Maria Fernanda Martínez Aldrete

1st semester group 1

PULP
The dental pulp is
connective tissue
soft and lax
located in the
central portion of
each tooth. It consists
of a portion
crown and a
root portion.
Contains glasses
blood vessels, nerves
and endings
nervous
closed inside
from the dentin.

The pulp has a

central zone and a
peripheral zone, the central zone contains arterioles, veins and
nervous trunks that enter the pulp from the duct
apical and
They proceed towards the coronal pulp chamber.

Fibroblasts are the predominant cells that live in

an extracellular matrix of glycosaminoglycans and fibers of
collagen. Odontoblasts are the second cells
more frequent.

The pulp has several functions, such as activities

initiatives, educational, protective, nutritional, and restorative.
All these clinical characteristics are important for
the production and maintenance of the teeth.

It can return after a trauma or with age, and

may contain diffuse areas of bundles of collagen fibers
and pulp calculations. It may also contain calcifications
diffused.

ANATOMY OF THE PULP

The human being has 52 dental pulp: 20 in the dentition
primary and 32 in the permanent.

All pulps have morphological characteristics.

similar, presenting a soft and gelatinous consistency
in a chamber surrounded by dentin that contains the
peripheral extensions of the pulp odontoblasts.

The total volume of the pulps of the permanent dentition is

around 0.38 ml
and the average volume of a single tooth is 0.2 ml (the pulps
the molars are some
four times greater than those of the incisors).
 Coronal pulp
The coronal pulp occupies the crown of the tooth. It is much
larger than the root pulp and has a
different structure from that of the root tissue.
It has six surfaces: Mesial, distal, vestibular, lingual,
occlusal and the floor. It also has pulp horns, which
they are protrusions of pulp that extend towards the
interior of the tips of the teeth.
In the cervical region, the coronal pulp connects to the pulp.
radicular. With age, the coronal pulp decreases in
size due to the continuous formation of dentin.

RADICULAR PULP
The pulp root canals extend from the
cervical region at the apex of the root. The root pulp of the
the anterior teeth are unique, while the teeth
posterior teeth have multiple root pulps.

The root pulp is sharp or conical and also becomes more

small with age
due to continuous dentinogenesis.
APICAL ORIFICES AND ACCESSORY CANALS

The apical foramen is the opening of the root pulp in the

interior of the periodontium. This opening is 0.3-0.6 mm,
being larger in the maxillary teeth.

If there are several apical canals, the largest one is

the apical opening and the more lateral ones are called
accessory ducts. The accessory ducts can
due to the presence of blood vessels that obstruct the
formation of dentin or a break in the root sheath
epithelial that induces the initial formation of the root.

HISTOLOGY

At the central level, the pulp is composed of large veins,

arteries and nerve trunks
surrounded by fibroblasts and collagen fibers included in
an extracellular matrix.

In the peripheral area along the dentin both in the

coronal pulp, as in the radicular, the cells are found
dentin-forming cells: the odontoblasts. The zone
odontogenic, the acellular zone and the cell-rich zone, thus
how the parietal nerve plexus of Raschkow includes these
odontoblasts.
The acellular zone is called the zone of Weil. Adjacent to this
there is a high cell density area called rich zone
in cells, in this area is the layer of
parietal nerves.

There is also the area of the horns or pulp horns.

where the odontoblasts are clustered and appear in
fence in contrast to its appearance in the rest of the area
coronal.

ODONTOBLASTS
The odontoblasts
review the perimeter
from the pulp, they are
small and oval
when they start their
differentiation, but
they will soon become
cylindrical.
Subsequently
they develop
extensions
around
how is the
dentin

They are bigger in

the coronal pulp that
at the root and it
cylindrical samples
on the horns or
pulp horns.
These tall cells and
cylindrical have
about 35 mm of
length in
the pulp horns, while in the root pulp they are
more cubical and flat in the apical region.

The extension of the odontoblast is the widest part of

the cell, extending from the pulp to the junction
amelodentinary.
The extension originates at the edge
predentin layer of the odontoblast, where the cell constricts
as the extension enters the dentinal tubule.

The active cell has a large nucleus in its basal portion and
a Golgi apparatus in its apical portion. Throughout the body
the cell has abundant endoplasmic reticulum
rough and numerous mitochondria.

Three types have been observed among adjacent odontoblasts.

of union complexes:
tight junctions (zonula occludens), in gap (gap) and
intermediates.

Adhesive joints are areas located around

these cells and that
they act in maintaining the positional relationship between
the cells.

The groove joints are openings between

odontoblasts for the
communication of cellular electrical impulses and the passage of
small
molecules, in this way, the odontoblasts can
synchronize your activity.
 FIBROBLASTS
Fibroblasts are the most numerous cells in the pulp,
since they are located throughout their extent. In the pulp
young fibroblasts produce collagen fibers and
fundamental substance (they have a large oval nucleus of
central location and multiple extensions.

The view of a fibroblast at a higher magnification shows the

Golgi apparatus, an abundant endoplasmic reticulum
rough adjacent and mitochondria. With age, these cells
they appear smaller, spindle-shaped and with few
organelles.

OTHER CELLS OF THE PULP

The nerve cells of the pulp include cells of
Schwann. These cells form the myelin sheath of the
nerves and are associated with all the pulp nerves.

In addition, endothelial cells that line can also be visualized

the capillaries, veins, and arteries of the pulp. Accompanying the
mayoría de vasos sanguíneos en la pulpa, se encuentran
pericytes and perivascular cells, as well as cells
undifferentiated.

They work as a cellular reserve and are put into action.

when new ones are needed
odontoblasts or fibroblasts.

Macrophages, normal constituents of the pulp, act

in the maintenance of this due to cellular renewal
in the pulp. B and T lymphocytes are also found, which
they confer an immune capacity to the pulp. In the vessels
blood cells in the pulp include erythrocytes, leukocytes,
eosinophils and basophils.
VASCULARIZATION
In the extracellular matrix, there are collagen fibers.
collagen originates from pulp fibroblasts and has been
found types I and III of collagen. Type I is produced
by the odontoblasts.

Type III is produced by pulp fibroblasts for the

maintenance of the pulp itself.

Surrounding the fibers is the fundamental substance of the

pulp. This substance is the environment that provides life.
for the cells of the pulp.

Type IV collagen is present in the pulp, associated with the

basal membrane surrounding the blood vessels. In the
the pulp itself there are also other types of
collagen, but in small amounts.

FIBERS AND GROUND SUBSTANCE

The pulp organ is highly vascularized, with vessels

arising from the external carotid arteries, the arteries
upper and lower alveoli.

The walls of the periodontal and pulp vessels become

thinner as they enter the pulp, already
that the pulp is protected by dentin.

Estas arterias de finas paredes penetran en el conducto

apical and follow a direct path from the root pulp
toward the coronal area. Along that path, the vessels
branches form that pass towards a plexus located in y
adjacent to the odontogenic zone of
the root.
These cups have three layers:
Internal limiter, which is formed by cells of shape
scaly surrounded by a fibrous basal membrane
closely associated.

2. Intermediate layer, consisting of muscle cells with a

thickness of one a
three cellular layers.

3. Outer layer, made up of a diffuse layer of fibers

of collagen that forms
a loose network around the larger arteries.

The presence of lymphatic vessels has been observed in the

pulp. These vessels have thin walls, are shaped
irregular, they are larger than capillaries and have a
incomplete sheet that supports the intimate and the medium.

NERVES
In the apical duct
of each molar and
premolar penetrates
various nerves, while
what in the teeth
previous ones enter a
unique nerve. These
nervous trunks
they pierce through the pulp

["radicular","continuing"]
towards the coronal area.

With the axons

myelinic also includes unmyelinated axons. A young molar
It can have 350-700 myelinated axons and 1,000-2,000 axons.
amielinics entering the apex.
The large nerve trunks are wrapped with cells.
of Schwann. Later the subodontoblastic plexus becomes
evident on the ceiling and the side walls of the pulp
coronal and to a lesser extent in the root canals.
This plexus includes myelinated and unmyelinated axons, and it
nervous plexus
of Raschkow.

From the parietal layer, the nerves lose their sheath of

myelin, move into the interior of the odontogenic area and
then they end up among the odontoblasts or extend towards
the interior of the dentinal tubules with the extensions
odontoblasts.

Nerve endings
Most of the pulp nerve endings are in
the odontogenic region of the pulp horns. Some
they end on or in association with the odontoblasts. Others
they are found in the predentinal tubules.

These nerve endings presumably intervene

in the reception of pain.
All these endings look similar and are
highly vascularized.
These endings are postganglionic sympathetic nerves.
with cellular bodies
located in the superior cervical ganglion.

PAIN AND DENTO-PULP COMPLEX

The pulp is very sensitive to temperature changes,
electrical and chemical stimuli and pressure. The teeth are a
of the few body structures that only perceive
the modality of pain.

The nerve endings in the dentinal tubules and the

pulp can be at a certain distance from where it is perceived
pain, in the amelodentinal junction and in the internal enamel.

Theory of direct innervation

It is based on the belief that the nerves extend to
the amelodentinal union.

Transduction Theory
They believe that the odontoblastic prolongation is the receptor and
that leads the pain to the nerve endings in the
peripheral pulp and in the dentinal tubules.

Hydrodynamic theory

It was developed to explain the transmission of pain to

through the thickness of the dentin. This theory is based on the
premise that, when stimulated the
dentin, the fluid and the odontoblastic extensions
they move within the tubules,
contacting the nerve endings in the dentin
internal and the adjacent pulp.

FUNCTIONS OF THE PULP

Its main function is to provide vitality to the
teeth with their cells, blood vessels, and nerves.
It is inductive, since in the initial development the pulp
(papilla) interacts with the oral epithelium and initiates the
tooth formation.
 The pulp is protective in its response to stimuli.
such as heat, cold, pressure or invasive operational techniques.
The pulp is nutritious, as it transports oxygen and
nutrients for development and functioning of
tooth.

It has the ability to be restorative through its

response to surgical incisions or dental caries
through the formation of reactive and reparative dentin.

REGRESSIVE CHANGES
Many regressive changes are related to stimuli.
environmental and with aging. As the tooth
as it ages, the pulp decreases in size due to the
continuous deposition of dentin.
As a result of aging and trauma, the
pulp cells decrease, just like the cytoplasm
perinuclear and the cytoplasmic organelles, such as
mitochondria and endoplasmic reticulum. This indicates that the
cellular activity has decreased.

FIBROUS CHANGES
In some cases, a diffuse fibrosis appears with fibers of
collagen along the pulp. It has not been determined what
mechanism causes this process, although it is believed that it is the
result of the pulpal injury.

One characteristic of aging is an increase in

collagen fibers, which become more evident with the
reduction of pulp size.

Some pulps contain diffuse areas of collagen,

while others have beams of this, due to the injury,
as well as to unknown systemic factors.
PULP CALCULATIONS
Pulp calculi are calcified, round masses.
oval, which appear in the duct or in the portions
coronals of the pulp organ.
They appear on teeth that have suffered injuries, as well as
in others with normal pulps. The pulp calculations also
they appear both in unerupted teeth and in
erupted teeth.

They are classified, according to their structure, in

true or false:
On the surface of these true denticles, they can
to meet
odontoblasts, and their extensions are visible in their
tubules.
False denticles have concentric layers of tissue.
calcified.
Dentinicles can appear free in the pulp, adhered
to the dentin, or included
in the dentin. Consequently, they have been classified as
free denticles, adhered or
included..

DIFFUSE CALCIFICATIONS
Diffuse calcifications appear as deposits
irregular calcifications along fiber beams of
collagen or blood vessels in the pulp.

They are considered a pathological process and usually appear

like a spray of mineral or like small masses of
this.