ENDODONTOLOGY
ENDODONTOLOGY
ENDODONTOLOGY
ENDODONTOLOGY
ENDODONTOLOGY
“Neuropeptides in dental pulp: the silent protagonists.”
Caviedes-Bucheli J, Munoz HR, zuero-Holguin MM, Ulate E
Dental pulp is a soft mesenchymal tissue densely innervated by afferent (sensory) fibers, sympathetic fibers, and
parasympathetic fibers. This complexity in pulp innervation has motivated numerous investigations regarding how
these 3 major neuronal systems regulate pulp physiology and pathology. Most of this research is focused on
neuropeptides and their role in regulating pulpal blood flow and the development of neurogenic inflammation. These
neuropeptides include substance P, calcitonin gene-related peptide, neurokinin A, neuropeptide Y, and vasoactive
intestinal polypeptide among others. The purpose of this article is to review recent advances in neuropeptide research
on dental pulp, including their role in pulp physiology, their release in response to common dental procedures, and
their plasticity in response to extensive pulp and dentin injuries. Special attention will be given to neuropeptide
interactions with pulp and immune cells via receptors, including studies regarding receptor identification,
characterization, mechanisms of action, and their effects in the development of neurogenic inflammation leading to
pulp necrosis. Their role in the growth and expansion of periapical lesions will also be discussed. Because centrally
released neuropeptides are involved in the development of dental pain, the pain mechanisms of the pulpodentin
complex and the effectiveness of present and future pharmacologic therapies for the control of dental pain will be
reviewed, including receptor antagonists currently under research. Finally, potential clinical therapies will be proposed,
particularly aimed to manipulate neuropeptide expression or blocking their receptors, to modulate a variety of biologic
mechanisms, which preliminary results have shown optimistic results