JSS ACADEMY OF HIGHER EDUCATION & RESERACH

JSS Dental College & Hospital

PULP

DR. SREESHYLA

Department of Oral Pathology & Microbiology

 Introduction
• 52 pulp organs (20 primary + 32 secondary).

Volume of pulp:

• The total volume of all permanent teeth pulp organs is

0.38 cc.

• The mean volume of a single adult pulp is 0.02 cc.

• Molar pulps are 3 to 4 times larger than incisor pulps

 Parts of pulp

Pulp chamber:

located in the crown of the tooth

Root canal:

seen in the root portion of the tooth.

• The portion of pulp that occupies the pulp
chamber is called as
coronal pulp
• The portion that occupies the root canal is
called as the
radicular pulp.
• The pulp communicates with the peri-
radicular tissue through the

- apical foramen and

- accessory canals or lateral canals.

DEVELOPMENT
 HISTOLOGICAL STRUCTURE

• Under decalcified sections of tooth.

• Four distinct zones

1. odontoblastic zone
2. cell free zone (Weil's zone)
3. cell rich zone and
4. pulp core.
 Odontoblastic zone

• seen at the periphery of the pulp

• consists of the cell bodies of odontoblasts

• Many nerve fibers enter this zone and terminate

between the odontoblasts.
 Cell free zone
• This layer is called as zone of Weil or sub odontoblastic layer

• This zone contains network of nerve fibers that have lost their
myelin sheath and are known as

subodontoblastic plexus or

Plexus of Rashkow or

parietal layer of nerves

 Cell rich zone

• situated just below the cell free zone.

• it is more prominent in coronal pulp

• It consists of fibroblasts,
undifferentiated mesenchymal cells,
macrophages,
immune competent cells
young collagen fibers.

• Serves as a reservoir for replacing the destroyed odontoblasts.

 Pulp core or pulp proper

• located in the centre of the coronal and radicular pulp

• contain loose connective tissue with abundant cellular

elements, nerves and blood vessels

• In young pulp contains more cells

In older pulp contains more of fibrous components

 STRUCTURAL COMPONENTS OF DENTAL PULP

Cells in the dental pulp

• Odontoblasts
• Fibroblasts
• Undifferentiated mesenchymal cells
• Immuno-competent cells

Extracellular components:
• Fibers - Collagen
• Intercellular ground substance

Connective tissue structures:

• Blood Vessels
• Lymphatic channels
• Nerve fibers
• Odontoblasts in three different stages can be
identified in pulp

1. synthetic or active odontoblasts,

2. intermediate or transitional odontoblasts

3. resting or aged odontoblasts.

 Undifferentiated mesenchymal cells
• Represent the totipotent or reserve cells which are derived from the
connective tissue cells of the pulp.

• Location: found along blood vessels in cell rich zone and are
scattered throughout the central pulp.

• Size: larger than fibroblasts

• Number: more in young pulp and decreases with age,

• Shape: polyhedral in shape with peripheral processes & large oval

staining nucleus.

• Function: It give rise to odontoblasts, fibroblasts, or macrophages.

 Immuno-component cells

• Histiocytes, or macrophages
• Dendritic cells
• Lymphocytes
• Mast cells
• Plasma cells
• Neutrophils
• Lymphocytes
• Monocytes, etc. are also seen
Lymphatic channels
• The lymph vessels are irregular lumen composed of
endothelial cells surrounded by an incomplete layer
of smooth muscle cells.

• anterior teeth drains into the submental lymph

nodes

• posterior teeth drains into the submandibular

and the deep cervical lymph nodes
Nerves:
• enter pulp through apical foramen.

• sensory supply: trigeminal nerve and superior cervical

ganglion.

• Non-myelinated –A δ and A β fibers which transmits sharp

pain and majority in number

• Non-myelinated or "c" fibers which transmits dull pain and

associated with blood vessel
 FUNCTIONS OF DENTAL PULP

1. Nutritive

2. Sensory

3. Formative

4. Defensive

5. Protective
1. Nutrtive:

• The blood vascular system nourishes and maintains the vitality of dentin

• by providing oxygen and nutrients to the odontoblasts.

2. Sensory:

• The pulp has both myelinated and nonmyelinated nerve fibers.

• Sensory nerve fibers present in the pulp respond to stimuli such as temperature,
pressure, vibration and chemical agents.

3. Inductive:

• Determines the crown pattern and differentiation of odontoblast cell through its
inductive influence.
4. Formative:

• the presence of odontoblasts which are the formative cells of

dentin.

5. Defence and protective:

• The pulp responds to irritation and protects itself and the

vitality of the tooth

• by producing reparative dentin or inducing dentinal sclerosis

• Pulp may initiate an inflammatory reaction in response to an

irritating stimulus,

• which aids in the process of repair of pulp.

 AGE CHANGES IN PULP

1. Size

2. Cellular & Fibrous changes

3. Changes in blood supply and innervations

4. . Reduction in sensitivity and healing potential

 Pulpal calcifications
• Pulp stones or denticles are nodular calcified masses present in
coronal or radicular pulp.

• Seen in functional as well as embedded or unerupted teeth.

• Incidence: 66% (10 - 30 years),

80% (30 - 50 years)
90% (above 50 years).

• Etiology: Infection,
trauma due to operative procedures,
vascular injury resulting in thrombosis and
systemic diseases (atherosclerosis)
Classification

Depending upon the relation to dentin

1. Free pulp stones: calcified structures lying free in the pulp

without being attached to the dentin

2. Attached pulp stones: attached to the dentin

3. Embedded pulp stones:

pulp stone is completely surrounded by dentin it is called

embedded pulp stone
Diffuse Calcification:

• linear strands parallel to the long axis of pulp.

• Present closely associated with blood vessels

• seen in radicular pulp.

Clinical significance:

• mild neurologic pain.

• difficult in extirpating the pulp during RCT.

 Clinical Considerations
• The pulp horns can be inadvertently exposed during cavity preparation and is more
common in case of deciduous dentition

• pulp can cause spread of disease to the periodontium through an accessory canal

• vitalometers, which test the reaction of the pulp to electrical stimuli, or thermal stimuli
for identify the "vitality" of the pulp.

• Laser Doppler flowmetry, an electro-optical technique used to record the pulpal blood
flow

• Pulp capping done in noninfected or minimally infected or accidentally exposed pulps