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The pulp cavity occupies the central

area of the tooth enclosed by dentin.


The pulp has the cellular, fibrous, neural
and vascular components of typical loose
connective tissue.
The main function of the pulp is the
production and maintenance of the
dentin.

GENERAL FEATURES

Each person normally has a total of 52 pulp


organs, 32 in the permanent & 20 in the primary
teeth.

The total volumes of all the permanent teeth pulp


organs is 0.38 cc.
The mean volume of a single adult human pulp is
0.02 cc.
Molar pulps are 3 to 4 times larger than incisor
pulps.
Cuspid has the longest pulp.
Mandibular central incisor has the smallest
pulp.
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Pulp horns or cornua

Pulp Chamber or coronal,


located in the crown
of
the tooth.
Root canal or radicular pulp,
is the portion of the pulp
located in the root area.
The apical foramen is the
opening from the pulp at
the apex of the tooth.
Accessory canals or lateral
canal, extra canal located
on the lateral portions of
the root.

The pulp cavity is


divided into
1. Coronal pulp
2. Radicular pulp

The average size of apical foramen of the


maxillary teeth in the adult is 0.4 mm.

In the mandibular teeth it is slightly smaller,


being smaller, being 0.3 mm in diameter.

ACCESSORY CANALS
Found in apical third region & furcation region.

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ODONTOBLAST LAYER
CELL-POOR ZONE
(WEILS ZONE)
CELL-RICH ZONE
PULP PROPER

Microscopic Zones in Pulp


Zones-from outer to inner
zone

Description

Odontoblastic layer

Lines the outer pulpal wall and


consists of the cell bodies of
odontoblast. Secondary dentin
may form in this area from the
apposition of odontoblast.

Cell-free zone

Fewer cells than odontoblastic


layer. Nerve and capillary plexus
located here

Cell-rich zone

Increased density of cells as


compared to cell-free zone and
also a more extensive vascular
system

Pulpal-core

Located in the center of the pulp


chamber, which has many cells
and an extensice vascular supply,
similar to cell-rich zone

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Connective tissue fibers


Collagen
Elastin
Fibronectin
Ground substance
Proteoglycans
Glycosaminoglycans
Basement membrane

Are the most numerous cell types in the


pulp.
Function in collagen fiber formation .
Have the typical stellate shape & extensive
processes that contact & are joined by
intercellular junctions.
Have abundant rough-surfaced endoplasmic
reticulum,
mitochondria
&
other
cell
organelles.
Also have the capability of ingesting &
degrading this same matrix.
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They are the primary cells in the very young pulp.

Only a few are seen in the pulps after root


completion.

Appear larger than fibroblasts.

Are polyhedral in shape


processes & large oval nuclei.

Are found along pulp vessels, in the cell-rich


zone & scattered throughout the central pulp. 22

with

peripheral

Viewed from the


spindle shaped.

side,

they

appear

They are believed to be a totipotent


cell & when need arises they may
become odontoblasts, fibroblasts, or
macrophages.

Decrease in number in old age.


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The second most prominent cell in the pulp.

Reside adjacent to the predentin with cell


bodies in the pulp & cell processes in the dentinal
tubules.

About 5 to 7 um in diameter & 25 to 40 um in


length.

Cell bodies are columnar in appearance with large


oval nuclei, which fill the basal part of the cell.

The plasma membranes of adjacent cells exhibit


junctional complexes.
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The tight & intermediate junctional complexes


are important for maintaining the integrity of
the odontoblastic layer & preventing the ingress
of foreign material, for example toxins & bacterial
products, from the oral cavity.

The
tight
junctions
provide
mechanical
attachment between adjacent odontoblasts.
Intermediate junctions have shown to extend around
the perimeter of odontoblasts as narrow bands.

The gap junctions are areas of reduced electrical


resistance that also allow selective exchange of
substances between odontoblasts.
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These are histiocytes, or macrophages,


mast cells, and plasma cells.

In addition, there are neutrophils,


eosinophils, basophils, lymphocytes, and
monocytes.

These cells emigrate from the pulpal


blood vessels & develop characteristics in
response to inflammation.
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Blood vessels of both the pulp & periodontium


arise from the inferior or superior alveolar
artery.

As the vessels enter the tooth their walls become


considerably thinner than those surrounding the
tooth.

Pulpal pressure is among the highest of body


tissues.

The flow of blood in arterioles is 0.3 to 1 mm/s,


in venules 0.15 mm/s , & in capillaries 0.08
33
mm/s.

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Those draining the anterior teeth pass to


the submental lymph nodes;

Those of the posterior teeth pass to the


submandibular
and
deep
cervical
lymph nodes.

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The majority of the nerves that enter the pulp


are non-myelinated.
Many of these gain a myelin sheath later in life.
Are sympathetic in nature.
Function in vasoconstriction.

The large myelinated fibers mediate the


sensation of pain.

The peripheral axons form a network of nerves


located adjacent to the cell-rich zone. This is
termed the parietal layer of nerves, also
known as the plexus of Rashkow.
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INDUCTIVE
FORMATIVE
NUTRITIVE
PROTECTIVE
DEFENSE

CELL CHANGES
Cells decrease in number.

Decrease in size & number of cytoplasmic


organelles.

The fibroblasts in the aging pulp exhibit less


perinuclear cytoplasm & possess long, thin
cytoplasmic processes.
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Increase in fibers in the pulp organ is gradual.


Any external trauma such as dental caries or
deep restoration usually causes a localized
fibrosis or scarring effect.
Collagen increase is noted in the medial &
adventitial layers of blood vessels as well.
Decrease in the size of pulp.
Plaques may appear in pulpal vessels.
Calcifications in the walls of blood vessels is
found most often in the region near the apical
foramen.
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Are nodular, calcified masses appearing in either or


both the coronal or root portions of the pulp organ.

Classified as true denticles, false denticles, &


diffuse calcifications.

The structure of true denticles is similar to


dentin.
Are rare & lie close to the apical foramen.

Development of true denticle is caused by the


inclusion of remnants of the epithelial root sheath
within the pulp.
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Do not exhibit dentinal tubules.

Appear as concentric layers of calcified


tissue.

In the center, there may be remnants of necrotic


& calcified cells.

Calcification of thrombi in blood vessels, called


phleboliths, may also serve as nidi for false
denticles.
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False calcification seen along the walls of


the blood vessel.

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Diffuse calcification
Diffuse calcification of the pulp, seen along
with pulp fibrosis.

Appear as irregular calcific deposits, usually


following collagenous fiber bundles or blood vessels.

Are usually found in the root canal & less often in


the coronal area.

Also classified according to their location in relation


to the surrounding dentinal wall; free, attached, &
embedded denticles.

The incidence as well as size of pulp stones increase


with age.

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The wide pulp chamber in the tooth of a young


person will make a deep cavity preparation
hazardous.

If opening a pulp chamber for treatment becomes


necessary, its size and variation in shape must be
taken into consideration.

The shape of the apical foramen and its location


may play an important part in the treatment of root
canals.

Pulpal-periodontal lesion due to accessory canals.


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When filling materials contain harmful


chemicals (e.g. acid in silicate cements
and monomer in composites), an
appropriate cavity liner should be used
prior to the insertion of restorations.

The vitality of the pulp depends on its


blood supply. The instruments called
vitalometers test the reaction of the
pulp to electrical or thermal stimuli.
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1. Ten cates oral histology -Nanci,Atonio


edition 2003,
2.Oral anatomy embrylogy & histologyBerkovitz 3rd edition
3.Essential of oral histology & embryology
Avery 3rd edition,
4.Oral histology and embrylogy by Orbans
11th edition
5.Textbook of oral medicine -Anil govindrao
ghom 2nd edition

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