関: dental pulp、pulp、pulpal

WordNet

remove the pulp from, as from a fruit
a soft moist part of a fruit (同)flesh
a mixture of cellulose fibers
reduce to pulp; "pulp fruit"; "pulp wood"
any soft or soggy mass; "he pounded it to a pulp" (同)mush
an inexpensive magazine printed on poor quality paper (同)pulp magazine
the soft inner part of a tooth
a means of enforcement; "the treaty had no teeth in it"
one of a number of uniform projections on a gear
something resembling the tooth of an animal
toothlike structure in invertebrates found in the mouth or alimentary canal or on a shell
hard bonelike structures in the jaws of vertebrates; used for biting and chewing or for attack and defense
a blast of a horn
having teeth especially of a certain number or type; often used in combination; "saw-toothed"

PrepTutorEJDIC

〈U〉(果実・野菜などの)果肉 / 〈U〉髄質(骨髄・歯髄など) / 〈U〉(製紙原料の)パルプ / 〈U〉《時にa~》どろどろしたもの / 《しばしば複数形で》(粗末な紙にきわもの記事を印刷した)低俗雑誌 / …‘を'パルプにする;…‘を'どろどろにする
『歯』 / 『歯状の物』,(くし・のこぎり・歯車・フォークなど)歯の働きをする物 / …に歯を付ける;…‘を'歯状(ぎざぎざ)にする
…もまた,その上 / 『あまりにも』,過度に,必要以上に / 『非常に』,大変,はなはだ(very, extremely) / 《話》《相手の否定の言葉に,肯定で応じて》ところがどうして
(笛・らっぱなどの)プープー鳴る音;(笛・らっぱなどを)プープー鳴らすこと / 〈笛・らっぱなど〉‘を'鳴らす / 〈笛・らっぱなどが〉鳴る
歯のある / V字型の突起がある,ぎざぎざの

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/05/29 01:54:26」(JST)

wiki en

The dental pulp is the part in the center of a tooth made up of living connective tissue and cells called odontoblasts. The dental pulp is a part of the dentin–pulp complex (endodontium).^[1] The vitality of the dentin-pulp complex, both during health and after injury, depends on pulp cell activity and the signaling processes that regulate the cell’s behavior.^[2]

Anatomy

Pulps of two extracted, not fully developed wisdom teeth, photographed from the bottom.

Each person can have a total of up to 52 pulp organs, 32 in the permanent and 20 in the primary teeth. The total volumes of all the permanent teeth organs is 0.38cc and the mean volume of a single adult human pulp is 0.02cc. Maxillary central incisor has shovel shaped coronal pulp with three short horns on the coronal roof and triangular in cross section. Canine has the longest pulp with elliptical cross section.

The large mass of pulp is contained within the pulp chamber of the tooth. The shape of each pulp chamber corresponds directly to the overall shape of the tooth, and thus is individualized for every tooth; the pulp tissue in the pulp chamber has two main divisions: coronal pulp and radicular pulp.^[2] Crowns of the teeth contain coronal pulp. The coronal pulp has six surfaces: the occlusal, the mesial, the distal, the buccal, the lingual and the floor. Because of continuous deposition of dentin, the pulp becomes smaller with age. This is not uniform throughout the coronal pulp but progresses faster on the floor than on the roof or side walls.

Radicular pulp is that pulp extending from the cervical region of the crown to the root apex. They are not always straight but vary in shape, size and number. The radicular portion is continuous with the periapical tissues through the apical foramen or foramina.

Apical foramen is the opening of the radicular pulp into the periapical connective tissue. The average size is 0.3 to 0.4 mm in diameter. There can be two or more foramina separated by a portion of dentin and cementum or by cementum only. If more than one foramen is present on each root, the largest one is designated as the apical foramen and the rest are considered accessory foramina.^[2] Most infections spread through the apical foramen from the pulp to periapical tissue.

Accessory canals are pathways from the radicular pulp, extending laterally through the dentin to the periodontal tissue seen especially in the apical third of the root. Accessory canals are also called lateral canals, because they are usually located on the lateral surface of the roots of the teeth.

Development

The pulp has a background similar to that of dentin, because both are derived from the dental papilla of the tooth germ. During odontogenesis, when the dentin forms around the dental papilla, the innermost tissue is considered pulp.^[3]

Internal Structure

Pulpal dentin junction. 1) outside tooth/enamel 2) dentin tubule 3) dentin 4) odontoblastic process 5) predentin 6) odontoblast 7) capillaries 8) fibroblasts 9) nerve 10) artery/vein 11) cell-rich zone 12) cell-poor zone 13) pulp chamber

The central region of the coronal and radicular pulp contains large nerve trunks and blood vessels.

This area is lined peripherally by a specialized odontogenic area which has four layers (from innermost to outermost):

Pulpal core, which is in the center of the pulp chamber with many cells and an extensive vascular supply; except for its location, it is very similar to the cell-rich zone.
Cell rich zone; which contains fibroblasts and undifferentiated mesenchymal cells.
Cell free zone (zone of Weil) which is rich in both capillaries and nerve networks.
Odontoblastic layer; outermost layer which contains odontoblasts and lies next to the predentin and mature dentin.

Cells found in the dental pulp include fibroblasts (the principal cell), odontoblasts, defence cells like histiocytes, macrophage, granulocytes, mast cells and plasma cells.The nerve plexus of Raschkow is located central to the cell-free zone.^[3]

The plexus of Raschkow

The plexus of Raschkow monitors painful sensations. By virtue of their peptide content they also play important functions in inflammatory events and subsequent tissue repair. There are two types of nerve fiber that mediate the sensation of pain: A-fibers conduct rapid and sharp pain sensations and belong to the myelinated group, whereas C-fibers are involved in dull aching pain and are thinner and unmyelinated. The A-fibers, mainly of the A-delta type, are preferentially located in the periphery of the pulp, where they are in close association with the odontoblasts and extend fibers to many but not all dentinal tubules. The C-fibers typically terminate in the pulp tissue proper, either as free nerve endings or as branches around blood vessels.

Functions

The primary function of the dental pulp is to form dentin (by the odontoblasts).

Other functions include:

Nutritive: the pulp keeps the organic components of the surrounding mineralized tissue supplied with moisture and nutrients;
Sensory: extremes in temperature, pressure, or trauma to the dentin or pulp are perceived as pain;
Protective: the formation of reparative or secondary dentin (by the odontoblasts);
Formative: cells of the pulp produce dentin which surrounds and protects the pulpal tissue.

Complications

Pulp acts as a security and alarm system for a tooth. Slight decay in tooth structure not extending to the dentin may not alarm the pulp but as the dentin gets exposed, either due to dental caries or trauma, sensitivity starts. The dentinal tubules pass the stimulus to odontoblastic layer of the pulp which in turns triggers the response. This mainly responds to cold. At this stage simple restorations can be performed for treatment. As the decay progresses near the pulp the response also magnifies and sensation to a hot diet as well as cold gets louder. At this stage indirect pulp capping might work for treatment but at times it is impossible to clinically diagnose the extent of decay, pulpitis may elicit at this stage. Carious dentin by dental decay progressing to pulp may get fractured during mastication (chewing food) causing direct trauma to the pulp hence eliciting pulpitis.

The inflammation of the pulp is known as pulpitis. Pulpitis can be extremely painful and in serious cases calls for root canal therapy or endodontic therapy.^[4] Traumatized pulp starts an inflammatory response but due to the hard and closed surroundings of the pulp pressure builds inside the pulp chamber compressing the nerve fibres and eliciting extreme pain (acute pulpitis). At this stage the death of the pulp starts which eventually progresses to periapical abscess formation (chronic pulpitis).

The pulp horns recede with age. Also with increased age, the pulp undergoes a decrease in intercellular substance, water, and cells as it fills with an increased amount of collagen fibers.This decrease in cells is especially evident in the reduced number of undifferentiated mesenchymal cells. Thus, the pulp becomes more fibrotic with increased age, leading to a reduction in the regenerative capacity of the pulp due its loss of these cells. Also, the overall pulp cavity may be smaller by the addition of secondary or tertiary dentin, thus causing pulp recession. The lack of sensitivity associated with older teeth is due to receded pulp horns, pulp fibrosis, addition of dentin, or possibly all these age-related changes; many times restorative treatment can be performed without local anesthesia on older dentitions.^[2]

References

^ http://endodontistrootcanal.com/endodontium/
^ ^a ^b ^c ^d Illustrated Dental Embryology, Histology, and Anatomy, Bath-Balogh and Fehrenbach, Elsevier, 2011, page 164.
^ ^a ^b Antonio Nanci, Ten Cate's Oral Histology, Elsevier, 2007, page 91
^ http://www.animated-teeth.com/root_canal/t1_root_canal.htm

Additional images

Illustration of tooth anatomy.

External links

An overview of the dental pulp: its functions and responses to injury, C Yu, PV Abbott, Australian Dental Journal Supplement 2007;52:(1 Suppl):S4-S16 at http://www.ada.org.au/app_cmslib/media/lib/0704/m70470_v1_633112728503963750.pdf
Guideline on Pulp Therapy for Primary and Immature Permanent Teeth, REFERENCE MANUAL V 34 / NO 6 12 / 13, 2009, American Academy of Pediatric Dentistry at http://www.aapd.org/media/Policies_Guidelines/G_Pulp.pdf

UpToDate Contents

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1. 歯の解剖学的構造および発達 anatomy and development of the teeth
2. 小児における歯の損傷の評価およびマネージメント evaluation and management of dental injuries in children
3. 歯性感染症の疫学、病因、および臨床症状 epidemiology pathogenesis and clinical manifestations of odontogenic infections
4. 歯性感染症の合併症、診断、および治療 complications diagnosis and treatment of odontogenic infections
5. シャルコーマリートゥース病などの一次性の遺伝性運動感覚性ニューロパチー hereditary primary motor sensory neuropathies including charcot marie tooth disease

English Journal

Extracellular Ca(2+) Promotes Odontoblastic Differentiation of Dental Pulp Stem Cells via BMP2-Mediated Smad1/5/8 and Erk1/2 Pathways.

Li S1, Hu J2, Zhang G1, Qi W3, Zhang P1, Li P1, Zeng Y1, Zhao W2, Tan Y1.
Journal of cellular physiology.J Cell Physiol.2015 Sep;230(9):2164-73. doi: 10.1002/jcp.24945.
Ca(2+) is the main element of many pulp capping materials that are used to promote the regeneration of tertiary dentin, but the underlying molecular mechanism is not clear. In this study, we found that Ca(2+) increased the expression of the odontoblastic differentiation marker gene DSPP and promoted
PMID 25656933

Pulp chamber temperature increase from curing light units: an in vitro study.

Cantekin K1, Buyuk SK2, Delikan E3, Pedük K3, Demirbuga S4.
Journal of dentistry for children (Chicago, Ill.).J Dent Child (Chic).2015 Sep-Dec;81(3):128-32.
PURPOSE: The purpose of this study was to compare temperature rises in the pulp chamber induced by halogen, plasma arc, and conventional light-emitting diode (LED) curing units with that induced via a new generation LED-curing unit (VALO) in extra power mode.METHODS: A Class I cavity was prepared on
PMID 25514256

Dopaminergic differentiation of stem cells from human deciduous teeth and their therapeutic benefits for Parkinsonian rats.

Fujii H1, Matsubara K1, Sakai K1, Ito M2, Ohno K2, Ueda M1, Yamamoto A3.
Brain research.Brain Res.2015 Jul 10;1613:59-72. doi: 10.1016/j.brainres.2015.04.001. Epub 2015 Apr 9.
Parkinson's disease (PD) is a progressive neurodegenerative disorder caused by the loss of nigrostriatal dopaminergic (DAergic) neurons and the depletion of striatal dopamine. Here we show that DAergic-neuron-like cells could be efficiently induced from stem cells derived from human exfoliated decid
PMID 25863132

Japanese Journal

Development of surface coating material for discolored tooth equipped with bleaching effect

EMOTO Makiko,TOMITA Koichi,KANEMARU Norikazu,TOKUDA Masayuki,TORII Mitsuo
Dental materials journal 31(5), 797-805, 2012-09-01
… H2O2 was released into buffer from this resin, but when placed onto tooth tissue with a protective layer of base resin, penetration of H2O2 into the pulp chamber was undetectable. …
NAID 10030875685

象牙質-歯髄複合体再生療法の確立を目指して : 断髄後の象牙質-歯髄複合体再生療法と歯髄の耐性誘導

諸冨孝彦
福岡歯科大学学会雑誌 38(2), 75-80, 2012-08-31
… Dental pulp is important for maintenance of tooth function. … Non-vital teeth lost their defensive abilities and which are often followed by the severe damages resulting in extraction of the tooth. … On the other hand, because the dental pulp exists within rigid hard tissue walls, it is confined to a low-compliance system. … Therefore, it is beneficial to establish the dentin-pulp complex regeneration therapy. …
NAID 110009518119

LPS刺激下における炎症性メディエーター産生に対するMMP-3の影響

瀧本晃陽,川島伸之,鈴木規元,小泉悠,山本弥生子,齋藤正寛,原田英光,中島美砂子,須田英明
日本歯科保存学雑誌 55(3), 202-210, 2012-06-30
目的:matrix metalloproteinase (MMP)-3は,典型的な細胞外マトリックスタンパクの分解酵素であるMMPファミリーの一員である.MMP-3はさまざまな生理学的および病理学的プロセスに関与している.近年,傷害を与えた歯髄組織にMMP-3を貼付すると,血管新生と創傷治癒が誘導されることが報告されたが,MMP-3の抗炎症作用の詳細についてはいまだ不明である.本研究の目的は,マク …
NAID 110009479997

Related Pictures

★リンクテーブル★

リンク元	「pulpal」「dental pulp」
関連記事	「pulp」「too」「tooth」

「pulpal」

Pulp (tooth)
	Section of a human molar
Details
Identifiers
Latin	pulpa dentis
MeSH	A14.549.167.900.260
Dorlands; /Elsevier	p_41/12679455
TA	A05.1.03.051
FMA	55631
	Anatomical terminology [edit on Wikidata]