Influence of the rate of force application on the absolute psychophysical threshold level of periodontal mechanoreceptors in man

Periodontal mechanoreceptors and bruxism at low bite forces

OBJECTIVE

In this study, we examined if 6-9 Hz jaw tremor, an indirect indicator of Periodontal Mechanoreceptor (PMR) activity, is different in bruxists compared to healthy participants during production of a low-level constant bite force.

METHODS

Bite force and surface EMG from the masseter muscle were recorded simultaneously as participants (13 patients, 15 controls) held a force transducer between the upper and lower incisors very gently.

RESULTS

Tremor in 6-9 Hz band for bruxists was greater on average compared to controls, but the difference was not significant, both for force recordings and EMG activity.

CONCLUSIONS

The low effect sizes measured with the current protocol contrast highly with those of our previous study, where larger, dynamic bite forces were used, and where jaw tremor was markedly different in bruxists compared with controls.

SIGNIFICANCE

We have now gained important insight into the conditions under which abnormal jaw tremor can be elicited in bruxism. From a scientific standpoint, this is critical for understanding the 'abnormality' of PMR feedback in bruxism. From a clinical perspective, our results represent progress towards the development of an optimal protocol in which jaw tremor can serve as a biological marker of bruxism.

The Dynamics of Voluntary Force Production in Afferented Muscle Influence Involuntary Tremor

Voluntary control of force is always marked by some degree of error and unsteadiness. Both neural and mechanical factors contribute to these fluctuations, but how they interact to produce them is poorly understood. In this study, we identify and characterize a previously undescribed neuromechanical interaction where the dynamics of voluntary force production suffice to generate involuntary tremor. Specifically, participants were asked to produce isometric force with the index finger and use visual feedback to track a sinusoidal target spanning 5-9% of each individual's maximal voluntary force level. Force fluctuations and EMG activity over the flexor digitorum superficialis (FDS) muscle were recorded and their frequency content was analyzed as a function of target phase. Force variability in either the 1-5 or 6-15 Hz frequency ranges tended to be largest at the peaks and valleys of the target sinusoid. In those same periods, FDS EMG activity was synchronized with force fluctuations. We then constructed a physiologically-realistic computer simulation in which a muscle-tendon complex was set inside of a feedback-driven control loop. Surprisingly, the model sufficed to produce phase-dependent modulation of tremor similar to that observed in humans. Further, the gain of afferent feedback from muscle spindles was critical for appropriately amplifying and shaping this tremor. We suggest that the experimentally-induced tremor may represent the response of a viscoelastic muscle-tendon system to dynamic drive, and therefore does not fall into known categories of tremor generation, such as tremorogenic descending drive, stretch-reflex loop oscillations, motor unit behavior, or mechanical resonance. Our findings motivate future efforts to understand tremor from a perspective that considers neuromechanical coupling within the context of closed-loop control. The strategy of combining experimental recordings with physiologically-sound simulations will enable thorough exploration of neural and mechanical contributions to force control in health and disease.

Psychophysical evaluation of haptic perception under augmentation by a handheld device

OBJECTIVE

This study investigated the effectiveness of force augmentation in haptic perception tasks.

BACKGROUND

Considerable engineering effort has been devoted to developing force augmented reality (AR) systems to assist users in delicate procedures like microsurgery. In contrast, far less has been done to characterize the behavioral outcomes of these systems, and no research has systematically examined the impact of sensory and perceptual processes on force augmentation effectiveness.

METHOD

Using a handheld force magnifier as an exemplar haptic AR, we conducted three experiments to characterize its utility in the perception of force and stiffness. Experiments 1 and 2 measured, respectively, the user's ability to detect and differentiate weak force (<0.5 N) with or without the assistance of the device and compared it to direct perception. Experiment 3 examined the perception of stiffness through the force augmentation.

RESULTS

The user's ability to detect and differentiate small forces was significantly improved by augmentation at both threshold and suprathreshold levels. The augmentation also enhanced stiffness perception. However, although perception of augmented forces matches that of the physical equivalent for weak forces, it falls off with increasing intensity.

CONCLUSION

The loss in the effectiveness reflects the nature of sensory and perceptual processing. Such perceptual limitations should be taken into consideration in the design and development of haptic AR systems to maximize utility.

APPLICATION

The findings provide useful information for building effective haptic AR systems, particularly for use in microsurgery.

Jaw tremor as a physiological biomarker of bruxism

OBJECTIVE

To determine if sleep bruxism is associated with abnormal physiological tremor of the jaw during a visually-guided bite force control task.

METHODS

Healthy participants and patients with sleep bruxism were given visual feedback of their bite force and asked to trace triangular target trajectories (duration=20s, peak force <35% maximum voluntary force). Bite force control was quantified in terms of the power spectra of force fluctuations, masseter EMG activity, and force-to-EMG coherence.

RESULTS

Patients had greater jaw force tremor at ∼8 Hz relative to controls, along with increased masseter EMG activity and force-to-EMG coherence in the same frequency range. Patients also showed lower force-to-EMG coherence at low frequencies (<3 Hz), but greater coherence at high frequencies (20-40 Hz). Finally, patients had greater 6-10 Hz force tremor during periods of descending vs. ascending force, while controls showed no difference in tremor with respect to force dynamics.

CONCLUSION

Patients with bruxism have abnormal jaw tremor when engaged in a visually-guided bite force task.

SIGNIFICANCE

Measurement of jaw tremor may aid in the detection/evaluation of bruxism. In light of previous literature, our results also suggest that bruxism is marked by abnormal or mishandled peripheral feedback from the teeth.

Threshold for Detection of Incisal Forces Is Increased by Jaw Movement

Current knowledge regarding the sensitivity of the teeth to forces is based on psychophysical experiments that measured touch detection thresholds under static jaw conditions. It is not known whether jaw movements alter the perception of forces applied to the teeth, but, based on limb movement studies, it is hypothesized that the perception of mechanoreceptor outputs will be downwardly modulated by jaw movements. We predicted that, compared with static jaw conditions, rhythmic jaw movements would be associated with significantly higher psychophysical thresholds for the detection of incisally applied forces. In eight participants, mechanical pulses were delivered to an incisor during static jaw holding or during cyclic jaw opening and closing. Analogous to findings in human limbs, the psychophysical salience of periodontal mechanoreceptor feedback was downwardly modulated by physiologically relevant movements; detection thresholds for mechanical pulses applied to a central incisor were significantly higher during jaw-closing movements than during static jaw positioning.

Mandibular physiological tremor is reduced by increasing-force ramp contractions and periodontal anaesthesia

We have previously shown that the application of anaesthesia to periodontal mechanoreceptors (PMRs) dramatically reduces the 6-12 Hz physiological tremor (PT) in the human mandible during constant isometric contractions where visual feedback is provided. This current study shows that during a ramp contraction where force is slowly increased, the amplitude of mandibular PT is almost five times smaller on average than when the same force ramp is performed in reverse, i.e. force is slowly decreased. This smaller tremor is associated with a higher mean firing rate of motor units (MUs) as measured by the sub-30 Hz peak in the multi-unit power spectrum. The decrease in the amplitude of PT following PMR anaesthetisation is associated in some instances with a similar increase in the overall firing rate; however this change does not match the diminution of tremor. The authors postulate that the decrease in mandibular PT during increasing force ramps may be due to a change in the mean firing rate of the MUs. The change in tremor seen during PMR anaesthetisation may in part be due to a similar mechanism; however other factors must also contribute to this.

Role of periodontal ligament receptors in the tactile function of teeth: a review

The tactile function of the human periodontal mechanoreceptors has mostly been studied by psychophysical approaches. It was concluded that periodontal mechanoreceptors play a major role in the tactile function of teeth. It must be noted however that the interocclusal tactile threshold is not solely determined by periodontal mechanoreceptors but also by pulpal, muscular or articular receptors. While temporomandibular joint receptors play a minor role, muscular receptors are important in the discriminatory ability for a mouth opening of 5 mm and more. To discriminate between the contribution of periodontal and other receptors in the oral tactile function, future studies should use appropriate psychophysical methodologies and well-defined stimulus parameters.

Reflex responses to periodontal and auditory stimulation in human masseter

An investigation was made of the reflex responses evoked in the human masseter by periodontal mechanoreceptors. Weak taps were applied to the labial surface of a central incisor tooth by an electromechanical stimulator with a flexible probe (von Frey hair). Forces as low as 0.2 N evoked inhibitory reflex responses in the surface electromyograms of both masseter muscles. These reflexes were modulated to markedly different extents in different subjects by auditory white noise, which always reduced the amplitude of the inhibition. The reflexes were abolished when local anaesthesia was infiltrated around the stimulated tooth and white noise was played into the ears. Evidence is presented that the sound of the tap on the tooth, transmitted through the air, is in itself sufficient to evoke an inhibitory reflex in masseter which is qualitatively similar to that from the periodontal receptors. Thus, in the absence of auditory masking, the total reflex evoked by tooth taps is the result of the summation of the inputs from both periodontal mechanoreceptors and auditory receptors.

Force-related changes in the masseter muscle reflex response to tooth-taps in man

In 14 subjects with no disorder of the masticatory apparatus, excitatory and inhibitory reflex responses in the masseter muscles were derived by standardized mechanical stimulation of the upper central incisor. A series of eight taps was delivered during isometric contraction at 40% of maximum EMG activity, with tapping forces ranging from 0.25-9 N. The mean post-stimulus masseteric EMG complex (PSEC) consisted of up to three inhibitory (I-1, I-2 and I-3) and three excitatory phases. The first inhibitory wave increased in duration with increasing tapping force, and the second and third inhibitory waves occurred at higher thresholds than the first inhibitory wave.

The effect of rate of force application on the threshold of periodontal ligament mechanoreceptors in the cat canine tooth

Mechanical stimuli in the form of ramp-plateau forces were applied to the tip of the crown of the left mandibular canine tooth in cats anaesthetized with alpha-chloralose. Electrophysiological recordings were made from functionally single fibres teased from the inferior alveolar nerve. The force threshold was determined for 34 periodontal ligament mechanoreceptors at different controlled rates of force application. Force threshold was dependent on the rate of force application to the crown tip. Rate sensitivity was present for all receptors across the range from rapidly to slowly adapting; the degree of rate sensitivity was graded according to the adaptation rate of the receptor. The results suggest that the velocity of mechanical stimulus application to teeth needs to be considered in studies involving periodontal mechanoreceptor responses and their reflexes.