From osseoperception to implant‐mediated sensory‐motor interactions and related clinical implications*

Abstract

summary Osseointegration of implants in the jaw bone has been studied thoroughly, dealing with various aspects such as bone apposition, bone quality, microbiology, biomechanics, aesthetics, etc. A key issue that has received much less attention is the physiologic integration of the implant(s) and the associated prosthesis in the body. The latter aspect is however very important to obtain new insights in oral functioning with implant‐supported prostheses. Amputated patients rehabilitated with a lower limb prosthesis anchored to the bone by means of an osseointegrated implant, have reported that they could recognize the type of soil they were walking on. Clinical observations on patients with oral implants, have confirmed a special sensory perception skill. The underlying mechanism of this so‐called ‘osseoperception’ phenomenon remains a matter of debate, because extraction of teeth involves elimination of the extremely sensitive periodontal ligaments while functional reinnervation around implants is still uncertain. Histological, neurophysiological and psychophysical evidence of osseoperception have been collected, making the assumption more likely that a proper peripheral feedback pathway can be restored when using osseointegrated implants. This implant‐mediated sensory‐motor control may have important clinical implications, because a more natural functioning with implant‐supported prostheses can be attempted. It may open doors for global integration in the human body.

Vibrotactile evaluation: Osseointegrated versus socket-suspended transfemoral prostheses

“…This suggests that a neurophysiological peripheral feedback pathway can be partly restored [16,[19][20]. Such an assumption is supported by findings showing that two types of stimulation (pressure and strokes by a toothbrush) of an OI thumb prosthesis resulted in cortical activation on both sides of the somatosensory cortex, using functional magnetic resonance imaging of the brain [21].…”

“…Osseoperception has also been identified regarding the benefit of improved sensory feedback for bite force and oral function in patients with OI implants in the edentulous jaw [13,16]. Later work has further established the importance of osseoperception in patients with dental implants [17][18].…”

“…Using this instrument, Jacobs et al tested the vibrometric tactile thresholds in a group of patients with upper-or lower-limb OI prostheses and a control group with socket-suspended prostheses [35]. The study used frequencies of 8,16,32,64,125, and 250 Hz. These researchers found that the detection thresholds for vibratory stimulation of socket-suspended prosthetic limbs generally were higher than for nondisabled limbs, while OI prostheses yielded better perception than the socketsuspended prostheses.…”

“…It included 17 patients tested preoperatively with socket-suspended prostheses and after 2 yr with OI prostheses and a control group (n = 17) using socket-suspended prostheses, evaluated once. Assessments on the prosthetic and intact feet were conducted at six frequencies (8,16,32, 64, 125, and 250 Hz). Furthermore, measurements were conducted to investigate how vibrometric signals are transmitted through a test prosthesis.…”

Neurophysiological aspects of the trigeminal sensory system: an update

“…The importance of these periodontal afferents becomes apparent after tooth extraction or in edentulous patients where their function is lost. However, after implant placement, we can see a mechanism of 'osseoperception' where sensory-motor control partially recovers (Jacobs and Van Steenberghe, 2006). This can be explained by the presence of intraosseous and periosteal receptors near the implant sites.…”