1 (en) Flashcards by Love Dog

Q

connective tissue organ

A

Dental pulp

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Q

Dental pulp Originates from ______ cells with specialized cells
(odontoblasts, arranged _____ in direct contact with dentin matrix)

A

mesenchymal,

arranged peripherally

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Q

The soft tissue component of the tooth

A

Dental pulp

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Q

Connective tissue organ containing a number of structures, including arteries, veins, a lymphatic system, and nerves

A

Dental pulp

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Q

Occupies the Pulp Cavity of the tooth that is entirely surrounded by ___

A

Dentin

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Q

FUNCTIONS OF THE PULP

A

Formative

Protective

Nutritive

Sensory

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Q

Preserving the vitality of all the cellular elements

o Vitality: blood vessels

A

Nutritive

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Q

Perception of stimuli

o From the nerve endings of the pulp

A

Sensory

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Q

Perception of stimuli

o From the nerve endings of the pulp

A

Sensory

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Q

function as a unit

A

Pulp and Dentin

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Q

The ____ create dentin
and in turn, the pulp is protected
by the dentin

A

odontoblasts

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Q

The outermost stratum of cells of the healthy pulp

A

ODONTOBLAST LAYER

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Q

What Surrounds the periphery of the pulp?

A

ODONTOBLAST LAYER

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Q

Immediately subjacent to the predentin

A

ODONTOBLAST LAYER

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Q

ODONTOBLAST LAYER Found are:

A

Cell bodies of odontoblasts Capillaries
Nerve fibers
Dendritic cells

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Q

more numerous, tall, columnar

A. Coronal
B. Mid portion of radicular pulp
C. Near the apical foramen
D. Palisade Appearance
E. Staggered array-nuclei
F. Small Intercellular

A

A

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Q

cuboidal

A. Coronal
B. Mid portion of radicular pulp
C. Near the apical foramen
D. Palisade Appearance
E. Staggered array-nuclei
F. Small Intercellular

A

B

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Q

flattened

A. Coronal
B. Mid portion of radicular pulp
C. Near the apical foramen
D. Palisade Appearance
E. Staggered array-nuclei
F. Small Intercellular

A

C

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Q

fence-like (in the periphery of the pulp)

A. Coronal
B. Mid portion of radicular pulp
C. Near the apical foramen
D. Palisade Appearance
E. Staggered array-nuclei
F. Small Intercellular

A

D

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Q

One actual layer of odontoblasts

Makes the layer appear to be 3-5 cells in thickness

A. Coronal
B. Mid portion of radicular pulp
C. Near the apical foramen
D. Palisade Appearance
E. Staggered array-nuclei
F. Small Intercellular

A

E

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Q

Connected by tight gap junctional complexes=connexin
protein

A. Coronal
B. Mid portion of radicular pulp
C. Near the apical foramen
D. Palisade Appearance
E. Staggered array-nuclei
F. Small Intercellular

A

F

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Q

Permit cell-to-cell interchange and passage of signal
molecules

A. Coronal
B. Mid portion of radicular pulp
C. Near the apical foramen
D. Palisade Appearance
E. Staggered array-nuclei
F. Small Intercellular

A

F

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Q

The presence or absence depends on the functional status of the pulp

o May not be apparent in rapidly dentin forming young
pulps and reparative dentin producing older pulps)

A

CELL-POOR zone / CELL-FREE LAYER OF WEIL

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Q

Traversed by blood capillaries, unmyelinated nerve fibers

A

CELL-POOR zone / CELL-FREE LAYER OF WEIL

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Although called cell-free, contains some o fibroblasts, o mesenchymal cells, o and macrophages.

CELL-POOR zone / CELL-FREE LAYER OF WEIL

Main Constituents of Cell Free Zone:

1. Nerve plexus of Raschkow 2. Ground Substance (unmyelinated nerve) 3. Ground Substance 4. Capillary plexus

Involved neural sensation of the pulp) 1. Nerve plexus of Raschkow 2. Ground Substance (unmyelinated nerve) 3. Ground Substance 4. Capillary plexus

2

Metabolic exchanges and limits the spread of infection Can also be found in the pulp core 1. Nerve plexus of Raschkow 2. Ground Substance (unmyelinated nerve) 3. Ground Substance 4. Capillary plexus

3

Involved in the nutrition of the odontoblasts and the cells of the zone 1. Nerve plexus of Raschkow 2. Ground Substance (unmyelinated nerve) 3. Ground Substance 4. Capillary plexus

4

Located central to the cell-free zone

CELL-RICH ZONE

More prominent in the coronal pulp than in the radicular pulp

CELL-RICH ZONE

Contains more fibroblasts than the rest of the layers; fibroblasts are seen in all the layers but this layer has a higher proportion

CELL-RICH ZONE

Main Components of CELL-RICH ZONE

1. Ground substance 2. Fibroblasts with its products -the collagen fibers, o Contains a relatively high proportion of fibroblasts compared with the more pulp core. 3. Immune cells like macrophages and dendritic cells 4.Undifferentiated mesenchymal stem cells (UDMSTC) and fibroblasts o Can give rise to odontoblast, fibroblast or macrophages

 The central mass of the pulp

PULP PROPER / PULP CORE

Most prominent cell in PULP PROPER / PULP CORE

fibroblast

It consists of: 1. Loose connective tissue (pulp matrix) 2. Larger blood vessels and nerves’ 3. Cells (fibroblast as the most prominent cell in this zone) o Fibroblast is most concentrated in cell rich zone

PULP PROPER / PULP CORE

CELLS OF THE DENTAL PULP (7)

ODONTOBLAST FIBROBLAST (PULP FIBROBLAST) MACROPHAGES DENDRITIC CELLS LYMPHOCYTES MAST CELLS UNDIFFERENTIATED MESENCHYMAL STEM CELLS

Are matrix-producing cells and show characteristic features associated with protein synthesis

ODONTOBLASTS

The most characteristic and specialized fell of the dentin-pulp complex

ODONTOBLASTS

Responsible for: Dentinogenesis

ODONTOBLASTS

Dentinogenesis o both during tooth development and aging o Makes dentin a living responsive tissue

ODONTOBLASTS

The primary function throughout the life of the pulp is the production and deposition of dentin.

ODONTOBLASTS

Represent the link between the dentin and the pulp.

ODONTOBLASTS

Postmitotic cell - once it has fully differentiated, it cannot undergo further cell division ○ Its lifespan coincides with the lifespan of the viable pulp

ODONTOBLAST

Primary Function: Production and Deposition of Dentin - throughout the life of the pulp

Odontoblasts

What are the Matrix-producing cells in Odontoblasts

○ Proteoglycans ○ Collagen Synthesis: Type l&V ○ Dentin Sialoprotein and Phosphophoryn

Occupies most of the space within the tubules ○ Housed within the dentinal tubules)

ODONTOBLAST PROCESS (Tome’s Process)

Cystoplasmic extensions of odontoblasts made up of _____ and ______ - principal ultrastructural components

microtubules, microfilaments

○ Important role in Sensory Transmission ○ fills the space around he odontoblastic process in dentinal tubules

Dentinal Fluid

the predominant cell in the pulp

FIBROBLASTS

Most numerous cell in the pulp and distributed throughout the pulp but particularly abundant in the cell rich zone

FIBROBLASTS

● Appear to be tissue-specific cells capable of giving rise to new cells ● Produce and maintain the matrix proteins of the ECM, ● Synthesizing types, I and Ill collagen, as well as proteoglycans and GAGs.

FIBROBLASTS

Responsible for collagen turnover in the pulp. ○ Has the ability to degrade collagen as well as form it

FIBROBLASTS

Scavenger cells Participate in immune reaction

MACROPHAGES

are accessory cells of the immune system

DENDRETIC CELLS

Termed as antigen-presenting cells

DENDRETIC CELLS

Indicates that the pulp is well equipped with cells required for the initiation of immune responses.

LYMPHOCYTES

Widely distributed in connective tissues, in small groups in relation to blood vessels.

MAST CELLS

Seldom found in the normal pulp tissue, routinely in chronically inflamed pulps

MAST CELLS

Have dramatic role in inflammatory reactions.

MAST CELLS

They resemble fibroblasts ○ They are stellate in shape, with a large nucleus and little cytoplasm ○ If present, usually located around the blood vessel in the cell-rich zone and is difficult to recognize

UNDIFFERENTIATED MESENCHYMAL STEM CELLS (UDMSC*)

Occupies the extracellular and extravascular space Amorphous and gel rather than a solid Major structural component is collagen

INTERSTITIUM

The main constituent of the pulp

THE GROUND SUBSTANCE

Part of the matrix that surrounds and supports the cellular and vascular elements of the pulp.

THE GROUND SUBSTANCE

An amorphous gel-like substance in the extracellular space (Proteoglycans responsible for its consistency)

THE GROUND SUBSTANCE

THE GROUND SUBSTANCE is Composed of ?(3)

proteoglycans, glycoproteins, and water.

Contains all components of the ECM except for fibrous materials such as collagen and elastin.

THE GROUND SUBSTANCE

serves as a transport medium for metabolites and waste products of cells and as a barrier against the spread of bacteria.

THE GROUND SUBSTANCE

● acts as a molecular sieve in regulating the diffusion of substances through the space

THE PULPAL INTERSTIMUM AND THE GROUND SUBSTANCE

Responsible for: ○ the water-holding properties of connective tissues (polyanionic polysaccharides)

THE PULPAL INTERSTIMUM AND THE GROUND SUBSTANCE

the interstitial fluid that fills the dentinal Tubules

Dentinal fluid-

is the hydrostatic pressure in the interstitial fluid surrounding the pulpal cells

Pulpal Tissue Fluid Pressure

increases PTFP to 13mm Hg during inflammatory changes

Reversible changes in the pulp

increases PTFP to 35 mm Hg

Irreversible changes in the pulp

Two Types of Structural Proteins are found in the Pulp:

Collagen Elastin

in Dentin and Pulp A. Type I Collagen B. Type Ill Collagen

A

the major subtypes of collagen in the pulp A. Type I Collagen B. Type Ill Collagen

B

T/f Elastin fibers confined to the walls of arterioles and not part of ECM)

T

The innervation of the pulp includes both (2)

Afferent Sensory neurons Efferent Autonomic neurons

Predominantly myelinated fibers A. Afferent Sensory neurons B. Efferent Autonomic neurons

A

Conduct sensory impulses A. Afferent Sensory neurons B. Efferent Autonomic neurons

A

Unmyelinated fibers A. Afferent Sensory neurons B. Efferent Autonomic neurons

B

Provide vasomotor control to circulation and therefore regulate the blood flow and intrapulpal blood pressure in response to stimuli. A. Afferent Sensory neurons B. Efferent Autonomic neurons

B

Two Types of Sensory Nerve Fibers in the Pulp

1. Myelinated (A fibers) 2. Unmyelinated (C fibers)

both innervate the dentinal tubules, and stimulated by dentinal fluid movement A. Myelinated (A fibers) B. Unmyelinated (C fibers)

A

Sharp, prickling pain A. Myelinated (A fibers) B. Unmyelinated (C fibers)

A

Base or a liner over a filling A. Myelinated (A fibers) B. Unmyelinated (C fibers)

A

Located at pulp proper Dull, burning, aching RCT A. Myelinated (A fibers) B. Unmyelinated (C fibers)

B

nociceptive or pain-sensing A. A-Delta and C fibers B. A-Beta fibers

A

transmit light touch or proprioceptive information A. A-Delta and C fibers B. A-Beta fibers

B

states that any fluid movement in the dentinal tubules and around the odontoblasts as the result of a stimulus excites the nerve endings and produces an impulse.

Hydrodynamic theory

Suggests that dentinal pain associated with stimulation of a Sensitive tooth ultimately involves ______.

mechanotransduction

○ from capillary transudate ○ important role in sensory transmission

Dentinal fluid

T/f In HYDRODYNAMIC THEORY ● cold expands the dentinal fluid ● Cold contracts the dentinal fluid

● Heat expands the dentinal fluid ● Cold contracts the dentinal fluid

What theory? Probing the cut or exposed dentinal surface may deform the tubules and produce fluid movement

HYDRODYNAMIC THEORY

Four possible treatment modalities (Dentin Hypersensitivity)

1. Formation of a smear layer by burnishing 2. Application of agents, such as oxalate compounds, that form insoluble precipitates within the tubules 3. Application of agents such as hydroxyethyl methacrylate (HEMA) with or without glutaraldehyde 4. Application of dentin bonding agents to seal off the tubules.

T/f The rate of oxygen consumption is HIGH in the (relatively sparse cellular composition)

F (The rate of oxygen consumption is LOW in the (relatively sparse cellular composition))

T/f Metabolic activity ○ Lowest during active dentinogenesis than after the crown completion ○ Greatest at Region of the odontoblast layer ○ Lowest at Pulp core

F Metabolic activity ○ Greatest during active dentinogenesis than after the crown completion ○ Greatest at Region of the odontoblast layer ○ Lowest at Pulp core

A shunt type of carbohydrate metabolism

Phosphogluconate

regular tubular dentin formed before eruption A. Primary dentin B. Secondary dentin C. Tertiary Dentin

A

regular circumferential dentin formed after tooth eruption A. Primary dentin B. Secondary dentin C. Tertiary Dentin

B

Irregular dentin that is formed in response to abnormal stimuli A. Primary dentin B. Secondary dentin C. Tertiary Dentin

C

Two types of tertiary dentin are recognized

Reactionary dentin Reparative dentin

formed by primary odontoblasts following a mild stimulus A. Reactionary dentin B. Reparative dentin

A

formed by newly differentiated or secondary odontoblasts A. Reactionary dentin B. Reparative dentin

B

T/f PULPAL CALCIFICATION (pulp stone/ nodules/ denticle) ● a common occurrence= present in at east 50% of all teeth ● cause: largely unknown ○ may be related to age/disease ○ may be found in normal pulp

T

As discrete concentric pulp stone or nodules (denticles) in the ____ pulp And as diffuse calcification in ____ pulp

coronal radicular

T/f Calcifications in the root cancis usually are not seen radiographically

T

T/f Age Changes ● Continued formation of secondary dentin throughout life gradually reduces the size of the pulp chamber and root canals.

T