Pathway 13-9-1 Pulp Repair
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Questions and Answers

What initiates the repair process of tissue injury in the dental pulp?

  • Proliferation of fibroblasts
  • Débridement by macrophages (correct)
  • Formation of collagen
  • Increased blood supply

    • Why is local circulation critical in wound healing and repair of dental pulp?

  • It enhances the tensile strength of collagen.
  • It transports immune cells and removes harmful agents. (correct)
  • It increases the number of odontoblasts.
  • It provides structural support to the pulp.

    • What type of dentin is formed after tooth eruption and remains continuous with primary dentin?

  • Secondary dentin (correct)
  • Tertiary dentin
  • Reparative dentin
  • Reactionary dentin

    • What defines reactionary dentin compared to reparative dentin?

    <p>Maintains continuity with secondary dentin (D)</p> Signup and view all the answers

    What role do growth factors play in the formation of reparative dentin?

    <p>They attract and cause proliferation and differentiation of MSC (C)</p> Signup and view all the answers

    In what situation would healing be most impaired in a tooth?

    <p>When the tooth has a limited blood supply (A)</p> Signup and view all the answers

    Which type of dentin is characterized by its irregular structure as a response to abnormal stimuli?

    <p>Tertiary dentin (A)</p> Signup and view all the answers

    Why is calcium hydroxide used in apexification treatment despite its high pH?

    <p>It enhances the release of growth factors like TGF-b (D)</p> Signup and view all the answers

    What is the relationship between age of the tooth and its healing potential?

    <p>Older teeth have reduced healing potential due to a restricted blood supply. (C)</p> Signup and view all the answers

    How is tertiary dentin formed during caries progression?

    <p>By depositing over primary or secondary dentin exposed to caries (C)</p> Signup and view all the answers

    What happens to the odontoblasts during the formation of reparative dentin?

    <p>They are destroyed leading to new odontoblast-like cells forming irregular dentin. (D)</p> Signup and view all the answers

    Which factor is NOT mentioned as part of the content related to growth factors released during caries progression?

    <p>Epidermal growth factor (A)</p> Signup and view all the answers

    What is the primary function of tertiary dentin once it forms in response to wear or caries?

    <p>To create a mineralized barrier protecting the pulp (B)</p> Signup and view all the answers

    Study Notes

    Pulpal Repair

    • Pulpal repair involves the formation of tertiary dentin, a specialized type of dentin that forms as a protective barrier against external stimuli.
    • Pulp healing begins with macrophages removing debris, followed by the proliferation of fibroblasts, capillary buds, and collagen formation.
    • The formation of tertiary dentin depends on the type of stimulus, the type of odontoblasts involved, and whether the stimulus leads to the loss of original odontoblasts.
    • Tertiary dentin can be classified as reactionary dentin or reparative dentin.
    • Reactionary dentin forms when the original odontoblasts are stimulated and the tubules remain continuous. It forms in response to stimuli such as excessive wear, cavity preparation, or restorative materials.
    • Reparative dentin forms when the original odontoblasts are destroyed, and new odontoblast-like cells differentiate to form a new, less tubular, and more irregular dentin. The tubules are not continuous with the secondary dentin.
    • The release of growth factors, such as TGF- b , IGF-1 and IGF-2 , BMPs, VEGF during secondary dentin formation plays a crucial role in stimulating the differentiation of mesenchymal stem cells into reparative dentin and new blood vessels.
    • Calcium hydroxide, often used in apexification treatment, has a slight demineralizing effect on dentin, which releases TGF- b and accelerates reparative dentinogenesis.
    • Potential future applications of molecular biology in restorative dentistry include:
      • Applying growth factors to dentin to stimulate peritubular dentin formation and occlusion of dentinal tubules.
      • Transfecting pulpal fibroblasts with BMP-7 to stimulate increased production of this growth factor.
      • Using specific amelogenin gene splice products (A 1 4 and A 2 4) to induce mineralization of root canals.
    • The formation of tertiary dentin can be considered a reparative process:
      • It forms in response to injury and helps the pulp retreat behind a barrier of mineralized tissue.
      • It has also been observed in normal, unerupted teeth, suggesting that tertiary dentin formation might be a natural process.

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