Dental Pulp (Exam II)

Question 1

What components can be found in mature dental pulp?

Answer 1

Dentin
Predentin
Odontoblast layer
Cell rich zone
Pulpal core
Pulpal dendritic cells

Question 2

The dental pulp consists of _____ tissue derived from _____ cells

Answer 2

loose connective
neural crest (ectomesenchymal) cells

Question 3

Mature dental pulp is divided into what two compartments?

Answer 3

1. Odontogenic zone
2. Pulpal core

Question 4

Odontoblast cell layer
Cell-free zone of Weil
Cell-rich zone
Parietal plexus of nerves (Raschkow’s plexus)

These are all components of:

Answer 4

The odontogenic zone of mature dentin

Question 5

Fibroblasts
Type I & III collagen
Extracellular matrix
Blood vessels
Nerve tissue

These are all components of:

Answer 5

The pulpal core of mature dentin

Question 6

Functions of the dental pulp include:

Answer 6

1. Embryonic induction
2. Formative
3. Protective
4. Reparative

Question 7

Cell populations in pulpal tissues include: (8)

Answer 7

1. Odontoblasts
2. Fibroblasts
3. Undifferentiated mesenchymal cells
4. Macrophages
5. Dendritic cells
6. Blood vessel related cells
7. Neural-related cells
8. Lymphocytes

Question 8

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

Answer 8

Type I, III, IV, & V

Question 9

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

Answer 9

1. Proteoglycans
2. Glycosaminoglycans
3. Phosphoproteins
4. Glycoproteins
5. Gamma-carboxyglutamate-containing proteins

Question 10

The gamma-carboxyglutamate containing proteins include:

Answer 10

1. BMP-2, 4 & 7
2. Fibroblasts growth factor
3. Epidermal growth factor
4. Dentin matrix protein

Question 11

Pulpal innervation includes both _____ & _____ nerve axons

Answer 11

Myelinated & nonmyelinated

Question 12

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

Answer 12

Parietal neural plexus

Question 13

The parietal neural plexus may also be called:

Answer 13

Raschow’s plexus

Question 14

The pulpal axons progressively branch, passing through the subodontoblastic layer as the parietal neural plexus, on to the _________ cell layer & some fibers enter _______

Answer 14

Odontoblastic cell layer
Dentinal tubules

Question 15

Most nerve endings in pulp are for:

Answer 15

Pain

Question 16

The nerve endings in pulp that are for pain are:

Answer 16

Free nerve endings as sensory afferents from trigeminal nerve

Question 17

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

Answer 17

Vasodilation/vasoconstriction

Question 18

Sensory afferents in the dental pulp come from:

Answer 18

Trigeminal nerve (CN 5)

Question 19

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

Answer 19

1. Pain
2. Mechanical (pressure)
3. Thermal (heat)
4. Tactile (touch)

Question 20

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

Answer 20

Sympathetic
Vasoconstriction

Question 21

The majority of myelinated pulpal nerve axons are:

Answer 21

A-deltaa

Question 22

A-delta myelinated pulpal nerve axons are:

Answer 22

Fast conducting

Question 23

What is the diameter range of A-delta myelinated pulpal nerves axons:

Answer 23

1-6 micrometers

Question 24

1% of myelinated nerve fibers are classified as _____ fibers

Answer 24

A-beta

Question 25

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

Answer 25

6-12 micrometers

Question 26

Nonmyelinated fibers are designated as ___ fibers & have small diameters ranging from 0.4 to 1.2 micrometers

Answer 26

C-fibers

Question 27

Fibers that are associated with SHARP, localized pain:

Answer 27

A-delta fibers

Question 28

Fibers that are associated with dull, diffuse pain:

Answer 28

C-fibers

Question 29

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

Answer 29

Vasodilation & stimulates fibroblast cell division

Question 30

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

Answer 30

Vasodilation & stimulates fibroblast cell division

Question 31

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

Answer 31

Vasoconstriction of smooth muscle

Question 32

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

Answer 32

Sympathetic vasconstriction

Question 33

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

Answer 33

Vasoactive or a precursor of epinpehrine

Question 34

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

Answer 34

Silencer of nociceptors (silencer of pain)

Question 35

List the neurotransmitters identified in dental pulp (6):

Answer 35

1. CGRP 2. Substance P 3. Epineprhine 4. Norepinephrine 5. Dopamine 6. Endorphine

Question 36

Each nerve fiber in dental pulp contributes atleast _____ to Raschow's plexus.

Answer 36

8 branches

Question 37

Each nerve fiber in dental pulp contributes alteast 8 branches in Raschow's plexus. Most terminate in the plexus as:

Answer 37

Free nonmyelinated nerve endings

Question 38

The terminal capillaries in dental pulp ______ deep to the odontoblastic layer

Answer 38

Anastomose

Question 39

Capillary loops are dense in the _____ & _____ & significantly less dense in the _____

Answer 39

Coronal & pulp horns Radicular pulp

Question 40

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

Answer 40

Continuous & fenestrated Lymph vessels

Question 41

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

Answer 41

Cholesterol plaques (atherosclerosis)

Question 42

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

Answer 42

Pulpal hypoxia

Question 43

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

Answer 43

Fenestrated capillaries

Question 44

Contributes to swelling & edema due to significant leakage of serum & states of inflammation

Answer 44

Fenestrated capillaries

Question 45

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

Answer 45

Pulpal fibrosis

Question 46

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

Answer 46

Diffuse calcifications

Question 47

Pulp stones may also be called:

Answer 47

Denticles

Question 48

True pulp stones contain _____ False pulp stones feature concentric layers of _____ but are void of _____

Answer 48

Dentinal tubules Calcified tissues; dentinal tubules

Question 49

Classifications of pulp stones include:

Answer 49

1. Free 2. Attached 3. Embedded

Question 50

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

Answer 50

Pulpal abscess

Question 51

What type of macrophages are found in pulpal abscesses?

Answer 51

1. Vacuolated macrophages 2. Syncytial macrophages or giant cells

Question 52

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

Answer 52

Resorb dentin adjacent to the inflammed pulp

Question 53

Due to the inability of pulpal tissue to swell, the increasing edema & inflammatory cell infiltration will eventually lead to ______ that in turn is expressed clinically by ______ & ______ of the PDL & associated alveolar bone

Answer 53

Pulpal necrosis Persistent pain; periapical necrosis

Question 54

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

Answer 54

Periapical necrosis

Question 55

Treatment for periapical abscess would include:

Answer 55

I&D or endodontic therapy