Masticatory reflex: manifestation features at mucositis and periimplantitis

Relevance. In the middle of the last century, based on clinical and physiological studies, the head of the Department of Prosthodontics of the First Leningrad Medical Institute named after Academician I.P. Pavlov, Professor I.S. Rubinov, prepared a scientific base and formulated the doctrine of functional links and reflexes of the masticatory apparatus. In subsequent years, other scientists and clinicians clarified the features of the masticatory apparatus reflex manifestations and functional characteristics of masticatory units in various oral diseases. New characteristics of reflex formation in various pathological conditions of the masticatory apparatus we re revealed.
Materials and methods. The paper presents data from a clinical and physiological study of the masticatory apparatus in 221 people of different age groups with implant-supported prostheses (two-stage endosseous implants). We studied the occlusal force using a gnathodynamometer and measured the muscle tone parameters at rest and the masticatory muscle contraction using a myotonometer. The study describes the masticatory apparatus musculoskeletal physiological reflex features and the manifestation in patients during dental rehabilitation, which was complicated by the gum and/or bone inflammation around the implants (mucositis and peri-implantitis ).
Results. The study found that the development of an inflammatory process in the area of the dental implant in the form of mucositis or peri-implantitis did not lead to a protective change in the kinematics of the lower jaw movement to reduce the load on the masticatory link with developing pathology in the area of peri-implant tissues. The paper shows the pathophysiological features of the manifestation of the masticatory apparatus reflexes when restoring the integrity of dentition using prostheses. It describes the mechanisms of forming a vicious pathogenesis cycle in inflammation development in the tissues adjacent to artificial support.
Conclusion. The clinical and physiological study substantiates the importance of routine preventive examinations, including radiographic examination, for timely diagnosis and treatment of an asymptomatic inflammatory process around a dental implant and an implant-supported restoration to avoid their premature functional and aesthetic failure.

1. Balin VN, Vasil'eva LV. In development of scientific views of prof. I.S. Rubinova and prof. A.K. Iordanishvili on pathogenesis and treatment of periodontal diseases. Terramedika. 2003;1(2):16-18. (In Russ.).

2. Balin DV, Iordanishvili AK, Muzikin MI. Features of personal response while replacing removable dentures in the prosthetic construction on an implants supports. Rossijskij vestnik dental'noj implantologii. 2016;34(2):46-53. (In Russ.).

3. Iordanishvili AK, Losev FF, Muzikin MI. Osteo-muscular physiological reflex chewing device and its characteristic. Parodontologija. 2017;85(4):9-14. (In Russ.). Available from: https://www.elibrary.ru/item.asp?id=32619736

4. Iordanishvili A.K. Fiziologija i patofiziologija zhevatel'norechevogo apparata: uchebnoe posobie. SPb.: Chelovek; 2016. 132 s. (In Russ.).

5. Iordanishvili A.K., Muzikin M.I., Zharova E.N. Projavlenie zhevatel'nogo refleksa u pacientov, pol'zujushhihsja ortopedicheskimi konstrukcijami na iskusstvennyh. Izvestija Rossijskoj Voenno-medicinskoj akademii. 2021;40(1):30-35. (in Russ.). Available from: https://www.elibrary.ru/item.asp?id=44805689

6. Muzikin M.I., Kokovihina E.V., Gerasimova E.A. Vozrastnaja i postjekstrakcionnaja atrofija cheljustej i sovremennye vozmozhnosti vosstanovlenija zhevatel'nogo apparata u pozhilyh i staryh ljudej. Uspehi gerontologii. 2021;34(1):134-143. (In Russ.). Available from: https://www.elibrary.ru/item.asp?id=45558935

7. Rubinov IS. Fiziologicheskie osnovy stomatologii. L.: Medicina; 1970. (In Russ.).

8. Fabbro MD, Dellavia C, Pellegrini G, Rosati R. Functional jaw muscle assessment in patients with a full fixed prosthesis on a limited number of implants: a review of the literature. European Journal of Oral Implantology. 2014;7(1):155-169.

9. Grigoriadis A. Adaptability of mastication in people with implant-supported bridges. Journal Of Clinical Periodontology. 2011;38(1):395-404. doi: 10.1111/j.1600-051X.2010.01697.x

10. Korhonen R. Can mechanical myotonometry or electromyography be used for the prediction of intramuscular pressure. Physiological Measurement. 2005;26(6):951-963. doi: 10.1088/0967-3334/26/6/006

11. Lobbezoo F. Topical review: modulation of trigeminal sensory input in humans: mechanisms and clinical implications. Journal of Orofacial Pain. 2002;16(1):9-21.

12. Trulsson M. From brain to bridge: masticatory function and dental implants. Journal of Oral Rehabilitation. 2012;2(39):858–877. doi: 10.1111/j.1365-2842.2012.02340.x