Pulp Biology and Tooth Pain

1. Nerves + Blood vessels + lymphatics
2. Fibroblasts

   Anmerkungen:

   • Secrete fibrous connective tissue
3. Odontoblasts

   Anmerkungen:

   • Secrete dentin
   1. Primary dentin

      Anmerkungen:

      • Before root formation is complete
   2. Secondary dentin

      Anmerkungen:

      • After root formation is complete
4. Undifferentiate mesenchymal cells
   1. Secondary odontoblast
      1. Tertiary dentin

         Anmerkungen:

         • Protects the pulp from injury
5. Surrounded by hard dentin
   1. Limits ability to expand
6. Lacks collateral circulation
   1. Limits ability to cope with infection

Anmerkungen:

• against infection

1. Sclerotic dentin
   1. Calcification of tubules in response to slowly advancing caries or aging
   2. PHYSIOLOGICAL proces

      Anmerkungen:

      • Dentin gets harder over time 
   3. SLOWLY advancing caries
2. Reactionary Dentin

   Anmerkungen:

   • Secondary dentin
   1. Reaction to MINOR damage
3. Reparative dentin

   Anmerkungen:

   • Tertiary dentin
   1. Repair for MAJOR damage
      1. New odontoblasts must be formed
4. Pulpal necrosis
   1. response to rapidly advanciing caries or other severe damage

1. Dentinal
   1. Aδ fibers
      1. First pain
         1. Coronal
2. Pulpitis
   1. C fibers
      1. Second pain
         1. Centrally pulp stroma
3. Referred Pain
   1. Preauricular pain
      1. Mandibular molars
         1. V3 innervation