Pathway 13-8-1 Vascular Supply

Study Notes

Pulp Blood Supply

Arterioles enter the tooth via the apical foramen with nerve bundles.
Smaller vessels can also enter through lateral or accessory canals.
Arterioles course through the central portion of the radicular pulp before branching towards the odontoblast layer.
These branches form a capillary plexus beneath the odontoblast layer.
Arterioles fan out toward the dentin in the coronal pulp and form a capillary network in the subodontoblastic region.
This network provides rich metabolites for the odontoblasts.
Blood flow is higher in the coronal portion than the root.
Blood flow in the pulp horns is higher than in other areas.
Capillaries extend into the odontoblast layer in young teeth, supplying nutrients to active odontoblasts.
The subodontoblastic capillaries have fenestrations facilitating rapid transport of fluids and metabolites to odontoblasts.
Average capillary density is about 1400/mm2.
Blood flows through the capillary plexus to postcapillary venules then to larger venules.
Venules have thin, discontinuous muscular walls promoting fluid movement.
Collecting venules increase in size as they move towards the central pulp.
The largest venules are considerably larger than arterioles.
Resting pulpal blood flow (PBF) is relatively high, averaging 0.15 to 0.60 mL/min/g tissue.
Blood volume is about 3% of pulpal wet weight.
PBF is greater in the peripheral layer of the pulp due to higher oxygen consumption.
Laser Doppler flowmeters can measure PBF changes through dentin via occlusal stents or rubber dam clamps.
Up to 80% of the Doppler signal might originate from periodontal tissue.
Laser Doppler flowmetry can detect revascularization.
Despite its potential, the use of laser Doppler and other techniques for determining pulp vitality is limited due to sensitivity, specificity, reproducibility, and costs.