2 - Physiology of Pulp

Question 1

what are the periradicular tissues

Answer 1

1. cementum
2. PDL
3. alveolar bone

Question 2

where do the pulp and periodontum blend

Answer 2

apical foramen and lateral canals

Question 3

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

Answer 3

apical foramen and lateral canals

Question 4

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

Answer 4

cementum

Question 5

is bone or cementum more resistant to resorption

Answer 5

cementum

Question 6

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

Answer 6

cellular cementum

Question 7

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

Answer 7

acellular cementum

Question 8

what is the narrowest prt of the canal

Answer 8

apical cemento-dentinal junction

Question 9

what is the distance frmo CDJ to opening

Answer 9

0.4 mm to 0.5 mm

Question 10

does the distance of CDJ increase or decrease with age

Answer 10

INCREASE

Question 11

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

Answer 11

PDL

Question 12

what nerves present in PDL

Answer 12

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

Question 13

is the PDL rich or poor in blood supply

Answer 13

RICH

Question 14

what is the first tissue to be destroyed by endo disease

Answer 14

PDL

Question 15

what is the last tissue to heal

Answer 15

PDL

Question 16

what is the source of pain to percussion/mastication

Answer 16

PDL

Question 17

what is the source of pain to hot and cold

Answer 17

pulp

Question 18

the pulp induces ___ to differentiate and produce dentin

Answer 18

odontoblasts

Question 19

types of dentin

Answer 19

primary, secondary, tertiary

Question 20

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

Answer 20

primary dentin

Question 21

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

Answer 21

mantle dentin

Question 22

secondary dentin is also referred to as what

Answer 22

functional dentin

Question 23

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

Answer 23

secondary dentin

Question 24

what is tertiary dentin also referred to as

Answer 24

reparative, irritation, or pathological dentin

Question 25

which dentin is rapid forming

Answer 25

tertiary

Question 26

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

Answer 26

tertiary dentin

Question 27

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

Answer 27

YES

Question 28

what are the theories of dentin sensitivity

Answer 28

1. dentin innervation theory 2. odontoblast receptor 3. hydrodrynamic theory

Question 29

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

Answer 29

dentin innervation theory

Question 30

where are nerves confined in dentin

Answer 30

inner 1/3rd of dentin

Question 31

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

Answer 31

TRUE

Question 32

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

Answer 32

FALSE! it does no prevent pain!

Question 33

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

Answer 33

odontoblast receptor theory

Question 34

do odontoblastic processes extend into dentinal tubules

Answer 34

yes

Question 35

to dentinal tubules extend to DEJ

Answer 35

yes

Question 36

are odontoblast closely associated with nerve terminals

Answer 36

yes

Question 37

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

Answer 37

hydrodynamic theory

Question 38

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

Answer 38

hydrodynamic theory

Question 39

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

Answer 39

EXPAND

Question 40

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

Answer 40

contract

Question 41

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

Answer 41

move it outward through osmosis

Question 42

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

Answer 42

move it outwards and can aspirate odontoblasts into dentinal tubules

Question 43

how can denin sensitivity be reduced

Answer 43

mineralization of dentinal tubules

Question 44

what are mineralized dentinal tubules called

Answer 44

peritubular dentin

Question 45

what can plud up exposed dentinal tubules

Answer 45

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

Question 46

how do desensitizing toothpastes work

Answer 46

occluding dentinal tubules with substances such as strotium fluoride

Question 47

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

Answer 47

pulpal calcifications

Question 48

what are pulpal calcifications commonly referred to as

Answer 48

pulp stones

Question 49

what are true pulp stones

Answer 49

resemble dentin

Question 50

what are false pulp stones

Answer 50

concentric rings in amorphous mass of calcified tissue

Question 51

are pulp stones attached or free

Answer 51

EITHER

Question 52

are most pulp stones true or false

Answer 52

FALSE

Question 53

what is the significance of pulp stones

Answer 53

it can get in the way of pulpal treatment

Question 54

do pulp stones occur more in young or old people?

Answer 54

occurs in both

Question 55

do pulp stones deal with pain

Answer 55

NO! nothing to do with pain!

Question 56

what are linear diffuse calcifications

Answer 56

pulp stones

Question 57

what are impediments to endodontics treatment

Answer 57

pulp stone

Question 58

what are the different sides of pulpal circulation

Answer 58

afferent and efferent

Question 59

what are the pulpal microvasculature

Answer 59

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

Question 60

where do afferent blood vessels enter

Answer 60

thru apical foramen

Question 61

what do afferent BV branch into

Answer 61

smaller meta-arterioles, pre-capillaries and capillaries

Question 62

___ supplies nutrients essential for dentin formation and for cell survival

Answer 62

circulation

Question 63

what is the source of dentinal fluid

Answer 63

pulp

Question 64

what are the 3 distinct structural layers of arterioles

Answer 64

1. adventitia 2. muscular layer 3. endothelial layer

Question 65

what layer of arteriole is CT

Answer 65

adventitia

Question 66

what layer of arteriole is responsible for vasoconstriction

Answer 66

muscular layer

Question 67

what layer of arteiroles is permeable

Answer 67

endothelial layer

Question 68

what are arterioles that become small

Answer 68

meta-arterioles

Question 69

what loses their CT layer/adventitia

Answer 69

meta-arterioles

Question 70

what vasculature only has an endothelial layer

Answer 70

capillaries

Question 71

where does fluid exchange take place

Answer 71

capillaries

Question 72

where do nutrients go out of circulation to cells

Answer 72

capillaries

Question 73

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

Answer 73

capillaries

Question 74

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

Answer 74

cell free zone

Question 75

what is TCN

Answer 75

terminal capillary network

Question 76

are capillaries terminal

Answer 76

yeah

Question 77

what is the exit side of pulpal circulation

Answer 77

efferent BV

Question 78

what removes waste products

Answer 78

efferent BV

Question 79

what are venules and lymphatics part of

Answer 79

efferent BV

Question 80

do venules have a muscular layer?

Answer 80

no

Question 81

are venules capable of vasoconstriction?

Answer 81

no bc no muscular layer

Question 82

___ and ___ constitute the efferent part of pulpal circulation

Answer 82

venules and lymphatics

Question 83

is there drainage frmo the pulp into regional lymph nodes

Answer 83

no per research

Question 84

what are the neural functions

Answer 84

1. sensory function 2. vasomotor function (vasoconstriction)

Question 85

sensory pulpal innervation comes from branches of ___ of ___

Answer 85

mandibular and maxillary divisions of trigeminal nerve

Question 86

where does sensory pulp innervation ener

Answer 86

enter teeth foramina and progress coronaly and peripherally

Question 87

sensory nerves branch extensively adjacent to cell rich zone called

Answer 87

plexus of rashkow

Question 88

do nerves gain or lose myeling sheet at cell rich zone

Answer 88

lose

Question 89

what are the different sensory nerves

Answer 89

a-delta and c fibers

Question 90

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

Answer 90

a-delta

Question 91

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

Answer 91

a-delta

Question 92

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

Answer 92

c nerve fibers

Question 93

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

Answer 93

c nerve fibers

Question 94

do immature teeth have a well developed sensory system

Answer 94

no

Question 95

why are young teeth less sensitive than adult teeth

Answer 95

because immature teeth do not have a well developed sensory system