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Development of Pulp
Development of Pulp
Development of Pulp
Synopsis
Introduction to pulp
Morphology
Development
Histological appearance
o Odontoblastic zone
o Cell free zone ( Zone of Weil)
o Cell rich zone
o Pulp core
Principal cells of pulp
o Odontoblasts
o Fibroblasts
o Undifferentiated ectomesenchymal cells
o Macrophages
o Immunocompetent cells
Odontoblasts
o Functional stages
Preodontoblast
Secretory
Transitional
Aged
o Cellular junction changes
Fibroblasts
o Sites present
o Function
o Histological appearance in young and old age
Undifferentiated ectomesenchymal cells
o Areas present
o Function
o Histological appearance in young and old age
Dental pulp stem cells
o Site
o Importance
Inflammatory cells
o Macrophages
o B and T lymphocytes
o Dendritic cells
Matrix and ground substance
o Composition
Collagen fibers- types 1 & 3
Ground substance
o Variation of collagen concentration within tooth
o Composition of ground substance
GAG
Glycoprotein
Water
o Function of ground substance
Vasculature and lymphatic supply of pulp
o Vasculature
Site variation
Pericytes
Variation in afferent and efferent vasculature
o Lymphatic supply
Innervation of dentin-pulp complex
o Path of innervation
o Innervation in the crown
o Innervation in the root
o Structural composition of nerve bundles
Dentin sensitivity
o Mechanisms of dentin sensitivity
Direct neural stimulation/innervation
Odontoblast receptor theory
Hydrodynamic theory
Pulp stones
o True or false pulp stone
o Attached or free pulp stone
Age changes of pulp
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DEVELOPMENT OF PULP
Occurs in 3 stages.
In bud stage, the dental lamina protrudes into the adjacent
ectomesenchyme. The pulp in this stage is characterized by
presence of densely packed cells comprising mostly of
fibroblasts.
In cap stage , these cells further differentiate to form the enamel
organ and dental papilla respectively. Earlier the vessels are
situated centrally and with growth blood vessels also develop
peripherally .
In the last bell stage, morphodifferentiation and
histodifferentiation of pulp occurs wherein the dental papilla
differentiated to form pulp . This process is initiated when the
Odontoblasts form dentin around the central region at which the
central dental papilla forms the pulp.
HISTOLOGICAL APPEARANCE
Odontoblastic zone in the periphery
Cell free zone – Zone of Weil
Cell rich zone- composed of fibroblasts, undifferentiated
mesenchymal cells, macrophages and Immunocompetent cells
and pulpal stem cells.
Pulp core- blood vessels and nerves of the pulp
PRINICIPLE CELLS OF PULP
Odontoblasts
o Most abundant and prominent cell of the pulp
o Number of Odontoblasts corresponds to number of dentinal
tubules.
o They are larger and columnar in the crown while they are
smaller and cuboidal in the root. Along the apical region,
the cells are even more flattened
o Can be classified based on their function.
The active synthetic phase
Elongated cells composed of basal nucleus ,a
basophilic cytoplasm and a prominent golgi
apparatus
Numerous vesicles and prominent organelles
are seen on the dentinal side of the cell while
mitochondria are dispersed throughout the cell
body
Nucleus contains numerous nucleoli and dense
peripherally displaced chromatin
Secretory granules present within the
Odontoblasts are released via the
Odontoblastic processes.
The transitional phase (seen with electron
microscope)
It is a narrower cell with nucleus displaced
from basal extremity and has a condensed
chromatin.
The number of ER are reduced and autophagic
vacuoles are present
The resting phase
Under light microscope seen as a stubby cell,
with little cytoplasm and a more
hematoxyphilic nucleus.
They are usually crowded and the nucleus is
more apically situated, and below very few
cytoplasmic organelles are seen.
Supra- nuclear region has no organelles but
present with lipid filled vacuoles.
Secretory granules are scarce or absent.
o The Odontoblasts attach to adjacent cells by gap junctions,
tight junctions and desmosomes.
o Gap junctions usually occur on lateral surface of
Odontoblasts and at base of the cell for connection with
the pulpal fibroblasts.
o Odontoblastic processes
Begins at the neck of the cell as they enter the
predentin layer.
They are devoid of organelles but are composed of
multiple microtubules and pits along its length.
Coated vesicles and pits are also seen within the
process which show pinocytotic activity ( uptake of
material from external environment by the formation
of the vesicle around them which is later suspended
in the cytoplasm.
o The basic structural organization of the Odontoblastic
process within the dentinal tubule is as follows:
Each dentinal tubule is occupied by an Odontoblastic
process
Each tubule is lined by peri- tubular dentin
A fluid called the dentinal fluid circulated between
the tubule and the process.
Some of the studies suggest that the possible
content of the dentinal tubule is proteoglycans,
tenascin, fibronectin, glycoprotein and transferrin.
Further studies are needed to evaluate the contents
and their possible actions.
RESEARCH RELEVANCE FOR ODONTOBLAST
Fibroblasts
o
o Most abundant cells in the pulp.
o Occur in larger numbers in the coronal portion of the pulp
and lead to formation of the cell rich zone.
o Main function is to form and maintain the extracellular
matrix of the pulp that is primarily made up of collagen
and ground substance.
o Based on their functional state
In early stages, where they actively produce the
matrix, they are more rounded, with plump
cytoplasm with abundant cellular organelles that
effectively help produce the matrix
At later stages, with age, the need for matrix
production is reduced and thus they resume a
spindle shape, with lesser organelles and a dense
nuclei.
o Also capable of the collagen they produced and thus
considered to play a role in the turnover of the pulpal
matrix.
RESEARCH RELAVANCE FOR FIBROBLASTS
o CRYOPRESERVATION MEDIUM
o 90% FBS
10% Dimethyl sulfoxide (DMSO)
Inflammatory cells
o Macrophages are mainly seen in the pulp core. They are
usually large oval or elongated cells that exhibit a dark
stained nucleus. They can also be seen in their resting
state ( termed as histiocytes or periocytes) they have
varies morphological features.
They aim at elimination of dead cells that help in the
turnover of fibroblasts in the pulp
o Usually T- lymphocytes are seen in the pulp and their
number increase when there is an injury to the pulp
o Mast cells are also present, but difficult to demonstrate in
the pulp as their lost during processing for histology due to
their fragility.
o Dendritic antigen- presenting cells
They are derived from the bone marrow
Found around the Odontoblastic layer in non-
erupting teeth and below the Odontoblastic layer in
the erupted teeth.
They capture and present foreign antigens to the T-
cells and aid in T-lymphocyte division and
differentiation and also take part in immuno-
surveillance.
They increase in number in case of carious teeth.
INNERVATION OF PULP
o The nerves enter the pulp through the apical foramina and the
accessory canal along with the blood vessels to form the
neurovascular bundle.
o They are primarily afferent sensory fibers of the trigeminal nerve
and the sympathetic branches from the superior cervical
ganglion.
o As they move coronally they branch out to form an extensive
plexus of nerves in the cell free zone of Weil called the “ sub-
odontoblastic plexus of Rashkow”
o There is no counterpart for the same in the radicular portion.
Instead, they are given off branches by the ascending trunk as
they move towards the coronal region.
o Histologically, the bundles have myelinated and unmyelinated
fibers where more unmyelinated fibers are seen in the coronal
aspect of the pulp.
o Mostly they terminate in the sub-odontoblastic layer but some
may pass through the odontoblasts and pierce into the dentinal
tubules.
PULP STONES
they are discrete calcified masses that have calcium-phosphorus
ratios comparable to that of dentin.
They can be singular or multiple in any tooth and are more
common at the orifice of the pulp chamber or within the root
canal
Histologically, they usually consist of concentric layers of
mineralized tissue formed by surface accretion around blood
thrombi, dying or dead cells, or collagen fibers.
At times, a pulp stone may contain tubules and be surrounded
by cells resembling odontoblasts. Such stones are rare and, if
seen, occur close to the apex of the tooth. Such stones are
referred to as true pulp stones .
Stones having no cells associated with them are called false pup
stones.
They can also be classified as free and attached pulp stone
o Attached pulp stone is when union occurs between the pulp
stone and the dentin wall, or if secondary dentin deposition
surrounds the stone .
o Free pulp stone is when the stone is completely surrounded
by soft tissue.
They decrease the total number of cells and affect the efficient
root canal debridement for treatment.