Pain reaction to cold stimulus in teeth with experimental fillings.
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Enzyme variants may serve an adaptive role in providing the correct vectorial properties for the metabolism of a tissue, or broadening its environmental tolerance range. To determine if the LDH isoenzyme pattern of human dental pulp changes during inflammation, supernatants from normal and inflamed dental pulp homogenates were separated by polyacrylamide gel electrophoresis. Inflamed pulps had a higher M subunit content and a markedly increased enzyme activity. These results might reflect adaptive changes at the enzyme level associated with a partial shift towards anaerobic metabolism during inflammation of the pulp.
This article deals with blood flow and tissue pressure changes in the inflamed dental pulp. While detailed patho-physiological studies of the circulation in the inflamed pulp are still partly lacking, available data from studies of the normal pulp tissue are also discussed. Knowledge of the normal physiological adjustments may indicate which circulatory changes would take place during inflammation. One of the focal points in the present article is how a localized increased tissue pressure may persist in the inflamed area without a circumferential spread to the rest of the pulp. The article is organized in the following manner: First a short review is given of the vascular changes during inflammation in general. Then available data from morphological and functional studies of the pulpal circulation are treated in some detail. Particular attention is given to the transcapillary fluid flow and the so-called 'self-strangulation theory'. The effect of a localized increased tissue pressure on pulpal blood flow is thereafter discussed.
Stimulation of intradental nerves has been widely used in pain research as a method for selective activation of pain pathways. It is believed that the only sensation experienced by human subjects in response to activation of pulp nerves is that of pain. However, this concept is not strictly correct. With electrical stimulation at threshold level or near to it a sensation which is not necessarily painful ("prepain") is experienced. When the stimulus intensity is increased suprathreshold, the sensation tends to change to a painful and unpleasant one. The changes in sensations are probably caused by activation of intradental nerve units with different thresholds and conduction velocities. In cats the fastest conducting pulp nerve fibres have the lowest thresholds and slowly conducting units are activated at much higher current levels. In most experiments on human teeth using natural stimuli like hot and cold the only sensation experienced has been pain. It seems also difficult for the subjects to find any difference between different stimuli. Correspondingly, in animal experiments it has been shown that different stimuli applied to dentine are capable of activating the same intradental nerve units probably with a common mechanism (hydrodynamic). However, some recent studies indicate that sensation of cold could be induced by stimulating human teeth.
The purpose of this study was to investigate pulpal response and bacterial invasion associated with five dentin bonding systems placed in cavities without an enamel margin. Two hundred and twenty-four dentin margin cavities were created by removing the surrounding marginal enamel of class V cavities in monkey teeth. These cavities were restored with a resin composite using various current dentin bonding systems. All of the dentin bonding systems showed odontoblastic layer changes to varying degrees, and slight to moderate inflammation at the initial stage. With the lapse of time, the degree of inflammation tended to decrease markedly, except for those cases in which bacteria were present. The result of SA/Photo Bond corresponded to that of the glass ionomer cement (negative control). Accordingly, this study suggests that a good bond and adaptation between resin and dentin should be obtained for eliminating pulpal irritation, even in the dentin cavity.
Taurodontism is a morpho-anatomical change in the shape of the tooth in which the body of the tooth is enlarged and the roots are reduced in size. Although taurodontism is a dental rarity, this unusual radicular form should merit circumspect considerations in planning and treatment. Endodontic management in taurodont teeth has been described as complex and difficult. The present paper describes the successful completion of endodontic treatment in three taurodontic teeth with appropriate use of instruments and techniques and also emphasizes the need for post endodontic rehabilitation.
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Trigeminal neuralgia may be due to many causes, being in this respect secondary. To a certain degree trigeminal neuralgia may be facilitated by an individual increase of reactivity in the trigeminal system to noxious factors. For this reason, in treating trigeminal neuralgia, it is necessary first of all to take into consideration the possible etiological factors including different diseases of the teeth, in the innervation of which an important role is played by the fibers of the trigeminal nerve.
After the description of the anatomic and histologic aspects of the healthy dental pulp, stress is laid on pulpal pathologies and on the use of ultramicroscopic techniques to analyze the cytologic modifications in normal and pathologic dental pulp tissues. The results obtained are presented.
For local congelation of pathologically altered sections of the tissue the design of an earlier devised cryosprayer has been improved. The newly constructed model is convenient in handling, reliable in operation, has low weight and overall dimensions and ensures good visual view of the operation field. The new model of the cryosprayer is recommended for use in the stomatological practice, for treatment precarcinous affections of the buccal mucosa and dental pulp.
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