INTRODUCTIO

N
• The Pulp is a soft mesenchymal connective
tissue that
• Occupies pulp cavity in the central part of
the teeth.
• It is a special organ because of the
unique environment
 FEA TURES OF
PULP
• Surrounded by rigid walls (dentin) - unable to
expand in response to injury as a part of the
inflammatory process
• Therefore pulpal tissue is susceptible to change in
pressure affecting the pain threshold
• Pulp is simple connective tissue
• Peripherally layer of specialized cells
(odontoblasts)
• Secondary dentin deposited gradually (physiological
process) reduces the blood supply
• Making the tooth resistant to trauma or infection
➢ Total 52 pulp organs; 32: Permanent, 20: Primary
➢ Total Volume of all permanent teeth pulp
organs is 0.38 cc.
➢ Mean volume of a single adult human pulp is
0.02 cc.
• Each of these organs has a shape that conforms to
that of the respective tooth.
 DEVELOPMENT

• During the 8th week of IUL, there is condensation

of the mesenchmye under the enamel organ-
Dental papilla.
• The enamel organ enlarge and enclose the dental
papilla in their central portion.
• Dental papilla controls the morphology & type of
tooth to be formed.
• Dental papilla shows :
– Extensive proliferation of cells
– High vascularity
 DEVELOPMENT

• Following the differentiation of the IEE into

ameloblasts, odontoblast differentiate from the
peripheral cells of dental papilla
• Well organized capillaries are found at beginning
of dentinogenesis
• Capillaries crowd around the odontoblast during
active dentinogenesis
• Root formation is carried out by the proliferation
of cells at the cervical loop.
REGIONS OF THE PULP CAVITY

• The cavity can be

pulp
divided into two main
regions: the coronal pulp is
located within the crown of
the tooth and the radicular
pulp is located within the
root.

A, Coronal pulp; B, Radicular pulp

 CORONA L
PULP
• Pulp occupying the pulp chamber of the crown of the tooth
• In young teeth it resembles the shape of the outer dentin
• It has six surfaces : occlusal, mesial, distal, buccal, lingual
and floor.
• Pulp horns are projections into the cusp
• This pulp constricts at the cervical region where
it continues as the radicular pulp
 RADICULAR PULP
• Pulp occupying the pulp canals of the root of the
tooth
• Inthe anterior tooth it is single and in
the posterior teeth it is multiple
• The radicular portions of the pulp is
continuous with the periapical tissues through
apical foramen
• As age advances the width of the radicular pulp is
reduced, and so is the apical foramen.
 APICAL
FORAMEN
1. Pulp cavity terminates at root apex as
small opening called apical foramen
2. Radicular pulp continuous with connective
tissue of the periodontium through this foramen.
3. Diameter in an adult- maxillary teeth-
0.4mm mandibular teeth-0.3mm
4. Wide open during development of root
 APICAL
5. FORAMEN
Sometimes apical opening is found on the
lateral side of the apex
6. There may be 2-3 foramina split by cementum
or dentin- APICAL DELTA

Neurovascular bundle entering

pulp through the foramen
 A CCESSORY
CA NA LS
• Leading laterally from the radicular pulp into the
periodontal tissue.
• They are numerous in the apical third of the root.
• Formed due to premature loss of HERS or when
developing root encounters a blood vessel.
• Overall occurrence is 33%
• May also be present at the furcation region
STRUCTURA L
ORGA NIZA TION
OF PULP
 HISTOLOGICA L ZONES
OF PULP
• Odontoblast layer

• Cell-free zone

• Cell-rich zone

• Pulp proper
 Dentin
Odontoblasts
layer

Predentin
Cell rich
zone Pulp core

Cell free zone

 ODONTOBLA STIC
LA Adjacent
➢ Location: YER to the predentin with the cell
bodies in the pulp and cell processes in the
dentinal tubules.

Denti
n
 CELL FREE
ZONE
• It is also called weil’s zone
• 40 microns wide &relatively free of cells
• Traversed by
– 1. Blood vessels
– 2. Unmyelinated nerves
– 3. Cytoplasmic process of fibroblasts
• This zone is found below the odontoblastic zone
 CELL RICH
ZONE
• Present in subodontoblastic layer
• Contains more proportions of fibroblast
and undifferentiated mesenchymol cells.
• Macrophages, dendritic cells and lymophocytes.
• Zone formed due to migration of cells from
pulp proper
• Mitosis seen when dead odontoblasts are replaced
• Also contain young collagen fibres during
early dentiogenis.
 PULP
CORE
• It is central region of the pulp
• Contains major blood vessels and nerves of
the pulp
• Pulpal cells and fibroblasts are also seen
 CELLS OF
PULP
• Odontoblasts
• Fibroblasts
• Undifferentiated Cells
• Defense Cells
 ODONTOBLA ST
S
•A Peripheral area of the pulp where the
odontoblasts reside is termed odontogenic zone.
• Arranged in Palisading pattern cells are
tall columnar forming a layer of 3 to 5 cells in
depth.
• Shape may vary
– Cornal pulp- columnar
– Midportion - cuboidal
– Apical region - Flattened
 ODONTOBLA ST
S
• These cells have large process extending
into dentin
• The no of odontoblasts corresponds to the number
of dentinal tubules
• Average no of odontoblasts estimated to
45,000 per [Link] of odontogenic zone.
• Odontoblasts in the crown are larger than in
the root.
 ODONTOBLA ST
S
• Shape of the odontoblasts also reflect
the functional activity of the cell.
• During phase, cells show increase
active in endoplasmic reticulum golgi
secretory vesicles.
appartus and
• Resting (or) Non active phase cells are flattened
little cytoplasm condensed chromatin and
decrease no of ER
 JUNCTIONA L
COMPLEX
• Numerous junctions such as gap junctions tight
junction and desmosomes are found between
odontoblasts.
• Indicating exchange of ions and small molecules.
• They promote cell to cell adhension and play a
role in maintaining polarity of odontoblasts
Gap junction

desmosome
 ODONTOGENIC PROCESS
• Odontoblasts give off a single process that extends
into dentin and housed within dentinal tubules
• These process devoid of major organelles
• They contain abundance of
microtubular filaments and coated vesicles
 FUNCTIONS OF ODONTOBLASTS

• Synthesis of organic matrix

• Synthesis of non collagenous substances like
sialoprotein, phosphophoryn, osteocalcin,
ostenoectin & osteopontin
• Intracellular accumulation of calcium
• Degradation of organic matrix
 FIBROBALSTS
• Cells that occur in greatest number in the pulp
• Function is to form, maintain the matrix that
consists of collagen fibers and ground substance
throughout the pulp
• They are spindle in shape.
• The fibroblasts are stellate shaped cells having
extensive process.
➢ The nucleus stains deep with basic dye and
the cytoplasm is highly stained and homogenous.

H&E stain

Immunohistoc
hemical
method
➢ These cells have a dual function: synthesize and
degradation of fibers and ground substances in the same
cell .
• In young pulp:
• large cells with large multiple processes centrally located
oval nucleus, numerous mitochondria, well developed
golgi bodies well developed RER
Fibroblast
(protein secreting cell).
➢In periods of less activity and aging these cells
appear smaller and round or spindle-shaped with
few organelles , they are termed fibrocytes.
 UNDIFFERENTIA TED
MESENCHYME
• These mesenchymal cells are distributed through out the
pulp, frequently around the perivascular area - believed
to be toti potent cell
• They are Polyhedral shaped with peripheral processes
and large oval nuclei
• Difficult to differentiate from fibroblast under
light microscopy
• Under adequate stimilus they may differentiate
into odontoblast or fibroblast or macrophages.
• In older pulp, their number and ability to differentiate
comes down
 DEFENCE
CELLS
• They play a major role local inflammation
and immunity.
• They are recruited from blood stream and remain
as transient inhabitants in pulp
• These cells are
1. Macrophages
2. Mast cells
3. Plasma cells
4. Lympocytes, Neutrophils, Eosinophils,
basophils and manocytes.
 I- HISTIOCYTE ( MACROPHAGE )
➢ In light microscope, the cells appear irregular in shape
with short blunt processes.
➢ The nucleus is small, more rounded and darker in staining than
fibroblast.
➢ Their presence is disclosed by intra-vital dyes such
trypan blue.
➢ These cells are distrbuted around the odontoblasts and
small blood vessels and capillaries.
➢ Engulfment and digestion of foreign material
➢ Constitute 8-9% of total pulpal populations
➢ In case of inflammation, *nuclei, increase in size and
exhibit a prominent nucleolus.
➢ It exhibits granules and vacuoles in their cytoplasm
➢ Invaginations of plasma membrane are
ultastructurally with aggregation of noted
phagosomes . vesicles
or
 II- MAST CELLS:
• They have a round nucleus and their
cytoplasm contains many dark staining granules.
• They are demonstrated by using specific stains
as toluidine blue.
• They produce histamin & heparin.
• Occur in small groups in relation to blood vessels
• Present only during pulpal inflammation
 III- PLASMA CELLS:

➢ These cells are seen during inflammation.

➢ The arrangement of chromatin gives the nucleus
a cart wheel appearance.
➢ The mature type exhibits a typical small
eccentric nucleus and more abundant cytoplasm.
➢ The plasma cells are known to produce antibodies.
 IV- LYMPHOCYTES

• Usually found extravascularly in the normal pulp

• During inflammation they increase in number.
• Lymphocyte present along the walls of blood vessels
• Usually they are not found in uninflamed pulp
• They phagocyte foreign material .
 V- EOSINOPHILS

➢They are found in normal pulp and they

increase during inflammation.
 EXTRA CELLULA R
MA TRIX
• Connective tissue fibers
– Collagen
– Elastin
– Fibronectin
• Ground substance
– Proteoglycans
– Glycosaminoglycans
• Basement membrane
 F I B R E S ( C OL L A G E N F I B R E S )

• Extra cellular structural protein,

major constituent of connective tissue
• Collagen fibers appear throughout the pulp
• Young fine fibers ranging in diameter from
10- 12mm.
• Pulp collagen fibers do not contribute to
dentin matrix production.
• After root completion pulp matures and bundles
of collagen fibers increase in number
• They scattered throughout the coronal or
radicular pulp, or they appear in bundles. These
are termed diffuse or bundle collagen
• Most prevalent in root canals, especially near
apical region.
• Type I:
▪Present as thick striated fibrils
▪Responsible for pulp architecture
• Type III:
▪Thinner fibrils, mainly distributed in cell free
and cell rich zones
▪Contributes to the elasticity of pulp
• Type IV:
▪Presentalong the basement
membrane of blood vessels
• Type V and VI:
▪Seen to form dense meshwork
of thin microfibrils through out the
stroma
• Collagen turnover is maintained by fibroblasts
• During bacterial infection & inflammation,
collagenolytic activity is accelerated following
collagenase produced by bacteria, PMN &
fibroblats
• Collagen synthesis is accelerated during
reparative dentin formation
 E L A S T IC F IB E R
• 1. This has the ability to expand and contract like
a rubber band
• 2. Elastic fibers are first formed in bundles of thin
micro filaments called Oxytalan fibers
• 3. Elastin is then deposited in between
oxytalan fibers.
• 4. Always associated with larger blood vessels
 F I B R O N EC T I N

• It plays a role in cell-cell & cell-matrix adhesion

• Has a major effect on the
proliferation, differentiation & organization of
cells.
• Seen around the blood vessels
• Also found in odontoblast layer with fibers passing
into predentin
• Fibrinoectin helps to maintain cell morphology
and provide a tight seal at this site.
• Fibronectin may be involved in cell migration and
anchorage in the wound healing process of the
connective tissue of pulp.
• It regulates the migration and differentiation of
secondary odontoblasts
 GROUND S U B S TA N C E

• It is a structure less mass, makes up the bulk

of the pulp
• Consists of complexes of proteins,
carbohydrate and water.
• Broadly classified as
– Glycoaminoglycans
– Proteoglycans
• These substances are the environment
that promotes life of the cells
 G LYC O S A M I N O G LYC A N S

• GAG found in pulp is mainly

chondroitin sulphate, dermatan sulphate &
hyaluronic acid
• Proteoglycans - provide protection
against compression.
• During dentinogenesis, the ground substance show
affinity for collagen and influence fibrinogenesis
• They have capacity to bind with calcium and help
in mineralisation
 B A S E ME NT ME MB R A NE
• It is a sheet like arrangement of extra cellular protein
matrix at the epithelial-mesenchymal interface
• Composed of 2 layers
– lamina densa- electron dense
– lamina lucida- electro lucent
• Basement membrane is a product of connective tissue and
epithelium
• It is composed of
– Collagen type IV
– Laminin-adhesive glycoprotein
– Fibronectin
– Heparin sulfate
 FUNCTIONS

• Act as sieve between epithelium and connective

tissue
• Helps in organisation and differentiation by
enabling interactions between extra cellular
molecules and cell surface receptors
– Eg: Odontoblasts during tooth development
 B L OOD S UP P L Y T O T HE P UL P

 The pulp organ is extensively vascular with vessels

arising from the external carotids to the superior
or inferior alveolar arteries. It drain by the same
vein.

The walls of the pulpal vessels become very thin as

their enter the pulp.

The blood vessels gain entry into the pulp through

the apical foramen and at times through accessory
• Pulpal blood flow is more rapid than in most area
of the body
• So pulpal pressure is highest of body tissues
• The flow of blood in
– arterioles - 0.3 to 1mm/sec
– Venules – 0.15mm/sec
– Capilaries – 0.08mm/sec
A R T E R I A L OF T E E T H
V E NOUS DR A I NA G E OF T E E T H
L Y MP HA T I C DR A I NA G E OF T E E T H
 NE R V E S UP P L Y T O T HE P UL P

• Nerves : Several large nerves enter the apical

canal of each Molar and Premolar and single ones
enter the anterior teeth. This trunks transverse the
radicular pulp, proceed to the coronal area and
branch peripherally.
• Structure of
Tooth A - crown
B -
enamel
C -
dentine
D - gum
E - tooth
pulp F -
cement
H - nerves &
blood vessels
 Nerve Plexus of Raschkow
• Nerves enter the tooth through the apical foramen
as myelinated nerve bundles. They branch to form
the subodontoblastic nerve plexus of Raschkow
which is separated from the odontoblasts by a cell-
free zone of Weil.
A, Odontoblasts; B, Cell-free zone of Weil; C, Nerve plexus of Raschkow
Nerves in
 Dental Pulp

Nerv Blood
Clinically Importance features of the Dental Pulp

❖ With age the pulp becomes less cellular. The

number of cells in the dental pulp decreases as
cell death occurs with age.
❖ The volume of the pulp chamber decreases with
continued deposition of secondary dentine. In
older teeth, the pulp chamber decreases in size;
in some cases the pulp chamber can be
obliterated.
❖ An increase in calcification in the pulp occurs
with age.
Age chan es the lp
Age changin
ges inp the
puulp
The size of the
pulp The apical
foramen The decrease
cellular elements d
The bl. vessels &
n.
Vitality
 Pulp calcification

localized
diffus
(pulp
e
stones )

True False
denticle denticle
True denticles
True denticles are rare &
small in size&
found near the apical
foramen.
They consist of irregular
dentin containing traces
of dentinal tubules and
odontoblas
few odontoblasts. t
dentin
Remnants of the epithelial root al
tubule
sheath invade the pulp s
tissues causing UMC of the
pulp to form this irregular
type of dentin.
False denticles
*They are evidence of
dystrophic
calcification of the pulp
tissue .
*They contain no dentinal
tubules.
*They are formed of
degenerated cells or areas
of hemorrhage which act
as a central nidus for
calcification.
*Overdoses of vit. D, may favor
*Pulp stones are classified
according to their location
into: free, attached and
embedded.
*They continue to increase in
size and in certain cases they attached

fill up the pulp chamber

completely.
*The close proximity of pulp
stones to blood vessels may fre
e
cause atrophy of it.
 Diffuse pulp calcification

*Commonly occurs on top

of hyaline degeneration in
the root canal and not
common in the pulp
chamber.
*They are irregular calcific
deposition in the pulp
tissue following the course
of blood vessels or
collagenous bundle.
Free True
Denticle
Odontobla
st
Dentin
al
Tubule
Predent s
in
A, True pulp stone; B,
Pulp cavity; C,
Dentin
 A, False pulp stone; B, Pulp cavity
False pulp stone
Functions
Functions of
of the
the pulp
pulp

1 Inductive:
Dental papilla induces the enamel
organ formation and also
determines the morphology of the
tooth .
2 Formative :
Pulp organ produces dentin.
Odontoblasts develop the organic
matrix and function in its calcification.
3 Reparative: through the formation of
highly mineralized reparative dentin
at the site of injury to seal off the pulp
from the source of irritation . Also the
pulp may mineralize the affected
dentinal tubules by forming sclerotic
dentin .
4 Defensive : pulp inflammation
represents other aspect of its
response to irritation. In this
condition, the defensive cells of the
pulp
will be increased and activated to
repair and heal the inflamed pulp
5Protective: : any environmental
irritating stimuli always elicit pain as
a response .
6Nutritive : the extensive pulp vasculature
ensures an excellent nourishment to the
odontoblasts for the continuously
forming secondary dentin . This is
provided through the capillaries found in
the odontogenic zone .