Test #2 Pulpal pathology Flashcards
What are the pathways of pulpal disease?
- Dentinal Tubules
- Direct pulp exposure
- Caries
- Iatrogenic
- Trauma
What is the most common cause of pulpal disease?
-Caries
T/F Exposed tubules always put pulp at risk
True
When a tooth has trauma what can lead to pulpal disease?
-A crack
T/F Periodontal disease is a two way street
True
Microbes in subgingival biofilms could reach the pulp by the same pathway as what?
-Intracanal microbes reach the periodontium
Pulpal necrosis only occurs if periodontal disease (pocket) reaches the apical foramen due to damaged of what?
-Blood vessels that penetrate the apical foramen
What is anachoresis?
-Microbes transported in blood to areas of tissue damage
Traumatized teeth become infected thru what pathway?
-Anachoresis/chemotaxis
What are three reactions that protect the pulp against caries?
- Decrease dentin permeability
- Tertiary dentin formation
- Inflammatory and immune responses
Pulp is the only connective tissue in the body with the ability to do what?
-Protect itself from certain external irritants
What is the cardinal sign of inflammation?
-Swelling
Increased blood flow leads to what?
- Vasodilation
- Increased capillary pressure
What does vasodilation and increased capillary pressure lead to?
-Increased capillary filtration
What does increased capillary filtration lead to?
-Increased tissue pressure
What does increased tissue pressure result in?
-Pulpal pain
The increased pressure outside the vessels does what?
-Compresses the thin walled venous vessels
THe increased pressure outside the vessels that compress the thin walled venous vessels lead to what?
- Decreased blood flow
- Increased filtration
- Strangulating the pulpal vessels
What does the viscous cycle of response to trauma occur at?
-At site of injury and can remain localized for some time especially if irritant is removed
If injurious irritant is strong and lasting the inflammation will spread where?
-Throughout the pulp from periphery to central to root periapical tissues = pulpal necrosis
What cells are found in the inflammatory process?
- PMN
- Macrophages
- Plasma cells
T/F Mast cells are found in normal/healthy pulps
False
-Are not found
T/F A pulp polyp is common
False
-Rare
What is another name of pulp polyp?
-Chronic hyperplastic pulpitis
What is chronic hyperplastic pulpitis?
- Successive breakdown of pulp stops
- Opening of pulp cavity occurs
Instead of necrosis in a pulp polyp what does the pulp tissue do?
-Proliferates
What type of teeth do chronic hyperplastic pulpitis occur?
-Generally young teeth
T/F Chronic hyperplastic pulpitis is generally symptomatic
False
-Assymptomatic
What does surface epithelium from from?
-Oral epithelial cell implantation
What is pulpal necrosis caused by?
-Bacteria and bacterial products or loss of blood supply
Infectious agents cause what type of necrosis?
-Liquifaction
What does blood loss cause?
-Ischemia/coagulation and necrosis
What causes chemical irritation to the pulp?
- Filings
- Erosion
- Bleaching
What are some thermal irritants to the pulp?
- Uninsulated large fillings
- Drilling
What are some mechanical damages to the pulp?
- Trauma
- Bruxism
- Attrition
- Abrasion
What are some direct irritants to the pulp?
- Bacterial irritation from caries
- Cracked tooth
- Root fractures
