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ICP > L5: Dentine-Pulp Complex > Flashcards

L5: Dentine-Pulp Complex Flashcards

1
Q

what common ancestry do dentine and pulp share?

A

dental papilla

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2
Q

what collagen types are present in dentine and pulp?

A

dentine: I
pulp: I, II, V

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3
Q

does peripheral dentine have type IV collagen?

what is type IV collagen?

A

No,

basement membrane

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4
Q

what type of dentinogenesis do existing odontoblast cells stimulate?

A

reactionary dentinogenesis

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5
Q

what type of dentinogenesis requires progenitor cells from the pulpal tissues in order to be stimulated?

A

reparative dentinogenesis

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6
Q

what is mantle dentine?

A

the first layer of dentine

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7
Q

what is mantle dentine layed down by?

A

odontoblasts

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8
Q

when is primary dentine formed?

A

it is formed by odontoblasts during the development of the tooth

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9
Q

when is secondary dentine deposited?

A

slowly throughout the life of the tooth

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10
Q

when is teritary dentine laid down?

A

rapidly on the pulpal aspect when there is occlusal wear/disease

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11
Q

where is dentinal fluid derived from?

A

pulpal extracellular fluid

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12
Q

What is the function of Dentin phosphoprotein (phosphophoryn) in mineralised dentine?

A

Modulates remineralisation

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13
Q

How is dentine and pulp related?

A

They are functionally coupled and integrated as a united tissue

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14
Q

What is the dentine pulp complex?

A

a dynamic tissue that responds mechanical, bacterial and chemical stimuli as a functional unit

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15
Q

Where is the dentine-pulp complex found?

A

in the dentine surrounding the pulp

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16
Q

What happens to the dentinal tubules in dentine closer to the pulp?

A

Number and size of dentinal tubules increases

17
Q

Why do the number of dentinal tubules increase as it moves closer to the pulp?

A

To allow communication between the dentine and pulp via nerves and odontoblast extentions

18
Q

How does tertiary dentine form?

A

Via communication through dentinal tubules by odontoblast processes, afferent nerve terminals and even processes of some immunocompetent cells

19
Q

what is the function of dentinal fluid?

A

supply nutrients and structural materials to dentine via pulpal blood vessels

20
Q

Which part of the tooth initiates an inflammatory response during dental disease?

A

dental pulp

21
Q

what happens to the dental pulp if infection continues to progress?

A

death of dental pulp

22
Q

What is the treatment following the death of dental pulp?

A

Endodontic treatment (pulp removal)

23
Q

What happens to the dentine with pulp removal?

A

Dentine becomes an inert tissue incapable of any response or repair

24
Q

Visually, what happens to the tooth when it becomes non vital?

A

discolouration

25
Q

Mechanically, what happens to the tooth when it becomes non vital?

A

fracture

26
Q

When is reactionary dentine formed?

A

During mild grades of injury, (shallow carious lesions/mild tooth wear related to erosion)
the odontoblasts and other pulpal cells underlying the lesion may well survive, and are stimulated or upregulated to secrete a reactionary type of tertiary dentine

27
Q

What is reactionary dentine?

A

A wound-healing response to reconstruct circumpulpal dentine as a response to injury

28
Q

What is required during reactionary dentine formation?

A

stimulation of existing odontoblast cells

29
Q

What is reparative dentine?

A

The formation of dentine by a new generation of odontoblast-like cells which may consist of a “bridge” formation

30
Q

When is reparative dentine formed?

A

When pulp is exposed, deepening of the carious lesion

31
Q

What is required during reparative dentinogenesis?

A

Reparative dentinogenesis needs recruitment of progenitor cells from the pulpal tissue

32
Q

What happens to the dentinal fluid when cutting burs produce vibrations during endodontic treatment?

A

Causes inward and outward fluid shifts

= A CRISIS for dentin-pulp complex

33
Q

What happens following the fluid movement when cutting burs produce vibrations during endodontic treatment?

A

Barrage of hydrodynamic stimuli across the dentine into the dental pulp resulting in pain for the patient if not anaesthetised

34
Q

What happens to the cells in dentine during endodontic treatment?

A

Displacement of odontoblasts= disruption of their internal cytoskeleton = cell death

35
Q

What happens following cell death of odontoblasts?

A

cells are replaced by new odontoblasts over the next few days

  • If the dentine is sterile and well-sealed, displacement of odontoblasts and their replacement with new cells would cause no pulpal inflammation.
36
Q

list the stages of pulpal inflammation after a cavity prep

A
  1. dentine not sealed well following a cavity prep
  2. microleakage within the restoration
  3. acute pulpal reactions into chronic stage due to MICRO-ORGANISMS and thier products

ICP (20 decks)

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