UNIVERSITY OF DJILALI LIABLES

FACULTY OF MEDECINE TALEB MOURAD

DEPARTEMENT OF DENTISTRY

Dental pulp
Presented by Miss. Mai Joumana
Summary
 Introduction
 Morphology : regions of the pulp cavity
zones of the pulp
 Histology
 Vascularity
 Innervation
 Functions
 Regressive changes (age changes)
 Diseases of pulp
 conclusion
Introduction

 The dental pulp is that soft connective tissue that

occupies the pulp cavity in the central part of the
teeth.
 Morphology: Regions of the pulp cavity

The pulp cavity can be devided into two main regions:

*The coronal pulp that is located within the crown of
the tooth.
* The radicular pulp which is located within the root.
A, Coronal pulp
B, Radicular pulp
 *The apical foramen :
Pulp cavity terminates at root apex a small opening
called apical foramen.
Radicular pulp communicates with the connective
tissue of the periodontium through this foramen.
It’s diameter for an adult maxillary teeth is 0,4 mm
& for a mandibular teeth is 0,3 mm.
* Accessory canals :
Leading laterally
from the radicular
pulp into the
peridental tissue.
Morphology: Zones of pulp
 A- Odontoblasts zone :
It’s adjacent to the predentine
along the pulp periphery.
They are dentin forming cells.
 B- Cell free zone (Weil’s zone) :
It’s 40 microns wide & relatively free of cells.it’s
traversed by :
1. Blood vessels
2. Unmyelinated nerves
3. Fibroblasts
it’s found below the odontoblastic zone.
 C- Cell rich zone :it’s present beneath the cell free
zone. It contains more propotions of fibroblast &
undifferenciated mesenchymal cells.
it also contains macrophages, dendritic cells &
lymphocytes.
Cell free zone

Cell rich zone

 D- The pulp core :
 It is the central region of the pulp.
 It contains blood vessels & nerves
Histology
1- Formative cells :
a- Odontoblasts :
5-7µm in diameter
24-40 in length
They have large extending process into
dentin. Their number coresponds to the
number of dentinal tubules. The averadge
number of odontoblast is estimated to
45000 per Sq.mm of odontogenic zone.
 b- Fibroblasts :
 Most numerous type of cells.

 Spindle in shape with elongated processes.

 They synthetize & degrade fibres in ground

substance.
 In period of less activity & aging ,these cells
appear smaller & round with few organelles, they
are termed fibrocytes.
2- Defensive cells :
a-Macrophages :
b- Plasma cells
c- Lymphocytes
d- Eosinophiles
e- Mast cells
Macrophage
lymphocyte
Plasma cell

Eosinophile Mast cell

 3- Progenitors cells :
* The undifferentiated mesenchymal cells :
 They are smaller than fibroblasts but have a similar

appearance . They are usually found along the

walls of blood vessels.
 They have the potentiality of forming other types of

formative or deffensive connective tissue cells.

Undifferentiated mesenchymal cells
Extracellular matrix
 Connective tissue fibres
- Collagen
- Elastin
- Fibronectin (glycoprotein)
 Ground substance
 Basement membrane
 Collagen fibres

Elastic fibres
 *Fibronectin :
 It plays a role in cell-cell & cell matrix adhesion .

 Has a major effect on prolifiration, differenciation

& organization of cells.

 It’s seen around the blood vessels.

 Also found in odontoblast layer with fiber passing

into the predentin.

 *Ground substance :
 A strucutureless mass that makes up the bulk of the

pulp.
 Consists of complexes of proteins, carbohydrate &

water.
 Broadly classified as

Glycosaminoglycans
Proteoglycan
 *Basement membrane :
 A sheet like arrangement of extra cellular protein

matrix at the epithelial mesenchymal interface.

 It is a product of connective tissue & epithelium.

 It is composed of :

Collagen type IV
Laminin adhesive glycoprotein
Fibronectin
Heparin sulfate
Vascularity
 The pulp cavity receives
blood from one arterial that
enters the apical foramen &
courses directly to the coronal pulp.
 Within the coronal pulp,

numerous arterial branches

form an interconnected network
of blood vessels as seen below
filled with ink.
Innervation
 Sensory nerve fibers that
originate from inferior &
superior alveolar nerve
innervate the odontoblastic
of the pulp cavity.
 These nerves enter the tooth

throgh the apical foramen as

myelinated nerves bundles.
 They branch to from the

subodontoblastic nerve pluxus

of Raschkow which is separated
from from the odontoblasts by the cell free zone .
Functions
 Inductive :
Dental papilla induces the enameml organ formation
& also determines the morphology of the tooth.

 Formative :
Pulp organ produces dentin. Odontoblasts develop
the organic matrix and function in its calcification.
 Reparative :
Through the formation of highly mineralized reparative at
the site of injury to seal off the pulp from the source of
irritation. Also the pulp may mineralize the effected
dentinal tubules by forming sclerotic dentin.
 Deffensive :

Pulp inflammation represents other aspects of its

response to irritation. In this condition, the deffensive
cells of the pulp will be increased & activated to repair
& heal the inflamed pulp & phagocytose the invading
bacteria & their toxin.
 Nutritive :
The extensive pulp vasculature ensures an excellent
nourishement to the odontoblasts for the
continuously forming secondary dentin. This is
provided through the capillaries found in the
odontogenic zone.
Regressive changes (age)
 Appearance of fewer cells in aging pulp.
 Cells are characterized by a decrease in size &
number of cytoplasmic organelles.
 Active pulpal fibrocyte has abundant rough
surfaced endoplasmic reticulum, notable golgi
complex & numerous mitochondria.
Reticular atrophy: the total affect is the production of a lessened vitality of the pulp
tissue & a lessened response to stimulation .
Pulp diseases

 Pulpitis- acute & chronic

 Pulp stones (denticles)
 Fibrosis
Pulpitis
 An inflammation of pulpal tissue (acute or chronic)
with or without symptoms , reversible or irreversible.
 Reversible pulpitis : pulp is capable of full recovery
if the irritating factor is removed (restore tooth
conservatively). Pain is sharp & intense, remains 5-
10mn.
 Irreversible pulpitis : pulp isn’t capable of recovery
(remove the diseased pulp tissue of entire tooth ).
Pain is less intense, initiated spontaneously, remains
longer than 20mn.
 Ethiology:
 penetration of microorganisms into dental pulp
(dental caries)
 Noninfectious character ( trauma, termic damage,
irritation by nonsuitable dental filling materil).
 Clinical symptoms :
 Continuous pain radiating into the face, ear or neck
with no previous history of pain.
Pulp calcification
 Also called pulp stones (denticles).
 Calcified masses into the dental pulp.
 True denticles have tubules like dentin.
 False denticles have a lamellated structure.
True denticle

False denticle
Pulp stones
Fibrosis
 Accumulation of both diffuse fibrillar & bundles of
collagen fibres.
 Fiber bundles may appear arranged
longitudinally in the radicular pulp & more diffuse
in coronal pulp.
 Collagen accumulation also accurs in some older
pulps.
 Increase in fibres in the pulp organ is gradual &
generalized.
 external trauma such as dental caries or deep
restaurations cause a localized fibrosis.
Conclusion
 The dental pulp is a unique tissue & it’s importance
is often ignored by clinincians. It’s unique because it
resides in a rigid chamber which provides strong
mechanical support & protection from the microbial
rich oral environnement.