Effect of vasodilating drugs on external carotid and pulpal blood flow in dogs: "stealing" of dental perfusion pressure.

Blood flow in the external cartoid artery (ECBF) and dental pulp (PBF) was measured during arterial infusion of vasodilators (isoprenaline, papaverine, acetylcholine and bradykinin). Systemic arterial pressure (AP) and local arterial pressure of the teeth (LAP) were recorded in a femoral and the lateral nasal artery respectively. All four vasodilators were found to increase ECBF and simultaneously reduce lateral nasal arterial pressure--or in other words-to STEAL" PERFUSION PRESSURE FROM THE TEETH. AP remained practically unchanged whereas PBF was variably affected. During infusion of isoprenaline PBF decreased on average by 19% of control. Papaverine nearly doubled PBG, while bradykinin caused no consistent change. Great pulpal flow variations were often recorded during constant acetylcholine infusion rate. The variable effect of the four vasodilators on PBF could partly be explained by the fall in LAP. Calculated pulpal resistance (LAP/PBF) showed no consistent change during isoprenaline infusion, bradykinin caused a slight fall and papaverine reduced LAP/PBF by 49%. The experiments demonstrate that due to the "stealing" of dental perfusion pressure caused by vasodilation in the neighbouring tissues, the effect of vasodilators on pulpal resistance vessels cannot be estimated without knowledge of the pressure in the small arteries directly feeding the teeth.