Osseoperception: physiological background and clinical implications

Reinhilde Jacobs

Preliminary abstract
Osseointegration of implants in the jaw bone has been studied thoroughly, dealing with various
aspects (bone apposition and quality, microbiology, biomechanics, esthetics, …). Another key
issue that received much less attention is the physiologic integration of the implant(s) and
prosthesis in body. The latter aspect is however very important to try getting new insights in oral
functioning with implant-supported prostheses.
Amputated patients, rehabilitated with a lower limb prosthesis, anchored to the bone by means of
an osseointegrated implant, have reported that they could feel the type of soil they were walking
on. This phenomenon has raised questions. Would this special feeling result from a changed
impact force through the rigid implant-bone interface, in contrast to the cushioning effect of the skin
under the socket prosthesis? Or would intraosseous or periosteal neural endings be involved?
Clinical observations on patients with oral implants, have confirmed such special sensory
perception skill.
The underlying mechanism of this so-called “osseoperception” phenomenon remains a matter of
debate, because extraction of teeth involves elimination of the extremely sensitive periodontal
ligaments while functional reinnervation around implants is uncertain. Histological,
neurophysiological and psychophysical evidence of osseoperception have been collected, making
the assumption more likely that the peripheral feedback pathway can be restored when dealing
with osseointegrated implants. This may have important clinical implications, because a more
natural functioning with implant-supported prostheses may be attempted. It may open doors for
global integration in the human body.

Preliminary reference list

1. Jacobs R. (1998) Osseoperception. Department of Periodontology, KULeuven: Leuven.

ISBN90-804618-1-4.
2. Jacobs R, Brånemark R, Olmarker K, Rydevik B, van Steenberghe D, Brånemark P-I.
Evaluation of the psychophysical detection threshold level for vibrotactile and pressure
stimulation of prosthetic limbs using bone anchorage or soft tissue support. Prosthetics
and Orthotics International 2000;24:133-142.
3. Van Loven K, Jacobs R, Swinnen A, Van Huffel S, Van Hees J, van Steenberghe D.
Perception through oral osseointegrated implants demonstrated by somatosensory evoked
potentials. Archives of Oral Biology 2000; 45: 1083-1090.
4. Van Loven K, Jacobs R, Van Hees J, Van Huffel S, van Steenberghe D. Trigeminal
somatosensory evoked potentials in humans. Electromyography an Clinical
Neurophysiology 2001; 41: 357-375.
5. Jacobs R, Wu C-H, Goossens K, Van Loven K, van Steenberghe D. Perceptual changes in
the anterior maxilla after placement of endosseous implants. Clinical Implant Dentistry
and Related Research 2001; 3:148-155.
6. Jacobs R, Wu C-H, Desnyder M, Kolenaar B, van Steenberghe D. Methodologies of oral
sensory tests. Journal of Oral Rehabilitation 2002;29:720-30.
7. Jacobs R, Wu CH, Goossens K, Van Loven K, Van Hees J, Van Steenberghe D. Oral
versus cutaneous sensory testing: a review of the literature. Journal of Oral
Rehabilitation 2002; 29:923-950.
8. Mraiwa N, Jacobs R, van Steenberghe D, Quirynen M. Clinical assessment and surgical
implications of anatomic challenges in the anterior mandible. Clinical Implant Dentistry
and Related Research 2003;5:219-225.
9. Jacobs R, Manders E, Van Looy C, Lembrechts D, Naert I, van Steenberghe D. Evaluation
of speech in patients rehabilitated with various oral implant-supported prostheses. Clinical
Oral Implants Research 2001;12:167-173.
10. Jacobs R, Bou Serhal C, van Steenberghe D. The stereognostic ability of natural dentitions
versus implant-supported fixed prostheses or overdentures. Clinical Oral Investigations
1997;1:89-94.