牙髓炎性痛的中枢调控机制研究进展  

Research Progress on Central Regulation Mechanism of Dental Pulp Inflammatory Pain

作　　者：王琰琪 孙书恺 WANG Yanqi;SUN Shukai(National Key Laboratory of Military Stomatology,National Clinical Research Center for Oral Diseases,Department of Pediatric Dentistry,School of Stomatology,the Fourth Military Medical University,Xi'an 710032,China)

机构地区：[1]军事口腔医学国家重点实验室,国家口腔疾病临床医学研究中心,第四军医大学口腔医学院儿童口腔科,陕西西安710032

出　　处：《口腔医学研究》2023年第1期15-19,共5页Journal of Oral Science Research

基　　金：国家自然科学基金面上项目(编号:81771095);陕西省重点研发计划-国际合作重点项目(编号:2021KWZ-26);陕西省自然科学基础研究计划项目(编号:2023-JC-2D-56)。

摘　　要：疼痛是儿童就诊时拒绝配合治疗的主要原因。如何减轻疼痛,避免患儿产生牙科恐惧症,提高患儿诊疗的合作率,是儿童口腔医生面临的巨大挑战。牙髓炎是最常见引起牙痛的口腔疾病之一。牙痛传导通路为牙髓神经中的C纤维和Aδ纤维将刺激传递至三叉神经节(trigeminal ganglion,TG),进一步传递至中枢神经系统。解剖学研究证实三叉神经脊束核尾侧亚核(trigeminal spinal subnucleus caudalis,Ⅴc),又称延髓背角(medullary dorsal horn,MDH),接受来自牙髓的初级传入纤维的投射,并在疼痛传递中起重要作用。本文回顾了近年来关于牙髓炎性痛的相关文献,就Ⅴc中神经元和小胶质细胞在疼痛调控中的作用做出总结,以期寻找到牙髓炎性痛的更多治疗靶点。Pain is the main reason why children refuse to cooperate with treatment when seeing a doctor.How to reduce pain,avoid dental anxiety,and improve the rate of cooperation in diagnosis and treatment is a great challenge for pediatric dentists.Pulpitis is one of the most common oral diseases that cause toothache.The conduction pathway of toothache is that C fiber and Aδfiber in pulp nerve transmit stimulation to trigeminal ganglion(TG),and further to the central nervous system.Anatomical studies have confirmed that trigeminal spinal subnucleus caudalis(Ⅴc),also known as the medullary dorsal horn(MDH),receives projections from primary afferent fibers of dental pulp and plays an important role in pain transmission.This paper reviews the relevant literature on dental pulp inflammatory pain in recent years,and summarizes the role of neurons and microglia in pain regulation inⅤc,which aims to look for more therapeutic targets for dental pulp inflammatory pain.

关 键 词：牙髓炎 疼痛 中枢 三叉神经脊束核尾侧亚核 延髓背角 

分 类 号：R781.31[医药卫生—口腔医学]