Ex 1- Pulp Flashcards
1
Q
The dental _____ is the soft connective tissue that supports dentin
A
pulp
2
Q
Pulp is unique as a tooth tissue because it is ______ and NOT _____
A
vascular
NOT calcified
3
Q
The embryonic origin of dental pulp is _________
A
ectoderm: neural crest ectomesenchyme- dental papilla
4
Q
What are the constituents of dental pulp?
A
cells + cellular elements
blood + lymphatic vessels
Extracellular matrix
5
Q
What are the 5 functions of the pulp?
A
Inductive Formative Nutritive Protective Defense/Reparative
6
Q
Pulp provides nutrients like _____ that keeps dentin moist
A
fluid
7
Q
What are the two functions of the protective nature of pulp?
A
sensory barrier (odontoblast junctions, positive pressure)
8
Q
What are the 2 functions of the defensive/reparative nature of pulp?
A
immune
formation of new dentin + pulp
9
Q
______ or lateral foramina can promote the spread of infection
A
accessory
10
Q
The size of the pulp chamber _____ with age b/c of the continuous deposition of dentin throughout life
A
decreases
11
Q
Cells of the pulp _______ with age and EC matrix of the pulp _____ with age
A
decrease
increase
12
Q
Pulp becomes more _______ with age
A
fibrous
13
Q
Pulp is not “normally” calcified but ______ calcifications are common
A
ectopic
14
Q
What are the 2 forms of ectopic calcifications?
A
pulp stones
diffuse calcifications
15
Q
Pulp stones are found in the _______ _______
A
pulp chamber near crown
16
Q
Diffuse calcifications are found near the _____ of the tooth bc calcifications become more diffuse as you move apically
A
root
17
Q
Large + dense pulp stones can be visible _________
A
radiographically
18
Q
What are the two main histologic organizations in the pulp?
A
- -odontogenic zone (where odontoblasts are- surround central core)
- -central core
19
Q
What are the 3 layers of the odontogenic zone?
A
- odontoblast layer
- cell free zone
- cell rich zone
20
Q
_____ are found in the cell rich zone and are the most common cells of the pulp
A
fibroblasts
21
Q
What are found in the pulp core (central core)?
A
fibroblasts
capillaries/arterioles/venules
nerves (perineural sheaths)
22
Q
What are the 5 general cells found in the pulp?
A
odontoblasts fibroblasts immune system cells inflammatory cells stem cells
23
Q
_______ cells are confined to the pulp and secrete ECM
A
Fibroblasts
24
Q
What are the 4 resident immune system cells found in the pulp?
A
macrophage
lymphocytes
eosinophils
dendritic cells
25
What are the 3 inflammatory cells found in the pulp?
plasma cells
mast cells
pmn's
26
_____ cells are the source of replacement odontoblasts or fibroblasts
stem
27
______ cells are found at the pulp dentin border and detect bacterial antigens
dendritic
28
What are the 3 main components of the extracellular matrix of pulp?
1. PG's + Associates (GAGs)
2. Glycoproteins
3. Collagen I + III
29
The main function of the _____ and _______ is matrix for diffusion, collagen fibrillogenesis and water retention
PG's + Associates (GAGs)
30
_______ ______ function of PG's keeps high positive pressure of pulp (keeps dentin wet)
water retention
31
________ function in having a role in cell adhesion (odontoblasts + fibroblasts) to ECM
Glycoproteins
32
_______ ___ & ___ function in giving the extracellular matrix tensile stength
collagen I + III
33
What are some similarities between pulp and dentin?
collagen type I
| PG's present
34
What are some differences between pulp and dentin?
dentin has dentin phosphoprotein
35
_____ cells have a high capacity for self-renewal and are multi-potent (can generate multiple cell types_
stem
36
Stem cells are ______ during development but also _____ in adults
plentiful
| present
37
______ adult stem cells are derived from a list of things including dental _______
multipotent
| dental pulp
38
The extent of _____ (cells ability to develop into many diff types of cells) and ability of stem cells to develop into _____ structures is more than originally thought
plasticity
39
What are the clinical implications of adult stem cells in teeth?
- repair or correction of genetic defects
| - regenerating organs (pulp)
40
Dental pulp stem cells can be induced to form _____, _____, and _____ _____cells in vitro
odontoblasts
adipocytes
glial-like
41
Dentin-like tissue from human dental pulp stem cells were transplanted subcutaneously into immunocompromised mice and ____ ___ complex formed
dentin-pulp
42
Stem cell niches probably present in ______ locations of mature pulp
multiple
43
________ are unique to pulp and are the ____ most numerous cell type in pulp
Odontoblasts
| 2nd
44
What are the functions of odontoblasts?
Dentinogenesis
Nutrients to dentin
Immune
45
Odontoblast processes extend into _____ ______ but not to the DEJ
dentinal tubules
46
Cell bodies of odontoblasts become more ______ toward the root of the tooth
cuboid
47
Odontoblast processes become _____ as you move apically
thinner
48
Odontoblasts contain _______ elements for protein transport and structural integrity. ______ provide protein transport and _____ provide structural integrity
cytoskeletal
microtubules
filaments
49
_____ and _____ junctions btw odontoblasts maintain position and polarity at pulp dentin border
Desmosomes + Adherens junctions
50
_____ junctions btw odontoblasts coordinate dentinogensis (cell communication- allow passage of molecules btw cells)
Gap
51
_____ junctions btw odontoblasts act as a barrier at the pulp dentin border, not allowing larger molecules to pass through (no diffusion)
Tight
52
Functional assays with HRP injections assessed the tight junction barrier at the odontoblast layer and suggested that ______ molecules were able to pass btw adjacent molecules but _____ molecules were unable to pass through at the pulp dentin border
smaller
| larger
53
Cavity preparations _______ the strength of tight junctions so HRP injections were seen within _____ _____
decrease
| dentinal tubules
54
Pulp is _____ vascularized and also has a ______ system
highly
| lymphatic
55
Pulp is distinguished from other tooth tissues because of the presence of ______ and ______ vessels
blood and lymphatic
56
Blood flow in the pulp is under ______ control
neural
57
Sympathetic innervation ______ the blood flow to the pulp and involves alpha-adrenergic receptors (norepinephrine)
constricts (different than rest of body)
58
Parasympathetic innervation _______ the blood flow to the pulp
not really involved in blood flow to the pulp
59
_______ innervation to the pulp results in vasodilation of blood vessels
sensory
60
Lymphatic vessels of the pulp are important in ______. They drain _____ accumulated during inflammation
healing
| proteins
61
Lymphatic vessels in pulp may have a ______ anatomy to overcome challenges associated with encasement in a hard tissue and ______ in the periphery
complex
| branch
62
Tooth pulp is ______ innervated
highly
63
What types of nerve fibers does pulp contain?
A delta
A beta
C
64
__ ______ nerve fibers are sensory pain fibers
A delta
65
___ nerve fibers are sensory pain fibers and sympathetic
C
66
___ _____ nerve fibers are sensory pain fibers and light touch
A beta
67
_____ is the main sensation arising from activating nerve fibers innervating the pulp (and surrounding dentin)
PAIN
68
Innervation beings at the _____ stage
Bell
69
Initiation -> ____ stage -> cap stage -> ____ stage ->dentinogenesis ->______ -> eruption -> mature
bud
bell
amelogenesis
70
Density of innervation _______ until eruption and more slowly until a few years after eruption
increases
71
Are primary and secondary dentition both innervated?
YES
72
Nerves enter the tooth through _____ foramen and terminate in the ____-_____ border zone and _____
apical
pulp-dentin
dentin
73
Odontoblast processes and nerves extend ___/___ of the way into dentin according to the dye I injection experiment
1/3
74
Early in dentinogenesis odontoblastic processes reach _____ dentin and later they _____
outer
| retract
75
Dentinal tubules are most highly innervated in the ____
crown
76
Nerve fibers terminate throughout the ___-_____ border zone
pulp-dentin
77
____plexus is a highly innervated region along the pulp-dentin border
Rashkow's
78
Nerve fibers profusely innervate the _____ -____ border zone
pulp-dentin
79
_____ ______ of dentinal pain accounts for the high sensitivity of the DEJ to exposure and accounts for the varied sensitivity of exposed dentin
Hydrodynamic theory
80
Hydrodynamic theory of dentinal pain says that sensitivity causes ____ movement that _____nerve fiber endings causing action potentials that cause pain
fluid
| stretches
81
Exposed _____ _____ are highly sensitive to pain
dentinal tubules
82
What experiment was used to support the hydrodynamic theory?
premolars destined for extraction were drilled and acid-etched to open the tubules and a tube was sealed into the cavity attached to a saline-filled syringe and manometer and tested positive and negative pressure
83
Both positive and negative pressure produced ______
pain
84
__ ______ and __ ____fibers are hypothesized to be pulp nerve fibers important for dydrodynamic/dentinal pain
A beta
| A delta
85
What is the theory for dentinal pain with the strongest evidence>
hydrodynamic theory
86
Odontoblast receptor theory of dentinal pain is highly ____ but the odontoblast probably functions in other ways to affect dentinal ______
unlikely
| sensitivity
87
_____ in the tubule is due to presence of odontoblast + nerve fiber affects fluid dynamics
Crowding
88
______ -_____ communication is possible- adhesive contacts could cause odonotblasts to "pull on" the nerve fiber
non-synaptic
89
Pain in the pulp can also arise _____ from stimuli in the pulp (hydrodynamic fluid flow NOT required)
directly
90
___ fibers have ___ (transmembrane receptors) receptors for inflammatory and _____ stimuli
C
TRP
thermal
91
______ is activated by many inflammatory mediators
TRPA1
92
Multiple types of nerve fibers + receptors underlie ____ from the tooth interior (pulp + dentin)
pain
93
Dentinal stimuli -> hydrodynamic forces -> A ___ + A ____ fibers --> _____ pain
A beta
A delta
sharp
94
A beta + A delta fibers (stretch sensitive receptors) are found in _______ tubules + most _______ pulp
dentinal
| superficial
95
electric pulp + hot + cold tests for pulp vitality easily activate A ____ fibers
delta
96
Infection or Trauma -> Inflammation (cytokines, prostglandins, brandykinin, inc pressure) -> ___ fibers --> ____ pain
C
| dull pain
97
C fibers are found in ____ only, _____ and ____ layers
pulp
superficial
deep
98
Electric pulp + hot + cold tests for pulp vitality are _____ effective in activating these C fibers
less
99
Tooth nerve sensitivity can change under conditions of _______ .
inflammation
100
Increase of pain receptors can occur during ________
inflammation
101
______ are present in dentinal + pulp sensory nerves
Neuropeptides
102
Neuropeptides are synthesized in the cell body of the ________ ganglion in the PNS (outside the brain)
trigeminal
103
_____ function occurs at the central endings of neuropeptides when peptides bind w/ receptors on brain neurons producing ______
Transmitter
| pain
104
Local regulatory functions occur at _____ endings in the tooth when peptides bind w/ receptors on vasculatrature/ local cells producing _____-_______ effects
peripheral
| pro-inflammatory
105
Sensory (pain) nerves have ____- ______ and _____ funciton
pro-inflammatory
| immune
106
What are the 4 functions of the sensory (pain) nerves?
- Vasodilation (oppose sympathetics)
- Plasma extravastion
- Angiogensis
- Interactions with immune cells
107
Sensory (pain) nerves interact with immune cells by stimulating ______ production by macrophages and ______ effects on immune cell migration
cytokine
| chemotactic
