Afferent C fibre innervation of cat tooth pulp: confirmation by electrophysiological methods

MATHEMATICAL MODELING FOR THE PREDICTION AND IMPROVEMENT OF TOOTH THERMAL PAIN: A REVIEW

Tooth pain, especially tooth thermal pain, is one of the most important symptoms and signs in dental clinic and daily life. As a special sensation, pain has been studied extensively in both clinic and experimental research aimed at reducing or eliminating the possible negative effects of pain. Unfortunately, the full underlying mechanism of pain is still unclear, because the pain could be influenced by many factors, including physiological, psychological, physical, chemical, and biological factors and so on. Besides, most studies on pain mechanisms in the literature are based on skin pain sensation and only few are based on tooth pain. In this paper, we present a comprehensive review on both neurophysiology of tooth pain mechanism, and corresponding thermal, mechanical, and thermomechanical behaviors of teeth. We also describe a multiscale modeling approach for quantifying tooth thermal pain by integrating the mathematic methods of engineering into the neuroscience. The mathematical model of tooth thermal pain will enable better understanding of thermal pain mechanism and optimization of existing diagnosis and treatment in dental clinic.

Functional properties of tooth pulp neurons responding to thermal stimulation

The response properties of tooth pulp neurons that respond to noxious thermal stimulation of the dental pulp have been not well-studied. The present study was designed to characterize the response properties of tooth pulp neurons to noxious thermal stimulation of the dental pulp. Experiments were conducted on 25 male ferrets, and heat stimulation was applied by a computer-controlled thermode. Only 15% of tooth pulp neurons (n = 39) responded to noxious thermal stimulation of the teeth. Tooth pulp neurons were found in both the superficial and deep nuclear regions of the subnucleus caudalis (Vc) and in the interface between the nucleus caudalis and interpolaris (Vc/Vi). Thirty-seven neurons had cutaneous receptive fields and were classified as either NS (16) or WDR (21) neurons. Repeated heat stimulation of the dental pulp sensitized and increased the number of electrically evoked potentials of tooth pulp neurons. These results provide evidence that both the Vc and Vc/Vi regions contain neurons that respond to noxious thermal stimulation of the dental pulp, and that these cells may contribute to the sensitization process associated with symptomatic pulpitis.

Action potential conduction in the terminal arborisation of nociceptive C-fibre afferents

Recordings of single human peroneal C-fibres and rat saphenous C-fibres confirm two different patterns of conduction at branching points. In general, an action potential (AP) arising from one terminal branch may be propagated not only centrally, but also antidromically into the other branches of the terminal arborisation. If a stimulus activates several converging branches of one unit, at each branching point only the AP arriving first from the simultaneously activated daughter branches will be propagated centrally, resetting the slower branches. However, occasionally a single electrical stimulus may evoke a double response in the parent axon. In this case, these two responses apparently originate from different terminal branches and require unidirectional conduction block to prevent the faster AP from invading and resetting the slower-conducting terminal. This conclusion is supported by the notion that when such a double response occurs, both responses immediately show additional activity-dependent slowing of the conduction velocity due to frequency increase in the parent axon (two spikes per stimulus, one from each of the two excited branches). A comparable discharge pattern in the stem axon can be induced by repetitive paired stimulation of one terminal branch. Then the slowing is induced by the doubled frequency along the whole nerve fibre including the terminal branch. Since in this case not only the stem axon, but also the terminal branches carry two spikes per pulse, activity-dependent slowing is predictably more pronounced. Unidirectional block thus provides insight into the differential amount of activity-dependent slowing (and hence postexcitatory hyperpolarisation) in the stem axon and terminal branches of cutaneous C-fibres. This comparison reveals that more than two-thirds of the slowing can be attributed to the terminal branches, since it is two- to fourfold that observed during double stimulation as compared with the unidirectional block condition. This indicates that the terminal branches are equipped with membrane proteins that are different from those of the parent axon.

Response of feline intradental nerve fibers to tooth cutting by Er:YAG laser

BACKGROUND AND OBJECTIVE

The aim of this study was to investigate the response of intradental A- and C-fibers during tooth cutting by Er:YAG laser.

STUDY DESIGN/MATERIALS AND METHODS

Bipolar electrical stimulation was applied to the cat's canine to identify functional single nerve fibers of the inferior alveolar nerve. The tip of the canine tooth was cut in 0.5-mm steps until the pulp was exposed. Teeth were alternately cut by using Er:YAG laser (50 mJ, 5 pps) and micromotor under water cooling. The nerve response recorded from the single nerve fibers during laser cutting was compared with that during micromotor cutting.

RESULTS

All 26 A-fibers responded to laser cutting with high frequency of nerve firings. The nerve firing rate was significantly higher during laser cutting compared with that during micromotor cutting of superficial dentin (Chi(2) test, P < 0.05) but was not significantly different at deep dentin (P > or = 0. 05). Nine of 11 C-fibers responded to laser cutting when the deep dentin was cut. Among those nine nerve fibers, three also showed a low frequency response to laser cutting of the superficial dentin.

CONCLUSION

During the tooth cutting, Er:YAG laser was more effective in activating intradental A-fibers compared with micromotor and also caused the activation of intradental C-fibers.

Characterization and gene expression of high conductance calcium-activated potassium channels displaying mechanosensitivity in human odontoblasts

Odontoblasts form a layer of cells responsible for the dentin formation and possibly mediate early stages of sensory processing in teeth. Several classes of ion channels have previously been identified in the odontoblast or pulp cell membrane, and it is suspected that these channels assist in these events. This study was carried out to characterize the K(Ca) channels on odontoblasts fully differentiated in vitro using the patch clamp technique and to investigate the HSLO gene expression encoding the alpha-subunit of these channels on odontoblasts in vivo. In inside-out patches, K(Ca) channels were identified on the basis of their K(+) selectivity, conductance, voltage, and Ca(2+) dependence. In cell-attached patches, these channels were found to be activated by application of a negative pressure as well as an osmotic shock. By reverse transcription-polymerase chain reaction, a probe complementary to K(Ca) alpha-subunit mRNA was constructed and used for in situ hybridization on human dental pulp samples. Transcripts were expressed in the odontoblast layer. The use of antibodies showed that the K(Ca) channels were preferentially detected at the apical pole of the odontoblasts. These channels could be involved in mineralization processes. Their mechanosensitivity suggests that the fluid displacement within dentinal tubules could be transduced into electrical cell signals.

Electrophysiological assessment of the cutaneous arborization of Adelta-fiber nociceptors

Little is known about the relationship between the branching structure and function of physiologically identified cutaneous nociceptor terminals. The axonal arborization itself, however, has an impact on the afferent signal that is conveyed along the parent axon to the CNS. We therefore developed electrophysiological techniques to investigate the branching structure of cutaneous nociceptors. Single-fiber recordings were obtained from physiologically identified nociceptors that innervated the hairy skin of the monkey. Electrodes for transcutaneous stimulation were fixed at two separate locations inside the receptive field. For 32 Adelta-fiber nociceptors, distinct steps in latency of the recorded action potential were observed as the intensity of the transcutaneous electrical stimulus increased, indicating discrete sites for action potential initiation. The number of discrete latencies at each stimulation location ranged from 1 to 9 (3.7 +/- 0. 2; mean +/- SE) and the mean size of the latency step was 9.9 +/- 1. 0 ms (range: 0.4-89.1 ms). For seven Adelta fibers, collision techniques were used to locate the position of the branch point where the daughter fibers that innervated the two locations within the receptive field join the parent axon. To correct for changes in electrical excitability at the peripheral terminals, collision experiments between the two skin locations and between each skin location and a nerve trunk electrode were necessary. Nine branch points were studied in the seven Adelta fibers; the mean propagation time from the action potential initiation site to the branch point was 31 +/- 5 ms corresponding to a distance of 54 +/- 10 mm. Almost half of the daughter branches were unmyelinated. These results demonstrate that collision techniques can be used to study the functional anatomy of physiologically identified nociceptive afferent terminals. Furthermore these results indicate that some nociceptive afferents branch quite proximal to their peripheral receptive field. Occlusion of action potential activity can occur in these long branches such that the shorter branches dominate in the response to natural stimuli.

Thermal sensitivity of endodontically treated teeth

CASE REPORTS

The problem of thermal sensitivity following non-surgical root-canal treatment is explored and case reports are presented. Possible causes for post-treatment discomfort from endodontic and restorative aetiologies are discussed, as are the mechanisms to explain the patients' painful experiences. Treatment of this problem may vary from the simple replacement of a defective restoration to a more extensive non-surgical retreatment of the case, despite radiographic evidence of an acceptable root filling and normal periradicular tissues.

Chlamydial heat shock proteins and disease pathology: new paradigms for old problems?

The mucosal pathogen Chlamydia trachomatis affects hundreds of millions of people worldwide and is a significant cause of sexually transmitted disease. Although most acute infections can be easily managed, complications often occur that can be especially severe in women. It has been proposed that increased exposure to conserved chlamydial antigens, such as through reinfection or persistent infection, results in chronic inflammation and tissue scarring and contributes to the pathogenesis of endometrial and fallopian tube damage. This immunopathologic damage is believed to be a principal cause of ectopic pregnancy and tubal factor infertility. The chlamydial heat shock protein Hsp60, a homolog of Escherichia coli GroEL, has been identified as one protein capable of eliciting intense mononuclear inflammation. Furthermore, several studies have revealed a correlation between Hsp60 responses and the immunopathologic manifestations of human chlamydial disease. The role of additional antigens in the immunopathologic response to chlamydiae is currently undefined. A prime candidate, however, is the chlamydial GroES homolog Hsp10, which is genetically and physiologically linked to Hsp60. Recent studies provide data to suggest that immune reactivity to Hsp10 is significantly associated with tubal infertility in a chlamydiae-exposed population. Chlamydia pneumoniae is a more recently defined chlamydial species that has been implicated in a variety of ways with chronic disease processes, such as adult onset asthma and atherosclerosis. Evidence indicates that Hsp60 is present in human atheroma and may play a role in lesion development by direct activation of macrophages. Hsp60 causes the elaboration of inflammatory cytokines, the induction of metalloproteinase, and the oxidation of low density lipoprotein. Each of these events is directly associated with the progress of atherosclerosis. Thus, chlamydial heat shock proteins may function in at least two ways to promote chronic disease: first by direct antigenic stimulation and second as signal transducers that result in macrophage activation. These concepts in disease pathology are discussed in the context of chlamydial infections.

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)

Neural form of voltage-dependent sodium current in human cultured dental pulp cells

Intradental, i.e. pulpal, cells may play an important part in sensory transduction in teeth, although the cellular mechanisms and the identity of the specific cell types involved are still unclear. Because the majority of cells in dental pulp are derived from neural crest, it seemed likely that these might have the membrane properties of other neural-derived cells found in the peripheral or central nervous system. The patch-clamp recording technique was used to show that cells in explant cultures from human dental pulp contain a voltage-gated, tetrodotoxin-sensitive inward current. Mean activation potential of the current was -42 +/- 2.5 mV and the voltage at half-inactivation was -79.4 +/- 5.3 mV, suggesting a neural-like sodium conductance. In addition, these cells were immunoreactive to glial acidic fibrillary protein, growth-associated protein (GAP-43), and vimentin, further suggesting that dental pulp contains a population of cells with membrane properties similar to neuronal satellite cells. These cells may contribute, either directly or indirectly, to somatosensation in teeth.

Effect of interstimulus interval on perceived sensation and intradental nerve activity during thermal tooth stimulation in man

The effect of interstimulus interval on nerve responses and subjective sensory ratings evoked by thermal stimulation of the teeth were studied in man. A total of 30 unitary discharges during heat stimulation of the lower incisor teeth were recorded from the inferior alveolar nerves using microneurographic technique. Fifteen of them had threshold sensory ratings above 3 (pain related-units) and 15 had ratings of less than 2 (non-pain-related units). Repetitive heat stimulation was applied to the teeth with interstimulus intervals of 180 s (ISI 180) and 30 s (ISI 30). Repetitive (ISI 180 and ISI 30) non-painful heat stimulation of the teeth did not alter either the intensity ratings or unitary discharge activities of non-pain-related units (P > 0.05). Repetitive painful heat stimulation of the teeth with ISI 180 did not alter the intensity ratings of pain-related units (P > 0.05), whereas that with ISI 30 significantly reduced the intensity ratings of pain-related units during a second session of heat trials (P < 0.05). On the other hand, repetitive heat stimulation of the teeth with ISI 180 caused a slight reduction in the firing frequency of pain-related units (P > 0.05). Repetitive painful heat stimulation with ISI 30 significantly reduced the firing frequency of pain-related units (P < 0.05).

Blood flow increase in the orofacial area of humans induced by painful stimulation

The purpose of this study was to investigate if painful stimulation produces blood flow changes in the tooth pulp and the facial skin in humans. Also, we attempted to find out if the possible blood flow changes induced by painful stimulation could be explained by central sympathetic and parasympathetic reflex mechanisms, by an antidromic activation of nociceptive axons (axon reflex), or by a change in central cardiovascular parameters. Laser Doppler flowmeter was used to assess the blood flow changes. Electrical tooth pulp stimulation at painful intensities induced a blood flow increase in the ipsilateral lip adjacent to the stimulus site, and vice versa. Nonpainful stimulation had no effects. Painful thermal stimulation of the upper lip also produced an increase in the blood flow of the ipsilateral upper incisor. The blood flow changes in the lip produced by dental stimulation were not correlated with changes in systemic blood pressure or heart rate. Painful electrical stimulation of the hand did not induce any changes in the pulpal blood flow, whereas painful dental stimulation produced a blood flow decrease in the finger but no change in the contralateral lip or cheek. In monkey experiments a regional block of the central conduction of the inferior alveolar nerve at the level of the mandibular foramen produced varying results: the blood flow increase in the lower incisor produced by noxious thermal stimulation of the ipsilateral lower lip was not abolished in two experiments but was abolished in other two experiments. It is concluded that painful stimulation can induce significant increases in the blood flow of the orofacial regions in humans. This increase is predominantly restricted to the region adjacent to the stimulus site and cannot be explained by changes in the central cardiovascular parameters. Central neuronal reflex mechanisms and an axon reflex may both underlie these blood flow increases.

Pain sensation during cold stimulation of the teeth: differential reflection of A delta and C fibre activity?

Cold stimuli of varying intensities were randomly applied to upper middle incisors of 12 healthy young subjects for a mean duration of 2 min by individually adapted thermodes the temperatures of which ranged from +30 degrees C to -30 degrees C. The subjects were asked to rate the magnitude of their pain sensations during application of the stimuli by means of a linear potentiometer according to a category scale. After each stimulus, they were asked to describe the quality of their pain sensations. Cold stimulation of the teeth evoked pain sensations were reproducible that in subsequent trials and could be graded according to stimulation intensity. Below certain individually different threshold thermode temperatures the onset of a stimulus was followed, after a short latency (1.6 +/- 1 sec), by a sharp and shooting pain sensation which immediately decreased after reaching its maximum value while the stimulus was still present. The mean maxima of the pain intensities were correlated to the thermode temperature. In general, this first pain component was followed by a second one (latency: 29.9 +/- 6.3 sec) with a lower threshold temperature, less of an increase in rate and lower magnitude. This was described as a dull, burning pain which was difficult to localize. The human pain ratings are compared to recordings of intradental nerve fibres in the cat and, under the assumption that the response behaviour of human pulpal nerve fibres is comparable to that of the cat, we hypothesize that the first pain component is evoked by intradental A delta fibres exhibiting their typical phasic response behaviour and firing during the initial steep temperature decrease. After some seconds, intradental temperature reached values sufficient to evoke C-fibre activity associated with the second pain component.

Potassium currents in cells derived from human dental pulp

Patch-clamp recording methods were used to monitor ion currents in tissue-cultured cells derived from human dental pulp. Recordings were made in excised, outside-in or whole-cell patches. In single-channel experiments, the majority of patches contained a high-conductance (approx. 140-180 pS) K(+)-selective ion channel. The probability of the channel being in an open state was dependent on membrane potential, internal calcium and negative pressure applied to the cell membrane. Whole-cell recordings were consistent with these findings; in response to step-wise depolarizations of the cell membrane, most displayed a family of outwardly rectifying, barium-sensitive currents. In addition, a number of patches contained a second class of potassium channel of intermediate (approx. 85-100 pS) conductance, which was largely voltage insensitive and independent of calcium concentration. These results suggest that pulp cells contain a high-conductance potassium channel which probably underlies the outwardly rectifying current found at the whole-cell level. Further, the existence of mechanosensitive channels in these cells raises the possibility that the response to mechanical perturbation of dental pulp may be mediated, in part, by direct effects on odontogenic cells.

Identification and characterization of afferent periodontal A delta fibres in the cat

1. The presence and responsiveness of afferent periodontal A delta fibres was studied in pentobarbitone-anaesthetized adult cats. 2. Extracellular single fibre recordings were made from fine nerve filaments split from the proximally cut end of the inferior alveolar nerve. Periodontal nerve fibres were identified by constant current stimulus pulses applied via platinum wire electrodes inserted into the periodontal space of the lower canine tooth. 3. Of a total of 252 periodontal nerve fibres, 97 (37%) were classified as A delta fibres according to their conduction velocities (CV) (> 2.5 m s-1, < 30 m s-1) as determined by electrical stimulation of the periodontal ligament. The mean (+/- S.D.) conduction velocity was 11.0 +/- 7.7 m s-1 (n = 97; range: 2.6-28.2 m s-1). 4. A good exponential correlation (r = 0.85) was found between the electrical thresholds of the A delta fibres and their conduction velocities. 5. For four A delta fibres a complete stimulus-duration curve was determined. It followed rather well the I = I0/(1-et/tau) law, where I represents the stimulus amplitude, t the stimulus duration, I0 the rheobasic current and tau the time constant. 6. In the intact tooth none of the identified periodontal A delta fibres showed any ongoing activity in the absence of intentional stimulation. 7. The responses of sixteen electrically identified periodontal A delta fibres were tested by mechanical, thermal and chemical stimuli applied to the periodontal space. Seven of nine periodontal A delta fibres tested responded to mechanical forces applied to the tooth from different directions of which none could be activated by slight touch. A rudimentary directional sensitivity was seen. When a human tooth was stimulated by a mechanical stimulus of similar strength the sensation evoked was described as a dull, poorly localized pain. 8. Six periodontal A delta fibres were activated by heat and/or cold and/or chemical stimulation. Two of eight periodontal A delta fibres tested responded to heat and four of six A delta fibres tested responded to cold stimuli applied to the alveolar bone overlying the periodontal ligament; none of them responded to both types of thermal stimuli. Two of seven periodontal A delta fibres tested were activated by a saturated solution of potassium chloride applied locally to the periodontal ligament; two of these responded also to cold. 9. The response behaviour of periodontal afferent A delta fibres observed in this study suggests that they may play a role in periodontal nociception.

Effects of capsaicin on KCl-induced blood flow and sensory nerve activity changes in the tooth pulp

Potassium ion-containing solutions have been shown to initially excite then depress intradental nerve activity (INA) when applied into deep dentinal cavities. The INA reflects activity originating in intradental A fibers. Application of KCl to deep dentinal cavities also induces an increase in pulpal blood flow (PBF). Capsaicin is known to exert a highly selective desensitizing effect on polymodal C-fiber nerve endings. These C fibers are generally believed to release vasoactive substances in response to stimulation. In order to determine if KCl exerts its vascular effect via activation of capsaicin-sensitive nerve fibers, we examined blood flow and sensory nerve responses to KCl obtained before and after capsaicin desensitization. The A-fiber nerve activity was determined by using INA recording technique. Blood flow was measured simultaneously from the same tooth using laser Doppler flowmetry. Local application of 0.25 M KCl to a deep dentinal cavity induced a brief spike burst and an increase in PBF of 76.0 +/- 14.6% (n = 8). Repeated applications of 0.25 M KCl caused a consistent increase in the peak PBF amplitude (n = 8). Local application of 100 microM capsaicin to a deep dentinal cavity caused an increase in PBF of 116.8 +/- 26.3% (n = 8) lasting 12-18 min, but capsaicin application did not appear to evoke any INA response. The amplitude of PBF in response to capsaicin application declined during repeated applications. Following repeated applications of capsaicin the PBF response to KCl was significantly reduced (9.9 +/- 4.3%, n = 8).(ABSTRACT TRUNCATED AT 250 WORDS)

Identification and characterization of afferent periodontal C fibres in the cat

The presence of afferent periodontal C fibres was studied in pentobarbitone-anaesthetized cats. Extracellular single-fibre recordings were made from fine nerve filaments split from the proximally cut end of the inferior alveolar nerve. Periodontal nerve fibres were identified by constant-current stimulus pulses applied via platinum wire electrodes inserted into the periodontal space. Of 260 periodontal nerve fibres, 142 (55%) were classified as C fibres according to their conduction velocities (less than or equal to 2.5 m/sec) as determined by electrical stimulation of the periodontal ligament (c.v.p). The mean (+/- S.D.) c.v.p was 1.2 +/- 0.6 m/sec (n = 142; range: 0.3-2.5 m/sec). In addition, the axonal conduction velocity of 14 periodontal C fibres was determined by bipolar electrical stimulation of the trunk of the inferior alveolar nerve (c.v.n). On average the c.v.n was 42% higher than the c.v.p; the mean value was 1.7 +/- 0.8 m/sec (n = 14; range: 0.6-3.9 m/sec). Nevertheless, the classification of nerve fibres based on c.v.p proved to be reliable; only 1 fibre had a c.v.p less than 2.5 m/sec and a c.v.n greater than 2.5 m/sec and a c.v.n greater than 2.5 m/sec and was therefore reclassified as an A delta fibre. The responses of 30 electrically identified periodontal C fibres were tested by mechanical, thermal and chemical stimuli applied to the periodontal space. Thirteen of 19 periodontal C fibres tested responded to a strong mechanical force applied to the tooth from different directions while none could be activated by slight touch. A rudimentary directional sensitivity was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Mechanically insensitive afferents (MIAs) in cutaneous nerves of monkey

A problem in the study of nociceptors is that intense stimuli are used to locate the receptive field (RF), and thus the receptor may be damaged before the first responses are recorded. In addition, some nociceptors do not respond to the mechanical stimuli often used to search for the RF. To overcome these problems, an electrical search technique was developed to locate the RF of cutaneous nociceptors. In the hairy skin of anesthetized monkey, we used this technique to locate the RF of 63 A delta-fibers and 22 C-fibers that had extremely high thresholds or were unresponsive to mechanical stimuli. We refer to these afferents as mechanically insensitive afferents (MIAs). Ten A delta-fiber MIAs had a short latency response to stepped heat stimuli and could be responsible for first pain sensation. Five A delta-fiber MIAs and one C-fiber MIA did not respond to mechanical or heat stimuli but did respond to injection into the electrical RF of an artificial inflammatory soup containing histamine, bradykinin, prostaglandin E1, and serotonin. These chemoreceptors might be responsible for the pain and itch sensations that result from chemical stimuli. Some MIAs became more responsive to mechanical stimuli after injection into the RF of the inflammatory soup and, thus, may contribute to the hyperalgesia to mechanical stimuli associated with cutaneous injury. A large proportion of the A delta-fiber (48%) and C-fiber (30%) afferents in this study were insensitive to mechanical stimuli. The role of these MIAs in sensation needs to be studied further. The electrical search technique enables a systematic study of these afferents to be performed. This technique may also be of use to identify and characterize dorsal horn neurons that have inputs from MIAs.