Dental Pulp

Oral Histology Dent 205 Summer semester 2005/2006

Dental pulp

Dental pulp

Crown - pulp chamber Root - root canal(s)

Dental papilla becomes dental pulp after beginning of dentinogenesis Dental pulp is a specialized connective tissue

Positioned inside a rigid chamber Has a role in forming hard tissue Periphery contains

Dentine-forming cells Nerve terminals Antigen-presenting cells

The rest of the dental pulp acts as a support system for peripheral components

Blood vessels and nerves that enter & leave through an apical foramen Cells and collagen fibers

Accessory canals

Occur most commonly on apical part

Lateral root canals Furcation canals

Composition of dental pulp

Loose connective tissue Components

Cells Extracellular matrix

Fibers Non-fibrous matrix - Semi-fluid gel

Matrix more plentiful than cells Functions of the matrix

Forms a scaffold that stabilizes the structure of the tissue Controls cellular activity

Fibers

Collagen

Type I (56%)

Thin & scattered in young teeth Irregular arrangement Near predentine, fibers are regularly arranges parallel to predentine surface

Type III (41%) Types V & VI

Large glycoproteins Associated with elastic fibers in other tissues Elastic fibers are absent

Fibrillin

Non-fibrous matrix

Glycosaminoglycans Hydrophilic Swell when hydrated accounting for High pressure in the dental pulp Mechanical support Easy movement of water-soluble molecules Types Chondroiten sulphate - predominent Dermatan sulphate small amounts Heparan sulphate Hyaluronan sulphate mostly unbound to proteins Proteoglycans Act as adhesion molecules bound to cell membranes and bind signaling molecules like GFs Other adhesion molecules Fibronectin that regulates cell shape, migration & differentiation Lamenin Around endothelial cells of blood vessels & Schwann cells Coating cell bodies and processes of odontoblasts

Cells
Odontoblasts Fibroblasts Defence cells Undifferentiated cells

Odontoblasts

Formation of dentine Survive for as long as the tooth is vital Odontoblasts cannot divide but subodontoblasts can Polarized columnar cells with processes extending within a tubule In root region, cells are more cuboidal Odontoblastic cell layer has A membrane-like properties Acts as a barrier to protect the dental pulp from outside irritants A limited permeability due to Desmosomes Tight junctions Gap junctions

Fibroblasts

Linked by adherense type junctions & gap junctions Stellate cells with star-like extensions Undergo cell division Functions

Production of fibers & ground substance and participate in their degradation May produce bone-like mineralized tissue as a response to pulpal injury Production of GFs and cytokines

Defence cells

T-lymphocytes

In small amounts Increase in pulpal injuries

Around blood vessels Around the odontoblastic layer

Macrophages & antigen-presenting cells

Mast cells are absent

Undifferentiated cells

Primitive mesenchymal cells Differentiate into odontoblats to produce tertiary dentine

Blood vessels

Run longitudinally through root canals from the apical foramena Gives off side branches while within the canals Branch profusely once they reach the pulp chamber Capillary loops extend towards the dentine Subodontoblastic capillary plexus Capillaries are present within & below the odontoblastic layer but do not enter the tubules Arteriovenous and venous-venous anastomosis Lymphatic vessels are hard to destinguish Nerve endings are associated with smooth muscles of arteriole walls Pulp has a high pulsatile interstitial fluid pressure which allows dentinal fluids to move outwards

Nerves

Dental pulp is highly innervated Scant perineurium or epineurium Two types of nerve fibers

25% are myelinated afferents

90% of which are narrow A fibers 10% are wider A fibers Afferents or Autonomic

Unmyelinated C fibers

Nerves

Run along side the blood vessels in the center of the pulp Branch profusely in the odontoblastic & subodontoblastic regions In the crown, subodontoblastic plexus is known as plexus of Raschkow

Evident only after eruption Some branches reach between odontoblasts & predentine Others continue & join the processes within the tubules May be a site of sensory activation as evident because axons lack Schwann cell covering

Nerve fiber types

Myelinated afferents carry sensation of sharp pain to CNS

A fibers A fibers
Afferents

Unmyelinated C fibers

Conduction of noxious stimuli to CNS Axon reflexes to control blood flow Sympathetic fibers supply the smooth muscles of arteriolic walls Evidence of parasympathetic supply is weak

Autonomic

*Some pulpal fibers may have a role in controlling the activity of odontoblasts

Nerve endings

Some A fibers enter the tubules in the coronal dentine Others end in predentine pulp junction It is suggested that there is a specialized junction between nerve endings & odontoblasts

Supraodontoblastic region

Not present in vital pulps Due to shrinkage of pulpal tissue during perparation Two structures are present

Regions

Unsheathed axons Dendritic antigen-presenting cells

Odontoblastic layer Subodontoblastic zone

Cell-free zone of Weil

No cells are evident Only axons & cell processes of fibroblasts & other cells Usually absent in radicular pulp Appears in contrast to cell-free zone Capillaries and nerve plexuses that contain the cell bodies of Schwann cells, endothelial cells, etc.

Cell-rich zone

Central region

The bulk of the dental pulp Central neurovascular core Fibroblasts, defence cells, undifferentiated cells Collagenous matrix and ground substance

Regions

Age-related changes

Getting smaller Reduction in vascular, neural & cellular contents Increase in fibrous matrix Some degree of mineralization

Pulp stones

Single vs. groups True (dentine-like that may be lamellated) vs. false (bone-like) Free vs. attached Tiny spicules throughout the pulp

Snow storm calcification