A PHYSIOLOGICAL STUDY ON THE CHEMICAL STIMULATION OF DENTAL PULP NERVE AND AN ETIOLOGICAL STUDY ON THE PAIN WITH PULPAL DISEASES.

我们将疼痛性牙髓刺激对周围和中枢神经系统反应性改变的基础动物实验与口腔-面部、头颈部疼痛与牙髓疾病关系的临床研究相结合。所得结果如下：(1)将一种小纤维兴奋剂和炎症剂芥菜油涂抹在大鼠臼齿牙髓上，使大鼠下颌肌肉静息肌电图活动增加，尤其是同侧咬肌发生了显著变化。(2)芥菜油对同侧犬牙髓的化学条件刺激可增强猫颈脊髓（C2 / C3）神经元对下牙槽神经（IANDN）电刺激的反应性；也就是说，在使用芥菜油后，在iandn中观察到短暂性的兴奋性增加以及皮肤感受野的扩张。这些结果表明，芥菜油刺激牙髓可以激活中枢致敏机制。(3)芥菜油对牙髓的化学刺激增加了单牙周机械感受初级纤维对牙尖压力刺激的兴奋性，并产生致敏作用，这可能与轴突反射引起的神经源性炎症有关。(4)对牙髓病引起的口腔、面部、头颈部剧烈疼痛患者的临床检查发现，这些疼痛与所谓的感染根管系统密切相关，其中部分患者被认为属于意发性疼痛组。这些结果表明，芥菜油化学刺激牙髓神经为牙髓炎症变化与疼痛关系的实验研究提供了有益的方法。

We performed a combined study of basic animal experments on the alteration of peripheral and central nervous system responsiveness with painful pulpal stimulation and clinical research on the relationship between the oro-facial, head and neck pain and the pulpal diseases. The results obtained are as follows ;(1) A small fiber exciant and inflammatory agent, mustard oil, applied to the rat molar tooth pulp, produced an increase activities in resting EMG of the rat jaw muscles, and a significant change especially in the ipsilateral masseter muscle.(2) Chemical conditionong stimulation of mustard oil to the ipsilateral canine tooth pulp enhenced the responsiveness of the cat cervical spinal cord (C2 of C3) neurons responding to the electrical stimulation to the inferior alveolar nerve (IANDN) ; that is, a temporal increase of the excitability as well as an expansion of cutaneous receptive field was observed in the IANDNs during the post-application periods of mustard oil. These results suggested that the mustard oil pulpal stimulation could activate the central sensitization mechanisms.(3) Chemical stimulation of the tooth pulp with mustard oil increased the excitability of the single periodontal mechanoreceptive primary fiber responding to the pressure stimulation to the canine tip, and produced the sensitization, which might be mediated by the neurogenic inflammation due to the axon reflex.(4) A clinical examination of the patients suffering from the severe pain in the oro-facial, head and neck region with respect to the pulpal diseases revealed that these kinds of pain were closely related with so-called infected root canal system, and that some of them were thought to be classified into the ideopathic pain groups.These results indicated that the chemical stimulation of the tooth pulp nerve with mustard oil provided useful methods in the experimental study on the relationship between the pulpal inflammatory changes and their related pain.