Pulp

Question 1

Fibres in pulp

Answer 1

Collagen

Oxytalan

Question 2

Components of pulp matrix for elasticity

Answer 2

Proteoglycans
Chondroitin SO4
Dermatan SO4

Question 3

Function of pulp - dentine tubule link

Answer 3

Reg. movement

• nutrients, minerals and mineralising proteins and ions for nerve terminals into tubules
• medications and toxins from bacteria from lesions into pulp

Question 4

Function of tertiary dentine and how placed

Answer 4

Reactionary dentine
- laid by primary odontoblasts in response to mild stimulus

Reparative dentine
- laid by secondary odontoblasts in response to extreme stimulus destroying primary ones

Overall, placed in dentine tubules to protect pulp in reaction to I.e. caries or tooth wear

Question 5

What projected into dentine tubules

Answer 5

Odontoblasts processes 
Nerve terminals 
Immune cells (dendritic)
Sentinel fluid
NO BLOOD

Question 6

Where nerve branches spread in subodontoblastic layer

Answer 6

Rashchow’s plexus

Question 7

Name of mechanism used for sensation of dentine

Answer 7

Hydrodynamic mechanism

Question 8

Describe nerve fibre types of pulp

Answer 8

A(beta) and A(delta) fibres

• hydrodynamic mechanism ( sharp pain )
• myelinated

C fibres

• not hydrodynamic mechanism, more intense stimuli (I.e.caries inflammation) - dull aching pain
• unmyelinated

Question 9

How pulp BV controlled

Answer 9

Sympathetic = vasoconstriction

Afferents (axon reflex) = vasodilator

Question 10

Pattern of dentine tubules closer to the pulp compared to surface?

Answer 10

Closer to pulp = more and wider tubules (more wet)

Question 11

Difference between reversible and irreversible pulpitis

Answer 11

1. Reversible
   - pain to cold or hot
   - hydrodynamic expression (Afibres)
   - no change in blood flow to pulp
   - can be treated and return to health
2. Irreversible
   - spontaneous pain
   - negative to cold and hot
   - increased blood flow
   - needs pulpectomy then RCT or tooth removal
3. Necrotic pulp
   - RCT or extraction

Question 12

Periapical diagnosis possibilities

Answer 12

1. Normal
2. Symptomatic
3. Asymptomatic
4. Acute apical abscesses (spontaneous pain)
5. Chronic apical abscess (little pain if any)
6. Condensing osteitis

Question 13

Pulp sensitivity tests

Answer 13

• electric pulp test
• heat
• cold
• drilling (if restorations makes above impossible)
• even dam tooth then use three in one

Question 14

Factors effecting pulp health

Answer 14

Various pulp exposure
Age (smaller and less of everything with time)
Periodontitis
Previous pulp insult

Question 15

Pulpectomy vs pulpoctomy

Answer 15

Pulpectomy = complete removal
Pulpoptomy = partial removal (only nexrotic tissue) - children and multi rooted