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ABE Oral Board Review > Pulpal and Periapical Anatomy and Physiology > Flashcards

Pulpal and Periapical Anatomy and Physiology Flashcards

1
Q

Results from interactions between ectodermal cells from the first branchial arch and neural crest-derived mesenchymal cells.

A

Odontogenesis (Thesleff)

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2
Q

Dental pulp arises from

A

The dental papilla. Mesenchymal tissue trapped between the inner and outer enamel epithelium (Thesleff).

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3
Q

Vascularization of the pulp precedes

A

innervation (sensory before sympathetic)

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4
Q

Ectodermal tissues

A

Enamel
HERS

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5
Q

Mesenchymal tissues

A

Dentin
Cementum
Pulp
PDL

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6
Q

Dentin composition

A

50% mineral
30% type I collagen
20% water
Kinney et al

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7
Q

Number and diameter of tubules ______ towards the pulp

A

increases

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8
Q

Odontoblastic processes extend into dentinal tubules _____mm

A

0.5
Brannstrom

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9
Q

3 types of dentin

A

Primary, secondary, tertiary
Kuttler

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10
Q

Primary dentin

A

secreted prior to eruption

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11
Q

Secondary dentin forms in response to _____

A

slightly aggressive effects of normal biologic function

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12
Q

Tertiary dentin forms in response to _____

A

more intense pulpal irritants

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13
Q

Reactionary vs reparative dentin

A

Reactionary – from existing odontoblasts
Reparative – from odontoblast-like cells
Mjor

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14
Q

Average of _____um of reparative dentin is formed per day

A

1.49
Reeves and Stanley

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15
Q

Pulp components

A

odontoblasts
fibroblasts
vascular structures
immune cells
nerves
extracellular connective tissue

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16
Q

pulpal collagen type

A

I, III (43%), and V

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17
Q

Predominant GAG in pulp

A

Dermatan sulfate
Linde

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18
Q

myelinated nerve fibers

A

A delta fibers - dentinal stimuli

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19
Q

unmyelinated nerve fibers

A

C fibers - pulpal irritants, release neuropeptides

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20
Q

87% of axons entering the pulp are

A

C fibers

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21
Q

short bursts of sensation

A

A delta

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22
Q

lingering pulpal pain

A

C fibers

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23
Q

Possess toll-like receptor 4 for LPS (respond directly to bacterial byproducts

A

C fibers

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24
Q

__________ adrenergic plexus present within pulp

A

Sympathetic
Pohto and Antila

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25
Q

Most sympathetics within the

A

pulp horns
Avery

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26
Q

_________ (cholinergic) fibers are also present with in the pulp

A

Parasympathetic
Inoue

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27
Q

hydrodynamic theory of dental pain by

A

Brannstrom

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28
Q

hydrodynamic theory states

A

fluid flow within the tubules activates nerve fibers

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29
Q

Direct conduction

A

free nerve endings within the tubules
Frank

30
Q

Transduction

A

gap junctions between odontoblasts within the tubules and nerve fibers
Avery

31
Q

B agonist on the pulp causes

A

Decreased blood flow, arteriol dilation compresses the venules (low compliance environment)
Kim

32
Q

Unique pulpal vascular structures

A

Arteriovenous shunts - Kramer
U-turn loops - Takahashi
cross-fence capillaries - Takahashi
venous-venous anastamoses - Takahashi

33
Q

Location of majority of lymphatics

A

Cell-free zone beneath the odontoblastic layer
Matsumoto

34
Q

Pulp progresses from highly cellular and vascular to _______ with aging

A

Fibrotic
Bernick and Nedelman

35
Q

Which apical foramen diameter changes with aging

A

The major apical foramen (increases)
The minor apical foramen remains constant

36
Q

Root shape predicts ______

A

The number, location, and morphology of the canals
Bjorndal

37
Q

Most famous canal configuration classification system

A

Vertucci

38
Q

Cementodentinal junction (CDJ)

A

minor apical foramen

39
Q

92.4% of major apical foramina open

A

short of the anatomical apex
Burch and Hulen

40
Q

Average distance from the major apical foramen to the anatomical apex

A

0.59mm - Burch and Hulen
0.9mm - El Ayouti (CBCT)

41
Q

Extends from the main canal to the PDL in the root body

A

Lateral Canal - De Deus

42
Q

Extends from the main canal to the PDL in the apical region

A

Secondary Canal - De Deus

43
Q

Derived from a seconday canal, extends toward the PDL in the apical region

A

Accessory Canal - De Deus

44
Q

Most common location for lateral anatomy

A

Apical third
De Deus and Vertucci

45
Q

Anatomical variants

A

Dens invaginatus
Dens evaginatus
C-shaped canal system

46
Q

Infolding of enamel and dentin into the root canal space

A

Dens invaginatus

47
Q

Dens invaginatus location and incidence

A

0.4% - 10% incidence (Hovland and Block)
42% lateral incisors (Rotstein)

48
Q

Dens invaginatus type III

A

Extends to the apex and may have its own apical foramen
Oehlers

49
Q

Out-pouching of enamel and dentin onto the occlusal or lingual surface.

A

Dens evaginatus

50
Q

Dens evaginatus most commonly found associated with

A

premolars

51
Q

_____% of DE contain pulp horns and fracture can lead to pulpal involvement

A

70% Oehlers

52
Q

Large, interconnected pulp tissues spaces usually found within fused roots

A

C-shaped canals

53
Q

_____% of mandibular seconds molars are C-shaped

A

8%
Cooke and Cox

54
Q

Caution when treating C-shaped canals due to

A

Thin canal walls
Gu et al

55
Q

Min et al C-shaped types

A

Continuous C-shaped orifice
C-shaped mesial orifice, separate distal
C-shaped MB-D orifice, separate ML

56
Q

Arterial supply to the dentition

A

aorta
brachicephallic (right side only)
common carotid
external carotid
maxillary artery
PSA, Infraorbital, inferior alveolar

57
Q

Lymph nodes that may become involved in dental infections

A

submandibular
submental
superior deep cervical
inferior deep cervical

58
Q

Sensation to the dentition and motor function to the muscles of mastication arise from the _______

A

Trigeminal nerve (CN V)

59
Q

Sensation to maxillary teeth

A

V2 (maxillary nerve)

60
Q

Sensation to mandibular teeth

A

V3 (mandibular nerve)

61
Q

V2 exits through

A

Foramen rotundum

62
Q

V3 exits through

A

Foramen ovale

63
Q

Primary afferent (A delta and C) cell bodies are located in the

A

trigeminal ganglion

64
Q

Primary afferent fibers synapse at the

A

subnucleus caudalis in the medullary dorsal horn

65
Q

Second order neurons decussate and project to the thalamus via the

A

trigeminothalamic tract

66
Q

Third order neurons travel to the cerebral cortex via the

A

thalamocortical tract

67
Q

Anatomical landmarks to consider during surgery

A

Maxillary sinus
Mental foramen
IAN

68
Q

Mx premolars or molars closer to Mx sinus

A

Molars (2nd molar closest)
Eberhardt

69
Q

IAN is closest to

A

Mn second molar
Kovisto

70
Q

Mental foramen is most often located

A

Between Mn premolar roots
Moiseiwitsch

ABE Oral Board Review (12 decks)

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