Khan Asma A, Owatz Christopher B, Schindler William G, Schwartz Scott A, Keiser Karl, Hargreaves Kenneth M
Department of Endodontics, University of Texas Health Science Center, San Antonio, Texas, USA.
J Endod. 2007 Jul;33(7):796-9. doi: 10.1016/j.joen.2007.01.021. Epub 2007 Mar 26.
An essential feature of symptomatic periradicular inflammation is mechanical allodynia, defined as reduced mechanical pain thresholds. A previous study evaluating a new digital force transducer showed that it reliably measures mechanical pain thresholds of teeth with normal periradicular tissues. In this study, we tested the hypothesis that the force transducer quantitatively measures mechanical allodynia in teeth with acute periradicular periodontitis (APP) and detects the effects of local anesthetic injection. Mechanical pain thresholds were measured in patients (n = 30) with irreversible pulpitis (IP) and APP and compared with their contralateral teeth. The results show that the mechanical pain thresholds of teeth with IP and APP were reduced by 77% compared with contralateral control teeth. The administration of local anesthesia reversed the mechanical allodynia by 62%, and significant sex-specific effects were observed. In addition, the normal teeth contralateral to the symptomatic teeth had lower mechanical thresholds than those observed in healthy volunteers, suggesting that central sensitization occurs during this type of odontalgia. Thus, we show that the mechanical pain thresholds are significantly reduced in teeth with IP and APP and that the force transducer has potential application as a diagnostic aid in measuring mechanical allodynia and as an outcome measure in endodontic clinical trials such as pharmacologic studies and mechanistic research.
症状性根尖周炎症的一个基本特征是机械性痛觉过敏，其定义为机械性疼痛阈值降低。先前一项评估新型数字力传感器的研究表明，它能够可靠地测量根尖周组织正常牙齿的机械性疼痛阈值。在本研究中，我们检验了以下假设：该力传感器可定量测量患有急性根尖周炎（APP）牙齿的机械性痛觉过敏，并检测局部麻醉注射的效果。对患有不可逆性牙髓炎（IP）和APP的患者（n = 30）进行机械性疼痛阈值测量，并与其对侧牙齿进行比较。结果显示，与对侧对照牙齿相比，患有IP和APP的牙齿的机械性疼痛阈值降低了77%。局部麻醉使机械性痛觉过敏逆转了62%，并观察到显著的性别特异性效应。此外，有症状牙齿对侧的正常牙齿的机械阈值低于健康志愿者，这表明在这种类型的牙痛期间会发生中枢敏化。因此，我们表明，患有IP和APP的牙齿的机械性疼痛阈值显著降低，并且该力传感器在测量机械性痛觉过敏方面有作为诊断辅助工具的潜在应用，以及在牙髓病临床试验如药理学研究和机制研究中作为结果测量指标的潜在应用。
