Quantitative ultrastructure of intradental nerve fibres in marmosets

Quantitative ultrastructural analysis of the neurofilament 200-positive axons in the rat dental pulp

INTRODUCTION

Previous studies have suggested that myelinated axons lose their myelin and become thinner in their peripheral course to the target organ. In this study, we investigated the morphologic changes of pulpal myelinated axons between their root portion (radicular pulp) and their terminal area (peripheral pulp).

METHODS

Sections of pulp of the rat upper molar teeth were immunostained for the marker of myelinated axons neurofilament (NF) 200. The proportion of NF200+ myelinated and unmyelinated fibers and their sizes were analyzed by using quantitative electron microscopy.

RESULTS

The axon area, myelin thickness, and fraction of NF200+ myelinated axons of all NF200+ axons were significantly lower in peripheral than in radicular pulp. In addition, large unmyelinated axons were frequently observed in peripheral pulp.

CONCLUSIONS

These results suggest that pulpal innervation originates predominantly from myelinated axons, and the myelinated axons undergo extensive morphologic changes during their course from the radicular to the peripheral pulp.

Inflammatory lesions of the tooth pulp induce changes in brainstem neurons of the rat trigeminal subnucleus oralis

Neuroplastic changes are known to occur in the CNS in response to injury of peripheral nerves. Previous investigation has demonstrated neuroplasticity in second-order neurons of the subnucleus oralis (SO) of the trigeminal (V) nuclear complex in association with aseptic injury to the tooth pulp. A question arises, therefore, as to whether similar changes occur in response to injury associated with inflammation induced by tooth pulp infection. The effects of tooth pulp infection on the mechanoreceptive fields (RFs) of SO neurons were examined in rats. Infection was established by exposure and removal of the coronal pulp of the mandibular first molar, which was left open to the oral environment for 7 (n = 5) or 28 (n = 6) days. Neurons in SO were then electrophysiologically characterized in chloralose/urethane-anesthetized rats. The RF and the response properties of 118 low-threshold mechanoreceptive (LTM) neurons from seven-day-old rats and 149 LTM neurons from 28-day-old rats were compared with those of 204 LTM neurons tested in 11 untreated (control) rats. Significant differences were noted in RF size and location when control, seven-day-old, and 28-day-old groups were compared. Radiographic examination revealed inconsistencies among examiners in the interpretation of periapical lesions < 2 mm in diameter and general agreement in the identification of periapical lesions > 2 mm in diameter. Histological examination of teeth with pulp exposure revealed superficial necrosis and inflammation without periapical extension in the seven-day-old animals and total pulp necrosis with periapical inflammation, abscess formation, and alveolar bone resorption in the 28-day-old animals. The results indicate that neuroplastic changes in LTM oralis neurons can develop subsequent to tooth pulp infection and that there may be a correlation between the incidence of these changes and the extension of the attending inflammation from the pulp to the dental supporting tissues.

Neural elements in dental pulp and dentin

This article addresses the structural and quantitative aspects of human tooth innervation and briefly considers the functions and clinical relevance of tooth axons. The classification of peripheral axons, the pulpal and dentinal innervation, and the theories of dentin sensitivity are discussed. Quantitative studies on tooth innervation are also reviewed. Human premolars receive about 2300 axons at the root-apex of which about 13% are myelinated and 87% are nonmyelinated fibers. Most apical myelinated axons are fast-conducting A delta-fibers with their receptive fields located at the pulpal periphery and inner dentin. These fibers are probably activated by a hydrodynamic mechanism and conduct impulses that are perceived as a short well-localized sharp pain. Most C-fibers are slow-conducting fine sensory afferents with their receptive fields located in the pulp and transmit impulses that are experienced as dull poorly localized and lingering pain. In addition to the nociceptive alarm signaling, the intradental sensory axons may play a regulatory role in the maintenance and repair of the pulpodentinal complex.

Number and size spectra of non-myelinated axons of human premolars

The aim of this study was to determine the number and size of apical non-myelinated (C) axons of healthy human premolars. The material was derived from a large collection of specimens prepared for a previous quantitative investigation on the myelinated (A) axons of human premolars. A total of 16 teeth (six maxillary first and five each of mandibular first and second premolars), removed from adolescents for orthodontic reasons, were used. Root discs of about 0.6 mm thickness were prepared at about 2 mm cervical to the root apex and processed for light and electron microscopy. The number of non-myelinated axons was determined by taking a total census of such fibres that could be identified and reconstructed by standardized composite electron micrographs from each root disc. The measurement of axons was done on a statistically representative sample of axons (n = 1810) using an electronic image processing unit. The 16 teeth had an average of 2000 +/- 1023 non-myelinated axons at the juxta-apical level (range 534-3912). The average diameter of the non-myelinated axons was found to be 0.5 +/- 0.4 microns (range 0.05-2.4 microns).

Teeth and tooth nerves

(1) Although our knowledge on teeth and tooth nerves has increased substantially during the past 25 years, several important issues remain to be fully elucidated. As a result of the work now going on at many laboratories over the world, we can expect exciting new findings and major break-throughs in these and other areas in a near future. (2) Dentin-like and enamel-like hard tissues evolved as components of the exoskeletal bony armor of early vertebrates, 500 million years ago, long before the first appearance of teeth. It is possible that teeth developed from tubercles (odontodes) in the bony armor. The presence of a canal system in the bony plates, of tubular dentin, of external pores in the enamel layer and of a link to the lateral line system promoted hypotheses that the bony plates and tooth precursors may have had a sensory function. The evolution of an efficient brain, of a head with paired sense organs and of toothed jaws concurred with a shift from a sessile filter-feeding life to active prey hunting. (3) The wide spectrum of feeding behaviors exhibited by modern vertebrates is reflected by a variety of dentition types. While the teeth are continuously renewed in toothed non-mammalian vertebrates, tooth turnover is highly restricted in mammals. As a rule, one set of primary teeth is replaced by one set of permanent teeth. Since teeth are richly innervated, the turnover necessitates a local neural plasticity. Another factor calling for a local plasticity is the relatively frequent occurrence of age-related and pathological dental changes. (4) Tooth development is initiated through interactions between the oral epithelium and underlying neural crest-derived mesenchymal cells. The interactions are mediated by cell surface molecules, extracellular matrix molecules and soluble molecules. The possibility that the initiating events might involve a neural component has been much discussed. With respect to mammals, the experimental evidence available does not support this hypothesis. In the teleost Tilapia mariae, on the other hand, tooth germ formation is interrupted, and tooth turnover ceases after local denervation. (5) Prospective dental nerves enter the jaws well before onset of tooth development. When a dental lamina has formed, a plexus of nerve branches is seen in the subepithelial mesenchyme. Shortly thereafter, specific branches to individual tooth primordia can be distinguished. In bud stage tooth germs, axon terminals surround the condensed mesenchyme and in cap stage primordia axons grow into the dental follicle.(ABSTRACT TRUNCATED AT 400 WORDS)

Encoding of the subjective intensity of sharp dental pain

This paper is a review and a discussion of our own pain research over the last decade. It is of a methodological and theoretical character and deals with preparation technique, choice of electrodes, control experiments involving pulpotomy and reliability tests of psychophysical methods for pain measurements, and the neuronal population encoding of sharp dental pain. The electrophysiological recording technique selectively picks up electrical activity induced in pulpal A-delta nerve fibers. The sensation of pain was quantified by means of an intermodal matching technique, finger span (PAS), in combination with sensory verbal descriptors covering a range from very, very weak to maximal pain. When a cold stimulus, ethyl chloride, was applied on the tooth surface a close agreement was demonstrated between intradental A-delta nerve activity (INA) and the sensation magnitude of pain (PAS) with respect to curve amplitude and time course. The high covariation of the neural and perceptual response measures indicated a good internal validity and confirmed also the basic soundness and the applicability of the procedures employed. For the purpose of further analyzing the functional relation of INA to PAS we studied specifically the effect of cold stimuli of different intensity on the integrated nerve response. Only sharp, shooting pain was accepted as a sensorial, perceptual correlate of the intradental A-delta nerve activity. Since an increase in amplitude was generally accompanied by an increase in duration of the responses, the fundamental question was raised how to best describe and characterize the neural and perceptual responses so that they most adequately reflect the information processing of the intensive aspect of sharp dental pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Number and size-spectra of myelinated nerve fibers of human premolars

The primary objective of this study was to determine the number and size of myelinated nerve fibers at the subcervical, midroot and juxta-apical levels of human premolars. Sixty-seven healthy premolars extracted from adolescents were utilized. Root-discs were prepared from the three sites and processed for light and electron microscopy. The myelinated nerve fibers were counted from semithin sections using a sampling microscope. The measurements were taken from composite electron micrographs using an electronic image processing unit. A total of 1883 myelinated axons from seven mandibular second premolars was gauged. The 67 teeth had an average of 312 +/- 149 myelinated nerve fibers at the juxta-apical level (range 18 to 728). The contra- and ipsilateral differences in means among the four groups of premolars were not significant (P > 0.05). The number of nerves increased significantly (P < 0.05) toward midroot and subcervical (P < 0.001) levels in all groups. The average neural diameter was 3.5 + 1.0 microns at the juxta-apical level, and the between-teeth difference in mean was found to be significant (P < 0.01). There was no decline (P > 0.05) in the diameter of myelinated nerve fibers toward midroot and subcervical levels.

The relation between intradental nerve activity and pulpal pain after heat stimulation

The effects of tooth surface stimulation on intradental nerve activity (INA) and subsequent pain perception were studied in human lower incisors later to be extracted for periodontal reasons. The INA elicited by hot gutta-percha briefly applied to the tooth surface was monitored by means of labial electrodes deeply implanted in the dentin and perceived pain was continuously rated using a finger-span technique. After each stimulation the subject was also requested to select a sensory descriptor that was appropriate to describe the maximal pain intensity. The very first application of heat induced a typical pattern of nerve activity consisting of three phases. An initial burst of 3-5 s duration, phase I, was followed by a depression relative to the baseline lasting for 20-30 s, phase II, that gradually turned into phase III constituting a slowly increasing firing rate. The spontaneously emerging activity (phase III) in the absence of a physical stimulus passed unnoticed by all the subjects despite an average increase in firing rate of 67% relative to the prestimulus noise level. Repeated heat applications at short intervals led to a decrease and finally to abolishment of the whole nerve response. The lack of pain during phase III may be explained in two ways: the rate of increase in firing frequency may be too slow to trigger those perceptual pathways involved in processing of pain; the slow development of the increased sensory nerve activity may lead to central habituation.(ABSTRACT TRUNCATED AT 250 WORDS)

Myelinated fibre diameters of human inferior alveolar nerves

These were examined in a series of 36 human post-mortem specimens. One unimodal, 32 bimodal and 1 trimodal diameter curves were demonstrated; group analysis of all samples gave a bimodal curve with 2-4 and 8-9 microns peaks.

Membrane junctions between odontoblasts and associated cells. A freeze-fracture study of the human odontoblastic cell layer with special reference to its nerve supply

The relationship between odontoblasts and adjacent cell structures within the odontoblastic cell layer was analyzed by means of the freeze-fracturing technique. Two principal forms of interodontoblastic cell structures were found. The first was tubular or thread-like in appearance, having a general diameter around 0.1-1.0 micron. From morphological criteria these were believed to represent small, unmyelinated nerve fibers. The second type of cell structure found between odontoblasts was more irregular and heterogeneous in outline, and often lamellar or branched. These slender formations sometimes proved to constitute cellular projections from adjacent odontoblasts or neighboring, subodontoblastic fibroblasts. Both the nerve-like fibers and the irregular branched cells between the odontoblasts showed morphological contact areas with odontoblastic cell bodies. At these sites the intracellular distances were reduced, and characteristic gap junctional complexes occurred. Nerve ending specialization or membrane structures indicating the presence of chemical synapses on the odontoblastic cell surface were not observed.

Dental sensory receptors

Teeth are innervated by unmyelinated sympathetic axons, and by unmyelinated and small myelinated sensory axons. Some sensory axons in teeth are terminal branches of larger parent axons, so that conduction from teeth to CNS in trigeminal nerves includes C-fiber, A-delta, and A-beta velocities. Sensory dental axons contain acetylcholine or substance P-like immunoreactivity. The sympathetic axons contain noradrenalin. Other neuropeptides may also be present, such as vasoactive intestinal peptide and serotonin. Dental axons of mature teeth of many species (man, monkey, cat, rodents, fish) are essentially the same, but continuously erupting teeth have smaller and fewer axons. Free sensory nerve endings in mature teeth are found in the peripheral plexus of Raschkow, the odontoblastic layer, the predentin, and the dentin. Free nerve endings are most numerous in those regions near the tip of the pulp horn, where more than 40% of the dentinal tubules can be innervated. Many dentinal tubules contain more than one free nerve ending. Intradentinal axons can extend as far as 0.2 mm into dentin but usually end less than 0.1 mm from the pulp. Some sensory endings also occur along pulpal blood vessels. In continuously erupting teeth nerve endings do not enter the dentin but remain within the pulp. Nerve endings in dentin are labeled by axonal transport. They are therefore as viable and active as the nerve endings in pulp. The axoplasm of the free nerve endings contains organelles typical of other somatosensory receptors. These organelles are most common in the successive beaded regions along the free nerve endings and include mitochondria, clear and dense-core vesicles, multivesicular bodies, profiles of smooth endoplasmic reticulum, and relatively few microtubules and neurofilaments. The beads can vary in size from about 0.2 to 2.0 microns and can have varying amounts of receptor organelles. The interbead axonal regions are thin and contain mainly microtubules and neurofilaments. Nerve endings are associated with companion cells after they leave the coronal nerve bundles; these companion cells include Schwann cells, fibroblasts, and odontoblasts. There is no good evidence of gap junctions or synapses between nerve endings and odontoblasts. Instead, the two cell types form appositions that have a 20-40 nm extracellular cleft and parallel apposed plasmalemmas but no unusual membrane-associated material. No special organelles occur in the odontoblastic cytoplasm at these sites.(ABSTRACT TRUNCATED AT 400 WORDS)

Electron microscopic demonstration of horseradish peroxidase-tetramethylbenzidine reaction product as a method for identifying sensory nerve fibers in the rat tooth pulp

The purpose of the present investigation was to determine if the horseradish peroxidase (HRP) technique could be used as a method for labeling sensory nerve fibers (specifically, tooth pulp afferents) for detailed ultrastructural analyses. HRP injected into the trigeminal ganglion of adult rats was taken up by ganglion cell bodies and transported anterogradely to their peripheral endings in the dental tissues. Following perfusion-fixation, the teeth were decalcified in EDTA, sectioned, reacted for HRP activity according to the tetramethylbenzidine (TMB) technique, and processed for electron microscopy. The HRP-TMB reaction product was clearly visible within most of the axons in the dental pulp, appearing as conspicuous, rectangular shaped aggregates of fine rods or needles.

Quantitative assessment of neural development in human premolars

The number of nerve fibers entering a tooth gives an indication of the tooth's capacity to perform a sensory function. Nerve fiber development was quantitated from cross sections of the apical portions of 49 erupted human premolars at various stages of root development and in subjects up to 71 years of age. Neural development was incomplete in immature teeth, greatly variable in young mature teeth, and complete in older teeth. Myelinated axons changed in number but not in size during tooth development. There were significantly fewer myelinated axons in teeth with open and parallel apical foramina than in older teeth. Unmyelinated axons did not change significantly in number with development but fewer large axons were found in older teeth. The number of unmyelinated axons enclosed in a single boundary lamina tended to be lower in older teeth. As a physiologic correlate, threshold responses to electrical stimulation were also determined prior to premolar removal. Threshold stimulation decreased significantly with apical foramen maturation. A significant negative correlation was found between the threshold stimulus and the number of myelinated axons in fully developed teeth, but not in immature teeth.

The number and size of axons at the apex of the cat's canine tooth

Using electron microscopy and morphometric analysis the number and size of axons entering the apex of the cat's mandibular canine tooth have been measured. The total number of axons varied from 761 to 1,903 between different animals but the maximum difference between right and left sides of the same animal was 353. From 56 to 79.6% of the axons were nonmyelinated; the difference in proportion between right and left sides never exceeded 6.4%. The mean circumference of myelinated axons ranged from 10.2 to 18.3 micrometers but again the right and left variation was much less and never exceeded 2 micrometers. In one tooth 38.8% of the myelinated axons were larger than 19 micrometers in circumference and thus outside the A delta range. The proportion was much smaller in other teeth but some "large" fibers were always present. Of all the nonmyelinated axons 19.7% showed some degree of axonal exposure to the extracellular space and 1.7% showed ax-oaxonal apposition. A small proportion of nonmyelinated axons showed evidence of apparent degeneration. Comparison of these data with those from studies at more coronal levels suggests that there is considerable branching and narrowing of fibers during their course through the dental pulp and that the degree of axonal exposure and apposition increases considerably. Some of the pulpal fibers are derived from larger axons than are normally associated with pain. The animal to animal variation in the parameters measured is considerable but right and left sides are similar.

Quantitative assessment of intrapulpal axon response to orthodontic movement

Nerve fiber changes are of potential concern during tooth movement. Quantitative and qualitative assessments using electron microscopy of nerve fibers entering the tooth give an indication of change in the remainder of the pulp. Eight healthy mandibular first premolars were selected from four subjects, so that respective pairs had open apices and short-term movement, open apices and long-term movement, closed apices and short-term movement, and closed apices and long-term movement. These were compared to forty-nine untreated control teeth. No significant differences in myelinated or unmyelinated axon number were observed between experimental and control teeth. Altered myelin figures, possibly degenerating, were observed in only a small percentage of axons in teeth moved for a short period. No alterations were observed in teeth moved for long periods. It is concluded that intrapulpal axon alterations are minimal and not progressive with conservative orthodontic tooth movement.

A fine-structural investigation on the extent of perineurial investment of the nerve supply to the pulp in rat molar teeth

The fine structure of the tissues immediately adjacent to nerve fibres supplying the rat molar pulp has been examined and compared with that of perineurium of other peripheral nerves. In the periapical region, almost all nerve fibres were invested with typical perineurium; only a few Schwann cell units (unmyelinated axons) lacked perineurium. In the pulp at the apex of the distal root, most fibres were invested by less typical perineurium but some were not invested at all. In the pulp at the coronal end of the root, nerve fibres were completely invested or incompletely invested with attenuated perineurium or lacked investment altogether. In the coronal pulp, there was virtually no perineurium at all. Thus rat molar pulp nerve fibres lack perineurium for distances of about 0.5-3.0 mm, distances greater than in situations such as skin or muscle. In normal peripheral nerves, the perineurium behaves as a barrier to the passage of substances from the immediate environment of the nerve fibres (endoneurium) to the surrounding environment (epineurium) and vice versa. Its absence around pulp nerve fibres raises questions about the nature of the pulp environment and may help to explain the sensitivity of pulp nerves to chemical, osmotic and other stimuli.

Pulpal axons in developing, mature, and aging feline permanent incisors. A study by electron microscopy

The ingrowth, maturation, and aging of pulpal axons was followed by electron microscopy in permanent mandibular incisors of 44 cats aged 35 days-11 years. The first axons entered the incisor pulps about 2 months after birth. Cells resembling Schwann cells, but lacking an axonal relation, were also observed at this time. Axonal ingrowth and maturation continued until 7 months, when the pulps contained 92-394 axons, 81-88% of which were unmyelinated. Between month 7 and 20 months the character of the incisor pulpal axons remained largely unchanged. In adult cats the myelinated pulpal axons had diameters of 1-6 micrometer. The relation between the number of myelin lamellae and the axon size correlated better with linear + logarithmic than linear functions. The g-ratios were higher than in most peripheral nerves, and tended to increase with axon diameter. In the old adult this tendency was more evident and the g-ratios were generally lower. From 3 years on the incisors displayed various age-related or pathological alterations. These were accompanied by axonal changes and axon loss. In contrast to earlier stages perineuriumlike sheaths were frequent in old teeth. The findings are discussed in relation to axon development in the inferior alveolar nerve and in primary incisor pulps.

Developmental growth and degeneration of pulpal axons in feline primary incisors

The life history of pulpal axons in primary mandibular incisors was examined by light and electron microscopy in 56 kittens aged from 25 days postconception to 120 days after birth. Cells resembling Schwann cells preceded the first arrival of pulpal axons, 1 week postnatally. myelination was initiated during the second week. Two months after birth the incisors were fully grown and each pulp contained about 100 axons. Between 10 and 20% of these were myelinated and ranged in size from 1 to 5 micrometer. The relation between number of myelin lamellae and axon size appeared nonlinear and differed markedly from that in similarly sized inferior alveolar nerve axons. During the third month many unmyelinated axons showed signs of degeneration. With progress of root resorption an increasing proportion of both unmyelinated and myelinated axons degenerated. In highly resorbed incisors necrotic Schwann cells were associated with degenerating axons and there was a generalized pulpal tissue reaction. In some teeth with advanced root resorption pulpal axons were lacking. A progressive derangement of all pulpal tissue elements continued until shedding during the second half of the fourth month. In incisor nerve branches below the incisor teeth axon degeneration was very limited.

A fine-structural survey of the pulpal innervation in the rat mandibular incisor

The innervation of the rat incisor pulp has been studied using transmission electron microscopy and light microscopy. Transverse sections of mandibular incisor pulp (380-460 gm rats) from numerous positions in the long axis of the tooth were examined systematically in the electron microscopy. Quantitative data on total axon populations were obtained. The nerve fibers were found to pass through the lingual half of the pulp from the apical end to within 2 mm of the incisal tip. Although the nerve fibers were seen to lie amongst the connective tissue cells between the blood vessels, the electron microscopic observations showed that the blood vessels are not innervated. Throughout their pulpal course the nerve fibers showed no trace of perineurial investment. Virtually all the axons were unmyelinated. Total numbers of axons were small (233-328) and peak diameters of 0.3-0.4 microM confirmed the observed immature appearance of the nerve supply. Obvious nerve endings were seldom observed and the axons showed no structural association with odontoblasts. The evidence indicates that, although most axons terminate near the incisal end of the tooth, no specific structure is supplied. The qualitative features of the axons do not suggest autonomic function; however, they are consistent with a sensory role.

Microtubule and microfilament populations of cell processes in the dental pulp

An attempt has been made to characterize the nature of the unidentified cell processes participating in gap junctions in the odontoblast layer. In peripheral and pulpal nerves, there is a strong relationship between together with the ratio of microtubules to microfilaments, has been measured and compared for four types of cell processes found in the dental pulp, including those participating in gap junctions. The processes taking part in the gap junctions cannot be distinguished from pulpal axons on the basis of microtubule-to-microfilament ratio nor on the relationship between microtubule and microfilament population and process caliber. While these findings do not prove that the "gap members" are nerve fibers, it does support the hypothesis that the processes taking part in gap junctions in the peripheral dental pulp are nerve fibers.

A quantitative analysis of the innervation of the pulp of the cat's canine tooth

Although the cat's canine tooth has become the accepted model for the electrophysiological study of dental sensory mechanisms no examination of its innervation has been carried out at the electron-microscopical level. This study looked at the number and size distribution of both myelinated and non-myelinated fibers in the crown of the cat's canine. The material examined was prepared by routine methods and the measurements taken from electron-microscopical montages of pulpal cross-sections. The measurements were made using a Quantimet 720 image analysis system. In one complete cross-section 3,470 fibers were counted. Eighty-one percent of these were non-myelinated with a modal diameter of 0.35 micron. The modal diameter of the myelinated fibers was 2.5 micron. The relative preponderance of non-myelinated fibers increased from core to periphery. The largest myelinated fibers were concentrated in the core. The fiber size distribution was similar in the single complete and two partial sections examined. It is concluded that all the fibers in the crown of the cat's canine would be contained in the A-delta and C groups and that the strikingly large number of fibers present suggests that the peripheral pulp has a dense innervation, many of the cell processes found there being unsheathed axons.

Sensation evoked by bipolar intrapulpal stimulation in man

Bipolar intrapulpal stimulation was applied to human teeth using the same procedure as in animal experiments. The effects of variation of stimulus parameters on the quality of sensation were studied. A prepain sensation exists which cannot be explained by diffusion of the stimulus to periodontal tissues. When the intensity of stimulation is increased, the prepain sensation is gradually replaced by a pinprick sensation. With long, high intensity stimulation, an acute long lasting very painful sensation appears. To evoke a pinprick sensation the best stimulation seems to be a 50 msec train (0.5 msec, 300 Hz, 0.5 mA). Longer train duration and a higher intensity of current are necessary to evoke a long lasting, acute very painful sensation. Since the exclusively Adelta and C nerve fiber content of the dental pulp is well documented and since it is possible to avoid current diffusion outside the dental pulp cavity, the tooth pulp implantation seems to be a good technic for studying pain, as long as the investigator uses adequate stimulation.

Development of neural elements in apical portions of cat primary and permanent incisor pulps

Pulp development was studied with light and electron microscopy in apical portions of cat primary and permanent incisors at various stages of development in order to qualitatively assess hypothesized differences during maturation. Primary and permanent tooth pulps passed through similar stages up to when the primary teeth began to resorb. At that point permanent tooth pulps continued to develop in complexity relative to myelinated axons and developed thin epineurial sheaths. Although the stages were similar in several regards, the time needed by the permanent tooth pulps to reach each stage was considerably greater than for the primary tooth pulps. It is of interest that the young permanent teeth had only a small portion of their final complement of nerves in spite of their relatively complete development. Individual axons, especially myelinated axons, appeared more immature in younger primary and permanent teeth. This suggests a less mature sensory capability for erupting primary teeth as compared to fully developed primary teeth as well as for erupting and young permanent teeth compared to old permanent teeth.

Responses of intradental nerves to electrical and thermal stimulation of teeth in dogs

1. Experiments were carried out to investigate the mechanism whereby thermal stimul excite nerves to produce pain from teeth. 2. Recordings have been made from single fibres dissected from the inferior dental nerve in dogs during thermal stimulation of the lower canine tooth. 3. In preliminary experiments, no units were found with thresholds close to the thresholds for pain in man (45 and 27 degrees C) and subsequently test stimuli of 55 degrees C, applied for up to 15 sec, and 0-5 degrees C were used. 4. Of 117 fibres tested, forty-three responded to cooling but not to heating and nine responded to heating but not to cooling. 5. By applying thermal stimuli direct to the saphenous nerve in cats, it was shown that these responses might have been due to direct excitation of nerves and not to stimulation of specialized receptors. 6. Some units responded to electrical stimulation of the tooth pulp with a latency which decreased abruptly at a critical intensity as the stimulus was increased above threshold. Evidence was obtained which suggested that this was due to branching of the fibres.

Sensory and reflex responses to tooth pulp stimulation in man

Experiments have been carried out to investigate whether all tooth pulp afferent nerves are capable of producing pain. Monopolar and bipolar stimuli were applied to teeth in human subjects and sensory thresholds determined. EMGs were recorded from the masseter and the anterior digastric muscles. With stimuli up to three times the sensory threshold, no response could be detected in the digastric but at, or just above, the sensory threshold, inhibitory effects were produced in masseter muscle. The latency of the muscle response with bipolar stimulation was 18-22 msec. There was no evidence of stimulus spread to nerves outside the teeth. Bipolar and monopolar stimulation both produced the same sensation but this was not described as painful. It is concluded that some pulpal afferent nerves may not be capable of producing pain, and that the sensory and reflex responses at threshold were probably produced by the same fibres.