Week 4 - Dental Pulp Flashcards

(48 cards)

1
Q

What is the cap stage characterized by?

A

Dental papilla development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the bell stage characterized by?

A

Primitive pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is capillary development?

A

During the bell stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What zones make up mature dental pulp?

A

Dentin
Predentin
Odontoblast layer
Cell rich zone
Pulpal core

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What cells make up the pulpal core?

A

Dendritic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What kind of tissue does dental pulp consist of and what is it derived from?

A

Consists of loose connective tissue derived from neural crest cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What two compartments is mature dental pulp divided into?

A

Odontogenic zone
Pulpal core

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What makes up the odontogenic zone?

A
  • Odontoblast cell layer
  • Cell-free zone of Weil
  • Cell-rich zone
  • Parietal plexus of nerves (Raschkow’s plexus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What makes up the pulpal core?

A
  • Fibroblasts
  • Type I and III collagen
  • Extracellular matrix
  • Blood vessels
  • Nerve tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the functions of dental pulp?

A
  • Embryonic induction (stimulates enamel organ)
  • Formative
  • Protective
  • Reparative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do cell populations in pulpal tissue include?

A
  • Odontoblasts
  • Fibroblasts (MOST AMOUNT)
  • Undifferentiated mesenchymal cells (ready to mature and become whatever)
  • Macrophages
  • Dendritic cells
  • Blood vessel-related cells (e.g., endothelial &
    pericytes)
  • Neural-related cells (e.g., Schwann cells)
  • Lymphocytes (for immune response)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is extracellular matrix of pulpal tissue made of?

A

Collagen types I, III, IV, and V (via odontoblasts)
- III is most numerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are non-collagenous matrix components?

A
  • Proteoglycans
  • Glycosaminoglycans
  • Phosphoproteins
  • Glycoproteins
  • γ- carboxyglutamate-containing proteins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are examples of γ- carboxyglutamate-containing proteins?

A
  • BMP-2, 4, and 7
  • Fibroblast Growth Factor (FGF)
  • Epidermal Growth Factor (EGF)
  • Dentin Matrix Protein (DMP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do γ- carboxyglutamate-containing proteins do?

A

Stimulate growth maturation of ameloblasts and odontoblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What nerve axons does pulpal innervation include?

A

Myelinated and nonmyelinated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where do nerve axons branch?

A

They progressively
branch, passing through the subodontoblastic layer
as the parietal neural plexus (Rashchow’s plexus), on
to the odontoblastic cell layer and some fibers enter
into dentinal tubules.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are most nerve endings in the pulp for?

A

pain (free nerve
endings as sensory afferents from CNV) with a few concerned with vasodilatation or constriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What nerve do sensory afferents come from?

A

Trigeminal CNV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are sensory afferents that the trigeminal nerve brings?

A
  • Pain
  • Mechanical (pressure)
  • Thermal (heat)
  • Tactile (touch)
21
Q

Sympathetic branches from the superior
cervical ganglion are primarily?

A

vasomotor
fibers to pulpal blood vessels, concerned
for the most part, with vasoconstriction

22
Q

The majority of myelinated pulpal nerve axons are

A

A-δ (A-delta):
* Fast conducting
* Diameter in range of 1-6 µm

23
Q

1% of myelinated nerve fibers are classified as

A

A-β
(A-beta) fibers:
* 6-12 µm diameter

24
Q

Nonmyelinated fibers are designated as

A

“C” fibers
and have small diameters, ranging from 0.4 to 1.2 µm

25
A-δ fibers are associated with what kind of pain?
Sharp, localized pain
26
“C” fibers are associated with what kind of pain?
Dull, diffuse pain
27
Neuropeptides and neurotransmitters identified in dental pulp include
 Calcitonin gene-related peptide (CGRP) * Vasodilatation, stimulates fibroblast cell division  Substance P * Vasodilatation, stimulates fibroblast cell division  Epinephrine * Vasoconstrictive via arteriole smooth muscles  Norepinephrine * Sympathetic vasoconstrictor  Dopamine * Vasoactive or a precursor of epinephrine  Endorphin * silencer of nociceptors (silencer of pain)
28
Each nerve fiber of dental pulp contributes to?
8 branches to Raschkow’s plexus
29
Where do most nerve fibers terminate?
Most terminate in the plexus as free, nonmyelinated nerve endings
30
What makes myelin sheath?
Schwann cells
31
What location has the highest branching of nerve axons? Lowest?
Highest: pulp horns Lowest: root
32
What is larger - arterioles or venules?
Venules
33
Where do terminal capillaries anastomose?
Deep to the odontoblastic layer
34
Where are capillary loops dense? less dense?
dense in the coronal and pulp horns and significantly less dense in the radicular pulp
35
What capillaries and vessels are found in pulp?
Continuous and fenestrated capillaries and lymph vessels are found in pulp
36
What happens to blood vessels in pulp with aging?
exhibit changes such as cholesterol plaques (atherosclerosis). If progressive and severe, atherosclerotic plaques can result in pulpal hypoxia due to vessel strangulation
37
What do fenestrated capillaries leak?
Serum that becomes a component of the "tissue fluid"
38
What do fenestrated capillaries contribute to?
Swelling and edema due to significant leakage of serum in states of inflammation - swelling due to more blood to area and leaking to surrounding areas
39
When does a pulpal fibrosis occur?
Shrinkage of the pulp with increasing age or persistent low-grade injury, e.g., multiple restorations in a single tooth, chronic bruxism, repeated thermal insult, etc.
40
What are diffuse calcifications?
Irregular calcified deposits along collagen fiber bundles or within blood vessels resulting from chronic low-grade inflammation
41
What do true pulp stones contain?
Dentinal tubules
42
What do false pulp stones feature?
concentric layers of calcified tissue but are void of dentinal tubules
43
What are pulp stones classified as?
either free, attached or embedded calcifications - no pain or issues unless need a root canal
44
What is an abscess?
a dense aggregation of neutrophils and macrophages and other inflammatory cells within connective tissue undergoing liquefactive necrosis (tissue is liquified)
45
Due to the inability of pulpal tissue to swell, the increasing edema and inflammatory cell infiltration will eventually lead to
Pulpal necrosis - clinically by persistent pain and periapical necrosis of the PDL and associated alveolar bone
46
The periapical necrosis is seen on dental radiographs as
a radiolucent area associated with the apex of the involved tooth
47
What is diffuse cellulitis?
Could be a result from periapical abscess, the abscess enlarges so much to where it's involving airways - spread to muscle and possibly airways
48
What is treatment for periapical abscess?
Incision and drainage Possible root canal