Jaw depression elicited by tooth pulp stimulation

Effect of local administration of eicosapentaenoic acid on the jaw-opening reflex in rats

Although eicosapentaenoic acid (EPA) application in vitro inhibits voltage-gated Na⁺ (Nav) channels in excitable tissues, the acute local effect of EPA on the jaw-opening reflex in vivo remains unknown. The aim of the present study was to determine whether local administration of EPA to adult male Wistar rats could attenuate the excitability of the jaw-opening reflex in vivo, including nociception. The jaw-opening reflex evoked by electrical stimulation of the tongue was recorded by a digastric muscle electromyogram (dEMG) in pentobarbital-anesthetized rats. The amplitude of the dEMG response was significantly increased in proportion to the electrical stimulation intensity (1×-5× threshold). At 3×, local administration of EPA dose-dependently inhibited the dEMG response, lasting 60 min, with maximum inhibition observed within approximately 10 min. The mean magnitude of dEMG signal inhibition by EPA was almost equal to that observed with a local anesthetic, 1% lidocaine, and with a half dose of lidocaine plus a half dose of EPA. These findings suggest that EPA attenuates the jaw-opening reflex, possibly by blocking Nav channels of primary nerve terminals, and strongly support the idea that EPA is a potential therapeutic agent and complementary alternative medicine for the prevention of acute trigeminal nociception.

Systemic administration of the dietary constituent resveratrol inhibits the nociceptive jaw-opening reflex in rats via the endogenous opioid system

The aim of the present study was to investigate whether, under in vivo conditions, systemic administration of resveratrol could attenuate the rat nociceptive jaw-opening reflex (JOR) via the endogenous opioid system. The JOR evoked by electrical stimulation of the tongue was recorded as digastric muscle electromyograms (dEMG) in pentobarbital-anesthetized rats. The amplitude of the dEMG increased significantly in proportion to the intensity of electrical stimulation (from 1× to 5 × threshold for the JOR). dEMG amplitude in response to 3× threshold electrical stimulation of the tongue was dose-dependently inhibited by intravenous administration of resveratrol (0.5-2mg/kg). Maximum inhibition of dEMG amplitude was seen within approximately 10min. These inhibitory effects were reversible, with dEMG responses returning to control levels after approximately 20min. Pretreatment of rats with naloxone resulted in significant, dose-dependent attenuation of the inhibitory effects of resveratrol on dEMG amplitude compared with control. These findings suggest that resveratrol inhibits the nociceptive JOR via the endogenous opioid system. Further, the findings of the present study strongly support the idea that resveratrol, which is not known to have any toxic side effects, combined with an opioid could be a potential therapeutic agent for the prevention of acute trigeminal nociception.

Management of Edentulous Orofacial Dyskinesia

Edentulous orofacial dyskinesia is a rare condition, characterized by involuntary rhythmic movements of the mandible and presents an embarrassing situation for the patient. Edentulism has been considered as one of the proponents of these irregular movements, and rehabilitation of these patients with complete denture-fabrication using traditional technique restores the masticatory inefficiency and the esthetic component of the patient. Surprisingly, these movements disappear during the clinical steps of complete denture-fabrication and upon insertion of the dentures. Disturbances in the proprioception following loss of tooth may be a contributory factor for edentulous dyskinesia.

Study of the neural basis of striatal modulation of the jaw-opening reflex

Previous experimental data from this laboratory demonstrated the participation of the striatum and dopaminergic pathways in central nociceptive processing. The objective of this study was to examine the possible pathways and neural structures associated with the analgesic action of the striatum. The experiments were carried out in rats anesthetized with urethane. The jaw-opening reflex (JOR) was evoked by electrical stimulation of the tooth pulp of lower incisors and recorded in the anterior belly of the digastric muscles. Intrastriatal microinjection of apomorphine, a nonspecific dopamine agonist, reduced or abolished the JOR amplitude. Electrolytic or kainic acid lesions, unilateral to the apomorphine-injected striatum, of the globus pallidus, substantia nigra pars reticulata, subthalamic nucleus and bilateral lesion the rostroventromedial medulla (RVM), blocked the inhibition of the JOR by striatal stimulation. These findings suggest that the main output nuclei of the striatum and the RVM may be critical elements in the neural pathways mediating the inhibition of the reflex response, evoked in jaw muscles by noxious stimulation of dental pulp.

Reduction of excessive electrical stimulus during electric pulp testing

AIM

To measure excessive electrical stimulus time during pulp testing via electromyography (EMG) in the anterior belly of the digastric muscle, voice and finger movement, and to determine whether excessive stimulus time could be attenuated by a specially designed automatic circuit breaker on the basis of the EMG signal.

METHODOLOGY

The signals from three human responses (EMG, finger and voice), induced by the Digitest (Parkell Inc., Farmingdale, NY, USA) electric pulp tester, were captured using a MP100 (Biopac System Inc., Goleta, CA, USA) and recorded into a personal computer. The excessive stimulus time from activation to the end of electrical stimulation was calculated for each of these three responses. The automatic circuit breaker was designed to disconnect the electrical output of the electric pulp testing (EPT) unit immediately after detecting the preset EMG level (100 mV). Each of the right central incisors and first premolars of 23 healthy individuals (16 males and seven females) was tested to see whether there was a difference in tooth type or gender. This was analysed by Wilcoxon signed rank test (nonparametric paired t-test) and Mann-Whitney test (nonparametric independent t-test), respectively.

RESULTS

Amongst three human responses, the electrical onset occurred in the order of EMG, finger and voice. Excessive stimulus time was 347.8 +/- 78.3 ms when observed by the EMG, 264.9 +/- 63.9 ms when observed by finger span and 229.4 +/- 41.8 ms when observed by the voice, which were all found to be significantly different (P < 0.05). When the automatic circuit breaker was used, the excessive stimulus time was 61.0 ms, which was 286.8 ms shorter than that measured from EMG onset when using the conventional EPT.

CONCLUSIONS

When the automatic circuit breaker was used, excessive stimulus time on the basis of EMG was attenuated on average by 286.8 ms.

Automatic stimulus breaker for electric dental pulp tester using pain response

The pulp test provides a means of examining the vitality of dental pulp using physical or chemical stimulation. During electrical pulp testing, an electrical current stimulates the intradental nerve, which may be painful and stressful to patients. The study involved measurement of the electromyogram (EMG) from the anterior belly of the digastric muscle, finger movement and voice response during electrical pulp testing. The excessive stimulus time from the onset time of response (EMG, voice and finger movement) to the end of the stimulation was obtained. The results indicated that the responses occurred in the order: EMG, finger and voice. Based on these results, an automatic stimulus shut-off circuit was developed using the above-mentioned responses to stimulus during electric pulp testing. Excessive stimulus time was reduced by prompt switching-off of the pulp tester output, 64 ms on average after the first detected response (EMG). Consequently, excessive stimulus times were reduced by 284 and 152 ms on average for the subject and examiner disconnection, respectively, using the developed automatic shut-off circuit. Therefore it was possible to minimise pain and stress by reducing excessive pulp stimulation.

Striatal Inhibition of Nociceptive Responses Evoked in Trigeminal Sensory Neurons by Tooth Pulp Stimulation

The noxious evoked response in trigeminal sensory neurons was studied to address the role of striatum in the control of nociceptive inputs. In urethane-anesthetized rats, the jaw opening reflex (JOR) was produced by suprathreshold stimulation of the tooth pulp and measured as electromyographic response in the digastric muscle, with simultaneous recording of noxious responses in single unit neurons of the spinal trigeminal nucleus pars caudalis (Sp5c). The microinjection of glutamate (80 ηmol/0.5 μl) into striatal JOR inhibitory sites significantly decreased the Aδ and C fiber–mediated–evoked response (53 ± 4.2 and 43.6 ± 6.4% of control value, P < 0.0001) in 92% (31/34) of nociceptive Sp5c neurons. The microinjection of the solvent was ineffective, as was microinjection of glutamate in sites out of the JOR inhibitory ones. In another series of experiments, simultaneous single unit recordings were performed in the motor trigeminal nucleus (Mo5) and the Sp5c nucleus. Microinjection of glutamate decreased the noxious-evoked response in Sp5c and Mo5 neurons in parallel with the JOR, without modifying spontaneous neuronal activity of trigeminal motoneurons ( n = 8 pairs). These results indicate that the striatum could be involved in the modulation of nociceptive inputs and confirm the role of the basal ganglia in the processing of nociceptive information.

Use of noninvasive dental dolorimetry to evaluate analgesic effects of intravenous and intrathecal administration of morphine in anesthetized dogs

OBJECTIVE

To determine whether changes in amplitude of the reflex-evoked muscle action potential (REMP) elicited by noninvasive dental dolorimetry (electrical stimulation of the tooth pulp) in anesthetized dogs may be used to objectively evaluate the effectiveness of IV and intrathecal (IT) administration of morphine.

ANIMALS

6 male Beagles that were 2 to 6 years old.

PROCEDURE

Dogs were used in a crossover design with at least a 5-day washout period between treatments. Each dog received morphine, saline (0.9% NaCl) solution, and oxytocin via the IV and IT routes of administration; however, only results for morphine and saline treatments were reported here. Dogs were anesthetized and prepared for noninvasive dental dolorimetry. After IV or IT administration, electrical stimulation was applied to a tooth, and REMPs of the digastricus muscle were recorded at 5-minute intervals for 60 minutes. To determine differences in REMP amplitude between treatments, a linear regression line was fitted for each dog-treatment combination.

RESULTS

The IV administration of morphine significantly inhibited REMP amplitude, compared with IV administration of saline solution. Intrathecal administration of morphine significantly inhibited REMP amplitude, compared with IT administration of saline solution.

CONCLUSIONS AND CLINICAL RELEVANCE

Noninvasive dental dolorimetry in anesthetized dogs has promise as a technique for use in evaluating the analgesic potential of drugs administered IV and IT through evaluation of their effect on REMP amplitude recorded for the digastricus muscle.

Striatal modulation of the jaw opening reflex

The effect of striatal electrical and chemical conditioning stimulation (L-glutamate 80-160 nmoles/0.5 microl) on the jaw opening reflex (JOR) was studied in Sprague-Dawley male rats anesthetized with urethane. The JOR was evoked by stimulation of the tooth pulp of lower incisors. This response was suppressed by transection of the dental root, which indicates according with the bibliography, a specific activation of the pulp nerves. Three type of responses were obtained on the evoked JOR by conditioning stimulation of the striatum; being the main one the suppression of the reflex elicited by tooth pulp activation. A second type of response was an increase of the tooth-JOR amplitude. This effect was observed more frequently with glutamate stimulation rather than with electrical activation of the striatum. A third response was observed with chemical stimulation but not by electrical stimulation of the striatum. This was a triphasic response which consisted in an increase followed by an inhibition and a late increase of the tooth-JOR amplitude. A biphasic effect, an increase prior to a decrease of the JOR amplitude, was also recorded with a minor frequency. The distribution of effective sites for electrical and chemical stimulation within the striatum are mainly similar located in the rostral aspect of the nucleus, with the inhibitory sites in the middle of the nucleus and intermingled with the excitatory ones. The complex responses (tri/biphasic) were observed ventrally and caudally in the nucleus. On the basis of the results mentioned above, one could assume that the striatum is related to the modulation of the JOR evoked probably by nociceptive stimulation. However, activation of other type of fibers could not be ruled out.

Fos expression in the ferret trigeminal nuclear complex following tooth pulp stimulation

The aim of this study was to establish which regions of the trigeminal nucleus are activated by tooth pulp stimulation in the normal ferret. The distribution of Fos-like immunoreactivity was examined following electrical stimulation of the tooth pulp in the awake and anaesthetized ferret. Stimulus-specific labelling was found in subnuclei caudalis and oralis of the trigeminal spinal nucleus. Three groups of chronically prepared animals; conscious, anaesthetized (alphaxolone/alphadolone) and anaesthetized-paralysed (alphaxolone/alphadolone with gallamine triethiodide), received electrical stimuli to both the upper and lower left canine teeth (1 Hz train of 3 x 0.5 ms at 200 Hz) at an amplitude of 10 times the threshold of the jaw opening reflex. Three control groups were treated identically except no stimulus was given. In stimulated anaesthetized and anaesthetized-paralysed animals, Fos-positive profiles were seen in laminae I and II of subnucleus caudalis and in the medial part of subnucleus oralis. There was no labelling evident in subnucleus interpolaris or the main sensory nucleus, or contralaterally in any of the subnuclei. In all conscious stimulated animals there was additional bilateral Fos-positive labelling, mainly in the deeper laminae of subnucleus caudalis. This bilateral labelling was not stimulus-specific as it was also seen in conscious non-stimulated animals. After correction for this bilateral labelling no significant difference was found between conscious, anaesthetized and anaesthetized-paralysed groups of stimulated animals or between the different groups of control animals. These results support the concept that the rostral parts of the trigeminal spinal nucleus are involved in processing of nociceptive input. They also demonstrate that light alphaxolone/alphadolone anaesthesia has no effect on stimulus-specific Fos expression following tooth pulp stimulation. The second aim of this study was to develop a clearly defined model for future studies in which Fos expression is no different to that seen in the conscious state. As in the conscious animal, labelling not associated with the stimulus is difficult to distinguish from stimulus specific labelling, further studies using this model of trigeminal nociceptive pathways would be best carried out in lightly anaesthetized animals.

Comparison of jaw-opening reflex response elicited by anterior and posterior tooth tapping in the cat

The response elicited by various levels of controlled mechanical stimuli to maxillary teeth was studied in 8 adult cats anaesthetized with alpha-chloralose. When an anterior tooth was tapped, short (4-6 ms) and long (16-20 ms) latency responses were recorded from the mylohyoid nerve. On the other hand, when a posterior tooth was tap-stimulated, only the long-latency response was induced. The effects of ether narcosis on the responses were studied. As the short-latency response was induced only by anterior tooth tapping and its amplitude increased according to increases in stimulus intensity, the response may be related to the protection of the mouth from entrance of harmful materials. The long-latency response was induced by light tapping on both anterior and posterior teeth and its amplitude increased according to increases in stimulus intensity to the posterior teeth rather than the anterior teeth. As it was readily inhibited by ether, the long-latency response may have a reflex centre in an area like the brain stem reticular formation which is particularly sensitive to ether and may be related to the regulation of jaw movement in mastication.

The nociceptive jaw-opening reflex: evidence for alpha 2 adrenoceptor involvement

The ability of alpha adrenoceptor agonists to modulate the tooth pulp stimulation evoked (TPS) jaw-opening reflex (JOR) was investigated in rats and rabbits. Low doses of clonidine (6.25-50 micrograms/kg, IV) significantly increased dEMG thresholds. These effects were antagonized by alpha 2 adrenoceptor antagonists (e.g., yohimbine), but not by alpha 1 adrenoceptor antagonists (e.g., prazosin) or mu receptor antagonists (e.g., naloxone). Polar alpha 2 adrenoceptor agonists (e.g., ST-91 and 4-hydroxyclonidine) that cross the blood brain barrier (BBB) poorly and lipophilic alpha 1 adrenoceptor agonists (e.g., ST-587) that cross the BBB easily were without affect on the TPS-JOR. Structures of the peripheral efferent neurocircuitry of the JOR (e.g., the digastric muscle and the neuromuscular junction of the digastric muscle and its motor nerve, the mylohyoid) were shown not to be active sites of clonidine's effect on the TPS-JOR. Treatment with phentolamine (an alpha adrenoceptor antagonist that poorly crosses the BBB) completely poorly crosses the BBB) completely antagonized clonidine's initial transient cardiovascular (pressor) effect without altering its TPS-JOR effects. Pretreatment with reserpine (a catecholamine depleting agent) failed to alter clonidine's affects on the TPS-JOR. Our studies suggest that alpha 2 adrenoceptors potently modulate the TPS-JOR and such modulation may be important in understanding trigeminal neuronal circuitries that partake in pain processing.

Inhibition of the nociceptive jaw opening reflex by the lateral reticular nucleus (LRN) in the rabbit

The effect of stimulation of the lateral reticular nucleus (LRN) on the jaw opening reflex (JOR), evoked by tooth pulp or by palatal tissue stimulation, was studied in anesthetized rabbits. The results show an inhibitory effect on the JOR evoked by tooth pulp stimulation, which is considered a nociceptive reflex, while no effect is shown on the JOR evoked by palatal tissue stimulation. The maximum effect was observed at intervals of 30-50 ms between the two stimuli and the more effective site of inhibition in the nucleus was found to be the ventrolateral portion. The result of a selective effect of LRN stimulation on nociceptive reflexes supports the view of a role of this nucleus in the central mechanisms of pain control.

Cortical cells driven by the low-threshold tooth pulpal afferent in cats

The input pattern and spatial distribution of tooth pulp-driven neurons (TPNs) in the cat cortex were studied by recording the unitary activities of these neurons. Stimulation was applied to the upper and lower canine and molar tooth pulps. It was possible to record activities of TPNs in the deep layers of the areas 3a and 3b of the coronal gyrus of cerebral cortex. TPNs driven by the ipsilateral tooth pulp stimulation were distributed more anteroventrally than those driven by contralateral stimulation. Cells driven by bilateral pulp stimulation were situated between these two neurons. The threshold intensity for TPNs in the area 3a was lower than that for neurons in 3b. The majority of TPNs in the area 3a of the anterior part of the coronal gyrus received inputs from low-threshold masseteric muscular afferents as well as from tooth pulp afferents. The findings suggest that TPNs in the area 3a may have a relation to orofacial motor functions.

Is the jaw-opening reflex a valid model of pain?

Tooth pulp shock does not produce only pain; low intensity stimulation results in a non-painful sensation that is termed pre-pain. In animals low intensity tooth pulp shock does not evoke escape behavior; the similarity of the animal escape/detection threshold ratio with the human pain/pre-pain threshold ratio is evidence that pre-pain and pain may be present in animals as in humans. Both pre-pain and pain may arise from the activation of a common afferent modality. The TP-JOR does not correlate with the degree of pain experienced under all conditions. The TP-JOR threshold is at or near the sensory detection threshold, at stimulation intensities which evoke pre-pain. Under normal conditions both the magnitude of the TP-JOR response and the degree of pain experienced increase with increasing stimulation intensity. The TP-JOR and the tooth pulp-evoked pain are affected in parallel by sensory habituation and both appear to relay in the rostral trigeminal complex. There are no cases where the TP-JOR is suppressed and pain is still experienced from tooth pulp shock; the suppression of the TP-JOR may therefore be an accurate index of analgesia. However, in humans treatments that produce analgesia have not been shown to produce suppression of the TP-JOR. Thus, the TP-JOR that persists following analgesic treatments is not a reliable index of either analgesia or pain.

Effect of pentobarbital on the strength duration curve of the jaw opening reflex to tooth pulp stimulation in cats

Brain stem field potentials and digastric electromyographic responses to tooth pulp stimulation were recorded in six chronically prepared adult cats. Strength duration curves were derived for both responses under conditions of wakefulness and anesthetic levels of sodium pentobarbital (35 mg/kg). For the muscle response, the slope of the strength duration curve for short duration pulses became more negative, and the chronaxies were significantly increased under anesthesia as compared to the awake state. For the field potential response, the same parameters were not significantly altered. The results suggest that the alteration in strength duration curve seen in the muscle response may be determined beyond the level of the first synapse.

Etiology and dental treatment of severe involuntary orofacial-cervical movement disorders

A number of electromyographic studies have demonstrated evidence of the effects of dental sensation on stomatognathic muscle function. Dental occlusal imbalances have been shown to affect markedly altered EMG patterns: asynchronism, hyperactivity, and loss of bilateral balance have been noted. In most patients, distorted dental occlusions affect muscle function so that the changes remain observable only on EMG recordings. In some patients, however, the asynchronism, hyperactivity, and loss of bilateral balance may become distressing to the patient and clinically observable. Dental occlusal therapy in two patients reduced involuntary dyskinetic movements involving the face, mouth, and neck. Sustained improvement has been noted for over 8 years.

Surgical determination of the site of crossing of jaw-opening reflex evoked by tooth pulp stimulation in the cat

Tooth pulp stimulation in the cat evokes a jaw-opening reflex that is usually bilateral. We defined the location of fibers crossing to activate the contralateral reflex by making midline sagittal transections at peripheral and central levels in 11 anesthesized cats. A local midsagittal transection of the brain stem 2-4 mm above the obex selectively eliminated the contralateral reflex response. Midline sagittal transections of the maxilla, mandible, cervical cord, or upper brain stem did not.

Cell responses evoked by tooth pulp stimulation above the marginal layer of the cat's trigeminal nucleus caudalis

In cats anesthetized with urethane, all-or-nothing, synaptically evoked recordings were made from 80 separate units in the descending spinal tract of the trigeminal nerve above the left trigeminal nucleus caudalis, at depths not exceeding 50 micrometer from the surface of the medulla. The units were excited by the left upper (21), left lower (25), either (28), or only on simultaneous stimulation of both (six) canine tooth pulps. There was no somototopic distribution. The latency of responses ranged from 4 to 82 msec. For the group of 28 units excited by upper and lower tooth pulps, there was close matching of response latencies from the two teeth. An abrupt decrease in latency upon increasing stimulation strength ("jumping"), and a gradual increase in latency during repetitive stimulation at a frequency between 1 and 20 Hz ("drifting") was characteristic of most, but not all, responses. Units evoked by stimulation of the inferior dental or infraorbital nerves had similar characteristics. Stimulation of a tooth pulp at threshold for a particular unit was used to test the excitability of that unit after suprathreshold stimulation of the same or a different canine tooth pulp. Stimulation of the upper left canine tooth pulp was generally only facilitatory, while stimulation of the lower left canine tooth pulp was initially facilitatory and later inhibitory. Stimulation of the upper or lower right canine tooth pulps did not excite but could inhibit units excited by the left canine tooth pulps. There was a significant correlation between the frequency at which a unit would follow repetitive stimulation and the duration of the inhibition generated by the first of a pair of stimuli. Long inhibition was associated with poor frequency following.

Local electrical stimulation: effective needling points for suppressing jaw opening reflex in rat

Effects of electroacupuncture on the jaw opening reflex after tooth pulp stimulation were investigated in lightly anesthetized rats. Electroacupuncture stimulation (45 Hz, 5 msec) was delivered to 8 meridian points and 6 nonmeridian ones for 15 min so as to compare the degree of suppression elicited from each point. Significant suppressive effects on the reflex were observed in the cases of Yin-Hsiang, Ho-Ku and Shou-Sanli stimulation and these effects were antagonized by naloxone. However, stimulation of Hsia-Kuan, Chu-Chih, Neiting and Taichi, although these points were reported to suppress oro-facial or dental pain in man, scarcely produced suppressive effects. On the other hand, stimulation of some nonmeridian points produced moderate analgesic effects as gauged by the jaw opening reflex. The present study revealed that specificity of the meridian points is not absolute, but relative and that Yin-Hsiang, Ho-Ku and Shou-Sanli points were fairly effective in suppressing pulp-evoked jaw opening reflex in rat, which is presumably a noxious reflex. When the jaw opening reflex was evoked by non-pulpal stimulation, electroacupuncture was less effective on the reflex.

Relative cerebral glucose metabolism evoked by dental-pulp stimulation in the rat

Electrical stimulation of dental pulp is widely acknowledged to produce a sensation that is predominantly or exclusively noxious in character. The authors report the pattern of local cerebral glucose utilization evoked by dental-pulp stimulation in the barbiturate-anesthetized rat, using the [14C]2-deoxyglucose method of Sokoloff. Autoradiographs were prepared from cryostat-cut brain sections of animals given an intravenous pulse of [14C]2-deoxyglucose and sacrificed after 45 minutes of continuous bipolar stimulation of the incisor tooth pulp. Areas of high optical density on the autoradiographs identified brain regions where glucose consumption, and hence functional activity, was maximal. Stimulus-related increases in glucose utilization were seen ipsilaterally in an uninterrupted column from the lower levels of trigeminal nucleus caudalis to the rostral extent of the main sensory nucleus. Mandibular incisor pulp stimulation yielded increased deoxyglucose uptake in relatively restricted dorsal portions of the nuclei, while maxillary pulp stimulation produced a more extensive area of uptake ventrally. Elevated deoxyglucose uptake was also seen in the contralateral ventrobasal thalamus and sensory cortex with maxillary, but not mandibular, pulp stimulation. No changes in metabolic activity were detected in extralemniscal or limbic structures. These initial results suggest that the [14C]2-deoxyglucose method may be a useful means of mapping central structures involved in nociception.

Sensory and reflex responses to tooth pulp stimulation in man

Experiments have been carried out to investigate whether all tooth pulp afferent nerves are capable of producing pain. Monopolar and bipolar stimuli were applied to teeth in human subjects and sensory thresholds determined. EMGs were recorded from the masseter and the anterior digastric muscles. With stimuli up to three times the sensory threshold, no response could be detected in the digastric but at, or just above, the sensory threshold, inhibitory effects were produced in masseter muscle. The latency of the muscle response with bipolar stimulation was 18-22 msec. There was no evidence of stimulus spread to nerves outside the teeth. Bipolar and monopolar stimulation both produced the same sensation but this was not described as painful. It is concluded that some pulpal afferent nerves may not be capable of producing pain, and that the sensory and reflex responses at threshold were probably produced by the same fibres.

Behavioral evidence showing the predominance of diffuse pain stimuli over discrete stimuli in influencing perception

This experiment was directed toward determining the relative effectiveness of discrete and diffuse pain stimuli in influencing perception and behavior. Shocks to the footpads were used to activate the discrete pain pathways and shocks to the upper canine teeth to activate the diffuse pain pathways. In the first phase of this experiment, cats were trained to escape from foot shock in a shuttle box. Current applied to the feet was varied in ascending and descending sequences for each animal according to the psychophysical method of limits and each animal was trained until stable thresholds for escape responding were achieved. In the second phase of the experiment, the effect on behavior of simultaneous activation of both the discrete and diffuse pain systems was assessed. The principal finding is this experiment was that excape responding that was well established when foot shock was presented alone was routinely abolished on trials when tooth shock and foot shock were presented together. These results were interpreted as indicating that the diffuse pain system was prepotent in influencing behavior when both the discrete and diffuse pain systems were activated simultaneously.

Research on variation in dental occlusion. A "state of the art" workshop conducted by the Craniofacial Anomalies Program, the National Institute of Dental Research

The following report on assessing research on variation in dental occlusion was based in part on a workshop conducted by the National Institute of Dental Research at the initiative of Richard L. Christiansen, Chief, Craniofacial Anomalies Program. The meeting was planned and developed by Robert J. Isaacson, Chairman, Touro M. Graber, Richard A. Riedel, and Richard L. Christiansen. This report is designed to provide a review of the achievements, directions, and needs of research concerning variations in dental occlusion. The workshop was held at the National Institutes of Health, Bethesda, Maryland, on Nov 22 and 23, 1972. The material presented by the workshop participants has been summarized and incorporated in this report. The subject of research related to the field of malocclusion was discussed in an article published in the American Journal of Orthodontics in January, 1971.

Impedance of amalgam-dentin interface in cat tooth

The impedance between two amalgam electrodes implanted in the maxillary canine of a cat was measured at various frequencies between 0.02 kilohertz (kHz) and 100 kHz. When plotted on the X-R plane as a function of frequency, two types of impedance loci were obtained. One resembled a circular are at low frequencies, whereas the other was parabolic or exponential in formmthe circular-arc loci are similar to those calculated from membrane models. The parabolic or exponential loci are predicted by a polyelectrolyte model.

Effect of fentanyl, a narcotic analgesic, on two components of the jaw opening reflex

An action of fentanyl, a short-acting narcotic, on the reflex discharge in the digastric nerve induced by the inferior alveolar nerve stimulation was investigated in alpha-chloralose anesthetized cats. In the ipsilateral digastric reflex discharge, there were an early phase induced by stimulus exciting Aalpha fibers and a late phase appearing when Adelta fibers were also stimulated. Following dorso-lateral cordotomy at the obex level, an isolation of the spinal trigeminal nucleus caudalis, a total area in the digastric reflex discharge decreased, while its first peak amplitude was little affected, indicating a disappearance of the late phase and a preservation of the early phase. Fentanyl depressed both the total discharge area and the first peak amplitude. After dorso-lateral cordotomy, the depression of the area decreased considerably, whereas that of the amplitude decreased slightly. Results indicate that fentanyl depressed both the early phase which is activated by the Aalpha fiber stimulation, not via the subnucleus caudalis and the late phase which is activated by the Adelta fiber stimulation via the sub-nucleus caudalis or its surroundings. The latter action would be related to the analgesic action of fentanyl.

Movements of the jaw after unexpected contact with a hard object

Responses to sudden contact of the teeth with a hard object hidden in soft food were investigated in seven individuals. The result recorded was unexpected stoppage of jaw movement, rather than a jaw opening reflex commonly thought to occur.