Sessle B J
J Dent Res. 1987 May;66(5):962-81. doi: 10.1177/00220345870660052201.
This review outlines recent research which has identified critical neural elements and mechanisms concerned with the transmission of sensory information related to oral-facial pain, and which has also revealed some of the pathways and processes by which pain transmission can be modulated. The review highlights recent advances in neurobiological research that have contributed to our understanding of pain, how acute and chronic pain conditions can develop, and how pain can be controlled therapeutically. Each section of the review also identifies gaps in knowledge that still exist as well as research approaches that might be taken to clarify even further the mechanisms underlying acute and chronic oral-facial pain. The properties of the sense organs responding to a noxious oral-facial stimulus are first considered. This section is followed by a review of the sensory pathways and mechanisms by which the sensory information is relayed in nociceptive neurones in the brainstem and then transmitted to local reflex centers and to higher brain centers involved in the various aspects of the pain experience--namely, the sensory-discriminative, affective (emotional), cognitive, and motivational dimensions of pain. Reflex and behavioral responses to noxious oral-facial stimuli are also considered. The next section provides an extensive review of how these responses and the activity of the nociceptive neurones are modulated by higher brain center influences and by stimulation of, or alterations (e.g., by trauma) to, other sensory inputs to the brain. The neurochemical processes, involved in these modulatory mechanisms are also considered, with special emphasis on the role of neuropeptides and other neurochemicals recently shown to be involved in pain transmission and its control. The final section deals with recent findings of peripheral and central neural mechanisms underlying pain from the dental pulp.
本综述概述了近期的研究，这些研究确定了与口腔面部疼痛相关的感觉信息传递所涉及的关键神经元件和机制，还揭示了疼痛传递可被调节的一些途径和过程。该综述突出了神经生物学研究的最新进展，这些进展有助于我们理解疼痛、急慢性疼痛状况如何发展以及疼痛如何通过治疗得到控制。综述的每个部分还指出了仍然存在的知识空白以及为进一步阐明急慢性口腔面部疼痛潜在机制可能采用的研究方法。首先考虑对有害口腔面部刺激作出反应的感觉器官的特性。接着这一部分，综述了感觉信息在脑干伤害性神经元中中继，然后传递到局部反射中枢以及参与疼痛体验各个方面的更高脑中枢（即疼痛的感觉辨别、情感（情绪）认知和动机维度）的感觉途径和机制。还考虑了对有害口腔面部刺激的反射和行为反应。下一部分广泛综述了这些反应和伤害性神经元的活动如何受到更高脑中枢影响以及对大脑其他感觉输入的刺激或改变（例如创伤）的调节。还考虑了这些调节机制中涉及的神经化学过程，特别强调了最近显示参与疼痛传递及其控制的神经肽和其他神经化学物质的作用。最后一部分论述了牙髓疼痛潜在的外周和中枢神经机制的最新发现。
