Neuropeptide expression and morphometric differences in crushed alveolar inferior nerve of rats: Effects of photobiomodulation.

Inferior alveolar nerve (IAN) injuries may occur during various dental routine procedures, especially in the removal of impacted lower third molars, and nerve recovery in these cases is a great challenge in dentistry. Here, the IAN crush injury model was used to assess the efficacy of photobiomodulation (PBM) in the recovery of the IAN in rats following crushing injury (a partial lesion). Rats were divided into four experimental groups: without any procedure, IAN crush injury, and IAN crush injury with PBM and sham group with PBM. Treatment was started 2 days after surgery, above the site of injury, and was performed every other day, totaling 10 sessions. Rats were irradiated with GaAs Laser (Gallium Arsenide, Laserpulse, Ibramed Brazil) emitting a wavelength of 904 nm, an output power of 70 mWpk, beam spot size at target ∼0.1 cm2, a frequency of 9500 Hz, a pulse time 60 ns, and an energy density of 6 J/cm2. Nerve recovery was investigated by measuring the morphometric data of the IAN using TEM and by the expression of laminin, neurofilaments (NFs), and myelin protein zero (MPZ) using Western blot analysis. We found that IAN-injured rats which received PBM had a significant improvement of IAN morphometry when compared to IAN-injured rats without PBM. In parallel, all MPZ, laminin, and NFs exhibited a decrease after PBM. The results of this study indicate that the correlation between the peripheral nerve ultrastructure and the associated protein expression shows the beneficial effects of PBM.

Mesenchymal stem cells modified with nerve growth factor improve recovery of the inferior alveolar nerve after mandibular distraction osteogenesis in rabbits.

Distraction osteogenesis is widely used in the treatment of bony deformities and defects. However, injury to the inferior alveolar nerve is a concern. Our aim was to investigate the feasibility of using lentiviral-mediated human nerve growth factor beta (hNGFß) of the inferior alveolar nerve in mandibular distraction osteogenesis in rabbits. To achieve this, mesenchymal stem cells (MSC) from the bone marrow of rabbit mandibles were isolated and genetically engineered using recombinant lentiviral vector containing hNGFß. Twenty New Zealand white rabbits underwent mandibular distraction osteogenesis, and 5 million MSC transduced with hNGFß-vector or control vector were transplanted around the nerve in the gap where the bone had been fractured during the operation (n=10 in each group). After gradual distraction, samples of the nerve were harvested for histological and histomorphometric analysis. We found that the genetically engineered MSC transduced by the lentiviral vector were able to secrete hNGFß at physiologically relevant concentrations as measured by ELISA. Histological examination of the nerve showed more regenerating nerve fibres and less myelin debris in the group in which hNGFß-modified MSC had been implanted than in the control group. Histomorphometric analysis of the nerve showed increased density of myelinated fibres in the group in which hNGFß-modified MSC had been implanted than in the control group. The data suggest that implantation of hNGFß-modified MSC can accelerate the morphological recovery of the inferior alveolar nerve during mandibular distraction osteogenesis in rabbits. The use of lentiviral-mediated gene treatment to deliver hNGFß through MSC may be a promising way of minimising injury to the nerve.

Revisión bibliográfica de la anatomía del nervio dentario inferior y su implicancia en la cirugía implantológica de los sectores posteriores mandibulares / A review of the literature on inferior alveolar nerve anatomy and its involvement with implant surgery of the posterior mandibular sectors

El nervio dentario inferior es una de las estructuras anatómicas más importantes a considerar previo a la colocación de implantes dentales en la mandíbula. La lesión de este nervio es una situación temida por los pacientes y los profesionales por la posibilidad de daño permanente en su conducción nerviosa. Es fundamental para todos los odontólogos que realicen maniobras quirúrgicas próximas a la entidad nerviosa, conocer ampliamente su recorrido, distribución y características normales, para prevenir la injuria del mismo y sus indeseables consecuencias. El objetivo de esta publicación es brindar información actualizada del conocimiento del nervio dentario inferior y su relación con la implantología oral...

Evaluación de la anatomía mandibular relacionada con la osteotomía sagital de la rama / Evaluation of mandibular anatomy related to sagittal split ramus osteotomy

La osteotomía sagital de la rama mandibular (SSRO) es una de las técnicas quirúrgicas más frecuentes para corregir las deformidades de la mandíbula. Con el fin de prevenir problemas anatómicos y quirúrgicos, los cirujanos requieren una mayor investigación sobre las estructuras anatómicas relacionadas con la SSRO. El objetivo de este estudio fue investigar las posiciones de la antilingula (AL), la entrada al nervio alveolar inferior (NAI) en la mandíbula y otros puntos de referencia anatómicos en relación con la língula mandibular (L). Fueron estudiadas 70 hemimandíbulas secas. La AL y los demás puntos de referencia y, la posición correspondiente de la L se marcaron en la cara medial y lateral de la rama mandibular respectivamente. Fueron medidas las distancias de la AL, NAI y L en los planos anterior-posterior y superior-inferior con un caliper, y se estableció su relación geométrica. Los resultados mostraron que la AL era perceptible en el 100 por ciento de las caras laterales mandibulares. La mayoría de las ALs se encuentran anterior a la L, con una distancia media de 0,66+/-2,43mm y 0,92+/-2,56 mm y, 4,23+/-2,97 mm y 3,62 +/- 3,14 mm superior a ella (lados derecho-izquierdo respectivamente) (ambos con un valor de p <0,001). Valores similares se observaron en relación con el NAI. No se encontraron diferencias significativas entre los lados derecho e izquierdo, para la mayoría de los parámetros. Los parámetros estudiados pueden asistir a los cirujanos maxilofaciales a determinar la proximidad anatómica del NAI, y reducir al mínimo el riesgo de dañar el nervio y vasos sanguíneos. No recomendamos el uso de la AL como única referencia anatómica cuando se realiza un procedimiento de SSRO.

Sagittal split ramus osteotomy (SSRO) of the mandible is one of the most common surgical techniques to correct mandibular deformities. In order to prevent many surgical anatomical problems, surgeons have found that further investigation of the anatomical structures related to SSRO is needed. This study aims to investigate positions of the antilingula (AL), inferior alveolar nerve (IAN) and other anatomic landmarks in relation to the lingula of dried mandibles. 70 Chilean dried hemimandibles were studied. The AL, others landmarks and the corresponding position of the L were marked on the internal and external aspect of the mandibular ramus respectively. The distances from the AL, IAN and L were measured in the anterior­posterior and the superior­inferior planes using a digital caliper and geometric relationship was established. The results showed the AL was discernible in 100 percent of lateral mandibular rami studied. The most of the AL was found anteriorly to the L with a mean distance of 0.66+/-2.43mm and 0.92+/-2.56mm, and 4.23 +/- 2.97mm and 3.62+/-3.14mm superiorly (right-left sides respectively) (both with p value <0.001). Similar values were seen in relation with IAN. No significant differences were found between the right and left sides, for the majority of parameters. The studied parameters will assist clinicians to determine the anatomical proximity to the IAN, and, minimize the risk of damaging nerver and vessels. We do not recommend the use of antilingula as only anatomical landmark when performing a SSRO procedure.

Microstructural and ultrastructural assessment of inferior alveolar nerve damage following nerve lateralization and implant placement: an experimental study in rabbits.

PURPOSE: The present study assessed damage to the inferior alveolar nerve (IAN) following nerve lateralization and implant placement surgery through optical and transmission electron microscopy (TEM). MATERIALS AND METHODS: IAN lateralization was performed in 16 adult female rabbits (Oryctolagus cuniculus). During the nerve lateralization procedure, one implant was placed through the mandibular canal, and the IAN was replaced in direct contact with the implant. The implant was placed in the right mandible, and the left side was used as a control (no surgical procedure). After 8 weeks, the animals were sacrificed and samples were prepared for optical and TEM analysis of IAN structural damage. Histomorphometric analysis was performed to determine the number and cross-sectional dimensions of nerve fascicles and myelin sheath thickness between experimental and control groups. The different parameters were compared by one-way analysis of variance at the 95% significance level. RESULTS: Alterations in the perineural and endoneural regions of the IAN, with higher degrees of vascularization, were observed in the experimental group. TEM showed that the majority of the myelinated nerve fibers were not affected in the experimental samples. No significant variation in the number of fascicles was observed, significantly larger fascicle height and width were observed in the control group, and significantly thicker myelin sheaths were observed in the experimental samples. CONCLUSION: IAN lateralization resulted in substantial degrees of tissue disorganization at the microstructural level because of the presence of edema. However, at the ultrastructural level, small amounts of fiber degeneration were observed.

Dynorphin-A immunoreactive terminals on the neuronal somata of rat mesencephalic trigeminal nucleus.

Dynorphin-A-like immunoreactivity was investigated in the rat mesencephalic trigeminal nucleus (Mes 5) at the light and electron microscopic levels. Dynorphin-A immunoreactive fibers and puncta, likely representing nerve terminals, were observed throughout rostrocaudal extension of the Mes 5 at the light microscopic level. Within the rostrocaudal extension, more abundant fibers and puncta were localized in the midbrain-pontine junction and pontine areas than in the midbrain area. At the electron microscopic level, dynorphin-A immunoreactive synapses were observed on the somata of Mes 5. Dynorphin-A-like immunoreactivity tended to be restricted to dense-cored vesicles in the synapses. These results suggest that dynorphin-A-containing fiber systems affect mastication through the Mes 5.

Synaptic contacts established by inferior alveolar nerve fibres in the paratrigeminal nucleus: an electron microscopic study in the rat.

A quantitative evaluation of the types of synaptic contacts from afferent fibres in the paratrigeminal nucleus after partial pulpectomy was compared with that after transection of the inferior alveolar nerve (IAN), using transganglionic degeneration. Degenerating terminals with a marked increase in axoplasmic electron opacity were observed bilaterally in the paratrigeminal nucleus of rats submitted to either partial pulpectomy or IAN transection. The total number of degenerating terminals observed after partial pulpectomy was 53% of that for IAN transection. This suggests a considerable contribution of tooth pulp afferent fibres in the total number of synaptic contacts in the intermediate and caudal parts of the paratrigeminal nucleus. In both the partial pulpectomy and IAN-transected groups, the majority of these synapses formed single asymmetric contacts with intermediate and distal dendritic segments, and accounted for 74% of all classified contacts. The remaining 26% of contacts occurred with proximal dendritic segments, dendritic spines, perikaryon, normal terminals and double post-synaptic elements. There was no statistically significant difference in the number of synaptic contacts for each type of synapse, with the exception of contacts with dendritic spines in the contralateral side, between the partially pulpectomised and IAN-transected groups.

Anatomía quirúrgica del nervio auriculotemporal en el acceso pre-auricular / Surgical anatomy of the auriculotemporal nerve in the pre-auricular acces

Con el objetivo de aportar datos anatómicos, que posibiliten el acceso a la región pre-auricular, con menor riesgo de lesión del nervio auriculotemporal en procedimientos quirúrgicos, fue realizada esta investigación, sobre las relaciones topográficas y biométricas de este nervio con la arteria y vena temporales superficiales y el trago. Fueron disecadas 24 hemicaras de cadáveres fijados con formaldehído al 10 por ciento, disponibles en el Laboratorio de Anatomía del Departamento de Morfología Humana de la Universidad Federal de Alagoas, Brasil. En siete casos (29,2 por ciento) el nervio subía posteriormente a los vasos temporales superficiales, y en otros siete (29,2 por ciento), subía junto a la vena. En tres casos (12,5 por ciento) el nervio emergía junto con la arteria. En dos casos (8,3 por ciento), el nervio estaba en posición intermedia. En cinco casos (20,8 por ciento), el nervio subía junto con ambos vasos. La menor distancia del nervio auriculotemporal a la línea pre-auricular fue de 0,3 mm, y la mayor fue de 11,5 mm, con media de 1,89 mm. La menor distancia del nervio con la arteria temporal superficial fue de 0,1 mm, y la mayor fue de 14,6 mm, con media de 8,66 mm, situándose la arteria anterior. Cuando la vena era anterior al nervio, la menor distancia entre sí, fue de 0,2 mm y la mayor, 10,9 mm, con media de 2,91 mm. Cuando la vena estaba en posición posterior, la distancia mínima fue de 0,1 mm, y la máxima de 9,4 mm, siendo la media de 2,54 mm. Concluimos que el nervio auriculotemporal presenta posición variable en la región pre-auricular y es la estructura más próxima a la línea pre-auricular.

VRl- and VRL-l-like immunoreactivity in normal and injured trigeminal dental primary sensory neurons of the rat.

The vanilloid receptor VR1 and the vanilloid receptor-like protein VRL-1 are associated with polymodal nociceptors, and may be important for pain processing in normal and injured teeth. Using immunohistochemistry, we have studied the distribution of these receptors in rat pulpal or gingival trigeminal ganglion neurons that were identified through retrograde labeling with fluoro-gold. Twenty-one percent to 34% of tooth pulp-innervating neurons were VRl-positive, while 32%-51% were VRL-1-immunoreactive. However, double-labeling experiments revealed that VR1 and VRL-1 rarely co-existed in the same cells, but rather seemed to be confined to separate subpopulations. Among the gingival neurons, about 25% were VR1-positive and about 41% were VRL-1-immunoreactive. A lesion of the inferior alveolar nerve, which supplies mandibular teeth and gingiva, resulted in a marked down-regulation of VR1 in the affected trigeminal ganglion cells. A down-regulation of VRL-l was also indicated. The results suggest that both VR1 and VRL-1 could have significant roles in pulpal and gingival nociceptive transduction.

Expanded polytetrafluoroethylene entubulation of the rabbit inferior alveolar nerve.

OBJECTIVE: The purpose of this study was to evaluate the use of an expanded polytetrafluoroethylene conduit in the treatment of a 6. 0-mm gap in the rabbit inferior alveolar nerve and compare the results with those of an autogenous interpositional tibial nerve graft. STUDY DESIGN: The inferior alveolar nerves of 5 adult New Zealand White female rabbits (10 nerves) were exposed bilaterally, and a 6-mm segment of each nerve was resected. On one side, chosen at random, the gap was immediately bridged through use of an 8.0 x 2. 0-mm expanded polytetrafluoroethylene conduit; on the other side, the gap was grafted with an autogenous tibial nerve graft. Two randomly selected nerves served as sham-dissected controls. At 15 weeks after surgery, the animals were killed and the entire nerve segments were harvested and prepared according to standard fixation and embedding techniques. The sections were examined histomorphometrically to quantify the degree of axonal regeneration through definition of fascicular number, total fascicular surface area, axonal density, and mean axonal diameter at 3 locations along the repair site. RESULTS: Light microscopic examination revealed the presence of disorganized neural tissue in both groups, with slightly more fibrovascular interfascicular tissue in the expanded polytetrafluoroethylene group. Histomorphometric analysis revealed no significant differences between groups for most of the measured variables. The mean axonal diameter varied between groups, and the fascicular number was greater in the expanded polytetrafluoroethylene group at the middle site. CONCLUSIONS: This study demonstrates that regeneration of the inferior alveolar nerve can occur across a 6.0-mm gap through an expanded polytetrafluoroethylene tube with results comparable to those of an autogenous nerve graft, significant donor site morbidity being avoided. The significant differences between groups were probably due to greater containment of regenerating axonal fibers in the expanded polytetrafluoroethylene group.

Course and composition of the nerves that supply the mandibular teeth of the rat.

The rodent dentition has become an important model for investigations of interactions between dental tissues and peripheral neurons. Although experimental nerve injury has been widely used for such studies, there is uncertainty about the courses of nerve fibers supplying the mandibular teeth. In order to clarify this, we used a mixture of monoclonal antibodies against neurofilament proteins to enhance demonstration of nerve fibers so that small nerves could be readily traced in serial frozen sections of mandibles of Sprague Dawley rats ranging in age from embryonic day (E) 18 to postnatal day (P) 90. The 1st molar and anterior portion of the 2nd molar were innervated by small nerves that emerged as distinct branches of the IAN trunk at or near the mandibular foramen. In contrast, the nerve supply to the 3rd molar and posterior part of the 2nd molar was a branch of the lingual nerve that bypassed the mandibular canal altogether. The IAN trunk split into the mental nerve and a large branch to the incisor about 2 mm anterior to the mandibular foramen. Thick branches of the incisor nerve descended into the incisor socket to form a dense plexus of nerve fiber bundles extending along the length of the incisor periodontium. The sparse pulpal innervation of the incisor was provided by a few thin fascicles that emerged from the caudal portion of the periodontal plexus to enter the incisor apex. The dental branches of the IAN and lingual nerve seen in the adult were well established and readily identifiable at age E18 even though their targets were limited to the follicles of the developing teeth. These studies show that the trigeminal branches that supply the mandibular teeth can be identified at a wide range of ages as distinct nerves at a considerable distance proximal to their targets. This detailed information on the courses taken by the dental nerves can provide an anatomical basis for increased precision in characterization and perturbation of neural pathways from the molars and incisor.

[The influence of nerve growth factor on inferior alveolar nerves regeneration in the silicone tubes].

OBJECTIVE: To explore the effect of exogenous nerve growth factor(NGF) in the regeneration of adult white rabbits inferior alveolar nerve within the silicone tubes. METHODS: In 24 adults white rabbits. A bilateral 8 mm inferior alveolar nerve gaps were created, and the proximal and distal stumps were inserted into a 12 mm silicone tube. The silicone tube of the right side was filled with exogenous NGF(experimental group) and the contralateral side was filled with saline (control group). Regeneration of the nerves was assessed by histological exam and nerve electrophysiological appreciation. Total number of the regenerating myelinated nerve fibers, the conduction velocities of nerves the thickness of myelin sheaths and the cross section area of myelinated nerve fibers between the experimental and the control groups were compared. RESULTS: The results showed that: 1. The experimental groups demonstrated more myelinated nerve fibers than that of the controls in 12 and 18 weeks. 2. At the same time following surgery, the myelin sheath thickness and the cross section area of myelinated nerves in the experimental groups were significantly greater than that in the controls. 3. In 12 and 18 weeks, the conduction velocities of regenerating nerves in the experimental groups were faster than that of the controls. CONCLUSION: This study suggested that exogenous NGF can enhance regeneration of inferior alveolar nerve with necovery of its sensory function.

Nerve fibers immunoreactive to calcitonin gene-related peptide, substance P, neuropeptide Y, and dopamine beta-hydroxylase in innervated and denervated oral tissues in ferrets.

The effect of sensory and sympathetic denervation on the localization and distribution of nerve fibers immunoreactive (IR) to calcitonin gene-related peptide (CGRP), substance P (SP), neuropeptide Y (NPY), and dopamine beta-hydroxylase (DBH) was studied in the dental pulp, periodontal ligament (PDL), and gingiva in ferrets. Unilateral axotomy was performed by resection of the inferior alveolar nerve (IAN) 10 days before the experiment (Group 1); sympathectomy, by unilateral removal of the cervical ganglion 5 days before the experiments (Group 2). Immunohistochemistry was performed on free-floating sections by the avidin-biotin-peroxidase technique. A considerably higher density of sensory fibers IR to CGRP and SP was found in the dental pulp than in PDL and gingiva. The majority of pulpal fibers were located in the walls of blood vessels. A subodontoblastic network of fibers IR to CGRP and SP was lacking in incisors and canines and was found only in the coronal pulp in premolars and molars. Sympathetic fibers were sparsely distributed in the pulp, and they were mainly confined to large vessels running centrally in the root pulp as well as the larger vessels in apical PDL and alveolar bone. Gingiva was well supplied with CGRP- and SP-IR nerves, and some NPY and DBH fibers were located in association with larger vessels. Round cell-like structures within the basal part of the epithelium were CGRP-IR. Axotomy induced a complete loss of CGRP- and SP-IR fibers in the anterior part of the jaws, whereas sympathectomy caused a reduction, but not a total loss, of NPY- and DBH-IR nerves. It is concluded that, except for some distributional differences, the oral tissues in the ferret have an abundant sensory innervation similar to that found in other species.

Coexpression of vasoactive intestinal polypeptide and substance P in reinnervating pulpal nerves and in trigeminal ganglion neurones after axotomy of the inferior alveolar nerve in the rat.

The effect of this axotomy on the expression of vasoactive intestinal polypeptide (VIP) in trigeminal ganglion neurones and nerve fibres in the first molar was examined immunohistochemically 3 weeks postsurgically in rats. A distinct upregulation of VIP-like immunoreactivity was found in 3 to 4% of the neurones (mean dia., 20.9 +/- 0.45 microns; mean cross-sectional area, 367 +/- 13.2 microns 2) in the mandibular region after axotomy. An almost complete coexpression was registered in neurones upregulated for VIP and growth-associated protein 43. Coexpression of VIP and substance P (SP) was found in a small number of the immunoreactive (IR) small-sized neurones, mainly in those in which VIP and SP were both weakly immunoreactive. In the uninjured ganglion, weakly labelled VIP-positive granules were frequently traced at high magnification in the cytoplasm of small neurones. No VIP-IR fibres were found in the control molar pulp, except for a few in the root pulp near the apex. However, 3 weeks after axotomy, a number of VIP-containing nerve fibres were found in the molar pulp and apical periodontium. Coarse VIP-IR fibres directed towards the odontoblast layer were a common finding. In some of these fibres VIP was shown to colocalize with SP. These results indicate that VIP is clearly expressed and transported in regenerating primary afferent neurones after axotomy of the inferior alveolar nerve.

Immunoelectron microscopic study on neuropeptide Y in the periodontal ligament of the incisor following peripheral nerve injury to the inferior alveolar nerve in the rat.

Immunoelectron microscopic analysis was carried out to examine whether neuropeptide Y (NPY)-like immunoreactivity (-LI) is localized in mechanoreceptors in the lingual periodontal ligament of the rat incisor following peripheral nerve injury to the inferior alveolar nerve (IAN). In the lingual periodontal ligament of normal animals, no NPY-like immunoreactive (-IR) primary afferents were observed, except for a very few sympathetic perivascular nerve fibers which showed NPY-LI. Fourteen days following chronic constriction injury to the IAN combined with sympathectomy of the superior cervical ganglion, thick NPY-IR nerve fibers showing tree-like raminifications were detected in the shear zone between the tooth-related part and alveolus-related part as well as in the alveolus-related part. Immunoelectron microscopy revealed that expanded NPY-IR nerve terminals were covered with several Schwann sheaths and that a part of the axoplasm expanded to the surrounding tissues. These ultrastructural features of NPY-IR structures were identical to those of periodontal Ruffini endings, categorized as slowly adapting mechanoreceptors. Thick (6-8 microns in diameter) NPY-IR axons were also observed without any apparent myelin sheath. The present results provide further evidence that NPY is closely associated with thick axons, probably myelinated nerves and Ruffini endings, following peripheral nerve injury.

Effects of peripheral axotomy of the inferior alveolar nerve on the levels of neuropeptide Y in rat trigeminal primary afferent neurons.

The effects of peripheral axotomy of the inferior alveolar nerve (IAN) on the presence and distribution of neuropeptide Y (NPY)-like immunoreactivity (IR) in the trigeminal sensory nuclear complex (TSNC) and trigeminal ganglion were investigated in the rat by immunohistochemistry. In the normal trigeminal ganglion, there were no NPY-IR cells, and some perivascular nerve fibres exhibited NPY-IR. In normal TSNC, many NPY-IR axons and nerve terminals were observed in the superficial layers of the subnucleus caudalis (SpVc) and paratrigeminal nucleus (paraV), but were sparse in the other subnuclei of the TSNC. Fourteen days following peripheral axotomy of the IAN, many large- and medium-sized cells in the trigeminal ganglion displayed NPY-IR, and marked increases in the numbers and staining densities of NPY-IR were observed in deeper laminae (laminae III-V) of the dorso-medial region of the SpVc and other nuclei, in addition to the dorso-medial region of the spinal trigeminal tract. Degrees of alterations of the levels of NPY were most marked in the SpVc. The present results indicate that peripheral axotomy of the IAN evokes the appearance of NPY-IR in the trigeminal ganglion and alterations of NPY-IR in the entire IAN projection areas of the TSNC.

Changes in the inferior alveolar nerve following mandibular lengthening in the dog using distraction osteogenesis.

Distraction osteogenesis as per Ilizarov was used to lengthen the canine mandible. In this study, physiological and ultrastructural examination of the inferior nerve was performed. Mandibular body corticotomies were performed, and the mandible was distracted 7 mm. The animals were killed 4 weeks after the distraction was completed. Bone formed within the distraction gap in all dogs. There was no statistically significant difference in the jaw-jerk voltage between control and experimental sides. There was a significant difference between the distracted and control nerves in only one area of one nerve.

Distribution of otic postganglionic and recurrent mandibular nerve fibres to the cavernous sinus plexus in monkeys.

The distribution of dorsal rami of the otic ganglion was traced on one or both sides of 1 rhesus and 15 cynomolgus monkeys using interrupted serial sections. From 15 to 24 fine rami containing unmyelinated and small myelinated nerve fibres entered the cranial cavity with the mandibular nerve through the foramen ovale. Most rami contributed to a plexus positioned in the crotch of the mandibular and maxillary nerves adjacent to the trigeminal ganglion. The plexus was augmented by an accessory otic ganglion. Rami then continued dorsally on each side of or through the maxillary nerve and joined the cavernous sinus plexus. The pathway described probably gives otic parasympathetic fibres access to the cerebral arteries and may share a wider distribution in common with other nerves contributing to the cavernous sinus plexus.

Electron microscopy of pterygopalatine ganglion in starved rats.

The ultrastructure of rat's pterygopalatine ganglionic neurocytes after starvation was investigated. The following changes of cell organelles were observed. The mitochondria display altered internal structures--lack of matrix, swellings, and myelin structures. Rough endoplasmic reticulum and free ribosomes were reduced. Strong plication of nuclear membrane, diminution of nucleoli, increased number of lysosomes and lipofuscin granules were also noticed. The extent of these changes is variable and depends on the time period of starvation. The smallest changes were observed in the groups starved for 24-48 hrs, the largest--in the groups starved 120-144 hrs.

Effects of the penetration of a root canal filling material into the mandibular canal. 2. Changes in the alveolar nerve tissue.

The root canal filling material "Vitapex" (Neo Dental Chemical Products Co., Tokyo), made of calcium hydroxide and iodoform with the addition of silicone oil, was experimentally injected into the mandibular canals of dogs, and its effect on the alveolar nerve tissue was examined by light and electron microscopy. No change was observed as long as the injected paste did not come into direct contact with the nerve, but tissue damage was found at sites of direct contact. After removal of degenerated nerve debris by macrophages and Schwann cells, the persisting external membranes or "Schwann tubes" appeared to provide a scaffolding for axonal regeneration and Schwann cell proliferation.