The possible role of the mylohyoid nerve in mandibular posterior tooth sensation.
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Anesthesia, Conduction↗
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[The effect of cutting the inferior alveolar artery and nerve on mandibular growth in rabbits].
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Alveolar Process↗
Primary afferent synaptic responses recorded from trigeminal caudal neurons in a mandibular nerve-brainstem preparation of neonatal rats.
1. Whole-cell patch-clamp recordings were made from the neurons in the superficial trigeminal caudal nucleus (substantia gelatinosa) visually identified in a parasagittal brainstem slice of neonatal rat with the mandibular nerve attached. 2. Stimulation of the mandibular nerve at 0.03 Hz evoked compound excitatory postsynaptic potentials (EPSPs) or currents (EPSCs) in trigeminal caudal neurons. When stimulated at higher frequency (> 0.5 Hz), compound synaptic responses were largely attenuated and a small component remained. This component had a monosynaptic nature, following high-frequency stimulation (33-50 Hz) with a stable synaptic latency. 3. The N-methyl-D-aspartate (NMDA) receptor antagonist D(-)-2-amino-5-phosphonopentanoic acid (D-AP5, 50 microM) largely attenuated the slow polysynaptic EPSCs. The AMPA/kainate receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX, 10 microM) largely attenuated monosynaptic EPSCs, but only weakly attenuated slow polysynaptic EPSCs. Simultaneous application of CNQX and D-AP5 completely abolished EPSCs. The monosynaptic EPSCs isolated by repetitive stimulation had both NMDA and non-NMDA components. 4. Monosynaptic EPSCs having high threshold had a relatively long latency. During repetitive stimulation (0.5-5.0 Hz), EPSCs having high threshold and long latency underwent a stepwise potentiation in an activity-dependent manner. The conduction velocity estimated for these EPSCs fell into the range of C-fibres. The activity-dependent potentiation was observed for both non-NMDA and NMDA EPSCs and was accompanied by a significant decrease in the coefficient of variation of EPSC amplitude. 5. We suggest that the activity-dependent potentiation of EPSCs is induced presynaptically and that it may underlie the wind-up phenomenon, an activity-dependent hyperexcitability of the primary afferent C-fibres.
2-Amino-5-phosphonovalerate↗
Peripheral axotomy of the rat mandibular trigeminal nerve leads to an increase in VIP and decrease of other primary afferent neuropeptides in the spinal trigeminal nucleus.
In the vasoactive intestinal polypeptide (VIP)-rich lumbosacral spinal cord, VIP increases at the expense of other neuropeptides after primary sensory nerve axotomy. This study was undertaken to ascertain whether similar changes occur in peripherally axotomised cranial sensory nerves. VIP immunoreactivity increased in the terminal region of the mandibular nerve in the trigeminal nucleus caudalis following unilateral section of the sensory root of the mandibular trigeminal nerve at the foramen orale. Other primary afferent neuropeptides (substance P, cholecystokinin and somatostatin) were depleted and fluoride-resistant acid phosphatase activity was abolished in the same circumscribed areas of the nucleus caudalis. The rise in VIP and depletion of other markers began 4 days postoperatively and was maximal by 10 days, these levels remaining unchanged up to 1 year postoperatively. VIP-immunoreactive cell bodies were absent from trigeminal ganglia from the unoperated side but small and medium cells stained intensely in the ganglia of the operated side after axotomy. These observations indicate that increase of VIP in sensory nerve terminals is a general phenomenon occurring in both cranial and spinal sensory terminal areas. The intense VIP immunoreactivity in axotomised trigeminal ganglia suggests that the increased levels of VIP in the nucleus caudalis are of peripheral origin, indicating a change in expression of neuropeptides within primary afferent neurons following peripheral axotomy.
Acid Phosphatase↗
A review of mandibular anesthesia nerve block techniques.
Anesthesia of the mandibular division of the trigeminal nerve is a routine dental procedure. However, failure to achieve a satisfactory level of anesthesia occurs often and can be frustrating for patient and practitioner alike. In this review article, the three most familiar mandibular nerve block techniques-the conventional Halsted approach and the Gow-Gates and Akinosi techniques-are presented and the advantages and disadvantages of each discussed.
Anesthesia, Dental↗
Topographic anatomy of the deep temporal nerves, with references to the superior head of lateral pterygoid.
Commonly, the nerve branches from the anterior mandibular nerve trunk pass between the roof of infratemporal fossa and the superior head of lateral pterygoid. However, varied courses of the mandibular nerve branches can be frequently observed. The purpose of this study was to clarify the positional relationships and the clinical relevance of the course variations of the branches of the anterior mandibular nerve trunk with reference to the surrounding anatomical structures. Thirty-six hemi-sectioned heads were studied in detail. In 20 cases, the posterior deep temporal nerve had a common trunk with the masseteric nerve and was then divided anteriorly (15 cases) or posteriorly (five cases). In 16 cases, the posterior deep temporal nerve arose from the mandibular nerve trunk independently. Based on the branching patterns of the middle deep temporal nerve, type A (one twig of the middle deep temporal nerve) was most frequent and occurred in 41.7%. Similarly, type B (two twigs), type C (three twigs) and type D (four twigs) were observed in 36.1%, 16.7%, and 5.5%, respectively. The twigs of the middle deep temporal nerve, which pierced the muscle fibers of the superior head of lateral pterygoid, were found in 21 cases (58.3%). Cases in which the middle deep temporal nerve pierced through all areas of the superior head were most frequent (56.5%). These results suggest that the piercing patterns of the middle deep temporal nerve show there is a possibility that it may be compressed during the actions of the superior head of lateral pterygoid.
Aged↗
Effect of nerve growth factor and Schwann cells on axon regeneration of distracted inferior alveolar nerve following mandibular lengthening.
OBJECTIVE: To study the effect of nerve growth factor (NGF) and Schwann cells on axon regeneration of the inferior alveolar nerve following mandibular lengthening with distraction osteogenesis. METHODS: Unilateral mandibular osteodistraction was performed in 9 healthy adult male goats with a distraction rate of 1 mm/d. Every 3 goats were killed on days 7, 14 and 28 after mandibular lengthening, respectively. The inferior alveolar nerves in the distraction callus were harvested and processed for ultrastructural and NGF immunohistochemical study. The inferior alveolar nerves from the contralateral side were used as controls. RESULTS: On day 7 after distraction, axon degeneration and Schwann cell proliferation were observed, and very strong staining of NGF in the distracted nerve was detected. On day 14 after distraction, axon regeneration and remyelination were easily observed, and NGF expression started to decline. On day 28 after distraction, the gray scale of NGF immunoreactivity recovered to the normal value and the Schwann cells almost recovered to their normal state. CONCLUSIONS: Gradual mandibular osteodistraction can result in mild or moderate axon degeneration of the inferior alveolar nerve. Nerve trauma may stimulate the proliferation of Schwann cells and promote the synthesis and secretion of NGF in the Schwann cells. Schwann cells and NGF might play important roles in axon regeneration of the injured inferior alveolar nerve following mandibular lengthening.
Animals↗
Optical mapping reveals the functional organization of the trigeminal nuclei in the chick embryo.
The functional organization of the trigeminal nuclei during embryogenesis was investigated using multiple-site optical recording with a fast voltage-sensitive dye. Brainstem preparations with three classified trigeminal nerve afferents, the ophthalmic, maxillary and mandibular nerves, together with motor nerve fibers, were dissected from five- to eight-day-old chick embryos. Electrical responses evoked by trigeminal nerve stimulations were optically recorded simultaneously from many loci of the stained preparations. We identified three response areas related to the trigeminal nerve: area I, located cephalic to the level of the trigeminal ganglion; area II, located caudal to the level of the trigeminal ganglion; and area III, located at the level of the trigeminal root. The neural responses in areas I and II were evoked by ophthalmic, maxillary or mandibular nerve stimulation, while the responses in area III were detected when the stimulation was applied to the trigeminal motor nerve. In comparison with the morphology indicated by DiI labeling, the results suggest that areas I, II and III correspond to the principal sensory nucleus of the trigeminal nerve, the spinal sensory nucleus of the trigeminal nerve and the trigeminal motor nucleus, respectively. We identified two components of the optical response: a fast and a slow signal. In five-day-old preparations, fast spike-like signals related to action potentials were recorded from the three response areas. In six-day-old preparations, slow optical signals which reflect glutamate-mediated excitatory postsynaptic potentials were detected from area II only when the ophthalmic nerve was stimulated: no slow signal was evoked by maxillary or mandibular nerve stimulation. In seven- and eight-day-old preparations, slow signals were detected from both areas I and II with every nerve stimulation. These results suggest that synaptic function is first generated in the spinal trigeminal nucleus by the six-day embryonic stage, and the developmental organization of synaptic function is not the same in the three trigeminal nerves or in the two sensory nuclei. Contour line maps of the signal amplitude revealed that the size and the area of the neural responses within the trigeminal nuclei changed dramatically with development. We compared the spatial distribution and temporal dynamics of the optical signals between the ophthalmic, maxillary and mandibular nerve stimulations, and we found that somatotopic organization is less clear in a rostrocaudal/mediolateral X-Y plane, although the areas of the maxillary and mandibular nerves appeared to separate in the lateral direction.
6-Cyano-7-nitroquinoxaline-2,3-dione↗
A method of rapid-sequence induction using high-dose narcotics with vecuronium or vecuronium and pancuronium in patients with coronary artery disease.
A method of rapid-sequence induction was studied in 18 patients undergoing coronary artery bypass grafting (CABG) to assess the adequacy of relaxation for endotracheal intubation without resulting in major changes in heart rate (HR). Ten patients received vercuronium, 0.2 mg/kg (V); and eight patients received vecuronium, 0.1 mg/kg, and pancuronium, 0.1 mg/kg (V + P). All patients then received fentanyl, 50 to 70 microg/kg, or sufentanil, 5 to 7 microg/kg, followed 60 seconds later by intubation. Patients were assessed for ulnar and mandibular nerve response to train-of-four (TOF) and tetanic (T) stimulation at 60 seconds; presence or absence of coughing or bucking; degree of vocal cord relaxation (1=none, 2=some, 3=complete relaxation); ability to intubate at 60 seconds; and changes in HR. At the time of intubation, 17 patients had four twitches to TOF and a positive response to T stimulation of the ulnar nerve, while all 18 patients had zero or one twitch to TOF and only four had a positive response to T stimulation of the mandibular nerve (P < .0001 for T and TOF, ulnar v mandibular). Coughing and bucking were not observed in any patient. Vocal cord position was "3" in 14 patients and "2" in four patients. All patients were intubated without difficulty. The mean change in HR was -4.1 beats/min for patients receiving V and +16.4 beats/min for those receiving V + P (P < .002 for change in HR), with two V + P patients developing tachycardia. It is concluded that the onset of neuromuscular blockade is more rapid in the distribution of the mandibular nerve than at the ulnar nerve; mandibular nerve stimulation is a better predictor of adequate intubating conditions; good intubating conditions can be attained with either V or V + P; and, rapid-sequence induction with V is safe from a cardiac standpoint as measured by changes in HR, but the addition of pancuronium is unnecessary.
Anesthetics, Combined↗
[Topographical and spatial anatomy of the mandibular alveolar nerve].
After reviewing the origin and the anatomical path of the mandibular alveolar nerve, the author describes the study techniques used on dry bone: serial frontal sections laid out sagittaly; catheterism prior to standard radiographs; and, fenestration of the external osseous wall. These techniques demonstrate the precise topographical and spatial anatomy of this branch of the trigeminal nerve (V3).
Humans↗
An electrophysiological study of the pathways of pulpal nerves from mandibular teeth in the cat.
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Action Potentials↗
Changes in the inferior alveolar nerve after mandibular lengthening with different rates of distraction.
PURPOSE: This study investigated the changes in the inferior alveolar nerve after mandibular lengthening with different rates of distraction. MATERIALS AND METHODS: Bilateral mandibular corticotomies were performed in 8 goats. The mandibles in 6 goats were lengthened 10 mm using a custom-made distractor with 2 different rates of distraction (1 mm/d [n = 3] and 2 mm/d [n = 3]); the other 2 nondistracted mandibles served as a control. The goats with distracted mandibles were killed at 2 weeks after completion of distraction. The inferior alveolar nerve specimens from all animals were harvested and processed for histologic and ultrastructural evaluation. RESULTS: The mandibles were lengthened successfully in the distracted animals. Morphologic changes in the inferior alveolar nerves were observed when compared with the nondistracted controls. Moreover, signs of nerve degeneration, such as demyelination, axonal swelling, axoplasmic darking, and decrease in the number of axons, were more extensive and prominent in those nerves distracted at a rate of 2 mm/d. CONCLUSIONS: Degenerative changes in the inferior alveolar nerve occur after mandibular lengthening by distraction osteogenesis. The distraction rate of 1 mm/d appears to be tolerable and safe for the inferior alveolar nerve, but rapid distraction may cause serious degeneration.
Animals↗
Unusual origins of the buccal and mylohyoid nerves.
Dissection of the mandibular nerve in a cadaver of southern Chinese origin showed the mylohyoid nerve arising from the lingual nerve and the buccal nerve arising from the inferior alveolar nerve within the mandibular ramus. It is estimated that this variation in the origin of the buccal nerve occurs in 6.1% of the southern Chinese population.
Cheek↗
[Evaluation of sensory deficit of the inferior alveolar nerve after mandibular osteotomy].
INTRODUCTION: Injury of the inferior alveolar nerve (IAN) is one of the most common complications of mandibular osteotomy. The wide differences in results published to date led us to evaluate the incidence of sensorial disorders persisting for one year in a series of 40 patients. MATERIAL AND METHOD: This study included 40 patients aged 14-58 years. We studied subjective expression of sensorial disorders using a questionnaire with items for the different orofacial functions related to the IAN. We studied the clinical expression of these sensorial disorders by testing the three modes of exteroceptive sensitivity (tact, temperature, pain) in 25 patients. Four clinical tests appropriate for the area of the mental nerve. Somesthesic evoked potentials were recorded in 8 patients. RESULTS: 77% of the patients complained of altered skin sensitivity but a sensorial deficit was revealed by clinical tests in only 60%. Somesthesic evoked potentials were perturbed for 64% of the nerves with a clinical deficit and in 100% without a clinical deficit. DISCUSSION: There was a greater incidence of subjective complaints than objective nerve injury. Recoring somesthesic evoked potentials provides interesting information for the electrophysiological diagnosis of nerve injury. Indications could be widened for traumatic injury of the IAN, particularly to obtain medicolegal documentation.
Adolescent↗
Influence of excision of the facial and inferior dental nerves on mandibular growth and development.
The purpose of this study was to evaluate the role of the facial and inferior dental nerves on mandibular growth and development. A sample of 10 mongrel dogs was randomly divided into two equal groups. Avulsion of the right inferior dental nerve was carried out on the first group. Surgical cutting of the extracranial portion of the right facial nerve was performed on the second group. Sham operations were made for the left sides of the mandibles of all animals. The animals were killed 3 months later and their mandibles visually and radiographically examined. Measurements were recorded in a double-blind experimental design. The data were statistically analyzed. The results obtained from this study indicate that surgical cutting of the extracranial portion of the facial nerve resulted in unilateral facial paralysis of the muscles of expression. However, after the animals were killed, no significant statistical differences were found between the nerve-devoid and sham sides of the mandible for both the facial nerve group and the inferior dental nerve group. Nevertheless, for the inferior dental nerve group, visual and radiographic examinations revealed various morphologic differences at the angular process regions of the mandibles. The impact of neural deprivation on mandibular growth and development was thus determined.
Animals↗
Distribution and possible origin of galanin-like immunoreactive nerve fibers in the mammalian dental pulp.
Human, dog, cat and rat dental pulps were investigated for the presence and distribution of galanin-like immunoreactive (-IR) nerve fibers, and the possible origin of pulpal galanin-IR nerve fibers in the rat was examined. Galanin-IR nerve fibers were present in the dental pulps of all species examined. Two types of galanin-IR nerve fibers were distinguished with regard to morphology; thin varicose nerve fibers and thick smooth-surfaced nerve fibers. Thin varicose galanin-IR nerve fibers were seen to run along the blood vessel in the human, dog and cat root pulp. In the coronal pulp, galanin-IR nerve fibers ran toward the odontoblastic layer but they did not form the subodontoblastic nerve plexus. In rat molar pulp, few galanin-IR nerve fibers were observed; the distribution of these nerve fibers was similar to those in human, dog and cat pulp. In contrast, many thick smooth-surfaced galanin-IR nerve fibers were observed near the blood vessels in incisor pulp of the rat; occasionally a few varicose galanin-IR nerve fibers were also observed. Transection of the inferior alveolar nerve or mandibular nerve caused complete disappearance of galanin-IR nerve fibers in rat dental pulp, while surgical sympathectomy of the superior cervical ganglion did not affect their distribution. The present results indicate that galanin-IR nerve fibers are present in the mammalian dental pulp, and that the intrapulpal galanin-IR nerve fibers in the rat originate from the trigeminal ganglion and are primary afferents.
Animals↗
Microanatomic analysis of the trigeminal nerve and potential nerve graft donor sites.
A histologic study was undertaken to define the microanatomic characteristics of two commonly injured peripheral trigeminal nerve branches (lingual and mandibular nerves) and the two nerves most frequently procured for use in their interpositional graft repair (sural and greater auricular nerves). Nerves, obtained from fresh human cadavers, were evaluated for total fascicular area, fascicle number, axon number, axon size, and axon density. The peripheral branches of the trigeminal nerve (third division) were morphometrically similar, with only a slight decrease in axon density in the lingual nerve. Comparisons between the donor nerves, however, showed numerous discrepancies at the axonal level. While the fascicular area of the sural nerve was only slightly smaller, axon numbers and densities were only one-half that of the trigeminal nerves. Although the greater auricular nerve was appreciably smaller in overall size, a much better correlation existed with the trigeminal nerve in axonal qualities. These microanatomic findings raise questions about the potential capability of these graft choices to optimally restore axonal connections between nerve ends in trigeminal nerve repair.
Axons↗
[Age-related characteristics of the myeloarchitectonics of the peripheral nerves].
By means of macromicroscopy and microscopy myeloarchitectonics of morphologically and functionally different somatic and visceral nerves (branches: mandibular nerve, cervical spinal nerves, inferior laryngeal nerve, hepatic plexus) have been studied in 11 age groups. During the prenatal period of ontogenesis asynchronism of myelogenesis is stated in various muscle branches of the nerves, dependent on formation of function in corresponding muscles and muscle groups. As demonstrate investigations on peculiarities of myelogenesis course in the somatic and visceral nerves studied, during the period of pre- and postnatal ontogenesis, its dynamics embraces three stages of myelogenesis, determined by G. B. Stovichek for visceral nerves: productive myelogenesis, stages of stabilization and involution. The stage of productive myelogenesis in the somatic nerves studied lasts up to the end of the adolescent period. Two phases are determined in it: the first lasts up to 2-3 years; the second--up to the end of the adolescent period and is characterized with a complete formation of the myelin fibers spectrum. In the visceral nerves studied increase of general amount of myelin fibers and their differentiation are completed simultaneously during the adolescent age. The stabilization stage of myeloarchitectonics of the nerves studied corresponds to the mature age (I and II periods) and the involution stage--to the elderly (and old) age.
Aging↗