Histopathologic study of the effect of pulpal disease upon nerve fibers of the human dental pulp

England, Marshall C.; Pellis, Edward G.; Michanowicz, Andrew E.

doi:10.1016/0030-4220(74)90401-0

Cited by 18 publications

(9 citation statements)

References 8 publications

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“…Because nerve fibres of the pulp are relatively resistant to necrosis and will be the last part of the pulp to die (Mullaney et al. 1970, England et al. 1974), the necrotic pulp may continue to respond to stimulation for some time (Fuss et al.…”

Section: Interpretation Of Test Results When Making a Diagnosismentioning

confidence: 99%

“…Although it is not possible to determine the histopathological status of the pulp on the basis of the pulp sensibility tests alone (Reynolds 1966, Lundy & Stanley 1969, there is a significant relationship between the lack of response to these tests and pulp necrosis (Marshall 1979, Seltzer & Bender 1984. Because nerve fibres of the pulp are relatively resistant to necrosis and will be the last part of the pulp to die (Mullaney et al 1970, England et al 1974, the necrotic pulp may continue to respond to stimulation for some time (Fuss et al 1986). However, essentially no response will be obtained with EPTs and thermal tests from teeth with pulp necrosis.…”

Section: Pulp Necrosismentioning

confidence: 99%

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Review of pulp sensibility tests. Part I: general information and thermal tests

2010

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A major, and essential, part of the diagnostic process for pulp disease is the use of pulp sensibility tests. When diagnosing pulp pain, these tests can be used to reproduce the symptoms reported by the patient to diagnose the diseased tooth as well as the disease state. However, a major shortcoming with these tests is that they only indirectly provide an indication of the state of the pulp by measuring a neural response rather than the vascular supply, so both false positive and false negative results can occur. The relevant literature on pulp sensibility tests in the context of endodontics up to January 2009 was reviewed using PubMed and MEDLINE database searches. This search identified papers published between November 1964 and January 2009 in all languages. Thermal tests have been used as an integral part of dental examinations. Two types of thermal tests are available, one uses a cold stimulus and the other uses a hot stimulus, and each has various methods of delivery. If these tests are used properly, injury to the pulp is highly unlikely. A review of the literature regarding the rationale, indications, limitations, and interpretation of thermal tests, the value of these diagnostic tests, as well as a discussion of the important points about each of these tests is presented.

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Section: Interpretation Of Test Results When Making a Diagnosismentioning

confidence: 99%

Section: Pulp Necrosismentioning

confidence: 99%

Review of pulp sensibility tests. Part I: general information and thermal tests

2010

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“…Byers et al (1987) noted a withdrawal of vital axons labeled by axonal transport from areas of acute inflammation. Other studies using light microscopy (England et al, 1974) and electron microscopy (Torneck, 1977;Mendoza et al, 1987) concluded that pulpal nerves remain intact within areas of inflammation. In the present study, there appeared to be two simultaneous, though not necessarily equal, influences at work in the inflamed rat molar; one primarily of degeneration and the other of regeneration.…”

Section: Discussionmentioning

confidence: 99%

“…Also, much is known about dental inflammation in general, even though correlations between dental pain and particular pathological conditions are still difficult (Tyldesley and Mumford, 1970;Brannstrom, 1981;Trowbridge, 1985). There have been a few studies of dental nerve reactions to inflammation, showing resistance in some cases (England et al, 1974;Torneck, 1977) and retraction away from inflammatory sites in others . Finally, CGRP immunocytochemistry so far works better in perfused animal teeth such as the rat molar than in extracted human teeth (Uddman et al, 1986;Silverman and Kruger, 1987).…”

mentioning

confidence: 99%

Inflammation of rat molar pulp and periodontium causes increased calcitonin gene‐related peptide and axonal sprouting

1988

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We have studied the response of nerve fibers containing calcitonin gene-related peptide immunoreactivity (CGRP-IR) to inflammation using a rate dental experimental system. Inflammation was induced by drilling tooth cusps to create pulpal exposures; the induced pulpitis and subsequent periapical lesions were studied 1-35 days later using standard CGRP immunohistochemistry and the avidin-biotin peroxidase method. The injury and resulting inflammation caused a disruption of CGRP-IR nerve fiber location and arborization that varied depending on whether the initial injury was limited to the pulp tip or extended throughout the pulp horn. At shorter survival periods (24 hr, 3 days) nerve fibers were either decreased or bundled into the center of the pulp with sprouting along the wound border. At 6 days necrosis and acute inflammation had advanced to varying degrees, and CGRP-IR fibers were extensively sprouted in the surviving pulp; the pulp also stained specifically for CGRP within 1-2 mm of the inflamed tissue at 6 days. At 35 days, we found total pulp necrosis in most teeth and the development of periapical bone loss, granulomatous tissue, and periapical abscesses. There was also an extensive increase in CGRP-IR nerve fibers in the tissues surrounding sites of severe periodontal inflammation and necrosis. In some cases, macrophage-like cells staining specifically for CGRP were near the abscesses. The results show important interactions between peptidergic nerve fibers and inflammatory cells, and are discussed in terms of the role of nerve fibers containing CGRP in neurogenic inflammation, mechanisms for intensification of CGRP immunoreactivity in affected fibers or neighboring cells, and implications for chronic inflammatory conditions, dental pain, and anesthesia.

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“…The persistence of components of nervous elements was not surprising. Other studies have also reported nerves in traumatized (1), infiamed or necrotic pulps (15,16); however, these were light and not electron microscopic examinations. In the present study there were few nervous elements as seen in the light microscope.…”

Section: Puipal Ischemic Infarctmentioning

confidence: 95%

The ischemic infarct pulp of traumatized teeth: A light and electron microscopic study

Cipriano

Walton

1986

Dental Traumatology

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Extirpated pulps from 42 traumatized, asymptomatic teeth with no history of periapical pathosis, pulp exposure, or responsiveness to pulp tests were examined by light microscopic techniques. Only 5 pulps demonstrated infarcts; these were further evaluated with the transmission electron microscope. Eight microscopically, as compared lo the normal controls, the pulp tissue of the so‐called ischemic infarct was markedly altered. Some areas showed inflammation and altered nuclei, but with no discernible neural elements, and with less collagen. The electron microscopic samples showed evidence of necrosis, pal‐terns of nuclear degradation, relative avascularity, degenerating neural elements, and disorganized collagen. It was concluded that the ischemic in fan; l phenomenon in the traumatized pulp docs occur occasionally, but presents a variety of structural alterations indicating degeneration.

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Histopathologic study of the effect of pulpal disease upon nerve fibers of the human dental pulp

Cited by 18 publications

References 8 publications

Review of pulp sensibility tests. Part I: general information and thermal tests

Review of pulp sensibility tests. Part I: general information and thermal tests

Inflammation of rat molar pulp and periodontium causes increased calcitonin gene‐related peptide and axonal sprouting

The ischemic infarct pulp of traumatized teeth: A light and electron microscopic study

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