EX2; Pulp

Question 1

What is the embryonic origin of the dental pulp

Answer 1

ectoderm
neural crest ectomesenchyme
dental papilla

Question 2

What are the constituents of the dental pulp

Answer 2

cells and cellular elements
blood and lymphatic vessels
extracellular matrix
*not calcified

Question 3

What are the 5 main functions of pulp

Answer 3

inductive
formative
nutritive
protective
defensive/reparative

Question 4

What are the two functions of the protective nature of pulp

Answer 4

sensory; high pressure

barrier; odontoblast junction

Question 5

What are the two functions of the defensive/reparative nature of pulp

Answer 5

immune

formation of new dentin and pulp

Question 6

What is the difference between a young pulp and an old pulp

Answer 6

the young pulp is much larger than the old pulp

Question 7

True or False

Pulp is not normally calcified, but ectopic calcifications are common

Answer 7

True; these are pulp stones, typically most coronal

Question 8

What becomes of calcifications in the pulp as it moves apically

Answer 8

the become diffuse

Question 9

Where can you find diffuse calcifications

Answer 9

in healthy and even un-erupted teeth

Question 10

True or False

Pulp stones cannot be visible radiographically

Answer 10

False; large dense ones can

Question 11

What are the two main histologic organizations in the pulp

Answer 11

odontogenic zone

central (pulp) core

Question 12

What makes up the odontogenic zone

Answer 12

odontoblast layer
cell free zone
cell rich zone

Question 13

What makes up the central (pulp) core

Answer 13

fibroblasts
capillaries/arterioles/venules
nerves (perineural sheath)

Question 14

What are the resident immune system cells found in the pulp

Answer 14

macrophage
lymphocytes
eosinophils
dendritic cells

Question 15

What are the inflammatory immune system cells found in the pulp

Answer 15

plasma cells
mast cells
PMNs

Question 16

These cells in the pulp detect bacterial antigens and are closely associated with the odontoblast layer

Answer 16

dendritic cells

Question 17

These cells serve as a source for replacement of odontoblasts or fibroblasts

Answer 17

stem cells

Question 18

What are the main components of the extracellular matrix of pulp

Answer 18

PGs and associates (GAGs)
glycoproteins
collagen I and III

Question 19

This is involved with collagen fibrillogenesis and water retention of the ECM of pulp

Answer 19

PGs and other associates

Question 20

This is involved in cell adhesion to the ECM

Answer 20

glycoproteins; fibronectin

Question 21

This gives the ECM of pulp tensile strength

Answer 21

collagen I and III

Question 22

True or False;

stem cells are only plentiful during development

Answer 22

False; they are also present in adults

Question 23

What are the clinical implications of adult stem cells in teeth

Answer 23

potential source for repair or correction of genetic defects

tissue-specific stem cell populations well known in regenerating organ (blood, bone, skin)

Question 24

What are the novel concepts of adult stem cells in pulp

Answer 24

extent of plasticity (able to become more/different)

ability to develop complex organized structures

Question 25

What specific type of adult stem cells are derived from dental pulp (bone marrow, etc.)

Answer 25

multipotent

Question 26

Dental pulp stem cells can be induced to form what

Answer 26

odontoblasts adipocyte glial-like cells in vitro

Question 27

Dentin-like tissue from the dental pulp stem cells transplanted subcutaneously in immunocompromised mice what occurred

Answer 27

dentin-pulp complex

Question 28

True or False | stem cell niches probably present in multiple location of mature pulp

Answer 28

True

Question 29

These are the 2nd most numerous cell type in the pulp

Answer 29

odontoblast

Question 30

What are the functions of odontoblasts

Answer 30

dentinogenesis nutrients to dentin immune

Question 31

What are the different shapes of the odontoblasts coronally or apically

Answer 31

toward the root they become more cuboid

Question 32

What becomes of the odontoblastic processes as it moves apically

Answer 32

they become thinner

Question 33

What are the differences between the odontoblastic processes and cell bodies microscopically

Answer 33

the bodies contain organelles the processes contain more cytoskeletal (microtubules) elements with no nucleus or organelles

Question 34

This type of junction between odontoblasts maintain position and polarity

Answer 34

desmosomes and adherens junctions

Question 35

This type of junction between odontoblasts coordinated dentinogenesis (cell communication)

Answer 35

gap junctions

Question 36

This type of junction between odontoblasts acts like a barrier, not allowing things to pass through

Answer 36

tight junctions

Question 37

What was the experiment involving HRP testing looking to discover about the pulp

Answer 37

How strong the tight junctions of the odontoblasts were; they injected HRP into the pulp and noticed out it did not penetrate the dentin, it stopped at the odontoblast layer

Question 38

What was showing involving cavity preparation and the strength of tight junctions of the odontoblasts

Answer 38

the cavity preparation showed to weaken those bonds, allowing HRP to penetrate the dentin

Question 39

What specifically distinguished the pulp from the other tooth tissues

Answer 39

the presence of blood and lymphatic vessels

Question 40

Blood flow in pulp is under what control

Answer 40

neural; sympathetic from superior cervical ganglion | sensory

Question 41

What does the sympathetic nervous system control regarding the blood flow in the pulp

Answer 41

constricts the blood flow | alpha-adrenergic receptors

Question 42

What is the importance of the lymphatic vessels in the pulp

Answer 42

healing; drain proteins accumulated during inflammation

Question 43

Lymphatic vessels in pulp may have what in order to overcome challenge associated with encasement in hard tissue

Answer 43

complex anatomy

Question 44

What type od nerve fibers does the pulp contain

Answer 44

A delta A beta C

Question 45

These nerve fibers are sensory pain fibers

Answer 45

A delta

Question 46

These nerve fires are sensory pain fibers and sympathetics

Answer 46

C

Question 47

These nerve fibers are sensory pain fibers and light touch

Answer 47

A beta

Question 48

What is the main sensation arising from activating nerve fibers innervating the pulp and surrounding dentin

Answer 48

pain

Question 49

Innervation begins at which odontogenic phase

Answer 49

bell stage

Question 50

Density of innervation increases until what

Answer 50

eruption, and probably decreases with aging

Question 51

True or False | Both primary and secondary dentition is innervated

Answer 51

True

Question 52

Nerves enter though where are termini where

Answer 52

enter through the apical foramen and terminate in the pulp-dentin border zone and dentin

Question 53

The dye injection into pulp determined how far the nerves and odontoblast processes transported into dentin, how far was this

Answer 53

only about 1/3 of the way in

Question 54

Where are the dentinal tubules most innervated

Answer 54

in the crown

Question 55

This is a highly innervated region along the pulp-dentin border

Answer 55

Rashkow's plexus

Question 56

Nerve fibers profusely innervate what

Answer 56

the pulp-dentin border

Question 57

What accounts for the high sensitivity of the DEJ to exposure

Answer 57

hydrodynamic theory

Question 58

The perturbed fluid in the dentin tubule causes what to occure

Answer 58

neural activity

Question 59

What experiment was used to support the hydrodynamic theory

Answer 59

premolars destined for extraction were drilled and acid-etched to open the tubules and a tube was sealed into the cavity attached to a saline-filled syringe and manometer and tested positive and negative pressure

Question 60

Was the register or pain any different with negative or positive pressure

Answer 60

positive was slightly lower, but still produced pain

Question 61

These nerve fibers are hypothesized to be pulp nerve fibers important for hydrodynamic dentinal pain

Answer 61

A beta (but A delta also involved)

Question 62

Why are A beta fibers the ones associated with dentinal pain

Answer 62

they have very low thresholds for pain

Question 63

The odontoblast receptor theory is highly unlikely, but how could it affect dentinal sensitivty

Answer 63

crowding in the tubule | non-synpatic communication possible; adhesive contacts could cause odontoblasts to "pull on" nerve fiber

Question 64

True or False | Pain can arise directly from stimuli in the pulp

Answer 64

True

Question 65

These nerve fibers have receptors for inflammatory and thermal stimuli

Answer 65

C fibers

Question 66

C fibers are members of this family which are transmembrane receptors for thermal and inflammatory pain in regions of the body

Answer 66

TRP receptor | TRPA1 receptor

Question 67

Sensitivity changes with what

Answer 67

inflammation

Question 68

These are present in dentinal and pulp sensory nerves

Answer 68

neuropeptides

Question 69

Peptides are synthesized in cell body of what

Answer 69

trigeminal ganglion

Question 70

What occurs at the central ending of neuropeptides

Answer 70

transmitter function

Question 71

If peptides bind with receptors on brain neurons, what occurs

Answer 71

pain

Question 72

What occurs at the peripheral endings of neuropeptides

Answer 72

local regulatory function

Question 73

If peptides find with receptors on vasculature/local cells, what occurs

Answer 73

pre-inflammatory

Question 74

What four things does sensory/pain nerve also do

Answer 74

vasodilation (oppose sympathetics) plasma extravasation angiogenesis interactions with immune cells

Question 75

How does sensory/pain nerves interact with immune cells

Answer 75

stimulation of cytokine production by macrophages | chemotactic effects on immune cell migration