Full mouth rehabilitation of edentulous patient with fixed implant prosthesis

There are various treatment options such as conventional complete denture, hybrid prosthesis and implant-supported fixed prosthesis for fully edentulous patients. In case of implant-supported fixed prosthesis, compared to removable prosthesis, it is difficult to place the implant in the correct position considering the anatomical contours of the final prosthesis. In this case, a full mouth rehabilitation with implant-supported fixed prosthesis was performed for a patient who required extraction of all remaining teeth due to dental caries and chronic periodontitis. In the implant placement stage, the implant was placed in the desired position using a surgical guide fabricated considering the anatomical contours of the final prosthesis, and the function and esthetics were evaluated through correction and re-fabrication of the fixed provisional restoration. A final restoration of porcelain fused to gold prosthesis was delivered to the patient based on the provisional restoration. To cope with complications such as loosening of screws and fracture of porcelain, a screw-retained type prosthesis was fabricated for the posterior part and a screw-cement-retained type prosthesis for the anterior part. As a result, the patient showed an improved prognosis in terms of functional and esthetics after the final prosthesis was delivered.

The Situation of Life-Sustaining Treatment One Year after Enforcement of the Act on Decisions on Life-Sustaining Treatment for Patients at the End-of-Life in Korea: Data of National Agency for Management of Life-Sustaining Treatment / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The “Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End-of-Life” was enacted on February 3, 2016 and went into effect on February 4, 2018 in Korea. This study reviewed the first year of determination to life-sustaining treatment (LST) through data analysis of the National Agency for Management of Life-Sustaining Treatment. @*Materials and Methods@#The National Agency for Management of LST provided data between February 4, 2018 and January 31, 2019 anonymously from 33,549 patients. According to the forms patients were defined as either elf-determinants or family-determinants. @*Results@#The median age of the patient was 73 and the majority was male (59.9%). Cancer patients were 59% and self-determinants were 32.1%. Cancer patients had a higher rate of self-determinants than non-cancer (47.3% vs. 10.1%). Plan for hospice service was high in cancer patients among self-determinants (81.0% vs. 37.5%, p < 0.001). In comparison to family-determinants, self-determinants were younger (median age, 67 years vs. 75 years; p < 0.001) and had more cancer diagnosis (87.1% vs. 45.9%, p < 0.001). Decision of withholding or withdrawing of LSTs in cancer patients was higher than non-cancer patients in four items. @*Conclusion@#Cancer patients had a higher rate in self-determination and withholding or withdrawing of LSTs than non-cancer patients. Continued revision of the law and education of the public will be able to promote withdrawing or withholding the futile LSTs in patients at end-of-life. Further study following the revision of the law should be evaluated to change of end-of-life care.

Three-dimensional printed complete denture fabrication using the scan data from the conventional denture-making process

Recently three-dimensional (3D) printed complete dentures are becoming more widely recognized as one of the treatment options for the edentulous patients. Korean National Healthcare, however, has not yet approved the application of the 3D printed dentures, and in the cases where the dentures should be refabricated, the conventional fabrication process needs to be entirely repeated.However, during the conventional process, the digital scan data of some key steps could be easily obtained. In this clinical case, using these data, a new pair of 3D printed dentures that improved the limitations of the first conventional dentures were successfully fabricated.

Three-dimensional printed complete denture fabrication using the scan data from the conventional denture-making process

Recently three-dimensional (3D) printed complete dentures are becoming more widely recognized as one of the treatment options for the edentulous patients. Korean National Healthcare, however, has not yet approved the application of the 3D printed dentures, and in the cases where the dentures should be refabricated, the conventional fabrication process needs to be entirely repeated.However, during the conventional process, the digital scan data of some key steps could be easily obtained. In this clinical case, using these data, a new pair of 3D printed dentures that improved the limitations of the first conventional dentures were successfully fabricated.

Full mouth rehabilitation for a Parkinson's diseases patient with chronic periodontitis: a case report

Parkinson's disease is a neurological disorder characterized by tremor, bradykinesia, akinesia, postural instability, and muscular rigidity, which is caused by the depletion of neurotransmitters such as dopamine. Cooperative dental treatment is more challenging because of tremor of Parkinson's disease. In this case, a 47-year-old Parkinson's disease patient with chronic periodontitis was treated with full-mouth rehabilitation using conventional fixed prostheses and implant fixed partial denture, which attained satisfactory outcomes functionally and esthetically. Short term periodic follow-ups will be needed with consideration for the characteristics of Parkinson's disease such as decreased manual dexterity.

Prosthetic rehabilitation using an obturator in a fully edentulous patient who had partial maxillectomy

Prosthetic rehabilitation of an edentulous patient who has a maxillary defect is difficult to achieve for many clinicians. The maxillary defect causes leakage of air during pronunciation and compromises denture stability, support and retention by reducing denture-bearing area and breaking peripheral seal. In these patients, the sizes and shapes of defects are very important factors which attribute to prognosis of maxillary obturators. This case report shows the prosthetic rehabilitation of the patient who had maxillectomy on the right maxillary sinus because of squamous cell carcinoma. The patient had a stepwise treatment protocol which started with pre-operative dental examination and followed by surgical, interim and definitive obturation phase. In this case, an acceptable level of retention could be obtained due to well-defined static defects and the preserved premaxillae and the patient was satisfied with the result of the treatment in the aspect of function and esthetics.

Prosthetic rehabilitation of a fully edentulous patient after maxillectomy: A case report / 대한치과보철학회지

Most patients with acquired maxillary surgical defects have difficulties such as functional impairments of mastication, speech, and deglutition as well as various degrees of facial deformity. The purpose of a prosthetic approach is to restore function and appearance with an obturator as normal as possible. This goal can be achieved when there is thoughful preoperative communication between a prosthodontist and a surgeon regarding a rehabilitation. In this case report, prosthetic rehabilitation was planned before the surgery for the patient diagnosed with squamous cell carcinoma in the right maxillary sinus with careful oral examination. Four months after maxillectomy, a definitive obturator was fabricated following the surgical and interim obturation phase. The objective of this case report is to describe the satisfactory results of the patient with improved rehabilitation of mastication, speech, deglutition, and appearance.

Dental implant treatment after healing of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in the same region: a case report

Although pathophysiology, incidence, and factors associated with the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and management strategies for patients treated with bisphosphonates or patients with BRONJ are well-established, few guidelines or recommendations are available for patients with a history of successfully healed BRONJ. We present a case of successful dental implant treatment after healing of BRONJ in the same region of the jaw, and speculate that implant placement is possible after healing of BRONJ surgery in select cases.

Atrioventricular Flow Wave Patterns before and after Birth by Fetal Echocardiography

BACKGROUND: Doppler echocardiographic measurements of both valves during intrauterine life can be used to calculate peak early filling velocity (E)/late peak atrial filling velocity (A) ratio as a single index of diastolic performance. The purposes of this study were to estimate the changes in atrioventricular valve flow from gestational age 37-40 weeks to 1 month of postnatal life and to clarify the difference in right and left ventricular diastolic filling patterns. METHODS: Atrioventricular flow waves were analyzed in 24 full-term pregnant women by fetal echocardiography. Postnatal follow-up studies were performed at 1 hour, 6 hours, 24 hours, 3 days, 1 week and 1 month. In each time point, pulsed Doppler echocardiography was used to interrogate Doppler waveform of E velocity, A velocity, total area under the curve (time velocity integral) and heart rate. RESULTS: Mitral E/A ratio significantly increased from 0.7 +/- 0.1 before birth to 1.0 +/- 0.3 at postnatal 1 hour, 1.0 +/- 0.2 at 1 week, and 1.5 +/- 1.0 at 1 month. Tricuspid flow E/A ratio was 0.8 +/- 0.3 before birth, 0.8 +/- 0.1 at 1 hour, 0.8 +/- 0.2 at 3 days, 0.9 +/- 1.0 at 1 month. Time velocity integral of tricuspid flow was significantly higher than that of mitral flow before birth, but there was no difference after birth. CONCLUSION: The dominance of mitral A wave before birth was changed very quickly after birth to the dominance of E wave, but the dominance of tricuspid A wave was maintained at 1 month. Diastolic function and compliance of mitral valve were better than those of the tricuspid valve after birth.

Cellular attachment and gene expression of osteoblast-like cells on zirconia ceramic surfaces / 대한치과보철학회지

STATEMENT OF PROBLEM: Zirconium oxide can be a substitute to titanium as implant materials to solve the esthetic problems of dark color in the gingival portion of implant restorations. PURPOSE: This study was performed to define attachment and growth behavior of osteoblast-like cells cultured on grooved surfaces of zirconium oxide and evaluate the genetic effect of zirconium oxide surfaces using the reverse transcriptase-polymerase chain reaction (RT-PCR). MATERIAL AND METHODS: MC3T3-E1 cells were cultured on (1) commercially pure titanium discs with smooth surface (T group), (2) yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) with machined surface (ZS group), and (3) Y-TZP with 100micrometer grooves (ZG group). Cell proliferation activity was evaluated through MTT assay and cell morphology was examined by SEM. The mRNA expression of Runx2, alkaline phosphatase, osteocalcin, TGF-beta 1, IGF-1, G3PDH in E1 cells were evaluated by RT-PCR. RESULTS: From the MTT assay, after 48 hours of adhesion of MC3T3-E1 cells, the mean optical density value of T group and ZG group significantly increased compared to the ZS group. SEM images of osteoblast-like cells showed that significantly more cells were observed to attach to the grooves and appeared to follow the direction of the grooves. After 24 hours of cell adhesion, more spreading and flattening of cells with active filopodia formation occurred. Results of RT-PCR suggest that T group, ZS group, and ZG group showed comparable osteoblast-specific gene expression after 24 hours of cell incubation. CONCLUSION: Surface topography and material of implants can play an important role in expression of osteoblast phenotype markers. Zirconia ceramic showed comparable biological responses of osteoblast-like cells with titanium during a short-time cell culture period. Also, grooves influence cell spreading and guide the cells to be aligned within surface grooves.

Novel treatment modality of implant-retained overdenture for immediate function in completely edentulous patients / 대한치과보철학회지

STATEMENT OF PROBLEM: Conventional mandibular complete denture lacks in support and stability for edentulous patients to use. PURPOSE: To enhance support and stability of mandibular complete denture, 2 implants were inserted on the inter-mental foramina space of edentulous patients. With 2 magnetic attachments on the inner side of the overdenture, we gave immediate loads and evaluated the stability of the implants, the responses of the supporting tissues, and the satisfaction of the patients. MATERIAL & METHODS: 6 edentulous patients (5 male, 1 female) each recieved 2 SLA implants in the inter-mental foramina region and implants were immediately loaded with overdenture with magnet attachments. To evaluate the implants stability and the peri-implant tissues, clinical exams, RFA tests and radiographic exams were preformed at the 1 week, 2wks, 6wks, 12wks, and 24wks. post-surgery. RESULTS: The mean surgery time was 45.7 +/- 7.7 mins., while the denture delivery time was 45.5 +/- 12.6 mins. Only 2 of 14 implants were failed. Survived implants that remained were clincally and radiographically stable. Mean ISQ values were relatively stable, showing 69.71+/-5.55, 69.00+/-9.48, 67.92+/-7.86, 67.92+/-9.58, 70.08+/-7.61, 71.92+/-6.43 at the 1 wk, 2 wks, 6 wks, 12 wks, 24 wks. follow up check. Crestal bone changes were -1.18mm+/-0.68mm, -1.35+/-0.69mm, -1.47+/-0.68 mm at the 6wks, 12wks, 24wks. follow up check. Bleeding on probing(BOP index) was not significant. CONCLUSION: Mandibular ovedentures with 2 magnetic attachments over two interforaminal implants on edentulous patients for immediate function is a recommendable novel treatment for edentulous patients which shows stability on the implants and supporting tissue.

Change in the Expression of p75 Neurotrophin Receptor and TRPV1 in the Spinal Cord and Dorsal Root Ganglion after an Injury to the Spinal Nerves in Rats / 대한정형외과학회잡지

PURPOSE: To determine the relationship between change in the expression of the p75 neurotrophin receptor (NTR) and transient receptor potential vanilloid 1 (TRPV1) after a spinal nerve injury with time. MATERIALS AND METHODS: The L5 and L6 spinal nerve of the rats were cut unilaterally. The spinal cord and dorsal root ganglion (DRG) were subjected to immunohistochemistry for p75 NTR and TRPV1. RESULTS: The immunoreaction (IR) for p75 NTR in the neuronal cytoplasm was persistently lower on the ipsilateral L5 and L6 DRG but higher in the satellite cells and fibers. The colocalization between p75 NTR and TRPV1 was increased temporarily in the L4 DRG in both sides. In the spinal cord, p75 NTR-IR decreased temporalily in the ipsilateral dorsal horn of the L4-L6 level and had recovered at 28 days after injury. CONCLUSION: These results show that a differential change in the expression of p75 NTR and TRPV1 is related to the different functional recovery of the sensory and motor system, and that increased colocalizations between p75 NTR and TRPV1 in a non-injured DRG might be related to the development of neuropathic pain after a peripheral nerve injury.

In vitro study of tooth temperature change during polymerization reaction of the cold-cured resins used in provisional crown and fixed partial dentures / 대한치과보철학회지

STATEMENT OF THE PROBLEM: The cold-cured resins used in fabrication of the provisional crown and fixed partial dentures could cause pulpal damage by heat generated during exothermic polymerization reactions. PURPOSE: In this in vitro study investigates the how external conditions such as material of the matrix, thickness of the matrix and thickness of dentin affect the temperature of the tooth during polymerization reaction of the cold-cured resins. MATERIAL AND METHODS: To measure the temperature of the resin, metal die was maintained to the temperature of 37 degrees C with water bath to simulate the temperature of thetooth and thermocouple was placed in the center of the metal die. Acrylic pipe was cut in height of 1, 2, 3, 6, 10 mm and placed on the metal die and mixed resin was pored in the acrylic pipe. As the resin polymerized temperature was recorded with the thermometer. Temperature of the resin using matrix was recorded by using the individual tray relieved in different thickness 2, 5, 7, 10 mm. The material of the matrix was irreversible hydrocolloid impression material, vinyl polysilloxane impression material and vacuum-formed template. Temperature rise of the resin using different thickness of tooth section was recorded by placing tooth section on the metal die and placing resin over the tooth section. RESULTS: [Table]. CONCLUSION: 1. Temperature rise increased as the thickness of the resin increased but there was no significant differences over 3 mm thickness of the resin. 2. The lowest temperature rise was showed in irreversible hydrocolloid impression material and vinyl polysilloxane impression material, vacuum-formed template as in orders. 3. Temperature rise of the resin decreased regardless of the thickness of the matrix when vinyl polysilloxane impression material was used as the matrix. 4. When irreversible hydrocolloid impressionmaterial was used as matrix, the temperature rise of the resin decreased as the thickness of the matrix increased and there was no temperature rise when thickness of the matrix reached 10 mm. 5. The temperature rise of the resin did not decreased when Polypropylene vacuum-formed template was used as the matrix. 6. The temperature of the resin increased as the thickness of the dentin decreased.

The effect of permanent magnet connecting with dental implant on bone extracellular matrix formation / 대한치과보철학회지

STATEMENT OF PROBLEM: The use of permanent magnetics is increasing in implant dentistry. PURPOSE: This study is to know the effect of permanent magnetics on bone matrix formation of osteoblasts. MATERIALS AND METHODS: The konus abutment-shaped permanent magnetics were connected to the implant fixture, and placed on the culture plate. The osteoblast-like cell: Mc3T3-E1 were used for cell culture. As the control group, the implants were connected to titanium healing caps, and cultured in the same conditions of experimental group. After 3, 7, 14 days, cells were cultured, and we measured and compared the amount of collagen type I, osteocalcin, which is bone matrix protein by Western immunoblotting analysis. RESULTS: As a result of Western immunoblotting analysis for estimating the amount of bone extracellular matrix, there was no difference between osteoblast of the experimental group and the control group during 3 and 7day-osteoblast culturing. However when cells were cultured for 14days, the amount of bone extracellular matrix was increased, on the experimental group. CONCLUSION: From these results, magnetic field of permanent magnetics might have effect on bone formation of osteoblast, especially at initial stage of implant placement. Therefore, their clinical application for implant or bone graft could be possible.

Effects of 3-aminobenzamide (3-AB) on the alterations in primary afferent and spinal neurons induced by spinal nerve injury in rats / 대한정형외과연구학회지

PURPOSE: The authors studied the effect of the 3-AB, an inhibitor of poly(ADP-ribose)polymerase (PARP), on the changes of primary afferents and spinal cord after spinal nerve injury. METHOD: The L5 and L6 spinal nerve of the rats were cut, and 3-AB (10 mg/Kg) was injected intraperitoneally once per day. The animals were sacrificed 3 days, 7 days, 14 days and 28 days after nerve injury. Binding of isolectin B4 (IB4) and immunohistochemistry (IHC) of CGRP for the changes in primary afferents, IHC of NK1 for sensory neurons, and of cleaved caspase 3 and NeuN for the apoptotic changes in spinal neurons were performed. RESULT: Decreased binding of IB4 and immunoreactivity (IR) for CGRP, increase of IR for NK1, and cleaved caspase 3 in both neurons and glia in ipsilateral dorsal horn were observed after spinal nerve injury. These changes were attenuated, especially at between 3 days and 14 days, by administration of 3-AB. CONCLUSION: It is suggested that inhibition of PARP by 3-AB may attenuate alterations of primary afferents and spinal neurons, at least in early stage, after spinal nerve injury.

Effects of 3-aminobenzamide (3-AB) on the alterations in primary afferent and spinal neurons induced by spinal nerve injury in rats / 대한정형외과연구학회지

PURPOSE: The authors studied the effect of the 3-AB, an inhibitor of poly(ADP-ribose)polymerase (PARP), on the changes of primary afferents and spinal cord after spinal nerve injury. METHOD: The L5 and L6 spinal nerve of the rats were cut, and 3-AB (10 mg/Kg) was injected intraperitoneally once per day. The animals were sacrificed 3 days, 7 days, 14 days and 28 days after nerve injury. Binding of isolectin B4 (IB4) and immunohistochemistry (IHC) of CGRP for the changes in primary afferents, IHC of NK1 for sensory neurons, and of cleaved caspase 3 and NeuN for the apoptotic changes in spinal neurons were performed. RESULT: Decreased binding of IB4 and immunoreactivity (IR) for CGRP, increase of IR for NK1, and cleaved caspase 3 in both neurons and glia in ipsilateral dorsal horn were observed after spinal nerve injury. These changes were attenuated, especially at between 3 days and 14 days, by administration of 3-AB. CONCLUSION: It is suggested that inhibition of PARP by 3-AB may attenuate alterations of primary afferents and spinal neurons, at least in early stage, after spinal nerve injury.

Spectrophotometric analysis of the influence of zirconia core on the color of ceramic / 대한치과보철학회지

STATEMENT OF PROBLEM: Problem of matching the appearance of porcelain restorations with the patient's natural dentition has always been a concern to dental clinicians. Recently, demands for esthetics, even in restorations requiring strength, has brought a revolution to dentistry and increased use of zirconia. Among the various factors, shade and translucency of the core can significantly affect the overall esthetics of the restoration and should be considered when selecting an all-ceramic system. PURPOSE: The purpose of this study was to spectrophotometrically evaluate the influence of different zirconia systems and core thickness on the final shade of all-ceramic restorations using the CIEL*a*b* system. MATERIAL AND METHODS: Core specimens (n = 20 per group) of In-Ceram Alumina, In-Ceram Zirconia, Digident CAD/CAM Zirconia, Cercon Zirconia were fabricated 20mm in diameter. 10 specimens of each group were fabricated at core thickness of 0.5mm and 0.7mm. These core specimens were veneered with shade A1 and A3 porcelain of the recommended manufacturer. CIEL*a*b* coordinates were recorded for each specimen with a spectrophotometer (Model CM-2600d, Minolta, Japan). Color differences were calculated using the equation delta E*=[(delta L*)2+(delta a*)2+(delta b*)2]1/2. RESULTS: 1. Specimens of core thickness 0.5mm and 0.7mm did not exhibit clinically perceived color difference. 2. Regarding shade reproducibility, In-Ceram Alumina and In-Ceram Zirconia showed significant difference within each group. 3. Cercon Zirconia group showed the highest L* value and Digident Zirconia group showed lowest a* and b* value. 4. Generally, the shade difference between materials was higher in the A3 shade group than in the A1 shade group. CONCLUSION: Within the limitations of this study, there was no color difference after increase in core thickness and every all-ceramic system has color characteristics that clinicians have to consider when selecting materials. Also, manufacturers of different porcelain systems must make every effort to achieve color reproducibility.

The effect of permanent magnet connecting with dental implant on distribution and attachment of osteoblast-like cell around the dental implant / 대한치과보철학회지

PURPOSE: The purpose of this study is to find the effect of rare earth magnet's magnetic field of to the osteoblast around the implant by the means of observation number, and distribution around the implant which is connected to the permanent magnet but not, counted and compared by the number of cells attached to the surface of the implant. MATERIAL AND METHOD: The permanent magnets, made in the healing cap form, were connected to the implant fixture, and placed on the culture plate, The osteoblast-like cell: MC3T3-E1 were used for cell culture. As the control group, the implant were connected to normal healing cap, and cultured in the same conditions. 48 hours later, using inverted microscope, the number and distribution of osteoblast around the implant were observed, and 72 hours later, the number of the cells attached to the implant were counted. RESULTS: As a result, the implant connected to the permanent magnet had proved to have a more concentrated cell distribution rate than the control group. The implant connected to the permanent magnet, neck area: which has about 10 gauss magnetic force, had more cells than apex area. The implant connected to the permanent magnet had proven to attach to the osteoblast more productively than control group's implant. CONCLUSIONS: This research showed that the magnetic field of the permanent magnet affected the distribution and growth rate of the osteoblast around the implant. In order to support this study, it also had need to monitor the progress of the permanent magnet specifically shown on the neck area, which has10 gauss magnetic force. So after additional research on the distribution and attachment of the cells, and further more, on bone formation, it will be concluded that the clinical applications, such as immediate loading of implant treatment are possible.

The effect of solder and laser weld on corrosion of dental alloys / 대한치과보철학회지

STATEMENT OF PROBLEM: Intraoral corrosion not only affects the esthetic and function of metallic dental restoration, but also has biologic consequences as well. Therefore, corrosion is considered a primary factor when choosing the dental alloy and laboratory technique. PURPOSE: The objective of this study was to compare the effects of solder and laser weld on corrosion. MATERIAL AND METHODS: Test specimens were made of 2 types of gold alloys, Co-Cr and Ni-Cr alloy and fabricated 3 methods, respectively: as cast, solder, and laser weld. For the analysis of corroding properties, potentiodynamic polarization test and immersion test conducted. The potentiodynamic polarization scan curve were recorded in 0.9% NaCl solution(pH 7) using Potentiostat/Galvanostat Model 273A. All specimens were exposed to 0.9% NaCl solution(pH 2.3) during 14 days. Elemental release into corrosive solution was measured by atomic emission spectrometry. Differences in corrosion potential and mass release were determined using ANOVA. RESULTS AND CONCLUSION: Through analyses of the data, following results were obtained. 1. In Pontor MPF and Wiron 99, corrosion potential of the solder group was statistically lower than as cast and laser weld group(p0.05). In Jel-Bios 10 and Wirobond, there was no difference of corrosion potential according to joining methods(p>0.05). 2. In all tested alloys, the amount of released metallic ion was greatest in the solder group(p0.05). 3. In scanning electron microscopic examination, except soldered Wiron 99 specimens, it is impossible to discriminate the corrosive property of solder and laser weld. 4. Under the this experimental circumstances, laser weld appears superior to the solder when corrosion is considered.

Anatomical Characterization of Vanilloid Receptor 1 (VR1)-positive Primary Afferents in Lower Lumbar Cord in the Rat / 대한해부학회지

Primary afferents sensitive to capsaicin and noxious heat express vanilloid receptor 1(VR1) in both their peripheral and central fibers and terminals. We used multiple immunofluorescence and confocal microscopy to characterize their pattern of termination in rat spinal cord, colocalization of neurochemical markers of primary afferents and other presynaptic receptors. VR1-positive unmyelinated fibers mainly terminate in lamina I, where they co-stain for CGRP, and to a limited extent for SP, and in lamina II, especially its medial half, where they co-stain for IB4. VR1 positive thin myelinated fibers terminate in lamina I and co-stain for the neurochemical tracer CTB, injected in the sciatic nerve. As revealed by simultaneous staining for the synaptic marker synaptophysin, VR1-positive terminals are abundant in lamina I and sparse in lamina II. In L6-S1 spinal cord, VR1-positive fibers and terminals were abundant in Lissauer's tract, lamina I-V, medial collateral path to lamina X, and lateral collateral path to sacral parasympathetic nucleus. Most of VR1 positive fibers in Lissuer's tract and LCP are colocalized with SP. In conclusion, it is suggested that VR1 positive fibers in spinal cord are both peptidergic and non-peptidergic, IB4 positive fibers, mediating both somatic and visceral sensations, and that peptidergic VR1 positive fibers are mainly related with visceral sense.