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Modulation of Dental Inflammation by the Sympathetic Nervous System

Department of Biomedicine, Section for Physiology, Faculty of Medicine, University of Bergen, Jonas Lies vei 91, N-5009, Bergen, Norway

View larger version (33K): [in a new window]   Figure 1. Schematic illustrations summarizing potential effects of sympathetic nerves on teeth. Stimulating effects of sympathetic nerves are indicated with (+), and inhibitory effects by (-). Top left panel illustrates a peripheral post-ganglionic sympathetic nerve terminal containing vesicles with noradrenaline (NA) or neuropeptide Y (NPY), which are released upon stimulation. Figs. below illustrate rat molar teeth in 3 different conditions. (A) Normal uninflamed pulp with sympathetic imbalance caused by unilateral sympathectomy recruits immunoglobulin-producing cells. (B) Electrical stimulation of sympathetic nerves causes recruitment of CD 43+ granulocytes in the normal dental pulp. During experimental orthodontic tooth movement (OTM), sympathetic nerves have an inhibitory effect on hard tissue resorption and a stimulating effect on CD 43+ cell recruitment in the dental pulp and PDL. (C) The inflamed pulp shows increased reparative dentin formation and sprouting of sympathetic nerve fibers, while the periapical lesion shows decreased IL-1 production and number of osteoclasts compared with a denervated sympathectomized tooth.

View larger version (143K): [in a new window]   Figure 2. Immunohistochemical micrographs from rat dental pulp (A,B) and compressed PDL (C,D) using antibody that marks CD 43+ cells. Rats were subjected to 10 days of orthodontic tooth movement. Sections A and C are from sympathectomized rats, while B and D are from control rats. (A) Sympathectomized rat showing CD 43+ granulocytes in the dental papilla and periodontal ligament (PDL), while the distal root pulp (P) of the first molar is totally lacking these cells. (B) Section from control rat in the same area. Numerous small CD 43+ cells, both in the distal papilla and dental pulp (open arrow). (C) Mesial surface of distal root from sympathectomized rat showing faintly stained large CD 43+ cells (open arrows) in the compressed PDL near areas of root resorption (arrow). These large immunoreactive cells with membrane staining are probably CD 43+ plasma cells. (D) Section from control rat in the same area as (C). Numerous small CD 43+ cells, mainly granulocytes (open arrows), in the PDL associated with root resorption (arrow). Dn, dentin; H, hyalinized zone; P, pulp; PDL, periodontal ligament. Scale bars, 100 µm. (From Haug et al., 2003; reprinted with permission from Springer)

View larger version (100K): [in a new window]   Figure 3. Immunohistochemical micrographs of dental pulp (A,B) and periapical lesions (C,D) in unilateral sympathectomized rats. (A,B,D) From the non-sympathectomized side; (C) from the contralateral sympathectomized side. (A) Maxillary first molar, 20 days after a small pulp exposure (*), showing NPY-IR fiber sprouting in the pulp adjacent to reparative dentin formation (non-sympathectomized side). (B) Higher magnification of boxed area in (A). NPY-IR fibers are beaded and run longitudinally toward reparative dentin. (C) Numerous ED1-IR multinucleated osteoclasts (arrow) lining periapical lesions in molar subjected to 20 days of large pulp exposure (sympathectomized side). (D) Similar to (C) from the contralateral non-sympathectomized side, showing significantly fewer ED1-IR osteoclasts (arrow) lining the periapical lesion when compared with the sympathectomized side in (C). B, bone; Dn, dentin; L, periapical lesion; RD, reparative dentin. Scale bars, 50 µm. (From Haug and Heyeraas, 2003; reprinted with permission from Elsevier)