Tooth dental pulp

Pulpitis- If the caries lesion progresses, infection of the dental pulp may occur, causing acute pulpitis (Pulpal inflammation). The tooth become sensitive to hot or cold, and then severe continuous throbbing pain ensues. In reversible pulpitis, filling is an option but in case of... 

An additional thermal property of interest is thermal diffusivity. The dental pulp sensory system is extremely sensitive to changes in temperature. These sensory inputs are interpreted only as pain. Metallic restorations of deep carious lesions of the tooth frequently need to have a low thermal conductor placed beneath them to avoid causing pulpal pain. The thermal diffusivity of composite varies from approximately that of tooth structure (0.183 mm2/s) to twice that value [204, 254], Metallic restorations of concern have diffusivities at least an... 

Shigehara S, Matsuzaka K and Inoue T (2006) Morphological changes and expression of HSP70, osteopontin and osteocalcin mRNAs in rat dental pulp cells with orthodontic tooth movement. Bull. Tokyo Den. Coll. 478 117-124. 

The inner part of the tcmth comprises a cravity, which contains soft connective tissue known as the dental pulp. It consists of blood vessels and nerve fibres and these enter the tooth via a small opening at the end of the tooth root called the apex. 

The pulp contains sensitive cells which can be damaged by extensive mechanical trauma to the tooth, or by chemical assault from substances released from materials used to repair the tooth. The pulp can also become infected and transmit that infection to the rest of the body through the circulatory system. For this reason, the bacterially mediated disease of dental caries is potentially serious and should not be left untreated [5],... 

The pulp of the tooth is a delicate specific tissue and there are severe consequences for its health if it becomes exposed [ 1 ]. Several things can lead to its exposure, specifically trauma of the tooth, dental caries and accidents in tooth preparation. Exposure can be followed by infection and inflammation, resulting in considerable pain to the patient and potential morbidity of the pulp itself. When exposure occurs, therefore, the tooth requires treatment. One approach involves complete removal (extirpation) of the pulp and root canal therapy. 

Teeth consist of three kinds of hard tissues (enamel, dentin, and cementum) and they attach to the alveolar bone through the periodontal ligament The dental pulp, the only vascularized tissue containing nerves, is encased in mineralized dentin. The structural integrity of tooth and periodontal tissue is a prerequisite for chewing and... 

Yamada, Y, Nakamura, S., Ito, K., Sugito, T, Yoshimi, R., Nagasaka, T., Ueda, M., 2010. A feasibility of useful cell-based therapy by bone regeneration with deciduous tooth stem cells, dental pulp stem ceUs, or bone-marrow-derived mesenchymal stem cehs for chnical study using tissue engineering technology. Tissue Eng. Part A 16, 1891-1900. 

A variety of sealants have been explored or developed (168), with many people having one or more applications of a sealant. Sealants are vital for promotion of adhesion, which significantly reduces caries formation (169-177). Pit and fissure sealants are covered under the American Dental Association (ADA) Acceptance Program. These materials are used to seal high caries-susceptible pits and fissures of the deciduous and permanent molars, and also to seal microspaces between the tooth and restorative materials, enabling these materials to adhere firmly both to prepared cavity walls and to other restoratives. They provide dental pulp protection and protection from secondary caries formation. 

Zheng L, et al. The effect of composition of calcium phosphate composite scaffolds on the formation of tooth tissue from human dental pulp stem cells. Biomaterials 2011 32 7053-9. 

Qvist, V. (1975). Pulp reactions in human teeth to tooth coloured filling materials. Scandinavian Journal of Dental Research, 83, 54-66. 

Anamura S, Dohi T, Shirakawa M, et al. 1988. Effects of phenolic dental medicaments on prostaglandin synthesis by microsomes of bovine tooth pulp and rabbit kidney medulla. Arch Oral Biol 33 355-360. 

The most common oral condition and dental emergency is dental caries, which is a destructive disease of the hard tissues of the teeth due to bacterial infection with Streptococcus mutans and other bacteria. It is characterized by destruction of enamel and dentine. Dental decay presents as opaque white areas of enamel with grey undertones and in more advanced cases, brownish discoloured cavitations. Dental caries is initially asymptomatic and pain does not occur until the decay impinges on the pulp, and an inflammation develops. Treatment of caries involves removal of the softened and infected hard tissues, sealing of exposed dentines and restoration of the lost tooth structure with porcelain, silver, amalgam, composite plastic, gold etc. 

Dental traumatic injury often results in fracture of the affected tooth, an injury that necessitates substantial repair. This fracture can vary in severity, from involving the enamel only, through involving both enamel and dentine, to involving both tissues and also exposure of the pulp. Trauma can also affect the root of the tooth, which can themselves be fractured as a result of the incident [44], Comphcations involving the root can often follow traumatic events, and may require endodontic treatment prior to repair of the fractured tooth crown. Certain patients may damage an already traumatized tooth, and this can inhibit the healing process in the tooth and lead to a variety of complications [61],... 

The tooth pulp can become exposed by a variety of processes, including deep caries, trauma or accidentally during cavity preparation in the dental chair [60]. The consequences can be severe, and include pain, infection and necrosis. When the pulp is exposed, steps need to be taken to manage the situation, and these involve either pulp capping with an appropriate material [60,61] or removal of the pulp followed by sealing of the tooth roots. In the present section of the chapter, we consider briefly materials for the first of these options, pulp capping. 

The main material used in this procedure is calcium hydroxide, CaCOH), which was first introduced to the dental profession in 1921. It is widely considered to be the best material available, since it is easy to use and is bioactive. Its bioactivity is demonstrated in that it stimulates migration, proUferation and differentiation of pulp fibroblast cells in vivo [62]. In this way, calcium hydroxide stimulates dentine formation and causes complete healing of the tooth [63], It is also usually antibacterial as a result of its high pH and therefore contributes to the disinfection of the pulp, an important aspect of the heaUng process [43]. 

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