The Innervation of Teeth

Abstract

The author, using the staining methods of Bielschowski, Gross, Beckwith, Weigert-Pal and Cajal in frozen and serial paraffin and celloidin sections, has investigated the dental innervations of man, monkey, dog, cat, and guinea-pig in health and disease. He discusses the anatomy and physiology of the dental innervation and the effect of section of the inferior dental nerve on the trophic, vasomotor, protective, and sensory functions, with special reference to the relation between dental disease and neuropathies. He describes the innervation of the tooth germ and the nature of the growing fibrils seen before calcification in the dentinal papilla and draws attention to the innervation of the periodontal membrane. He has found that these nerves anastomose across the crest of the interdental septa with their fellows and demonstrates coiled sub-cemental nerve-endings. He has been unable to find any difference in the eruption and casting of teeth after section of the inferior dental nerve, and does not find degeneration of the nerves of deciduous teeth prior to casting to be inevitable. He discusses the effect of local anæsthesia on the dental pulp, some of the causes of odontalgia and neuralgia and the effect of old age and general disease on the dental innervation. He has failed with lethal or continued sublethal doses of ethyl and methyl alcohol, lead or tetanus and diphtheria toxins, using the oral, gastric, subcutaneous and intravenous route, to produce dental neuronic change. The effects of fracture of teeth and jaws, the introduction of arsenic into the pulp chamber and amputation and extirpation of the pulp are examined. The vital resistance of the pulp and the significance of granulomata as a protective mechanism are discussed. The author has found that after extraction although there is at first degeneration of the nerve-fibres concerned, there may subsequently be regeneration, sometimes in the form of plexiform neuroma. He has produced degenerative changes in both the nerves and the Gasserian ganglia on both the operated and unoperated sides by the introduction of tetanus and diphtheria toxins into extraction sockets, where the neuronic involvement is proportionate to the degree of trauma with which the extraction is effected. The rôle of innervation in tooth movement during eruption and orthodontic correction, and after the extraction of anterior teeth, has been investigated, the latter by roentgencinematography.