1What are the 3 basic features of enamel?
Avascular, No Nerves, Nonvital Tissue but not static
2What is the hardest calcified tissue in the body?
Enamel
3What percent of enamel is inorganic material?
96%
4What percent of enamel is organic material?
1%
5What percent of enamel is made up of water?
3%
6What is the main component of enamel?
Calcium Hydroxyapatite (Ca10(PO4)6(OH)2)
7What is the most radiopaque part of a tooth?
Enamel
8What color is enamel on its own?
Bluish White
9Why does enamel appear yellow-white?
Because of underlying dentin
10What is the process of enamel matrix formation called?
Amelogenesis
11What cells produce enamel matrix?
Ameloblasts
12Where do ameloblasts originate from?
IEE
13What is the secretory surface that secretes enamel matrix called?
Tomes' Process
14Which layer does enamel originate from?
Ectoderm
15What cells transport materials into partially mineralized enamel?
Ameloblasts
16What is partially mineralized enamel called?
Matrix
17Where does matrix formation begin?
Incisal/Occlusal Portion of Future Crown near DEJ
18Which direction does enamel apposition move after starting at the incisal/occlusal edge?
Cervically towards the CEJ
19What happens to ameloblasts after enamel formation is complete?
Become part of the reduced enamel epithelium (REE)
20What does the REE become after peeling away from the erupting tooth?
Junctional Epithelium
21True or False: Mineralization continues after eruption into oral cavity
True
22What are the microscopic alternating light and dark bands on enamel called?
Hunter-Shreger Bands
23How can Hunter-Shreger bands be seen?
With Reflected Light
24What causes Hunter-Shreger bands?
Curvature of Enamel Rods
25What is the region surrounding the enamel rods called?
Interprismatic Region (aka interrod enamel)
26Why does the interprismatic region appear different from the rod core on cross sections?
It has different crystalline orientation
27What does the basement membrane between the enamel organ and the dental papilla become?
The DEJ
28What shape is the DEJ?
Scalloped
29Why is the DEJ scalloped?
Increases Strength of the Junction
30Where is the DEJ most pronounced?
The Coronal Region
31What does enamel look like under cusps?
Gnarled Enamel
32Why is gnarled enamel under cusps?
Gives Extra Strength for Occlusion
33What are the incremental lines in enamel called?
Lines of Retzius
34What forms lines of Retzius?
The Rhythmic Deposition of Enamel (workest periods)
35What are the raised lines found on non-masticatory surfaces of some teeth?
Imbrication Lines
36What are the grooves found on non-masticatory surfaces of some teeth called?
Perikymata
37What structure is associated with imbrication lines and perikymata?
Lines of Retzius
38Which teeth most commonly have imbrication lines and perikymata?
Maxillary Central Incisors, Canines, and First Premolars
39What causes imbrication lines and perikymata?
Unknown
40What is the accentuated incremental line of Retzius that marks the stress of birth?
Neonatal Line
41Where are neonatal lines found?
In all Primary Teeth and in the Larger Cusps of Permanent 1st Molars
42What are the short dentinal tubules near the DEJ called?
Enamel Spindles
43What forms enamel spindles?
Odontoblasts cross the basement membrane prior to mineralization and become trapped
44Where are enamel spindles especially prominent?
Beneath Cusps and Incisal Tips
45What are the areas of less mineralization found in the inner third of enamel?
Enamel Tufts
46What are the partially calcified vertical sheets of enamel matrix called?
Enamel Lamellae
47What are enamel lamellae made of?
Degenerated Ameloblasts Trapped in Matrix
48Are Enamel Lamellae or Enamel Tufts longer and narrower?
Enamel Lamellae
49What feature of enamel may develop in sites of high tension and appear as a "crack" in the tooth?
Enamel Lamellae
50What is the loss of enamel through tooth-to-tooth contact called?
Attrition
51What is the loss of enamel through friction unrelated to mastication?
Abrasion
52What is the loss of enamel through a chemical means (acid)?
Erosion
53What are V-shaped notches in enamel from tensile and compressive forces called?
Abfraction
54What is the extensive loss of enamel due to drug use called?
Meth Mouth
55Which embryological structure does dentin and pulp form from?
Dental Papilla
56What is the role of dentin in the dentin/pulp relationship?
Dentin Protects Pulp
57What is the role of pulp in the dentin/pulp relationship?
Deposits Additional Dentin
58Which layer of the tooth forms the bulk of the tooth?
Dentin
59How does dentin appear when exposed?
Rougher and softer than enamel
60What percent of dentin is made up of inorganic material?
70%
61What percent of dentin is made up of organic material?
20%
62What percent of dentin is water?
10%
63Is dentin more or less mineralized than enamel?
Less
64Is dentin more or less mineralized than bone and cementum?
More
65How does dentin appear radiographically?
More Radiolucent than Enamel and More Radiopaque than Pulp
66What is the process of predentin formation called?
Dentinogenesis
67What cells perform dentinogenesis?
Odontoblasts
68What do odontoblasts form from?
Outer Cells of Dental Papilla
69What is the newly formed, unmineralized matrix formed during primary dentin formation?
Predentin
70True or False: Dentin formation occurs throughout the life of a tooth
True
71Which type of dentin forms from primary and secondary mineralization and is more mineralized?
Globular Dentin
72Which type of dentin forms only during primary mineralization and is less mineralized?
Interglobular Dentin
73What happens during primary mineralization?
Calcium Hydroxyapatite crystals form globules (calcospheres)
74What happens during secondary mineralization?
Globules Fuse Together
75What are the 3 components of mature dentin?
Dentinal Tubules, Dentinal Fluid, and Odontoblastic Process
76What are long tubes within the dentin tha provide nutrition to the dentin called?
Dentinal Tubules
77Where do dentinal tubules extend?
From outer wall of pulp to DEJ & DCJ
78What are the long, cellular extensions located within the dentinal tubles called?
Odontoblastic Process
79What do the odontoblastic processes attach to?
The Cell Body of Odontoblasts in the Pulp
80True or False: Odontoblastic Processes are always present in mature dentin
False
81What is the function of the odontoblastic processes?
Provide Pain Sensation
82What material located in the dentinal tubule surrounds the cell membrane of the odontoblast and provides nutrition for the odontoblastic processes?
Dentinal Fluid
83What part of the tooth is linked to hydrodynamic theory?
Dentinal Fluid
84True or False: The Odontoblastic Process is Curved
True
85Which odontoblastic process curvature is an S-shaped curve extending all the way to the pulp?
Primary Curvature
86Which odontoblastic process curvature is a small delicate curve showing the daily changes of odontoblasts?
Secondary Curvature
87What does the primary curvature of the odontoblastic process show?
Overall Tubule Course Over Time
88What happens to odontoblastic processes as they get closer to the pulp?
They get larger and more crowded
89What type of dentin creates walls of dentinal tubules?
Peritubular
90What type of dentin forms in between tubules?
Intertubular
91Which type of dentin is more mineralized?
Peritubular
92Which type of dentin is less mineralized?
Intertubular
93Which dentin class is the first predentin to form/mature?
Mantle Dentin
94What type of dentin does mantle dentin have more of?
Peritubular Dentin
95What class of dentin forms the bulk of dentin and is deep to mantle dentin?
Circumpulpal Dentin
96What are the 3 classes of dentin by timing of formation?
Primary, Second, Tertiary (Sclerotic)
97When is primary dentin formed?
Before Completion of the Apical Foramen
98When is secondary dentin formed?
After Completion of Apical Foramen and Continues throughout the life of the Tooth
99Where does secondary dentin form in relation to primary dentin?
Internally
100Why does tertiary dentin form?
In response to trauma
101What type of tubules do tertiary dentin have?
Irregular and Course
102What happens when odontoblastic processes die and dentinal tubules are vacant?
They fill with a mineralized substance
103What type of dentin replaces pulp tissue?
Sclerotic Dentin
104What are incremental lines in dentin called?
Imbrication Lines of VonEbner
105What are the dark bands in dentin that appear as a result of disturbances in body metabolism called?
Contour Lines of Own
106What is the most pronounced line of Owen?
Neonatal Line
107What is the peripheral portion of dentin beneath the root's cementum called?
Tomes' Granular Layer
108What type of dentin makes up Tomes' Granular Layer?
interglobular Dentin
109What are short, sharp pains from temperature changes, mechanical irritation, dehydration, and chemical exposure called?
Dentinal Hypersensitivity
110What can cause dentinal hypersensitivity?
Caries, Cavity Preparation, Recession, Attrition, CEJ area doesn't meet, and Aggressive Scaling
111What is the theory that changes in dentinal fluid deliver pain sensation to the brain?
Hydrodynamic Theory
112What is the treatment for dentinal hypersensitivity?
Seal Dentinal Tubules
113How can dentinal tubules be sealed in order to treat dentinal hypersensitivity?
Fluoride Varnish, Sensitivity Toothpastes, Desensitizing Agents, and Restorations
114What type of tissue is pulp?
Connective Tissue
115What is pulp formed from?
Central Cells of Dental Papilla
116What is contained within pulp?
Intercellular Substance, Fluid, Cells, Lymphatics, Vessels, Nerves, and Fibers
117What is the function of pulp?
Involved in support, maintenance and continued formation of dentin, Senses extremes in temperature, pressure or trauma, Supplies surrounding mineralized tissue with moisture and nutrients, and protects the formation of raparative or secondary dentin
118Where is coronal pulp located?
In the crown of the tooth
119What are the smaller extensions of coronal pulp into the cusps of posterior teeth called?
Pulp Horns
120What pulp is located in the root of the tooth?
Radicular Pulp
121What structure connects the pulp with the PDL?
Apical Foramen
122What are additional openings from the pulp to the PDL called?
Accessory or Lateral Canals
123How are accessory canals formed?
WHen HERS encounters blood vessels
124Are the axons of sensory/afferent neurons in dential tubules myelinated or non-myelinated?
Myelinated
125Are the nerves in blood vessels myelinated or non-myelinated?
Non-Myelinated
126Which layer of pulp forms the outer pulpal wall, contains the cell bodies of odontoblasts, forms secondary and tertiary dentin and protects the tooth from damage?
Odontoblastic Layer
127Which pulp zone is one layer in frm the odontoblastic layer and contains nerves and the capillary plexus?
Cell-Free Zone
128Which pulp zone has the most cells and vascular supply?
Cell Rich Zone
129Whcih pulp zone is located int he center of the pulp chamber and has some cells and vascular supply?
Pulpal Core
130What happens to pulp with age?
Pulp cavities become smaller and less sensitive
131What are the main features of cementum?
Thickest at tooth's apex and interradicular areas, Thitnnest at the CEJ, No innervation, Avascular, Forms throughout the life of the tooth
132What is cementum mostly made of (and what percent of it is composed of this material)?
65% Calcium Hydroxyapatite
133Which part of the tooth is the most similar to bone?
Cementum
134What does cementum form from?
Dental Sac
135What causes the formation of cementoblasts?
Dental Sac Cells Contact Root Dentin
136What do cementoblasts do?
Lay down cementoid
137What happens to cementoblasts after cementum is formed?
They become entrapped by cementum and become cementocytes
138What microscopic structures of cementum join tooth and bone by inserting to the outer cemental wall?
Sharpey's Fibers
139Where are cementocytes located in the dentin?
Within the Lacunae
140What is located within the lacunae in cementum?
Cementocytes
141How are the lacunae in cementum similar in histology to bone?
Canals are oriented toward the PDL, No Nerves, and Processes diffuse nutrients from the ligament
142What happens to cementoblasts that do not become entrapped in cementum?
They line up along the cemental surface of the PDL
143What happens to cementum if the tooth is injured?
Subsequent layers of cementum form
144What are the 3 patterns of the CEJ?
Overlap, Meet, and Gap
145In which CEJ pattern does the cementum overlap the enamel?
Overlap
146In which CEJ patter does cementum meet end-to-end with enamel?
Meet
147In which CEJ pattern is there a gap between cementum and enamel leaving exposed dentin?
Gap
148Which CEJ pattern is the most common?
Meet
149Which CEJ pattern is the least common?
Overlap
150True or false: CEJ Patterns can vary on the same tooth
True
151What cells resorb cementum due to trauma?
Odontoclasts
152What structure forms as a result of cementum resorption?
Reversal Line
153What structure forms as a result of the repair of resorbed cementum?
Arrest Lines
154Is cementum or bone more readily resorbed?
Bone
155True or False: Cementum continuously remodels and repairs just like bone
False
156What type of cementum is deposited first and contains no embedded cementocytes?
Acellular Cementum
157What type of cementum is the last layer deposited mainly in the apical third of the root with cementoblasts at the periphery in the PDL and many embedded cementocytes?
Cellular Cementum
158Which type of cementum forms faster?
Cellular
159What material makes up the majority of alveolar bone?
Calcium Hydroxyapatite
160What are the features of alveolar bone?
Lamellae, Haversian Canal, Lacuna, Canaliculi, Osteon, Periosteum, Osteon, Traveculae, Haversion Canals, and Volkmann's Canals
161Is cementum or alveolar bone more easily remodeled?
Alveolar Bone
162What is the function of alveolar bone?
Supports and protects the teeth
163True or False: Alveolar bone is part of the periodontium
True
164What structure contains the roots of the teeth?
Alveolar Bone
165What is the portion of bone apical to the roots of the teeth that forms the body of the maxilla and mandible called?
Basal Bone
166What are the two other names for alveolar bone proper?
Cribriform Plate and Bundle Bone
167What is the supporting alveolar bone made of?
Cortical and Trabecular Bone
168What type of bone is the tooth socket composed of?
Compact Bone
169What is the name for the uniformily radiopaque line surrounding a tooth?
Lamina Dura
170What is the name of the most cervical rim of bone?
Alveolar Crest
171What type of bone is cortical bone?
Compact Bone
172What type of bone is trabecular bone?
Cancellous Bone
173Where is cortical bone located?
Facial and Lingual Surfaces
174Where is Trabecular Bone located?
Between alveolar bone proper and plates of cortical bone
175What is the interdental bone between two teeth called?
Interdental Septum
176What is the bone between the roots of the same tooth called?
Interradicular Septum
177What structures form the end of principle fibers?
Sharpey's Fibers
178What are the two main bleaching agents?
Hydrogen Peroxide and Carbamide Peroxide
179How can a patient aleviate tooth sensitivity?
Use a less concentrated agent, Use fluoridated products, Use sensitivity toothpast w/potassium nitrate, limit the exposure to whitening agents, avoid very hot or very cold beverages
180What are the clinical appearances of Bulimia Nervosa?
Swelling of the face along the cheeks and jawline, scars and scrapes on the knuckles from self-induced vomiting, bloodshot eyes
181How are the teeth affected by Bulimia Nervosa?
Stomach acid causes erosion which leads to decay, gum disease, and cavities
182Which teeth are the most affected by Bulimia Nervosa?
Palatal and Lingual Surfaces of Anterior Teeth
183How can a patient minimize erosion due to Bulimia Nervosa?
Brush Daily (avoid brushing right after purging), Increase water intake after purging, chew xylitol gum, floss daily, consider and seek regular dental treatment
184What are the 6 main causes of bruxism?
Stress, Personality, Genetics, Medical Disorder, Lifestyle Habits (smoking and high caffeine intake), and Medications
185What is dentinal hypersensitivty?
Dentin because exposed and causes sensitivity and/or pain due to open and exposed dentinal tubules
186What is the hydrodynamic theory?
Dentinal Tubules are Stimulate by Changes in the Dentinal Fluid causing Sensitivity
187What are the main causes of hypersensitivity?
Caries, attrition, recession, gap at the CEJ exposes dentin, enamel stripped by excessive scaling
188What are some professional treatments for hypersensitivity?
Fluoride Varnish, SDF, Dental Bonding, Gum Tissue Graft, Root Canal, Restorations
189What are the active ingredients used to treat hypersensitivity?
Potassium Nitrate and Stannous Fluoride
190Why are root canals sometimes necessary?
Infected pulp swells and builds pressure within the canal causing extreme pain. RCT relieves this pain and saves the tooth
191What are some symptoms of periapical absesses?
Severe Toothache, Pain from Hot or Cold Food or Drink, Pain when Biting, Swelling, Swollen or Tender Lymph Nodes, Foul Smell from the Mouth, and a sudden nasty liquid in the mouth accompanied by pain relief
192Why are crowns needed after a root canal?
Once the pulp is removed, the tooth is dead and easily breaks and can become discolored
193What is happening in the tension zone of a tooth undergoing orthodontic treatment?
A small gap is being formed on the side opposite to the way the tooth is being pulled causing tension in the PDL. This causes the alveolar bone to initiate bone formation
194What is happening in the compression zone of a tooth undergoing orthodontic treatment?
The PDL located on the side of the tooth in the same direction the tooth is being pulled becomes compressed and causes alveolar bone to begin resorption