Electrical Tooth Stimulation Research Articles

Differential changes in gingival somatosensory sensitivity after painful electrical tooth stimulation.

We aimed to evaluate the effect of painful tooth stimulation on gingival somatosensory sensitivity of healthy volunteers in a randomized, controlled design. Thirteen healthy volunteers (six women, seven men; 28.4 ± 5.0 years) were included for two experimental sessions of electrical tooth stimulation: painful tooth stimulation and tooth stimulation below the sensory threshold (control). Eight of the human subjects participated in a third session without tooth stimulation. In all sessions, the somatosensory sensitivity of the gingiva adjacent to the stimulated tooth was evaluated with a standardized battery of quantitative sensory tests (QST) before, immediately after and 30 min after tooth stimulation. Painful tooth stimulation evoked significant decreases in warmth and heat pain thresholds (P < 0.001) as well as pressure pain thresholds (increased sensitivity) (P = 0.024) and increases in mechanical detection thresholds (decreased sensitivity) (P < 0.050). Similar thermal threshold changes (P < 0.019) but no mechanical changes were found after tooth stimulation below the sensory threshold (P > 0.086). No QST changes were detected in the session without tooth stimulation (P > 0.060). In conclusion, modest increased gingival sensitivity to warmth, painful heat and pressure stimuli as well as desensitization to non-painful mechanical stimulation were demonstrated after tooth stimulation. This suggests involvement of competing heterotopic facilitatory and inhibitory mechanisms. Furthermore, stimulation below the sensory threshold induced similar thermal sensitization suggesting the possibility of activation of axon-reflex-like mechanisms even at intensities below the perception threshold. These findings may have implications for interpretation of somatosensory results in patients with chronic intraoral pain.

Enhancement of Analgesic Effect by Combination of Non-Noxious Stimulation and Noxious Stimulation in Humans.

The aim of the this study was to investigate the combined effects of heterosegmental non-noxious and noxious stimulation on electrically induced tooth pain. The late component of somatosensory-evoked potentials (SEP), induced by electrical tooth stimulation and pain intensity, were examined under electrical stimulation to forearms. Noxious, non-noxious, and combined non-noxious and noxious electrical stimulation were applied to median nerves on the forearms. Four experimental sessions (ie, control session, combined non-noxious and noxious stimulation session, non-noxious stimulation session, and noxious stimulation session were performed for each subject at each 10-minute interval for 30minutes. The amplitudes of the SEP and VAS scores in the combined stimulation session decreased significantly compared with those in the control session and the reduction rates were 51.1% (13.4μV) and 41.0% (23.5mm), respectively. These results show that the combined stimulation has a more potent analgesic effect than that of either the non-noxious or the noxious stimulation. It is suggested that a potent analgesia was produced by an activated central mechanism, including endogenous opioid and descending pain inhibitory systems due to combined non-noxious and noxious stimulation.

Electrophysiological evidence on epileptiform activity enhanced by electrical stimulation of teeth in rats

The aim of this study was to evaluate the possible effects of electrical stimulation (ES) of tooth on penicillin-induced epileptiform activity in rats.Experiment was realized on 24 adult male Sprague Dawley rats. Rats were assigned three groups [stimulation group (SG), penicillin group (PG), and penicillin+stimulation group (PSG)]. In SG, ES was only applied. Ten pulses of electrical current were delivered to the teeth for a duration of 2 milliseconds at 1-second intervals from a stimulator. Currents were applied in the range of 40–240 μA with 40 μA steps. Electrocorticography (ECoG) recordings were taken before and after ES. In PG, ECoG recordings were taken before and during the injection of penicillin. In PSG, after epileptiform activity was induced, ES was applied and ECoG recordings were taken as in SG. All the data were analyzed with Student’s t test. Applied currents did not cause any epileptiform activity in SG. When the PSG was compared with the PG it was seen that the spike frequency of epileptiform activity increased in a statistically significant way after application of 240 μA (P < 0·05). On the other hand current application caused an increase in the spike amplitude of the PSG compared with the amplitude of the PG, but it was not statistically significant.We concluded that ES of tooth with high current can trigger epileptiform activity in rats. For this reason, further research is required to evaluate the effects of ES of tooth for pulp testing on epileptic human subjects and antiepileptic drug users.

Effects of dexmedetomidine on conditioned pain modulation in humans

Systemic administration of dexmedetomidine (DEX; selective α(2) -adrenoceptor agonist) is found to inhibit diffuse noxious inhibitory control in rats, now referred to as conditioned pain modulation (CPM) in humans. The present study was designed to investigate the effect of intravenous administration of DEX on CPM in humans. There were two sequential sessions in this double blind, randomized study. The first session was the control with normal saline infusion (N(1st), L(1st), H(1st)). During the second session, three types of agents were infused: normal saline (N(2nd)); a low plasma concentration of DEX (0.04 ng/mL; L(2nd)); and a high plasma concentration of DEX (0.08 ng/mL; H(2nd)). The amplitude of somatosensory evoked potentials (ampSEP)s and the visual analogue scale of tooth pain (VASt) induced by electrical tooth stimulation were evaluated with and without conditioning CO(2) laser stimulation of the hand. The inhibition rate (% inhibition) was calculated [= (1-[ampSEP or VASt with conditioning stimuli]/[ampSEP or VASt without conditioning stimuli]) × 100] to compare the magnitude of the DEX effects on CPM. The inhibition rates of ampSEPs and VASt in Types N, L and H varied significantly, demonstrating a dose-dependent reduction of CPM effects of ampSEP and VASt during randomized DEX administration, consistent with results from animal studies. The present study shows that systemic administration of an α(2) -adrenoceptor agonist (DEX), less than the clinical dose, inhibited CPM in humans. These results may provide some mechanistic insight into why many chronic pain patients show impaired CPM.

Tracing Toothache Intensity in the Brain

Identification of brain regions that differentially respond to pain intensity may improve our understanding of trigeminally mediated nociception. This report analyzed cortical responses to painless and painful electrical stimulation of a right human maxillary canine tooth. Functional magnetic resonance images were obtained during the application of five graded stimulus strengths, from below, at, and above the individually determined pain thresholds. Study participants reported each stimulus on a visual rating scale with respect to evoked sensation. Based on hemodynamic responses of all pooled stimuli, a cerebral network was identified that largely corresponds to the known lateral and medial nociceptive system. Further analysis of the five graded stimulus strengths revealed positive linear correlations for the anterior insula bilaterally, the contralateral (left) anterior mid-cingulate, as well as contralateral (left) pregenual cingulate cortices. Cerebral toothache intensity coding on a group level can thus be attributed to specific subregions within the cortical pain network.

Heterotopic CO2Laser Stimulation Inhibits Tooth-Related Somatosensory Evoked Potentials

The diffuse noxious inhibitory control (DNIC) effect is the neurophysiological basis for the phenomenon that heterotopic "pain inhibits pain" in remote areas of the body. The effect of DNIC is mediated by spino-bulbo-spinal loops and a final postsynaptic inhibitory mechanism. The DNIC effect depends on intensity, duration, quality, and application site of conditioning stimulation and stimulated nerve fiber-type. DNIC induced by CO(2) laser conditioning stimulation has, however, not yet been investigated, and the present study was designed to examine this. As the indicator of test stimulation, the late component of somatosensory evoked potentials (SEPs) induced by electrical tooth stimulation and pain intensity were examined under CO(2) laser conditioning stimulation. As the conditioning stimuli, CO(2) laser energy (lambda = 10.6 microm, spot size Ø = 2 mm) was applied to the dorsum of the left hand. The maximum reductions in SEP amplitude and pain intensity evaluated using a visual analog scale were 34.7% and 28.7%, respectively during CO(2) laser conditioning stimulation. No aftereffect was observed. The present study revealed that CO(2) laser radiation attenuated the late component of SEPs induced by electrical tooth stimulation, triggering the DNIC effect but with no aftereffect.

Effects of Acupuncture at Large Intestine 4 (LI 4) on Electrical Tooth Pulp Stimulation: A Randomized Controlled Pilot Study

Background: Research studies have shown acupuncture to have efficacy in the treatment of dental pain, as confirmed by the 1997 NIH Consensus Conference on Acupuncture. Objective: To determine if dry needling acupuncture at Hegu Large Intestine 4 acupoint (LI 4) can reduce the dental pulp sensory threshold produced by electrical pulp stimulation of incisor teeth. Design and Setting: A prospective, randomized placebo-controlled, single-blinded pilot study at the Universidad Mayor (university dental clinic), Santiago, Chile. Participants: A total of 40 healthy adults who had never received acupuncture, who were not receiving anticoagulant medication, nor had any incisor dental restorations. Intervention: Manual stimulation of LI 4 or sham acupuncture with a blunt needle that only touched the skin without penetrating it. Main Outcome Measures: Dental pulp sensory threshold evoked by pulp stimulation. Results: No significant differences in pain reduction were found between the volunteers who received real acupuncture and those who received the placebo intervention. Conclusion: Acupuncture performed at LI 4 did not reduce dental pulp sensory threshold.

Assessment of the Outcomes of Cerebral Blood Flow Measurements After Electrical Stimulation of Upper Right Incisor Tooth in Rabbits

The cerebral vessels are innervated by sympathetic, parasympathetic, and sensory nerves. A sensory innervation of the cerebral vessels originating in the trigeminal ganglion has been described in a number of species by several investigations. It has been shown that the electrical stimulation of the trigeminal ganglion causes an increase of cerebral cortical blood flow (CCoBF). The aim of the present study was to determine the effects of dental electrical stimulation the CCoBF in rabbits. A stimulating electrode was located in the upper right incisor tooth of rabbits and trigeminal ganglion was stimulated orthodromically via the infraorbital nerve. Variations in the cortical CCoBF were evaluated by laser-Doppler flowmetry. In experiment group, CCoBF increased together with the beginning of electrical stimulation (5 V, 0.5-ms impulse duration, square-shaped, 10-Hz frequency). The right and left hemisphere CCoBF values of stimulation period at 15s, 30s, 45s, 60s, 75s, and 90s were significantly higher than those of baseline and 105 and 120s (p < 0.05). The maximum increase in right and left CCoBF was 15.6% and 15.1% respectively. In post-stimulation period, the right CCoBF decreased gradually and returned to the baseline values at 120 s. In experiment groups, the CCoBF values of right hemisphere were comparable that of left hemisphereL (p > 0.05). This study demonstrated that the electrical stimulation of the trigeminal nerve's infraorbital branch via dental pulp increases the cortical right and left CCoBF under physiological conditions.

Diffuse noxious inhibitory controls triggered by heterotopic CO 2 laser conditioning stimulation decreased the SEP amplitudes induced by electrical tooth stimulation with different intensity at an equally inhibitory rate

The purpose of this study was to investigate (1) whether selective A δ-fiber stimulation with CO 2 laser produces a diffuse noxious inhibitory controls (DNIC) effect in the trigeminal nerve territory; and (2) whether the DNIC effect differs depending on test stimulus intensities under constant conditioning stimuli. To examine whether the CO 2 laser radiation on the dorsum of the hand selectively stimulates A δ-fibers, laser evoked potentials (LEP) were recorded. The mean peak latency of LEP was 381.4 ms. The findings revealed that the CO 2 laser selectively stimulated A δ-fibers. Electrical tooth stimuli with 3 levels of intensities (1.2, 1.4, 1.6 times the pain threshold) were applied to subjects as test stimulation in randomized order, with a CO 2 laser stimulus of 18 mJ/mm 2 applied to the dorsum of the hand for 4 min as the noxious conditioning stimulus. Somatosensory evoked potentials (SEP) induced by electrical tooth stimulation were recorded and tooth pain intensity was evaluated using a visual analogue scale (VAS). The amplitudes of the SEP late component and VAS values were significantly decreased only during the conditioning stimuli without aftereffect. The inhibitory rates of the amplitudes ranged from 31.3% to 34.6% and the VAS values from 29.0% to 31.2%. There were no significant differences in their inhibitory rates between the 3 test stimulus intensities. The result indicated that selective A δ-fiber stimulation with the CO 2 laser produces a DNIC effect in the trigeminal nerve territory and suggested that the DNIC effect does not depend on the intensity of the test stimuli.

Heterotopic ischemic pain attenuates somatosensory evoked potentials induced by electrical tooth stimulation: Diffuse noxious inhibitory controls in the trigeminal nerve territory

The purpose of this study was to determine whether the late component of somatosensory evoked potentials (SEP) induced by electrical tooth stimulation and pain intensity are inhibited by heterotopic ischemic stimulation. The tourniquet pressure with 50 mmHg greater than the individual’s systolic pressure was applied to the left upper arm for 10 min as ischemic conditioning stimulation. The late component of SEP and visual analogue scale (VAS) were recorded at 4 times and both were significantly decreased when ischemic conditioning stimulation was applied. The maximum reductions in SEP amplitude and the VAS value were 26.1% and 21.2%, respectively, during ischemic conditioning stimulation. After-effect was observed 5 min after removal of the conditioning stimulation. The present study revealed that heterotopic ischemic stimulation attenuated the late component of SEP induced by electrical tooth stimulation, triggering diffuse noxious inhibitory controls (DNIC) and after-effects in the trigeminal nerve territory. It was also suggested that the DNIC effect differs, depending on the intensity, kind, and quality of the test and conditioning stimuli.

Nitrous oxide analgesia in humans: acute and chronic tolerance

Electrical tooth stimulation was used to investigate whether humans develop tolerance to nitrous oxide (N 2O) analgesia within a single administration as well as over repeated administrations. In a double-blind cross-over experiment, 77 subjects received a 40-min administration of 38% N 2O at one session and placebo gas at the other. The sessions were separated by 1 week and the order of gas administration was counterbalanced. Acute analgesic tolerance developed for pain threshold but not for detection threshold. There was no evidence of a hyperalgesic rebound effect following cessation of the N 2O administration. In a second double-blind experiment, 64 subjects received both 30-min of placebo gas and 30-min of 35% N 2O, separated by a 35-min gas wash-out period, during each of five sessions. Sensory thresholds were assessed prior to drug or placebo administration (baseline) and between 7–12 and 25–30 min of gas administration. A control group of 16 subjects received only placebo gas at these five sessions. During a sixth session, the experimental procedures were similar to the previous sessions except that the control group received N 2O for the first time and the experimental group was sub-divided to test for conditioned drug effects. For both detection and pain threshold measures, acute tolerance developed during the initial N 2O exposure and chronic tolerance developed over repeated administrations. Although chronic tolerance developed, a test for Pavlovian drug conditioning found no evidence of conditioned effects on sensory thresholds. In conclusion, acute and chronic tolerance develop to N 2O's analgesic effects in humans.

Effect of electrical tooth stimulation on blood flow and immunocompetent cells in rat dental pulp after sympathectomy

Previous experiments show that nerves have effect on the emigration of immunocompetent cells during acute neurogenic inflammation. The present study aims to determine whether the sympathetic or sensory nerves are responsible for emigration of CD43+ and I‐A antigen‐expressing cells in the dental pulp after electrical tooth stimulation. Wistar rats were used. Experimental rats (n = 6) had the right superior cervical ganglion removed (SCGx), whereas control rats (n = 6) had sham surgery. Fourteen days later, electrical stimulation of the right maxillary 1st molar was performed in both groups for 20–25 s every 5th min for a total period of 4 h. Changes in pulpal blood flow (PBF) were recorded with a laser Doppler flowmeter. All rats were transcardiacally perfused and processed for immunohistochemistry using antibodies against neuropeptides and immune cells. Intermittent electrical stimulation consistently increased PBF and depleted sympathetic and sensory neuropeptides in the dental pulp. The increase in PBF gradually decreased and approached control values at the end of the 4 h stimulation period. A significant increase in the number of I‐A antigen‐expressing dendritic cells was found in both the SCGx (P < 0.001) and control rats (P < 0.007). In contrast, tooth stimulation did not increase the number of CD43+ cells in the SCGx rats compared to the unstimulated contralateral control molar. Significantly more CD43+ PMN cells (P < 0.01) were found in the control rats after stimulation. It is concluded that stimulation of sympathetic nerves causes recruitment of CD43+ PMN cells, whereas stimulation of sensory nerves causes emigration of I‐A antigen‐expressing dendritic cells in the dental pulp.

An experimental system for a heterotopic pain stimulation study in humans

So far heterotopic pain stimulation study has been performed in humans. Many studies have examined changes in subjective pain threshold and nociceptive somatic reflex. However, there are few studies using somatosensory evoked potentials (SEPs) for heterotopic pain stimulation study. Here we describe a new experimental system for a heterotopic pain stimulation study in humans. This system consists of three subsystems including the electrical test stimulation for teeth, the recording of SEP induced by electrical tooth stimulation and conditioning nerve stimulation. The preliminary experiment performed in eight healthy subjects indicated that the electrical test stimulation subsystem with the SEP recording subsystem is also very well indicated for subjective and objective pain evaluation, including VAS estimation and the amplitude of the SEP late component induced by electrical tooth stimulation. Under the experimental system in the present study, electrical median nerve stimulation as conditioning stimulation significantly decreased both the SEP amplitude induced by electrical tooth simulation and subjective pain expressed by the VAS. These results revealed that our experimental system works well and it is very suitable and useful for the study of the pain mechanism under heterotopic stimulation in humans.

Heterotopic painful stimulation decreases the late component of somatosensory evoked potentials induced by electrical tooth stimulation

The purpose of this study was to determine the relationship between the late component of somatosensory evoked potentials (SEP) induced by electrical tooth stimulation and subjective pain estimation when heterotopically painful stimulation was delivered to humans. The noxious electrical conditioning stimuli were applied to the left median nerve in noxious session I and the right median nerve in noxious session II for 10 min. The amplitude of the late component and visual analogue scale (VAS) value were both decreased significantly by conditioning stimuli in both sessions. The maximum decreases in SEP amplitude and VAS value induced by conditioning stimuli were respectively 40.2 and 37.2% in noxious session I and 49.3 and 42.3% in noxious session II. After-effect was observed 5 min after removal of the conditioning stimuli. The rates of decrease were thus nearly the same and independent of the site of conditioning stimulation in noxious sessions I and II. The SEP amplitude was significantly correlated with VAS values. The present study revealed that SEP amplitude and subjective pain intensity estimated by VAS following electrical tooth stimulation can be decreased by noxious stimuli to hand. This finding that heterotopic painful stimulation attenuates experimentally-induced tooth pain suggests a triggering of diffuse noxious inhibitory control (DNIC) with after-effect in trigeminal region.

Morphine‐Fluoxetine Interactions in Healthy Volunteers: Analgesia and Side Effects

The authors evaluated the ability of fluoxetine, a selective serotonin reuptake inhibitor (SSRI), to enhance the analgesic potency of morphine. Fifteen volunteers participated in this double-blind crossover study. All received combinations of morphine or saline with either fluoxetine 30 mg or placebo. The authors used individual morphine pharmacokinetics to program an infusion pump to achieve plasma morphine levels of 15, 30, and 60 ng/ml. Analgesia during morphine infusion was assessed using a model of electrical tooth stimulation. Subjective side effects, measurements of end-tidal CO2, O2 saturation, pupil size, and testing of psychomotor performance were obtained. Plasma morphine concentrations were not affected by fluoxetine. In comparison to placebo, oral fluoxetine resulted in less sedation during morphine infusion and less nausea during morphine washout. Morphine-induced pruritus, psychomotor function, and respiratory depression were unaffected by fluoxetine. Acute administration of 30 mg oral fluoxetine augmented analgesia by approximately 3% to 8% and reduced morphine-associated nausea, mood reduction, and drowsiness.

Response properties of slowly and rapidly adapting periodontal mechanosensitive neurones in the primary somatosensory cortex of the cat

Periodontal mechanosensitive neurones in the primary somatosensory (SI) cortex are classified as either slowly or rapidly adapting. The responses of cortical neurones and their projection pathways were studied using mechanical and electrical stimulation of the teeth and electrical stimulation of the thalamic posteromedial ventral (VPM) nuclei and contralateral SI cortex. A total of 247 periodontal mechanosensitive units were recorded from the SI cortex in 35 anaesthetized cats, distributed mainly in area 3b: 14% were slowly adapting and 86% rapidly adapting units; 62% of the slowly adapting and 9% of the rapidly adapting units were single-tooth units sensitive to stimulation of only one tooth. The incidence of slowly adapting units with an ipsilateral receptive field was almost equal to that of slowly adapting units with a contralateral receptive field, and more than half of the units were directionally selective to mechanical tooth stimulation. The majority of rapidly adapting units had their receptive field in the contralateral teeth and were directionally non-selective to tooth stimulation. The latencies of the cortical responses of the slowly and rapidly adapting units were 7.3 and 10.7 ms, respectively, on electrical stimulation of the contralateral teeth, and 1.8 and 2.0 ms, respectively, on electrical stimulation of the ipsilateral VPM nucleus. From these findings, it is inferred that slowly adapting neurones are useful for discriminating the tooth stimulated, the stimulus direction, the stimulus intensity and the change of pressure applied to the tooth, while rapidly adapting neurones could function to signal initial contact with food or the opposing teeth.

Effect of the sensory neuropeptide antagonists h-CGRP (8–37) and SR 140.33 on pulpal and gingival blood flow in ferrets

In a previous study, it was concluded that the neuropeptides calcitonin gene-related peptide (CGRP) and substance P are released during resting conditions in the (exposed) ferret dental pulp, contributing to a basal vasodilator tone in the pulpal vessels. In order to exclude the possibility that the method used elicited axon reflexes, which might be responsible for neuropeptide release, the present study was designed without pulp exposure. Non-invasive laser–Doppler flowmetry was used to measure the effects of intra-arterial infusions of the antagonists h-CGRP (8–37) and SR 140.33 (neurokinin 1-receptor antagonist) on pulpal and gingival blood flow before, during and after electrical tooth stimulation. Infusions of h-CGRP (8–37) reduced the basal blood flow in the pulp by 31.4±5.2% ( p<0.001) and in the gingiva by 22.6±4.8% ( p<0.05). A further significant decrease in basal blood flow was measured in both pulp and gingiva following SR 140.33 administration. The reduction in blood flow was 16.9±1.9% ( p<0.005) in the pulp and 19.3±5.6% ( p<0.05) in the gingiva. The systemic arterial pressure remained unchanged both during and after the periods of infusion. Tooth stimulation before the antagonist infusion significantly increased the pulpal blood flow by 71.9±15.3% ( p<0.005). Infusion of h-CGRP (8–37) greatly reduced this electrically induced vasodilatation, indicating that CGRP is the principal factor responsible for the vasodilatation observed after tooth stimulation. This study confirms the previous finding that a resting vasodilator tone due to the release of CGRP and SP exists in the ferret dental pulp. It is concluded that spontaneous, basal release of the neuropeptides CGRP and substance P exists both in dental pulp and gingiva in the ferret.

Effects of the NMDA receptor antagonist ketamine in electrically induced A delta-fiber pain

Both ketamine and pethidine have previously been found to have analgesic effects in experimentally induced C-fiber pain. The aim of the present study was to examine the effects of ketamine and pethidine in A delta-fiber-mediated pain induced by electrical tooth stimulation. In this double-blind crossover study, an upper right central incisor was stimulated by a Bofors electrical stimulator before and after the intravenous administration of drugs. According to a randomized protocol and with a one-week wash-out period, 9 healthy female volunteers were given either racemic ketamine 0.3 mg/kg or pethidine 0.7 mg/kg, and 11 participants were given (R)-ketamine 0.5 mg/kg or (S)-ketamine 0.15 mg/kg. Pain thresholds were registered by an amperemeter on the stimulator. Drug-induced side effects were registered by use of a standardized questionnaire and visual analog scales. Both ketamine and pethidine gave significant but short-lasting increases in pain thresholds compared to no medication. The participants reported more pronounced mental side effects after ketamine injection. A comparison of (R)- and (S)-ketamine revealed no statistical difference in the effect on pain thresholds of the two enantiomers at the present doses, but 7 out of 11 participants reported to have fewer and less pronounced side effects from (R)-ketamine than from (S)-ketamine. Ketamine and pethidine have only a marginal effect on pain thresholds in electrically induced A delta-fiber-mediated tooth pulp pain, in contrast to the analgesic effects previously found in experimental and postoperative C-fiber-mediated pain. The ketamine enantiomers at the doses used in this study showed equal analgesic properties but different side effect profiles.

The role of sensory neuropeptides and nitric oxide on pulpal blood flow and tissue pressure in the ferret.

A study was designed to investigate the effects of close intra-arterial infusion of antagonists to the sensory neuropeptides calcitonin gene-related peptide and substance P, as well as the effect of the nitric oxide synthesis inhibitor L-NAME on pulpal blood flow and interstitial fluid pressure during resting conditions and after electrical tooth stimulation. The micropuncture technique was used to measure tissue pressure and laser-Doppler flowmetry for blood flow recordings in ferret canine teeth. Close intra-arterial infusion of antagonists to calcitonin gene-related peptide and substance P significantly reduced resting blood flow (p < 0.05) and interstitial fluid pressure (p < 0.005) by unchanged systemic arterial pressure, while L-NAME administration caused a significant rise in interstitial fluid pressure (p < 0.05) and systemic arterial pressure (p < 0.005), with a concomitant fall in resting blood flow (p < 0.005). Tooth stimulation after calcitonin gene-related peptide antagonist infusion gave no significant change in blood flow or interstitial fluid pressure, whereas substance P antagonist infusion only partly eliminated the vasodilator response. L-NAME had no effect on the vasodilation induced by tooth stimulation. It is concluded that a resting vasodilator tone due to release of calcitonin gene-related peptide, substance P, and nitric oxide exists in the ferret dental pulp. The sensory neuropeptides exert their effect predominantly on pre-capillary vessels, and nitric oxide predominantly on post-capillary vessels. The sensory neuropeptide calcitonin gene-related peptide seems to be mainly responsible for the increase in blood flow and interstitial fluid pressure during tooth stimulation, whereas there was no evidence that nitric oxide participates in the vasodilation induced by tooth stimulation.

Pulp interstitial fluid pressure and blood flow after denervation and electrical tooth stimulation in the ferret

The effects of sensory and sympathetic denervation on simultaneously measured interstitial fluid pressure and blood flow in the canine pulp before, during and after electrical tooth stimulation were investigated in 25 ferrets. The micropuncture technique was used to measure interstitial fluid pressure and laser-Doppler flowmetry was used to record pulpal blood flow. Animals with an intact innervation (group 1) served as controls. Sensory denervation was by axotomy of the left inferior alveolar nerve 10 days before the experiment (group 2) and sympathectomy by removal of the left cervical ganglion 5 days before the experiments (group 3). The study was designed to verify whether denervation affected basal pulp blood flow and interstitial fluid pressures during control conditions and/or after tooth stimulation. During control conditions the interstitial fluid pressure averaged 1.32 ± 0.07 kPa in group l, whereas the mean was only 0.51 ± 0.13 kPa in the axotomized animals (group 2). The difference was highly significant, indicating decreased blood or interstitial fluid volume in the pulp after inferior alveolar nerve axotomy. In the sympathectomized group neither the interstitial fluid pressure nor the pulp blood flow was significantly different from those of group I. Electrical tooth stimulation caused an almost simultaneous increase in interstitial fluid pressure and pulp blood flow in groups I and 3, whereas stimulation did not significantly change either variable in the axotomized animals (group 2). It is concluded that a resting nervous vasodilator tone of sensory origin exists in the ferret dental pulp, and that the sensory nerves are responsible for the increased interstitial fluid pressure and pulp blood Row during tooth stimulation.