Coronal and radicular pulp
Apical foramen
Accessory canal
Functions of dental pulp
Components of dental pulp
Functions of pulpal extracellular matrix
Organization of cells in the pulp
The principle cells of the pulp
The pathways of collagen synthesis
Matrix and ground substances
Vasculature and lymphatic supply
Innervation of Dentin- pulp complex
Disorders of the dental pulp
Advances in pulp vitality testing
Coronal and radicular pulp
Apical foramen
Accessory canal
Functions of dental pulp
Components of dental pulp
Functions of pulpal extracellular matrix
Organization of cells in the pulp
The principle cells of the pulp
The pathways of collagen synthesis
Matrix and ground substances
Vasculature and lymphatic supply
Innervation of Dentin- pulp complex
Disorders of the dental pulp
Advances in pulp vitality testing
I prepared this presentation during the first year of my MDS. This will give you a basic idea and necessary information about the pulp of the teeth and its histology. Hope you guys find it useful.
A Complete presentation explaining the complete morphology of Maxillary first molar, for the benefit of people like me who tried and failed to find everything in one package
Amelogenesis is the formation of enamel. During amelogenesis, the ameloblast (enamel-forming cells) undergo various stages i.e the life cycle of ameloblast.
For more content check out my blog: www.rkharitha.wordpress.com "a little about everything dental"
It is a presentation in detail about the strongest structure of the oral cavity "ENAMEL". It is a simple topic but people find it difficult to learn about it. I hope my presentation is a simple method to learn about it. I would like to thank my professors for assign me this project and i learn't a lot from it and still learning my basics daily.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
I prepared this presentation during the first year of my MDS. This will give you a basic idea and necessary information about the pulp of the teeth and its histology. Hope you guys find it useful.
A Complete presentation explaining the complete morphology of Maxillary first molar, for the benefit of people like me who tried and failed to find everything in one package
Amelogenesis is the formation of enamel. During amelogenesis, the ameloblast (enamel-forming cells) undergo various stages i.e the life cycle of ameloblast.
For more content check out my blog: www.rkharitha.wordpress.com "a little about everything dental"
It is a presentation in detail about the strongest structure of the oral cavity "ENAMEL". It is a simple topic but people find it difficult to learn about it. I hope my presentation is a simple method to learn about it. I would like to thank my professors for assign me this project and i learn't a lot from it and still learning my basics daily.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Upload By : Ahmed Ali Abbas
Babylon University College of Dentistry
download this file from Website on google theoptimalsmile.wix.com/dentistry
Oral histology
mandibular premolars, common triats and differences between mandibular first and second premolar. buccal aspect, lingual aspect, mesial aspect, distal aspect, occlusal aspect of mandibular premolars
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. Periodontium
The word Periodontium refers to the
attachment apparatus of teeth and consists :
– Cementum
– Alveolar bone lining tooth socket
– Periodontal ligament
– Part of Gingiva facing the tooth
3. Periodontal Ligament
The space occupied
by PDL is called
Periodontal Space
Coronally :-
Continuous with
Gingiva
Apically :-
Continuous with
Pulp
Is the connective tissue which surrounds the roots of
the teeth and Attaches tooth root to the bony alveolus
4. The width of PDL ranges from 0.15
– 0.38mm
Thinnest around middle 1/3rd of
root and has “Hour-Glass”
appearance
Reduced in nonfunctional and
unerupted teeth.
Increased in teeth subjected to
heavy functional stresses.
Thicker in deciduous teeth than
permanent teeth.
The principal fibers run a wavy
course from Cementum to
alveolar bone
9. Synthetic cells
Unique characteristics of Synthesizing cells:
Vesicular nucleus containing prominent nuclei
Abundant cytoplasm containing numerous RER
and Increased Golgi bodies
Large numbers of Mitochondria
Cells with above description present on Alveolar
surface of PDL Osteoblasts
Such cells lying in body of soft connective tissue of
PDL Fibroblasts
Cells found on cemental surface Cementoblasts
10. Osteoblasts
Bone forming cells lining the alveolar bone of tooth
socket closely resembling cementoblasts
Cuboid in shape with prominent spherical and large
nucleus placed at basal end of cell
Large amounts of RER gives the cytoplasm of active
osteoblasts a slightly basophilic hue
Active osteoblast produces an enormous quantity of
collagen type-I
Alkaline phosphatase is present and is mostly found
on the apical cell membrane
13. Fibroblasts
Predominant cells in PDL
Capable of Both Secretion and Degradation of
Collagen
Fibroblasts near cementum are derived from
investing layer of dental papilla and fibroblasts near
Alveolar bone are derived from Perivascular
Mesenchyme of Dental Follicle and show abundant
Alkaline phosphatase activity
Fibroblasts are large cells with extensive cytoplasm
and characteristics of synthesizing cells are seen
prominently
14. Fibroblasts are of various shapes:
– Fusiform
– Tripolar
– Stellate
Fibroblasts of PDL have Cilia and the Cilia is
associated with Control of Cell cycle or Inhibition of
Centriolar Activity
These cells produce growth factors and cytokines
such as IGF-1, BMP’s, PDGF, IL-1, etc
TGF-β stimulates synthesis of collagen and Inhibits the
synthesis of collagenase
15.
16. Functions of Fibroblasts
To produce structural connective tissue proteins:
Collagen
Elastin
Proteoglycans
Glycoproteins
Glycosaminoglycans
Collagenolytic enzymes:
Matrix Metalloproteinases (MMP’s)
Fibroblasts are responsible for formation and
remodelling of PDL
They have a signaling system to maintain width of
PDL by preventing encroachment of bone or cementum
into the PDL space
17. Differences between
PDL Fibroblasts
Ectomesenchymal origin
Expression of Alkaline
phosphatase and cyclic
AMP is MORE
Motile and Contractile
and hence can generate a
force for tooth eruption
Gingival Fibroblasts
Mesodermal origin
Expression of Alkaline
phosphatase and cyclic
AMP is LESS
Non-contractile and no
role to play in tooth
eruption
19. Cementoblasts
Cuboidal cells with large vesicular nucleus
Active in cementum formation found adjacent to the
surface of cementum and show all the prominent
features of synthesizing cells
Cells depositing cellular cementum show abundant
basophilic cytoplasm and cytoplasmic processes and
nuclei are folded and irregularly shaped
Cells depositing - acellular cementum – DO NOT
SHOW prominent cytoplasmic processes
21. Resorptive Cells
Osteoclasts & Cementoclasts:
Found in areas of resorption.
Multinucleated
Originate from undifferentiated mesenchymal
cells in periodontal ligament.
23. Cytoplasm of the cells produce a
substance which dissolves the organic
components of bone and a chelating
agent capable of bringing calcium salts
into solution.
Where ever their cytoplasm comes
into contact with bone - hollows or
grooves called 'Howship's Lacunae' are
formed.
When bone resorption ceases - they
disappear.
24. Progenitor cells
These cells have the capacity to undergo
mitotic division.
They give rise to all of the specialized
synthetic cells.
Epithelial cell rests of Malassez:
Remanents of Hertwig’s Epithelial Root
Sheath.
Epithelial double strands and islands limited
by basement membrane of reticulin.
26. Mast cells
These are small round or oval cells.
12 - 15μm.
Characterized by numerous
cytoplasmic granules.
These granules contain heparin and
histamine.
Histamine plays and important role in
inflammatory reactions and also in
antigen antibody reaction.
27.
28. Macrophages
These can be visualized by the presence
of phagocytosed material in their cytoplasm.
They are derived from blood monocytes.
32. Fibers
Made up of collagen and Oxytalan.
Elastic fibers are restricted to the walls of blood
vessels.
The majority of fibers are collagen.
Mostly made up of type I collagen and some
amount of type III collagen.
The collagen fibers are gathered in bundles
having a clear orientation relative to the
periodontal space - “Principal fibers”.
36. Principal Fibers
Alveolar Crest group:
They radiate from the crest of the
alveolar process and attach themselves to
the cervical part of the Cementum.
These fibers resist tilting, intrusive,
extrusive and rotational forces.
Most often confused with Dentoperiosteal
fibers
37.
38. Horizontal group:
They run at right angles to long axis of
tooth from Cementum to Bone.
Roughly parallel to the occlusal plane of the
arch
They are found immediately apical to the
alveolar crest fiber group. They are limited
mostly to the coronal one-fourth of the
periodontal ligament space.
These fibers resist horizontal and tipping
forces.
39. Oblique group:
Most numerous and occupy
nearly 2/3rd of the ligament.
They are attached to
cementum apically from their
attachment to the bone
thereby resulting in their
oblique orientation within the
periodontal space
These fibers constitute the
main attachment.
These fibers resist vertical
and intrusive forces.
40. Apical group:
They radiate from the
cementum at the root tip to
become anchored into the
fundus of the bony socket.
The apical fibers resist the
forces of luxation, may
prevent tooth tipping and
protect delicate blood and
lymph vessels and nerves
traversing the PDL space at
the root apex.
These fibers are not seen on
incompletely formed roots.
41. Interradicular Group:
From the crest of
interradicular septum, bundles
extend to furcation of
multirooted teeth.
These fibers resist tooth
tipping, torquing and luxation.
These fibers are lost, if age-
related gingival recession
proceeds to the extent, that
the furcation area is exposed.
Total loss of these fibers
occurs in chronic
inflammatory periodontal
disease.
44. Elastic Fibers
There are three types of elastic fibers, which are
histochemically and ultrastructurally different.
They are, the mature elastic fibers, (elastin)
fibers, the elaunin fibers, and the oxytalan fibers.
Elaunin and oxytalan fibers have been described
as immature elastic fibers.
Mature elastic fibers consist of a microfibrillar
component surrounding an amorphous core of
elastin protein.
45. Elaunin Fibers
Elaunin fibers are seen as bundles of microfibrils
embedded in a relatively small amount of
amorphous elastin.
These fibers may be found within the fibers of the
gingival ligament.
46. Oxytalan Fibers
These are immature elastic fibers.
Found in the periodontal ligament.
Largely restricted to the walls of blood vessels.
The orientation of these fibers is quite different.
They tend to run axially - one end being
embedded into cementum or possibly in bone
and the other - into the wall of a blood vessel.
In the vicinity of apex they form a complex
network.
47. Reticular Fibers
These are fine immature collagen fibers with
argyrophilic staining properties and are related to
basement membrane of blood vessels and
epithelial cells which lie within the periodontal
ligament.
These fibers are composed of type III collagen.
54. Sharpey's Fibers: The collagen fibers are
embedded into the cementum on one side of
the periodontal space and into alveolar bone
on the other.
Intermediate Plexus:
When examined under light microscope
the fibers appear to be joined in the mid
region of the periodontal space giving rise
to a zone of distinct appearance, so called
"Intermediate Plexus" – believed to be site for
rapid remodeling of fibers.
57. Blood Supply:
From three sources -
1. From the apical vessels supplying the
dental pulp.
2. Branches from intra-alveolar vessels.
3. Branches form gingival vessels.
Lymphatics:
Net work of lymphatic vessels following
the path of blood vessels.
59. Nerves are usually associated with blood vessels
Pass through foramina in the alveolar bone to
enter the periodontal ligament.
Myelinated or non myelinated.
Either large or small in diameter:
- larger diameter - concerned with touch.
- smaller diameter - concerned with pain.
Cementicles:
Calcified bodies.
Origin is probably from degenerated epithelial
cells – forming a nidus for calcification.