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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 toot 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 a tooth consisting of soft tissue that is densely innervated by afferent (sensory) fibers, sympathetic fibers, vascular structures, lymphatics and specialized cells such as odontoblasts (characteristic cells 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 consisting of ____ that is densely innervated by:

A

soft tissue; 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 cells of the 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. support
  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: primary dentin
D: secondary dentin
E: predentin

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16
Q

Label 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

Most prevalent cell in the pulp organ:

A

fibroblast

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21
Q

Fibroblasts elaborates ____ fibers and ground substance

A

type I & III collagen

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22
Q

Elaborates type I & III collagen fibers and ground substance:

A

Fibroblasts

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23
Q

Function in wound healing:

A

fibroblasts

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24
Q

A basic cell in connective tissue:

A

fibroblasts

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25
Q

Important in pulpal regeneration:

A

fibroblasts

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26
Q

Cell unique to the pulp:

A

Odontoblast

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27
Q

Odontoblasts are responsible for:

A

dentinogenesis

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28
Q

Odontoblasts produce ___ and ___ which becomes mineralized

A

collagen fiber & proteoglycan matrix

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29
Q

Odontoblastic processes extend into:

A

tubules

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30
Q

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

A

Trigeminal nerve (branches V2 & V3)

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31
Q

Additional innervation to the pulp may come from the ____ nerve.

A

mylohyoid

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32
Q

Due to the pulpal innervation, an IA block alone may provide:

A

insufficient anesthesia

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33
Q

Dental pulp is supplied by both ___ & ___

A

myelinated and non-myelinated axons

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34
Q

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

A

Myelinated A fibers

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35
Q

Myelinated A fibers are classified according to:

A
  1. diameter
  2. velocity
  3. conduction of function
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36
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)

37
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)
38
Q

About 90% of myelinated A fibers are:

A

Delta A fibers

39
Q

What is the diameter and conduction of velocity of unmyelinated C fibers?

A

diameter: 0.4-1.0 um

velocity: 0.5-2.0 m/sec

40
Q
  • relatively low stimulation threshold
  • quicker response
A

A- fibers

41
Q

Pain characteristics of sharp & pricking are those of:

A

A- fibers

42
Q
  • relative high stimulation threshold
  • slow in onset (late)
A

C-fibers

43
Q

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

A

C-fibers

44
Q

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

A

A-fibers

45
Q

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

A

C-fibers

46
Q

Label this image:

A

A: sclerosis
B: dead tracts
C: tertiary dentin by fibroblasts

47
Q

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

A

Branstromm’s “Hydrodynamic Theory”

48
Q

What theory is accepted as the basis of dentinal sensitivity?

A

Branstromm’s “Hydrodynamic Theory”

49
Q

Common etiologies of pulp irritation include: (4)

A
  1. microbiological
  2. mechanical
  3. chemical
  4. trauma
50
Q

The pulp is amazingly resilient if covered by:

A

at least 0.5mm of healthy dentin

51
Q

Reasonable pulpal trauma can be survived if bacteria are:

A

minimized or eliminated

52
Q

Many etiologies of pulpal damage are:

A

Iatrogenic

53
Q

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

A

Pulp Polyp (hyperplastic pulpitis)

Doesn’t Hurt- can’t heal

54
Q

Trauma to the pulp can be both:

A

external & internal

55
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

56
Q

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

A

secondary dentin

57
Q

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

A

Secondary dentin

58
Q

How is secondary dentin arranged?

A

uniformly

59
Q

Calcific metamorphosis is also known as: (2)

A
  1. Pulp Sclerosis
  2. Dystrophic Calcification
60
Q

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

A

Calcific metamorphosis

61
Q

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

A

secondary & tertiary dentin

62
Q

Calcific Metamorphosis will not occur unless:

A

the pulp is vital

63
Q

Remember: The FUNCTION of ____ is to create tooth

A

odontoblasts

64
Q

The deposition of primary dentin occurs during the:

A

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

65
Q

May also be called pulp sclerosis or dystrophic calcification:

A

calcific metamorphosis

66
Q

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

A

refer

67
Q

The #1 cause of pulpal injury is of ____ origin.

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

A

microbiological

dental caries

68
Q

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

A

Kakehashi

69
Q

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

A

They did not develop pulpal or periradicular lesions

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

70
Q

Size of bacteria compared to the size of tubules:

A

bacteria: 0.2-5um

tubules: 50um

71
Q

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

A
  1. cracked or fractured tooth
  2. cemental defect @ CEJ
  3. open dental tubules
  4. perio invasion into apex
  5. pulpal invasion in P/A
  6. lateral or accessory canals
72
Q

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

A

caries/leaking restoration

73
Q

The central goal of RCT obturation is to:

A

Seal ALL portals of access (entry or exit)

74
Q

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

A

iatrogenic and irreversible damage

75
Q

Cutting with insufficient coolant causes: (3)

A
  1. aspiration of odontoblasts into tubules
  2. “cooking of pulp in its own juices”
  3. ultimately “pulpal necrosis”
76
Q

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

A

10 degrees celcius

77
Q

Excessive air drying of exposed dentin:

A

aspiration

78
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
79
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)

80
Q

Tertiary dentin may also be called:

A

reparative dentin

81
Q

Where is tertiary dentin deposited and by what?

A

in the immediate area of injury, by fibroblasts

82
Q

Tertiary dentin attempts to:

A
  1. repair
  2. protect
  3. insulate
82
Q

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

A

altered

83
Q

Common causes of external trauma to the pulp include:

A

falls & sports accidents

84
Q

Common causes of internal trauma to the pulp include:

A

Para-normal habits (bruxism)

85
Q

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

A

pulpal injury

86
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 a pH of 12)
  2. Disinfecting agents
  3. Acidic preparations
  4. Composites
87
Q
A

Endodontics (19 decks)

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