HISTOSTRUCTURE OF DENTAL PULP IN AN ABORTED FETUS WITH MULTIPLE CONGENITAL MALFORMATIONS AND DYSMORPHIC STIGMATA AT 21 WEEKS OF GESTATION

Dental pulp, a multicellular tissue of mesenchymal origin, is known to contain blood vessels, nerves, immune cells, immature (mesenchymal stromal) cells, and most cellular and fibrous elements found in connective tissue. Tooth development originates from the ectoderm, the lining of the primary oral cavity. Enamel forms from the ectoderm of the head region, while dentin, pulp, cementum, and periodontium develop from the ectomesoderm. The primary function of the pulp is dentin production. The pulp nourishes the dentin through odontoblastic processes, with nutritional elements present in the tissue fluid. The pulp also contains nerves; some of these provide sensation to tooth structures, while others terminate in the muscular elements of blood vessels, regulating the pulp's blood supply. The pulp is well-protected from external irritation when surrounded by an intact dentin wall. It can develop a highly effective response to irritation, whether mechanical, thermal, chemical, or bacterial in nature. A defensive reaction may manifest as the formation of irregular dentin if the irritation is mild, or an inflammatory reaction in cases of more severe irritation. Although the rigid dentin wall should be considered a protective barrier for the pulp, under certain conditions, it also poses a threat to its existence. During pulp inflammation, hyperemia and exudate lead to an increase in pressure, which can cause necrosis—pulp self-destruction—due to vascular occlusion.