Histo: Dentin Sensitivity D1 2008

Front 1

NERVE BUNDLES ENTERING PULP INCLUDE

Back 1

1. SENSORY BRANCH OF THE TRIGEMINAL (V) NERVE
2. SYMPATHETIC BRANCHES FROM SUPERIOR CERVICAL GANGLION

Front 2

AXONS MOST FAST CONDUCTING AND ASSOCIATED W/ SHARP LOCALIZED PAIN

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MYELINATED AXONS

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AXONS ASSOCIATED W/ DULL AND MORE DIFFUSE PAIN

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UNMYELINATED AXONS

Front 4

PATH OF PULPAL NERVES AND BLOOD VESSELS ENTERING THE TOOTH

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APICAL FORAMEN

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VESSELS BEGINNING AS LARGE BUNDLE AND OCCLUSALLY TOWARD THE MARGIN OF THE PULP BECOME SMALLER

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BLOOD VESSEL

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UNMYELINATED AXONS FORM A NETWORK IN WHICH LAYER OF THE PULP

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1. PULP CELL RICH ZONE
2. CELL FREE ZONE (SUBODONTOBLASTIC PLEXUS OF RASCHKOW)

Front 7

LOCATION OF FREE AXONS EXTENTION

Back 7

1. TUBULES W/I PREDENTIN-14%
2. TUBULES OF MINERALIZED DENTIN- (8% IN PULP HORNS)
3. UNDERLYING CORONAL PULP- 2%

Front 8

LOCATION OF FREE AXONS ARE LIMITED IN DENTIN

Back 8

1. SHORT DISTANCE W/I INNER DENTIN

Front 9

LOCATION RESEARCHER HAD FAILED TO PROVIDE CONVINCING AND DIRECT EVIDENCE FOR THE PRESENT AXON IN

Back 9

1. OUTER MINERALIZED DENTIN
OR AT DENTINO-ENAMAL JUNCTION (DEJ)

Front 10

WHATABOUT ODONTOBLAST PROCESSES RESEARCH PROVIED NO DATA CONVINCING EVIDENCE IN HUMAN ERUPTED TEETH

Back 10

1. THAT THE ODONTOBLAST PROCESSES EXTEND ALL THE WAY TO THE OUTER DENTIN AND BEYOND TO DEJ

Front 11

A JUNCTIONAL COMPLEX OBSERVED B/W ADJACENT ODONTOBLASTS CELL BODIES AND PROCESSES IN HUMAN TEETH

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NUMEROUS GAP JUNCTIONS

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A JUNCTIONAL COMPLEX NOT OBSERVED BETWEEN ODONTOBASTS PROCESSES AND NEURAL ELEMENT

Back 12

GAP JUNCTION

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A JUNCTIONAL COMPLEX WHICH FACILITATE COMMUNICATION INVOLVE IN REGULATING ODONTOBLASTIC ACTIVITIES SUCH AS FORMATION OF SECONDARY DENTIN

Back 13

GAP JUNCTION

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JUNCTIONAL COMPLEX(S) FOUND B/W ODONTOBLAST OR ODONTOBLASTIC PROCESSES

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1. GAP JUNCTION
2. DESMOSOME-LIKE

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LOCATION OF ODONTOBLASTIC PROCESSES AND THEIR BRANCHES

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1. PRE-DENTIN
2. MINERALIZED DENTIN

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LOCATION OF DENTINAL TUBULES IN HUMAN TOOTH

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INNER MINERALIZED DENTIN

Front 17

REASON (S) DENTINAL FLUID EXIST OR SEEM IN DENTINAL TUBULE

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1. DRILLING PROCEDURE
2. IMPOSSIBLE ( EXPERIMENTALLY) TO COMFIRM DENTINAL FLUID EXIST IN TUBULES OF INTACT DENTIN
3. RESEACH DATA SHOW IT IS POSSIBLE FOR FLUID TO CRICULATE INTO DENTINAL TUBULES

Front 18

3 THEORIES PROPOSED TO EXPLAIN DENTIN SENSITIVITY

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1. DIRECT CONDUCTION (NEUROGENIC)
2. TRANSDUCTION
3. HYDRODYNAMIC THEORY

Front 19

A DENTIN SENSITIVITY THEORY THAT PROPOSES DENTIN HAS NERVE ENDINGS THAT RESPOND TO MECHANICAL, THERMAL OR CHEMICAL STIMULI

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DIRECT CONDUCTION THEORY (NEUROGENIC)

Front 20

EVIDENCE FOR OR AGAINST DIRECT CONDUCTION DENTIN SENSITIVITY THEORY: FREE AXONS EXIST IN PREDENTIN AND INNER DENTIN IN SMALL NUMBER

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EVIDENCE FOR DIRECT CONDUCTION THEORY

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EVIDENCE FOR OR AGAINST DIRECT CONDUCTION DENTIN SENSITIVITY: TANGENTIAL SECTIONS SHOWED THAT IN PREDENTIN AXONS SHOW BRANCHING THAT COVER A SUBSTANTIAL AREA

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EVIDENCE FOR DIRECT CONDUCTION THEORY

Front 22

EVIDENCE FOR OR AGAINST DIRECT CONDUCTION DENTIN SENSITIVITY: NUMBER OF AXONS IN DENTINAL TUBULES ARE VERY SMALL, AND AXONS ABSENT IN OUTER DENTIN AND AT THE DEJ

Back 22

EVIDENCE AGAINST

Front 23

EVIDENCE FOR OR AGAINST DIRECT CONDUCTION DENTIN SENSITIVITY: APPLICATION OF ANEASTHETICS OR PROTEIN PRECIPITATING AGENTS TO EXPOSED DENTIN SURFACE DO NOT ALLEVIATE THE PAIN

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EVIDENCE AGAINST

Front 24

A DENTIN SENSITIVITY THEORY PROPOSED THAT ODONTOBLASTS ACT AS RECEPTORS AND TRANSMITS STIMULI TO EFFERENT AXON IN THE PULP (SUBODONTOBLASTIC PLEXUS OF RASCHKOW)

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TRANSDUCTION THEORY

Front 25

EVIDENCE FOR OR AGAINST DENTIN SENSITIVITY THEORY: ODONTOBLASTS ARE EMBRYOLOGICALLY DERIVED FROM MIGRATING NEURAL CREST CELLS AND SO MANY RETAIN THE ABILITY TO CONDUCT IMPULSES

Back 25

EVIDENCE FOR

Front 26

EVIDENCE FOR OR AGAINST DENTIN SENSITIVITY TRANSDUCTION THEORY: ODONTOBLASTIC PROCESSES ARE ABSENT IN OUTER DENTIN AND AT DEJ

Back 26

EVIDENCE AGAINST

Front 27

EVIDENCE FOR OR AGAINST DENTIN SENSITIVITY TRANSDUCTION THEORY: NO SYNAPTIC CONNECTIONS OR GAP JUNCTIONS ARE OBSERVED B/W ODONTOBLASTS AND PULPAL NEURAL ELEMENT

Back 27

EVIDENCE AGAINST

Front 28

EVIDENCE FOR OR AGAINST DENTIN SENSITIVITY TRANSDUCTION THEORY: APPLICATION OF PROTEIN PRECIPITATING AGENTS TO EXPOSED DENTIN DOES NOT ABOLISH THE PAIN

Back 28

EVIDENCE AGAINST

Front 29

EVIDENCE FOR OR AGAINST DENTIN SENSITIVITY TRANSDUCTION THEORY: MEMBRANE POTENTIAL OF ODONTOBLASTS AS MEASURED IN VITRO BY PHYSIOLOGISTS IS TOO LOW TO PROVIDE TRANSDUCTION

Back 29

EVIDENCE AGAINST

Front 30

A DENTIN SENSITIVITY THEORY PROPOSED THAT STIMULI CAUSES MOVEMENTS OF DENTINAL FLUID WHICH ARE PERCEIVED BY FREE NERVE ENDINGS ASSOCIATED W/ THE ODONTOBLASTS

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DENTIN SENSITIVITY HYDRODYNAMIC THEORY

Front 31

EVIDENCE FOR OR AGANIST DENTIN SENSITVITY HYDRODYNAMIC THEORY: DOES NOT REQUIRE THE PRESENCE OF FREE NERVE ENDINGS NOR ODONTOBLASTIC PROCESSES IN THE OUTER DENTIN OR AT THE DEJ WHICH IS CLINICALLY OBSERVED TO BE A HIGHLY SENSITIVE AREA

Back 31

EVIDENCE FOR

Front 32

EVIDENCE FOR OR AGANIST DENTIN SENSITVITY HYDRODYNAMIC THEORY: DENTINAL FLUID MOVEMENT HAS BEEN EXPERIMENTLY SHOWN TO OCCUR IN RESPONSE TO STIMULI SUCH AS HEAT OR COLD

Back 32

EVIDENCE FOR

Front 33

EVIDENCE FOR OR AGANIST DENTIN SENSITVITY HYDRODYNAMIC THEORY: DURING CERTAIN CLINICAL PLROCEDURES MOVEMENT OF ODONTOBLAST NUCLEI INTO PROXIMAL ENDS (ASPIRATION) WAS SHOWN TO OCCUR

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EVIDENCE FOR

Front 34

EVIDENCE FOR OR AGANIST DENTIN SENSITVITY HYDRODYNAMIC THEORY: THEORY ASSUMES THAT DENTINAL TUBULES ARE OPEN ALL THE WAY TO THE DEJ, WHICH MAY NOT BE THE CASE

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EVIDENCE FOR

Front 35

EVIDENCE FOR OR AGANIST DENTIN SENSITVITY HYDRODYNAMIC THEORY: DOES NOT REQUIRE THE PRESENCE OF FREE NERVE ENDINGS NOR ODONTOBLASTIC PROCESSES IN THE OUTER DENTIN OR AT THE DEJ WHICH IS CLINICALLY OBSERVED TO BE A HIGHLY SENSITIVE AREA

Back 35

EVIDENCE FOR

Front 36

EVIDENCE FOR OR AGANIST DENTIN SENSITVITY HYDRODYNAMIC THEORY: DENTINAL FLUID MOVEMENT HAS BEEN EXPERIMENTLY SHOWN TO OCCUR IN RESPONSE TO STIMULI SUCH AS HEAT OR COLD

Back 36

EVIDENCE FOR

Front 37

EVIDENCE FOR OR AGANIST DENTIN SENSITVITY HYDRODYNAMIC THEORY: DURING CERTAIN CLINICAL PLROCEDURES MOVEMENT OF ODONTOBLAST NUCLEI INTO PROXIMAL ENDS (ASPIRATION) WAS SHOWN TO OCCUR

Back 37

EVIDENCE FOR

Front 38

EVIDENCE FOR OR AGANIST DENTIN SENSITVITY HYDRODYNAMIC THEORY: THEORY ASSUMES THAT DENTINAL TUBULES ARE OPEN ALL THE WAY TO THE DEJ, WHICH MAY NOT BE THE CASE

Back 38

EVIDENCE FOR

Front 39

EVIDENCE FOR OR AGANIST DENTIN SENSITVITY HYDRODYNAMIC THEORY: IT IS UNLIKELY THAT A THERMAL STIMULUS CAN ILLICIT AN IMPULSE THROUGH CONDUCTION AND CONVENTION OF DENTINAL FLUID THAT CAN BE TRANSMITTED AT A SPEED AS FAST AS 50 MILLISECOND

Back 39

EVIDENCE AGAINST

Front 40

A DENTIN SENSITIVITY THEORY WHICH PROVIDE A MOST PLAUSIBLE EXPLANATION AND MOST ACCEPTABLE ONE

Back 40

HYDRODYNAMIC THEORY