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121 Histology & Embryology > Pulp > Flashcards

Pulp Flashcards

1
Q

Young pulp

A

Contains high quantities of cells and fine collagen fibrils

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2
Q

Older pulp

A

Opposite of young pulp

May contain calcified structures (pulp stones/ diffuse calcifications)

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3
Q

General characteristics of pulp

A

Limited regenerative capabilites- does contain viable cells

Pulp size decreases w/ age due to continuous dentin formation

Foramen size decreases w/ age due to continuous cementum formation & causes offset position and/or obliteration

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4
Q

Embryonic origin of pulp

A

Ectomesenchyme/mesenchyme- neuroectoderm

Neural crest cells of the head give rise to the dental papilla

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5
Q

Cells that comprise pulp

A 
Fibroblasts
Odontoblasts
Mesenchymal cells
Pericytes/Rouget cells
Dendritic cells
Macrophages
Extravasated WBC's
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6
Q

Fibroblasts

A

Synthesize collagen and amorphous/ground substance

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7
Q

Odontoblasts

A

Synthesize dentin (collagen, ground substance, calcium hydroxyapatite)

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8
Q

Mesenchymal cells

A

Differentiate into collagen, ground substance and calcium hydroxyapatite

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9
Q

Pericytes/Rouget cells

A

Associated w/ capillaries (contractile capabilities)

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10
Q

Dendritic cells

A

Phagocytize antigens, transfer these to macrophages

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11
Q

Macrophages

A

Complete antigen elimination process

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12
Q

Extravasated WBC’s

A

Leukocytes- neutrophils, eosinophils, basophils

Lymphocytes- B-cells, t-cells, NK cells

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13
Q

Intercellular substance in pulp

A

Gelatinous matrix- collagen fibers & some reticular fibers

Ground substance- glycoproteins, proteoglycans, H2O

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14
Q

Formative/Inductive functions of pulp

A

Dentinogenesis- primary, secondary, tertiary dentin (reparative/reactive)

Induces enamel formation and determines type/morphology of the tooth

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15
Q

Nutritive functions of pulp

A

Nourishes odontoblasts and dentin via pulpal blood supply

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16
Q

Sensory functions of pulp

A

Nerve fibers mediate pain (sensory/afferent)

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17
Q

Protective functions of pulp

A

Responds to irritations causing pain (mechanical, thermal, chemical, bacterial)

Pulpal reactions: tertiary dentin formation, inflammatory response—>

Acute= increased leukocytes (PMNs)
Chronic= Increased lymphocytes & plasma cells
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18
Q

Composition of pulp

A 
Cells
Intercellular substance
Tissue fluid (ECF)
Blood vessels
Lymphatic vessels
Nerve tissue
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19
Q

1st Pulp zone/ Odontoblastic layer

A

Peripheral layer- one cell layer- lines pulp chamber/canals

Function: Formative (primary/secondary), protective (tertiary), sensory (pain)

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20
Q

2nd Pulp Zone- Cell Free Zone/Cell Free Layer of Weil

A

Fewer cells
During dentinogenesis, increased # of mesenchymal cells present

Function: sensory & nutritive
Contains: Nerve fibers, capillaries, collagen fibers & ground substance

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21
Q

3rd Pulp Zone- Cell Rich Zone

A

Increased cell content: fibroblasts, mesenchyme cells (migrate through cell free zone)

Decreased # of cells with age

Function: Formative, sensory, nutritive
Contains: Nerve fibrils & capillaries

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22
Q

Nerve and vascular plexus- Deep to cell rich zone

A

Raschkow’s plexus/parietal plexus of nerves

Vascular plexus of blood vessels (capillary network is more extensive during dentinogenesis)

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23
Q

4th Pulp Zone- Pulp Core

A

Bulk of pulp
Function: Formative, sensory, nutritive
Composition: All cells and intercellular substance

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24
Q

Vasculature of pulp

A

Maxillary Artery: Superior (max) and inferior (mand) alveolar arteries

Dental and alveolar arteries supply PDL & pulp. Pulpal BV branch off PDL vessels

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25
Pulpal blood vessels
Coronal pulp: capillary loops form "vascular plexus" | Radicular pulp: Arterioles pass to subodontoblastic region
26
Arteriovenous Anastomoses
Drains the capillary beds in subodontoblastic region and exit by apex
27
Pericytes/Rouget cells
Myofibril in nature, contractile capabilities assist capillaries
28
Where do lymphatics run?
Same course as blood vessels (branch from PDL lymphatic vessels)
29
Which teeth do the submental nodes drain?
Mandibular incisors
30
Which teeth are drained by the superior deep cervical nodes?
Maxillary 3rd molars
31
Which teeth are drained by the submandibular nodes?
All maxillary and mandibular teeth besides the mandibular incisors and maxillary 3rd molars
32
Where does the maxillary division/superior alveolar nerve pass through?
Foramen rotundum
33
What area is targeted by the anterior superior alveolar block?
Incisors and canines
34
What area is targeted by the Middle superior alveolar block?
Premolars and MB root of the maxillary 1st molar
35
What area is targeted by the Posterior superior alveolar block?
DB root and pa;atal root of 1st molars, 2nd and 3rd molars
36
Where does the mandibular division/inferior alveolar nerve pass through?
Foramen Ovale
37
What area does the inferior alveolar block & lingual nerve block target?
All mandibular teeth and lingual gingiva
38
What are does the long buccal/buccal block target?
Posterior buccal gingiva
39
What are does the mental incisive block target?
Mandibular anteriors, premolars and associated buccal gingiva
40
Types of nerves
Sensory | Autonomic
41
Sensory- myelinated
Raschkow's plexus- terminate between the odontoblastic cell bodies; may enter dentin tubules w/ odontoblastic process
42
Autonomic- unmyelinated
Regulate lumen of blood vessels
43
What are dystrophic calcifications?
Diffuse Responsible for calcifications in root canals Diffuse calcifications of collagen fibers surrounding nerve fibers & BV Increase in size with age/ caries, restorations and/or trauma
44
Pulp stones/ Denticles
Calcified bodies, irregular to round shape Vary in size, increased size with age May lodge in or over root canal
45
Structural classifications of denticles
True denticle False denticle
46
What are true denticles?
Rare- found only in RADICULAR pulp Formed by odontoblasts- induced by HERS Contain: dentin tubules, odontoblastic processes and odontoblasts
47
What are false denticles?
Concentric calcifications formed around foci of dead cells or collagen bundles No odontoblasts, odontoblastic processes or dentin tubules
48
Location classifications of denticles
3 types- free, attached and interstitial Found in coronal and radicular pulp (mostly radicular)
49
What are free denticles
Free floating in the pulp
50
WHat are attached denticles
On wall of pulp chambers (dentin) & protrude into pulp chamber
51
What are interstitial denticles
Completely embedded in the wall of the pulp chamber (dentin)
52
Mechanical pulpal irritations
Operative high speed drill
53
Thermal pulpal irritations
Heat produced by operative procedures Hot and cold in general can affect irritated pulp
54
Chemical pulpal irritations
Restorative materials such as zinc phosphate or eugenol -sweet or sour
55
Bacterial pulpal irritations
Caries invasion | Periodontal pocket, involving the apical region
56
Unnatural forces pulpal irritation
Stress fractures in enamel High restorations Changes in air pressure if pulp tissue is inflammed
57
What is focal reversible pulpitis
Earliest form of pulpitis- pulpal hyperemia Localized to pulp of irritated dentin tubules Cause: caries and defective restorations Reversible if treated early Tooth sensitive to cold and biting
58
What is acute pulpitis?
``` Caries that have reached the pulp Extensive acute inflammation PMN's very prominent; pus formation Heat and biting cause pain Notreversible Tx: RCT pulpectomy (permanent) pr pulpotomy (deciduous) ``` Comes at night, goes away in the morning
59
What is chronic pulpitis
``` Symptoms are milder Cause caries- dull ache Little response to thermal change Lymphocytes and plasma cells present Tx: RCT ```
60
What is chronic hyperplastic pulpitis
Deciduous teeth only ``` Chronic pulpal disease Caused by caries Pulp expands out of lesion and bleeds easily Heat causes pain Tx: pulpotomy ```
61
What are periapical abscesses?
Acute or chronic tissue breakdown at apical region Cause: caries and/or trauma Acute: PMN's- very painful Chronic: Lymphocytes & plasma cells- no pain Radiolucent on radiographs
62
Periapical granuloma- caries or trauma
Localized granulation tissue due to infection Tissue contained in a capsule, separates it from bone Tx: RCT and possible apioectomy Apical radiolucency
63
Periapical cysts
True cysts Lined with epithelium- fluid filled Develop from granulomas and associated with cell rests of Malassez (remnants of HERS) Usually asymptomatic
64
Hallmark signs of cellulitis
``` Diffuse inflammation of the deep connective tissue Infection spreads from localized area Severe swelling of face and/or neck Area tissue become hard/rubbery Skin may appear red fever and malaise PMNs prominent ```
65
Serious cellulitis infection
May spread to floor of mouth and close the airway May spread to cavernous sinus of the brain Either may result in death
66
Internal root resorption
Starts within vital pulp tissue Cause: unknown, trauma is suspected Clastic cells (monocytes)- resorb root from inside canal Tx: RCT- if diagnosed early
67
Dental pulp stem cells
Cells derived from embryonic mesenchyme
68
Location of dental pulp stem cells
Most abundant in primary teeth | Fewer in permanent teeth
69
Dental significance of dental pulp stem cells
Signals tissue formation and repair in the dentin-pulp complex

121 Histology & Embryology (15 decks)

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