Seminar on Response of Pulpodentin complex to stimuli ,department of conservative dentistry and Endodontics,CODS,BPKIHS,DHARAN,NEPAL

1. PBL
GROUP-4
-Anita, Ashma, Garima,
Neha,Prawin,Ranjana, Shabnam, Smita,
Suvin Chaudhary
Resource Faculty- Dr. Ashok Ayer
Presented By: Prawin Kushwaha
BDS-2014,CODS

2. RESPONSE OF PULPODENTIN
COMPLEX TO STIMULI

3. 1.Introduction to
pulpodentin complex
2.Stimuli present on
pulpodentin complex
4.Conclusions
3.Different responses of
pulpodentin organ to
external stimuli
CONTENTS :

4. INTRODUCTION TO PULPODENTIN
COMPLEX
 Dentin and pulp are embryologically, histologically,
and functionally the same tissue and therefore are
considered as a complex.

5. Structure and response of dentin to the injury are largely functions
of the odontoblasts and the other cells in the pulp,but these cells
are dependent on the dentin for their protection and state of
differentiation.
Normal form and function of one cannot be maintained without
other
The embryonic dental papillae is responsible for the formation of
this coupled tissue
CONTINUED…

6. CONTINUED
Hence it is obvious that the response of the pulp to
any restorative material will be influenced by its
surrounding dentin also
Dentinal fluid in the tubules, which is continuous with
the extracellular fluid of pulp serves as a medium for
relaying injurious agents to the pulp to induce an
inflammatory response

7. RESPONSE OF PULPODENTIN COMPLEX TO
VARIOUS STIMULI
Traumatic
Chemical
Bacteric or Septic
Electric
Thermic
Caries
Restorative materials
IRRITANTS

8. Pulp venules
STIMULATION
Increased pulp
interstitial fluid
Increased pulp
pressure
Increased tubular
fluid flow
Release of
inflammatory
agents?
Increased blood
viscosity and rbc
congestion in capillary
bed
Increased A-V shunt
blood flow
Outward dentinal
fluid flow and
aspiration of
odontoblasts
CNS, Pain, Reflexes
Vasodilation, Increased permeability
Pulpal axonal reflex due to dentine stimulation
Without infection,
Vascular changes could
be resolved.
Axon
reflex
SP, CGRP
Dentine

9. o adequate cooling of the burs is
essential to prevent the injury to
dentin and also to underlying
odontoblastic region of the pulp
oWhen the cooling is inadequate
,the injury leads to displacement
of odontoblastic nuclei into
dentinal tubules
RESPONSE OF PULPODENTIN COMPLEX
TO VARIOUS STIMULI
1.Pulpal reaction to tooth
preparation

10. if the cooling is missing or excessive pressure is utilized constantly –
the burning of dentin becomes evident
The most common feature in the reaction is outward movement of
the contents of dentinal tubules
It is established that such flow of fluid ,later is helpful in formation of
peritubular dentin
The disturbance and redistribution of the cellular constituents if
continued leads to degeneration of odontoblastic process
Formation of dead tracts and subsequently formation of tertiary
CONTINUED…

11. in case of cavities are prepared deep and without coolant,
vasoconstriction is noted
peripheral flow of fluid following cavity preparation allows
plasma proteins to enter the tubules
clotting of tubules ,fibrinogen cause obstruction of these
tubules
CONTINUED…

12. oThe dentinal caries may be in any form or at any site, affects
the underlying pulp
oThe acidic environment of carious lesions cause both tissue
dissolution and in aggressive lesions ,cellular injury as well
oThe initiation of pulpal inflamation also stimulate
the repair process
oA balance usually occurs between repair and deviation
from the balance leads to change in dentin pulp complex
2.Pulpal reaction to caries

13. Fig: Flowchart showing pulpal reaction to caries

14. In case of rampant caries ,the breakdown of affected enamel
and dentin will occur within months
Leads to destruction of odontoblasts and lack of tertiary dentin
formation
The progress of caries , if halted ,leads to formation of
reparative dentin with differentiation of new secondary
odontoblast like cells
If the lesion is allowed to progress pulp necrosis
may flow
CONTINUED…

15.  Trauma in the form of – accident, wear, erosion,
orthodontic movements and other occlusal traumas
 Trauma may lead to fracture of enamel , dentin and
exposure to pulp
3.Pulpal reaction to trauma

16. Extensive trauma: the pulp supply to the pulp is severed off
Either the pulp is necrosed with time or characterised by formation
of hard tissue in the pulp chamber
Hard tissue in the form of osteodentin
CONTINUED…

17. Orthodontic movements of teeth putting pressure more than
required
increased blood flow in the pulp
hyperaemia in the tooth adjacent to the one where force is
applied
CONTINUED…

18. Teeth suggested to heavy forces (orthodontic
treatment)
Vacuolization of odontoblastic impaired
predentin
layer and the pulpal tissue formation
suggestive of degeneration of pulp
CONTINUED…

19. oVital tooth bleaching incorporates 10 percent carbamide
solution
oInitial reaction of the pulp less distinction of cell free
zone
oLater scattered leucocytes are observed along with
irregularities in the pseudostratified odontoblastic layer
4.Pulpal reaction of vital bleaching

20. PULPAL REACTION TO LOCAL
ANESTHETICS
VASOCONTRICTORS
-such as lidocaine and epinephrine
-benefits:enhance the duration of anesthesia
Side Effects: reduce the blood flow of the pulp
1.The supplemental anesthetic techniques
cause severe reduction or evn transient cessation of
pulpal blood flow
2. The effect of intrapulpal anesthesia on the pulp is
not considered,since it is used during root canal
therapy when other anesthetic administrations are
NOTE
:

21. SUMMARY….

22. REFERENCES :
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