Evolution of root form endosseous dental implant-Transformation from bone anchored to ligament anchored implants and its neurological aspects-Sensory dental implants

Abstract

This review paper investigates the possible transformation of endosseous dental implant, primarily from the current osseointegrated to the future ligament anchored implant within which a new class of implants with enhanced feature of "neuro-ligament integration" may appear. Endosseous dental implants used presently to replace missing teeth get fused with bone but they do not have any periodontal ligament interface between the alveolar socket and the surface of the implant, which natural teeth do. Hence, they lack any proprioceptive sensation, which is important for discrimination, directional and masticatory sensation. Attempts have been made to regenerate periodontium around the implant in 90s, which was not completely successful. Thereafter, there has been limited research. However, recent advances in tissue engineering and biomaterials gave renewed hope of establishing sensory dental implants. In this review, various methods of regeneration of periodontium onto the surface of titanium implants have been discussed along with the possible types of neurological assessment and neuroimaging that could be carried out for validation of its afferent feedback. The review starts by giving background information of major stages and terminologies in the field of oral implants, its response to host tissue in bone, various surface modification of dental implants, stem cells that are used for periodontal regeneration, different approaches for regeneration of periodontium, concept of proprioception in periodontium, osseoperception of dental implants and concludes with neurophysiology of oro-dento-facial region in brain including its detection and measurements methods.