A Systematic Review of the Cervical Plexus Accessory Innervation and Its Role in Dental Anesthesia

Trigeminal sensory nerve patterns in dentine and their responses to attrition in rat molars

OBJECTIVE

Our goal was to define trigeminal nerve ending quantities and patterns in rat molar dentine, their responses to attrition (tooth wear), and their associated odontoblasts and connections with pulpal plexuses.

DESIGN

Trigeminal ganglia were labeled for axonal transport of ³H-proteins to dentinal nerve endings in male rats (3-13 months old). Autoradiography detected radio-labeled dentinal tubules as indicators of nerve ending locations. Quantitative morphometry was done (ANOVA, t-tests), and littermates were compared for attrition and innervation.

RESULTS

There were six dentinal patterns, only two of which had an associated neural plexus of Raschkow and cell-free zone (Den-1, Den-2). Other nerves entered dentin from bush-like endings near elongated odontoblasts (Den-B), as single fibers (Den-X), as networks in predentine (PdN), or as single fibers in tertiary dentine at cusp tips (Den-S). There were at least 186,600 innervated dentinal tubules within the set of three right maxillary molars of the best-labeled rat, and similar densities were found in other rats. Attrition levels differed among cusps and in littermates (t-test p < 0.02-0.0001), but the matched right/left cusps per rat were similar. Innervations of tertiary and enamel-free dentine (Den-S, Den-X) were preserved in all rats. Den-B and Den-2 coronal patterns were unchanged unless displaced by dentinogenesis. Den-1 losses occurred in older cusps, while Den-2 patterns increased near cervical and intercuspal odontoblasts.

CONCLUSIONS

The extensive molar dentinal innervation had unique distributions per rat per cusp that depended on region (buccal, middle, palatal) and attrition, but only two of six patterns connected to a plexus of Raschkow.

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