Pulp Biology and Tooth Pain

1. Nerves + Blood vessels + lymphatics
2. Fibroblasts

   Nota:

   • Secrete fibrous connective tissue
3. Odontoblasts

   Nota:

   • Secrete dentin
   1. Primary dentin

      Nota:

      • Before root formation is complete
   2. Secondary dentin

      Nota:

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

         Nota:

         • 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

Nota:

• against infection

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

      Nota:

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

   Nota:

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

   Nota:

   • 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