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Anderson DJ, Hannam AG, Mathews B. Sensory mechanisms in mammalian teeth and their supporting structures. Physiol Rev 1970; 50:171-95. [PMID: 4908088 DOI: 10.1152/physrev.1970.50.2.171] [Citation(s) in RCA: 243] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Greenstein G, Tarnow D. The Mental Foramen and Nerve: Clinical and Anatomical Factors Related to Dental Implant Placement: A Literature Review. J Periodontol 2006; 77:1933-43. [PMID: 17209776 DOI: 10.1902/jop.2006.060197] [Citation(s) in RCA: 220] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The mental foramen is a strategically important landmark during osteotomy procedures. Its location and the possibility that an anterior loop of the mental nerve may be present mesial to the mental foramen needs to be considered before implant surgery to avoid mental nerve injury. METHODS Articles that addressed the position, number, and size of the mental foramen, mental nerve anatomy, and consequences of nerve damage were evaluated for information pertinent to clinicians performing implant dentistry. RESULTS The mental foramen may be oval or round and is usually located apical to the second mandibular premolar or between apices of the premolars. However, its location can vary from the mandibular canine to the first molar. The foramen may not appear on conventional radiographs, and linear measurements need to be adjusted to account for radiographic distortion. Computerized tomography (CT) scans are more accurate for detecting the mental foramen than conventional radiographs. There are discrepancies between studies regarding the prevalence and length of the loop of the mental nerve mesial to the mental foramen. Furthermore, investigations that compared radiographic and cadaveric dissection data with respect to identifying the anterior loop reported that radiographic assessments result in a high percentage of false-positive and -negatives findings. Sensory dysfunction due to nerve damage in the foraminal area can occur if the inferior alveolar or mental nerve is damaged during preparation of an osteotomy. CONCLUSIONS To avoid nerve injury during surgery in the foraminal area, guidelines were developed based on the literature with respect to verifying the position of the mental foramen and validating the presence of an anterior loop of the mental nerve. These guidelines included leaving a 2 mm zone of safety between an implant and the coronal aspect of the nerve; observation of the inferior alveolar nerve and mental foramen on panoramic and periapical films prior to implant placement; use of CT scans when these techniques do not provide clarity with respect to the position of the nerve; surgical corroboration of the mental foramen's position when an anterior loop of the mental foramen is suspected of being present or if it is unclear how much bone is present coronal to the foramen to establish a zone of safety (in millimeters) for implant placement; once a safety zone is identified, implants can be placed anterior to, posterior to, or above the mental foramen; and prior to placing an implant anterior to the mental foramen that is deeper than the safety zone, the foramen must be probed to exclude the possibility that an anterior loop is present. In general, altered lip sensations are preventable if the mental foramen is located and this knowledge is employed when performing surgical procedures in the foraminal area.
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Abstract
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)
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Nosrat IV, Smith CA, Mullally P, Olson L, Nosrat CA. Dental pulp cells provide neurotrophic support for dopaminergic neurons and differentiate into neurons in vitro; implications for tissue engineering and repair in the nervous system. Eur J Neurosci 2004; 19:2388-98. [PMID: 15128393 DOI: 10.1111/j.0953-816x.2004.03314.x] [Citation(s) in RCA: 172] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Glial cell line-derived neurotrophic factor (GDNF) mRNA is highly expressed by dental pulp cells (DPCs) prior to the initiation of dental pulp innervation. We show that radioactively labelled exogenous GDNF is retrogradely transported from neonatal teeth and vibrissae to the trigeminal neurons, indicating that GDNF acts as a classical neurotrophic factor in the trigeminal system. We also show that DPCs from both rats and humans produce nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and GDNF mRNAs in vitro, promote the survival and phenotypic characteristics of embryonic dopaminergic (DA) neurons and protect DA neurons against the neurotoxin 6-hydroxy-dopamine (6-OHDA) in vitro. By using inhibitory antibodies to NGF, BDNF and GDNF, we show that the promotion of DA neuron survival relates to the production and release of neurotrophic proteins by DPCs in vitro. We suggest that in vivo production of neurotrophic factors by DPCs play roles in tooth innervation. However, continued production of neurotrophic factors by the DPCs might have wider implications. We propose that the dental pulp is a viable source of easily attainable cells with possible potential for development of autologous cell transplantation therapies. We also show that a population of neural crest-derived dental pulp cells acquire clear neuronal morphology and protein expression profile in vitro, indicating the presence of a cell population in the dental pulp with neuronal differentiation capacity that might provide additional benefits when grafted into the CNS.
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Research Support, U.S. Gov't, P.H.S. |
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Oshima M, Mizuno M, Imamura A, Ogawa M, Yasukawa M, Yamazaki H, Morita R, Ikeda E, Nakao K, Takano-Yamamoto T, Kasugai S, Saito M, Tsuji T. Functional tooth regeneration using a bioengineered tooth unit as a mature organ replacement regenerative therapy. PLoS One 2011; 6:e21531. [PMID: 21765896 PMCID: PMC3134195 DOI: 10.1371/journal.pone.0021531] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Accepted: 05/30/2011] [Indexed: 11/18/2022] Open
Abstract
Donor organ transplantation is currently an essential therapeutic approach to the replacement of a dysfunctional organ as a result of disease, injury or aging in vivo. Recent progress in the area of regenerative therapy has the potential to lead to bioengineered mature organ replacement in the future. In this proof of concept study, we here report a further development in this regard in which a bioengineered tooth unit comprising mature tooth, periodontal ligament and alveolar bone, was successfully transplanted into a properly-sized bony hole in the alveolar bone through bone integration by recipient bone remodeling in a murine transplantation model system. The bioengineered tooth unit restored enough the alveolar bone in a vertical direction into an extensive bone defect of murine lower jaw. Engrafted bioengineered tooth displayed physiological tooth functions such as mastication, periodontal ligament function for bone remodeling and responsiveness to noxious stimulations. This study thus represents a substantial advance and demonstrates the real potential for bioengineered mature organ replacement as a next generation regenerative therapy.
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Research Support, Non-U.S. Gov't |
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Byers MR, Dong WK. Comparison of trigeminal receptor location and structure in the periodontal ligament of different types of teeth from the rat, cat, and monkey. J Comp Neurol 1989; 279:117-27. [PMID: 2492311 DOI: 10.1002/cne.902790110] [Citation(s) in RCA: 117] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The periodontal ligament is richly innervated by mechanoreceptors whose cell bodies are located either in the trigeminal ganglion (TG) or the mesencephalic (MS) trigeminal nucleus. Both are sensitive to stretch of the ligament induced by tooth movement, but their thresholds, central connections, and functional significance differ. This study compared the location of TG and MS receptors in the periodontal ligament of cat teeth after labeling each by anterograde axonal transport. We also compared the location and ultrastructure of the feline TG receptors with labeled TG receptors in the periodontal ligament of monkey teeth and rat incisors in order to determine their location and ultrastructural properties. We found that the MS and TG receptors had a different distribution in the periodontal ligament of cat teeth; the MS terminals were concentrated below and next to the base of the roots, whereas the TG receptors were most numerous around the middle of the roots. The TG receptors of monkey teeth had a similar location to the feline TG receptors, but those of rat incisors were very different. Rat incisors are curved, continuously erupting teeth, and their TG receptors were located primarily on the lingual side in the alveolar (nonerupting) portion of the ligament. Ultrastructural comparisons found that most mechanoreceptors in the periodontal ligament of all the teeth had an unencapsulated branched Ruffini-like structure. The TG receptors in the rat incisor ligament were the largest; those of monkey had the most varied form. Some coiled or encapsulated receptors were found in the monkey and cat ligament, but not in the rat incisor ligament. The TG receptors appear to be located at sites that would be most easily stretched during tooth contact. The different sites and intensity of the stretch forces occurring during the use of different types of teeth may determine the variations in the size and location of the TG mechanoreceptors and of their associated support cells. The different distribution of MS receptors may contribute to their response thresholds and static properties, which differ from those of TG receptors.
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Abstract
(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)
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Trulsson M, Johansson RS. Orofacial mechanoreceptors in humans: encoding characteristics and responses during natural orofacial behaviors. Behav Brain Res 2002; 135:27-33. [PMID: 12356430 DOI: 10.1016/s0166-4328(02)00151-1] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We used microneurography to characterize stimulus-encoding properties of low-threshold mechanoreceptive afferents in human orofacial tissues. Signals were recorded from single afferents in the infraorbital, lingual and inferior alveolar nerves while localized, controlled, mechanical stimuli were delivered to the facial skin, lips, oral mucosa and teeth. We likewise analyzed activity in these afferents during orofacial behaviors such as speech, chewing and biting. The afferents in the soft tissues functionally resemble four types described in the human hand: hair follicle afferents, slowly adapting (SA) type I and type II afferents and fast adapting (FA) type I afferents. Afferents in the facial skin, lips and buccal mucosa respond not only to contact with environmental objects, but also to contact between the lips, changes in air pressure generated for speech sounds, and to facial skin and mucosa deformations that accompany lip and jaw movements associated with chewing and swallowing. Hence, in addition to exteroceptive information, these afferents provide proprioceptive information. In contrast, afferents terminating superficially in the tongue do not signal proprioceptive information about tongue movements in this manner. They only respond when the receptive field is brought into contact with other intraoral structures or objects, e.g. the teeth or food. All human periodontal afferents adapt slowly to maintained tooth loads. Populations of periodontal afferents encode information about both which teeth are loaded and the direction of forces applied to individual teeth. Most afferents exhibit a markedly curved relationship between discharge rate and force amplitude, featuring the highest sensitivity to changes in tooth load at low forces (below 1 N). Accordingly, periodontal afferents efficiently encode tooth load when subjects first contact, hold, and gently manipulate food by the teeth. In contrast, only a minority of the afferents encodes the rapid and strong force increase generated when biting through food. We conclude, that humans use periodontal afferent signals to control jaw actions associated with intraoral manipulation of food rather than exertion of jaw power actions.
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Review |
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Mumford JM, Bowsher D. Pain and protopathic sensibility. A reveiw with particular reference to the teeth. Pain 1976; 2:223-243. [PMID: 800250 DOI: 10.1016/0304-3959(76)90002-6] [Citation(s) in RCA: 98] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Review |
49 |
98 |
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Linden RW. Properties of intraoral mechanoreceptors represented in the mesencephalic nucleus of the fifth nerve in the cat. J Physiol 1978; 279:395-408. [PMID: 671357 PMCID: PMC1282623 DOI: 10.1113/jphysiol.1978.sp012352] [Citation(s) in RCA: 96] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
1. The activity of neurones in the mesencephalic nucleus of the fifth nerve that respond to forces applied to the teeth were recorded using extracellular microelectrodes; the properties of these neurones have been studied. 2. Electrophysiological evidence consistent with the view that primary afferent intraoral mechanoreceptor fibres have their cell bodies in the trigeminal mesencephalic nucleus is presented. 3. Two groups of intraoral mechanoreceptor neurones were found. The first group, the periodontal mechanoreceptor neurones, which have been described by previous workers, responded to electrical stimulation of the ipsilateral superior or inferior dental nerves and to forces applied to single teeth in the ipsilateral maxilla or mandible respectively. The response characteristics of the mesencephalic periodontal mechanoreceptor neurones differed in two respects from those observed in peripheral nerve studies by previous workers: (a) there were no spontaneously active neurones, and (b) there were no neurones that responded for over 10 sec to a sustained application of a suprathreshold mechanical stimulus to the teeth. The second group, not described before, responded to electrical stimulation of the ipsilateral palatine nerve, and responded to forces applied to all the teeth in the maxillary arch, both contralateral and ipsilateral as well as to forces applied to the nose and hard palate. The site of these receptors is unknown. They have been termed 'Type P' intraoral mechanoreceptors. 4. The recording sites of both the periodontal and Type P mechanoreceptor neurones were all situated in the caudal part of the mesencephalic nucleus of the fifth nerve.
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Barber J, Mayer D. Evaluation of the efficacy and neural mechanism of a hypnotic analgesia procedure in experimental and clinical dental pain. Pain 1977; 4:41-48. [PMID: 337220 DOI: 10.1016/0304-3959(77)90085-9] [Citation(s) in RCA: 91] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Previous research implicates an endogenous central pain inhibitory mechanism in opiate analgesia, analgesia produced by focal electrical stimulation of the brain, and acupuncture analgesia. This investigation evaluates the possibility that analgesia produced by hypnosis is also mediated by such a mechanism. Results suggest that hypnotic analgesia is unlikely to involve this central pain inhibitory mechanism since hypnotic analgesia is not altered by naloxone hydrochloride, a specific narcotic antagonist. Results further demonstrate that the hypnotic procedure used produces an unusually effective and reliable increase in pain threshold. This finding generalizes to the control of clinical dental pain, and suggests that hypnotic pain control is a more widespread phenomenon in the population than has been thought.
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Clinical Trial |
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Byers MR, Schatteman GC, Bothwell M. Multiple functions for NGF receptor in developing, aging and injured rat teeth are suggested by epithelial, mesenchymal and neural immunoreactivity. Development 1990; 109:461-71. [PMID: 2169390 DOI: 10.1242/dev.109.2.461] [Citation(s) in RCA: 90] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We have used immunocytochemistry to analyse expression of nerve growth factor receptor (NGFR) in developing, aging and injured molar teeth of rats. The patterns of NGFR immunoreactivity (IR) in developing epithelia and mesenchyme matched the location of NGFR mRNA assayed by in situ hybridization with a complementary S35-labeled RNA probe. The following categories of NGFR expression were found. (1) There was NGFR-IR in the dental lamina epithelium and in adjacent mesenchyme during early stages of third molar formation. (2) NGFR-IR nerve fibers were posterior and close to the bud epithelium. (3) During crown morphogenesis NGFR expression was prominent in internal enamel epithelium and preodontoblasts; it faded as preameloblasts elongated and as odontoblasts began to make predentin matrix; and it was weak or absent from outer enamel epithelium, the cervical loop, and differentiated ameloblasts and odontoblasts. (4) When NGFR-IR nerve fibers entered the molars late in the bell stage, they innervated the most mature peripheral pulp and dentin in an asymmetric pattern which correlated more with asymmetric enamel synthesis than with mesenchymal NGFR-IR distribution. (5) The mesenchymal pulp cells continued to have intense NGFR expression in adult teeth, especially near coronal tubular dentin. (6) The pulpal NGFR-IR decreased in very old rats or subjacent to reparative dentin (naturally occurring or experimentally induced). (7) During root formation, the preodontoblasts had NGFR-IR but most root mesenchymal cells and Hertwig's epithelial root sheath did not. This work suggests that there are important epithelial and mesenchymal targets of NGF regulation during molar morphogenesis that differ for crown and root development and that do not correlate with neural development. The continuing expression of NGFR-IR by pulpal mesenchymal cells in adult rats was most intense near coronal odontoblasts making tubular dentin; and it was lost during aging, or subjacent to sites of dentin injury that caused a phenotypic change in the odontoblast layer.
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Byers MR, Wheeler EF, Bothwell M. Altered expression of NGF and P75 NGF-receptor by fibroblasts of injured teeth precedes sensory nerve sprouting. Growth Factors 1992; 6:41-52. [PMID: 1350451 DOI: 10.3109/08977199209008870] [Citation(s) in RCA: 82] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Profuse sprouting of sensory nerve fibers occurs in tooth pulp by 1-4 days following dentin injury. A possible role for nerve growth factor (NGF) in that neural response is suggested here by the demonstration that NGF mRNA and protein are increased 6 hr after injury to adult rat molars. The enhanced expression of NGF mRNA was localized to fibroblasts underlying the injury. A concomitant depletion of mRNA encoding the 75 Kd NGF receptor (NGFR) was observed in those fibroblasts. The increase in NGF mRNA was transitory and mRNA levels fell below normal levels by 2 days after injury. Both NGF and NGFR mRNA remained low thereafter in injured pulp. The inverse shifts in fibroblastic mRNA encoding NGF and NGFR were not affected by prior denervation of the tissue, or by pretreatment with dexamethasone. The regulatory mechanisms therefore must involve endogenous, non-neuronal, non-inflammatory factors that are released in response to injury.
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Shigenaga Y, Suemune S, Nishimura M, Nishimori T, Sato H, Ishidori H, Yoshida A, Tsuru K, Tsuiki Y, Dateoka Y. Topographic representation of lower and upper teeth within the trigeminal sensory nuclei of adult cat as demonstrated by the transganglionic transport of horseradish peroxidase. J Comp Neurol 1986; 251:299-316. [PMID: 3771833 DOI: 10.1002/cne.902510303] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Transganglionic transport of horseradish peroxidase-wheat germ agglutinin conjugate (HRP-WGA) entrapped in hypoallergenic polyacrylamide gel was used to study the patterns of termination of primary afferents that innervate the lower and upper tooth pulps within the trigeminal sensory nuclear complex (TSNC). HRP injections were made into the inferior and superior alveolar nerves in order to compare the central projections of the whole nerve with those from tooth pulps. In addition, the relationship between the distribution of the trigeminothalamic tract cells and the projection sites of the tooth pulp afferents was investigated by injecting HRP into the posterior ventral thalamus. HRP-labeled tooth pulp afferent fibers innervating the lower and upper teeth projected to the subnucleus dorsalis (Vpd) of pars principalis, the rostrodorsomedial part (Vo.r) and nucleus dorsomedialis (Vo.dm) of pars oralis, the medial regions of pars interpolaris, and laminae I, II, and V of pars caudalis. Terminal fields of the lower tooth pulp afferents formed a rostrocaudally running, uninterrupted column from the midlevel of Vpd to the caudal tip of caudalis. In contrast, the column of termination of upper tooth pulp afferents was discontinuous at the Vpd/Vo.r transition, and ended at the more rostral level of the caudalis than that of the lower tooth pulp afferents. The representation of the lower and upper teeth in the TSNC was organized in a somatotopic fashion which varied from one subdivision to the next, although terminal zones of the inferior and superior alveolar nerves overlapped within the Vo.r, Vo.dm, and dorsomedial part of rostral pars interpolaris. The lower and upper teeth were represented in the Vpd, Vo.r, Vo.dm, medial region of pars interpolaris, and laminae I, II, and V, in a ventrodorsal or caudorostral, dorsoventral, lateromedial, dorsoventral, and mediolateral or dorsomedial-ventrolateral sequence, respectively. The smaller, more focal terminal areas of the teeth contrasted sharply with more extensive terminal fields of the alveolar nerves. The HRP injections within the thalamus indicated that neurons in Vpd, the caudal pars interpolaris, and laminae I/V of caudalis, which are subdivisions of TSNC that receive pulpal projections, sent their axons to the ipsilateral and contralateral posterior ventral thalamus.(ABSTRACT TRUNCATED AT 400 WORDS)
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Robinson PP. Reinnervation of teeth, mucous membrane and skin following section of the inferior alveolar nerve in the cat. Brain Res 1981; 220:241-53. [PMID: 7284754 DOI: 10.1016/0006-8993(81)91215-4] [Citation(s) in RCA: 80] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
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.
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Miyamoto JJ, Honda M, Saito DN, Okada T, Ono T, Ohyama K, Sadato N. The Representation of the Human Oral Area in the Somatosensory Cortex: a Functional MRI Study. Cereb Cortex 2005; 16:669-75. [PMID: 16079244 DOI: 10.1093/cercor/bhj012] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The tactile sensation of the teeth is involved in various oral functions, such as mastication and speech. Using functional magnetic resonance imaging, we investigated the cortical sensory representation of the oral area, including the teeth. First, we identified the somatotopic representation of the lips, teeth and tongue in the postcentral gyrus (GpoC). Tactile stimuli were applied to the lower lip, tongue and teeth. The foci activated by each stimulus were characterized by the center of gravity (COG) of activated areas. Secondly, we examined the rostro-caudal changes in the somatotopic organization in the GPoC in terms of the overlap between each sensory representation. In the rostral portion of the GPoC, the COG of the representation of teeth was located significantly superior to that of the tongue and inferior to that of the lip, consistent with the classical 'sensory homunculus' proposed by Penfield; however, this somatotopic representation became unclear in the middle and caudal portions of the GPoC. The overlap between each representation in the middle and caudal portions of the GPoC was significantly greater than that in the rostral portion of the GPoC. These findings support the theory that the input from oral structures converges hierarchically across the primary somatosensory cortex.
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Hong D, Byers MR, Oswald RJ. Dexamethasone treatment reduces sensory neuropeptides and nerve sprouting reactions in injured teeth. Pain 1993; 55:171-181. [PMID: 7906026 DOI: 10.1016/0304-3959(93)90146-g] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Dental injuries have been shown to generate extensive structural and cytochemical changes in sensory fibers that contain neuropeptides such as calcitonin gene-related peptide (CGRP) or substance P (SP). The present study was designed to test whether the anti-inflammatory drug dexamethasone (DEX) can alter neural responses to dental injuries. DEX (20 micrograms/100 g body weight) was given to adult rats (n = 10) prior to dental surgery and daily thereafter for 4 days. Control animals received sterile saline vehicle (n = 6) or no injection (n = 1). Each rat was then anesthetized for dental surgery and a cavity was drilled partway through dentin on the anterior side of the right maxillary first molar. Pulp exposure injuries were also made on two right mandibular molars in 14 of 17 rats. After 4 days of daily drug treatment, the rats were anesthetized and fixed by perfusion with formaldehyde-picric acid, and their jaws were prepared for immunocytochemistry. Neural CGRP immunoreactivity near the maxillary cavity injury site of DEX-treated rats was reduced more than 50% compared to controls, as determined both qualitatively and by digital analysis. The SP immunoreactive (IR) fibers in molar pulp also had extensive inhibition of neural reactions to cavity injury. DEX also reduced the immunoreactivity for CGRP and SP in normal contralateral rat molars of all treated rats, and it caused a postoperative loss of weight. Pretreatment for 1-5 days prior to the 4 day injury gave the same results as pretreatment for 1 h. The mandibular pulp exposure injuries induced a chronic abscess and advancing pulpal necrosis but did not show differences in nerve reactions between DEX-treated rats and the controls. In conclusion, the synthetic steroid dexamethasone suppressed the CGRP and SP neuropeptide immunoreactivity in normal dental nerves and it reduced nerve-sprouting responses to dentin cavity injuries; however, sensory nerve reactions to pulpal exposure injuries were not affected by DEX in these experiments.
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Greenwood F, Horiuchi H, Matthews B. Electrophysiological evidence on the types of nerve fibres excited by electrical stimulation of teeth with a pulp tester. Arch Oral Biol 1972; 17:701-9. [PMID: 4505461 DOI: 10.1016/0003-9969(72)90196-3] [Citation(s) in RCA: 77] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Fried K, Arvidsson J, Robertson B, Brodin E, Theodorsson E. Combined retrograde tracing and enzyme/immunohistochemistry of trigeminal ganglion cell bodies innervating tooth pulps in the rat. Neuroscience 1989; 33:101-9. [PMID: 2481244 DOI: 10.1016/0306-4522(89)90314-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Rat trigeminal neurons innervating tooth pulps were retrogradely labelled with fluorogold and analysed enzyme- and immunohistochemically for their content of substance P, calcitonin gene-related peptide, fluoride-resistant acid phosphatase, GM 1 ganglioside, carbonic anhydrase and neurofilament protein. The data showed that both small, medium-sized and large trigeminal neurons were labelled after fluorogold deposition in maxillary molar pulps, with a majority of the cells being medium-sized and large. Less than 2% of the pulpal neurons showed substance P-like immunoreactivity. Fifty-six per cent of the pulpal nerve cells were calcitonin gene-related peptide-positive. These cells were small, medium-sized and large. Only 1% of the fluorogold-labelled cells contained fluoride-resistant acid phosphatase enzyme activity. This paralleled the finding that the pulpal neurons were unstained by Griffonia simplicifolia isolectin I-B4, a plant lectin which preferentially binds to fluoride-resistant acid phosphatase-positive cells. Choleragenoid-like immunoreactivity, which identifies cells with the GM 1 ganglioside receptor, was found in 70% of the fluorogold-labelled pulpal neurons. Approximately 80% of the fluorogold-labelled cells showed RT 97-immunoreactivity. RT 97 labels neurofilament protein and is present in large light primary sensory neurons. No pulpal neurons appeared to contain carbonic anhydrase, as judged from both enzyme- and immunocytochemical observations. The findings suggest that, in the rat, trigeminal tooth pulp neurons, which according to the classical view are nociceptive, form a heterogeneous group of neurons with a minority of small cells which may contain calcitonin gene-related peptide but rarely either substance P or fluoride-resistant acid phosphatase. However, the vast majority of pulpal nerve cells appear to have sizes and cytochemical characteristics which are not generally associated with nociceptive primary sensory neurons.
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Byers MR, Kish SJ. Delineation of somatic nerve endings in rat teeth by radioautography of axon-transported protein. J Dent Res 1976; 55:419-25. [PMID: 1063751 DOI: 10.1177/00220345760550032001] [Citation(s) in RCA: 71] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
We have shown that there is extensive innervation of cusp pulp and dentin in rat molars. The dental nerves either end freely below the odontoblast layer or form gap junction endings on the odontobast cell body or along its dential process. The nerves are largely absent from response dentin, are found in contact with virtually all other odontoblasts at the tip of the cusps, are less frequent in intercuspal regions, and are absent from root dentin and odontoblast layers. The incisors were completely different from the molars, perhaps because they are continuously erupting teeth. The distribution of nerve endings in rat molars may be representative of that in teeth of other species, but the nerve endings should be mapped radioautographically for each type of tooth before generalizations can be made.
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Abstract
Neurotrophic factors have robust effects on development, differentiation, maintenance and regeneration of neurons. In the present study, we have used in situ hybridization to determine the specific sites of gene activity of five neurotrophic factors during tooth development. Nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) mRNAs were mainly detected in the dental papilla/pulp in postnatal rats, and the pattern of expression correlated with onset of dental innervation. In contrast, neurotrophin 3 (NT3) and 4 (NT4) mRNA expression patterns were predominantly epithelial and were strongest during early developmental stages when teeth are not yet innervated. Glial cell line-derived neurotrophic factor (GDNF) mRNA was present in dental epithelium at early stages, but later in development, GDNF mRNA expression was mainly mesenchymal and observed in the odontoblast layer and extending into the subodontoblast zone. Our results suggest that both neurotrophins and GDNF may have multiple functions during tooth development. In addition to an influence on the establishment of the dental innervation, neurotrophic substances might have morphogenetic effects such as modulating the proliferation or differentiation of developing epithelial and mesenchymal cells.
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