Lecture 3 (9/5) Flashcards by Abagayle Moody

The primary function of dental pulp is:

formative

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

Branstromm’s Hydrodynamic Theory of Pain

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

secondary dentin

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

caries/leaking restorations

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What is the most common etiology of pulpal inflammation?

microbiological

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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):

pulpal organ

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The pulpal organ is the central mass of tooth consisting of ____ that is densely innervated by:

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

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What are the specialized cells in the pulpal organ?

odontoblasts
fibroblasts

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What cells are characteristic cells of the pulp?

odontoblasts

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

fibroblasts

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What are the afferent fibers that innervate the pulpal organ?

sensory fibers

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

sympathetic

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

odontoblasts- dentin
ameloblasts - enamel

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What are the secondary functions of the dental pulp?

support
protection
sensation
defense
repair

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Label the following image:

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

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Label the following image:

Odontoblastic layer

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Label the following image:

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

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Fibroblasts arise from:

undifferentiated ectomesenchymal cells

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_____ arise from undifferentiated ectomesenchymal cells

fibroblasts

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Most prevalent cell in the pulp organ:

fibroblast

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Fibroblasts elaborates ____ fibers and ground substance

type I & III collagen

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Elaborates type I & III collagen fibers and ground substance:

Fibroblasts

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Function in wound healing:

fibroblasts

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A basic cell in connective tissue:

fibroblasts

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Important in pulpal regeneration:

fibroblasts

Cell unique to the pulp:

Odontoblast

Odontoblasts are responsible for:

dentinogenesis

Odontoblasts produce ___ and ___ which becomes mineralized

collagen fiber & proteoglycan matrix

Odontoblastic processes extend into:

tubules

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

Trigeminal nerve (branches V2 & V3)

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

mylohyoid

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

insufficient anesthesia

Dental pulp is supplied by both ___ & ___

myelinated and non-myelinated axons

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

Myelinated A fibers

Myelinated A fibers are classified according to:

1. diameter 2. velocity 3. conduction of function

List the diameters of the following fibers: 1. A alpha fibers 2. A beta fibers 3. A gamma fibers 4. A delta fibers

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

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

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

About 90% of myelinated A fibers are:

Delta A fibers

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

diameter: 0.4-1.0 um velocity: 0.5-2.0 m/sec

- relatively low stimulation threshold - quicker response

A- fibers

Pain characteristics of sharp & pricking are those of:

A- fibers

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

C-fibers

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

C-fibers

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

A-fibers

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

C-fibers

Label this image:

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

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

Branstromm's "Hydrodynamic Theory"

What theory is accepted as the basis of dentinal sensitivity?

Branstromm's "Hydrodynamic Theory"

Common etiologies of pulp irritation include: (4)

1. microbiological 2. mechanical 3. chemical 4. trauma

The pulp is amazingly resilient if covered by:

at least 0.5mm of healthy dentin

Reasonable pulpal trauma can be survived if bacteria are:

minimized or eliminated

Many etiologies of pulpal damage are:

Iatrogenic

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

Pulp Polyp (hyperplastic pulpitis) Doesn't Hurt- can't heal

Trauma to the pulp can be both:

external & internal

Label the following images:

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

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

secondary dentin

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

Secondary dentin

How is secondary dentin arranged?

uniformly

Calcific metamorphosis is also known as: (2)

1. Pulp Sclerosis 2. Dystrophic Calcification

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

Calcific metamorphosis

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):

secondary & tertiary dentin

Calcific Metamorphosis will not occur unless:

the pulp is vital

Remember: The FUNCTION of ____ is to create tooth

odontoblasts

The deposition of primary dentin occurs during the:

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

May also be called pulp sclerosis or dystrophic calcification:

calcific metamorphosis

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

refer

The #1 cause of pulpal injury is of ____ origin. The #1 threat to health of the dental pulp is:

microbiological dental caries

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

Kakehashi

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

They did not develop pulpal or periradicular lesions (basically he fucked w the pulp but kept that shit CLEAN, and the mice were okay)

Size of bacteria compared to the size of tubules:

bacteria: 0.2-5um tubules: 50um

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

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

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

caries/leaking restoration

The central goal of RCT obturation is to:

Seal ALL portals of access (entry or exit)

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

iatrogenic and irreversible damage

Cutting with insufficient coolant causes: (3)

1. aspiration of odontoblasts into tubules 2. "cooking of pulp in its own juices" 3. ultimately "pulpal necrosis"

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

10 degrees celcius

Excessive air drying of exposed dentin:

aspiration

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

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

______ 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

Tertiary (Reparative dentin)

Tertiary dentin may also be called:

reparative dentin

Where is tertiary dentin deposited and by what?

in the immediate area of injury, by fibroblasts

Tertiary dentin attempts to:

1. repair 2. protect 3. insulate

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

altered

Common causes of external trauma to the pulp include:

falls & sports accidents

Common causes of internal trauma to the pulp include:

Para-normal habits (bruxism)

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

pulpal injury

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

1. Direct or indirect pulp cap (CaOH has a pH of 12) 2. Disinfecting agents 3. Acidic preparations 4. Composites