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Operative (week 1) > Pulp Biology (Exam I) > Flashcards

Pulp Biology (Exam I) Flashcards

1
Q

Dental papilla

A
  • AKA dental pulp

- Originates from dental lamina

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2
Q

Describe the sequence of Odontogenesis?

A
  • Dentinogenesis occurs before amelogenesis

- Tooth forms from the inside out

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3
Q

What does the Dental sac form?

A

Forms the alveolar bone and periodontium originates

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4
Q

Dental pulp originates where?

A

Originates from immature mesenchymal tissue

Bell stage; the dental papilla at 10 weeks

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5
Q

Describe Root formation?

A
  • Forms from cervical loop
  • AKA epithelia diaphragm Hertwigs root sheath
  • Dental papilla enclosed by the inner and outer enamel epithelium
  • Inner and outer enamel epithelium join to form the epithelial diaphragm or the cervical loop to form the future cemento-dentinal junction
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6
Q

Describe the Cell rests of Malassez?

A
  • Epithelial root sheath breaks up.
  • Connective tissue of the dental sack contacts dentin and forms cementoblasts and the periodontal ligament.
  • Some epithelial cells remain in the periodontal ligament as cell rests of Malassez.
  • Residual epithelial cells from root sheath can form a lateral periodontal cyst which are typically benign
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7
Q

Describe Lateral and accessory canals

A
  • Two routes of formation
  • Direct contact between pulp and periodontal ligament

-Formed by a break in the root sheath before dentin is formed or a blood vessel traveling between the dental sac and the dental papilla

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8
Q

Accessory canals located in

A
  • Furcation

- Apical 1/3rd

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9
Q

Lateral canals located in

A

Coronal 2/3rd

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10
Q

Lateral and accessory canals contain

A
  • Connective tissue

- NO odontoblasts or pulp tissue

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11
Q

Describe The Apical foramen

A
  • Pulp contacts PDL at apex and is offset .5 to 1 mm.
  • Contains neuromuscular bundle.

-Can be a delta, an apical foramen with several accessory canals.

-In mature tooth, size varies from .3 to.6 mm.
CHANGES because of cementum deposition

Note: Caries is most common pathology resulting in endodontic treatmen

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12
Q

Describe the Histology of the pulp

A
  • Pulp is a form of connective tissue
  • Pulp is in a non-compliant environment
  • It is surrounded by rigid walls of the tooth
  • It cannot swell in response to infection
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13
Q

Cells of the healthy pulp contain what?

A

1) Fibroblasts (MOST COMMON)
2) Mesenchymal Cells
3) Odontoblasts
4) Histocytes
5) Dendritic Cells
6) Lymphocytes

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14
Q

Describe Fibroblasts

A

1) most common cell in the pulp
2) Form type I and III collagen
3) Form ground substance

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15
Q

Describe Odontoblasts

A
  • Form dentin
  • Columnar cells in crown
  • Cuboidal in midroot
  • Squamous at apex
  • Forms dentin, type I collagen
  • Highly specialized
  • Cell body and Tomes Process
  • Odontoblastic process to DEJ
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16
Q

Describe Defense Cells

A

Cells associated w/ a inflammatory response as seen in the pulp as a result of a irritant

17
Q

Describe the Fibers?

A
  • Pulp contains collagen.
  • Type I is in dentin, secreted by the odontoblast
  • **Type I and III secreted by fibroblast and are in pulp.
  • No elastic fibers.
  • Apical region contains most collagen.
18
Q

Describe the Exteracellular Matrix

A
  • Water
  • Glycosaminoglycans
  • Collagen (I, III)
  • Non-Collagenous Proteins
  • Tenascin
  • Fibronectin
  • Substrate adhesion glycoproteins
  • Involved in the attachment, spreading and migration of cells
  • Medium for transport of nutrients and oxygen
19
Q

Describe the Pulpal “ Afferent Sensory “ Nerve Supply

A

A-Delta fibers (pain fibers)

1) Low stimulation threshold
2) Myelinated
3) High conduction velocity
4) Pulp-dentin border
5) Sharp lightening type of pain
* *REVERSIBLE

C fibers

1) High stimulation threshold
2) Non-myelinated
3) Low conduction velocity
4) Distributed thru central pulp
5) Throbbing dull, lingering
* *IRREVERSIBLE PULPITIS

20
Q

Describe the Pulpal “ Efferent Motor” Nerve Supply

A

Smooth muscle of the capillaries
Sympathetic
Parasympathetic?
Nerves extend only 100 to 200 microns into the dentin

21
Q

What are the 3 Theories of dentin sensitivity?

A

1) Direct Innervation
Nerve fibers in tubule

2) Odontoblastic Receptor
Nerves and odontoblasts are close

3) Hydrodynamic
Pulpal fluid movement in tubules triggers nerves
Accepted theory, correct answer for board
*MOST COMMON

22
Q

Describe the Blood supply to the pulp

A

-Internal Maxillary artery:
“Main blood supply of the pulp”

1) Posterior superior alveolar artery
2) Middle superior alveolar artery
3) Anterior superior alveolar artery
4) Inferior alveolar artery
5) Arterioles enter thru apical foramen and lateral canals, course toward crown
6) Most numerous in the subodontoblastic zone

23
Q

Describe the Venus return of the pulp?

A

1) Pterygoid plexus and Internal maxillary vein
2) Veins are larger, not innervated

3) A-V shunts in pulp
- Regulates blood flow
- Defense mechanism for inflammation shunting blood from artery directly to vein bypassing capillary within tooth

4) Exit thru apical foramen and lateral canals
5) Thin walled

6) Blood flow is greater in coronal pulp
Lymphatic vessels are also present in the pulp

24
Q

What are the Functions of the pulp?

A

1) Induction- Produces predentin
Stimulates the initial formation of ameloblasts

2) Formation- Continuously forms secondary dentin
Most important function
Normal physiological process not in response to irritation or injury

3) Nutrition- Dentinal fluid nourishes dentin
4) Defense- Forms reparative dentin
5) Innervation- Innervates dentin

25
Q

What are the Zones of the pulp?

A

Pulp proper- central core of pulp.
Cell rich zone-contain undifferentiated cells and fibroblasts.
Cell free zone -no cells.
Odontoblastic layer-odontoblasts line the predentin.

26
Q

Age changes of pulp?

A
  • Blood vessels and nerve fibers decrease and mineralize.
  • Collagen and reticular fibers form bundles.
  • Diffuse and localized calcification occurs.
  • No correlation between calcification and symptoms.
27
Q

Describe the Pulpal calcifications

A 
-Pulp stones or denticles-Chamber
True- smooth
False- concentric layers
Free- in chamber
Attached- to chamber wall
Embedded- in chamber wall

-Diffuse or linear calcifications- Radicular
Occur along nerves, vessels, or collagen bundles

28
Q

What are the Immune Response to carious exposure ?

A

Small: APCs & random migration of T cells

Large: PMNs & B cell activation

Prolonged: Specific T cells in effector phase to eliminate bacterial elements

29
Q

Do not perform a _______ _______ _________ of a carious exposure

A
  • Direct
  • Pulp
  • Cap
30
Q

What is the cavity prep-inflammation response-reparative dentin?

A

Mechanical:
1) Normal pulp

2)Deep cavity prep
Odontoblasts destroyed
Acute inflammatory response
Cell division in cell rich zone

3) Pulp recovers

31
Q

What are the Pulpal defense mechanisms?

A

1) Vascular reactions

2) Neural reactions

32
Q

Due to low compliance what happens to the pulp?

A
  • Increased pulpal blood flow (determines vitality of the pulp)
  • Increased pulpal tissue pressure
  • Decreased pulpal blood flow
  • Build-up of toxic metabolites
  • Eventual localized necrosis
  • The inflammatory response with vascular permeability, cellular infiltrate and vascular stasis causes a rise in intrapulpal pressure.

-Pulp is encased in rigid walls which causes stasis and microabscess which leads to necrosis

33
Q

What happens during Pulpal Reactions to Insult?

A
  • AV shunting
  • Secondary dentinal mechanisms
  • Reactionary and reparative dentin formation
  • Immune reactions
34
Q

What are the Immune Cells in the Inflamed Pulp?

A

PMN’s
T, B, NK Cells
Plasma Cells (IgG, IgA against microbes in the carious lesion)

Operative (week 1) (6 decks)

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