Dental Pulp

Question 1

Dental Pulp consists

Answer 1

of loose connective tissues derived from neural crest (ectomesenchymal) cells.

Question 2

Mature dental pulp is divided into what 2 compartments

Answer 2

Odontogenic zone and pulpal core

Question 3

The odontogenic zone consists of

Answer 3

odontoblast cell layer, cell-free zone of Weil, Cell-rich zone, parietal plexus of nerves (raschkow’s plexus)

Question 4

The pulpal core consists of

Answer 4

Fibroblasts, Type 1 and 3 collagen, extracellular matrix, blood vessels, and nerve tissue

Question 5

Functions of the dental pulp

Answer 5

Embryonic induction, formative, protective, and reparative

Question 6

Cell populations in pulpal tissues include

Answer 6

Odontoblasts, fibroblasts (most), undifferentiated mesenchymal cells, macrophages, dendritic cells, blood vessel-related cells, neural-related cells, lymphocytes

Question 7

Non-collagenous matrix components are

Answer 7

Proteoglycans, glycosaminoglycans, phosphoproteins, glycoproteins, gamma-carboxyglutamate-containing proteins

Question 8

Extracellular matrix of pulpal tissues

Answer 8

Collagen types 1, 3, 4, and 5 (via odontoblasts) and non-collagenous matrix components

Question 9

gamma-carboxyglutamate-containing proteins are

Answer 9

BMP-2, 4, and 7
Fibroblast growth factor (FGF)
Epidermal Growth factor (EGF)
Dentin Matrix Protein (DMP)

Question 10

Dental pulp innervation

Answer 10

Both myelinated and nonmyelinated nerve axons. Branching passing through the subodontoblastic layer as the parietal neural plexus (Rashchrow’s plexus), on to the odontoblastic cell layer and some fibers enter into dentinal tubules

Question 11

Most nerve endings in pulp are for ______ with a few concerned with _____ and _______

Answer 11

Pain
Vasodilation
Contriction

Question 12

Free nerve endings are what types

Answer 12

sensory afferent from C-5

Question 13

Trigeminal n is

Answer 13

sensory afferents

• pain
• mechanical (pressure)
• thermal (heat)
• tactile (touch)

Question 14

Sympathetic branches from the superior cervical ganglion are

Answer 14

Primarily vasomotor fibers to pulpal blood vessels, concerned for the most part with vasoconstriction

Question 15

What are the majority of myelinated pulpal nerve axons

Answer 15

A-delta: fast conducting and diameter in range of 1-6Mm

Sharp localized pain

Question 16

1% of myelinated nerve fibers are classified as

Answer 16

A-beta fibers: 6-12Mm

Question 17

Nonmyelinated fibers are detonated as

Answer 17

“C” fibers and have small diameters, ranging from 0.4 to 1.2 Mm
Slow, ache, diffuse, dull pain

Question 18

Calcitonin gene-related peptide (CGRP)

Answer 18

Vasodilation, stimulates fibroblast cell division

Question 19

Substance P

Answer 19

Vasodilation, stimulates fibroblast cell division

Question 20

Epinephrine

Answer 20

Vasoconstrictive via arteriole smooth muscles

Question 21

Norepinephrine

Answer 21

Sympathetic vasoconstrictor

Question 22

Dopamine

Answer 22

Vasoactive or a precursor of epinephrine

Question 23

Endorphin

Answer 23

Silencer of nociceptors (silencer of pain)

Question 24

Each nerve fiber consists of at least

Answer 24

8 branches to Raschkow’s plexus. Most terminate in the plexus as free, nonmyelinated nerve endings

Question 25

Venules have a diameter of

Answer 25

100-150

Question 26

Arterioles have a diameter of

Answer 26

50-100

Question 27

Terminal cappillaries anastomose deep to the

Answer 27

Odontoblastic layer

Question 28

Capillary loops are

Answer 28

dense in the coronal and pulp horns. Less dense in the radicular pulp

Question 29

Continuous and fenestrated capillaries and lymph vessels are found where?

Answer 29

the pulp

Question 30

With again, blood vessels in pulp will exhibit changes like

Answer 30

Cholesterol plaques (artherosclerosis)

Question 31

What can progressive and severe atherosclerosis plaques result in?

Answer 31

Pulpal hypoxia due to vessel strangulation

Question 32

Fenestrated capillaries leak

Answer 32

serum that becomes a component of the so-called “tissue fluid” - also contribute to swelling and edema due to significant leakage of serum in states of inflammation

Question 33

Pulpal fibrosis occurs with

Answer 33

increasing age or persistent low-grade injury. Ex: multiple restorations in a single tooth, chronic bruxism, repeated thermal insult, etc.

Question 34

Diffuse calcifications are

Answer 34

irregular calcified deposits along collagen fiber bundles or within blood vessels resulting from chronic low-grade inflammation

Question 35

Pulp Stones (Denticles)

Answer 35

True pulp stones contain dentinal tubules.

Question 36

False pulp stones

Answer 36

feature concentric laters of calcified tissue but are void of dentinal tubules

Question 37

Pulp stones are classified as either

Answer 37

free, attached, or embedded.

Question 38

Pulpal Abscess

Answer 38

A dense aggregation of neutrophils and macrophages and other inflammatory cells within connective tissue undergoing liquefactive necrosis

Question 39

Syncytial macrophages (multinucleated)

Answer 39

Giant cells resorbing dentin and bone adjacent to inflamed pulp

Question 40

Pulpal Abscess

Answer 40

The increasing edema and inflammatory cell infiltration will eventually lead to pulpal necrosis that also in expressed clinically by persistent pain andperiapical necrosis of the PDL with associated alveolar bone.

Question 41

Periapical necrosis is seen on radiograph as

Answer 41

a radiolucent area associated with the apex of the involved tooth

Question 42

Invasion of pulp by restorative materials

Answer 42

most likely a zinc oxide base used because of pulpal exposure during cavity preparation