Dentine-Pulp Complex and Pathology

Question 1

What about the dental caries lesion can determine whether the changes to the dentine-pulp complex are reversible or irreversible

Answer 1

• Anatomical considerations of the lesion location
• Dynamic activity of the carious lesion
• Extent of the lesions
• Age of the pulp

Question 2

How can deep carious lesions be dealt with

Answer 2

Removing the peripheral aspect of the cavity followed by carefully removing the lesions at the base of the cavity overlying the pulp until hard stained dentine is reached

Question 3

What factors can influence the pulp healing responses after the pulp has been injured after cavity preparation and restoration

Answer 3

• Drill speed
• The use of coolant
• Operator pressure
• Extent of cavity preparation
• Unecessary iatrogenic removal of dentine
• Extensive and prolonged use of etchants

Question 4

What two biological events occur in pulpal repair

Answer 4

• Progenitor cell recruitment - reparative dentinogenesis - ageing population - compromised response
• Odontoblast-like cell differentiation and stimulation of dentine matrix secretion - reparative dentinogenesis

Question 5

What are some difficulties encountered with indirect pulp capping

Answer 5

• Difficulty with this technique in knowing how rapid the carious process has been
• How much tertiary dentine formed
• Knowing exactly when to stop excavating

Question 6

Why is ageing an issue for the pulpal tissue

Answer 6

As blood supply is crucial due to its health and regenerative ability. Ageing causes pulpal tissue to become more fibrous with reduction in pulp volume as a result of physiological secondary dentine formation and reactionary dentine over the years

Question 7

What is the material of choice for pulp capping

Answer 7

Calcium Hydroxide

Question 8

What cells need to be preserved in cases of excessive pulpal injury

Answer 8

Preservation of an adequate stem or progenitor cell population for repair