The role of the endogenous opioid system in modulating orthodontic-induced neurogenic inflammation of the dental pulp: A comprehensive review of the literature

IF 7.1 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

International endodontic journal Pub Date : 2025-05-14 DOI:10.1111/iej.14251

Javier Caviedes-Bucheli, Nestor Rios-Osorio, Esteban Ulate-Rodríguez, Hernan Dario Muñoz-Alvear, José F. Gaviño-Orduña, P. Sebastian Ortolani-Seltenerich, Jose F. Gomez-Sosa, Hugo Roberto Munoz

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引用次数: 0

Abstract

Background

Orthodontic forces may lead to neurogenic inflammation in the dental pulp by triggering the release of somatosensory neuropeptides such as Substance P (SP), Calcitonin gene-related peptide (CGRP) and Neurokinin A (NKA). In the vast majority of patients, acute symptoms are not triggered, probably due to the control of the neurogenic inflammatory process exerted by endogenous opioid systems.

Objective

This review aimed to assess the cellular and molecular mechanisms through which the endogenous opioid system modulates the orthodontic-induced neurogenic inflammation of the dental pulp and to identify potential mechanisms for endogenous control of pulp pain.

Methods

A literature search was conducted in the databases Pubmed, ISI Web of Science and Scopus to find relevant studies using the keywords: “orthodontic movement,” “opioids” and “neurogenic inflammation.” Following the PRISMA and Amstar recommendations, studies were selected for the literature review.

Results

After removing duplicated and irrelevant articles, and those that does not meet the inclusion criteria, 38 articles were selected and classified according to the opioid peptides analysed in relation to orthodontic movement and dental pulp.

Discussion

Both peripheral and central pathways, via endogenous opioid systems such as somatostatin (SST), dynorphin, β-endorphin, methionine enkephalin, endocannabinoids and anti-inflammatory cytokines, modulate the neurogenic inflammation elicited by orthodontic movements. The bradykinin and monoaminergic systems also appear to display regulatory effects on pain response. These control mechanisms, however, may be insufficient in cases where severe orthodontic forces are applied, thus leading to asymptomatic irreversible pulpitis or necrosis.

Conclusion

The opioid system regulates neurogenic pulpal inflammation and pain at the level of the central and peripheral nervous systems by releasing endogenous substances, including SST, opioid peptides, endocannabinoids and anti-inflammatory cytokines.

Abstract Image

查看原文本刊更多论文

内源性阿片系统在调节正畸诱导的牙髓神经源性炎症中的作用：文献综述。

背景：正畸力可触发体感觉神经肽的释放，如P物质（SP）、降钙素基因相关肽（CGRP）和神经激肽A (NKA)，从而导致牙髓神经源性炎症。在绝大多数患者中，急性症状不会被触发，可能是由于内源性阿片系统对神经源性炎症过程的控制。目的：本综述旨在评估内源性阿片系统调节正畸诱导牙髓神经源性炎症的细胞和分子机制，并确定内源性控制牙髓疼痛的潜在机制。方法：以“orthodontic movement”、“opioids”、“neurogenic inflammation”为关键词，在Pubmed、ISI Web of Science和Scopus数据库中进行文献检索，查找相关研究。根据PRISMA和Amstar的建议，选择研究进行文献综述。结果：剔除重复、不相关及不符合纳入标准的文献后，根据分析的阿片肽与正畸运动及牙髓的关系，筛选出38篇文献进行分类。讨论：外周和中枢通路通过内源性阿片系统，如生长抑素（SST）、促啡肽、β-内啡肽、甲硫氨酸脑啡肽、内源性大麻素和抗炎细胞因子，调节正畸运动引起的神经源性炎症。缓激素和单胺能系统也表现出对疼痛反应的调节作用。然而，这些控制机制在施加严重正畸力的情况下可能是不够的，从而导致无症状的不可逆牙髓炎或坏死。结论：阿片系统通过释放内源性物质，包括SST、阿片肽、内源性大麻素和抗炎细胞因子，在中枢和外周神经系统水平调控神经源性牙髓炎和疼痛。

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来源期刊

International endodontic journal 医学-牙科与口腔外科

CiteScore

10.20

自引率

28.00%

发文量

195

审稿时长

4-8 weeks

期刊介绍： The International Endodontic Journal is published monthly and strives to publish original articles of the highest quality to disseminate scientific and clinical knowledge; all manuscripts are subjected to peer review. Original scientific articles are published in the areas of biomedical science, applied materials science, bioengineering, epidemiology and social science relevant to endodontic disease and its management, and to the restoration of root-treated teeth. In addition, review articles, reports of clinical cases, book reviews, summaries and abstracts of scientific meetings and news items are accepted. The International Endodontic Journal is essential reading for general dental practitioners, specialist endodontists, research, scientists and dental teachers.