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D2 S PAR 1 > Endo II PAR 1 > Flashcards

Endo II PAR 1 Flashcards

1
Q

The dental pulp consists primarily of __________ nerve fibers

A

sensory

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2
Q

Tooth development begins in the ____ week of gestation

A

5th

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3
Q

Mineralization of primary dentition begins during the _____ week of gestation

A

14th

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4
Q

When does the permanent dentition begin to develop?

A

the 14th week of gestation– this is the same time that the primary dentition starts to mineralize

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5
Q

Primary teeth erupt at around _____ months and permanent teeth at around _____ or _____ years

A

primary– 6 months
permanent– 5 or 6 years

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6
Q

Ectoderm gives rise to what part of teeth?

A

ectoderm– ameloblasts for enamel

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7
Q

Cranial neural crest gives rise to what part of teeth

A

cranial neural crest is derived ectomesenchyme– dentin, pulp, periodontal tissue

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8
Q

Over _____ genes have been demonstrated to be active in tooth development

A

200

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9
Q

Initiation of tooth development begins with the formation of the ________ _________

A

Dental lamina– thickening of the oral epithelium

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10
Q

The underlying mesenchyme is called the _______ ________ and forms what?

A

Dental papilla- it forms the future dentin and pulp

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11
Q

3 stages of early tooth development

A
  1. Bud stage– mesenchyme condenses and looks like a cap on the dental papilla, multiple signaling molecules involved
  2. Cap stage– enamel knot is formed in the enamel organ epithelium, critical signaling center
  3. Bell stage– crown is final shape, histodifferentiation of the cells that will make the hard tissue
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12
Q

2 signals and transcription factors involved in tooth development?

A

BMP– bone morphologic protein
FGF– fibroblast growth factor

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13
Q

What is the secondary enamel knot responsible for?

A

Cusp formation in posterior teeth

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14
Q

What are CGRP and SP?

A

neuropeptides, inflammatory mediators, potent vasodilators

CGRP– calcitonin gene related peptide

SP– substance P

enter the dental papilla in the advanced bell stage (after initiation of dentin and enamel formation)

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15
Q

Pulp dentin complex morphologic zones (picture)

A
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16
Q

What is in the odontoblastic layer?

A
  • capillaries
  • nerve fibers
  • dendritic cells
  • odontoblasts
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17
Q

What is in the Cell free zone of Weil?

A
  • plexus of Rashkow (rich network of mostly unmyelinated nerve fibers)
  • capillaries
  • fibroblast processes
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18
Q

What is in the cell rich zone?

A
  • high density of fibroblasts
  • undifferentiated mesenchymal cells (stem cells)
  • precursors for odontoblast replacement
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19
Q

What is in the pulp proper?

A
  • large blood vessels and nerves– centrally located and branch laterally
  • coronal pulp– fibroblasts and collagen in ECM
  • apical pulp– dense collagen fibers, continuation of PDL
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20
Q

Dentin components

A

(dentin is a calcified connective tissue)

70% inorganic material
10% water
20% organic matrix (91% of collagen is type I)

collagenous matrix has phosphoproteins, proteoglycans, acidic glycoproteins, growth factors, and lipids

21
Q

Dentin tubules are ___um at the DEJ and ____ um at the pulpal surface

A

DEJ– 1 micrometer
pulpal surface– 3 micrometer

remember that tubules are larger at the pulpal surface than at the DEJ (so there is a **decrease in dentin hardness at the pulp due to increased tubule surface area)

22
Q

How many tubules penetrate dentin?

A

millions of tubules– 40,000-70,000 per square mm

23
Q

Permeability of root dentin is ____ to _____ times LESS than that of coronal dentin

A

10-20 times less permeable

24
Q

Etching will ______ the dentin tubules, where as the smear layer (microcrystalline debris) causes dentin tubules to be ________

A

etching– opens tubules
smear layer– closes tubules

25
Q

Are bacteria usually found in dental tubules when there are caries?

A

NO– bacteria usually NOT IN DENTIN TUBULES
- most likely due to outward push of dentin fluid and immunoglobulins

26
Q

Bundles of ________________ collagen reduces the functional diameter of dentinal tubules and thus reduces permeability

A

Intraluminal collagen
- intraluminal collagen may also trap suspended bacteria

27
Q

Noxious stimulus causes what protective mechanism

A

Outward flow– flushing action (reduces bacteria)
- odontoblasts and nerves release inflammatory mediators, vasodilation, and increased plasma fluid into pulp through the dentin tubules

28
Q

Factors affecting permeability of dentin and removal of substance by the pulp? (picture)

A
29
Q

3 theories of dentin sensitivity?

A
  • classic
  • modified
  • hydrodynamic
30
Q

Main function of the interstitial fluid?

A

transport medium for nutrients and waste products between cells and capillary blood– mainly by diffusion through the capillary wall

31
Q

Argyrophilic Fibers

A

reticular fibers of the ECM around blood vessels, traverse between odontoblasts into the pre-dentin matrix

most of the fibers in the ECM are type 3 collagen fibers

32
Q

ECM variation with age and location

A

older and more apically located = more fibrous

younger and more coronally located = less fibrous

33
Q

What is the predominant cell of the connective tissue and where does it originate?

A

Fibroblasts– originate from ectomesenchyme
- responsible for formation and maintenance of the fibrous components and ground substances

34
Q

What is the major organic component of dental pulp?

A

Collagen– made and secreted by odontoblasts and fibroblasts

The fibers secreted by odontoblasts eventually become mineralized

Collagen secreted by fibroblasts do NOT mineralize

35
Q

Type I collagen – product of odontoblasts (process)

A
  • packaged as pro collagen in vesicles
  • released as tropocollagen into matrix
  • arranges into collagen fibrils extracellularly
36
Q

Products of odontoblasts? (there are 4)

A
  1. Type I collagen
  2. calcium phosphate transported in vesicles
  3. enzymes– alkaline phosphatase
  4. proteoglycans
    - mineralization initiation and control
    - dentin phosphoprotein (unique to dentin)
37
Q

What has the highest blood flow of all oral tissues?

A

Pulp

38
Q

What passes through the apical foramen?

A

arterioles, venues, and lymphatics

no collateral circulation!

large vessels move vertically toward coronal pulp and smaller vessels branch laterally

39
Q

The vessels in the pulp horn form _____ _____ loops

A

hair pin loops

40
Q

What connects arterioles directly to venues in the pulp?

A

AVAs– arteriovenous anastomosis

  • these are a way of shunting blood away from an area of injury where damage to micro-circulation may result in thrombosis or hemorrhage
41
Q

U-turn loops

A

similar two AVA– plays a role in blood flow regulation during initial stages of inflammation

42
Q

Sympathetic nerves from the ___________ ___________ __________ have a general vaso_________ effect for the pulp

A

superior cervical ganglion, vasoconstrictor

43
Q

Pain from the pulp is transmitted through which fibers?

A

A delta, C

44
Q

What is the last major structure to enter the pulp during development?

A

myelinated A delta fibers

45
Q

Neuropeptides are produced and released by _________ neurons, and have the _____________ effect of producing an inflammatory response

A

sensory, antidromal

46
Q

Substance P is commonly found in ___ fibers

A

C fibers

47
Q

Both SP and CGRP are vaso___________s

A

vasodilators

48
Q

Which neuropeptides are pro-inflammatory?

A

Neurokinin A (NKA) and Substance P

49
Q

Which neuropeptides are anti-inflammatory?

A

Neuropeptide Y, Vasoactive intestinal peptide (VIP)

D2 S PAR 1 (2 decks)

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