Purpose: To compare subjects' sensory responses to horizontal and vertical forces on tooth- and implant-supported restorations.
Keywords: osseoperception, dental implant, proprioception, tooth proprioception, implant proprioception
Materials and Methods: In this prospective study, three protocols simulating the horizontal or vertical forces that occur during mastication were used to obtain subjective responses from subjects. These protocols included the measurement of horizontal force intensity during excursive movements and the identification of initial contact during guided and free vertical closure. Responses were recorded using a 1- to 10-point visual analog scale (VAS) and/ or monitored with electromyography (EMG) and Tekscan.
Results: The study included 30 patients with a single implant-supported restoration (ISR) with a contralateral tooth-supported restoration (TSR). For horizontal forces similar to those of mastication (0.6 N), subject VAS scores were similar for both ISRs and TSRs at 6.3 vs 6.1, respectively. At reduced forces (0.2 and 0.4 N), subject responses were greater for the TSR at 3.4 and 5.4, respectively, as opposed to 1.2 and 2.6 for ISR, respectively (P < .01). During vertical guided closure (Test 1) at 25% of maximum bite force (MBF), subjects were more successful at correctly identifying initial contact of TSRs at a rate of 12 out of 17, compared to ISRs, which achieved a rate of 4 out of 13 (P < .1). In vertical free closure (Test 2), subject responses for the correct identification of initial contact at 50% MBF were similar for both TSRs and ISRs at 13 out of 17 and 9 out of 13, respectively. However, comparing the correct responses for subjects whose initial contacts were ISR showed a significant improvement in correct answers from Test 1 to Test 2, from 4 out of 13 correct to 9 out of 13 correct (P < .05).
Conclusion: While the mechanism is not clear, subjects' ability to discern the horizontal and vertical forces at levels comparable to mastication appear similar between TSRs and ISRs.