The innervation of skin and oral mucosa plays a major physiological role in exteroception. It also has a clinical interest as illustrated by sensory changes after neurosurgical procedures. These sensory changes often rely only on the patients' subjective reports, although objective assessments are possible. This review compares the neurophysiological features of the trigeminal sensory pathways with those of cutaneous sensory innervation. In this review, three receptor groups will be discussed: mechanoreceptors, thermoreceptors and nociceptors. Differences between receptors in the glabrous skin, the hairy skin and the oral mucosa will be highlighted. Sensory testing devices have been developed to quantify psychophysiological parameters such as the threshold level for receptor activation upon mechanical stimulation, but such devices have been merely developed to determine the threshold of skin receptors (tactile, thermal). Later on, some have been adapted to suit the particularities of the oral environment. This review attempts to compare the available literature on test devices for oral versus cutaneous tactile function. It summarizes what is common or rather particular to the devices used to study either cutaneous or oral receptors.
Natural dentitions offer superior vibrotactile function compared to any other dental status. Full dentures often show a stronger deterioration of the (vibro)tactile function compared with implant-supported prostheses.
The objective of this study was to determine whether patients with phantom tooth symptoms have an altered sensory perception as compared to pain-free subjects. Ten patients (mean age 56, range 32-71, nine females) were diagnosed as suffering from "phantom tooth" according to a specifically designed phantom tooth questionnaire including components of the McGill Pain Questionnaire. An SCL-90 form was completed and assessment of sensory perception was carried out by determination of the threshold level for light touch sensation, two-point discrimination, and thermal sensation in a case-control design. Results. Of all the observed questionnaires, 5.7% seemed to deal with phantom tooth, with a female preponderance (ratio 9:1). Complaints were predominantly reported in the upper jaw (ratio 8:2) with the majority in the molar region (ratio 5:3). Phantom tooth subjects showed significantly lower threshold levels for light touch sensation, most markedly on the affected side. The average psychoneurotic profile showed a tendency towards higher scores for the phantom tooth subjects. Conclusion. The phantom tooth phenomenon may show a number of features which might aid differential diagnosis. To verify influences such as upper molar predominance and increased light touch sensation, another study should be performed on a larger patient sample.
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