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DMD 5241 > Pulp and Periodontum (complete) > Flashcards

Pulp and Periodontum (complete) Flashcards

1
Q

What kind of cell creates enamel

A

Ameloblasts

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2
Q

What kind of cell creates dentin

A

Odontoblasts

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3
Q

What percentage of enamel becomes mineralized

A

98%

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4
Q

What is the structure of dentin similar to

A

it is similar to a bundle of straws. it has tubes that pass all the way through it. from the dentinoenamel junction to the pulp

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5
Q

What can be found in the tubes of the dentin

A

Nerve Endings

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6
Q

What is the periodontal ligament

A

lots of ligaments that hold the tooth to the alveolar bone

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7
Q

What is the layer of the tooth that the periodontal ligament attaches to

A

the cementum

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8
Q

What is the surface of the dentinoenamel junction like

A

Very rigid with projections all over it ^^^^^^^^^.

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9
Q

Why is the dentinoenamel junction rigidy like this ^^^^^^

A

it increases surface area, and that allows it to hold the dentin and enamel tightly together

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10
Q

What is the DEJ

A

the dentino enamel junction

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11
Q

What is the CEJ

A

The cementoenamel junction

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12
Q

What is the CDJ

A

the cementodental junction

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13
Q

What can be found in the pulp chamber

A
  1. Blood vessels
  2. Lymph vessels
  3. Nerves
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14
Q

What is an abscess tooth

A

a tooth that has had infection in it, but because the tooth is rigid, the swelling from the infection has no option but to push out of the apex of the tooth and form a pool of infection in the surrounding bone at the apical end of the root

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15
Q

What is the dental pulp

A

the loose connective tissue found inside the tooth

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16
Q

What is the function of the dental pulp

A

to form and support the dentin

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17
Q

What initiates the formation of enamel

A

the odontoblasts

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18
Q

how do odontoblasts initiate the formation of enamel

A

at the basal membrane they interact with dental epithelium and signal it to start creating enamel

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19
Q

What are the only kind of nerve fibers in the tooth

A

Autonomic (sympathetic) nerve fibers

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20
Q

What kind of neural receptors or sensory neurons are found in the pulp

A

Nociceptors (pain sensing neurons)

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21
Q

What do nociceptors do?

A

They only send pain signals when stimulated

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22
Q

Are nociceptors in the dentin as well as in the pulp

A

yes, nociceptors are in both

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23
Q

Does the pulp chamber respond to external stimuli

A

yes, the nerves in the pulp chamber and in the dentin will respond to external stimuli

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24
Q

Can dentin be reformed?

A

Yes it can

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25
Q

How is dentin reformed

A

new odontoblasts are differentiated, and those form the new dentin

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26
Q

How many of the components of the immune system can be found in the tooth

A

All components of the immune system

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27
Q

What is endodontics

A

a dental specialty that involves the diagnosis and treatment of diseases of the pulp and periapical tissues

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28
Q

What is the goal of endodontics

A

the prevention of treatment of apical periodontitis

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29
Q

What are the 5 signs of inflammation

A
  1. swelling
  2. heat
  3. redness
  4. loss of function
  5. pain
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30
Q

What happens to the pulp chamber with age

A

It shrinks

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31
Q

What causes the pulp chamber to become smaller as we get older

A

the continued growth of dentin down into the pulp chamber

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32
Q

At what point in embryonic development do the teeth begin to form

A

the 6th week

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33
Q

Does the lack of formation of a primary tooth have any indication of potential lack of the succedaneous permanent tooth

A

yes, if you are missing the primary tooth there is a good chance you will also be missing the permanent tooth

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34
Q

What are the three stages of tooth development

A
  1. BUD
  2. CAP
  3. BELL
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35
Q

What is the IEE/IDE

A

the inner enamel epithelium

of the internal dental epithelium

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36
Q

What is the Inner enamel epithelium

A

(in the bell stage of tooth development)
It forms the internal/inferior border of the bell shape between the invagining Dental papilla and the Stellate reticulum. It marks where the dentinoenamel junction will eventually be

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37
Q

What is the Outer enamel epithelium

A

(in the bell stage of tooth development)
it forms the outer/superior border of the bell shape, and holds the stellate reticulum in place. It will eventually form the outermost layer of enamel on the crown of the tooth

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38
Q

What is the stellate reticulum

A

The liquid goo that the body of the enamel comes from

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39
Q

What is the dental papilla

A

The invagination into the bell shape of the forming tooth. This will become the PULP TISSUE

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40
Q

What builds cemetum

A

cementoblasts

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41
Q

True or false the dentin is lined with cementum

A

True

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42
Q

What is the enamel organ (dental organ)

A

The bell shaped downward growth

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43
Q

from what germ layer does the enamel organ come

A

the Ectoderm

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44
Q

What is responsible for amelogenesis

A

the enamel organ (dental Organ)

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45
Q

What is amelogenesis

A

the creation of enamel

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46
Q

From what type of cells does the dental papilla (dental pulp) come

A

It comes from neural crest cells and mesenchyme cells

it is ectomesenchymal in nature

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47
Q

Where are the ameloblasts and odontoblasts that begin to lay down tooth material at the basal lamina from

A

the Ameloblasts are from the IEE/IDE

The odontoblasts are from the outermost layer of the dental papillae

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48
Q

What is going on with theIDE and ameloblasts at the late cap stage

A

the IDE has differentiated into Ameloblasts but no enamel has been laid down

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49
Q

What is going on with the dental papilla and the odontoblasts at the late cap stage

A

The outer layer of the dental papilla hasn’t differentiated into odontoblasts yet

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50
Q

What happens in the bell stage with the dental papilla and the odontoblasts

A

after the outermost cells of the dental papilla have differentiated into odontoblasts. they begin to lay down dentin in the bell stage (before enamel gets laid down)

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51
Q

What are the steps that lead to the beginning of the laying down of the dentin and the enamel

A
  1. cells of the IDE/IEE signal to the preodontoblasts
  2. That causes the odontoblasts to begin dentin formation
  3. cells from the IDE/IEE respond to signas from the odontoblasts and begin to deposit enamel
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52
Q

What comes first, the dentin or the enamel

A

the dentin

53
Q

What happens to the ameloblasts as they mature

A
  1. they become long and columnar

2. they eventually lose their nucleus

54
Q

What happens to the odontoblasts as they mature

A
  1. They have the majority of the cell (with the nucleus) towards the apical end of the developing tooth, with a small rod like extension toward the basal lamina
  2. They keep their nucleus
55
Q

What is the direction in which all teeth form

A

all teeth form from crown to root

56
Q

What is the cervical loop

A
  1. The place where the IDE/IEE and ODE/OEE meet.

2. the most apical point of the bell shaped thing

57
Q

In which direction is the dentin being deposited

A

in an apical direction

58
Q

how quickly does dentin get deposited

A

4.5 um per day

59
Q

What is the first layer of dentin deposited called

A

primary dentin (it makes up the mantel dentin)

60
Q

What is predentin

A

the most internal layer of dentin that remains unmineralized

61
Q

What are the percentages of the components of mature dentin by weight

A

70% inorganic material (calcium hydroxyapetite)
20% organic material (type I collagen)
10% water

62
Q

What is the significance of the cervical loop

A
  1. it is the end of the anatomical crown

2. it is the place where root formation begins

63
Q

What is HERS

A

Hertwig’s Epithelial root sheath

64
Q

What makes up HERS

A

the combination of the IDE/IEE and ODE/OEE becoming fused and proliferating apically

65
Q

What does HERS do

A
  1. signals for the differentiation of odontoblasts

2. Acts as a template for the root

66
Q

Is cell proliferation genetically determined

A

yes

67
Q

What causes the formation of multiple roots

A

opposing segments of HERS proliferating both horizontally and vertically

68
Q

What is the epithelial diaphragm

A

toward the apex of the root HERS segments move horizontally (where they move horizontally is the epithelial diaphragm)

69
Q

What is the Hyaline Layer of HERS

A

The innermost cells of the HERS

70
Q

what does the Hyaline layer of HERS do

A

it secretes hyaline over the new dentin, and help bind cementum to the dentin

71
Q

Where do the cementoblast cells around the root come from

A

they form when the HERS cells fragment, and allow CELLS of the dental follicle to contact the dentin.
Those CELLS differentiate into cementoblasts

72
Q

What is the purpose of the cementum

A

it achors the PDL to hold the tooth in the socket

73
Q

What are the epithelial cell rests of Malassez

A

They are the cell remnants of HERS that remain in close proximity to the root

74
Q

What is the significance of the epithelial cell rests of Malassez

A

Inflammation can cause these cells to form cysts

75
Q

When is root formation usually complete

A

approximately 3 years post eruption

76
Q

How does the root lengthen

A

The tooth itself moves toward the surface, while the root grows downward

77
Q

What causes the formation of multiple roots

A

it is guided by HERS
lateral extensions of HERS meet in the middle of the forming root, then they join together in the middle and cause a bifurcation which guides the root to form multiple roots

78
Q

What are the parts of the root canal system or pulp (from incisal/occlusal to apical)

A
  1. Pulp Horns
  2. Pulp Chamber
  3. Root canal Orifice
  4. Root Canal
  5. Apical foramen
79
Q

What are Pulp horns

A

vertical extension out of the pulp chamber

80
Q

What is the pulp chamber

A

the largest opening in the pulp, defined by anywhere above the root canal orifices

81
Q

What is the root canal orifice

A

the openings of the root canal into the pulp chamber

82
Q

What is the root canal

A

The long tubes in the pulp that run from the pulp chamber to the apical foramen

83
Q

What are lateral/accessory canals

A

Channels of communication between the pulp and the PDL. excluding the apical foramen

84
Q

How do lateral/accessory canals form

A

they form when a localized area of HERS is fragmented

85
Q

How does the apical foramen become formed

A
  1. HERS continues to extend to a predetermined length
  2. HERS moves laterally and encloses more pulp
  3. Once all different portions of hers have converged until they have nearly met. the space left between them in the apical foramen
86
Q

What enters through the apical foramen

A
  1. blood vessels
  2. Nerves
  3. Lymph vessels
87
Q

Where is the apical foramen located during the process of root formation? and where is it located when root formation is complete

A
  1. During the root formation process it is located at the end of the anatomical root
  2. When root formation is complete (3 yrs post eruption) the apical foramen is slightly more coronal than before (due to cementum formation)
88
Q

What happens to the apical foramen from when it is first formed to when the root is finished

A
  1. it becomes smaller

2. it has moved slightly coronal

89
Q

What causes the apical formation to move coronal and become smaller as the root formation process is finished

A

The addition of cementum to the root of the tooth and into the apical foramen

90
Q

Is there a difference between the anatomic/radiographic apex and the apical foramen

A

Yep, the anatomic/radiographic apex is more apical than the apical foramen

91
Q

Why is it important to know that the anatomic/ radiographic apex is different from the apical foramen

A

When performing a root canal, the tooth must be filled to the apical foramen, and not further to the anatomic/radiographic apex. if it is filled all the way to the anatomic/radiographic apex it will fail.

92
Q

What causes the anatomic/radiographic apex to be different from the apical foramen

A

the addition of cementum into the apical end of the tooth. as it is added it pinches off the root, and makes the opening smaller.

93
Q

How far into the apical end of the root is cementum added

A

just up to the apical foramen

94
Q

Are Periodontal ligaments attached to the apical end of the root.

A

yes, they are attached up until the apical foramen, or anywhere that there is cementum

95
Q

How is the CDJ important near the apex of the tooth

A

where the CDJ comes to the interior surface of the tooth is where apical constriction is at its greatest, or the location of the apical foramen

96
Q

What ends and what begins at the apical foramen

A

The pulp ends and the PDL begins

97
Q

how do the hyaline layer interact with the cementum

A

the cementum is laid over the hyaline layer, and that hyaline layer binds the cementum to the dentin

98
Q

What are sharpeys fibers

A

they are the part of the PDL that is imbedded into the Cementum

99
Q

What are the two things that the PDL is directly bound to

A
  1. Cementum on the tooth side

2. Lamina Dura on the bone side

100
Q

What is the lamina Dura

A

Very dense bone at the edge of the alveolar socket to which the PDL attaches

101
Q

What are the types of CEJs and what are the percentages of their frequency

A
  1. 60% - the cementum overlaps the enamel
  2. 30% - the cementum and enamel are edge to edge
  3. 10% - the enamel and cementum don’t quite meet up
102
Q

Does the thickness of cementum around the tooth vary from coronal to apical end of the root

A

yes, the cementum layer is thicker toward the apical end of the tooth than it is toward the coronal end of the root

103
Q

What are the types of Dentin

A
  1. primary
  2. secondary
  3. tertiarty
104
Q

What is the primary dentin

A

It is the first layer of dentin laid down, usually there when you are born. This includes the mantle dentin

105
Q

What is the mantle dentin

A

the most coronal portion of the dentin that is very dense.

106
Q

What is the secondary dentin

A

as you age, more dentin is added to the inside of the tooth. This dentin is secondary dentin

107
Q

does the secondary dentin maintain tubular continuity with the primary dentin?

A

yep

108
Q

What does it mean that secondary dentin maintains tubular continuity with the primary dentin

A

that the tubes through the primary dentin are continued through the secondary dentin into the pulp

109
Q

What is teritiary dentin

A

its less organized irregular dentin

110
Q

Does the tertiary dentin maintain tubular continuity with the secondary dentin

A

some times it does, sometimes it doesn’t. it depends on the type of tertiary dentin

111
Q

What are the types of tertiary dentin

A
  1. reactionary

2. reparative

112
Q

What is the difference between reactionary and reparative tertiary dentin

A
  1. reactionary tertiary dentin is added by the original odontoblasts, and is there for tubular
  2. Reparative tertiary dentin is added by new odontoblasts, and is therefor atubular
113
Q

What are the different types of cells in the dental pulp

A
  1. odontoblasts
  2. dental pulp stem cells
  3. fibroblasts
  4. dendritic and antigen presenting cells
114
Q

where are the odontoblasts in the dental pulp

A

they are on the outer surface of the dental pulp

115
Q

How do the odontoblasts in the dental pulp differ from the coronal to apical end of the tooth

A

they are more numerous and larger in the coronal pulp than they are in the cervical and mid root of the pulp

116
Q

What happens to the odontoblasts of the dental pulp

A
  1. some apoptose
  2. some die and are replaced by stem cells
  3. some live and continue to build dentin
117
Q

What do dental pulp stem cells do

A

they differentiate into new odontoblasts

118
Q

What do the fibroblasts of the dental pulp do

A

They produce collagen and ground substance

119
Q

What is the most common cell type in the dental pulp

A

fibroblasts

120
Q

can fibroblasts in the dental pulp be replaced

A

yes, by less differentiated cells

121
Q

what do the dendritic and antigen presenting cells do in the dental pulp

A

They are cells of the immune system

122
Q

What is the inner most layer of dentin like

A

it is predentin, which means that it is not yet mineralized

123
Q

What is the difference between intertubular dentin and peritubular dentin

A
  1. intertubular dentin is all of the dentin between the tubules, and peritubular dentin is the dentin directly around the tubules
  2. Intertubular dentin has more collagen fibrils than peritubular dentin
  3. Peritubular dentin is harder than intertubular dentin
124
Q

How does the exterior (near enamel or cementum) end of the dentin tubules compare to the interior (near pulp) end of the dentin tubules

A

the ends of the tubules near the enamel are much smaller in diameter than the end of the tubules near the pulp.

125
Q

What are pulp stones

A

calcification or creation of stones in the pulp

126
Q

When are pulp stones most common

A

in aged, chronically inflamed, or traumatized pulp

127
Q

what is the largest blood vessel that enters the apical foramen

A

the arteriole

128
Q

Where does the innervation of the tooth come from

A

the 2nd and 3rd divisions of the trigeminal nerve

129
Q

Are the nerves in the tooth myelinated or unmyelinated

A

both

DMD 5241 (10 decks)

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