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Endodontics > Lecture 3 (9/5) > Flashcards

Lecture 3 (9/5) Flashcards

1
Q

The primary function of dental pulp is:

A

Formative

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2
Q

What describes “anything that causes movement of the fluid within the dentinal tubules & causes pain in the pulp”?

A

Branstromm’s Hydrodynamic Theory of Pain

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3
Q

Uniform deposition of _____ reducing the general size of the pulp, but retaining the general form as the tooth matures is known as:

A

Secondary dentin

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4
Q

Most common portal of entry of microbiological irritants into the pulpal space is:

A

Caries/leaking restorations

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5
Q

What is the most common etiology of pulpal inflammation?

A

Microbiological

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6
Q

Central mass of tooth consisting of soft tissue that is densely innervated by afferent (sensory) fibers, sympathetic fibers, vascular structure, lymphatics and specialized cells such as odontoblasts (characteristic of pulp) and fibroblasts (most common/prevalent cell type in pulp:

A

Pulpal organ

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7
Q

The pulpal organ is the central mass of tooth conisting of _____ that is densely innervated by:

A

soft tissues; afferent (sensory) fibers, sympathetic fibers, vascular structures, lymphatics and specialized cells

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8
Q

What are the specialized cells in the pulpal organ?

A
  1. Odontoblasts
  2. Fibroblasts
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9
Q

What cells are characteristic of pulp?

A

Odontoblasts

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10
Q

What cells are the most common/prevalent cell type in pulp?

A

Fibroblasts

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11
Q

What are the afferent fibers that innervate the pulpal organ?

A

Sensory fibers

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12
Q

In addition to the afferent (sensory) fibers that innervate the dental pulp, there are also ____ fibers

A

Sympathetic

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13
Q

The primary function of the dental pulp is formative, meaning the odontoblasts form ____ (with dental epithelium), and the ameloblasts form _____

A

Odontoblasts- dentin
Ameloblasts- enamel

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14
Q

What are the secondary functions of the dental pulp?

A
  1. supportive
  2. protection
  3. sensation
  4. defense
  5. repair
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15
Q

Label the following image:

A

A: mantle dentin
B: tertiary dentin
C: secondary dentin
D: predentin

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16
Q

What do the arrows indicate in the following image?

A

Odontoblastic layer

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17
Q

Label the following image:

A

A: pulpal horns
B: pulp chamber
C: root canal
D: apical foramen

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18
Q

Fibroblasts arise from:

A

Undifferentiated ectomesenchymal cells

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19
Q

______ arise from undifferentiated ectomesenchymal cells

A

Fibroblasts

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20
Q

Fibroblasts elaborates _____ fibers and ground substance

A

type I & II collagen

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21
Q

Elaborates type I & III collagen fibers and ground substance:

A

Fibroblast

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22
Q

Function in wound healing:

A

Fibroblast

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23
Q

A basic cell in all connective tissue:

A

Fibroblast

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24
Q

Important in pulpal regeneration:

A

Fibroblast

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25
Q

Cell that is unique to the pulp:

A

Odontoblast

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26
Q

Odontoblast are responsible for:

A

Dentinogenesis

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27
Q

Odontoblast produce _____ & ____ which become mineralized

A

Collagen fiber & proteoglycan matrix

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28
Q

Odontoblastic processes extend into:

A

Tubules

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29
Q

What nerve is the principle sensory innervation of both maxillary & mandibular pulp?

A

Trigeminal nerve (branches V2 and V3)

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30
Q

Additional innervation to the pulp may come from the _____ nerve

A

Mylohyoid

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31
Q

Due to pulpal innercvation, and IA block alone may provide:

A

Insufficient anesthesia

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32
Q

Dental pulp is supplied by both _______ & ______

A

Myelinated and non-myelinated axons

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33
Q

____ fibers are classified according to diameter, velocity of conduction and function

A

Myelinated A fibers

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34
Q

Myelinated A fibers are classified according to:

A
  1. diameter
  2. velocity of conduction
  3. function
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34
Q

List the diameters of the following fibers:

  1. A alpha fibers
  2. A beta fibers
  3. A gamma fibers
  4. A delta fibers
A

(micrometers)
1. (12-20)
2. (5-12)
3. (3-6)
4. (1-5)

35
Q

List the velocity of conduction of the following fibers:

  1. A alpha fibers
  2. A beta fibers
  3. A gamma fibers
  4. A delta fibers
A

(m/sec)
1. (70-120)
2. (30-70)
3. (15-30)
4. (6-30)

36
Q

About 90% of myelinated A fibers are:

A

Delta A fibers

37
Q

What is the diameterand conduction of velocity of unmyelinated C fibers?

A

diameter: 0.4-1.00 um

velocity: 0.5-2.0 m/sec

38
Q

-relatively low stimulation threshold
-quicker response

A

A-fibers

39
Q

Pain characteristics of sharp & pricking pain are those of:

A

A-fibers

40
Q

-relatively high stimulation threshold
-slow in onset (late)

A

C-fibers

41
Q

Pain characteristic of dull, aching and more diffuse, less bearable pain are those of:

A

C-fibers

42
Q

Associated with early sharp pain (think ACUTE) maybe RP:

A

A-fibers

43
Q

Associated with dull, diffuse pulpal pain (think chronic damage) IP:

A

C-fibers

44
Q

Label the following image:

A

A: Sclerosis
B: Dead tracts
C: Tertiary dentin by fibroblasts

45
Q

Anything that causes movement of the fluid within the dentinal tubules causes pain in the pulp:

A

Branstromm’s “Hydrodynamic Theory”

46
Q

What theory is accepted as the basis of dentinal sensitivity?

A

Branstromm’s “Hydrodynamic Theory”

47
Q

Common etiologies of pulp irritation include: (4)

A
  1. microbiological
  2. mechanical
  3. chemical
  4. trauma
48
Q

The pulp is amazingly resilient if covered by:

A

atleast .5mm of healthy dentin

49
Q

Reasonable pulpal trauma can be survived if bacteria are:

A

minimized or eliminated

50
Q

Many etiologies of pulpal damage are:

A

Iatrogenic

51
Q

What can be seen in the following image? What is the significance?

A

Pulp polyp (hyperplastic pulpitis)

Doesn’t hurt- can’t heal

52
Q

Trauma to the pulp can be both:

A

External & internal

53
Q

Label the following images:

A

Image 1: Young pulp
A) primary dentin
B) pulp
C) cementum

Image 2: Aged pulp
A) primary dentin
B) pulp
C) secondary dentin
D) cementum

54
Q

Compared to a young pulp, what is additionally present in an aged pulp?

A

Secondary dentin

55
Q

____ dentin reduced the general size of the pulp but retains the general form as the tooth matures

A

Secondary dentin

55
Q

How is secondary dentin arranged/laid down?

A

Uniformely

55
Q

Calcific metamorphis is also known as: (2)

A
  1. pulp sclerosis
  2. dystrophic calcification
56
Q

Probably a combination of secondary and tertiary dentin formation in response to extensive and chronic injuries before the pulp became necrotic:

A

Calcific metamorphis

56
Q

Calcific metamorphis is probably a combination of ______ formation in response to extensive and chronic injuries before the pulp became necrotic (no deposition unless pulp is vital):

A

secondary & tertiary dentin

57
Q

Calcific metamorphis will not occur unless:

A

the pulp is vital

58
Q

Remember: The FUNCTION of ______ is to create tooth

A

odontoblasts

59
Q

The deposition of primary dentin occurs during the:

A

development of the root in a young patient (6-9 years old)

60
Q

May also be called pulp sclerosis or dystrophic calcification:

A

Calcific metamorphis

61
Q

Typically when calcific metamorphis is observed, what should you do as a provider?

A

Refer

62
Q

The #1 cause of pulpal injury is of ____ origin

The #1 threat to health of the dental pulp is:

A

microbiological; dental caries

63
Q

______ exposed pulps of germ free and conventional rats to their own flora. The gnotobiotic rats did not develop pulpal or periradicular lesions.

A

Kakehashi

64
Q

Kakehashi exposed pulps of germ free and conventional rats to their own flora. What was the outcome of the rats?

A

They did not develop pulpal or periradicular lesions

(basically he fucked with the pulp but kept that shit CLEAN, and the mice were okay)

65
Q

Size of bacteria compared to the size of the tubules:

A

Bacteria: 0.2-5 um

Tubules: 50 um

66
Q

List some common portals of access for microbiological irritants: (6)

A
  1. cracked or fractured tooth
  2. cemental defect at DEJ
  3. open dental tubules
  4. perio invasion into apex
  5. pulpal invasion in P/A
  6. lateral or accessory canals
67
Q

One of the most common causes of of microbiological irritants gaining a portal of access into the pulp is:

A

caries/leaking restoration

68
Q

The central goal of RCT obturation is to:

A

Seal ALL portals of access (entry or exit)

69
Q

Most operative procedures are accompanied by significant opportunity for ____ and ____ to the pulp.

A

iatrogenic and irreversible damage

70
Q

Cutting with insufficient coolant causes: (3)

A
  1. aspiration of odontoblasts into tubules
  2. “cooking of the pulp in its own juices”
  3. ultimately “pulpal necrosis”
71
Q

Pulpal necrosis can occur at what temperature (when cutting with insufficient coolant):

A

10 degrees celcius

72
Q

Excessive air drying of exposed dentin:

A

Aspiration

73
Q

List some common mechanical irritants of the pulp: (4)

A
  1. aspiration (air drying excessively)
  2. desiccants (alcohol, chloroform, Cavit, etc.)
  3. polishing
  4. use of laser
74
Q

_____ is deposited over time in the immediate area of the injury by fibroblasts in an attempt to repair, protect or insulate the pulp from further injury

A

Tertiary (Reparative dentin)

75
Q

Tertiary dentin may also be called:

A

Reparative dentin

76
Q

Where is tertiary dentin deposited and by what?

A

In the immediate area of injury; by fibroblasts

77
Q

Tertiary dentin attempts to:

A
  1. repair
  2. protect
  3. insulate
78
Q

When tertiary dentin is deposited, the general form of the pulp is:

A

altered

79
Q

Common causes of external trauma to the pulp include:

A

Falls & sports accidents

80
Q

Common causes of internal trauma to the pulp include:

A

Para-normal habits (bruxism)

81
Q

Application of any irritating or toxic element to the pulp or dentinal tubules may cause:

A

pulpal injury

82
Q

List some examples of irritating or toxic elements commonly used that may cause pulpal injury: (4)

A
  1. direct or indirect pulp cap (CaOH has pH of 12)
  2. Disinfecting agents
  3. Acidic preparations
  4. Composites
83
Q
A

Endodontics (17 decks)

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