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Oral Histology > Pulp > Flashcards

Pulp Flashcards

1
Q

Pulp

A

Soft connective tissue that supports dentin

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2
Q

What are some unique features of pulp?

A

Vascular

Not calcified

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3
Q

What is the embryonic origin of the pulp?

A

Ectoderm - neural crest ectomesenchyme - dental papilla

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4
Q

What are some contents of pulp?

A

Cells and cellular elements
Blood and lymphatic vessels
Extracellular matrix

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5
Q

What are the functions of pulp?

A 
Inductive
Formative
Nutritive
Protective
Defensive/Repairative
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6
Q

Inductive function of pulp

A

Very early in development, it is involved in inducing transition from dental lamina to bud stage

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7
Q

Nutritive function of pulp

A

Helps supply the dentin with nutrients and water

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8
Q

What changes might an endodontically treated tooth undergo?

A

Dentin will become more brittle because pulp can bring nutrients

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9
Q

What are the protective mechanisms of the pulp?

A

Sensory mechanism

Barrier

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10
Q

Sensory mechanism of pulpal protection

A

Nerve fibers travel in the pulp, which inform us if the tooth is injured, causing us to use the tooth less, preventing further damage

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11
Q

Barrier mechanism of pulpal protection

A

Pulp are under positive pressure at odontoblast junctions - if there is a break, the positive pressure forces things out into the oral cavity, protecting the underlying pulp

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12
Q

Defensive/repairative mechanisms of pulp

A

Immune system

Formation of new dentin and pulp

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13
Q

What are the types of foramina of the pulp?

A

Apical foramen

Accessory foramen

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14
Q

What happens to pulp chambers as we age?

A

They get smaller - making endo more difficult with older patients
Pulp has more cells at a young age and more extracellular matrix in older ages

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15
Q

T/F - the pulp is never calcified

A

False - it is common to have ectopic calcifications

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16
Q

What are the types of ectopic calcifications?

A

Pulp stones

Diffuse calcifications

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17
Q

Pulp stones

A

Ectopic calcification commonly found in pulp chamber in crown of the tooth
Spherical or ovoid
No clear cause

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18
Q

Diffuse calcifications

A

Ectopic calcification often found near blood vessels

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19
Q

Are ectopic calcifications problematic?

A

Not likely, mostly likely just an annoyance if you’re an endodontist

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20
Q

What are the zones of the pulp?

A

Odontogenic zone

Pulp core

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21
Q

Odontogenic zone layers

A

Odontoblast layer
Cell free zone
Cell rich zone

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22
Q

Odontoblast layer

A

Most superficial layer of odontogenic zone
Single layer of odontoblasts lining the pulp dentin border
Can look like multiple layers, but its likely an artifact of how the slide was cut

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23
Q

Cell free zone

A

Cells are less prominent

Middle layer of odontogenic zone

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24
Q

Cell rich zone

A

Increase concentration of fibroblasts

Deep layer of odontogenic zone

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25
Q

Pulp core

A

Lots of fibroblasts, blood vessels, and nerves

26
Q

What cells are found in the pulp?

A

Odontoblasts
Fibroblats
Immune system cells
Stem cells

27
Q

Odontoblasts

A

Cells that make dentin

Has processes that go into dentinal tubules

28
Q

Fibroblasts

A

Confined in the pulp
Secrete ECM of the pulp
-mostly collage, but other proteins as well

29
Q

What are the 2 types of immune system cells in the pulp?

A

Resident immune cells

Inflammation cells

30
Q

What are the types of Resident Immune cells

A

Macrophages
Lymphocytes
Eosinophils
Dendritic cells

31
Q

Dendritic cells

A

Sit at the PD order, surveying the environment

If there’s an infection, these present the infection to the immune system

32
Q

Inflammation cells

A

When you get a tooth infection, these cell numbers increase
Plasma cells
Mast cells
PMNs

33
Q

Stem cells

A

Source of replacement for odontoblasts or fibroblasts
High capacity of self reneway
Mutlipotent - can generate multiple cell types

34
Q

What are components of the ECM of the pulp?

A

Proteoglycas
Glycoproteins
Collagen

35
Q

Proteoglycan function in pulp

A

Gelatinous matrix for diffusion of molecules through the pulp
Help control when and how much collagen is secreted
Water retention - important for keeping pulp moist and keeping positive pressure

36
Q

Glycoprotein function in the pulp

A

Cell adhesion to the ECM

37
Q

Collagen function in the pulp

A

Tensile strength

38
Q

What types of collagen are found in the pulp?

A

I and III

39
Q

Odontoblast function in the pulp

A

Dentinogenesis
Nutrients to dentin
Immune - can secrete immunity molecules when needed

40
Q

What are the types of junctions between odontoblasts?

A

Desmosomes and adherens junction
Gap junctions
Tight junctions

41
Q

Desmosomes and adherens junctions

A

Maintain position and polarity of odontoblasts

42
Q

Gap junctions

A

Coorinate dentinogenesis - once one odontoblasts decides to make dentin, it signals to neighbors to do the same thing using gap juncitons

43
Q

Tight juncitons

A

Form a barrier to prevent things from diffusing between odontoblasts
Sits at apical portion of cells

44
Q

Why are the structures of tight junctions so complex?

A

The more complex they are, the better they are at keeping things out

45
Q

T/F - Tight junctions prevent all things from getting between odontoblasts

A

False - small things can still potentially get through. Tight junctions are better at preventing large molecules from going through

46
Q

What is the importance of lymphatic tissue in the pulp?

A

Healing - they drain proteins that accumulate during inflammation

47
Q

Why does the lymphatic tissue have complex anatomy in the pulp?

A

To overcome challenges associated with encasement in a hard tissue

48
Q

What are the types of nerve fibers in the pulp

A

A-delta fibers
C fibers
A-beta fibers

49
Q

What happens to innervation during tooth eruption?

A

Density of innervation increases - it decreases with aging

50
Q

Where do nerve fibers enter the pulp?

A

Apical foramen

51
Q

How far do nerve fibers extend into the dentin?

A

We’re not sure - but it’s likely not all the way to the DEJ

52
Q

Where is the dentin most highly innervated?

A

In the crown

53
Q

Hydrodrynamic theory of dentinal pain

A

Air, solids, or cold can create a fluid wave in the dentinal tubule, which stretches the nerve fiber, activating pain

54
Q

Does pain in the pulp follow the Hydrodynamic theory of dentinal pain?

A

No, just the dentin.

55
Q

What type of pain receptors are associated with the pulp?

A

TRP receptors

56
Q

TRP receptors

A

Family of transmembrane receptors for thermal and inflammatory pain in many regions of the body
Activated by many inflammatory mediators

57
Q

Describe the path of pain associated with A fibers

A

Dental stimuli –>
Hydrodynamic forces –>
A-beta and A-delta fibers –>
Sharp pain

58
Q

Describe the path of pain associated with C fibers

A

Infection or trauma –>
Inflammation –>
C fibers –>
Dull pain

59
Q

What fibers can be activated by electric pulp and hot/cold testing?

A

A fibers

60
Q

What do neuropeptides do at central endings?

A

They have a transmitter funciton

They bind to receptors on brain neurons and produce pain

61
Q

What do neuropeptides do at peripheral endings?

A

They have a local regulatory function

They bing with receptors on vasculature and local cells and lead to pro-inflammatory response

Oral Histology (12 decks)

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