Pulp (tooth)
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Overview
| Pulp (tooth) | |
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| Section of a human molar | |
| Latin | pulpa dentis |
| Gray's | subject #242 1118 |
| MeSH | Dental+pulp |
| Dorlands/Elsevier | p_41/12679455 |
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The dental pulp is the part in the center of a tooth made up of living soft tissue and cells called odontoblasts.
Anatomy
Each person has a total of 52 pulp organs, 32 in the permanent and 20 in the primary teeth. The total volumes of all the permanent teeth organs is 0.38cc and the mean volume of a single adult human pulp is 0.02cc. Maxillary central incisor has shovel shaped coronal pulp with three short horns on the coronal roof and triangular in cross section. Cuspid has the longest pulp with elliptical cross section.
Crowns of the teeth contain coronal pulp. The coronal pulp has six surfaces: the occlusal, the mesial, the distal, the buccal, the lingual and the floor. Because of continuous deposition of dentin, the pulp becomes smaller with age. This is not uniform throughout the coronal pulp but progresses faster on the floor than on the roof or side walls.
Radicular pulp is that pulp extending from the cervical region of the crown to the root apex. They are not always straight but vary in shape , size and number. The radicular portion is continuous with the periapical tissues through the apical foramen or foramina.
Apical foramen is the opening of the radicular pulp into the periapical connective tissue. The average size is 0.3 to 0.4 mm in diameter. There can be two or more foramina separated by a portion of dentin and cementum or by cementum only. Most infections spread through the apical foramen from the periapical tissue to the pulp or from the pulp to periapical tissue.
Accessory canals are pathways from the radicular pulp , extending laterally through the dentin to the periodontal tissue seen especially in the apical third of the root.
Structural features
The central region of the the coronal and radicular pulp contains large nerve trunks and blood vessels.
This area is lined peripherally by a specialized odontogenic area which has three layers (from innermost to outermost)
1. Cell rich zone; innermost pulp layer which contains fibroblasts
2. Cell free zone (zone of Weil) which is rich in both capillaries and nerve networks. The nerve plexus of Rashkow is located in here
3. Odontoblastic layer; outermost layer which contains odontoblasts and lies next to the predentin and mature dentin
Cells found in the dental pulp include fibroblasts (the principal cell), odontoblasts, defence cells like histiocytes, macrophages, granulocytes, mast cells and plasma cells
Clinical significance
An inflammation of a pulp is known as pulpitis. Pulpitis can be extremely painful and in serious cases calls for the removal of the infected tooth or teeth.
Endodontology | |
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| Diagnostic tests | Electric pulp test - Thermal test - Percussion test |
| Pulpal Diagnosis | External resorption - Internal resorption - Irreversible pulpitis - Reversible pulpitis - Necrotic pulp - Pink tooth of Mummery |
| Periapical Diagnosis | Acute apical periodontitis - Chronic apical periodontitis - Perio-endo lesion - Fistula - Periapical abscess - Phoenix abscess - Vertical root fracture |
| Anatomy | Apical foramen - Pulp - Pulp chamber - Root canal |
| Armamentarium and material | Amalgam - Apex locator - Files and reamers - Gutta-percha - Dental dam - Rotary technology - Sodium hypochlorite - Silver points - Eucalyptol - Saline - EDTA |
| Endodontic procedures | Apicoectomy - Endodontic therapy - Internal bleaching - Retreatment |
| Other specialties | Orthodontology - Periodontology - Prosthodontology |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
