Dental pulp presentation 3

GOOD MORNING
www.indiandentalacademy.com

THE DENTAL PULP

DENTAL PULP
• INTRODUCTION
• EMBRYOLOGY
• ANATOMY
• HISTOLOGY
• PHYSIOLOGY
• THE PULP-DENTIN
COMPLEX
• PULP PATHOLOGY
• REGRESSIVE
CHANGES
• CONCLUSION
• REFRENCES

INTRODUCTION
• The DENTAL PULP
is a soft connective
tissue that occupies
the center of each
tooth & consists of
soft connective tissue
• The total volume of all
permanent teeth pulp
organs is 0.38cc

EMBRYOLOGY
• The dental pulp has its
genesis about the 6th
week
of IU life
• The tooth pulp is initially
called the DENTAL
PAPILLA ,it is a
condensed area of
ectomesenchyme
• After dentin formation
begins the tissue is
designated as PULP
ORGAN

DEVELOPMENTAL DEFORMITIES
• PULPAL DYSPLASIA
• HYPOPHOSPHATASIA
• REGIONAL
ODONTO DYSPLASIA
• Type 1 DENTIN DYSPLASIA
• Type 2 DENTIN DYSPLASIAwww.indiandentalacademy.com

• DENTINOGENESIS IMPERFECTA
• SHELL TEETH
• DENS-IN-DENTE

ANATOMY
• PULP CHAMBER&CORONAL
PULP
• ROOT CANAL&RADICULAR PULP
• APICAL FORAMEN
• ACCESSORY & LATERAL
CANALS
• CLINICAL CONSIDERATIONSwww.indiandentalacademy.com

VERTUCCI’S MODIFICATION OF WEINS CLASSIFICATION
OF ROOT CANAL CONFIGURATIONS

ANATOMY OF THE PULP OF
INDIVIDUAL TEETH
MAXILLARY ANTERIORS

MAXILLARY POSTERIORS

MANDIBULAR ANTERIORS

MANDIBULAR POSTERIORS

HISTOLOGY
Starting at the periphery the pulp is divided into:
1)odontoblastic zone
2)cell free zone
3)cell rich zone
4)central zone

ODONTOBLASTIC ZONE
•Formed by odontoblastic cell bodies. whereas
their processes Tomes processes are located in
the predentin matrix &the dentinal tubules
extending into the dentin.
•Their function throughout their life is the
production of dentin

CELL FREE ZONE
• Also called ZONE OF WEIL
• Constitutes plexus of capillaries,the nerve
plexus of RASCHKOW&ground substance

Composed of the following:
• Ground substance
• Synthetic cells
• Fibers
• Progenitor cells
• Defensive cells
CELL RICH ZONE

This is the pulp proper,contains blood
vessels ,nerves&lymphatic vessels.
CENTRAL ZONE

LYMPHATIC SUPPLY:
•All the maxillary teeth &mandibular
canines,premolars&molars drain into
SUBMAXILLARY NODES
•Mandibular incisors drain into
SUBMENTAL NODES

ARTERIALSUPPLY:
• Internal maxillary
arteryinferior alveolar
artery
infraorbital artery
posterior superior alveolar
artery
• Rate of pulpal blood
flow:40-50ml/min/100gm
pulp tissue
• Arteriole-0.3-1mm/sec
• Venules-0.15mm/sec
• Capillaries-0.08mm/sec

VENOUS SUPPLY
• All the veins from all the teeth drain
into pterygoid plexus which is
present posterior to maxillary
tuberosity

• The sensory
mechanism of pulp is
composed of sensory
afferent &autonomic
efferent systems.
• 80%of the nerve
fibers are c-fibers
,nonmyelinated
• Remaining fibers are
A-delta fibers& are
myelinated-they
form PLEXUS OF
RASCHKOW
NERVE SUPPLY

They divide into:
•Marginal fibers
•Complex predentinal fibers
•Dentinal fibers
•Simple predentin fibers
•Nerve impulses travel thru nerve trunk & exit thru
apical foramen & in the periapical area joins the
MAXILLARY &MANDIBULAR divisions of the
TRIGEMINAL Nerve

THE PULP DENTIN ORGAN
• Despite the differences in structure &composition , pulp&dentin
are integrally connected in the sense that physiologic&pathologic
reactions in one tissue will also affect the other.
• Not only do the two tissues have a common embryonic origin they
also remain in intimate relationship thruout the life of the vital
tooth.
• PHYSIOLOGIC CONSIDERATIONS:
Dentinogenesis
Dentin permeability
Dentin sensitivity:
Hydrodynamic theory

PATHOLOGICAL CONSIDERATIONS:
• The most common cause of pulpal injury is
progression of dental caries
• Caries destroys dentin at a rate of 1mm/six months
• Pulpitis ensues before actual invasion of the pulp by
bacteria from carious dentin
• Inflammation

REACTION OF PULP-DENTIN ORGAN TO
VARIOUS IRRITANTS:
• Healthy reparative reaction
• Unhealthy reparative reaction
• Destuctive reaction

PHYSIOLOGY
The dental pulp performs the following functions:
• Inductive
• Formative
• Nutritive
• Sensory
• Defensive or reparative

PULP PATHOLOGY
CAUSES OF PULPAL DISEASES
1.Microbial :
Caries
Anachoresis
Invasion from pressure
Periodontal involvement
Systemic infections

2.mechanical&thermal irritants:
a.Cavity preparation:
• Pressure
• cutting
• Type of instrument
• Depth of the cavity
• Heat production
• Surface area of contact
• Dessication
• Coolant
• Vibration

b.Effect of electrosurgery
c. Periodontal curettage
d.Other physical traumata
e.Impressions
f.Effect of tooth movement

3.Chemical irritants:
• a.Dentin sterilizing agents:
Phenol
Silver nitrate
camphorated para chlorophenol
• b.Cleansing &drying medicaments:
hydrogen peroxide
alcohol
acid etchant
• c.Smear layer
• d. Restorative materials:
silicate cement
zinc phosphate cement
zinc oxide eugenol cement
zinc polycarboxylate cement
GIC
Amalgam
Composites
• e.Bleaching agents www.indiandentalacademy.com

4.Radiant irritants:
•X-radiation
•Co60 radiation
•Laser beam

PULPAL DISEASES
Clinical classification:
1.Pulpitis:a.Reversible
b.Irreversible
-acute
-chronic—
Asymptomatic with pulpexposure
Hyperplastic pulpitis
Internal resorption
2.Pulp degeneration
3.Necrosis

4.Inatact pulp with scattered chronic inflammatory cells
5.Chronic partial pulpitis- with partial liquifaction necrosis
with partialcoagulation necrosis
6.Chronic total pulpitis- with partial liquefaction necrosis
7.Total pulp necrosis
Histological classification:
1.Intact uninflamed pulp
2.Atrophic pulp
3.Acute pulpitis

The Inter –relationship of
Pulpal&Periodontal diseases

REGRESSIVE CHANGES
• Decrease in cellular components
• Dentinal sclerosis
• Decrease in size &volume of pulp
• Pulp stonesdenticles
True denticles Free
False denticles Attached
Embedded
• Diffuse calcifications
• Clinical considerations

CONCLUSION
According to a survey conducted by AMERICAN
ACADEMY OF PAIN it was found that dental pain stands
in 4 th position in relation to the most unbearable pain a
person can ever experience,So a Dentist can take all the
credit in treating that pain with the thorough knowledge of
basic sciences& biology of THE PULP &PULP-DENTIN
complex,& also the dentist can opt for the materials &
methods that will produce favorable reactions in tissues
&restore the teeth to their proper form & function.

REFERENCES
1.THE DENTAL PULP– SELTZER &BENDER – 3rd
Ed.
Page-64-274,303-361
2.ORAL HISTOLOGY&EMBRYOLOGY– ORBANS-
11Th
Ed. Page-139-178
3.OPERATIVE DENTISTRY– MARZOUK
Page-38-53
4.TEXT BOOK OF ORAL PATHOLOGY– SHAFER
4Th
Ed. Page-58-64
5.PATHWAYS OF THE PULP– COHEN—8Th
Ed, 9th
Ed
Page-573-598
6.HARTYS’ ENDODONTICS IN CLINICAL PRACTICE
4Th
Ed. Page-18-31
7.ENDODONTICS– INGLE– 5th
Ed
Page-95-175www.indiandentalacademy.com

THANK YOUwww.indiandentalacademy.com

Dental pulp presentation 3

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Dental pulp presentation 3