ANATOMY OF THE PULP

The pulp is the living tissue which occupies the pulp cavity.

Endodontia “inside a tooth” Pulp canal (s) located in root or roots of teeth _Pulp chamber–found under anatomical crown _Pulp horns–elongations of the chamber which often corresponds to the cusps or lobes _Apical foramen–opening at or near the apex –in/out _Lateral canals–extend towards periodontal ligament _Supplementary canal–not present in all teeth

Physiology–function _Formation of Dentin: primary, secondary, reparative _Nutrition _Sensation _Defense and Protection _Pulp Canal Development _Changes with age  Pulp Latin - pulpa + flesh The 1. Any soft, juicy animal or vegetable tissue. 2. A richly vascularized an innervated connective tissue of mesodermal origin, contained in the central cavity of a tooth and delimited by the dentin, and having formative, nutritive, sensory and protective functions. a. Formative–odontoblasts produce dentin throughout the life of the tooth. This is called secondary dentin. b. Nutritive: from blood to odontoblast cytoplasmic extensions in dentin. c. Sensory: pain from heat, cold, drilling, sweets, decay, trauma, infection. Clinical Perspective A. Remember, the pulp is your friend! Treat it with lots of respect. It's like having a diagnostic computer planted in the tooth. B. The slightest exposure to the outside elements (carious exposure, a fracture, idiopathic procedures) will cause DEATH TO THE PULP the majority of the time. C. A accurate diagnosis may be made by asking the patient the correct questions. An x-ray is always another diagnostic tool. however many times the tooth will appear normal. Digital x-rays promise to be even more definitive. The following symptoms can be used as guide lines to your diagnosis. COLD- The tooth is being irritated. The list of irritations can be long. Common irritations are decay, abrasion, erosion, overworked, improper brushing, whitening agents. HOT- The tooth needs endodontic therapy or removal HOT AND COLD- There is a internal fracture or stress line typically at the junction of the enamel-dentin

no odontoblast layer) –not associated with any symptoms  Regions of the Pulp Odontoblast layer Cell-free zone (of Weil) **Sub-odontoblastic plexus of Raschkow –Terminal and sub terminal branches of sensory fibers Cell rich zone **increased cell density **blends into bulk of pulp  Pulp Anatomy 1. Classifications: Type I. Chamber – anterior – in the crown – Posterior–partly in the crown. irritation.Necrotic tissue present or periodontally involved. III. Accessory foramen–most commonly found near the apex. Protective response to injury or decay by forming reparative dentin. This can be corrected with a new restoration.  Dental Papilla is the undifferentiated predecessor of the dental pulp. Cytodifferentiation begins at the bell stage (not cap stage) under the influence of the internal epithelium the peripheral cells of the papilla differentiate into odontoblasts. Once pulp chamber in each tooth Roof–incisal or occlusal border Floor–in multi rooted teeth–the cervical portion with openings for each root canal 2. Root canal–also known as pulp canal found in root of a tooth. d.  Changes of the Pulp Age Developmental stage **Synthetic activity of odontoblasts and fibroblasts are high–protein synthesis Mature stage **Activity subsides to a low but constant level **”ready state” to accelerate due to outside stimulus Pulpal calcification **Over 90% of old human teeth show signs –diffuse –pulp stones – true denticles (have odontoblastic layer) –false denticles (more frequent. The root canal is a continuation of the chamber. Apical foramen–at or near the root apex b. 90% of the time when the tooth hurts to percussion there is necrotic tissue in the pulp. SWEET-Similar to cold. HURTS TO THE BITE.  Variations of Pulp Anatomy Genetics Age of Tooth Function: Normal Para function Disease–Systemic During Tooth Formation . It is thought that the ectomesenchymal (neural crest) cell provide initiative for differentiation.location. II. a. IV 3. mostly in the cervical part of the root. This tends to be a external source involving exposed dentin and plaque.

III D-2 Canals 35% Type II Mandibular 2ns M-2 canals 64% Type II. lateral incisors and canines: Type I Mandibular central incisors–1-2 canals Type I. II Mandibular lateral incisors–1-2 canals Type I. III Maxillary 2nd premolar–one root-50% have 2 canals Type I or II. MB-2 canals-type III. or II. III. 90% have 2 canals: Type I. P-1 canal Maxillary 2nd molar MB-has 2 canals 17% Mandibular 1st M-2 canals MB and ML Type II. III Mandibular 1st and 2nd premolar-one root 1st Type I (70%) Type IV (24%) 2nd Type I Maxillary 1st molar DB-1 canal.Local Trauma – Caries –Recession –Tooth Damage  Chamber Variations Pulp horns–projection beneath cusps or mamelons in the roof of the chamber. Floor–flat in young teeth convex with aging  Anatomy of the Pulp Mandibular *Incisors–70-90% 1 canal *Canines *Premolars *First Molar –follows crown contour –two canals in M root *Second Molar *Third Molar–high variability Maxillary *Incisors–triangle to circular *Canines–canal wider labio-lingually *First Premolar–70% have two roots *Second Premolar-split canal two foramina *First Molar–60% of MB have two canals *Second Molar *Third Molar–high variability  Young Teeth (see diagrams of types) Maxillary central incisors. 1 canal 27% D-1 canal . II Mandibular canines–Type I Maxillary 1st premolar–approximately 60% have 2 roots.