Osseoperception: An Implant Mediated Sensory Motor Control- A Review

Active Tactile Sensibility in Implant Prosthesis vs. Complete Dentures: A Psychophysical Study

BACKGROUND AND OBJECTIVES

Proprioceptive information from natural dentition and adjacent oral tissues enables correct masticatory function, avoiding damage to the teeth. Periodontium is the main source of this relevant information, and when a tooth is lost, all this proprioceptive sensibility relies on receptors from muscles, the mucous membrane or the temporomandibular joint, and this sensibility gets worse. Active tactile sensibility measures this proprioceptive capability in microns by psychophysical studies consisting of introducing thin metal foils between patients' dental arches during chewing to see if they are able to notice them or not. Osseoperception is a complex phenomenon that seems to improve this sensibility in patients wearing dental implants. The objective of this investigation is to measure this sensibility in different prosthetic situations by performing a psychophysical investigation.

MATERIAL AND METHODS

We divided 67 patients in three groups depending on their prosthetic situation and performed a psychophysical study by introducing aluminium foils of different thicknesses in order to establish an active tactile sensibility threshold in every group. We also measured variables such as prosthetic wearing time, age or gender to see how they may influence threshold values. We used Student's t-test and Mann-Whitney U tests to analyse these results.

RESULTS

Active tactile sensibility threshold values in implants are lower than those from complete dentures but higher than values in natural dentition. However, values in implants are closer to natural dentition than complete denture values. Age, gender or prosthetic wearing time have no influence in active tactile sensibility thresholds.

CONCLUSION

Active tactile sensibility threshold values depend on prosthetic rehabilitations and the mechanoreceptors involved in every situation. Implant prosthesis presents an increased active tactile sensibility thanks to osseoperception phenomenon.

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.

Importance of Osseoperception and Tactile Sensibility during Masticatory Function in Different Prosthetic Rehabilitations: A Review

Background and Objectives: Tactile sensibility is an important characteristic for evaluating the masticatory efficiency in different occlusal situations. When a tooth is extracted, relevant proprioceptors from the periodontal ligament get lost; and after the rehabilitation of this abscess by means of oral prosthesis, this sensibility decreases influencing masticatory function. Osseoperception is a sensitive phenomenon associated with dental implants that allows an increased tactile sensibility to those wearing implant prostheses. The purpose of this study was to determine the difference in tactile sensibility values between implant prosthesis, complete dentures, and natural teeth through a review of the available literature. Materials and Methods. In order to dissect the information, 24 articles from 2004 to 2021 were analyzed from MEDLINE, PubMed Central, and Web of Science databases. These articles were directly related to measuring tactile sensibility in different situations and demonstrating the influence of osseoperception in an improved masticatory function. Results: Tactile sensibility in implant prosthesis is slightly reduced compared with natural dentition but presents improved values with regard to complete dentures. Conclusions: Implant prosthesis are more effective during masticatory function than complete dentures, as they present an increased tactile sensibility, very similar to that present in natural dentition. This enhanced sensibility in implants is due to the osseoperception phenomenon.

Investigating the role of gingiva in the tactile function of teeth at the cortical level

The role of the gingiva in the tactile perception of teeth is unclear, and the physiological basis of tooth tactile function needs to be examined at the cortical response level. In the presented study, gingiva from the upper left canine was removed under local anesthesia from five cats. Intrinsic signal optical imaging was used to measure population response characteristics of the cat oral-related cortex when punctate mechanical stimuli were separately applied to the left gingiva-stripped canine and right intact canine. Then, their response characteristics were compared. There were no significant differences in the cortical response strength between the anesthetized and unanesthetized canines. Signal strength of the gingiva-stripped tooth was significantly weaker than that of the intact tooth at low stimulus strength. However, no significant differences between the gingiva-stripped tooth and intact tooth were found after saturation. Based on the evoked cortical responses, the gingiva is involved in low-intensity tactile perception of teeth, which could explain the reason why chronic gingivitis results in the paresthesia of natural teeth.

Active Tactile Sensibility of Brånemark Protocol Prostheses: A Case-Control Clinical Study

Few studies have assessed active tactile sensibility in patients rehabilitated with implants. Improved knowledge about functional tactile sensibility will contribute to several clinical applications, such as protocols for immediate loading, prosthesis design, occlusal improvement in implantology, and physiological integration of implant-supported prostheses. The present study evaluated active tactile sensibility in patients rehabilitated with Brånemark-type mandibular prostheses that impede the total mucosa-supported maxillary prosthesis. Thirty-five subjects participated in this study. The experimental group (n = 18) inclusion criteria were as follows: Brånemark-type prosthesis and a total mucosa-supported maxillary prosthesis. The control group (n = 17) was composed of participants with complete healthy dentition. Carbon foils with different thicknesses (12 μm, 24 μm, 40 μm, 80 μm, and 200 μm) were placed in the premolar region to evaluate the brink of active oral tactile sensibility. The researchers assessed the participants 120 times. After evaluation, we observed a statistical difference (p < 0.05) between the groups. Additionally, the degree of sensibility was found for all thicknesses, except for 12 μm, on both sides. There was a more significant increase in perception in the control group as the carbon thickness increased. The tactile sensibility threshold was 2.5 times greater for participants with prostheses. Thus, the tactile sensibility for mandibular implant-supported and maxillary mucosa-supported prostheses is significantly lower than that of dentate patients, which was detected above the thickness of 80 μm; in patients with natural dentition, different thicknesses were seen starting from 24 μm.

The Need to Work Arm in Arm: Calling for Collaboration in Delivering Neuroprosthetic Limb Replacements

Over the last few decades there has been a push to enhance the use of advanced prosthetics within the fields of biomedical engineering, neuroscience, and surgery. Through the development of peripheral neural interfaces and invasive electrodes, an individual's own nervous system can be used to control a prosthesis. With novel improvements in neural recording and signal decoding, this intimate communication has paved the way for bidirectional and intuitive control of prostheses. While various collaborations between engineers and surgeons have led to considerable success with motor control and pain management, it has been significantly more challenging to restore sensation. Many of the existing peripheral neural interfaces have demonstrated success in one of these modalities; however, none are currently able to fully restore limb function. Though this is in part due to the complexity of the human somatosensory system and stability of bioelectronics, the fragmentary and as-yet uncoordinated nature of the neuroprosthetic industry further complicates this advancement. In this review, we provide a comprehensive overview of the current field of neuroprosthetics and explore potential strategies to address its unique challenges. These include exploration of electrodes, surgical techniques, control methods, and prosthetic technology. Additionally, we propose a new approach to optimizing prosthetic limb function and facilitating clinical application by capitalizing on available resources. It is incumbent upon academia and industry to encourage collaboration and utilization of different peripheral neural interfaces in combination with each other to create versatile limbs that not only improve function but quality of life. Despite the rapidly evolving technology, if the field continues to work in divided "silos," we will delay achieving the critical, valuable outcome: creating a prosthetic limb that is right for the patient and positively affects their life.

Effects of different implant surface properties on the biological behavior of Schwann cells

OBJECTIVES

This study investigated the effects of different implant surface properties on the biological behavior of Schwann cells.

METHODS

Schwann cells (SCs) were cultured on three types of implant surfaces including smooth polished (SMO), sand-blasted, large grit, acid-etched (SLA), and chemically-modified SLA (modSLA). At different time points, the morphology and adhesion of SCs on the implant surfaces were observed by scanning electron microscope. Cell proliferation activity was detected by MTT method. The expression levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) were detected by enzyme-linked immunosorbent assay. Changes in the mRNA levels of NGF and BDNF were detected by real-time fluorescent quantitative polymerase chain reaction (PCR).

RESULTS

SCs adhered, stretched, and proliferated well on the three types of implant surfaces. On the 3rd, 5th, and 7th days, the OD values of the SMO group were higher than those of the SLA group and the modSLA group, and the difference was statistically significant (P<0.05). On the 3rd day, the expression and mRNA levels of NGF and BDNF in the SLA group and the modSLA group were higher than those in the SMO group (P<0.05); in particular, the levels in the modSLA group were higher than those in the SLA group (P<0.05).

CONCLUSIONS

Different implant surface properties have different effects on the biological behavior of SCs. Proliferation of SCs is significantly promoted by smooth surface, while secretion and gene expression of neurotrophic factors are significantly promoted by modSLA surface at early stage.

Osseointegration for Amputees: Current Implants, Techniques, and Future Directions

Osseointegrated prostheses provide a rehabilitation option for amputees offering greater mobility, better satisfaction, and higher use than traditional socket prostheses. There are several different osseointegrated implant designs, surgical techniques, and rehabilitation protocols with their own strengths and limitations. The 2 most prominent risks, infection and periprosthetic fracture, do not seem unacceptably frequent or insurmountable. Proximal amputations or situations leading to reduced mobility are exceptionally infrequent. Osseointegrated implants can be attached to advanced sensory and motor prostheses.

Update and review of the gerodontology prospective for 2020's: Linking the interactions of oral (hypo)-functions to health vs. systemic diseases

New lines of evidence suggest that the oral-systemic medical links and oral hypo-function are progressively transcending beyond the traditional clinical signs and symptoms of oral diseases. Research into the dysbiotic microbiome, host immune/inflammatory regulations and patho-physiologic changes and subsequent adaptations through the oral-systemic measures under ageism points to pathways leading to mastication deficiency, dysphagia, signature brain activities for (neuro)-cognition circuitries, dementia and certain cancers of the digestive system as well. Therefore, the coming era of oral health-linked systemic disorders will likely reshape the future of diagnostics in oral geriatrics, treatment modalities and professional therapies in clinical disciplines. In parallel to these highlights, a recent international symposium was jointly held by the International Association of Gerontology and Geriatrics (IAGG), Japanese Society of Gerodontology (JSG), the representative of USA and Taiwan Academy of Geriatric Dentistry (TAGD) on Oct 25th, 2019. Herein, specific notes are briefly addressed and updated for a summative prospective from this symposium and the recent literature.

Ability to adjust occlusal force in implant-supported overdenture wearers

PURPOSE

The purpose of this study was to evaluate the occlusal force adjusting ability of implant-supported overdenture (IOD) wearers, as compared with natural teeth and complete dentures.

METHODS

Subjects were those with natural dentition (ND group; 19 subjects), those with implant-supported overdentures (IOD group; 7 subjects), and those with complete dentures (CD group; 14 subjects). Subjects were asked to hold test foods (peanuts and biscuits mounted on a custom-made apparatus with a force transducer) between their anterior incisors (hold phase) and split test foods (split phase). The mean value of the occlusal force during the hold phase (hold force), the peak force rate during the split phase (peak force rate), the time required to split test foods (duration), and the maximum occlusal force in the split phase (split force) were selected as outcomes. Data were analyzed with Wilcoxon's signed rank test, the Kruskal-Wallis test, and multiple regression analysis (Statistical significance levels: 5%).

RESULTS

For peanuts, the peak force rate for the ND group was significantly higher than the IOD and CD groups. The duration of the CD group was significantly longer than the ND and IOD groups. Multiple regression analysis indicated that even with adjustment for age and sex, there were significant differences in the peak force rate between the ND and the IOD, CD groups, and in the duration between the ND and CD group.

CONCLUSIONS

Subjects with IODs showed superior ability to adjust occlusal force, as compared with complete dentures, although it didn't match the natural dentition.

[Effects of platelet-derived growth factor on nerve regeneration around implant in rats]

OBJECTIVE

To investigate the effect of platelet-derived growth factor (PDGF) on nerve regeneration in peri-implant tissues.

METHODS

SD rats with implants in their femurs were injected with PDGF solution. The effects of PDGF on nerve regeneration in peri-implant tissues were analyzed by immunohistochemical staining.

RESULTS

PDGF increased the number of nerve fibers in peri-implant tissues at early stage. PDGF had no significant effect on the number of nerve fibers in peri-implant tissues at late stage. Moreover, these nerves had a typical structure of peripheral nerve fibers.

CONCLUSIONS

PDGF can promote nerve regeneration in peri-implant tissues at early stage. This study provided a certain experimental basis for the clinical application of PDGF to promote nerve regeneration and further improve the sensory function of the implant.

Association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars: a long-term follow-up clinical and radiographic analysis

Purpose

The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015.

Methods

Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars.

Results

The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion.

Conclusions

This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.