Clinical and Basic Research on Pulpal inflammation

牙髓炎是一种常见的牙科疾病。本研究的目的是从功能上探讨牙髓炎症的基本机制，特别是疼痛，这是该疾病的重要和特有的症状。每项研究的结论如下：1.在上颈髓(C2或C3)可见下牙槽神经支配神经元。颈部肌肉输入也汇聚到这些神经元上。三叉神经内有分支神经纤维分布于乳牙髓及其后的恒牙髓内。灯盏花素本身对根尖周组织缺氧所致的乳牙髓神经纤维有麻醉作用。强刺激使牙髓神经纤维在牙髓炎症的早期阶段敏化，有髓纤维首先增加其活性，然后产生并减少它们。而无髓纤维即使在炎症的晚期仍保持活性。这些神经活动参与了特征性牙髓痛的发生。摘除牙髓后，由于根管内药物的作用，牙周神经纤维显示出修饰的活性。草酸钾溶液应用于裸露牙本质对牙髓组织无刺激作用，对患者牙本质过敏有明显的改善作用。对看似由牙髓和/或牙周疾病引起的牵涉疼痛进行统计分析。仔细的麻醉测试很容易就发现了致病牙齿。下颌磨牙髓髓摘除最有效的方法是口腔和舌侧联合应用渗透麻醉。

Pulpal inflammation is a commonly observed disease in dental clinics. The purpose of this research projects was functionally to investigate the basic mechanisms of the pulpal inflammation with special reference to the pain, which was an important and characteristic symptom of this disease. The conclusion of each study was as follows :1. The inferior alveolar nerve-driven neurons were identified in the upper cervical spinal cord (C2 or C3). Neck muscle inputs also converged onto these neurons.2. Branched nerve fibers existed in the trigeminal nerve innervating both the deciduous tooth pulp and the following permanent one.3. Epinephrind itself had the anesthetic effects on the deciduous tooth pulp nerve fibers, caused by the anoxia in the periapical tissue.4. The strong stimuli made the pulpal nerve fibers sensitized in the early stage of the pulpal inflammation, and the myelinated fibers at first increased their activities and later generated and decreased them. While the unmyelinated fibers kept their activities even in the late stage of the inflammation. These nerve activities were involved in the characteristic pulpal pain.5. Periodontal nerve fibers showed the modified activity due to the intracanal medicament after pulpal extirpation procedures.6. Potassium Oxalate solution did not have stimulative effects on the pulp tissue when applied to the exposed dentin, and showed significant effects to improve the dentin hypersensitivity in patients.7. The referred pain seemingly caused by the pulpal and/or periodontal diseases was statistically investigated in patients. A careful anesthetic test easily revealed the causative tooth.8. The infiltrating anesthesia applying both on the buccal and lingual side of the tooth was the most effective method for the extirpation of the lower molar tooth pulp.