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D1 Spring - Histopathology > Week 4 - Dental Pulp > Flashcards

Week 4 - Dental Pulp Flashcards

1
Q

What is the cap stage characterized by?

A

Dental papilla development

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2
Q

What is the bell stage characterized by?

A

Primitive pulp

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3
Q

When is capillary development?

A

During the bell stage

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4
Q

What zones make up mature dental pulp?

A

Dentin
Predentin
Odontoblast layer
Cell rich zone
Pulpal core

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5
Q

What cells make up the pulpal core?

A

Dendritic cells

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6
Q

What kind of tissue does dental pulp consist of and what is it derived from?

A

Consists of loose connective tissue derived from neural crest cells

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7
Q

What two compartments is mature dental pulp divided into?

A

Odontogenic zone
Pulpal core

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8
Q

What makes up the odontogenic zone?

A
  • Odontoblast cell layer
  • Cell-free zone of Weil
  • Cell-rich zone
  • Parietal plexus of nerves (Raschkow’s plexus)
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9
Q

What makes up the pulpal core?

A
  • Fibroblasts
  • Type I and III collagen
  • Extracellular matrix
  • Blood vessels
  • Nerve tissue
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10
Q

What are the functions of dental pulp?

A
  • Embryonic induction (stimulates enamel organ)
  • Formative
  • Protective
  • Reparative
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11
Q

What do cell populations in pulpal tissue include?

A
  • Odontoblasts
  • Fibroblasts (MOST AMOUNT)
  • Undifferentiated mesenchymal cells (ready to mature and become whatever)
  • Macrophages
  • Dendritic cells
  • Blood vessel-related cells (e.g., endothelial &
    pericytes)
  • Neural-related cells (e.g., Schwann cells)
  • Lymphocytes (for immune response)
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12
Q

What is extracellular matrix of pulpal tissue made of?

A

Collagen types I, III, IV, and V (via odontoblasts)
- III is most numerous

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13
Q

What are non-collagenous matrix components?

A
  • Proteoglycans
  • Glycosaminoglycans
  • Phosphoproteins
  • Glycoproteins
  • γ- carboxyglutamate-containing proteins
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14
Q

What are examples of γ- carboxyglutamate-containing proteins?

A
  • BMP-2, 4, and 7
  • Fibroblast Growth Factor (FGF)
  • Epidermal Growth Factor (EGF)
  • Dentin Matrix Protein (DMP)
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15
Q

What do γ- carboxyglutamate-containing proteins do?

A

Stimulate growth maturation of ameloblasts and odontoblasts

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16
Q

What nerve axons does pulpal innervation include?

A

Myelinated and nonmyelinated

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17
Q

Where do nerve axons branch?

A

They progressively
branch, passing through the subodontoblastic layer
as the parietal neural plexus (Rashchow’s plexus), on
to the odontoblastic cell layer and some fibers enter
into dentinal tubules.

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18
Q

What are most nerve endings in the pulp for?

A

pain (free nerve
endings as sensory afferents from CNV) with a few concerned with vasodilatation or constriction

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19
Q

What nerve do sensory afferents come from?

A

Trigeminal CNV

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20
Q

What are sensory afferents that the trigeminal nerve brings?

A
  • Pain
  • Mechanical (pressure)
  • Thermal (heat)
  • Tactile (touch)
21
Q

Sympathetic branches from the superior
cervical ganglion are primarily?

A

vasomotor
fibers to pulpal blood vessels, concerned
for the most part, with vasoconstriction

22
Q

The majority of myelinated pulpal nerve axons are

A

A-δ (A-delta):
* Fast conducting
* Diameter in range of 1-6 µm

23
Q

1% of myelinated nerve fibers are classified as

A

A-β
(A-beta) fibers:
* 6-12 µm diameter

24
Q

Nonmyelinated fibers are designated as

A

“C” fibers
and have small diameters, ranging from 0.4 to 1.2 µm

25
Q

A-δ fibers are associated with what kind of pain?

A

Sharp, localized pain

26
Q

“C” fibers are associated with what kind of pain?

A

Dull, diffuse pain

27
Q

Neuropeptides and neurotransmitters identified in
dental pulp include

A

 Calcitonin gene-related peptide (CGRP)
* Vasodilatation, stimulates fibroblast cell division
 Substance P
* Vasodilatation, stimulates fibroblast cell division
 Epinephrine
* Vasoconstrictive via arteriole smooth muscles
 Norepinephrine
* Sympathetic vasoconstrictor
 Dopamine
* Vasoactive or a precursor of epinephrine
 Endorphin
* silencer of nociceptors (silencer of pain)

28
Q

Each nerve fiber of dental pulp contributes to?

A

8 branches to
Raschkow’s plexus

29
Q

Where do most nerve fibers terminate?

A

Most terminate in the
plexus as free, nonmyelinated nerve endings

30
Q

What makes myelin sheath?

A

Schwann cells

31
Q

What location has the highest branching of nerve axons? Lowest?

A

Highest: pulp horns
Lowest: root

32
Q

What is larger - arterioles or venules?

A

Venules

33
Q

Where do terminal capillaries anastomose?

A

Deep to the odontoblastic layer

34
Q

Where are capillary loops dense? less dense?

A

dense in the coronal and pulp horns and significantly less dense in the radicular pulp

35
Q

What capillaries and vessels are found in pulp?

A

Continuous and fenestrated capillaries and lymph vessels are found in pulp

36
Q

What happens to blood vessels in pulp with aging?

A

exhibit changes such as cholesterol plaques (atherosclerosis). If progressive and severe, atherosclerotic plaques can result in pulpal hypoxia due to vessel strangulation

37
Q

What do fenestrated capillaries leak?

A

Serum that becomes a component of the “tissue fluid”

38
Q

What do fenestrated capillaries contribute to?

A

Swelling and edema
due to significant leakage of serum in states of inflammation
- swelling due to more blood to area and leaking to surrounding areas

39
Q

When does a pulpal fibrosis occur?

A

Shrinkage of the pulp
with increasing age or persistent low-grade injury, e.g., multiple restorations in a single tooth, chronic bruxism, repeated
thermal insult, etc.

40
Q

What are diffuse calcifications?

A

Irregular calcified deposits along collagen fiber bundles or within blood vessels resulting from chronic low-grade inflammation

41
Q

What do true pulp stones contain?

A

Dentinal tubules

42
Q

What do false pulp stones feature?

A

concentric layers of
calcified tissue but are void of dentinal tubules

43
Q

What are pulp stones classified as?

A

either free, attached or embedded calcifications
- no pain or issues unless need a root canal

44
Q

What is an abscess?

A

a dense aggregation of
neutrophils and macrophages and other inflammatory
cells within connective tissue undergoing liquefactive
necrosis (tissue is liquified)

45
Q

Due to the inability of pulpal tissue to swell, the
increasing edema and inflammatory cell infiltration
will eventually lead to

A

Pulpal necrosis - clinically by persistent pain and periapical necrosis of the PDL and associated alveolar bone

46
Q

The periapical necrosis is seen on dental radiographs
as

A

a radiolucent area associated with the apex of the involved tooth

47
Q

What is diffuse cellulitis?

A

Could be a result from periapical abscess, the abscess enlarges so much to where it’s involving airways
- spread to muscle and possibly airways

48
Q

What is treatment for periapical abscess?

A

Incision and drainage
Possible root canal

D1 Spring - Histopathology (14 decks)

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