MARTIN, CHRISTINE JOYE O. DR.

JOCELYN FLORES

DENT2A (TH 11:00-1:00) ORAL HISTOLOGY

QUIZ
PULP and PERIODONTAL LIGAMENT
1-2 PARTS OF PULP CAVITY

The pulp cavity is topographically divided into:

a) PULP CHAMBER or CORONAL PULP –This is located in the crown of the tooth.
This has pulp horns which are protrusions that extend into the cusp of each
tooth.
b) ROOT CANALS or RADICULAR PULP –This is located in the root area portion of
the tooth extending from the cervical region of the crown to the root apex.
In anterior teeth, the radicular pulps are single and in the posterior ones,
they are multiple. The outline of the radicular pulp conforms with the
dentino-cemental junction.
3-7 ENUMERATE 5 PRINCIPAL FIBER GROUPS

The principal fiber groups of periodontal ligament are:

a) ALVEOLAR CREST GROUP (ACG) –This group extends obliquely from the
cementum just beneath the junctional epithelium to the alveolar crest.
This fibers also run from the cementum over the alveolar crest and to the
fibrous layer of the periodontium covering alveolar bone. This functions to
prevent extrusion of the tooth and resist lateral tooth movement.
b) HORIZONTAL GROUP –This extends at right angles to the long axis of tooth
from cementum to the alveolar bone.
c) OBLIQUE GROUP –This is the largest group or the most numerous of the
periodontal ligament. This extends from the cementum in a coronal
directing obliquely to the bone. This functions to bear the brunt of vertical
masticatory stresses and transform them into tension on the alveolar bone.
d) APICAL GROUP –This radiates in an irregular fashion from cementum to the
bone at the apical region of the socket. This functions to resist forces of
luxation, prevent tooth tipping, and protect the delicate blood vessels,
nerves, and lymphs at the apex.
e) INTERRADICULAR GROUP –This fan out from cementum to the tooth in the
furcation areas of multirooted teeth.

PRINCIPAL FIBER GROUPS

8-10 THREE GENERAL CLASSIFICATIONS OF PULP STONES

The three general classifications of pulp stones are:

 ACCORDING TO THEIR HISTOLOGIC OF STRUCTURE:

1. TRUE DENTICLES –These have dentinal tubules like dentin. The
odontoblasts maybe on the surface of the denticles, and their processes
are evident in their tubules.
LEGEND:

2. FALSE DENTICLES –This has concentric A –TRUE

DENTICLES
layers of calcified tissue. In the center of
these false stones, there may be a group B- DENTINAL
TUBULES
of cells that appear necrotic. The
predominance of denticles is false ones
and appears free in the pulp.
3. MIXED DENTICLES LEGEND:

A –PULP
 ACCORDING TO LOCATION IN RELATION TO
B –DENTIN
DENTINAL WALL:
1. FREE DENTICLE –These denticles are C –FALSE
PULP STONE
completely surrounded by pulp tissue.
2. ATTACHED or ADHERENT DENTICLE –
These denticles are partly fused to the
dentinal wall.
3. EMBEDDED or INTERSTITIAL DENTICLE –
These denticles are completely
surrounded by dentin.

 ACCORDING TO FORM:
1. NODULAR –These are denticles that are round in shape.
2. AMORPHOUS –These are denticles that have no definite form.
3. FIBRILLAR or DIFFUSE –These are denticles that appear more often in
the root canal than the coronal area of the pulp. It is a result of
elongated calcification following the course of blood vessels and
nerves.
ESSAY
1. Why should we always protect the pulp from injuries (like accidentally
exposing pulp during restorative procedures etc.)? (5pts)

Pulp is a specialized and highly vascularized connective tissue that comprises

of nerves, vessels, lymph channels, etc. As it is located at the central portion of
the tooth, it is also known as the “heart of the tooth”. This function for: (1)
provides nutrition to dentin and pulp, (2) produces and maintains dentin, (3)
sensory, and (4) defense mechanism through triggering of inflammatory and
immune response. If inflammation of the pulp is present, it can spread to the
periodontium and vice versa. Also, pulp exposure from caries, trauma or tooth
cavity preparation can be severe and lead to pain and/or infection, and
eventually pulpal pathosis resulting in either root canal treatment or an
extraction.

Cavity preparation and associated procedures, the toxicity of restorative

materials and the continuing challenge from leakage of bacteria and their
products at the margins of restorations can contribute further damage to that
caused by the original caries. This may tip the balance from a reversible to an
irreversible pulpitis; it also highlights the importance of a holistic approach to
management of dental caries, which aims to restore the functional integrity of
the tooth while preserving its vitality and protect the pulp from further damage.

Pulp capping is a technique used in dental restorations to prevent the dental

pulp from necrosis, after being exposed, or nearly exposed during a cavity
preparation. This treatment is to preserve the pulpal vitality. If pulp tissue is
removed completely, tooth becomes “non-vital” and hence is insensible to any
kind of stimulus. A fundamental consideration in pulp protection is the
recognition that infection is a key driver of inflammation, which often determines
the outcomes for pulp survival.
 2. How does the periodontal ligament perform/demonstrate its supportive
function? (5pts)

The PDL is the connective tissue that surrounds the root and attaches it to the
alveolar bone. This is also Continuous with the connective tissues of the gingiva
and communicates with marrow spaces in bone. They serve as (1) provision for
soft tissue, (2) transmission of occlusal forces to the bone, (3) attachment of
teeth to the bone, (4) maintenance of gingibal tissues in their proper relationship
to the teeth, and (5) resistance to impact of occlusal forces.

The periodontal ligament is composed of principal fibre bundles that exit the
cementum and alveolar bone and to the cement of the adjacent teeth.
Specifically, the alveolar crest fibers functions in preventing the extrusion of
tooth and resisting the lateral movements. Next, the horizontal fibers functions to
resists tooth development by lateral pressure. The oblique fibers functions to
sustain occlusal stress. This also serves to suspend and anchor tooth socket. Next,
the apical fibers prevents vestibule-oral tipping and it protects vital structures at
apical foramen. Lastly, the interradicular fibers are attached from the
cementum and inserted to the nearby alveolar bone to function for resisting
tipping and torque.

These fibers help the tooth withstand the naturally substantial compressive
forces which occur during mastication and remain embedded in the bone. As a
matter of fact the width of the periodontal ligament increases when the teeth is
subjected to an occlusal stress. This permits the teeth to withstand the
considerable forces of mastication. Also, the periodontal ligament fibers being
non-elastic, this prevents the tooth from being moved too far. This is due to the
network of fine collagenous fibre bundles that surround the interstitial spaces
that are arranged at angles arranged like a suspension bridge or hammock. The
oblique fibers alter their wavy pattern and sustain the major part of the axial
force. The compressed ligament provides support for the loaded teeth.