Evaluation of Oral Stereognosis in Relation to Tactile Ability and Patient Satisfaction

Effects of tongue lesions and palatal coverage on oral sensory functions

STATEMENT OF PROBLEM

Oral stereognosis (OS) plays a significant role in the oral rehabilitation of patients with edentulism, as it influences their adaptation to new prostheses. Because of the essentially tactile characteristic of oral sensory perception, the tongue and palate appear to have a crucial function in OS. However, little is known about the influence of tongue lesions on OS and sensorial function. In addition, controversies remain regarding the role of the palate.

PURPOSE

The purpose of this clinical study was to evaluate whether tongue lesions and palatal coverage are disruptive to OS and gustatory function.

MATERIAL AND METHODS

Seventy participants (mean age=30.7 ±6.7 years) were divided into a tongue lesion group (experimental; n=35) and a control group (n=35). The tongue lesion group included participants with geographic, fissured, or hairy tongue. OS was evaluated with the oral stereognosis ability (OSA) test. Gustatory function was assessed with exposure to flavored solutions. After completing the above tests, the participants received a palate covering device, and then OS and gustatory function were immediately reevaluated. Data were analyzed with the Mann-Whitney and Wilcoxon tests (α=.05).

RESULTS

OSA and gustatory function scores did not differ among the tongue lesion and control groups with and without palatal coverage (all P>.05). After palatal coverage, the tongue lesion group took more time to perform the OSA test than the control group (P<.05).

CONCLUSIONS

Neither the presence of tongue lesions nor palatal coverage influenced OS or gustatory function. The OSA test response times were longer for the tongue lesion group after they had received palatal coverage.

Palatal coverage and oral stereognosis: A systematic review and meta-analysis

STATEMENT OF PROBLEM

Complete denture wearers present with less sensory function than dentate individuals because of the loss of periodontal receptors. However, the role of the palatal receptors on such function is still unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to evaluate the influence of palatal coverage associated with complete dentures or palatal devices on oral stereognosis in edentulous or dentate adults.

MATERIAL AND METHODS

Eight major literature databases and the nonpeer-reviewed literature were searched up to December of 2021. Randomized clinical trials and nonrandomized clinical trials comparing oral stereognosis in edentulous or dentate participants using conventional complete dentures or implant-supported prostheses or those using palatal devices were included. Bias was assessed with Cochrane tools (ROBINS-I and RoB 2.0). Meta-analyses were conducted to compare oral stereognosis before and after palatal coverage (α=.05). Certainty of the evidence was verified using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

RESULTS

Of 14 included studies, the risk of bias was considered low for 9 studies and moderate for 5 studies. Despite the very low certainty of evidence, meta-analyses showed no differences in oral stereognosis immediately after complete denture insertion (standardized mean difference [SMD]=0.302; 95% confidence interval [CI]: -0.124, 0.728; P=.165; I2=92.4%). Oral stereognosis scores improved after ≥1 month of complete denture use compared with initial evaluations without them. Qualitative analysis indicated that oral stereognosis was not influenced by palatal coverage shortly after complete denture installation and that oral stereognosis scores improved over time after prosthesis use.

CONCLUSIONS

Oral stereognosis improved with the use of palate-covering prostheses over time. However, because of the very low certainty of evidence, the statement must be interpreted with caution.

A comparative evaluation of neurophysiological activity, active tactile sensibility and stereognostic ability of complete denture prosthesis, and implant-supported prosthesis wearer-A pilot study

AIM

The study aimed to evaluate the effect of implant-supported prosthesis in completely edentulous participants in terms of osseoperception ability, neural activity, and stereognostic ability in comparison to removable prosthetic options.

MATERIALS AND METHODS

A total sample of 18 patients, irrespective of gender and age were allocated into three groups according to the three-treatment protocol (upper and lower complete denture, upper complete denture opposing lower implant-retained overdenture, implant-supported fixed prosthesis in both arches). Four weeks after completion of the treatment procedure active tactile sensibility (ATS) was checked by using varying thicknesses (12, 40, 80, 100, 200 μ) of articulating foils and papers. Functional magnetic resonance imaging (fMRI) was performed to record neurophysiological activity in cerebral cortex in all the participants. Various forms of test pieces (heat cure acrylic resin) were used to evaluate stereognostic ability. Data regarding the neurophysiological activity were analyzed by using Krushkal-Wallis test and p ≤ 0.05 was considered to be statistically significant. Data from stereognostic ability test procedure and ATS were compared by using chi-squared test and p ≤ 0.05 was considered to be statistically significant.

RESULTS

Statistically significant difference was found in between the articulating foils in terms of true negative responses as the foil thickness increased in participants wearing complete denture in both the arches (p = 0.004) and implant-supported fixed prosthesis in both the arches (p = 0.010). Participants in implant-supported fixed prosthesis group showed significantly more activation in primary motor cortex (right side), somatosensory cortex (left side), angular gyrus (both sides), temporal lobe (left) compared to other groups. No significant difference found in thalamus and premotor cortex region in between the participants of different groups. No statistically significant difference found in between the groups in terms of true responses identifying correct shapes. Mean number of correct responses in stereognostic ability test were 4.16 (83.33%), 3.5 (70%), 3.83 (76.66%) for participants of complete denture group, upper complete denture opposing lower implant retained overdenture group, and implant-supported fixed prosthesis group, respectively.

CONCLUSION

Primary motor cortex, somatosensory cortex, and other regions of brain were diffusely activated in participants wearing implant-supported fixed prosthesis in both the arches. Less number of false responses were recorded in participants of implant-supported fixed prosthesis group and upper complete denture opposing lower implant-retained overdenture group in ATS test compared to participants wearing complete denture in both the arches.

A 5-Year Retrospective Study Evaluating Periodontal Health and Oral Health-Related Quality of Life of Implant-Supported Overdentures With Locator and Magnetic Attachments

This study compared peri-implant vertical bone loss, the periodontal index, prosthodontic maintenance requirements and oral health-related quality of life (OHQoL) of patients using mandibular implant-supported overdentures with 2 different attachment systems after an average of 5 years of use. Sixteen mandibular overdenture patients with magnet attachments (group 3), 24 with implant-supported mandibular overdentures with Locator attachments (group 2), and 25 conventional complete denture patients (group 1) were included in the study. The existing at least 5 years old dentures of all patients were evaluated for prosthodontic maintenance by the same prosthodontist and the patients were administered the oral health impact profile-14-Turkish version (OHIP-TR-14) questionnaire. Peri-implant tissue health was evaluated clinically in terms of plaque scores, bleeding scores, probing depth, and gingival index. Radiographic evaluation was performed in terms of peri-implant vertical bone loss. Radiographic evaluations were performed 5 years after overdenture insertion. There were no statistically significant differences between the groups in terms of total OHIP-TR-14 scores (P > .05). Although the average vertical bone resorption measured in group 2 at the end of 5 years was 1.38 mm, there was an average vertical bone loss of 1.45 mm in group 3, but this difference was not statistically significant (P > .05). Among the periodontal health indicators, there were no statistically significant differences in the mean values for periodontal indexes. According to results of the study, there were no differences in peri-implant vertical bone loss in groups 2 and 3, in periodontal health in mandibular overdentures with groups 2 and 3, or between total OHIP-TR-14 scores of patients in all groups.

Effect of complete dentures on oral stereognostic ability in edentulous patients: A systematic review

Aim:

Oral stereognosis is an important sensation for a human being to percept any type of materials that are introduced in the oral cavity. It is defined as the ability of an individual to recognize objects using only tactile sensation without using vision, audition, balance, somatic function, taste, or smell. The primary purpose of this review was to evaluate the effect of complete dentures on oral stereognostic ability in edentulous subjects.

Settings and Design:

Systematic review based on PRISMA guidelines.

Materials and Methods:

A systematic search of the electronic databases like PubMed and Web of Science was done using keywords – “stereognosis,” “oral stereognosis,” “complete denture,” and “complete edentulism.” In addition to this, a manual search of references mentioned in the articles and gray literature was done. Data extraction and assessment were done by two independent reviewers.

Statistical Analysis Used:

Qualitative analysis.

Results:

The literature search yielded a total of 61 articles. Thirteen duplicate articles were removed and 36 articles were rejected after initial screening of titles and abstracts. A total of 12 articles were selected for full text reading and 5 of them were included for qualitative analysis.

Conclusion:

All the included studies showed complete denture treatment therapy improved stereognostic ability in terms of correct identification of test pieces and time taken to identify the objects. There is also a direct relationship between the adaptability of dentures and stereognostic ability.