Diagnosis of occlusal dysesthesia utilizing prefrontal hemodynamic activity with slight occlusal interference

Abstract

Clinical diagnosis of occlusal dysesthesia (OD), also referred to as phantom bite syndrome, is currently based on the absence of objective occlusal discrepancy despite the persistent complaint of uncomfortable bite sensation. We previously demonstrated that the subjective feeling of occlusal discomfort generated by artificial occlusal interference can be objectively evaluated using prefrontal hemodynamic activity in young healthy individuals. The aim of this study was to investigate whether dental patients with and without OD show distinct prefrontal activity during grinding behavior with an occlusal interference. Six dental patients with OD (OD group) and eight patients without OD (control group) grinded piled occlusal strips placed between their first molars and reported their perception and discomfort thresholds during continuous monitoring of prefrontal hemodynamic activity with a portable functional near‐infrared spectroscopy. Although patients without OD showed the typical hemodynamic pattern of increased oxyhemoglobin and reduced deoxyhemoglobin (HHb) concentration, those with OD showed persistent incremental increases of HHb concentration that began at the loading of occlusal strips on their molars before they executed grinding. The intensities of the task‐related HHb activities showed statistically significant differences between OD and control groups, particularly at channel 3, arranged over the left frontal pole cortex. When the discrimination criterion was set using the intensity values of channel 3 from both groups, the overall accuracy of the OD discrimination was 92.9%. Although physiological interpretation has yet to be elucidated, the task‐related response of an increase in HHb may be a useful neuronal signature to characterize dental patients with OD.

Uncomfortable bite - is it always a dental problem?

“…Znaleziono 43 artykuły, z których po ocenie tytułów i streszczeń wyodrębniono 4 oryginalne prace, spełniające ustalone kryteria włączenia. [6][7][8][9] Przeglądając piśmiennictwo wybranych artykułów zakwalifikowano jeszcze jedną pracę. 10…”

“…A total of forty-three articles were found, of which, after evaluation of the titles and abstracts, four original works were selected, meeting the predetermined inclusion criteria. [6][7][8][9] While reviewing the reference literature of selected articles, one more work was qualified. 10…”

“…Wyniki uzyskane przez Ono i wsp. z 2016 roku 9 potwierdzają różnicę w hemodynamicznej aktywności kory przedczołowej między osobami ze stwierdzoną dyzestezją a osobami (OD) and healthy people during chewing. Six patients with OD (group OD) and eight patients without OD (the controls) had the occlusal strips placed between the first molars.…”

Prefrontal modulation during chewing performance in occlusal dysesthesia patients: a functional near-infrared spectroscopy study

“…Based on proposals by Melis and Zawawi [1], the study population included OD patients who persistently complained of uncomfortable bite sensation for at least 6 months in the absence of dental occlusal discrepancies, such as centric prematurity or nonworking interference, or when the complaints were disproportionate to those conditions [14]. Fifteen OD patients, 8 males and 7 females, with a mean age of 49.9 ± 16.1 years were investigated, and the results were compared to those obtained from 15 age-and gender-matched (Fisher's exact test and Z test) HC subjects (8 males, 7 females; age 39.3 ± 15.3 years).…”

“…For example, Su et al [13] reported a positive relationship between somatization subscale and bilateral superior medial prefrontal activities in patients with somatoform pain disorders. With regard to somatization in the oral region, Ono et al [14] recently examined prefrontal activity and tooth contact sensation in relation to tooth grinding, and they found that increased prefrontal hemodynamic responses may reflect top-down attention and/or self-regulation against uncomfortable somatosensory input induced in OD patients. In addition, Umezaki et al [15] reported that temporal hyperperfusion was improved along with alleviation of oral cenesthopathy in a clinical study.…”