Dental & Oral Health

Biography

Biography: Pascale Habre-Hallage

Abstract

The periodontal ligament, that connects the root of the tooth to the jaw bone, contains many mechanoreceptors that encode tooth load when subjects contact and gently manipulate food with the teeth. Tooth loss will remove these receptors and reduce the intra-oral neural input to the brain. The rehabilitation ofedentulism by means of endosseous implants leads to an improvement in the sensory and motor functions but fail to reach the same level of sensitivity as dentate subjects. Patients with a lower limb prosthesis anchored by a percutaneous osseointegrated implant reported that this allowed them to feel the kind of soil they walked on. Th is sensory improvement coined ‘osseoperception’ was defi ned as a perception of external stimuli transmitted via the implant through the bone by activation of receptors located in the peri-implant environment, the periosteum, the skin, the muscles and/or the joints. Hence, it remains uncertain whether this improvement can be ascribed to neural endings in the implant-bone interface itself or to intraosseous neural endings (‘osseoreceptors’) located further either in the bone marrow or above in the periosteum. Histological, neurophysiological and psychophysical evidence of osseoperception is available. Yet, from the current evidence it remains unclear whether an altered innervation (from periodontal to peri-implant) may have changed the tactile function of implant-rehabilitated sites. The identification of the possible sensorimotor cortical adaptive processes that may be associated with the loss of teeth and their replacement by endosseous implants has beenalso explored by functional magnetic resonance imaging (fMRI). Th is presententionwill describes, at a cortical level, the basis of tactile osseoperception aft er tooth replacement by a boneanchored implant. It will also elucidate other neurophysiological aspects of oral implants, such their refl ex function, and point out their clinical meaning.