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23 Endodontics > 2 - Physiology of Pulp > Flashcards

2 - Physiology of Pulp Flashcards

1
Q

what are the periradicular tissues

A
  1. cementum
  2. PDL
  3. alveolar bone
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2
Q

where do the pulp and periodontum blend

A

apical foramen and lateral canals

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3
Q

at what site can diseases from the pulp and periodontum start and extend into the other

A

apical foramen and lateral canals

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4
Q

what is a bone like tissue that is the attachment site for PDL fibers

A

cementum

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5
Q

is bone or cementum more resistant to resorption

A

cementum

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6
Q

what type of cementum is in apical 1/2 of root

A

cellular cementum

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7
Q

what type of cementum is in coronal 1/2 of root

A

acellular cementum

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8
Q

what is the narrowest prt of the canal

A

apical cemento-dentinal junction

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9
Q

what is the distance frmo CDJ to opening

A

0.4 mm to 0.5 mm

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10
Q

does the distance of CDJ increase or decrease with age

A

INCREASE

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11
Q

what supports tooth in socket and absorbs forces of mastication an consists of periodontal fibers

A

PDL

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12
Q

what nerves present in PDL

A
  1. sensory nerve fibers
  2. sympathetic nerve fibers
  3. mechanoreceptors (proprioceptive fibers)
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13
Q

is the PDL rich or poor in blood supply

A

RICH

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14
Q

what is the first tissue to be destroyed by endo disease

A

PDL

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15
Q

what is the last tissue to heal

A

PDL

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16
Q

what is the source of pain to percussion/mastication

A

PDL

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17
Q

what is the source of pain to hot and cold

A

pulp

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18
Q

the pulp induces ___ to differentiate and produce dentin

A

odontoblasts

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19
Q

types of dentin

A

primary, secondary, tertiary

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20
Q

what is the first layers of dentin to be depsited as tooth is forming

A

primary dentin

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21
Q

what is the name of the very first layer of primary dentin to be deopsited

A

mantle dentin

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22
Q

secondary dentin is also referred to as what

A

functional dentin

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23
Q

what dentin is deposited throughout life of the tooth as a response to physiological and functional stimulus

A

secondary dentin

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24
Q

what is tertiary dentin also referred to as

A

reparative, irritation, or pathological dentin

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25
Q

which dentin is rapid forming

A

tertiary

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26
Q

which dentin has very few and irregular dentinal ubules with a low mineralized matrix

A

tertiary dentin

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27
Q

can tertiary dentin be incomplete and many times incapable of preventing pulpal disease

A

YES

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28
Q

what are the theories of dentin sensitivity

A
  1. dentin innervation theory
  2. odontoblast receptor
  3. hydrodrynamic theory
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29
Q

what theory:

nerve endings penetrate dentin. direct mechanical stimulation of these nerves will initiate action potential

A

dentin innervation theory

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30
Q

where are nerves confined in dentin

A

inner 1/3rd of dentin

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31
Q

T/F: pain producing substances such as bradykinin fail to induce pain when applied to dentin

A

TRUE

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32
Q

T/F: bathing dentin with local anesthetic solutions prevent pain

A

FALSE! it does no prevent pain!

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33
Q

what theory:

postulates that odontoblasts can transmit mechanical stimulus and transfer it as a signal to a close by nerve ending. thereby turning into a painful stimulus

A

odontoblast receptor theory

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34
Q

do odontoblastic processes extend into dentinal tubules

A

yes

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35
Q

to dentinal tubules extend to DEJ

A

yes

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36
Q

are odontoblast closely associated with nerve terminals

A

yes

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37
Q

what theory:

rapid fluid movement in dentinal tubules results in distortion of nerve endings which will then start an impulse

A

hydrodynamic theory

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38
Q

what theory explains hot, cold, air, and sweets sensitivity

A

hydrodynamic theory

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39
Q

per the hydrodynamic theory, what does heat do to dentinal fluid

A

EXPAND

40
Q

per the hydrodynamic theory, what does cold do to dentinal fluid

A

contract

41
Q

per the hydrodynamic theory, what does sugar to to dentinal fluid

A

move it outward through osmosis

42
Q

per the hydrodynamic theory, what does air do to dentinal fluid

A

move it outwards and can aspirate odontoblasts into dentinal tubules

43
Q

how can denin sensitivity be reduced

A

mineralization of dentinal tubules

44
Q

what are mineralized dentinal tubules called

A

peritubular dentin

45
Q

what can plud up exposed dentinal tubules

A

accumulation of minerals, organic material, fluorides, and sometimes bacteria

46
Q

how do desensitizing toothpastes work

A

occluding dentinal tubules with substances such as strotium fluoride

47
Q

what is pulp tissue that become calcified or mineralized deposits in pulp tissue

A

pulpal calcifications

48
Q

what are pulpal calcifications commonly referred to as

A

pulp stones

49
Q

what are true pulp stones

A

resemble dentin

50
Q

what are false pulp stones

A

concentric rings in amorphous mass of calcified tissue

51
Q

are pulp stones attached or free

A

EITHER

52
Q

are most pulp stones true or false

A

FALSE

53
Q

what is the significance of pulp stones

A

it can get in the way of pulpal treatment

54
Q

do pulp stones occur more in young or old people?

A

occurs in both

55
Q

do pulp stones deal with pain

A

NO! nothing to do with pain!

56
Q

what are linear diffuse calcifications

A

pulp stones

57
Q

what are impediments to endodontics treatment

A

pulp stone

58
Q

what are the different sides of pulpal circulation

A

afferent and efferent

59
Q

what are the pulpal microvasculature

A
  1. arterioles
  2. metarterioles
  3. capillaries
  4. venules
  5. lymph vessels
60
Q

where do afferent blood vessels enter

A

thru apical foramen

61
Q

what do afferent BV branch into

A

smaller meta-arterioles, pre-capillaries and capillaries

62
Q

___ supplies nutrients essential for dentin formation and for cell survival

A

circulation

63
Q

what is the source of dentinal fluid

A

pulp

64
Q

what are the 3 distinct structural layers of arterioles

A
  1. adventitia
  2. muscular layer
  3. endothelial layer
65
Q

what layer of arteriole is CT

A

adventitia

66
Q

what layer of arteriole is responsible for vasoconstriction

A

muscular layer

67
Q

what layer of arteiroles is permeable

A

endothelial layer

68
Q

what are arterioles that become small

A

meta-arterioles

69
Q

what loses their CT layer/adventitia

A

meta-arterioles

70
Q

what vasculature only has an endothelial layer

A

capillaries

71
Q

where does fluid exchange take place

A

capillaries

72
Q

where do nutrients go out of circulation to cells

A

capillaries

73
Q

what collects waste products frmo cells where they go into the efferent part of circulation

A

capillaries

74
Q

what is the extensive branching of capillaries in sub-odontoblastic zone

A

cell free zone

75
Q

what is TCN

A

terminal capillary network

76
Q

are capillaries terminal

A

yeah

77
Q

what is the exit side of pulpal circulation

A

efferent BV

78
Q

what removes waste products

A

efferent BV

79
Q

what are venules and lymphatics part of

A

efferent BV

80
Q

do venules have a muscular layer?

A

no

81
Q

are venules capable of vasoconstriction?

A

no bc no muscular layer

82
Q

___ and ___ constitute the efferent part of pulpal circulation

A

venules and lymphatics

83
Q

is there drainage frmo the pulp into regional lymph nodes

A

no per research

84
Q

what are the neural functions

A
  1. sensory function
  2. vasomotor function (vasoconstriction)
85
Q

sensory pulpal innervation comes from branches of ___ of ___

A

mandibular and maxillary divisions of trigeminal nerve

86
Q

where does sensory pulp innervation ener

A

enter teeth foramina and progress coronaly and peripherally

87
Q

sensory nerves branch extensively adjacent to cell rich zone called

A

plexus of rashkow

88
Q

do nerves gain or lose myeling sheet at cell rich zone

A

lose

89
Q

what are the different sensory nerves

A

a-delta and c fibers

90
Q

what are larger myelinated nerve fibers with faster speed of conduction and low threshold o excitability, located peripherally on the pulp

A

a-delta

91
Q

what is associated with initial momentary sharp pain in response to external stimuli

A

a-delta

92
Q

what are smaller, unmyelinated nerve fibers with slower speed of conduction and a higher threshold of excitability, locaed deeper in the pulp

A

c nerve fibers

93
Q

what is associated with continuous, constant, throbbing pain related to pulpal tissue damage and inflammatory process

A

c nerve fibers

94
Q

do immature teeth have a well developed sensory system

A

no

95
Q

why are young teeth less sensitive than adult teeth

A

because immature teeth do not have a well developed sensory system

23 Endodontics (12 decks)

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