Update on the concepts and probable role of peptidergic nerves in dentine sensitivity and pain mechanisms.
Both, myelinated (A-) and unmyelinated (C-) and efferent sympathetic nerves are found in the dental pulp. The myelinated nerves are sensory and respond to stimulation of dentine with external stimuli. The A-fibres may be responsible for the sharp piercing pain sensations induced by stimulation of dentine in human subjects. C-fibres respond only when the stimuli reach the pulp proper. Activation of C-fibres may be responsible for the dull, delayed pain which radiates to the rest of the face. Immunohistochemical studies have demonstrated the existence of intradental peptidergic nerves. These are the substance P (SP), calcitonin gene-related peptide (CGRP) and vasoactive intestinal polypeptide (VIP) nerves. It is suggested that peptidergic intradental nerves may play a role in increased dentine sensitivity during inflammation and dentine hypersensitivity.