Clinical Oral Investigations

, Volume 14, Issue 2, pp 161–168 | Cite as

Assessment of changes in the oral tactile function of the soft tissues by implant placement in the anterior maxilla: a prospective study

  • P. Habre-HallageEmail author
  • N. Bou Abboud-Naman
  • H. Reychler
  • D. van Steenberghe
  • R. Jacobs
Original Article


The aim of the present study was to assess the somatosensory function in the peri-implant soft tissues in the anterior jaw bone by means of two psychophysical tests. Light-touch sensation (LTS) and two-point discrimination (2PD) were performed before, and at planned intervals until 18 months after the placement of one or two implants in the anterior maxilla. The same tests were used on the contralateral control sites. The psychophysical threshold was determined by performing the staircase method. The mean values and standard deviation of LTS and 2PD, pooled over the four sessions at each test area, were calculated. Despite a large intersubject variation in both the LTS and 2PD, significantly high intra-individual correlations were found (P < 0.005). For LTS, the thresholds were not significantly affected over time (P > 0.05) on both implant and control sites. The 2PD increased significantly after surgery and maintained the higher discriminatory sense for 1 year (P-value 0.005). The control sites remained stable over time. However, no correlation was revealed between LTS and 2PD perception (Pearson correlation test). In this prospective study, no major differences between the different sites and testing sessions were reported; except for the 2PD thresholds which were lowered after implant surgery. These findings suggest that the regenerated nerves may be responsible for the increased 2PD sensitivity in the peri-implant soft tissue. The unchanged LTS thresholds did not allow confirming this hypothesis.


Oral implants Tactile threshold Perception Psychophysical tests Oral sensory function 


Conflicts of interest



  1. 1.
    Abarca M, van Steenberghe D, Malevez C, De Ridder J, Jacobs R (2006) Neurosensory disturbances after immediate loading of implants in the anterior mandible: an initial questionnaire approach followed by a psychophysical assessment. Clin Oral Investig 10:269–277CrossRefPubMedGoogle Scholar
  2. 2.
    Aviv JE, Hecht C, Weiberg H, Dalton JF, Urken ML (1992) Surface sensibility of the floor of the mouth and tongue in healthy controls and in radiated patients. Otolaryngol Head Neck Surg. 107:418–423PubMedGoogle Scholar
  3. 3.
    Bale E, White FH (1982) Quantitative light and electron microscopical studies of the epithelial-connective tissue junction in intraoral mucosae. J Microsc 128:69–78PubMedGoogle Scholar
  4. 4.
    Cordeiro PG, Schwartz M, Nevers RI, Tuma R (1997) A comparison of donor and recipient site sensation in free tissue reconstruction of the oral cavity. Annals of Plastic Surgery 39:461–468PubMedGoogle Scholar
  5. 5.
    Desjardins RP, Winkelmann RK, Gonzalez JB (1971) Comparison of nerve endings in normal gingiva with those in mucosa covering edentulous alveolar ridges. J Dent Res 50:867–879PubMedGoogle Scholar
  6. 6.
    Dyck PJ, Curtis DJ, Bushek W, Offord K (1974) Description of Minnesota thermal disks and normal values of cutaneous thermal discrimination in man. Neurology 24:325–330PubMedGoogle Scholar
  7. 7.
    El–Sheikh AM, Hobkirk JA, Howell PGT, Gilthorpe MS (2003) Changes in passive tactile sensibility associated with dental implants following their placement. Int J Oral Maxillofac Implants 18:266–272PubMedGoogle Scholar
  8. 8.
    Essick GK, Patel S, Trulsson M (2002) Mechanosensory and thermosensory changes across the border of impaired sensitivity to pinprick after mandibular nerve injury. J Oral Maxillofac Surg 60:1250–1266CrossRefPubMedGoogle Scholar
  9. 9.
    Falmagne JC (1985) Elements of psychophysical theory. In Oxford: Clarendon. 1st edition, pp. 219-220.Google Scholar
  10. 10.
    Fujii N, Ohnishi H, Shirakura M, Nomura S, Ohshima H, Maeda T (2003) Regeneration of nerve fibres in the peri–implant epithelium incident to implantation in the rat maxilla as demonstrated by immunocytochemistry for protein gene product 9.5 (PGP9.5) and calcitonin gene–related peptide (CGRP). Clin Oral Implants Res 14:240–247CrossRefPubMedGoogle Scholar
  11. 11.
    Garzino M, Ramieri G, Panzica G, Preti G (1996) Changes in the density of protein gene product 9.5–immunoreactive nerve fibers in human oral mucosa under implant–retained overdentures. Archives of Oral Biology 41:1073–1079CrossRefPubMedGoogle Scholar
  12. 12.
    Hansen JH (1980) Neurohistological reactions following tooth extractions. Int J Oral Surg 9:411–426PubMedGoogle Scholar
  13. 13.
    Jacobs R, van Steenberghe D (1991) Comparative evaluation of the oral tactile function by means of teeth or implant–supported prostheses. Clin Oral Implants Res 2:75–80CrossRefPubMedGoogle Scholar
  14. 14.
    Jacobs R, van Steenberghe D (1993) Comparison between implant–supported prostheses and teeth regarding the passive threshold level. Int J Oral Maxillofac Implants 8:549–554PubMedGoogle Scholar
  15. 15.
    Jacobs R, van Steenberghe D (1994) Role of periodontal ligament receptors in the tactile function of teeth: a review. J Periodontal Res 29:153–167CrossRefPubMedGoogle Scholar
  16. 16.
    Jacobs R, Wu C–H, Goossens K, Van Loven K, van Steenberghe D (2001) Perceptual changes in the anterior maxilla after placement of endosseous implants. Clin Implant Dent Relat Res 3:148–155CrossRefPubMedGoogle Scholar
  17. 17.
    Jacobs R, Wu CH, Goossens K, Van Loven K, Van Hees J, van Steenberghe D (2002) Oral versus cutaneous sensory testing: a review of the literature. J Oral Rehabil 29:923–950CrossRefPubMedGoogle Scholar
  18. 18.
    Jacobs R, van Steenberghe D (2006) From osseoperception to implant–mediated sensory–motor interactions and related clinical implications. J Oral Rehabil 33:282–292CrossRefPubMedGoogle Scholar
  19. 19.
    Johansson RS, Vallbo AB (1979) Tactile sensibility in the human hand: relative and absolute densities of four types of mechanoreceptive units in glabrous skin. J Physiol 286:283–300PubMedGoogle Scholar
  20. 20.
    Johansson RS, Vallbo AB (1980) Spatial properties of the population of mechanoreceptive units in the glabrous skin of the human hand. Brain Res 184:353–366CrossRefPubMedGoogle Scholar
  21. 21.
    Johansson RS, Trulsson M, Olsson KA, Westberg K–G (1988) Mechanoreceptor activity from the human face and oral mucosa. Exp Brain Res 72:204–208CrossRefPubMedGoogle Scholar
  22. 22.
    Klineberg I, Murray G (1999) Osseoperception: sensory function and proprioception. Adv Dent Res 13:120–129CrossRefPubMedGoogle Scholar
  23. 23.
    Komiyama O, De Laat A (2005) Tactile and pain thresholds in the intra–and extra–oral regions of symptom–free subjects. Pain 115:308–315CrossRefPubMedGoogle Scholar
  24. 24.
    Kydd WL, Daly CH, Wheeler JB 3rd (1971) The thickness measurement of masticatory mucosa in vivo. Int Dent J 21:430–441PubMedGoogle Scholar
  25. 25.
    Lambrichts I, Creemers J, van Steenberghe D (1992) Morphology of neural endings in the human periodontal ligament: an electron microscopic study. J Periodontal Res 27:191–196CrossRefPubMedGoogle Scholar
  26. 26.
    Linden RW, Scott BJ (1989) The effect of tooth extraction on periodontal ligament mechanoreceptors represented in the mesencephalic nucleus of the cat. Arch Oral Biol 34:937–941CrossRefPubMedGoogle Scholar
  27. 27.
    Lundqvist S, Haraldson T (1992) Oral function in patients wearing fixed prosthesis on osseointegrated implants in the maxilla: 3–year follow-up study. Scand J Dent Res 100:279–283PubMedGoogle Scholar
  28. 28.
    Lundqvist S (1993) Speech and other oral functions. Clinical and experimental studies with special reference to maxillary rehabilitation on osseointegrated implants. Swed Dent J Suppl 91:1–39PubMedGoogle Scholar
  29. 29.
    Mason AG, Holland GR (1993) The reinnervation of healing extraction sockets in the ferret. J Dent Res 72:1215–1221PubMedGoogle Scholar
  30. 30.
    Macefield VG (2005) Physiological characteristics of low–threshold mechanoreceptors in joints, muscle and skin in human subjects. Clin Exp Pharmacol Physiol 32:135–144CrossRefPubMedGoogle Scholar
  31. 31.
    Marchetti C, Farina A, Cornaglia AI (2002) Microscopic, immunocytochemical, and ultrastructural properties of peri–implant mucosa in humans. J Periodontol 73:555–563CrossRefPubMedGoogle Scholar
  32. 32.
    Mericske–Stern R (1994) Oral tactile sensibility recorded in overdenture wearers with implants or natural roots: a comparative study. Int J Oral Maxillofac Implants 9:63–70PubMedGoogle Scholar
  33. 33.
    Mühlbradt L, Ulrich R, Möhlmann H, Schmid H (1989) Mechanoperception of natural teeth versus endosseous implants revealed by magnitude estimation. Int J Oral Maxillofac Implants. 4:125–130PubMedGoogle Scholar
  34. 34.
    Mühlbradt L, Ulrich R, Möhlmann H, Schmid H, Wendler K (1990) Die wahrnehmung von überschwelligen kräften an enossalen implantaten und natürlichen zähnen. Zahnärtzl. Implantol VI:161–165Google Scholar
  35. 35.
    Muller HP, Schaller N, Eger T, Heinecke A (2000) Thickness of masticatory mucosa. J Clinical Periodontol 27:431–436CrossRefGoogle Scholar
  36. 36.
    Muller W, Schroeder HE (1980) Differentiation of the epithelium of the human hard palate. Cell Tissue Res 209:295–313CrossRefPubMedGoogle Scholar
  37. 37.
    Ogawa T, Ogimoto T, Sumiyoshi K, Koyano K (2003) Pressure–pain threshold of oral mucosa and its region-specific modulation by pre-loading. J Oral Rehabil 30:1062–1069CrossRefPubMedGoogle Scholar
  38. 38.
    Rapp R, Kirstine WD, Avery JK (1957) A study of the multiplicity of nerve endings in the human gingiva and periodontal membrane. J Canad Dent Assoc 23:637–645Google Scholar
  39. 39.
    Rowe MJ, Tracey DJ, Mahns DA, Sahai V, Ivanusic JJ (2005) Mechanosensory perception : are there contributions from bone associated receptors? Clin Exp Pharmacol Physiol 32:100–108CrossRefPubMedGoogle Scholar
  40. 40.
    Sessle BJ, Yao D, Nishiura H, Yoshino K, Lee JC, Martin RE, Murray GM (2005) Properties and plasticity of the primate somatosensory and motor cortex related to orofacial sensorimotor function. Clin Exp Pharmacol Physiol 32:109–114CrossRefPubMedGoogle Scholar
  41. 41.
    Sukotjo C, Abanmy AA, Ogawa T, Nishimura I (2002) Molecular cloning of wound inducible transcript (wit 3.0) differentially expressed in edentulous oral mucosa undergoing tooth extraction wound–healing. J Dental Res 81:229–235CrossRefGoogle Scholar
  42. 42.
    Suzuki Y, Matsuzaka K, Ishizaki K, Tazaki M, Sato T, Inoue T (2005) Characterization of the peri–implant epithelium in hamster palatine mucosa: behavior of Merkel cells and nerve endings. Biomed Res 26:257–269CrossRefPubMedGoogle Scholar
  43. 43.
    Tanaka T, Kido MA, Ibuki T, Yamaza T, Kondo T, Nagata E (1996) Immunocytochemical study of nerve fibers containing substance P in the junctional epithelium of rats. J Periodontal Res 31:187–194CrossRefPubMedGoogle Scholar
  44. 44.
    Weinstein S (1962) Tactile sensitivity of the phalanges. Percept Mot Skills 14:351–354CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • P. Habre-Hallage
    • 1
    • 5
    Email author
  • N. Bou Abboud-Naman
    • 2
  • H. Reychler
    • 3
  • D. van Steenberghe
    • 4
  • R. Jacobs
    • 5
  1. 1.Department of Prosthodontics, Faculty of DentistrySaint-Joseph University, Campus of Medical SciencesBeirutLebanon
  2. 2.Department of Periodontology, Faculty of DentistrySaint-Joseph University, Campus of Medical SciencesBeirutLebanon
  3. 3.Department of Stomatology and Maxillo-Facial SurgeryCatholic University of LouvainBrusselsBelgium
  4. 4.Professor emeritus of the Faculty of MedicineCatholic University of LeuvenLeuvenBelgium
  5. 5.Laboratory of Oral Physiology, Department of Periodontology, Faculty of MedicineCatholic University of LeuvenLeuvenBelgium

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