Physiological properties of periodontal mechanosensitive neurones in the trigeminal (Gasserian) ganglion of the rat

From periodontal mechanoreceptors to chewing motor control: A systematic review

PURPOSE

This critical review summarizes the current knowledge of the structural and functional characteristics of periodontal mechanoreceptors, and understands their role in the signal pathways and functional motor control.

METHOD

A systematic review of the literature was conducted. Original articles were searched through Pubmed, Cochrane Central database and Embase until january 2016.

RESULT

1466 articles were identified through database searching and screened by reviewing the abstracts. 160 full-text were assessed for eligibility, and after 109 exclusion, 51 articles were included in the review process. Studies selected by the review process were mainly divided in studies on animal and studies on humans. Morphological, histological, molecular and electrophysiological studies investigating the periodontal mechanoreceptors in animals and in humans were included, evaluated and described.

CONCLUSION

Our knowledge of the periodontal mechanoreceptors, let us conclude that they are very refined neural receptors, deeply involved in the activation and coordination of the masticatory muscles during function. Strictly linked to the rigid structure of the teeth, they determine all the functional physiological and pathological processes of the stomatognathic system. The knowledge of their complex features is fundamental for all dental professionists. Further investigations are of utmost importance for guiding the technological advances in the respect of the neural control in the dental field.

Force encoding by human periodontal mechanoreceptors during mastication

This overview summarises current knowledge on the force-encoding properties of periodontal mechanoreceptors supplying the human postcanine teeth and describe their signalling during chewing. Microneurographic experiments reveal that these receptors adapt slowly to maintained tooth loads. Similar to periodontal receptors at anterior teeth, about half respond to forces applied to more than one tooth and their receptive fields are broadly tuned to direction of force application. However, population analyses demonstrate that periodontal receptors supplying anterior and posterior teeth differ in their capacity to signal horizontal and vertical forces, respectively. Most periodontal receptors exhibit a strongly curved relationship between discharge rate and force amplitude, featuring the highest sensitivity to changes in force at forces below 1N for anterior teeth and 4N for posterior teeth. Also the dynamic sensitivity is markedly reduced at high forces. According to a quantitative model of responses in periodontal receptors based on these data, most receptors efficiently encode food contact during chewing, but due to the marked saturation tendencies at higher forces these receptors poorly encode the magnitude of the strong chewing forces and the force changes occurring at these high loads. Information provided by periodontal receptors is critical for the specification of manipulative forces used when food is positioned between the teeth and prepared for chewing. When the strong chewing forces are applied to crush the food, the receptors signal functionally important information about the mechanical properties of food as well as the spatial contact patterns between the food and the dentition.

Physiological properties of molar-mechanosensitive periodontal neurons in the trigeminal ganglion of the rat

Spike discharges from periodontal mechanosensitive neurones responding to the mechanical stimulation of molar teeth were recorded from the trigeminal ganglion of rats anaesthetized with pentobarbital sodium. Maxillary molar-sensitive units were close together in a narrow, lateral area of the maxillary division of the ganglion, whereas those of mandibular molar-sensitive units were scattered throughout the mandibular division. The majority of maxillary molar-sensitive units responded only to stimulation of the first molar. They were slowly adapting and responded most strongly to pressure applied to the lingual surface and buccal cusp of the tooth or to the buccal surface and lingual cusp. By contrast, approximately one-half of the mandibular molar-sensitive units were rapidly adapting, multitooth units that responded to tooth stimulation almost equally in all directions. The other half were slowly adapting and activated most effectively by pressure applied to the lingual surface and buccal cusp of the molar tooth. These slowly adapting units consisted of first molar-sensitive, single- and multitooth units. Differences in the response characteristics of the maxillary and mandibular molar-sensitive periodontal units may reflect differences in the sensory role of individual molars.

Response of human jaw muscles to axial stimulation of a molar tooth

The reflexes of the main jaw-closer muscles (masseter and anterior temporalis) on both sides of the jaw were investigated using surface electromyography to observe reflex activity following mechanical stimulation of the 1st right upper-molar tooth at various forces under a number of levels of jaw-muscle activity. As with analogous studies performed on the incisor, three distinct reflex events were identified in the EMG before the earliest conscious subject reaction: early excitation, inhibition and late excitation. However, contrary to observations found during studies on the incisor, excitation, not inhibition was the primary reflex response. The application of a local anaesthetic block around the stimulated molar showed that the primary agents in eliciting the observed reflexes were not contained within the periodontium of the stimulated tooth. A diminished representation of periodontal mechanoreceptors around the molar teeth and more elaborate root structures, hence a more solid connection to the jaw and consequently less tooth movement, were deemed the likely reason for the distinction between the reflex responses of the incisal and molar regions. In addition to the reflex studies, the minimum reaction time of a number of subjects was determined to permit the distinction of a reflex event and an event that could be a conscious subject reaction. It was found that the reaction time of the temporalis muscles was significantly shorter than those of the masseter, while no significant difference was found between the left and right sides. Overall, the data showed that the presence or absence of background muscle activity and subject variability were the main causes of changes in the reflex response, provided the level of the stimulus was greater than 3 N. The application of local anaesthetic had no impact on the reflexes evoked.

Receptive field properties of human periodontal afferents responding to loading of premolar and molar teeth

Impulses in 45 single mechanoreceptive afferents were recorded from the human inferior alveolar nerve with permucosally inserted tungsten microelectrodes. All afferents responded to mechanical stimulation of one or more premolar or molar teeth and most likely innervated their periodontal ligaments. For each afferent, isolated "ramp-and-hold" shaped force profiles of similar magnitudes (252 +/- 24 mN; mean +/- SD) were applied to the lower first premolar, the second premolar, and the first molar on the recording side. The tooth loads were applied in six directions: lingual, facial, mesial, and distal in the horizontal plane and up and down in the vertical direction of the tooth. The afferents response during the static phase of the stimulus was analyzed. All afferents were slowly adapting, discharging continuously in response to static forces in at least one stimulation direction. Twenty-nine afferents (64%) were spontaneously active, exhibiting an ongoing discharge in the absence of external stimulation. Stimulation of a single tooth was found to excite each afferent most strongly. The most sensitive tooth (MST) was the first premolar for 23, the second premolar for 13, and the first molar for 9 afferents. About half of the afferent population also responded to loading of one or two more teeth. The response profiles of these afferents indicated that the multiple-teeth receptive fields were due to mechanical coupling between the teeth rather than branching of single afferents to innervate several teeth. The afferent responses to loading the mesial and distal halves of the first molars were very similar. Thus both intensive and directional aspects of the afferent response when loading one side of the tooth was preserved to a great extent when loading the other side. When loading the MST, the afferents typically showed excitatory responses in two to four of the six stimulation directions, i.e., the afferents were broadly tuned to direction of tooth loading. In the horizontal plane, the afferent populations at the premolar teeth expressed no clear directional preferences. The afferents at the molar, however, showed a strong directional bias in the distal-lingual direction. In the vertical plane, there was a preference for downward-directed forces with a gradually decreasing sensitivity distally along the dental arch. The present results demonstrate that human periodontal afferents supplying anterior and posterior teeth differ in their capacity to signal horizontal and vertical forces, respectively.

Physiological properties of periodontal mechanosensitive neurones in the posteromedial ventral nucleus of rat thalamus

Unitary discharges of periodontal mechanosensitive (PM) neurones responding to mechanical tooth stimulation were recorded from the posteromedial ventral nucleus (VPM) of rat thalamus. PM neurones are distributed in the ventromedial area in the rostral two-thirds of the VPM nucleus. Maxillary and mandibular tooth-sensitive neurones are arranged in dorsoventral sequence. Of the PM neurones, 36% were slowly adapting to pressure applied to the tooth and 67% were rapidly adapting. The majority of PM units were sensitive to the contralateral incisor tooth. Response magnitudes of the slowly adapting neurones varied with stimulus direction and were directionally selective to mechanical tooth stimulation. The optimal stimulus direction was labiolingual or linguolabial. Rapidly adapting neurones were directionally non-selective to tooth stimulation. The threshold for mechanical stimulation was <0.05 N. Mean response latencies evoked by electrical stimulation of the peripheral receptive fields were 4.6 ms in the slowly adapting neurones and 5.8 ms in the rapidly adapting neurones.

Correlations between response properties of periodontal mechanosensitive neurones in the primary somatosensory cortex of the rabbit and cortically induced rhythmical jaw movements

The response properties of incisor- and molar-sensitive periodontal mechanosensitive (PM) neurones in the primary somatosensory (SI) cortex of rabbits were examined and rhythmical jaw movements induced by repetitive electrical stimulation of the recording sites of cortical PM neurones were observed. PM units were recorded from the rostromedial (RM) and rostrolateral (RL) areas of the SI cortex. In the RM area, most PMs (85%) were lower incisor-sensitive. Electrical stimulation of the RM area produced chopping-type rhythmical jaw movements. In the RL area, both incisor- and molar-sensitive PM units were recorded, and molar-sensitive units were located more rostromedially than incisor-sensitive units. More than half (66%) of the incisor-sensitive PM units were upper incisor-sensitive. The incidences of sustained-response type units were 8 and 10% for upper incisor- and lower incisor-sensitive units and 28 and 34% for upper molar- and lower molar-sensitive units, respectively. The optimal stimulus directions for the upper molar-sensitive units were predominantly labial or lingual, whereas those for most of the lower molar-sensitive units were lingual. Electrical stimulation of the PM unit-recording sites in the RL area induced grinding-type rhythmical jaw movements. Based on these findings, the lower incisor-sensitive neurones in the RM area of the SI cortex might mainly contribute to a neural network that controls jaw movements during ingestion. Furthermore, the response properties of molar-sensitive cortical neurones might be useful for discriminating the magnitude and direction of the biting force during grinding. Further studies are needed to clarify the role of upper incisor-sensitive neurones in the RL area in triggering grinding-type rhythmical jaw movements.

Response properties of periodontal mechanosensitive neurones in the rat trigeminal sensory complex projecting to the posteromedial ventral nucleus of the thalamus

Unitary discharges from periodontal mechanosensitive (PM) neurones responding to mechanical stimulation of the tooth were recorded from the trigeminal sensory complex in the rat brainstem. Of the PM units recorded, 22% were activated by antidromic stimulation of the contralateral (20%) or ipsilateral (2%) posteromedial ventral nucleus of the thalamus. Although thalamic-projecting neurones were recorded extensively throughout the trigeminal sensory complex, they originated most often in the region from the caudal main sensory nucleus to the rostral subnucleus oralis of the trigeminal spinal tract nucleus. The response latencies of the rostral nucleus units to orthodromic stimulation of peripheral receptive fields and antidromic stimulation of the thalamus were significantly shorter than those of the caudal nucleus units. More than half were single-tooth units originating from incisor teeth. They responded continuously when pressure was applied to the tooth. The magnitude of the response varied with the direction of the stimulus. Maximal responses were obtained when the stimulus was applied labiolingually or vice versa. The threshold for mechanical stimulation of the tooth was less than 0.05 N. The rostrocaudal distribution and response properties of thalamic-projecting PM neurones were very similar to those of non-thalamic-projecting PM units that were not activated by antidromic stimulation of the thalamus.

Response properties of slowly and rapidly adapting periodontal mechanosensitive neurones in the primary somatosensory cortex of the cat

Periodontal mechanosensitive neurones in the primary somatosensory (SI) cortex are classified as either slowly or rapidly adapting. The responses of cortical neurones and their projection pathways were studied using mechanical and electrical stimulation of the teeth and electrical stimulation of the thalamic posteromedial ventral (VPM) nuclei and contralateral SI cortex. A total of 247 periodontal mechanosensitive units were recorded from the SI cortex in 35 anaesthetized cats, distributed mainly in area 3b: 14% were slowly adapting and 86% rapidly adapting units; 62% of the slowly adapting and 9% of the rapidly adapting units were single-tooth units sensitive to stimulation of only one tooth. The incidence of slowly adapting units with an ipsilateral receptive field was almost equal to that of slowly adapting units with a contralateral receptive field, and more than half of the units were directionally selective to mechanical tooth stimulation. The majority of rapidly adapting units had their receptive field in the contralateral teeth and were directionally non-selective to tooth stimulation. The latencies of the cortical responses of the slowly and rapidly adapting units were 7.3 and 10.7 ms, respectively, on electrical stimulation of the contralateral teeth, and 1.8 and 2.0 ms, respectively, on electrical stimulation of the ipsilateral VPM nucleus. From these findings, it is inferred that slowly adapting neurones are useful for discriminating the tooth stimulated, the stimulus direction, the stimulus intensity and the change of pressure applied to the tooth, while rapidly adapting neurones could function to signal initial contact with food or the opposing teeth.

Response characteristics of periodontal mechanoreceptors to mechanical stimulation of canine and incisor teeth in the cat

The alveolar bone that overlies the labial aspect of the root of the right lower canine tooth was pared down until paper thin. Thirty-five periodontal mechanosensitive (PM) units sensitive to stimulation of the canine and incisor and to punctate stimulation through the thinned bone of the periodontal ligament of the canine were recorded from the inferior alveolar nerve rostral to the masseter muscle. The units showed a sustained and directionally selective response to pressure applied to the teeth. The optimal directions of stimulation for each tooth in the receptive field were parallel and oriented linguolabially. When the canine was stimulated mechanically in the optimal stimulus direction, the interspike intervals of the responses were relatively regular in most PM units (91%). The conditioning and test stimuli were applied to the adjacent canine and third incisor. The conditioning stimulus (0.10 N) was given to one of these teeth in the optimal stimulus direction. The test stimulus (0.02 N or 0.05 N) was applied to the adjacent tooth in the opposite direction in order to examine the effect of mechanical spreading of the conditioning stimulus on the adjacent tooth. In most PM units, the spike discharges evoked by the conditioning stimulus given to the incisor were stopped by the test stimulus given to the canine. When the given stimuli were reversed, the firings evoked by the conditioning stimulus were slightly depressed by the test stimulus. After removing the spot-like PM receptor site(s) in the paper-thin area of bone, all units but one did not respond to stimulation. These results provide evidence that neurones with multiple-tooth receptive fields and regular spike-interval responses recorded from the inferior alveolar nerve come from the mechanical spreading effect of the stimulation of one tooth on an adjacent tooth through the trans-septal fibre system and that neurones with irregular-interval responses are due to the ramification of PM fibres peripherally.