Shoji N
Department of Oral Diagnosis and Radiology, Tohoku University School of Dentistry, Sendai, Japan.
J Dent Res. 1996 Sep;75(9):1637-43. doi: 10.1177/00220345960750090401.
In a previous study in cats, we found that electrical stimulation of the tooth pulp caused blood flow increases at various sites in the ipsilateral oral mucosa (upper and lower gingivae, lower lip, buccal mucosa and tongue, and, notably, bilaterally in the palatal mucosa). Tooth-pulp stimulation is well-known to induce severe pain and to evoke autonomic reflex responses in other organs and tissues. The purpose of this study was: to confirm that tooth-pulp stimulation may indeed induce autonomically mediated vasodilator responses in the feline oral mucosa away from the stimulated tooth, and to test our hypothesis that the reflex pathway involves parasympathetic vasodilator fibers as efferents. Dynamic changes in palatal mucosal blood flow (PMBF), with lower lip blood flow (LBF) as a control, were investigated in anesthetized, cervically sympathectomized cats by means of Laser Doppler Flowmetry. Unilateral electrical stimulation of the maxillary canine tooth pulp produced hexamethonium-sensitive bilateral increases in PMBF in a stimulus-intensity-dependent manner, without an increase in systemic blood pressure; LBF increased only ipsilaterally. Bilateral section of the glossopharyngeal nerve roots had no effect on the vasodilator responses, while unilateral section of the facial nerve root or lesion of the pterygopalatine ganglion (PPG) abolished the response on that side. Intracranial electrical stimulation of the peripheral cut ends of the facial or glossopharyngeal nerve roots caused an increase in ipsilateral PMBF. These results indicate that unilateral tooth-pulp stimulation induces a bilateral reflex vasodilator response in the palatal mucosa mediated via parasympathetic vasodilator fibers that emerge from the brain stem with the facial nerve and reach the blood vessels via PPG. Although there is a dual innervation of the cat palatal mucosa by parasympathetic vasodilator fibers running via the facial and glossopharyngeal nerve roots, the latter are not involved in the bilateral reflex responses.
在之前一项针对猫的研究中,我们发现电刺激牙髓会导致同侧口腔黏膜不同部位(上、下牙龈、下唇、颊黏膜和舌,尤其值得注意的是,腭黏膜双侧)的血流增加。众所周知,牙髓刺激会引发剧痛,并在其他器官和组织中诱发自主反射反应。本研究的目的是:确认牙髓刺激确实可在猫口腔黏膜中远离受刺激牙齿的部位诱发自主介导的血管舒张反应,并检验我们的假设,即反射通路涉及副交感神经血管舒张纤维作为传出神经。在麻醉且经颈交感神经切除的猫身上,通过激光多普勒血流仪研究了以唇血流(LBF)为对照的腭黏膜血流(PMBF)的动态变化。对上颌尖牙髓进行单侧电刺激会以刺激强度依赖的方式产生六甲铵敏感的双侧PMBF增加,而全身血压无升高;LBF仅在同侧增加。双侧切断舌咽神经根对血管舒张反应无影响,而单侧切断面神经根或翼腭神经节(PPG)损伤则消除了该侧的反应。对面神经或舌咽神经外周切断端进行颅内电刺激会导致同侧PMBF增加。这些结果表明,单侧牙髓刺激会通过副交感神经血管舒张纤维在腭黏膜中诱发双侧反射性血管舒张反应,这些纤维从脑干与面神经一起发出,并通过PPG到达血管。尽管猫腭黏膜由通过面神经和舌咽神经根运行的副交感神经血管舒张纤维进行双重支配,但后者不参与双侧反射反应。