Background and Objectives: Tactile sensibility is an important characteristic for evaluating the masticatory efficiency in different occlusal situations. When a tooth is extracted, relevant proprioceptors from the periodontal ligament get lost; and after the rehabilitation of this abscess by means of oral prosthesis, this sensibility decreases influencing masticatory function. Osseoperception is a sensitive phenomenon associated with dental implants that allows an increased tactile sensibility to those wearing implant prostheses. The purpose of this study was to determine the difference in tactile sensibility values between implant prosthesis, complete dentures, and natural teeth through a review of the available literature. Materials and Methods. In order to dissect the information, 24 articles from 2004 to 2021 were analyzed from MEDLINE, PubMed Central, and Web of Science databases. These articles were directly related to measuring tactile sensibility in different situations and demonstrating the influence of osseoperception in an improved masticatory function. Results: Tactile sensibility in implant prosthesis is slightly reduced compared with natural dentition but presents improved values with regard to complete dentures. Conclusions: Implant prosthesis are more effective during masticatory function than complete dentures, as they present an increased tactile sensibility, very similar to that present in natural dentition. This enhanced sensibility in implants is due to the osseoperception phenomenon.
Background and Objectives: Addressing deep carious lesions poses significant challenges in daily dental practice due to the inherent complexity of their treatment. Traditionally, complete removal of carious tissues has been the norm, potentially leading to pulp tissue exposure and subsequent pulpitis. In contemporary dentistry, there is a growing preference for minimally invasive techniques, such as selective removal, offering a more conservative approach with enhanced predictability and success rates. Materials and Methods: Our study commenced with a comprehensive systematic review. After that, we performed a meta-analysis focused exclusively on randomized controlled trials involving permanent dentition. Our investigation incorporated seven selected articles, which scrutinized success rates and the incidence of pulp exposure in minimally invasive techniques (MIT) versus conventional techniques (CT). Statistical analysis employed U Mann–Whitney and Wilcoxon tests to interpret the results. Results: Although the difference did not reach statistical significance, MIT demonstrated marginally superior success rates compared to CT. Furthermore, MIT exhibited a lower percentage of pulp exposure when contrasted with CT. However, due to the limited sample size, statistical significance for this difference could not be established. Conclusions: Minimally invasive techniques for caries removal emerge as a conservative and promising approach to safeguard pulp tissues in comparison to conventional techniques. The need for additional randomized controlled trials is emphasized to unequivocally establish the superior success rates of these procedures over their conventional counterparts.
Background and Objectives: The periodontium has important proprioceptive receptors that prevent teeth from using excessive occlusal forces during chewing. There are other receptors from adjacent tissues that replace periodontal ones when teeth are extracted and rehabilitated with prosthesis, although they seem to be less effective. Psychophysical studies investigate tactile sensibility thresholds, which are useful to measure this masticatory efficiency in different prosthetic rehabilitations. There are two types of sensibility depending on the receptors that are activated during these studies: active and passive tactile sensibility. The purpose of this study is to obtain active and passive tactile sensibility threshold figures in natural dentition and prosthetic rehabilitations so we can compare them and understand how this sensibility works in different situations. Materials and Methods: We performed a systematic review of the available literature, following PRISMA guidelines and including articles from 2004 to 2021 in the MEDLINE database. Only 10 articles were included in this investigation as they provided concrete threshold figures. Results: The mean values of active tactile sensibility thresholds in complete dentures, implant prosthesis and natural dentition are 64 µ, 23.3 µ and 16.1 µ, respectively. The mean values of passive tactile sensibility thresholds in implant prosthesis and natural dentition are 6.7 N and 0.8 N, respectively. Conclusions: Implant prosthesis have lower thresholds, that are very close to those present in natural dentition, than complete dentures due to an increased tactile sensibility. Active tactile sensibility thresholds present fewer differences between values than passive tactile ones; as these are only influenced by receptors from periodontal or periimplant tissues.
Background and Objectives: Proprioceptive information from natural dentition and adjacent oral tissues enables correct masticatory function, avoiding damage to the teeth. Periodontium is the main source of this relevant information, and when a tooth is lost, all this proprioceptive sensibility relies on receptors from muscles, the mucous membrane or the temporomandibular joint, and this sensibility gets worse. Active tactile sensibility measures this proprioceptive capability in microns by psychophysical studies consisting of introducing thin metal foils between patients’ dental arches during chewing to see if they are able to notice them or not. Osseoperception is a complex phenomenon that seems to improve this sensibility in patients wearing dental implants. The objective of this investigation is to measure this sensibility in different prosthetic situations by performing a psychophysical investigation. Material and Methods: We divided 67 patients in three groups depending on their prosthetic situation and performed a psychophysical study by introducing aluminium foils of different thicknesses in order to establish an active tactile sensibility threshold in every group. We also measured variables such as prosthetic wearing time, age or gender to see how they may influence threshold values. We used Student’s t-test and Mann–Whitney U tests to analyse these results. Results: Active tactile sensibility threshold values in implants are lower than those from complete dentures but higher than values in natural dentition. However, values in implants are closer to natural dentition than complete denture values. Age, gender or prosthetic wearing time have no influence in active tactile sensibility thresholds. Conclusion: Active tactile sensibility threshold values depend on prosthetic rehabilitations and the mechanoreceptors involved in every situation. Implant prosthesis presents an increased active tactile sensibility thanks to osseoperception phenomenon.
The aim is to quantitatively analyze the diameter and tubular density and semi-quantitatively analyze the elemental composition (Calcium and Phosphorus) in the dentin of primary teeth of children with Osteogenesis Imperfecta (OI) in comparison with a control group. Material and methods: A microstructural (in vitro) analysis of primary teeth of children with OI was performed with SEM and EDS. The variables measured were the tubule count (tubule/mm2) and diameter (µm) at 2000 times magnification at four points of the dentin of different depths. A semiquantitative analysis of the elemental composition of the dentin was performed with EDS of Calcium and Phosphorus (cps). Descriptive and inferential analysis (Fisher’s exact test, the Mann–Whitney U test, the Kruskal–Wallis test, the Bonferroni post hoc test, the ANOVA test of repeated measures, a test of inter- and intra-subject effects, and the Geisser–Greenhouse test) were carried out. Data were analyzed with a 95% confidence level (p-value < 0.05). Results: A total of 25 deciduous teeth from 17 patients with OI and 30 teeth from healthy children were studied. There were differences in the count and tubular diameter for the control group with OI; in addition, the behavior curve changed when the systemic disease was severe. While there were no differences in the amount of dentinal Calcium, the OI tooth showed a significantly lower amount of Phosphorus (p < 0.05), except in the pulpal dentin (p > 0.05). Conclusion: The alterations of the dentinal tubules (density and diameter) were more pronounced in the most severe phenotypes of systemic disease. The amount of Phosphorus was decreased in the dentin of the primary teeth of children with OI compared to the control group.
Background: Selective caries removal aims to preserve pulp vitality and tooth structure by eliminating only infected dentin. Caries detector dyes and laser fluorescence devices are the main diagnostic tools supporting this minimally invasive approach.Objective: To evaluate and compare the diagnostic performance, benefits, and limitations of these two modalities. Additionally, it examines potential synergies with magnification tools and proposes future directions for clinical protocol development.Methods: A scoping review was conducted following PRISMA-ScR guidelines. Of 124 articles screened, four met the inclusion criteria for direct comparison of caries detector dyes and laser fluorescence systems. Diagnostic accuracy, clinical outcomes, and bias risk (ROBINS-I/ROBINS-E) were assessed.Results: All four studies supported the effectiveness of both techniques in selective caries removal. Laser fluorescence devices showed higher sensitivity (ranging from 0.76 to 0.92) and specificity (0.74 to 0.88), along with better accuracy in detecting infected dentin compared to dyes. Dyes were noted for ease of use but showed greater variability in outcomes. Risk of bias ranged from low to moderate across studies.Conclusions: Laser fluorescence systems appear to be more reliable for intraoperative caries detection during selective caries removal. Nevertheless, a combined diagnostic approach, particularly with magnification, may optimize outcomes. These findings support the integration of fluorescence systems in caries management protocols. Further clinical trials are needed to validate these findings and develop standardized, evidence-based protocols.