The Dentin-Pulp Complex and Its Role in Cariology Flashcards
Largest portion of the tooth structure, extending almost the full length of the tooth
Dentin
The hardness of the dentin is about 1/5 the hardness of the enamel.
True
Both dentin and pulp are derived from where
Mesoderm
The enamel is slightly darker than the dentin
False
Distinct, large-diameter collagen fibrils
von Korff’s fibers
Formed by the elongation and growth of the cervical loop into the dental sac
Hertwig Epithelial Root Sheath (HERS)
Both primary and secondary mineralization occurred and has complete crystalline fusion
Globular dentin
Only primary mineralization occurred in the predentin and the globules do not fuse completely
Interglobular dentin
Hereditary type of dentin of dentin dysplasia where the normal enamel chips off due to lack of support by the abnormal underlying dentin
Dentinogenesis Imperfecta
Most common dentinogenesis imperfecta
Type II
Dentinogenesis imperfecta associated with osteogenesis imperfecta
Type I
Small canals that extend through the entire width of dentin, from the pulp to the DEJ
Dentinal tubules
More mineralized than intertubular dentin
Peritubular dentin
Much more permeable than root dentin
Coronal dentin
When dentin is exposed due to caries, cavity preparation, gingival recession, or attrition
Dentin Hypersensistivity
Odontoblastic processes that crossed the DEJ into the enamel
Enamel spindles
May serve as pain receptors, explaining enamel sensisitivity
Enamel spindles
Incremental lines of bands of dentin apposition similar to the incremental lines of Retzius in enamel
Imbrication lines of von Ebner
Series of dark bands which are adjoining parallel imbrication lines
Contour lines of Owen
Peripheral part of dentin beneath the root’s cementum, adjacent to the dentinocemental junction
Tomes Granular Layer
Unmineralized zone of dentin immediately next to the odontoblasts
Predentin
First predentin that forms and matures near the DEJ
Mantle dentin
Formed before completion of apical foramen and more rapidly.
Primary dentin
Formed after completion of the apical foramen and slower.
Secondary dentin
Formed as a result of localized injury to dentin
Tertiary dentin
Reaction to a long-term, low level acid demineralization in slowly advancing lesions, and can only be formed when the tooth pulp is vital.
Sclerotic dentin
Reaction to a moderate-intensity attack and has severe stimuli that can result in the formation within the pulp chamber of unattached dentin.
Reparative dentin
Reaction to severe, rapidly advancing caries characterized by very high acid levels
Pulpal necrosis
Exposed portion of the reactive sclerotic dentin, resistant to acid attack, hard and darkened
Eburnated dentin
Deepest zone of dentin caries lesions
Zone 1: Hard dentin
Template for remineralization of intertubular dentin
Intact collagen
Inner carious dentin
Zone 2: Firm Dentin
Outer carious dentin
Zone 3: Soft dentin
Intact smooth white lesions of discolored brown/black lesions
Inactive/Arrested caries
Innermost soft, connective tissue of the tooth
Dental pulp
Lines of the outer pulpal wall and consists of odontoblasts and may form secondary dentin
Odontoblastic layer
Contains fewer cells than odontoblastic layer
Cell-free zone
Increased density of cells and more extensive calcular supply
Cell-rich zone
Center of pulp chamber
Pulpal core
Function of the pulp that supplies nutrients and moisture to dentin through the blood vascular supply to the odontoblasts and their processes
Nutritive
Formative/developmental function of the pulp is the production of primary and tertiary dentin by odontoblasts
False
Response to irritation by mechanical, thermal, chemical, or bacterial stimuli
Defensive/reparative
Adult teeth have larger pulp
False
Narrowing of dentinal tubule diameter, deposition of peritubular dentin
Aging
Mineralized masses of dentin either amorphous or complete with dentinal tubules
Denticles
Denticles are formed during tooth development or as a response to microtrauma
True
Symptom-free and normal responsive to pulp testing
Normal pulp
Discomfort is experienced when a stimulus such as cold or sweat is applied and goes away within seconds following removal of stimulus
Reversible pulpitis
Sharp, lingering, and spontaneous pain that may be accentuated by postural changes and OTC analgesics are usually ineffective
Symptomatic Irreversible Pulpitis
Vital inflamed pulp is incapable of healing, trauma, or deep caries that would likely result in exposure
Asymptomatic Irreversible Pulpitis
Death of the pulp and non-responsive to pulp testing
Pulp necrosis
ADA-recommended nonrestorative treatment for cavitated caries lesions that is also topically applied
Silver diamide fluoride
Cutting debris produced and unavoidably compacted into a layer on the cut surface during tooth preparation with rotary instruments
Smear layer
Prevent collagen collapse with excessive air drying
Etched dentin
Prevent pulpal involvement with caries or tooth wear
Pulp protection
Use of copious water coolant during tooth preparation
Thermal medication
Relief of pulpal inflammation, facilitation of dentin bridging
Pulpal medication
Use of bases to provide resistance to thin dentin
Mechanical protection
Removal of the vital coronal pulp and usually done of primary teeth without abscess and spontaneous pain
Pulpotomy
Done on non-vital pulp and is complete removal of the coronal and radicular pulp
Pulpectomy
Complete removal of the pulp with shaping and obturation of the canals
Root canal treatment
Endodontic procedure that aims to either induce a hard tissue barrier in a tooth with open apex or the continued apical development of an incomplete root in teeth with apical periodontitis
Apexification
Vital pulp therapy to encourage continued root development and maturation with normal root thickness
Apexogenesis
Newer methods; allows continued root development in terms of both length and thickness
Revascularization and regeneration
Dentin that is closer to the enamel is harder than dentin closer to the pulp
True
Dentin formation stops when the roots of teeth are already completed
False
Dentinal tubules are larger near the pulp
True
Iatrogenic pulp exposure is less likely in deep carious lesions of young teeth than in aged teeth
False
