|CLINICAL CONDITION||HISTOLOGICAL PICTURE|
|Hypersensitive exposed dentin||Elevated number of nerve fibers in underlying pulp and dentin (“nerve sprouting” occurs in response to inflammatory stimuli).|
|Silent Pulpitis||Fibrotic changes in pulp forms a barrier between the lesion & the nerve fibers.|
|Co-existence of vital pulp & periapical lesions||May be caused by CGRP nerve sprouting à neuropeptides released à effect of neuropeptides on bone and periapical tissues.|
|Difficult anesthesia for inflamed teeth||Elevated number of nerve fibers adjacent to the area of inflammation à if cytochemical changes in the affected nerve fibers extend all the way upto the ganglion à leads to reduced efficacy of nerve block anesthesia.|
|Episodic toothache||Depends on cycles of tissue destruction, with adjacent nerve sprouting, followed by local healing with fibrous sequestration of the lesion, creating a barrier between inflammation and nerve fibers.|
[From: Inoki R, Kudo T, Olgart LM. Dynamic aspects of dental pulp. Cambridge, Great Britain: Chapman and Hall. 1990.