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At least 667 records · Page 37Linked to original sources
PubMed1994

Dense innervation of human radicular dental pulp as revealed by immunocytochemistry for protein gene-product 9.5.

Protein gene-product 9.5 (PGP 9.5) is a novel neurone-specific protein. At light- and electron-microscopic levels, human radicular dental pulp was heavily innervated by PGP 9.5 nerve fibres. Thick nerve bundles showing intense PGP 9.5 immunoreactivity ascended in the centre of the pulp, with some nerve fibres extending from the trunk towards the peripheral pulp at regular intervals. However, the fibres did not form a plexus (of Raschkow) beneath the odontoblast cell layer. The PGP 9.5-positive nerve fibres penetrated into the predentine and dentine beyond the odontoblast cell layer where some nerves terminated. In the predentine, PGP 9.5-positive nerve fibres were densely distributed. In tangential sections along the pulpodentinal border, the nerve fibres ran in contact with odontoblast processes. Immunoelectron microscopy revealed that all nerve fibres were immunoreactive for PGP 9.5 in the radicular predentine and dentine, and terminated in contact with the odontoblast cell processes. The distribution pattern and terminal formation of predentinal and dentinal nerves were identical to those of coronal pulp, as reported previously. The dense innervation in radicular dental pulp, overlooked in previous reports, might be responsible for dentine hypersensitivity.

Adolescent↗
PubMed1994

Dynamic plasticity of dental sensory nerve structure and cytochemistry.

Hypersensitive dentine responds to normal changes in touch or temperature with abnormal pain sensations. This paper reviews studies that have shown dynamic changes in sensory nerve structure, cytochemistry and location after tooth injury, suggesting that those changes contribute to dentine hypersensitivity. Nerve fibres containing calcitonin gene-related peptide (CGRP) are the main type of sensory fibre to innervate dentine. Evidence that many of those dentinal nerve endings originate from small myelinated fibres is presented here. The location of CGRP nerve terminals correlates with the pulpal gradients of nerve growth factor that have been demonstrated in normal teeth by in situ hybridization histochemistry. When shallow cavities are drilled into the outer dentine of rat molars a five-to-eight-fold increase in pulpal nerve growth factor precedes the extensive structural changes in the sensory nerve reactions eventually subside if healing occurs, but both continue if inflammation continues. Evidence correlating pulpal inflammation with long-term changes in central trigeminal pain pathways is reviewed. There can be extensive neuroplasticity after tooth injury, both within dental pain fibres and in central pain pathways. The timing of those alterations of nerve structure, location, and cytochemistry is consistent with their involvement in mechanisms of dentine hypersensitivity.

Animals↗
PubMed1994

Nerve-pulp interactions.

Pulpal haemodynamics are naturally intermeshed with inflammatory responses. Cellular and humoral factors may be the vehicles that aid in physiological regulation, but when these systems are overly activated, they may lead to pathological changes. Sensory nerves may initiate inflammatory reactions when activated, and interestingly, recent findings show that vasoconstrictor nerves in the pulp can inhibit the release of neurally stored vasoactive and inflammatory mediators. Thus, there are options for endogenous control of inflammation. Perhaps a variation in the effectiveness of such control can explain why symptoms of hypersensitivity and pain are so unpredictable and individual. What naturally occurring agents are involved in early tissue changes and how do they act? Some agents exert their effects both on vessels and nerves. Thus, there is an intriguing mutual interplay between nerves and tissue reactions. A prolonged, painful stimulation may generate increased blood flow and inflammation, and vice versa, inflammation may lead to pain. This complexity of mechanisms generates many questions that need answers.

Animals↗
PubMed1994

Factors affecting nerve excitability and conduction as a basis for desensitizing dentine.

Nerve excitability is principally determined by the state of membrane sodium channels, which can be influenced by factors such as drugs or the ionic composition of the extracellular fluids. The excitability of isolated nerves is increased by lowered extracellular calcium and hydrogen ion concentrations, and similar effects are seen on intradental nerve excitability. This is of interest as some agents used to desensitize hypersensitive dentine are believed to act by reducing intradental nerve excitability. A variety of ions, including potassium and divalent cations, have been shown to reduce intradental nerve excitability when applied in relatively high concentrations to dentine close to the pulp. However, these conditions do not mimic the clinical situation, where agents are applied to outer dentine, up to 2 mm from the pulp. Also, when agents are applied to dentine it is difficult to quantify the precise changes in extracellular fluid composition, and there is the additional complication of possible interactions between the agents and dentine. These problems can be minimized by using isolated nerves, which allow better control over the conditions and ionic concentrations necessary to achieve nerve conduction block. Such methods can provide a convenient way to screen potential desensitizing agents before evaluation in vivo or in clinical trials.

Action Potentials↗
PubMed1986

Hypersensitive teeth. Part I: Etiology.

Although several theories have been suggested for hypersensitive dentin, it appears that the hydrodynamic theory is most plausible. If a clinical diagnosis of dentin hypersensitivity can be made, occlusion of the patent tubules would result in a reduction of hypersensitivity by the rapid fluid shift within the tubules. The naturally occurring defense mechanisms would wall off the narrow tubules producing the fluid flow, thus reducing the pain associated with hypersensitivity. In Part II of this article the current treatment modalities for dentin hypersensitivity will be discussed.

Dental Pulp↗
PubMed1992

Performance of a glass ionomer luting cement over 5 years in a general practice.

Over a 5-year period, 1435 teeth in patients under recall in a general dental practice have received cast restorations luted with a glass ionomer cement. The material has demonstrated an exceptionally low rate of secondary caries, excellent retention of castings, and acceptable compatability with the dental pulp.

Cementation↗
PubMed1992

An evaluation of smear layer with various desensitizing agents after tooth preparation.

According to hydrodynamics, any agent blocking the dentinal tubules reduces the flow of fluids and diminishes hypersensitivity. The properties of the desensitizing agents that sponsor tubular occlusion and the barrier efficiency resulting from the interaction of the smear layer with test materials were examined with the scanning electron microscope and energy-dispersive x-ray microanalysis. Selected dentinal desensitizing was accomplished with burnishing procedures, cavity varnish, calcium hydroxide, and topical fluoride. Subjective evaluations were also recorded clinically after tooth preparation. This investigation indicated that the smear layer did not protect against zinc phosphate cement, and that cavity varnish prevented the formation of the smear plugs. The smear layer and plugs were basically composed of calcium and phosphorus, the major ingredients of dentin.

Adult↗
PubMed1993

Potassium nitrate-zinc oxide eugenol temporary cement for provisional crowns to diminish postpreparation tooth pain.

Pulpal injury commonly occurs with tooth preparation for complete fixed partial dentures. This can be documented by the substantial incidence of pain after tooth preparation. In this study, a 4% potassium nitrate-zinc oxide eugenol temporary cement was used to secure provisional crowns over recently prepared teeth and it significantly reduced the incidence and severity of pain after tooth preparation and impression taking.

Adult↗
PubMed1988

The soft laser: therapeutic tool or popular placebo?

Because of the alleged effectiveness of soft laser therapy in the treatment of a wide range of medical and dental conditions, it is becoming increasingly popular with both patients and practitioners. It was the purpose of this study to assess soft laser treatment of hypersensitive dentin, gingivitis, pulp-capped teeth, herpes labialis, and nausea. Clinical trails demonstrated no advantage in augmenting or replacing conventional treatment of these conditions with soft laser therapy, despite its positive effect on patient attitude toward treatment.

Adolescent↗