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Oral Biology > QUIZ 3 Dentin Pulp Complex II > Flashcards

QUIZ 3 Dentin Pulp Complex II Flashcards

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1
Q

the pulp is intimately connected to and continuous with the ___

A

dentin

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2
Q

the pulp allows the tooth organ to respond to ___

A

external stimuli

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3
Q

the death of the pulp is a critical event in the long term ___ of the tooth

A

mechanical stability

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4
Q

what is the primary cell type of pulp?

A

fibroblasts, followed by odontoblasts

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5
Q

dental pulp arises from the ___, which is ___ tissue

A
  • dental papilla
  • ectomesenchymal
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6
Q

dental pulp provides the support structures for the mineralized components of the tooth. what are the individual support structures?

A
  • blood vessels
  • innervation
  • fibroblasts
  • pool of immune cells
  • pool of progenitor cells for replacement and repair
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7
Q

what are the 4 histological zones of the dental pulp, from outer to inner?

A
  1. odontoblast layer
  2. cell free zone of Weil
  3. cell rich (cell dense zone)
  4. pulp core
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8
Q

label this photo

A
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9
Q

the dental pulp ECM is a ___ matrix, comprised of collagen ___ (mostly) and collagen ___. it also contains numerous noncollagenous ___ and ___.

A
  • soft connective tissue
  • III
  • I
  • proteoglycans
  • glycoproteins
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10
Q

what happens to the dental pulp ECM with age?

A

collagen content increases and fibrils aggregate into larger bundles, with the greatest concentration apically

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11
Q

what composes the ground substance of the pulp?

A
  • proteoglycans (GAG chains)
  • glycoproteins
  • water (physiological fluid)
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12
Q

what are the 5 proteoglycans found in pulp?

A
  • chondroitin-6-sulfate
  • chondroitin-4-sulfate
  • herparin sulfate
  • dermatan sulfate
  • keratan sulfate
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13
Q

label this picture

A
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14
Q

what do proteoglycans in the dental pulp do?

A

pull in water; keep the squidly bits squidgy

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15
Q

what is the key dentin-pulp complex cell type?

A

odontoblasts

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16
Q

describe the odontoblast components and morphology

A
  • polarized cells, elongated nucleus at the pulpal side of the cell, secretory components (golgi bodies) towards the dentinal side
  • larger and more columnar in the crown than the root, where they are more cuboidal
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17
Q

odontoblasts form a discrete layer of cells held together by ___

A
  • junctional complexes
    • adherens junctions, NOT zonular
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18
Q

odontoblasts are held together by junctional complexes, which may give a degree of ___ to the odontoblast layer

A

permeability (serum proteins may pass)

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19
Q

odontoblasts can form ___ with pulpal fibroblasts

A

gap junctions

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20
Q

odontoblasts produce and secrete ___ and ___

A

collagen and non-collagenous protein

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21
Q

odontoblasts are responsible for the production and sequestration of which key growth factors in dentin matrix?

A
  • VEGF
  • TGF beta 1
  • BMP-2
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22
Q

describe aged odontoblasts

A

fewer organelles, less secretory activity, and nucleus is somewhat more central

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23
Q

growth factors can be released via ___ primarily from the odontoblast process

A

secretory vesicles

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24
Q

describe odontoblast turnover

A

assumed to be long lived, but can be replaced from mesenchymal progenitor pool

the process is not understood, key to responsiveness of tooth and capacity for self-repair

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25
Q

there is a role of ___ in dentin matrix in the recruitment of new odontoblasts

A

sequestered growth factors

26
Q

___ are found in the pulp core and the cell rich zone

A

fibroblasts

27
Q

fibroblasts produce and maintain the ___ of the pulpal tissue

A

supportive matrix

28
Q

the pulpal tissue matrix supports what 5 things?

A
  • progenitor cells
  • immune cells
  • vasculature
  • lymph
  • nervous tissue
29
Q

___ may have a role in facilitating mesenchymal progenitor cell recruitment and differentiation

A

fibroblasts

30
Q

what are dental pulp progenitor cells?

A
  • mesenchymal progenitor cells present in dental pulp
  • in response to damage to the dentin, they are recruited to form new odontoblast-like cells
  • involved in reparative dentin formation
31
Q

progenitor cells are recruited as a result of ___ via stimulatory signals, which results in ___ dentin

A
  • trauma
  • reparative
    • some progenitor cells will have to remain so they can continue to be progenitor cells, while others will differentiate and form reparative dentin
32
Q

what immune cells are present in normal healthy pulp?

A

macrophages (innate immunity) and dendritic cells (acquired immunity)

33
Q

what two cell types are prevalent in inflamed/infected pulp?

A

T and B lymphocytes

34
Q

healthy pulp plays a key role in cell ___ and ___. involvement in immune response to ___.

A
  • turnover and clearance
  • infection (TNF alpha, IL-1 beta)
35
Q

___ are antigen presenters to T cells and are found under the odontoblast layer

A

dendritic cells

36
Q

dendritic cells are closely associated with ___ and ___ components of the pulp: coordinated tissue responses

A

neuronal and vascular

37
Q

pulp vasculature arises from which arteries?

A

external carotid arteries, and superior/inferior alveolar arteries

38
Q

there are ___ arterioles per root, which access the pulp through the ___ and spread upwards into the coronal pulp

A
  • 4-8
  • apical foramen
39
Q

younger teeth have ___ vascular access than older teeth

A

better; because they have a larger apical foramen

40
Q

capillary networks are present in which zone? during formation of primary dentin, capillary networks are present in which layer?

A
  • cell free zone
  • present in odontoblast layer
41
Q

what happens as arterioles proceed into the pulp?

A

caliber increases, vessel wall decreases

42
Q

describe vascular supply to the dental pulp

A
  • arterioles to capillaries to venules
  • arterioles branch, anastomose to venules in capillary plexi located in the cell free zone (sub-odontoblast)
  • venules leave via apical foramen, connect to superior and inferior alveolar viens and ultimately internal jugular vein
43
Q

describe lymphatic supply to the dental pulp

A
  • drain vascular exudate, interstitial fluid out of pulp
  • steady state: lymph flow is equal to arterial interstitial flow
  • lymphatic vessels: thinner walls, epithelial lining, and thin smooth muscle layer
44
Q

the dental pulp is highly innervated by nerves which enter through the ___, in close contact with blood vessels (called ___ bundles)

A
  • apical foramen
  • neurovascular
45
Q

nerve fibers enter the pulp chamber through the apical foramen, then branch out through the ___, forming the ___

A
  • coronal pulp
  • plexus of raschkow
46
Q

in root pulp, there are no ___, only branches of nerve fibers

A

plexuses of raschkow

47
Q

in the dental pulp, incoming nerve fibers consist of ___ nerves from the ___, and ___ branches from the ___

A
  • afferent
  • trigeminal
  • sympathetic
  • superior cervical ganglion
48
Q

what are the functions of dental pulp innervation?

A

control blood flow, nociception, immune response

49
Q

describe sensory innervation of dentin

A
  • nerve bundles consist of both myelinated “A delta” and unmyelinated “C” axons
  • myelination decreases as fibers proceed towards the coronal pulp
  • some unmyelinated nerve axons pass into the dentinal tubules and are closely associated with odontoblasts (minority)
  • no clear understanding of the role of these fibers, or how they are organized
50
Q

all cell types of dental pulp function to respond to ___

A

external stimuli

51
Q

vasculature, immune system, and nervous system coordinate the ___ response

A

repair

52
Q

describe the coordination of the repair response

A
53
Q

what are the 3 theories of dentin sensitivity?

A
  1. direct innervation
  2. odontoblast nociception
  3. tubule fluid conductance (hydrodynamic)
54
Q

describe support/combination of support for the proposed models of dentin sensitivity

A
  • there are nerves in some tubules, but a minority
  • odontoblasts are neural crest derived, but anatomically do not synapse extensively with pulpal nerves; gap junctions exist however
  • local anasthetics applied to exposed dentin ineffective, changes in fluid levels can cause sensitivity
55
Q

what are pulp stones?

A

mineralized tissue formed inappropriately in the pulp

56
Q

what is the difference between free and attached pulp stones?

A
  • free
    • more common, surrounded by soft pulp tissue
  • attached
    • bound to dentin, or embedded in secondary dentin
57
Q

what is the difference between true and false pulp stones?

A
  • true
    • contain tubules and are associated with odontoblast-like cells (rare)
  • false
    • consists of atubular mineralized tissue, sometimes with necrotic tissue at the center (more common)
58
Q

pulp stones occur around what?

A

collagen fibers, dead cell aggregates or thrombi

59
Q

pulp stones are more prevalent after what age?

A

50

60
Q

what can happen if pulp stones grow too large?

A

they can compress pulp and make debridement difficult (think about endodontic cases)

61
Q

describe age-related changes in pulp

A
  • recession of the pulp due to secondary dentin formation: reduction in cell number
  • cell aging, reduction in cell response to stimuli
  • decrease in pulp permeability (peritubular occlusion), but more brittle teeth
  • loss of nerve axons, decrease in sensitivity
  • dystrophic calcification in central pulp

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