Dental Pulp- Exam II Flashcards

1
Q

What components can be found in mature dental pulp?

A

dentin
predentin
odontoblast layer
cell rich zone
pulpal core
pulpal dendritic cells

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2
Q

The dental pulp consists of ____ tissue derived from ____ cells.

A

loose connective tissue; neural crest (ectomesynchemal) cells

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3
Q

Mature dental pulp is divided into what two compartments?

A

Odontogenic zone and pulpal core

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4
Q

Odontoblast cell layer
cell-free zone of Weil
Cell-rich zone
Parietal plexus of nerves (Raschkow’s Plexus)
These are all components of:

A

Odontogenic zone of mature dentin

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5
Q

Fibroblasts
Type 1 and 3 collagen
Extracellular matrix
Blood vessels
Nerve tissue
These are all components of:

A

Pulpal core of mature dentin

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6
Q

The functions of the dental pulp include:

A
  1. embryonic induction
  2. Formative
  3. Protective
  4. Reparative
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7
Q

Cell populations in pulpal tissues include: (8)

A
  1. odontoblasts
  2. fibroblasts
  3. undifferentiated mesenchymal cells
  4. macrophages
  5. dendritic cells
  6. blood vessel related cells
  7. neural-related cells
  8. lymphocytes
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8
Q

The extracellular matrix of pulpal tissues incudes what type of collagen?

A

type 1, 3, 4 and 5

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9
Q

Non-collagenous matrix components of dental pulp include: (5)

A
  1. proteoglycans
  2. glycosaminoglycans
  3. phosphoproteins
  4. glycoproteins
  5. gamma-carboxyglutamate- containing proteins
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10
Q

The gamma-carboxyglutamate-contianing proteins include:

A
  1. BMP 2, 4 and 7
  2. fibroblast growth factor
  3. epidermal growth factor
  4. dentin matrix protein
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11
Q

Pulpal innervation includes both _____ and ____ nerve axons.

A

myelinated and unmyelinated

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12
Q

The pulpal innervation (axons) progressively branch, passing through the subodontoblastic layer as the _______.

A

parietal neural plexus

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13
Q

The parietal neural plexus may also be called:

A

Rashchows plexus

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14
Q

The pulpal axons progressively branch, passing through the subodontoblastic layer as teh parietal neural pelxus , on to the _____ cell layer and some fibers enter into ____.

A

odontoblastic cell layer; dentinal tubules

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15
Q

Most nerve endings in pulp are for:

A

pain

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16
Q

The nerve endings in pulp that are for pain are:

A

free nerve endings as sensory afferents from trigeminal nerve

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17
Q

A few nerve endings in the dental pulp are concerned with:

A

vasodilation and vasoconstricton

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18
Q

sensory afferents in the dental pulp come from:

A

trigeminal nerve (CN5)

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19
Q

Sensory afferents from the trigeminal nerve in the dental pulp include:

A
  1. pain
  2. mechanical (pressure)
  3. thermal (heat)
  4. tactile (touch)
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20
Q

____ branches from the superior cervical ganglion are primarily vasomotor fibers to pulpal blood vessels, concerned for the most part, with ____.

A

sympathetic; vasoconstriction

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21
Q

The majority of myelinated pulpal nerve axons in dental pulp are:

A

A-delta

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22
Q

A-delta myelinated pulpal nerve axons are:

A

fast conducting

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23
Q

What is the diameter range of a-delta myelinated pulpal nerve axons?

A

1-6 micrometers

24
Q

1 % of myelinated nerve fibers are classified as:

A

A-beta fibers

25
Q

What is the diameter range of A-beta myelinated pulpal nerve fibers?

A

6-12 micrometers

26
Q

Non-myelinated fibers are designated as ____ fibers and have small diameters, ranging from 0.4-1.2 micrometers

A

C fibers

27
Q

Fibers that are associated with SHARP, localized pain:

A

A-delta fibers

28
Q

Fibers that are associated with dull, diffuse pain

A

C fibers

29
Q

Calcitonin gene-related peptide (CGRP) is a neuropeptide found in the dental pulp that function in:

A

vasodilation, and stimulates fibroblast cell division

30
Q

Substance P is a neuropeptide found in the dental pulp that functions in:

A

vasodilation, and stimulates fibroblast cell division

31
Q

Epinephrine is a neuropeptide found in the dental pulp that functions in:

A

vasoconstriction of smooth muscle

32
Q

Norepinephrine is a neuropeptide found in the dental pulp that functions in:

A

sympathetic vasoconstriction

33
Q

Dopamine is a neuropeptide found in the dental pulp that functions in:

A

Vasoactive or a precursor of epinephrine

34
Q

Endorphin is a neuropeptide found in the dental pulp that functions in:

A

Silencer of nociceptors (silencer of pain)

35
Q

List the neurotransmitters involved in dental pulp:

A
  1. CGRP
  2. Substance P
  3. Epinephrine
  4. Norepinephrine
  5. Dopamine
  6. Endorphin
36
Q

Each nerve fiber in dental pulp contributes to to atleast _____ to Raschkow’s Plexus

A

8 branches

37
Q

Each nerve fiber contributes to atleast 8 branches to Raschkow’s plexus. Most terminate in the plexus as:

A

free nonmyelinated nerve endings

38
Q

The terminal capillaries in dental pulp ____ deep to the odontoblastic layer:

A

anastomose

39
Q

Capillary loops are dense in the ____ and _____ and significantly less dense in the _____

A

coronal and pulp horns; radicular pulp

40
Q

____ & _____ capillaries and _____ vessels are found in the pulp

A

continuous and fenestrated capillaries and lymph vessels

41
Q

With aging, blood vessels in the pulp will exhibit changes such as:

A

cholesterol plaques (atherosclerosis)

42
Q

If progressive and severe, atherosclerotic plaques can result in ______ due to vessel strangulation

A

pulpal hypoxia

43
Q

______ leak serum that becomes a component of the so-called tissue fluid

A

fenestrated capillaries

44
Q

Contributes to swelling and edema due to significant leakage of serum in states of inflammation

A

fenestrated capillaries

45
Q

Occurs with increasing age or persistent low-grade injury (like multiple restorations in a single tooth, chronic bruxism, repeated thermal insult, etc.):

A

pulpal fibrosis

46
Q

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

A

diffuse calcifcations

47
Q

Pulp stones may also be called:

A

Denticles

48
Q

True pulp stones contain ____.

False pulp stones feature concentric layers of _____ but are void of _____.

A

dentinal tubules

calcified tissue; dentinal tubules

49
Q

Classifications of pulp stones include:

A
  1. free
  2. attached
  3. embedded
50
Q

Defined as a dense aggregation of neutrophils and macrophages and other inflammatory cells within connective tissue under going liquefactive necrosis

A

pulpal abscess

51
Q

What type of macrophages are found in pulpal abscesses?

A
  1. vacuolated macrophages
  2. syncytial macrophages or giant cells
52
Q

What do the syncytial macrophages or giant cells in a pulpal abscess do?

A

resorb dentin adjacent to the inflamed pulp

53
Q

Due to the inability of pulpal tissue to swell, the increasing edema and inflammatory cell infiltration will eventually lead to ____, that in turn is expressed clinical by _______ and _____ of the PDL and associated alveolar bone

A

pulpal necrosis

persistant pain; periapical necrosis

54
Q

Seen on dental radiographs as a radiolucent area associated with the apex of the involved tooth:

A

periapical necrosis

55
Q

Treatment for a periapical abscess would include:

A

I & D