Aim: Dentine hypersensitivity (DH) is characterized by a short, sharp pain arising from exposed dentin. Most published literature reports on... » More

Aim: Dentine hypersensitivity (DH) is characterized by a short, sharp pain arising

from exposed dentin. Most published literature reports on peripheral neural

aspects of this pain condition. The current investigation focused on differential

cerebral activity elicited by stimulation of sensitive and insensitive teeth by means

of natural air stimuli.

Materials and Methods: Five graded stimulus strengths were randomly applied by

means of a multi-injector air jet delivery system, each followed by an individual

rating of perceived stimulus intensity. Brain activity was analysed by functional

magnetic resonance imaging (fMRI).

Results: Stimulation of sensitive teeth induced significant activation in the thalamus,

somatosensory cortices (SI & SII), anterior, middle and posterior insular

cortices, anterior midcingulate cortex, perigenual anterior cingulate cortex and

frontal regions (BA10 and BA46). Differential responses to DH and painless perceptions

were observed in the anterior insula and anterior midcingulate cortex.

Conclusion: For the first time, this fMRI study demonstrates the feasibility of

investigating cerebral processes related to DH evoked by natural (air) stimuli.

Our neuroimaging data additionally provide evidence that differential activity in

the anterior Insula (aIC) and anterior midcingulate cortex (aMCC) may represent

clinically relevant pain experienced by DH patients.

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