SUMMARY1. In anaesthetized cats the left maxillary and mandibular canine and incisor teeth were extracted. Nine weeks later the animals were anaesthetized again and titanium implants were placed into the edentulous ridge of the maxilla and mandible.2. Terminal experiments were performed between 9 weeks and 10 months after inserting the implants. Recordings were made from the trigeminal ganglia and peripheral nerves of anaesthetized cats. Neurones were identified which responded to forces applied to the maxillary teeth but none was found which responded to forces applied to the implant.3. The responses of motor units in the temporalis muscle were studied in response to ramp-plateau forces applied to the maxillary canine tooth and maxillary implant using peristimulus time histograms and cumulative sum (cusum) analysis. A small amount of inhibition of the motor units was observed in response to the applied forces to the implant. However, the inhibition was much more profound when similar forces were applied to the tooth.4. The results confirm that when forces are applied to a tooth, periodontal mechanoreceptors are stimulated which evoke reflex inhibitions to motor units in the jaw-closing muscles. However, there is evidence that mechanoreceptors situated distant to the periodontium can also evoke such reflexes.5. The results are discussed in relation to the overall functional role of periodontal mechanoreceptors in the reflexes of mastication.

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Periodontal receptors can be located in the periodontal ligament itself, the alveolar bone, the periosteum and the gingiva. The aim of the present study was to quantify the contribution of the periodontal ligament receptors in eliciting a reflex response in human masseter muscles. Surface EMG recordings were made in 17 human subjects, fully or partially edentulous, and all provided with osseointegrated oral implants ad modum Brånemark. They maintained a constant clenching level. Mechanical stimulation of an oral implant in the upper central incisor region failed to elicit a reflex in fully edentulous subjects with oral implants in both jaws. The absence of a reflex response strongly suggests that the receptors in the periodontal ligament itself are mainly responsible for the reflex. Stimulation of the same area in subjects with oral implants in the upper jaw and natural teeth in the lower jaw elicited a reflex response in most subjects. Since they were instructed to clench in full habitual occlusion, transmission from the stimulated area to periodontal receptors of natural teeth is very probable.

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Although condylar dislocation is not uncommon, terminology, diagnostics, and treatment concepts vary considerably worldwide. This study aims to present a consensus recommendation based on systematically reviewed literature and approved by the European Society of TMJ Surgeons (ESTMJS). Based on the template of the evidence-based German guideline (register # 007-063) the ESTMJS members voted on 30 draft recommendations regarding terminology, diagnostics, and treatment initially via a blinded modified Delphi procedure. After unblinding, a discussion and voting followed, using a structured consensus process in 2019. An independent moderator documented and evaluated voting results and alterations from the original draft. Although the results of the preliminary voting were very heterogenous and differed significantly from the German S3 guideline (p < 0.0005), a strong consensus was achieved in the final voting on terminology, diagnostics, and treatment. In this voting, multiple alterations, including adding and discarding recommendations, led to 24 final recommendations on assessment and management of TMJ dislocation. To our knowledge, the ESTMJS condylar dislocation recommendations are the first both evidence and consensus-based international recommendations in the field of TMJ surgery. We recommend they form the basis for clinical practice guidelines for the management of dislocations of the mandibular condyle.