exam 2: dental pulp

Question 1

the dental pulp consists of loos connective tissue derived from ____________cells.

Answer 1

neural crest (ectomesenchymal) cells

Question 2

mature dental pulp is divided into two compartments :

Answer 2

odontogenic zone
pulpal core

Question 3

4 parts of odontogenic zone of dental pulp:

Answer 3

1. odontoblast cell layer
2. cell-free zone of weil
3. cell-rich zone
4. parietal plexus of nerves (raschkow’s plexus)

Question 4

4 parts of pulpal core of dental pulp:

Answer 4

1. fibroblasts
2. type I and II collagen
3. extracellular matrix
4. blood vessels
5. nerve tissue

Question 5

4 functions of dental pulp

Answer 5

embryonic induction
formative
protective
reparative

Question 6

cell population in pulpal tissue include:
1
2 (this is the most popular of all cells)
3
4
5
6
7
8

Answer 6

1. odontoblasts
2. fibroblasts
3. undifferentiated mesenchymal cells
4. macrophages—-
5. dendritic cells— 4&5 both 8% of total cell population
6. blood vessel-related cells
7. neural-related cells
8. lymphocytes

Question 7

makes up the extracellular matrix of pulpal tissues:
1
2

Answer 7

1. collagen types I, III, IV, V (III being the most numerous)
2. non-collagenous matrix components

Question 8

components of non-collagenous matrix in the ECM of pulpal tissues

Answer 8

1. proteoglycans
2. glycosaminoglycans
3. phosphoproteins
4. glycoproteins
5. y-carboxyglutamate containg proteins (BMP, FGF, EGF, DMP)

Question 9

pulpal innervation includes both myelinated and nonmyelinated nerve axons. They progressively branch, passing through the subodontoblastic layer and the _______________, on to the odontoblastic cell layer and some fibers enter into _________

Answer 9

parietal neural plexus (Rashchow’s plexus)

into dentinal tubules

Question 10

most nerve endings in pulp are for _____ with a few concerned with vasodilation or constriction

Answer 10

pain

Question 11

sensory afferents from the nerve __________:
1
2
3
4

Answer 11

trigeminal CV

1. pain
2. mechanical (pressure)
3. thermal (heat)
4. tactile (touch)

Question 12

________branches from the SUPERIOR CERVICAL GANGLION are primarily vasomotor fibers to pulpal blood vessels, concerned for the most part, with _________

Answer 12

sympathetic

vasoconstriction

Question 13

majority of myelinated pulpal axons are:

Answer 13

A-delta

-fasting conducting
-diameter in range of 1-6um

Question 14

1% of myelinated nerve fibers are classified as

Answer 14

a-beta fibers
-6-12 um diameter

Question 15

nonmyelinated fibers are designated as:

these have small diameters ranging from .4 to 1.2um

Answer 15

C fibers

Question 16

these fibers are associated with sharp, localized pain:

these fibers are associated with dull, diffuse pain

Answer 16

a-delta sharp
c fibers dull

Question 17

list all neuropeptides and neurotransmitters identified in the dental pulp:
1
2
3
4
5
6

Answer 17

1. CGRP- calcitonin gene related peptide
2. substance P
3. epinephrine
4. norepinephrine
5. dopamine
6. endorphin

Question 18

neuropeptides and neurotransmitters identified in the dental pulp that:

vasodilation, stimulates fibroblast cell division

Answer 18

calcitonin gene related peptide and substance P

Question 19

neuropeptides and neurotransmitters identified in the dental pulp that:
vasoconstriction via arteriole smooth muscle

Answer 19

epinephrine

Question 20

neuropeptides and neurotransmitters identified in the dental pulp that is sympathetic vasoconstrictor:

Answer 20

norepinephrine

Question 21

vasoactive or precursor of epinephrine

Answer 21

dopamine

Question 22

silencer of nociceptors (silence of pain)

Answer 22

endorphin

Question 23

each fiber contributes at least ___branches to raschkow’s plexus. most terminate in the plexus as FREE nonmyelinated nerve endings

Answer 23

8 branches

Question 24

predentin has (more/less) nerve axons compared to dentin up to 100um

what is the order of most to least nerve axons between=
mineralizing front, predentin and dentin up to 100um

Answer 24

more

predentin>mineralizing front>dentin up tp 100um

Question 25

what is the order of most to least nerve axons based on remaining crown, root, and pulp horn=

Answer 25

pulp horn>remaining crown> root as you get further into tooth, there are less nerve axons

Question 26

the terminal capillaries anastomose (branch) deep to the odontoblastic layer. -capillary _____ are dense in the coronal and pulp horns and much less dense in the radicular pulp -_________ capillaries, _____ capillaries and lymph vessels are found in pulp -with age, blood vessels in pulp will exhibit changes such as ____________. if this progressive it can result in pulpal hypoxia due to vessel strangulation

Answer 26

capillary loops continuous and fenestrated capillaries cholseterol plaque (atherosclerosis)

Question 27

what capillaries leak serum that become a component of the "tissue fluid" -also contribute to swelling and edema due to significant leakage of serum in states of inflammation

Answer 27

fenestrated

Question 28

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

Answer 28

pulpal fibrosis

Question 29

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

Answer 29

diffuse calcifications

Question 30

pulp stones aka denticles true pulp stones contain _________. false pulp stones feature _________________ but are void of dentinal tubules

Answer 30

true=dentinal tubules false= concentric layers of calcified tissue (void dentinal tubules

Question 31

pulp stones are classified as either : 1 2 3

Answer 31

free attached embedded

Question 32

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

Answer 32

abcess

Question 33

due to inability of pulpal tissue to swell, the increasing edema and inflammatory cell infiltration will eventually lead to pulpal _______ that in turn is expressed clinically by persistent pain and periapical necrosis of the PDL and associated alveolar bone

Answer 33

pulpal necrosis

Question 34

periapical necrosis is seen on dental radiographs as a _______ area associated with the apex of the involved tooth

Answer 34

radiolucent