Pulp (tooth)

The dental pulp ( pulpless of latin, meat '), also: the pulp or colloquially ( and erroneously) dental nerve, the inner part of the tooth, the pulp chamber ( pulp cavity ) filled out, which is enveloped by the dental hard tissues. The pulp cavity extends from the crown to the tip of the tooth root (s).

Construction

The pulp consists of connective tissue with blood and lymphatic vessels and nerve fibers. Suction. Tomes fibers, processes of the odontoblasts, so dentinbildender cells, set in a very fine, with the naked eye to be recognized dentinal tubules ( tubules ) up to the enamel-dentin border continued. In addition to the odontoblast projections can be found in some dentinal tubules and nerve fibers. These give suprathreshold mechanical, thermal or chemical stimuli as pain sensation again.

Anatomically, a distinction is made between crown and root pulp.

Physiological development

Before milk teeth or permanent teeth break through into the oral cavity, form the cells of the dental pulp during tooth development dentin and enamel. In the adolescent age the pulp cavity is very far and thus the distance between the pulp and the tooth surface is not very large. Tooth decay can thus very quickly penetrate to the pulp and lead to pulpitis. The pulp cavity is smaller with increasing age, there is produced continuously from the inside dentin. This in turn increases the distance between the pulp and the tooth surface continuously.

Pathological changes of the pulp

Task of the dentist is to distinguish between reversible and irreversible pulpitis, determine the cause and initiate appropriate therapy. The pulp has its own lack Lymphabflussystem only a very limited potential for regeneration.

We distinguish:

• Pulpitis: inflammation of the dental pulp.
• Pulpagangrän: The pulp tissue dies off by anaerobic germs and dissolves.
• Denticles: calcification of pulp tissue by means of rounded to oval hard tissue body. Can be caused by age or trauma; Denticles can also arise as a result of healing processes or by therapeutic interventions. They are usually discovered as incidental findings on radiographs or during root canal preparation
• Apical periodontitis: Inflammatory processes in the root tip of a tooth
• Odontogenic infections: abscesses with and without connections to the oral cavity or into the jaw bone ( fistula )

Tissue Engineering

New findings show that regeneration of dental pulp in terms of tissue engineering could be possible. Results from the field of basic research show that dental stem cells after sowing in a suitable carrier material can form tubular pulp tissue and dentin. Clinical case reports describe a procedure in young teeth with incomplete root development, which can lead to progression of root growth after provocation of bleeding into the root canal to the regeneration of dental pulp.