Degree of adaptability of the somatosensory cortex to change: Prospects for integration of bone-mounted dental prostheses

Tactile Sensibility Thresholds in Implant Prosthesis, Complete Dentures and Natural Dentition: Review about Their Value in Literature

Background and Objectives: The periodontium has important proprioceptive receptors that prevent teeth from using excessive occlusal forces during chewing. There are other receptors from adjacent tissues that replace periodontal ones when teeth are extracted and rehabilitated with prosthesis, although they seem to be less effective. Psychophysical studies investigate tactile sensibility thresholds, which are useful to measure this masticatory efficiency in different prosthetic rehabilitations. There are two types of sensibility depending on the receptors that are activated during these studies: active and passive tactile sensibility. The purpose of this study is to obtain active and passive tactile sensibility threshold figures in natural dentition and prosthetic rehabilitations so we can compare them and understand how this sensibility works in different situations. Materials and Methods: We performed a systematic review of the available literature, following PRISMA guidelines and including articles from 2004 to 2021 in the MEDLINE database. Only 10 articles were included in this investigation as they provided concrete threshold figures. Results: The mean values of active tactile sensibility thresholds in complete dentures, implant prosthesis and natural dentition are 64 µ, 23.3 µ and 16.1 µ, respectively. The mean values of passive tactile sensibility thresholds in implant prosthesis and natural dentition are 6.7 N and 0.8 N, respectively. Conclusions: Implant prosthesis have lower thresholds, that are very close to those present in natural dentition, than complete dentures due to an increased tactile sensibility. Active tactile sensibility thresholds present fewer differences between values than passive tactile ones; as these are only influenced by receptors from periodontal or periimplant tissues.

Population response characteristics of intrinsic signals in the cat somatosensory cortex following canine mechanical stimulation

Intrinsic signal optical imaging has been widely used to measure functional maps in various sensory cortices due to better spatial resolution and sensitivity for detecting cortical neuroplasticity. However, application of this technique in dentistry has not been reported. In this study, intrinsic signal optical imaging was used to investigate mechanically driven responses in the cat somatosensory cortex, when punctate mechanical stimuli were applied to maxillary canines. The global signal and its spatial organization pattern were obtained. Global signal strength gradually increased with stimulus strength. There was no significant difference in response strength between contralateral and ipsilateral mechanical stimulation. A slightly greater response was recorded in the sigmoidal gyrus than in the coronal gyrus. The cat somatosensory cortex activated by sensory inputs from mechanical stimulation of canines lacks both topographical and functional organization. It is not organized into columns that represent sensory input from each tooth or direction of stimulation. These results demonstrate that intrinsic signal optical imaging is a valid tool for investigating neural responses and neuroplasticity in the somatosensory cortex that represents teeth.

Perceptual changes in the peri-implant soft tissues assessed by directional cutaneous kinaesthesia and graphaesthesia: a prospective study

BACKGROUND

The innervation of skin and oral mucosa plays a major physiological role in exteroception. This innervation is also clinically relevant as sensory changes occur after neurosurgical procedures.

PURPOSE

The goal of this study was to compare the perception of mechanical stimuli applied to the buccal mucosa in the vicinity of osseointegrated oral implants with that in the controlateral dentate side. The role of the previously reported increased innervation in the peri-implant soft tissues in the oral sensorimotor function was thus examined.

MATERIALS AND METHODS

Seventeen subjects with 20 implants were tested. Directional cutaneous kinaesthesia (DCK) and graphesthesia (G) were performed on the buccal side of the alveolar mucosa before and at planned intervals after implant placement. The observation was pursued until 6 months after the prosthetic rehabilitation. In each subject, the contralateral mucosa served as a control to the implant sites. Average percentages of correct responses in a four-choice task for DCK and a three-choice task for G were calculated.

RESULTS

Despite an intersubject variation in both the DCK and G, high intraindividual correlations were found (p < .005). The implant sites showed a significant difference toward the control sites at the four interval test for both tests. For DCK and G, the average of correct responses decreased after abutment connection (i.e., after the implant uncovering surgery) to increase afterwards to reach a level close to, but still lower than, the control sites 3 to 6 months after the prosthetic rehabilitation.

CONCLUSION

The DCK and G are simple but reliable sensory tests that can be easily applied in the oral region. This prospective study indicates that tooth loss reduces tactile function compared with implant-supported prostheses. The peri-implant soft tissues could be partially involved in the osseoperception function.

The neurophysiology of osseointegrated oral implants. A clinically underestimated aspect

Amputation of a limb or a tooth leads to the loss of a large number of exteroceptors. These play an important role in sensory perception and feedback, which tune the motor control. Even after rehabilitation with a prosthetic device, tactile function remains impaired. This can present a subsequent risk of overloading the prosthesis. The peri-implant interface of oral osseointegrated implants is characterized by the absence of a periodontal ligament, a crucial difference towards the natural dentition, from a biomechanical but also from a neurophysiologic point of view. Patients rehabilitated with osseointegrated implants seem subjectively not much impaired in their masticatory and other oral functions. This observation might be linked to the presence of some peripheral feedback pathway to the sensory cortex. It may be attributed to the activation of receptors in the peri-implant environment (either bone or periosteum). This phenomenon called osseoperception, when it relates to the consciousness of the applied stimuli, has been described for both oral and skeletal implants. In the present review, besides osseoperecption other neurophysiological aspects of oral implants, such their reflex function, will be outlined and their clinical meaning pointed out.

Properties and plasticity of the primate somatosensory and motor cortex related to orofacial sensorimotor function

1. The lateral pericentral region of the cerebral cortex has been well documented in primates to be important in sensorimotor integration and control and in the learning of new motor skills. 2. The present article provides, first, an overview of limb sensorimotor cortical mechanisms and, second, outlines recent evidence pointing to an important role for the face sensorimotor cortex in semi-automatic, as well as trained, orofacial motor behaviour and to its propensity for neuroplastic changes in association with orofacial motor skill acquisition or an altered oral environment.