrodynamic theory

A

A beta and A delta fibers

116
Q

what fibers are responsible for inflammation pain

A

C fibers (pulp only, superficial and deep)

117
Q

what make cause inflammatio in the pulp

A

Cytokines
Prostaglandins
Bradykinin
INcreased pressure

118
Q

how can tooth sensitivity change

A

can be hypersensitized under conditions of inflammation because more pain receptors are expressed when inflammed

119
Q

Roll of nerve fibers aside for sensation

A

Protective role by limiting use (sensation)

release of neuropetides

120
Q

what neuropetides are realsed by the pulp nerves

A

Substance P and CGRP (calcitonin-gene related peptide)

121
Q

location of cell body for the tooth

A

Trigeminal ganglion

122
Q

where are nueropeptides released

A

Released at both the Peripheral ending (tooth)

and Central ending in the CNS

123
Q

why are nueropeptides relased

A

painful stimulase
Brain: neurotransmitter for pain
Pulp: bind w receptors on vasculature/local cells for a pro-inflammation response

124
Q

Important part of the skull for pain in the tooth

A

Meckel’s cave

125
Q

what are the Inflammatory runction of the nerve

A

VAsodilation (oposite of sympa)
plasma extravasation
Angiogenesis
Interaction with immune cells

126
Q

how does Inglamation of nerve is pulp interact with the immune cells

A

Stimulate cytokine production by macrophages

Chemotactic effects on immune cell migration

oral histology (14 decks)

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