EFFECTS OF INJURY AND INFLAMMATION ON PULPAL AND PERIAPICAL NERVES
EFFECTS OF INJURY AND INFLAMMATION ON PULPAL AND PERIAPICAL NERVES
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DOI：
10.1016/s0099-2399(06)81568-2
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发表时间：
1990-02-01
影响因子：
4.2
通讯作者：
KIMBERLY, CL
中科院分区：
文献类型：
--
作者：
BYERS, MR;TAYLOR, PE;KIMBERLY, CL
本文回顾了几项涉及牙齿神经纤维对损伤和炎症反应的研究。在三种程度的损伤之一后的不同时间（1至35天）通过免疫细胞化学检查含有降钙素基因相关肽（CGRP）的牙神经纤维亚组：（a）轻度：在麻醉的成年大鼠的第一磨牙的颈牙本质中形成浅腔后四天，我们发现CGRP纤维已萌芽到下面的成牙本质细胞层和牙本质中，然后在3周时恢复正常。 (b)中间：如果宫颈腔被酸蚀，我们发现成牙本质细胞层受损，微脓肿形成，并且CGRP纤维在脓肿附近发芽，随后形成修复性牙本质并愈合。 (c)严重：如果牙髓暴露，可能会发生多种反应，其中最常见的是严重坏死，导致根尖周病变的发展。对牙髓脓肿和坏死进展阶段的分析显示，CGRP 神经纤维在脓肿和活髓之间的退缩界面处萌芽；(a) (b) 病变发生期间的根尖周区域； (c) 肉芽肿性牙周组织中的慢性脓肿周围。这些研究涉及各种牙科临床问题，例如牙齿过敏、阵发性牙痛、根尖周病变的早期发作、牙科麻醉以及感觉纤维和神经肽在组织防御和愈合中的可能作用。
Several studies dealing with the reactions of dental nerve fibers to injury and inflammation are reviewed in this article. The subgroup of dental nerve fibers that contains calcitonin gene-related peptide (CGRP) was examined by immunocytochemistry at various times (1 to 35 days) after one of three degrees of injury: (a)Mild: Four day after making shallow cavities into cervical dentin of first molars of anesthetized adult rats, we found that CGRP fibers had sprouted into the subjacent odontoblast layer and dentin, and then returned to normal by 3 wk. (b)Intermediate: If the cervical cavities were acid etched, we found damage to the odontoblast layer, microabscess formation, and sprouting of CGRP fibers near the abscess, with subsequent formation of reparative dentin and healing. (c)Severe: If the pulp was exposed, a variety of reactions could occur, the most prevalent of which was a severe necrosis leading to development of periapical lesions. Analysis of the progressive stages of pulpal abscess and necrosis showed sprouting CGRP nerve fibers (a) at the retreating interface between abscess and vital pulp; (b) in periapical areas during onset of lesions; and (c) around chronic abscesses in granulomatous periodontal tissues. These studies are discussed in relation to various dental clinical problems such as hypersensitive teeth, episodic toothache, early onset of periapical lesions, dental anesthesia, and possible roles for sensory fibers and neuropeptides in tissue defense and healing.