Dental Pulp.ppt

DENTAL PULP BY DR. VARDENDRA M

1. DENTAL PULP
Dr. Vardendra M
Reader
Dept of Oral Pathology
NDC, Raichur

2. Contents:
1.Pulp-Introduction.
2.Zones of Pulp.
3.Functions of Pulp.
4.Age changes of Pulp.
5.Clinical considerations of Pulp.

3. Pulp
Pulp is the soft connective tissue component of the dentin –pulp
complex.that supports dentin.
Pulp organ resides in the pulp chamber surrounded by dentin.
Molar pulp organs are 3-4 times larger than incisor pulp organ.
Coronal pulp: six surfaces,pulp horns, located centrally.
Radicular pulp ant:single radicular pulp.
Post:multiple.
Vary in size: ,shape,and no.
apical foramen: max.teeth-0.4mm
mand teeth-0.3mm.
Location,shape of AF change according to
functional influence of teeth.
Tipping of teeth-relocation of Af.
Accessory canals: Apical 1/3
rd
of root,spread of infection,

4. PULPAL ARCHITECHTURE
LooseCTderivedfromneuralcrestcells,coffinedto
pulpchamber&RC

5. Cellfreezone
Cellrichzone:containsprogenitor
odontoblasts
Centralpulp:pulpproper
ContainslargeBV&nervetrunks
Myelenated&unmyelenatednerves
areincloseassociationwithBV
PULPAL ARCHITECHTURE

6. Zones of pulp
1. Odontoblastic zone.
2. Cell-free zone of weil’s.
3. Cell-rich zone.
4. The pulp core.

7. ODONTOBLASTIC LAYER
-palisade pattern,
-3-5 cells deep.
-no.of odontoblasts =no.of tubules.
Coronally -more , larger, tall columnar,
50µmheight.
Centrally -cuboidal .
Apically -flat.
The morphology –reflects –functional activity.
Active cell:
Tall ,columnar, basal nucleus, basophilic
cytoplasm , prominent golgi zone.
Resting cell:
Stubby ,little cytoplasm,hematoxyphilic
Trasitional stage:
narrow,displaced nucleus,autophagic vacuoles.

8. life span of odontoblasts
Theyaretheendcells.
Slowandcontinuousdepositionofsecondary
dentinsuggeststhatodontoblastshavealong
lifespan.

9. Fibroblasts
Majority of cells in pulp.
Numerous in coronal pulp.
Forms & maintains pulp matrix.
Active cell,& aging cell.
Also participates in remodelling of ECM.
Apoptosis-in cell rich zone-indicates cell turnover.

10. Multipotent stem cells,in cell rich zone & pulp core.
polyhedral cells,large,lightly stained,central nucleus.
Older pulp: less no.of cells .
Reduction in no.of cells , reduces the regenerative
potential of pulp.
Undifferentiated Mesenchymal Cell

12. Bone marrow derived cells.
In and around the odontoblast layer in un-erupted teeth.
Presents antigen to T-lymphocytes.
Immuno surveillance.
More in carious teeth
Process of dendritic cells extend in to the dentinal tubules.
Dendritic Cells

13. Matrix & ground substance.
Matrix –collagen &ground substance.
Collagen type I & type III.
Collagen fibers -apical portion of pulp.
Glysoaminoglycans, glycoproteins& water.
Supports the cells,& transport of nutrients.
Alterations in composition ,produces decreased cellular
function &irregular mineral deposition

14. FUNCTIONS OF PULP
Inductive:Theinteractionbetweentheepitheliumandthe
ectomesenchymeduringmaturationisreciprocallyinductive.
Formative & morphologic:Elaboration of dentin by
odontoblasts.
Responsiblefortheformacquiredbypulpchamber
Nutritive:Vascularsupplyforthesurroundingdentin.
Sensory:Carriesnervesthatgivesdentinitssensitivity.
ProtectiveorReparative:ByproductionofTertiarydentin.

15. INNERVATION OF PULP
Nervesupplyisfromsensoryafferentbranchofthetrigeminal
nerveandsympatheticbranchesfromsuperiorcervicalganglion.
Containsbothmyelinatedandnon-myelinatednervefibers.
A∂fibers.
Cfibers.
Pulpalafferentnervescandistinguishbetweenmechanical,
thermal&tactilestimuli.
Mostofthenervebundlesterminateinthesub-odontoblasticnerve
plexus.
Smallno.ofnervefiberspassbetweentheodontoblastcellbodies
toenterdentinaltubules.

16. SUB-ODONTOBLASTIC
PLEXUS OF RASCHKOW
Eachnervefiberisestimatedto
produceatleast8terminal
branches.
Contributestoanextensiveplexus
ofnervesinthecellfreezoneof
weil’sbelowtheodontoblasticlayer
inthecrownportionoftheteeth.
Demonstratedinsilverstained
sections.
Nosuchplexusisfoundinroots.

17. AGE CHANGES OF PULP
Cell changes.
Fibrosis.
Pulp stones/denticles.
Diffuse calcifications.

18. FIBROUS CHANGES IN PULP
Fibrosisisduetoaging&Injury.
increaseincollagenfibers’bundleswhichbecomes
moreevidentwiththedecreaseinpulpsize.

19. CELL CHANGES
Reduction in no of cells , cell organelles and activity.
Fibrosis: aging,trauma or caries cause local fibrosis or scarring
effect.
Increase in collagen is more apparent than actual due to
decrease in size of the pulp.
Vascular changes: Atherosclerotic plaques may be found in
pulpal vessels.
Pulp stones: nodular calcified masses appearing in either or
both coronal and root portions of pulp.
Incidence increases with age.
Asymptomatic unless they impinge on nerves or blood vessels.
Seen in erupted &unerupted teeth.

20. PULP STONES
Resultsfromectopiccalcificationduetomicrotraumaoraging
Normallyareasymptomatic,unlesstheyimpingeonblood
vesselsornerves
Free
Attached

21. True Denticles:
Similar in structure to dentin .
Rare , located near apical foramen.
Could be due to inclusion of remnant of epithelial root sheath.
False denticles:
Do not exhibit dentinal tubules.
Concentric layers of calcified tissue.
Arise around vessels.
Phleboliths also give rise to false denticles.

22. PULP STONES

23. Free denticles:
Entirely surrounded by pulp tissue.
Embedded denticles:
Entirely surrounded by dentin.
Diffuse calcifications:
Occurasirregularcalcified
depositsfollowingcollagenfiber
bundles.
Commonly found in roots.

24. Clinical considerations:
Size.shape & pulp horn in decidous & permanent.
Pulpitis
pulp stones.
Internal resorption.
Dentinogenesis imperfecta.
Dentin dysplasia.
Regional odontodysplasia.
Attrition, Abrasion,Abfraction ,Erosion.

25. CONCLUSION
Pulpishighlyconnectivetissueoftoothwhichgives
nutritiveandsensationtothetoothanditssurrounding
structures.

26. questions
1.Zones of pulp.
2.Age changes of pulp.
3.Pulp stones.
4.Define pulp.Zones of pulp and Functions
of pulp.
5.Cells of pulp.

27. Thank you…