E1 Pulp

Question 1

What is the origin of the oral cavity and teeth?

Answer 1

Neural crest cells

Question 2

Which cells give rise to the dental lamina?

Answer 2

Neural crest cells

Question 3

Does the tooth form from the crown or apex?

Answer 3

crown

Question 4

What occurs first dentin (dentinogenesis) or enamel (amelogenesis)?

Answer 4

dentin

Question 5

What is the sequence of tooth formation?

Answer 5

Bud, cap, bell, dentinogenesis, amelogenesis, apositional dentin and enamel. BCBDAA!

Question 6

T/F Root formation occurs after dentinogenesis and amelogeness

Answer 6

T

Question 7

What are the three terms used to describe the primordial root?

Answer 7

Cervical loop
Hertwigs Epithelial root sheath
Epithelial diaphragm

Question 8

What are cell rests of Malassez?

Answer 8

Epithelial cells that remain in the periodontal ligament space during root formation

Question 9

Which cysts can develop later in life due to the cell rests of Malassez?

Answer 9

Lateral periodontal cysts

Question 10

Do lateral and accessory canals contain pulp tissue?

Answer 10

No, they do not

Question 11

What is the difference between lateral and accessory canals?

Answer 11

Lateral canals if in the coronal 2/3 of root. Accessory canals in the apical 1/3 of root and furcation areas

Question 12

Where are accessory canals more numerous?

Answer 12

Apical 1/3 of root

Question 13

Why does the apical foramen change in size with age?

Answer 13

Continual cementum deposition

Question 14

What does the pulp-dentin complex include?

Answer 14

Predentin, odontoblastic layer, cell free zone, cell rich zone, central pulp. POCCC.

Question 15

What does the cell rich zone contain?

Answer 15

Undifferentiated mesenchymal cells, blood vessels, defense cells

Question 16

What is the most prominent and common cell in the pulp? Which layer is it located in?

Answer 16

Fibroblast.

Cell rich zone

Question 17

What do fibroblasts differentiate into?

Answer 17

Odontoblasts, Types 1 and 3 collagen, and ground substance

Question 18

What is the shape of fibroblasts?

Answer 18

Spindly-shaped

Question 19

What is the one job of odontoblasts?

Answer 19

Produce dentin

Question 20

Where are the odontoblasts well organized? Where least organized?

Answer 20

Mid root area just above the cell rich zone.

Least organized in apical pulp. Most organized in coronal pulp

Question 21

What is the shape of odontoblasts in each third of the pulp?

Answer 21

Columnar in coronal pulp.
Cuboidal in the middle third.
Squamous in the apical pulp

Question 22

What is the long extension of the odontoblast cell body called?

Answer 22

Tomes process (or odontoblast process)

Question 23

Where does the Tomes process extend?

Answer 23

Into the dentinal tubules

Question 24

What kind of medium is the ground substance?

Answer 24

Glycoprotein medium for the transport of nutrients and oxygen to the cells of the pulp

Question 25

Does pulp contain collagen?

Answer 25

Yes. Type 1 in dentin, secreted by odontoblasts. Type 1 and 3 in pulp secreted by fibroblast

Question 26

What are the afferent sensory cells? Which fibers are located more peripherally and which ones more centrally?

Answer 26

A(alpha)-Delta fibers (peripherally located), and C fibers located more centrally).

Question 27

What are the efferent motor nerves associated with in the pulpal nerve supply?

Answer 27

Contraction of smooth muscles in the capillaries

Question 28

Are alpha fibers myelinated? What type of pain are they associated with?

Answer 28

Yes, and they have a high conduction velocity. Associated with sharp lightening type of pain.

Question 29

Reversible pulpitis is associated with which type of pain fibers? Irreversible pulpitis?

Answer 29

Alpha - reversible pulpitis | C fibers are associated with irreversible pulpitis

Question 30

Are C fibers myelinated? What type of pain are they associated with?

Answer 30

C fibers are non-myelinated. Associated with dull, lingering, poorly localized pain

Question 31

How deep do the Tomes processes extend into the dentin?

Answer 31

100-200 microns

Question 32

What are the three theories of dentin sensitivity?

Answer 32

1. Direct innervation 2. Odontoblastic receptor 3. Hydrodynamic

Question 33

How does the hydrodynamic theory of dentinn sensitivity work?

Answer 33

Pulpal fluid movement in tubules triggers nerves

Question 34

What is the most accepted theory of dentin sensitivity?

Answer 34

Hydrodynamic theory

Question 35

What determines the vitality of the pulp?

Answer 35

Normal blood supply

Question 36

Which artery provides the blood supply to the pulp?

Answer 36

Internal maxillary artery

Question 37

What are the functions of A-V shunts?

Answer 37

1) Bypass the capillary bed during inflammation, which decreases the intrapulpal blood pressure 2) Help control normal pulpal circulation THEREFORE, they are defense mechanisms as well as physiologic blood flowing control mechanisms

Question 38

What are the functions of the pulp?

Answer 38

Induction, formation, innervation, nutrition, defense. I FIND.

Question 39

What is the most important function of the pulp?

Answer 39

Secondary dentin formation, which occurs thru out life

Question 40

What is tertiary dentin formation?

Answer 40

Repairative dentin formation in response to an irritant or dental procedures. Repairative, irritational, and tertiary dentin are all terms for dentin that forms in response to an irritant

Question 41

Is there a correlation between pathology and calcification (pulp stones)?

Answer 41

No

Question 42

What is the most common irritant to the pulp?

Answer 42

Caries

Question 43

Which immune cells are present in the pulp during an immune response?

Answer 43

PMNs, T, B, and NK cells Plasma cells (IgG, IgA, against microbes in the carious lesion)

Question 44

Are direct pulp caps over carious exposures recommended?

Answer 44

No

Question 45

What is the success rate of pulp caps after a 10 year follow up?

Answer 45

13%

Question 46

T/F Pulp reactions include vascular ad neural reactions

Answer 46

T

Question 47

What are the defense mechanisms of the pulp? (4)

Answer 47

AV shunting Secondary Dentinal Mechanisms Reparative Dentin Formation Immune Reactions