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Perényi J, Fazekas A, Benedek Gy:

Neurophysiological Background of Pain in the Orofacial Area Review of the literature

The article presents an overview on the peripheral and central neural mechanisms underlying pain in the orofacial area. First a definition of pain and a description of general aspects of orofacial pain are presented. Characteristics of acute and chronic pain are also described. The study highlights the sense organs, the molecular mechanisms and categories of primary afferents involved in peripheral events of orofacial pain. After describing the brain-stem nuclei participating in trigeminal pain and their functional role, primary afferents involved in nociceptive sensation from the tooth pulp, explanations of dentinal sensitivity and differences between the brain-stem endings of primary afferents among different species are discussed in details. The role of higher brain centres, with a special emphasis on the thalamus and somatosensory cortex in the development of orofacial pain sensation is considered. The last section provides a review about how the activities of nociceptive neurons are controlled by higher brain centres and neurochemicals involved in pain transmission.

Key words: orofacial pain, dentinal sensitivity, trigeminal nociceptive sensation, modulation of pain, neural aspects of pain