Branched afferent nerves supplying tooth-pulp in the cat

Effect of full crown preparation on pulpal blood flow in man

OBJECTIVE

To determine if full crown preparation causes an increase in pulpal blood flow (PBF), indicating inflammation, in human subjects.

DESIGN

The experiments were carried out on 35 intact, mandibular posterior teeth in 13 subjects: 32 were abutments for 16 fixed bridges that replaced first molars; the other 3 were first premolars adjacent to abutment teeth that served as un-operated controls. Crown preparations were made using an air-rotor with water-spray under regional block anaesthesia (4% articaine with epinephrine 1:100,000). PBF was recorded with a laser Doppler flow meter (LDF) before and after administering the anaesthetic, with the LDF probe on the buccal enamel. PBF was then recorded from the abutment teeth with the probe on buccal dentine after preparing the buccal surfaces of both teeth, after completing the crown preparations, and after 1 and 7days. PBF was also recorded from the buccal enamel of the control teeth on each occasion.

RESULTS

The mean±S.D. PBF values before and after anaesthesia were 2.63±2.13 and 2.42±2.38P.U. respectively, which were not significantly different (Paired t-test). The mean values for the abutment teeth after buccal preparation, after complete crown preparation, and after 1 and 7days were 5.20±2.49, 4.53±2.52, 4.92±2.98 and 5.48±2.65P.U. respectively. The 4 values for each tooth were not significantly different (two-way RM ANOVA). In the control group, the values under all six conditions were not significantly different.

CONCLUSIONS

Regional block anaesthesia produced no change in PBF, nor did full-crown preparation, neither immediately after the procedure nor 1 and 7days later.

Changes in the Distribution of Periodontal Nerve Fibers during Dentition Transition in the Cat

The periodontal ligament has a rich sensory nerve supply which originates from the trigeminal ganglion and trigeminal mesencephalic nucleus. Although various types of mechanoreceptors have been reported in the periodontal ligament, the Ruffini ending is an essential one. It is unknown whether the distribution of periodontal nerve fibers in deciduous teeth is identical to that in permanent teeth or not. Moreover, morphological changes in the distribution of periodontal nerve fibers during resorption of deciduous teeth and eruption of successional permanent teeth in diphyodont animals have not been reported in detail. Therefore, in this study, we examined changes in the distribution of periodontal nerve fibers in the cat during changes in dentition (i.e., deciduous, mixed and permanent dentition) by immunohistochemistry of protein gene product 9.5. During deciduous dentition, periodontal nerve fibers were concentrated at the apical portion, and sparsely distributed in the periodontal ligament of deciduous molars. During mixed dentition, the periodontal nerve fibers of deciduous molars showed degenerative profiles during resorption. In permanent dentition, the periodontal nerve fibers of permanent premolars, the successors of deciduous molars, increased in number. Similar to permanent premolars, the periodontal nerve fibers of permanent molars, having no predecessors, increased in number, and were densely present in the apical portion. The present results indicate that the distribution of periodontal nerve fibers in deciduous dentition is almost identical to that in permanent dentition although the number of periodontal nerve fibers in deciduous dentition was low. The sparse distribution of periodontal nerve fibers in deciduous dentition agrees with clinical evidence that children are less sensitive to tooth stimulation than adults.

Mechanisms underlying ectopic persistent tooth-pulp pain following pulpal inflammation

In order to clarify the peripheral mechanisms of ectopic persistent pain in a tooth pulp following pulpal inflammation of an adjacent tooth, masseter muscle activity, phosphorylated extracellular signal-regulated protein kinase (pERK) and TRPV1 immunohistochemistries and satellite cell activation using glial fibrillary acidic protein (GFAP) immunohistochemistry in the trigeminal ganglion (TG) were studied in the rats with molar tooth-pulp inflammation. And, Fluorogold (FG) and DiI were also used in a neuronal tracing study to analyze if some TG neurons innervate more than one tooth pulp. Complete Freund's adjuvant (CFA) or saline was applied into the upper first molar tooth pulp (M1) in pentobarbital-anesthetized rats, and capsaicin was applied into the upper second molar tooth pulp (M2) on day 3 after the CFA or saline application. Mean EMG activity elicited in the masseter muscle by capsaicin application to M2 was significantly larger in M1 CFA-applied rats compared with M1 vehicle-applied rats. The mean number of pERK-immunoreactive (IR) TG cells was significantly larger in M1 CFA-applied rats compared with M1 vehicle-applied rats. Application of the satellite cell inhibitor fluorocitrate (FC) into TG caused a significant depression of capsaicin-induced masseter muscle activity and a significant reduction of satellite cell activation. The number of TRPV1-IR TG cells innervating M2 was significantly larger in M1 CFA-applied rats compared with M1 vehicle-applied rats, and that was decreased following FC injection into TG. Furthermore, 6% of TG neurons innervating M1 and/or M2 innervated both M1 and M2. These findings suggest that satellite cell activation following tooth pulp inflammation and innervation of multiple tooth pulps by single TG neurons may be involved in the enhancement of the activity of TG neurons innervating adjacent non-inflamed teeth that also show enhancement of TRPV1 expression in TG neurons, resulting in the ectopic persistent tooth-pulp pain following pulpal inflammation of adjacent teeth.

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.

A clinical classification of the status of the pulp and the root canal system

Many different classification systems have been advocated for pulp diseases. However, most of them are based on histopathological findings rather than clinical findings which leads to confusion since there is little correlation between them. Most classifications mix clinical and histological terms resulting in misleading terminology and diagnoses. This in turn leads to further confusion and uncertainty in clinical practice when a rational treatment plan needs to be established in order to manage a specific pathological entity. A simple, yet practical classification of pulp diseases which uses terminology related to clinical findings is proposed. This classification will help clinicians understand the progressive nature of the pulp disease processes and direct them to the most appropriate and conservative treatment strategy for each condition. With a comprehensive knowledge of the pathophysiology of pain and inflammation in the pulp tissues, clinicians may accomplish this task with confidence.

Glial cell line-derived neurotrophic factor (GDNF) from adult rat tooth serves a distinct population of large-sized trigeminal neurons

Glial cell line-derived neurotrophic factor (GDNF) mediates trophic effects for specific classes of sensory neurons. The adult tooth pulp is a well-defined target of sensory trigeminal innervation. Here we investigated potential roles of GDNF in the regulation of adult trigeminal neurons and the dental pulp nerve supply of the rat maxillary first molar. Western blot analysis and radioactive 35S-UTP in situ hybridization revealed that GDNF in the dental pulp and its mRNAs were localized with Ngf in the coronal pulp periphery, in particular in the highly innervated subodontoblast layer. Retrograde neuronal transport of iodinated GDNF and Fluorogold (FG) from the dental pulp indicated that GDNF was transported in about one third of all the trigeminal dental neurons. Of the GDNF-labelled neurons, nearly all (97%) were large-sized (> or =35 microm in diameter). Analysis of FG-labelled neurons revealed that, of the trigeminal neurons supporting the adult dental pulp, approximately 20% were small-sized, lacked isolectin B4 binding and did not transport GDNF. Of the large-sized dental trigeminal neurons approximately 40% transported GDNF. About 90% of the GDNF-accumulating neurons were negative for the high-temperature nociceptive marker VRL-1. Our results show that a subclass of large adult trigeminal neurons are potentially dependent on dental pulp-derived GDNF while small dental trigeminal neurons seems not to require GDNF. This suggests that GDNF may function as a neurotrophic factor for subsets of nerves in the tooth, which apparently mediate mechanosensitive stimuli. As in dorsal root ganglia both small- and large-sized neurons are known to be GDNF-dependent; these data provide molecular evidence that the sensory supply in the adult tooth differs, in some aspects, from the cutaneous sensory system.

Centrally mediated reflex vasodilation in the gingiva induced by painful tooth-pulp stimulation in sympathectomized human subjects

This study was designed to determine whether painful electrical stimulation of the tooth pulp induces centrally mediated reflex vasomotor changes in human gingiva and whether the sympathetic nervous system is involved in the vasomotor responses. Dynamic changes in maxillary gingival blood flow (GBF) following painful electrical stimulation of the mandibular lateral incisor were investigated, by means of laser-Doppler flowmetry, in both healthy volunteers and patients undergoing sympathetic blockade for hyperhidrosis. Increases in GBF were observed in both healthy volunteers and patients on the ipsilateral side without an increase in systemic blood pressure, but the evoked GBF increase disappeared when pain sensation was abolished by local anesthetization with 2% xylocaine solution. The vasodilator responses did not differ in amplitude between before and after the sympathectomy. These results suggest that painful tooth stimulation evokes centrally mediated reflex vasodilation, presumably via parasympathetic efferent fibers, in the human gingiva and that sympathetic vasomotor mechanisms are not involved in these responses.

Blood flow changes in human dental pulps when capsaicin is applied to the adjacent gingival mucosa

OBJECTIVE

The purpose of this study was to determine whether changes occur in pulpal blood flow when capsaicin is applied to the adjacent gingival or alveolar mucosa in human beings.

STUDY DESIGN

Laser Doppler flowmetry was used to measure changes in pulpal blood flow (PBF) after applying capsaicin to adjacent gingival mucosa in 20 human volunteers. The procedure was repeated on 10 subjects after administration of an ipsilateral inferior alveolar nerve block and on the other 10 subjects after application of topical anesthetic to their adjacent gingival and alveolar mucosa.

RESULTS

PBF increased in 16 subjects and did not change in 4 subjects after capsaicin application. Ipsilateral inferior alveolar nerve block did not alter this effect. Pretreatment with topical lidocaine resulted in no change or decreased PBF in 8 subjects and increased PBF in 2 subjects.

CONCLUSION

Changes occur in the PBF of the mandibular canine teeth of some humans when capsaicin is applied to the adjacent gingival or alveolar mucosa.

Increased blood flow and nerve firing in the cat canine tooth in response to stimulation of the second premolar pulp

Mustard oil or mechanical stimulation was applied to maxillary second premolar tooth pulps and pulpal blood flow and or intradental nerve activity in the ipsilateral canine tooth were recorded in the cat. Mustard oil application to the second premolar pulp significantly increased blood flow in the canine tooth pulp to 162.0+/-65.8% (n = 16) of the prestimulation flow compared to control data obtained with application of mineral oil (107.0+/-5.1%, n = 6) (Mann-Whitney U-test, p = 0.0009). Sectioning of the infraorbital nerve and its branches on the experimental side (n = 4) did not affect this increase in pulpal blood flow. The paraperiosteal injection of 2% lidocaine (1.0 ml) without vasoconstrictor significantly inhibited the increase in canine pulpal blood flow induced by mustard oil application to the second premolar pulp (109.8+/-6.8% of the prestimulation level, n = 7) (Mann-Whitney U-test, p = 0.0013). Sporadic firing or sometimes bursts of action potentials in the canine pulp nerves were recorded during and/or after the mustard oil application to the second premolar pulp in three of 16 cases. Four single pulp nerve units firing in synchrony with the mechanical stimulation of the second premolar pulp were recorded in two of eight canines, which substantiated the existence of branched afferents innervating both teeth. These findings suggest that stimulation of the second premolar pulp may induce axon reflex-related vasodilation and intradental nerve firing in the canine pulp via branched afferent fibres innervating both the second premolar and canine teeth.

Course and composition of the nerves that supply the mandibular teeth of the rat

The rodent dentition has become an important model for investigations of interactions between dental tissues and peripheral neurons. Although experimental nerve injury has been widely used for such studies, there is uncertainty about the courses of nerve fibers supplying the mandibular teeth. In order to clarify this, we used a mixture of monoclonal antibodies against neurofilament proteins to enhance demonstration of nerve fibers so that small nerves could be readily traced in serial frozen sections of mandibles of Sprague Dawley rats ranging in age from embryonic day (E) 18 to postnatal day (P) 90. The 1st molar and anterior portion of the 2nd molar were innervated by small nerves that emerged as distinct branches of the IAN trunk at or near the mandibular foramen. In contrast, the nerve supply to the 3rd molar and posterior part of the 2nd molar was a branch of the lingual nerve that bypassed the mandibular canal altogether. The IAN trunk split into the mental nerve and a large branch to the incisor about 2 mm anterior to the mandibular foramen. Thick branches of the incisor nerve descended into the incisor socket to form a dense plexus of nerve fiber bundles extending along the length of the incisor periodontium. The sparse pulpal innervation of the incisor was provided by a few thin fascicles that emerged from the caudal portion of the periodontal plexus to enter the incisor apex. The dental branches of the IAN and lingual nerve seen in the adult were well established and readily identifiable at age E18 even though their targets were limited to the follicles of the developing teeth. These studies show that the trigeminal branches that supply the mandibular teeth can be identified at a wide range of ages as distinct nerves at a considerable distance proximal to their targets. This detailed information on the courses taken by the dental nerves can provide an anatomical basis for increased precision in characterization and perturbation of neural pathways from the molars and incisor.

Bilateral reflex vasodilation in the palatal mucosa evoked by unilateral tooth-pulp stimulation in the cat

In a previous study in cats, we found that electrical stimulation of the tooth pulp caused blood flow increases at various sites in the ipsilateral oral mucosa (upper and lower gingivae, lower lip, buccal mucosa and tongue, and, notably, bilaterally in the palatal mucosa). Tooth-pulp stimulation is well-known to induce severe pain and to evoke autonomic reflex responses in other organs and tissues. The purpose of this study was: to confirm that tooth-pulp stimulation may indeed induce autonomically mediated vasodilator responses in the feline oral mucosa away from the stimulated tooth, and to test our hypothesis that the reflex pathway involves parasympathetic vasodilator fibers as efferents. Dynamic changes in palatal mucosal blood flow (PMBF), with lower lip blood flow (LBF) as a control, were investigated in anesthetized, cervically sympathectomized cats by means of Laser Doppler Flowmetry. Unilateral electrical stimulation of the maxillary canine tooth pulp produced hexamethonium-sensitive bilateral increases in PMBF in a stimulus-intensity-dependent manner, without an increase in systemic blood pressure; LBF increased only ipsilaterally. Bilateral section of the glossopharyngeal nerve roots had no effect on the vasodilator responses, while unilateral section of the facial nerve root or lesion of the pterygopalatine ganglion (PPG) abolished the response on that side. Intracranial electrical stimulation of the peripheral cut ends of the facial or glossopharyngeal nerve roots caused an increase in ipsilateral PMBF. These results indicate that unilateral tooth-pulp stimulation induces a bilateral reflex vasodilator response in the palatal mucosa mediated via parasympathetic vasodilator fibers that emerge from the brain stem with the facial nerve and reach the blood vessels via PPG. Although there is a dual innervation of the cat palatal mucosa by parasympathetic vasodilator fibers running via the facial and glossopharyngeal nerve roots, the latter are not involved in the bilateral reflex responses.

Neurogenic inflammation and tooth pulp innervation pattern in sympathectomized rats

This study investigated possible collateral C-fiber innervation between the pulps of rat molars by assessing neurogenic inflammation (NI) induced by the C-fiber excitant mustard oil (MO). MO was applied to the pulp of the left mandibular first molar in two groups of rats: group 1, guanethidine sympathectomized rats (to dismiss sympathetic activation by MO); and group 2, unsympathectomized rats. A third group of unsympathectomized rats (group 3) had saline applied to the pulp of the left mandibular molar and served as a MO control. The NI-related plasma extravasation was examined in these teeth and in the remaining left mandibular teeth by a spectrophotometric analysis of extravasated plasma protein bound to Evans' Blue (EB) dye. The collateral innervation pattern was inferred from the NI pattern. EB concentrations were measured in the left mandibular teeth and the corresponding contralateral teeth, and expressed as a ratio. Statistical analysis of the data revealed significant differences in EB ratios in the first, second, and third molars between groups 1 and 3. This result suggests collateral C-fiber innervation exists within the pulps of molar teeth in the same dental quadrant. No difference in EB ratios was noted in the first and second molars between groups 1 and 2. Therefore, sympathetic efferents have no apparent effect on the degree of MO-induced NI.

Evidence for slowly conducting afferent fibres innervating both tooth pulp and periodontal ligament in the cat

The presence of afferent nerve fibres branching to innervate both the dental pulp and periodontal ligament was studied in pentobarbitone-anaesthetised cats. Extracellular single nerve-fibre recordings were made from fine filaments split from the proximally cut end of the inferior alveolar nerve. Nerve fibres were identified by bipolar constant-current stimulus pulses applied to the periodontal space via platinum wire electrodes. In each case activation of the nerve fibres was also attempted by monopolar electrical stimulation of the dental pulp via a platinum wire electrode inserted into the dentine. Eleven of 142 C fibres and 4 of 97 A delta fibres identified by electrical stimulation of the periodontal ligament also could be activated by electrical stimulation of the dental pulp. Fourteen of the 142 C fibres identified by electrical stimulation of the periodontal ligament exhibited discrete latency jumps at different suprathreshold stimulus strengths. Eight of them also could be activated by electrical stimulation of the dental pulp. Eight of the 15 fine branching afferent fibres were tested with non-electrical stimuli of both periodontal ligament and dental pulp by application of heat, cold and potassium chloride. Three of the 4 C fibres could be activated with at least one of these stimuli applied to both tissues. In one case receptive fields were located in both periodontal ligament and dental pulp. The remaining 5 slowly conducting fibres were activated only from one type of tissue. The results suggest that a small percentage (6%) of the slowly conducting nerve fibres in the inferior alveolar nerve innervate both the periodontal ligament and the dental pulp. According to their response behaviour they might be involved in nociception.

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)

Axon reflex vasodilatation in cat dental pulp elicited by noxious stimulation of the gingiva

Antidromic stimulation of sensory nerves has been shown to increase blood flow in the tissue they innervate. This study was designed to determine if antidromic vasomotor responses occur in feline dental pulp and if they are mediated by branched axons supplying both tooth pulp and gingiva. Dynamic changes in pulpal blood flow (PBF) elicited by electrical stimulation, pinching, heating, and capsaicin application to the gingivae were investigated in cat mandibular canine teeth by means of Laser Doppler Velocimetry. All inferior alveolar nerve bundles and the cervical sympathetic trunk had been previously sectioned to avoid the occurrence of brainstem reflexes, e.g., somato-autonomic vasomotor reflexes. Increases in PBF were observed in seven out of 12 cats when a restricted gingival area adjacent to the canine teeth was stimulated as described, but the increases were abolished after the sensitive gingival area was painted with lidocaine jelly, a surface anesthetic. These vasodilator responses, remarkably reduced following repeated application of 30 mM of capsaicin, are considered to be induced via antidromic activation of capsaicin-sensitive nociceptive nerve fibers, presumably by axon reflex mechanisms, suggesting that nerve terminals supplying the gingiva originate from parent axons which have collaterals that innervate the canine tooth pulp.

A possible explanation for the response characteristics of multi-tooth periodontal ligament mechanoreceptors in the cat

During the course of a study on the morphology of periodontal ligament mechanoreceptors it was observed that a direct relation, without intervening bone, existed between the mandibular canine and first premolar tooth roots in the cat. An area, representing a window in the alveolar septal bone, extended 2-3 mm from the apex towards the tooth crown. Ruffini nerve terminals were observed amongst the collagen bundles in the ligament between the roots of the two teeth. Light and electron microscopy were used to identify the receptors. It is proposed that a periodontal ligament mechanoreceptor can respond to forces applied to adjacent teeth; movement of both teeth need not occur. This may explain the observation made in the past that single periodontal ligament mechanoreceptors respond to forces applied to more than one tooth.

Quantitative study of the apical nerve fibers of adult and juvenile rat molars

The rat molar has become an important model for studies of interactions between nerves and the pulp-dentin complex, yet there is only limited quantitative information on the number and size distribution of axons entering the roots of this tooth. This study was undertaken to provide such a detailed characterization of the apical innervation of the rat molar. An additional objective was to compare the apical nerve composition of young, recently erupted rat molars with that of mature teeth in order to determine whether there is ongoing maturation of the innervation after the teeth have attained functional occlusion. A complete census was made of the nerve fibers entering the roots of both mature and recently erupted juvenile mandibular first molars in Sprague-Dawley rats. Each of the four roots of the first molars was processed for electron microscopy of thin sections near the apex. The majority of intradental nerve fibers entered the molar via the two larger (mesial and distal) roots. Within the apical root pulp, most, but not all, axons occurred within well-defined fascicles associated with blood vessels. Molars from adult animals (age 4 months) had a mean total of 232 (S.D. = 49, N = 7 teeth) myelinated fibers and 806 (S.D. = 143) unmyelinated axons entering the four roots. Fibers exceeding the A delta size range (circumference > or = 19 microns) accounted for only 4% of the myelinated axons at the apex. Molars from juvenile animals (age 4 weeks) had fewer myelinated fibers (mean 176, S.D. 18, N = 8), but more unmyelinated axons (mean 1,174, S.D. 160) than adults. The mean ratio of unmyelinated axons to myelinated axons was 6.6:1 for juveniles compared to 3.5:1 for adults. Juvenile teeth contained no myelinated fibers that exceeded 19 microns in circumference. These results indicate that the innervation of the rat molar resembles that of teeth of non-rodent mammals in that (1) innervation density is high, (2) there is a high ratio of unmyelinated axons, and (3) most of the myelinated fibers are of thin caliber. Furthermore, it appears that after the molar erupts, maturation of the nerve fiber composition continues with processes that include both a marked decrease in the number of unmyelinated axons and an increase in the number and size heterogeneity of myelinated fibers.

The neurophysiological basis and the role of inflammatory reactions in dentine hypersensitivity

Recent studies indicate that intradental A-type nerve fibres are responsible for the sensitivity of dentine and are activated by fluid movements in dentinal tubules (hydrodynamic mechanism). The patency of the tubules affects dentine sensitivity to a great extent. Both A delta- and A beta-type nerve fibres respond to dentinal (hydrodynamic) stimulation in a similar way. Only a few studies have been made on the regional sensitivity of dentine or the receptive areas of intradental nerve fibres. The results indicate that the fibres innervating different parts of coronal dentine are equally sensitive to dentinal stimulation but those in the cervical area may be less responsive. Inflammation in the pulp can considerably alter dentine sensitivity. In dog teeth with chronically exposed dentine, nerve responses to hydrodynamic stimulation were reduced although other functional changes indicated nerve sensitization. This may be due to spontaneously occurring changes in the exposed dentine that block the tubules. In acute experiments on cat and dog teeth with open dentinal tubules, certain inflammatory mediators increase the sensitivity of the responding nerve fibres. It seems that intradental C-fibres do not respond to hydrodynamic stimulation of dentine. They are polymodal and activated when external stimuli reach the pulp proper. They could perhaps mediate the dull pain connected with pulpitis. However, they might also have an important modifying effect on dentine sensitivity because they can release neuropeptides, which function in the inflammatory reactions.

The incidence and distribution of branched pulpal axons in the adult ferret

Previous laboratory studies have revealed that some axons branch to supply the pulps of two teeth, but the incidence of such fibres in different regions of the jaws has not been investigated. The present study has used electrophysiological techniques to determine the incidence and distribution of branched pulpal axons in ferret maxillary and mandibular teeth. Under anaesthesia, pairs of Ag/AgCl electrodes were inserted into cavities in the left mandibular (10 animals) or maxillary (seven animals) teeth. Using these electrodes, electrical stimuli were applied to each tooth in turn, and averaged responses were recorded individually from the other teeth. The responses revealed 14 axons that branched to supply two mandibular teeth and for 13 of these the teeth were adjacent. The responses had latencies of 1-9.8 ms (mean 3.8 ms) and amplitudes of 4-320 microV (mean 49 microV). These axons most commonly branched to supply the second and third premolars, and the canine and third incisor, and the branching point was always within the mandibular canal. Thirty-four branched axons supplying maxillary teeth were found (latency, 1.4-18.8 ms, mean 5.9 ms; amplitude; 5-210 microV, mean 36 microV); 14 of these supplied adjacent teeth and they most commonly innervated the canine and incisors.

Parallels between properties of high-threshold mechanoreceptors of the goat oral mucosa and human pain report

In the following experiments, we examined parallels between properties of A-delta high-threshold mechanoreceptors (HTMs; mechanonociceptors, MN, and intense pressure receptors, IPR) innervating the goat mucosa and human mucosal pain report. As suggested in previous studies, activation thresholds of afferents which are generally considered to be mechanical nociceptors are far below mechanical pain thresholds. It was determined that classification of nociceptors by frequency thresholds, i.e., the pressure at which HTMs maintained a minimum frequency (97 g/mm2 and 117 g/mm2 for IPRs and MNs respectively) brings afferent reactivity into alignment with perceptual events. The range of reactivity of the nociceptor pool paralleled pain report from "faint-weak" (142 g/mm2) to "strong-intense" (277 g/mm2). It is suggested that coding of intense mechanical pain from compressive forces is likely to arise from both individual afferents, whose reactivity spanned the range, and from recruitment of afferent populations with progressively higher thresholds.

Distribution and morphological characteristics of axons in the periodontal ligament of cat canine teeth and the changes observed after reinnervation

The distribution and morphological characteristics of myelinated and non-myelinated axons innervating the lower canine periodontal ligament (PDL) in adult cats have been analysed. After perfusion fixation and decalcification, the teeth were slit transversely, divided into segments, and embedded in plastic. Ultrathin sections of each segment were examined in the electron microscope and used to reconstruct the whole PDL at 1, 4, 7, and 9 mm from the tooth apex. One millimeter from the tooth apex there were a mean of 920 myelinated axons and 1,415 non-myelinated axons. The numbers of axons declined toward the tooth crown. Bundles of myelinated and small non-myelinated axons lay adjacent to the blood vessels midway between the bone and cementum. Isolated myelinated axons appeared to have split away from these main nerve bundles and entered the avascular zone of the ligament, where they lost their myelin sheaths to become large non-myelinated axons rich in mitochondria. These non-myelinated axons sometimes appeared to be linked to collagen fibres and were thought to be the mechanoreceptor terminals. Twelve weeks after sectioning and inferior alveolar nerve, the total number of axons innervating the periodontal ligament was 50% of that found in the contralateral controls. The large non-myelinated axons had smaller mean diameters and contained fewer mitochondria, a change which may be consistent with a reduction in mechanoreceptor excitability.

Involvement of afferent nerves in pulpal blood-flow reactions in response to clinical and experimental procedures in the cat

A unilateral resection of the mandibular nerve (n = 20) was made 10-14 days before investigation of the contribution of afferent nerves in vasodilator reactions in the dental pulp. Lower canine teeth were subjected to various stimuli and pulp blood-flow responses monitored by laser Doppler flowmetry. An absence of response to bipolar electrical (5 impulses, 50 microA, 5 ms, 2 Hz) stimulation on the tooth surface was used to demonstrate a successful chronic nerve lesion. Local application of capsaicin (10(-4) M) in a deep dentinal cavity induced a long-lasting increase in pulpal blood flow in control teeth only. Bradykinin (10(-3) M) induced significantly larger responses in control than in denervated teeth (58.3 +/- 9.8% and 24.5 +/- 4.9%, respectively, p less than 0.005, n = 8); in addition, the onset was slower and the duration of the response significantly (60%) shorter than in control teeth. Intermittent grinding of surface dentine instantly increased flow in control teeth by 53.0 +/- 12.5% (n = 12) whereas in denervated teeth the response was delayed and significantly (70%) smaller. Deeper preparation produced responses of similar magnitude in control and denervated teeth (69 and 50%, respectively) but the onset was delayed in denervated teeth. Low-intensity ultrasonic stimulation caused vasodilation in intact teeth (38% increase) but had no effect in denervated teeth. This effect was abolished after local anaesthetic (mepivacaine) injection. Sympathectomy (n = 3) did not influence stimulation-induced blood-flow responses in the dental pulp.(ABSTRACT TRUNCATED AT 250 WORDS)

Collateral branching innervation of rat molar teeth from trigeminal ganglion cells shown by double labelling with fluorescent retrograde tracers

Somatotopic projections of each maxillary molar tooth were defined by injecting individual teeth with True blue and plotting the location of fluorescent cells in sections of the trigeminal ganglia. Collateral branching was investigated by injecting True blue and Diamidino yellow into pairs of maxillary molar teeth and examining the ganglia for double labelled cells. Maxillary molar teeth project to the lateral ophthalmomaxillary region of the ipsilateral ganglion with extensive overlap of the projections from individual teeth. Double labelling with both dyes demonstrated considerable collateral branching from single trigeminal ganglion cells to the molar teeth.

The role of periodontal receptors in the jaw-opening reflex in the cat

1. In anaesthetized cats, graded electrical stimulation of the inferior alveolar nerve at just above threshold for the largest afferent fibres caused inhibition of jaw-closer motoneurones. Stimulus strength had to be increased to 1.5 times threshold with double shocks to cause reflex contraction of the digastric muscle. 2. Inhibition of jaw-closer muscles and excitation of digastric muscle resulted from transients of force applied to the upper canine tooth. However, the threshold for the digastric response was approximately 11 times higher than that of the periodontal afferent units recorded in the mesencephalic nucleus of the fifth nerve (MesV). Vibration of the upper canine at 50 Hz, with amplitude adequate to excite periodontal afferents, caused no digastric contraction. 3. Stimulation in the caudal part of the MesV so as to excite periodontal afferents caused no digastric reflex, provided that the stimulus did not spread to other parts of the fifth nerve nuclei. 4. It is concluded that under these conditions the low-threshold periodontal mechanoreceptors cause inhibition of jaw-closer muscles, but no significant excitation of jaw-opener muscles. 5. These findings are discussed from the point of view of the control which periodontal mechanoreceptors may exert over the biting force during mastication.

The neurobiology of facial and dental pain: present knowledge, future directions

This review outlines recent research which has identified critical neural elements and mechanisms concerned with the transmission of sensory information related to oral-facial pain, and which has also revealed some of the pathways and processes by which pain transmission can be modulated. The review highlights recent advances in neurobiological research that have contributed to our understanding of pain, how acute and chronic pain conditions can develop, and how pain can be controlled therapeutically. Each section of the review also identifies gaps in knowledge that still exist as well as research approaches that might be taken to clarify even further the mechanisms underlying acute and chronic oral-facial pain. The properties of the sense organs responding to a noxious oral-facial stimulus are first considered. This section is followed by a review of the sensory pathways and mechanisms by which the sensory information is relayed in nociceptive neurones in the brainstem and then transmitted to local reflex centers and to higher brain centers involved in the various aspects of the pain experience--namely, the sensory-discriminative, affective (emotional), cognitive, and motivational dimensions of pain. Reflex and behavioral responses to noxious oral-facial stimuli are also considered. The next section provides an extensive review of how these responses and the activity of the nociceptive neurones are modulated by higher brain center influences and by stimulation of, or alterations (e.g., by trauma) to, other sensory inputs to the brain. The neurochemical processes, involved in these modulatory mechanisms are also considered, with special emphasis on the role of neuropeptides and other neurochemicals recently shown to be involved in pain transmission and its control. The final section deals with recent findings of peripheral and central neural mechanisms underlying pain from the dental pulp.

Immunocytochemistry of enkephalin and serotonin distribution in restricted zones of the rostral trigeminal spinal subnuclei: comparisons with subnucleus caudalis

The spinal trigeminal subnucleus caudalis processes nociceptive input from the head. However, physiological and behavioral studies in monkeys and humans indicate that painful stimuli from the central face and oral cavity also project through trigeminal nuclei rostral to the spinal subnucleus caudalis. Both enkephalin (ENK) and serotonin (5-HT) are present in rostral trigeminal nuclei and these regions receive inputs from the raphe complex. Thus, it appears that elements of pain-modulating circuitry proposed by Basbaum and Fields (Annu. Rev. Neurosci., 7:309-338, 1984) for the spinal and medullary dorsal horn may also exist in this region. In order to begin an exploration of this circuitry, the present study combines the techniques of retrograde transport of HRP from the ventral posteromedial thalamic nucleus (VPM) of the cat's thalamus to label trigeminothalamic relay cells. Secondarily, immunocytochemical techniques are employed to define the distribution patterns of ENK and 5-HT cells and terminals in relationship to both labeled and nonlabeled neurons in each of the subnuclei of the spinal trigeminal nucleus. Trigeminothalamic relay cells were observed in laminae I and II, the magnocellular region, and the interstitial nucleus (IN) of subnucleus caudalis (Vc). ENK was found in axodendritic and axosomatic terminals, together with a population of small fusiform neurons in all these same areas except the magnocellular region. ENK axosomatic contacts innervated approximately 30% of labeled relay cells, chiefly in lamina I and the IN, or small unlabeled neurons in the same area. Serotonin activity occurred principally in lamina I and the IN and was confined almost exclusively to axodendritic terminals. Examination of subnucleus interpolaris (Vi) revealed relay cells distributed throughout the length of the nucleus and increasing in numbers at rostral levels. A rostral extension of the IN was found just ventrolateral to the main body of Vi and contained numerous labeled cells. The distribution of ENK activity was restricted to the ventral part of Vi and the IN and occurred in axodendritic and axosomatic terminals. These latter elements innervated 30-40% of labeled relay cells in Vi, particularly those located in the IN. Cells containing ENK generally resembled the fusiform cells found in Vc and were distributed in ventral Vi and the IN. Some ENK cells were larger, displayed several dendrites, and occurred only in the ventral Vi. Serotonin within Vi and Vc was confined principally to axodendritic terminals.(ABSTRACT TRUNCATED AT 400 WORDS)

Convergence of cutaneous, tooth pulp, visceral, neck and muscle afferents onto nociceptive and non-nociceptive neurones in trigeminal subnucleus caudalis (medullary dorsal horn) and its implications for referred pain

Because of the likely involvement of central convergence of afferent inputs in mechanisms underlying referred pain, the activity of single neurones was recorded in the cat's trigeminal (V) subnucleus caudalis (medullary dorsal horn) to test for the presence and extent of convergent inputs to the neurones. In chloralose-anaesthetized or decerebrate unanaesthetized cats, electrical stimuli were applied to afferents supplying facial skin, oral mucosa, canine and premolar tooth pulp, laryngeal mucosa, cervical skin and muscle, and jaw and tongue muscles, and tactile and noxious mechanical and thermal stimuli were applied to skin and mucosa. Considerable proportions of caudalis neurones which could be functionally classified on the basis of their cutaneous receptive field properties as low-threshold mechanoreceptive (LTM), wide-dynamic-range (WDR), or nociceptive-specific (NS) neurones, could be excited by electrical stimulation of several of these afferent inputs. Extensive convergence of afferent inputs, including inputs from skin or mucosal areas outside the neuronal oral-facial receptive field delineated by natural stimuli, was a particular feature of the units classified as cutaneous nociceptive neurones (i.e., WDR and NS). On the basis of antidromic activation, 15% of these WDR and NS neurones were shown to have a direct projection to the contralateral thalamus. The findings question the use of terminology and classifications of somatosensory neurones based only on the cutaneous receptive field properties of the neurones since distinctions between the different neuronal populations become less obvious when properties other than those related to cutaneous afferent inputs are taken into account. Moreover, the observations of extensive convergence of different types of afferents, which was especially apparent in cutaneous nociceptive neurones, also suggest a role for these neurones in mediating deep pain and in spread and referral of pain.

Innervation of the dental pulp during tooth succession in the cat

The possibility that axons branch to supply the pulps of both the upper deciduous canine tooth and its permanent successor has been investigated by stimulating the pulp of one tooth and recording from the pulp of the other. In cats less than about 14 weeks of age, the permanent canine was too poorly developed to allow electrodes to be applied to it satisfactorily. In 5 of 14 preparations in cats aged 14-23 weeks, compound action potentials were recorded in one canine during stimulation of the other. These responses were not abolished by sectioning the infraorbital nerve or its canine branch in the floor of the orbit or by paralysing the animal, but they were abolished by sectioning the pulp of the permanent canine, indicating that they were due to branched axons. In preparations in which there was no tooth-to-tooth response, there was usually evidence that the pulp of one or other of the teeth did not have a functional innervation. The results indicate that at least some of the nerves which supply the pulp of a deciduous tooth are retained to supply its permanent successor.

Activation of trigeminal brain-stem nociceptive neurons by dural artery stimulation

Vascular head pain is thought to result from activation of trigeminal sensory nerve fibers innervating cranial blood vessels. Support for this hypothesis was sought by searching in the trigeminal brain-stem subnucleus caudalis (SNC) for neuronal responses evoked by electrical stimulation of the middle meningeal artery (MMA). Seventy-eight SNC neurons were found which could be excited by MMA stimulation of the facial skin. These results provide the first report of the existence and functional properties of brain-stem neurons likely to be involved in mediating vascular head pain.

Tooth pulp-evoked potentials in the monkey: cortical surface and intracortical distribution

The distribution of tooth pulp-evoked potentials (TPEPs) was characterized in the primary motor (MI), primary somatosensory (SI) and secondary somatosensory (SII) cortices of the monkey. Bipolar electrical tooth pulp stimulation elicited TPEP components P23 and N44 over SI, P26 and N72 over MI, and P72, N161, P280, N420, P561 and N662 over SII. Muscular artifacts and extradental input did not affect the TPEP as demonstrated by experiments using a neuromuscular blocking agent and removal of the pulp, respectively. The short latency TPEPs recorded over SI and MI were evoked by low stimulus intensities and activation of A beta nerve fibers, whereas the long latency TPEPs recorded over SII required higher stimulus intensities and the additional recruitment of A delta nerve fibers. Intracortical recordings revealed polarity reversals of components P23 and N44 in area 3b, P26 and N72 in area 4, and P72, N161, P280, N420, P561 and N662 in the upper bank of the lateral sulcus (SII). Evidence presented in this study suggests that TPEPs recorded from SI and MI relate to non-nociceptive mechanisms while TPEPs recorded from SII relate to nociceptive mechanisms.

Physiological properties of intradental mechanoreceptors

A major role of tooth receptors in signaling overt or impending tissue damage (nociception) has been previously established by substantial evidence from mechanical, thermal and chemical stimulation of exposed dentin. We report evidence showing that some intradental receptors in canine teeth of the cat detect mechanical transients applied to intact enamel. This new finding suggests that dental innervation may play an important non-nociceptive role in oral function such as detecting tooth contact during mastication and swallowing.

Functional difference of tooth pulp-driven neurons in oral and facial areas of the somatosensory cortex (SI) of the cat

Single-unit discharges were recorded in the oral and facial areas of the cat somatosensory cortex (SI) while electrical stimuli were individually delivered to eight tooth pulps. The incidence of the tooth pulp-driven (TPD) neurons was 44.7% in the oral area, but only 17.3% in the facial area. Both sets of neurons were also excited by nonnoxious stimulation of the oral structures or of the facial hair, and thus were polymodal. These TPD neurons were confirmed histologically to be in area 3b and were classified into monotooth input type and multitooth input type according to their response to stimulation. Neurons of the monotooth input type appeared three times more frequently in the oral area than in the facial area. The input(s) to the TPD neurons in the former area were slightly stronger from the canine(s) than from the molar(s), but the opposite was the case in the facial area. In the oral area, 83% of the TPD neurons responded with brisk discharges of short latency, whereas 54% of the TPD neurons in the facial area responded with those of a long latency. These findings suggest that the pulpal information to the somatosensory cortex is conveyed by pathways that appear, at least at certain points in the nervous system, to be spatially separated.

An electrophysiological study of canine, premolar and molar tooth pulp afferents and their convergence on medullary trigeminal neurons

The two main aims of this study were (1) to compare the conduction velocities of tooth pulp (TP) afferents innervating the cat canine, premolar and molar teeth and (2) to determine the degree of convergence of afferent input originating in these different teeth on medullary dorsal horn (MDH) neurons. Experiments were conducted on 10 cats anesthetized with chloralose. Single unit extracellular recordings were obtained from the tooth pulp or the MDH. The distribution of conduction velocities of afferents originating in the mandibular and maxillary canines, premolars and mandibular molar were all found to be similar except that the mean conduction velocity of canine afferents was slightly higher than the means for the other teeth. A total of 48 MDH neurons excited by TP stimulation was studied. Most MDH neurons activated by electrical stimulation of one of the TPs could also be activated by stimulation of one or more of the other TPs. In addition to the marked convergence from different teeth, most of the TP-activated neurons also had convergent inputs from facial skin and/or intraoral mucosa.

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)

Autoradiographic location of sensory nerve endings in dentin of monkey teeth

We have used the autoradiographic method to locate trigeminal nerve endings in monkey teeth. The nerve endings were labeled in two adult female Macaca fascicularis by 20 hours of axonal transport of radioactive protein (3H-L-proline). We found a few labeled axons in contralateral mandibular central incisors and one mandibular canine. In ipsilateral teeth, numerous myelinated and unmyelinated axons were labeled; they formed a few terminal branches in the roots but primarily branched in the crown to form the peripheral plexus of Raschkow and to terminate as free endings in the odontoblast layer, predentin, and as far as 120 micrometers into dentinal tubules. Electron microscopic autoradiography showed that the radioactive axonally transported protein was confined to sensory axons and endings; odontoblasts and dentin matrix were not significantly labeled. Labeled free nerve endings were closely apposed to odontoblasts in dentin but did not form distinctive junctions with them. Nerve endings were most numerous in the regular tubular dentin of the crown adjacent to the tip of the pulp horn, occurring in at least half of the dentinal tubules there. Reparative dentin was poorly innervated, even near the tip of the crown, and it had a different tubular structure and adjacent pulpal structure from the innervated dentin. Radicular dentin was not innervated in most areas but did contain a few labeled axons where the predentin was wide and the odontoblasts were columnar, as at the buccal and lingual poles of some roots. Our results show tha dentinal sensory nerve endings in primate teeth can be profuse, sparse, or absent depending on the location and structure of dentin and its adjacent pulp. When dentin was innervated, the tubules were straight and contained odontoblast processes, the predentin was wide, the odontoblast cell bodies were relatively columnar, and there was an adjacent cell-free zone and pulpal nerve plexus.

Axon number and size distribution in the developing feline inferior alveolar nerve

The number and size distribution of axons in the developing feline inferior alveolar nerve (IAN) were examined by electron microscopy. Seven cat fetuses and thirty kittens and cats aged from 25 days post conception (dpc) to 11 years were used. The total number of IAN axons increased from 4,400 to 16-17,000 between 25 and 40 dpc, and then decreased to about 13,000 before birth. This level was maintained up to at least 11 years. Myelinated axons first appeared by 45 dpc and constituted 28% at birth. The young adult proportion of about 45% myelinated axons was established at 2 months. In the old adult (11 years) 55% of the IAN axons were myelinated. Size measurements showed that unmyelinated axons had diameters of 0.1-0.5 micrometer at 25 dpc. From 55 dpc and on the size range extended from 0.1 micrometer to 1 micrometer. The size range of myelinated axons was 1-4.5 micrometers at birth and 1-8 micrometers 2 months postnatally. A bimodal size distribution first appeared by 2 months, and the range was 1-13 micrometers from 6 months and on. The findings were compared with age-related changes in the primary and permanent dentitions.

Autoradiographic demonstration of ipsilateral and contralateral sensory nerve endings in cat dentin, pulp, and periodontium

In order to determine the location of sensory nerve ending in cat teeth, 3H-proline and 3H-leucine were injected into the left trigeminal ganglion of eight cats aged 6.5-10 months; 24 hours was allowed for axonal transport of radioactive protein to dental nerve endings, and the endings were then detected by autoradiography. The pulps of most ipsilateral (left) teeth contained some labeled axons. These axons ended in the odontoblastic layer and predentin of roots and crown; at the tip of the pulp horn of each cusp, nerve endings also extended as far as 150 micrometer into dentinal tubules. Labeled nerve endings were extremely rare in contralateral (right) teeth; only one tooth of 83 studied (eight cats) contained heavily labeled axons, and one other had faintly labeled axons. Both labeled contralateral teeth were central maxillary incisors. Their labeled axons were unbranched in the root and arborized in the crown to end among odontoblasts and many adjacent dentinal tubules. Labeled periodontal nerve endings were most numerous in the apical one-third of the ligament, with some endings extending as far as the gingiva. The nerve endings in the periodontal ligament were often clustered and appeared to end freely between the collagen bundles; their radioactivity varied in the same way as that of pulp nerves in the adjacent root.

Reinnervation of teeth, mucous membrane and skin following section of the inferior alveolar nerve in the cat

The reinnervation of teeth, mucous membrane and skin has been investigated in the cat following section of the inferior alveolar nerve. Evidence for regeneration of sectioned fibres and for sprouting of unsectioned nerves supplying adjacent tissues (collateral sprouting) was sought. In some experiments the cut nerve ends were reapposed whilst in others the central stump was either covered with an acrylic cap or sealed inside a nylon tube. The jaw opening reflex evoked by electrical stimulation of canine tooth pulp was abolished by inferior alveolar nerve section but returned within 3-9 weeks with a raised threshold and increased latency. After re-apposition or acrylic capping, some sectioned nerves regenerated but, compared with normal, they had decreased conduction velocities, greater variation in their mechanoreceptor fields and produced smaller compound action potentials in the teeth. There was little evidence of collateral sprouting. The nylon tube completely blocked regeneration but the denervated tissues were reinnervated by collateral sprouting. Fibres supplying tooth pulp were present in the ipsilateral mylohyoid, the ipsilateral and contralateral lingual nerves and the contralateral inferior alveolar nerve. Except for the ipsilateral lingual nerve, these nerves do not normally include pulpal fibres. Partial reinnervation of skin and mucous membrane occurred and this was derived from the ipsilateral mylohyoid, lingual and buccal nerves and the contralateral inferior alveolar nerve.

Trigeminocerebellar mossy fiber branching to granule cell layer patches in the rat cerebellum

Recent micromapping studies of tactile areas in rat cerebellum have revealed a spatially precise mosaic of granule cell layer areas termed 'patches', with multiple patches on several folia resulting in multiple representations of the same body part. The research reported in the present paper tested the hypothesis that trigeminocerebellar mossy fiber branching is patch-related, so that collaterals terminate only within the boundaries of one or more of the tiny (often less than 1 sq. mm) patches having similar receptive fields. This hypothesis was supported by 3 separate series of electrophysiological experiments: (1) electrical stimulation in a patch resulted in short latency, low threshold responses confined within the boundaries of a second patch having a similar receptive field; (2) antidromic collison tests demonstrated that collaterals of axons originating in nucleus interpolaris reach pairs of patches with similar receptive fields; and (3) micromapping of the area from which a particular interpolaris neuron could be antidromically activated revealed that local terminal branching of a given mossy fiber axon appeared to be confined within the boundaries of a single patch. Together these results indicate that trigeminocerebellar mossy fiber branching is related to the fractured somatotopical organization of the granule cell layer. Possible functional implications of such mossy fiber branching are discussed.

On the number and nature of regenerating myelinated axons after lesions of cutaneous nerves in the cat

1. Electrophysiological and anatomical techniques were used to investigate normal and regenerating sural and posterior femoral cutaneous nerve fibres in the cat. 2. One and a half years after transection of these nerves it was found that the regenerating neurones supported multiple sprouts in the distal stump of the nerve. The branching occurred at or beyond the level of the neuroma and some of the branched fibres innervated split receptive fields on the skin. 3. Counts of the number of axons in the proximal stumps of transected nerves showed that the whole original population of myelinated fibres persisted for at least 18 months. About 75% of these fibres successfully crossed the unrepaired transection site and regenerated into the distal stump of the nerve to re-form functional connexions in the skin. 4. After nerve crush all the myelinated axons regenerated. None showed signs of abnormal branching. 5. After crush the conduction velocities of the regenerated axons in the distal stump of the nerve reached nearly normal values by 6 months. After nerve transection the distal conduction velocities were reduced to 50% of normal even 18 months after the injury. 6. The implications of these findings for the recovery of function after nerve injury in man are discussed.

Changes in primary afferent depolarization of sensory neurones during peripheral nerve regeneration in the cat

1. Micro-electrode recordings were made from normal and regenerating sural nerve fibres in cats. Increases in the excitability of the central terminals of these fibres after conditioning stimulation of other sural nerve fibres were taken as evidence for primary afferent depolarization. 2. At all recovery times studied the excitability changes seen were significantly less than those seen in control animals. Two factors contributed to the changes in primary afferent depolarization. First, the proportion of fibres that showed no evidence of primary afferent depolarization increased significantly. This proportion became smaller as recovery progressed. Secondly, where primary afferent depolarization was present, the magnitudes of the effects were slightly but significantly decreased compared with control values. 3. Excitability changes of the central terminals of sural nerve fibres were also measured after conditioning stimulation of the ipsilateral, unlesioned accessory sural nerve. One month after sural nerve transection there was a significant increase in the proportion of fibres showing no evidence of excitability changes following accessory sural nerve conditioning stimulation compared with control animals. Thus, the loss of primary afferent depolarization of regenerating sural nerve fibres was neither simply a consequence of desynchronization of the volley of impulses entering the spinal cord after conditioning stimulation of other regenerating sural fibres, nor due to fewer fibres being activated during conditioning stimulation of the lesioned nerves. 4. A possible explanation of these results is that after peripheral nerve crush or transection the central terminals of the damaged fibres retract or atrophy. Then as regeneration of the nerve proceeds, the central terminals of the fibres re-form.

The course, relations and distribution of the inferior alveolar nerve and its branches in the cat

The course, relations and distribution of the inferior alveolar nerve and its branches in the cat are described. The nerves have been studied by dissection, histologically and by using electrophysiological techniques. Dissection revealed a basic pattern on which some individual variation was superimposed. The inferior alveolar nerve has three branches supplying the alveolar process (alveolar branches), one branch supplying the canine and incisor region (canine/incisor branch) and four mental branches (posterior, main and 2 anterior). Fibres supplying the teeth were found in all except the mental branches. Pulpal, periodontal and buccal gingival margin fibres from an individual tooth generally travelled together, but often in more than one branch. Branched axons supplying both tooth pulp and an area of mental skin were found. The axons branched at the point of separation of the appropriate mental nerve from the main trunk. A cutaneous midline overlap of 1-2 mm was found, but there was no transmedian innervation of tooth pulps.

Evidence for primary afferent depolarization of single tooth-pulp afferents in the cat

1. Responses of single tooth-pulp afferents to electrical stimulation of sites in the trigeminal sensory nuclear complex were recorded from caine teeth in cats. 2. Changes in the excitability of the central terminals of a pulpal afferent after stimulation of other groups of sensory nerves were taken as evidence for changes in their polarization. 3. Electrical stimulation of nerves in other teeth resulted in raised excitability of the central terminals of pulpal afferents lasting up to 300 msec. The greatest effects were observed 30--100 msec after the conditioning stimulus. 4. Increased terminal excitability was also observed after the ipsilateral infraorbital nerve was stimulated. This occurred when only nerve fibres with conduction velocities in the A alpha range were excited. 5. Mechanical stimulation of a canine tooth produced increases in terminal excitability of pulpal afferents innervating the same tooth. 6. A similar effect was also observed after a brief pull on a group of ipsilateral mystacial vibrissae. 7. No evidence of decreases in the excitability of the central terminals of tooth-pulp afferents was obtained with any of the conditioning stimuli.

Some anatomical and electrophysiological properties of tooth-pulp afferents in the cat

1. The responses of nerves which could be excited by electrical stimulation of the canine tooth-pulp were recorded from the trigeminal ganglion. 2. Preliminary experiments showed that the responses of mandibular canine pulpal afferents were recorded from the postero-lateral part of the trigeminal ganglion whereas the responses of maxillary canine pulpal afferents were recorded from the central part of the ganglion. 3. The conduction velocity differed in various parts of these nerves; the conduction velocity inside the tooth tended to be slower than that from the tooth to the trigeminal ganglion; the mean conduction velocity in the part of the nerve peripheral to the trigeminal ganglion was faster than that in the part central to the ganglion, and in the central part the conduction velocity decreased caudally. 4. Collision experiments combining tooth stimulation and stimulation of sites in the trigeminal sensory nuclear complex were carried out to investigate the projections of individual pulpal afferents. 5. The results of these experiments showed that some tooth-pulp afferents bifurcate and project to both the main sensory nucleus and the nucleus caudalis. For other pulpal afferents only a projection to the main sensory nucleus or the nucleus caudalis could be demonstrated. 6. Pulpal afferents that bifurcated had faster conduction velocities than those for which no bifurcation could be shown.