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

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.