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Histopathology > Dental Pulp > Flashcards

Dental Pulp Flashcards

1
Q

What layers does the dental pulp have?

A

pulpal core
cell rich zone
odontoblast layer
(predentin?)

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2
Q

What are the layers of the odontogenic zone of dental pulp?

A
  • Odontoblast cell layer
  • Cell-free zone of Weil
  • Cell-rich zone
  • Parietal plexus of nerves (Raschkow’s plexus)
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3
Q

What is in the pulpal core?

A
  • Fibroblasts
  • Type I and III collagen
  • Extracellular matrix
  • Blood vessels
  • Nerve tissue
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4
Q

What is the dental pulp derived from?

A

neural crest cells

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5
Q

What is the main component of dental pulp?

A

loose connective tissue

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6
Q

What are the four functions of dental pulp?

A
  • Embryonic induction
  • Formative
  • Protective
  • Reparative
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7
Q

What are the cells of the pulpal tissue?

A
  • fibroblasts (most)
  • odontoblasts
  • undifferentiated mesenchymal cells
  • macrophages/dendritic cells (8%)
  • blood vessel related cells (pericytes, endothelial, etc.)
  • neural related cells (schwann, etc.)
  • lymphocytes
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8
Q

What are the collagen types in dental pulp?

A

Type III (most)
Type I, IV, V

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9
Q

What are the non-collagenous matrix components of dental pulp?

A
  • Proteoglycans
  • Glycosaminoglycans
  • Phosphoproteins
  • Glycoproteins
  • γ- carboxyglutamate-containing proteins
  • BMP-2, 4, and 7
  • Fibroblast Growth Factor (FGF)
  • Epidermal Growth Factor (EGF)
  • Dentin Matrix Protein (DMP)
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10
Q

Does pulp have myelinated or nonmyelinated nerve axons?

A

both!

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11
Q

Most nerve endings in the pulp are for…

A

pain

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12
Q

Nerves of the pulp progressively branch and then follow what path?

A
  • pass through the subodontoblastic layer as the parietal neural plexus (Rashchow’s plexus)
  • then into the odontoblastic cell layer and some fibers enter into dentinal tubules.
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13
Q

What cranial nerve are the sensory afferents of the dental pulp from?

A

trigeminal (CN V)

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14
Q

What are the sensory afferents in dental pulp?

A

pain
mechanical
thermal
tactile

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15
Q

Sympathetic branches from the superior cervical ganglion are primarily ________ fibers to pulpal blood vessels.

A

vasomotor

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16
Q

Sympathetic branches from superior cervical ganglion do what to blood vessels?

A

vasoconstriction (mostly)

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17
Q

What ganglion are the sympathetic branches to the dental pulp from?

A

superior cervical ganglion

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18
Q

The majority of myelinated pulpal nerve axons are…

A

A-δ (A-delta)

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19
Q

What are A-δ (A-delta) nerves?

A

fast conducting
diameter (1-6 um)

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20
Q

1% of myelinated nerve fibers are classified as…

A

A-β (A-beta) fibers
6-12 um diameter

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21
Q

Nonmyelinated fibers are designated as…

A

“C” fibers

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22
Q

What are “C” fibers?

A

small diameters (0.4-1.2 um)
slower

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23
Q

What fibers are associated with sharp, localized pain?

A

A-δ (A-delta)

24
Q

What fibers are associated with dull, diffuse pain?

A

“C” fibers

25
Q

What are the neuropeptides/neurotransmitters in dental pulp?

A
  • Calcitonin gene-related peptide (CGRP)
  • Substance P
  • Epinephrine
  • Norepinephrine
    -Dopamine
  • Endorphin
26
Q

What does substance P do in dental pulp?

A

Vasodilatation, stimulates fibroblast cell division

27
Q

What does calcitonin gene-related peptide (CGRP) do in dental pulp?

A

Vasodilatation, stimulates fibroblast cell division

28
Q

What does epinephrine do in dental pulp?

A

Vasoconstrictive via arteriole smooth muscles

29
Q

What does norephinephrine do in dental pulp?

A

Sympathetic vasoconstrictor

30
Q

What does dopamine do in dental pulp?

A

Vasoactive or a precursor of epinephrine

31
Q

What does endorphin do in dental pulp?

A

silencer of nociceptors (silencer of pain)

32
Q

Each fiber contributes at least __ branches to Raschkow’s plexus.

A

8

33
Q
A
34
Q

Does the distribution of nerve axons in intratubular predentin increase or decrease from pulp horns down to the root?

A

decrease
- pulp horns = 27%
- remaining crown = 14%
- root = 11%

35
Q

Does the distribution of nerve axons in intratubular dentin increase or decrease from predentin to dentin up to 100 um?

A

decrease
ex: in pulp horns
predentin = 27%
mineralizing front = 11%
dentin up to 100 um = 8%

36
Q

Do venules or arterioles have a bigger diameter?

A

venules (100 um to 150 um)
arterioles (50 um to 100 um)

37
Q

Terminal capillaries anastomose deep to what layer of dental pulp?

A

odontoblastic layer

38
Q

Capillary loops are dense in the _________________ and significantly less dense in the radicular pulp

A

coronal and pulp horns

39
Q

What type of capillaries are found in the pulp?

A

Continuous and fenestrated capillaries

40
Q

If progressive and severe, atherosclerotic plaques can result in _________________ due to vessel strangulation.

A

pulpal hypoxia

41
Q

What can fenestrated capillaries leaking serum cause?

A

swelling and edema that can lead to inflammation

42
Q

When does pulpal fibrosis occur?

A

increasing age or persistent
low-grade injury, e.g., multiple
restorations in a single tooth,
chronic bruxism, repeated
thermal insult

43
Q

What is pulpal fibrosis?

A

shrinkage of the pulp

44
Q

What are diffuse calcifications?

A

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

45
Q

What are pulp stones (denticles)?

A
  • True pulp stones contain dentinal tubules
  • False pulp stones feature concentric layers of calcified tissue but are void of dentinal tubules
46
Q
A

fenestrated capillaries

47
Q
A

pulpal fibrosis

48
Q
A

diffuse calcifications

49
Q
A

False pulp stones (false denticles)

50
Q
A

True pulp stones
- can be attached, embedded, or free (yellow arrow)

51
Q
A

Pulp stones

52
Q

What is a pulpal abscess?

A

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

53
Q

What does edema, inflammatin, and pulpal necrosis lead to clinically?

A

persistent pain and periapical necrosis of the PDL and associated alveolar bone

54
Q
A

necrotic pulp (box) with periaprical abscess (arrow)

55
Q
A

diffuse cellulitis

56
Q
A

I and D (incision and drainage) of periapical abscess

Histopathology (13 decks)

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