Lec 3 Flashcards

1
Q

necrosis travels which direction

A

coronal to apical

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2
Q

what is the pulpal organ

A

central mass of tooth made of soft tissue, sensory innervations vessels/lymphactics
odontoblasts and fibroblasts

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3
Q

most common cell in pulp?

A

fibroblasts

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4
Q

primary function of pulp?

A

formative: odontoblasts form dentin
ameloblasts form enamel

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5
Q

secondary functions of pulp?

A

support, protection, sensation, defense, repair

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6
Q

what are fibroblasts?

A

most common cell in pulp, basic cell in all CT
arise from ectomesenchymal cells
form type I and III collagen and ground substance
important for regeneration in wound healing

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7
Q

what are odontoblasts?

A

cell in pulp responsible for dentinogenesis
also important in amelogenesis
produce collagen fibers and proteoglycan matrix (become mineralized dentin)
processes extend into dentin tubules

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8
Q

when does sclerotic dentin form?

A

when bacteria invade the pulp

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9
Q

how is tertiary dentin formed differently

A

formed by fibroblasts in response to trauma
-has no dentinal tubules

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10
Q

what is the Hydrodynamic Theory for tooth sensitivity

A

anything that causes movement of the fluid in the dentinal tubules causes pain/sensitivity in the pulp

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11
Q

what is the lamina dura

A

cortical bone around tooth, thin layer
white line on radiograph

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12
Q

when does primary dentin form?

A

as the roots of teeth develop, young patients

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13
Q

when does secondary dentin form

A

after tooth eruption

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14
Q

what happens to the pulp as we age

A

secondary dentin deposition as we age
reduces the size of the pulp uniformly, but retains the general form of the pulp
(tertiary dentin will change shape of pulp!)

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15
Q

what is pulp canal obliteration PCO?
(also called calcific metamorphosis)

A

Pulp sclerosis, a combo of secondary and tertiary dentin formation in response to chronic injury.
Occurs before pulp becomes necrotic, must be vital to occur.
Canal is blocked, refer to advanced endo

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16
Q

what are the 4 common etiologies of pulp irritation?

A

microbiological
mechanical
chemical
trauma

17
Q

what amount of dentin must cover the pulp to remain healthy

A

0.5 mm of dentin covering pulp keeps it healthy

18
Q

many etiologies of pulp are what type of cause?

A

iatrogenic (bur heating up pulp)

19
Q

what is the #1 cause of pulp irritation?

A

microbiological
dental caries is the #1 threat to the pulp

20
Q

what are the portals of access for MO to enter the pulp (5)

A

caries/leaking restoration (most common!)
cracked or fractured teeth
cemental defect at CEJ
open dentinal tubules
perio invasion into apex (deep pocket)

21
Q

what are some examples of mechanical irritation of the pulp

A

iatrogenic:
cutting w/o coolant
aspiration of odontoblasts into tubules (occurs when dentin overheats)
PULP CANNOT TOLERATE HEAT!! (10 degrees)
excessive drying w/ air
dessicants (alocohol, chloroform)
polishing
pulp exposure
use of laser

22
Q

trauma to the pulp can include?

A

external: falls and sports accidents
internal: habits like bruxism

23
Q

if the pulp is vital, what will Pt feel during cold testing?

A

pain! Vital pulp still has sensitivity
if pain lingers, sign that RC is needed
no pain = necrotic pulp

24
Q

when is tertiary dentin deposited?

A

deposited over area of injury by fibroblasts
attempt to repair, protect, or insulate pulp from more injury
form/shape of pulp is changed