In one of many studies, he examined how
two of the receptors signal
while holding and biting through a peanut.
In the bite phase, the saturated receptors
trigger at maximum, as soon as, the biting phase started.
But they got quickly saturated and stopped triggering,
while the non-saturated receptors follow the bite force.
He compared natural teeth
with complete denture and the implants.
In this slide we see the hold and biting force.
The patients with dentures and implants
lack the receptors.
Meaning that they will not feel where the peanut is
and have another interception than patients with teeth.
It will give a different pattern
in the holding and biting phase,
so it's not so much about the biting force
as it is about the precision.
The periodontal receptors signals
very detailed information about position,
direction and intensity of chew and bite forces.
This information is utilized by the brain
to regulate the jaws movements during normal operation.
Patients with implants which lack this information,
demonstrate clear disturbances
in the fine motor control of jaw regulations.
Also, implant doesn't feel interferences
in the same way as teeth.
The clinical implication for this is
that with teeth, the jaws will automatically try
to chew in a cusp fossa relation
giving a load through the root.
While with implants,
the patient can chew a little on the side without knowing it
giving bending forces to the reconstructions.
So in patients with implants,
the reconstruction should have more flat cusps
and more narrow occlusal table
in order to avoid the bending forces.
One of the anatomical difference
between the tooth and implant
is the fibres supporting the surrounding tissues.
In this slide, we can see the fibres that are the same
for the teeth and implants.
The small dots represent the circumferential fibres
surrounding the tooth like a rubber band.
But the tooth also have cement in certain fibers
or Sharpey's fibres originating from the cement
to the bone and the gingival tissues.
The clinical implication for this is
that the cement can penetrate much easier
and deeper when cementing a crown on an implant
compared to a tooth.
It is sometimes hard to see
that there is cement excess
and many times you can't see it on the X-ray at all.
This can give you fistulas and bone loss.
In summary, we do have the differences
between tooth and implants
is the shock absorbing effect,
the movements of the teeth.
We have the perception
and finally, we have the anatomical differences.
Nikos MattheosClinical Associate Professor in Implant Dentistry
