Pathophysiology of pain/ dental implant courses by Indian dental academy

 An acute – sharp pain pathway  A slow – chronic pain pathway Odontogenic pain transmission is mediated primarily by peripheral sensory neurons of the trigeminal nerve.

These specialized nerve endings and their respective axons all known as PRIMARY AFFERENT NOCICEPTORS. These peripheral sensory neurons are myelinated Aδ-fibers mainly innervating dentin and ummyelinated C-fibers innervating the body of the pulp.

Most of the myelinated nerve fibers of pulp are A-δ fibers.

They are relatively large fibers with fast conduction velocities.

They enter the root canal and divides into smaller branches coursing coronally through the pulp.

PROCESSING In most cases the input from the pulpal and periradicular tissues is transmitted through the maxillary and mandibular branches of trigeminal nerve towards the CNS for processing Activation of primary afferent nociceptors is called TRANSDUCTION PROCESSING OF THE FAST PAIN SIGNALS The acute sharp pain signals are transmitted in the peripheral nerves to the spinal cord by small type of A δ fibres.

They terminate at two points in the dorsal horns of the spinal cord in lamina I (lamina marginalis) lamina V