Migration of inflammatory cells

Local damage pulp activates the migration of inflammatory cells. After traumas, various substances are exempt from resident cells that invitations neutrophils and mononuclear cells (monocytes and T - and B-lymphocytes) to leave the cardiovascular system. If no or little bacterial involvement in conjunction with the injury, for example. after the preparation of the injury, the infiltration of neutrophils will be limited, and these cells will soon disappear. On the contrary, the bacterial action, for example, along the margins of poorly sealed restoration, neutrophils can accumulate in large quantities and type of the tooth pulp ends of the dentinal tubules (Fig. 2.18). In this position they are likely to contribute to the tooth pulp protection, blocking both the spread of bacterial macromolecules and the penetration of bacterial organisms (4).

Peripheral blood monocytes also infiltration in the place of injury.

Once the tissue, monocytes are activated and become macrophages, which will have many important functions, including:

• bacterial killing;
• purification of cellular debris;
• antigen presentation;
• stimulation of tissue repair on angiogenesis and fibroblast proliferation.

For further information about the mediators of inflammation of the pulp of the tooth see advanced concept 2.4.

Advanced concepts of 2.4 Mediators of inflammation of the pulp of the tooth

In concert, numerous local production of inflammatory mediators, including eicosanoids, cytokines and neuropeptide support the inflammatory process and the subsequent repair phase. As CGRP and SP to chemotactic attraction of leukocytes, induce the expression of adhesion molecules on the vessel walls needed to exit these cells, tissues and modulate T-lymphocytes activity (34, 62).

In many animal models, increased flexibility of the tooth pulp innervation was not observed. Within 48 hours after experimental impact of the pulp in the oral environment, neuropeptides, including swaps and CGRP, enlarged in nerve endings close to the zone of inflammation. Additionally, there are numerous branching and germination of peptides containing nerve endings in the border zone of the inflammatory process (39). This result peptides containing nerves is part of an over-reaction protection, which fully developed within 48 hours after the injury and lasts as long as irritation persists. These local phenomena governed trigeminal cells of the body through the peripheral influences. Activating signals are transmitted by a neuro-trophin: nerve growth factor (NGF). This substance is usually formed at a low level in the tooth pulp fibroblasts and serves to maintain the integrity of the peripheral nerve endings (46) and to accelerate the recovery of tissues (45). Therefore, increased local innervation, and increasing levels of neuropeptide support mobilization and activation of cells required for optimum protection and repair response...