Dentin Pulp Complex II Flashcards

1
Q

What is the endgame of dentistry?

A

KEEP THE PULP HAPPY

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2
Q

What is the dental pulp?

A

Living, highly cellular core of the tooth

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3
Q

What is the primary cell type of the pulp?

A

Fibroblasts
—Maintain pulp matrix

*Next most numerous are the odontoblasts

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4
Q

The dental pulp arises from>

A

ECTOMESENCHYMAL

—Dental papilla

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5
Q

What does the pulp do>

A

Support the mineralized components of the tooth

Includes:

  • Blood vessels
  • Innervation
  • Fibroblasts
  • Immune cells
  • Progenitor cells for replacement and repair
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6
Q

What are the 4 histological zones of the pulp from outer to inner?

A

OD Layer

Cell FREE Zone of Weil

Cell RICH Zone

Pulp Core

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7
Q

The extracellular matrix of the dental pulp is comprised of 2/3rds what and 1/3rd what?

A

2/3rds - Collagen III

1/3rd - Collagen I

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8
Q

T/F - With age, collagen content increases, and fibrils aggregate into larger bundles, with the greatest concentration apically.

A

TRUE

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9
Q

The ground substance of the pulp is made of what 3 things?

A

Proteoglycans

Glycoproteins

Water

*On a non-mineralized collagen matrix

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10
Q

What are odontoblasts (ODs)?

A

POLARIZED cells

Elongated nucleus at the pulpal side of cell

Secretory components (Golgi bodies)
—Toward the dentinal side
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11
Q

ODs form a layer of cells held together by what?

A

Junctional complexes

ADHERANS JUNCTIONS, NOT ZONULAR

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12
Q

ODs can form gap junctions with what?

A

Pulpal fibroblasts

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13
Q

Fx of ODs?

A

Creation and maintenance of dentin

Supported by the rest of the pulp

Collagen and non-collagenous protein production and secretion

Key growth factors

Vesicular release from the OD process forms peritubular dentin

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14
Q

T/F - Tertiary dentin has NO tubules.

A

TRUE

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15
Q

What do fibroblasts do?

A

Support odontoblasts and help to hold things in place

Produce and maintain the supportive matrix of the pulpal tissue

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16
Q

Where are fibroblasts found?

A

Pulp core and cell rich zone

17
Q

What are the dental pulp progenitor cells?

A

Mesenchymal progenitor cells present in the pulp

They are recruited to form new odontoblast-like cells in response to the dentin
—Involved in reparative dentin formation

18
Q

Tell me about the immune cells in the pulp.

A

Macrophages

IL-1beta, TNFalpha

Dendritic cells

19
Q

What is the vascular supply to the pulp?

A

Arise from external carotid aa and sup/inf alveolar aa

20
Q

T/F - 4-8 arterioles/root access the pulp thru the apical foramen.

A

TRUE

Progression: Arterioles, capillaries, venules

Capillaries present in the cell free zone

21
Q

Tell me about the lymphatic supply to the dental pulp.

A

Drain vascular exudate, and interstitial fluid out of the pulp

  • Lymph flow is equal to arterial interstitial flow
  • Lymphatic vessels have thinner walls, epithelial lining, and thin smooth muscle layer
22
Q

T/F - The pulp is highly innervated by nerve (nociceptive nerve endings).

23
Q

T/F - Nerve fibers branch out thru the coronal pulp, forming the PLEXUS OF RASCHKOW.

24
Q

In the root pulp, are there plexuses of RASCHKOW?

A

No

-Branches of nerve fibers

25
Incoming nerve fibers consist of afferent nerves from the _________, and sympathetic branches from the ______ _______ ________.
Trigeminal Superior cervical ganglion
26
Nerve bundles consist of what 2 types of axons?
Alpha-delta - myelinated C - unmyelinated
27
T/F - Myelination decreases as fibers proceed toward the coronal pulp.
TRUE
28
T/F - Some unmyelinated nerves pass into the tubules and are closely associated with odontoblasts.
TRUE
29
Walk me thru the chart on slide 17.
``` Infection/breakdown of matrix -Vasculature, immune cells, nerves —Progenitor cells —-Fibroblasts —-Odontoblasts ``` Fibroblasts lead to pulp matrix repair Odontoblasts lead to tertiary dentin
30
What are the 3 models of dentin sensitivity?
Direct innervation Odontoblast nociception Tubule fluid conductance
31
What are pulp stones?
Mineralized tissue formed inappropriately in the pulp -True —Tubules and OD-like cells (rare) -False —Atubular mineralized tissue, sometimes with necrotic tissues at the center
32
Why does the pulp recede as we grow older?
Secondary dentin formation | -Reduction in cell number
33
Tell me more about age related changes in pulp.
Decrease in pulp permeability (peritubular occlusion), but more brittle teeth Loss of nerve axons, decrease in sensitivity