Neurovascular interactions in the dental pulp in health and inflammation

J Endod. 1990 Feb;16(2):48-53. doi: 10.1016/S0099-2399(06)81563-3.


The two key components in pulpal inflammation are microcirculation and sensory nerve activity. With advancement of techniques they can be measured simultaneously in the same tooth. Excitation of A-delta fibers seems to have an insignificant effect on pulpal blood flow (PBF), whereas C fiber activation causes an increase in PBF. This C fiber-induced PBF increase is caused by neurokinins, especially substance P, which is released from the C fiber nerve terminals. Manipulation of PBF has varying effects on sensory nerve activity. An increase in PBF causes excitation of both A-delta and C fibers via an increase in tissue pressure, whereas flow reduction has an inhibitory effect on A-delta fibers, but no discernible effect on C fiber activity. Understanding of this complex neurovascular relationship in the pulp, especially given the fact that the pulp is in a low compliance system, is prerequisite to more comprehensive characterization of pulpal inflammation.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Dental Pulp / blood supply*
  • Dental Pulp / innervation*
  • Humans
  • Microcirculation
  • Nerve Fibers
  • Neuropeptides / physiology
  • Pulpitis / physiopathology*
  • Ultrasonics


  • Neuropeptides