牙种植体周围骨感知现象的研究进展

Research progress on osseoperception around the dental implant

关键词:  骨感知  种植体周生理  牙周机械感受器  神经纤维

Key words:  osseoperception  physiology of peri-implant  periodontal mechanoreceptor  nerve fiber

摘要:

“骨感知”即在缺失牙，缺乏牙周膜的情况下种植体-骨仍具有的感知功能，是来源于骨锚合修复体接受机械刺激时的感觉，通过颞下颌关节、肌肉、皮下、黏膜和骨膜组织等机械感受器传导，并通过中枢神经系统对信息的传递在感觉运动功能的维持中发生适应性改变。关于骨感知的存在以及其影响因素，目前研究方法包括：组织生理学研究、电生理学研究、心理生理学评估及大脑反射功能等。组织生理学研究证实种植体周骨界面存在神经纤维，并试图确定该神经纤维的来源以及与骨感知的相关性；电生理学研究将神经领域的神经传导机制研究方法运用到骨感知的研究中，证实骨感知由多种传导通路机制共同作用；心理生理学评估主要从患者的主观感受来研究其种植后的感知功能；大脑反射功能客观地观察了种植体在受压或施压时的大脑反射能力。本文就目前种植体周围骨感知机制研究进展及临床意义进行综述。

Abstract:

Replacement of the loss teeth has significant functional and psychological effects. The capability of osseointegrated dental implants to transmit a certain amount of tactile sensibility through osseointegrated dental implants is called osseoperception. A large number of studies have evidenced that osseoperception is derived from the bone-anchored restoration. The mechanoreceptors, which receive mechanical stimulation, may be present in temporomandibular joints, muscles, skin, mucous membrane and periosteal tissue. They transfer sensation and maintain adaptive changes through the central nervous system. There have been a large number of researchers studying the existence and relevant influencing factors of osseoperception at different levels. Various study methods include histophysiological, electrophysiological, psychological physiology evaluation and assessment of brain reflection function. Histophysiology studies have confirmed that there are nerve fibers lying around the implant-bone surface. Attempt has been made to determine the source of the nerve fibers and their correlation with function of osseoperception. In electrophysiological studies, the research methods for nerve conduction in neural mechanism have been applied to the study of osseoperception and demonstrated that osseoperception is the combination of many pathway mechanisms. Psychological physiology assessment is to study osseoperception according to the patient's subjective feeling after the treatment of implant. Brain reflection function is used to assess reflection ability of brain when exerts force on the implants. “Osseoperception” has also been playing a vital role in clinical treatment. In one place, it provides the basic theory of treatment for dentists, and in another place it brings patients with restoring original health chewing function and good perception ability which largely improve their standard of life.