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Oral Histology > The dental pulp > Flashcards

The dental pulp Flashcards

1
Q

What is the soft connective tissue that supports dentin?

A

the dental pulp

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2
Q

T/F. The dental pulp is vascular and calcified.

A

False, the dental pulp is vascular and NOT calcified.

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3
Q

What is the embryonic origin of the dental pulp?

A

ectoderm - neural crest ectomesenchyme-dental papilla

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4
Q

What are the constituents of the dental pulp?

A

cells & cellular elements, blood and lymphatic vessels, extracellular matrix

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5
Q

What are the functions of the pulp?

A

inductive, formative, nutritive, protective (sensory, barrier) and defensive/reparative (immune, formation of new dentin and pulp)

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6
Q

What part of the pulp promotes the spread of infection?

A

accessory/lateral foramina

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7
Q

T/F. As one ages, the pulp chamber increases.

A

False, it decreases.

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8
Q

Over time, the dental pulp ___ its cellularity and ___ its extracellular matrix.

A

decreases; increases

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9
Q

What are the two forms of ectopic calcifications found in the pulp?

A
  1. pulp stones (in the pulp chamber)

2. diffuse calcifications (in the root)

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10
Q

If large and dense, pulp stones can be seen where?

A

radiographs

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11
Q

What are the three layers of the odontogenic zone?

A

odontoblast layer (closest to the predentin)
cell free zone
cell rich zone

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12
Q

Which area in the odontogenic zone has the greatest concentration of fibroblasts?

A

the cell rich zone

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13
Q

The odontoblast layer of the odontogenic ___ contains a single layer of ___ lining the ___-dentin junction.

A

zone; odontoblast; pulp

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14
Q

What structures can be found in the pulp core?

A

capillaries, fibroblasts and nerves

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15
Q

What are the four major types of cells found in the pulp?

A

odontoblasts
fibroblasts
immune system cells
stem cells

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16
Q

Which immune system cells are resident to the pulp?

A

macrophages
lymphocytes
eosinophils
dendritic cells

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17
Q

Which immune system cells are inflammatory?

A

plasma cells
mast cells
polymorphic neutrophils

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18
Q

Which cell type of the pulp is confined to the pulp and secretes the extracellular matrix?

A

fibroblast

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19
Q

What cells are the source of replacement for odontoblasts or fibroblasts?

A

stem cells

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20
Q

What are the components of the ECM of the pulp?

A

proteoglycans (&GAGs)
glycoproteins
collagen

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21
Q

What types of collagen are found in the ECM of the pulp?

A

type I and III

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22
Q

What is the function of the proteoglycans of the ECM?

A

they are involved in collagen fibrillogenesis and water retention

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23
Q

What is the function of the glycoproteins in the ECM?

A

role in cell adhesion to the ECM

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24
Q

What is the function of collagen in the ECM?

A

tensile strength

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25
Q

Which ECM structures are found in both the pulp and dentin?

A

proteoglycans and type I collagen

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26
Q

Which ECM structures are found in the pulp and not the dentin and vice versa?

A

pulp - type III collagen

dentin - DSPP

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27
Q

In vitro, dental pulp cells can be induced to form odontoblasts, ___ and ___ cells.

A

adipocytes; glial-like

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28
Q

What is the 2nd most numerous cell type found in the pulp? 1st?

A

2nd - odontoblasts

1st- fibroblasts

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29
Q

What are the functions of odontoblasts?

A

dentinogenesis, nutrients to dentin, immune

30
Q

What shape are the cell bodies of odontoblasts near the root?

A

more cuboid

31
Q

Odonotoblasts have ___ elements used for protein transport and structural integrity.

A

cytoskeletal

32
Q

___ and ___ junctions between odontoblasts maintain position and polarity.

A

Desmosomes; Adherens

33
Q

What are channels between odontoblast that coordinate dentinogenesis?

A

gap junctions

34
Q

Which type of junction serves as a barrier for odontoblasts?

A

tight junctions

35
Q

What are three examples of tight junctions in odontoblasts?

A

claudin, occludin, and JAM

36
Q

If they are extensive enough, ___ ___ can form a barrier.

A

tight junctions

37
Q

How do cavity preparations affect the cells?

A

it can disrupt the barrier

38
Q

T/F. The dental pulp is highly vascularized but does lacks lymphatics. This distinguishes it from other tooth tissues.

A

False, The dental pulp is highly vascularized AND HAS lymphatics. This distinguishes it from other tooth tissues.

39
Q

Branching of the pulpal vasculature occurs near what area?

A

the odontoblastic zone

40
Q

The ___ system constricts the blood vessels in the pulp when ___ binds to alpha-adrenergic receptors.

A

sympathetic; NE

41
Q

T/F. There is no supply from the parasympathetics to the pulp that causes vasodilation. This is accomplished by sensory input.

A

True.

42
Q

How do the lymphatics play a role in healing of the pulp?

A

it drains proteins that accumulated during inflammation

43
Q

___ vessels in the pulp may have a complex anatomy to overcome challenge associated with encasement in a hard tissue.

A

Lymphatic

44
Q

What type of fibers innervate the pulp?

A

A-delta, C fibers and A-beta

45
Q

Which fiber type is associated with no-touch sensations, included no pain, in other areas of the body?

A

A-beta fibers. They are sensory pain fibers in the pulp

46
Q

What is the main sensation arising from activating nerve fibers innervating the pulp and surrounding dentin?

A

pain

47
Q

Innervation begins at the ___ stage.

A

Bell

48
Q

There is an increase in the density of innervation until when?

A

eruption

49
Q

T/F. Both primary AND secondary dentition is innervated.

A

True.

50
Q

Nerves enter through the ___ ___ and terminate in the ___-___ border zone and ___.

A

apical foramen; pulp-dentin; dentin

51
Q

What lipophilic dye is taken up by nerve processes and can tell you how far it is transported into dentin?

A

Dye I injections (this also stains odontoblasts)

52
Q

Why is Dye I used?

A

It shows how far nerve and odontoblast process extend into dentin

53
Q

T/F. In early dentinogenesis, odontoblast processes reach the outer dentin. Later, they seem to retract.

A

True.

54
Q

Where are dental tubules most highly innervated?

A

the crown

55
Q

In the crown, what is the plexus of nerves that occupies the cell-free zone?

A

Rashkow’s plexus

56
Q

If the nerve fibers don’t extend all the way to the DEJ, why is there high sensitivity to the DEJ when exposed?

A

Fluid movements stretch the nerve fibers and there stretch sensitive endings equate pain. This phenomenon is known as the Hydrodynamic Theory of Dentinal Pain.

57
Q

T/F. The more pressure, the less pain.

A

False, the more pain.

58
Q

What type of nerve fibers play a role in the hydrodynamic dentinal pain theory?

A

A-beta fibers, they have VERY LOW thresholds for mechanical stimulation in other parts of the body.

59
Q

What were the two theories of dentinal pain that have been rejected? Why?

A

Direction stimulation, nerve fibers don’t extend that far

Odontoblast receptor, no functional connection ODB and nerve fibers found

60
Q

How else can odontoblast affect dentinal sensitivity?

A

nerve fibers are found in close proximity to ODB. Crowding affects fluid dynamics and adhesive contacts cause ODB to “pull on” nerve fiber (non-synaptic communication).

61
Q

T/F. Pain can also arise DIRECTLY from stimuli in the pulp.

A

True.

62
Q

Which pulpal fibers have TRP receptors for inflammatory and thermal stimuli?

A

C fibers

63
Q

___ receptor on the nerve fibers of pulp is activated by many inflammatory mediators.

A

TRPA1

64
Q

Dentinal stimuli initiate ___ forces that signal A-___ and A-___ fibers in the dentinal tubules and most superficial pulp to perceive ___ pain.

A

hydrodynamic; beta; delta; sharp

65
Q

Electric pulp and Hot & Cold test for pulp vitality ___ activate A-___ fibers but are less effective in activating ___ fibers.

A

easily; delta; C

66
Q

___ or ___ causes inflammation and ___-fibers found only in the ___ (superificial and deep) are activated and perceive ___ pain.

A

Infection; trauma; C; dull

67
Q

T/F. Expression of pain receptors can increase during inflammation.

A

True.

68
Q

___ are found in dentinal and pulp sensory nerves.

A

Neuropeptides

69
Q

Where are the cell bodies that synthesize neural peptides?

A

trigeminal ganglion

70
Q

T/F. Peptides bind with receptors on brain neurons (cental endings) and lead to pain. Peptides bind with receptors on vascularture/local cells (peripheral endings) and cause pro-inflammatory responses.

A

True.

71
Q

Sensory (pain) nerves promote ___ (opposing sympathetic control), cause plasma ___, angiogenesis and interactions with ___ cells (cytokine production by macrophages, chemotactic cell migration).

A

vasodilation; extravasation; immune

Oral Histology (13 decks)

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