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Background : Short-term follow-up of masticatory adaptation after rehabilitation with an immediately loaded implant-supported prosthesis: a pilot assessment [1]

Background : Short-term follow-up of masticatory adaptation after rehabilitation with an immediately loaded implant-supported prosthesis: a pilot assessment [1]

author: Mihoko Tanaka, Collaert Bruno, Reinhilde Jacobs, Tetsurou Torisu, Hiroshi Murata | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

Tooth loss represents a major oral disability comparable to an amputation, with severe impairment of oral functions [1]. While denture wearers can rely on mucosal sensors, anchoring prosthetic teeth to the bone via osseointegrated implants has been assumed to create a (partial) sensory substitution for missing periodontal ligament receptors from stimuli transmitted via the bone [2]. The restoration of the sensory feedback pathway is necessary for the physiological integration of implant-supported prostheses in the human body. It helps to optimize essential oral functions, such as chewing and biting. Studies on such functions usually report an improvement of oral functions with implant-supported prostheses as opposed to conventional dentures [3–9]. Improved oral function also impacts on quality of life [10], often scored with ratings for function, pain, discomfort, and psychosocial factors using the GOHAI system [11]. However, one should realize that such rehabilitation may also create some patient-related masticatory and other problems or complications [12]. Such complaints could be related to uncomfortable occlusion, accidental biting of the cheek or tongue, or problems during speech. Other complications might include fractures of prosthetic or implant components. For adequate mastication, the ability to adapt to food of various levels of hardness and various volumes is important. In individuals with natural dentition, such information is processed by the periodontal ligament receptors [13–15]. Since patients with implant-supported prostheses lose the periodontal ligament and its elaborate associated peripheral feedback mechanism, it is possible that they are not able to differentiate food hardness and texture. In this context, it is important to mention that some studies reported no significant improvement of masticatory function after implant treatment [3, 16, 17]. Jacobs et al. [3] indeed noticed that some of these patients might realize that the peripheral feedback mechanism is no longer assisting them, rendering some of them afraid of biting too hard. [3] Instead, these anxious patients are found to bite submaximally with implant-supported prostheses [3].

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