Dental deafferentation and brain damage: A review and a hypothesis.

In the last few decades, neurobiological and human brain imaging research have greatly advanced our understanding of brain mechanisms that support perception and memory, as well as their function in daily activities. Knowledge of the neurobiological mechanisms behind the deafferentation of stomatognathic systems has also expanded greatly in recent decades. In particular, current studies reveal that the peripheral deafferentations of stomatognathic systems may be projected globally into the central nervous system (CNS) and become an associated critical factor in triggering and aggravating neurodegenerative diseases. This review explores basic neurobiological mechanisms associated with the deafferentation of stomatognathic systems. Further included is a discussion on tooth loss and other dental deafferentation (DD) mechanisms, with a focus on dental and masticatory apparatuses associated with brain functions and which may underlie the changes observed in the aging brain. A new hypothesis is presented where DD and changes in the functionality of teeth and the masticatory apparatus may cause brain damage as a result of altered cerebral circulation and dysfunctional homeostasis. Furthermore, multiple recurrent reorganizations of the brain may be a triggering or contributing risk factor in the onset and progression of neurodegenerative conditions such as Alzheimer's disease (AD). A growing understanding of the association between DD and brain aging may lead to solutions in treating and preventing cognitive decline and neurodegenerative diseases.

Mandibular movement during speech of two related Latin languages.

OBJECTIVES/HYPOTHESIS: This study assessed the kinesiographic recordings of jaw movements during reading a text in Galician and Spanish language. STUDY DESIGN: Cross-sectional blind study. METHODS: A homogeneous healthy group of 25 normal stomatognathic system and native Galician participants was studied. Frontal and parasagittal plane recordings of the intraborder lateral jaw movements and during reading Galician and Spanish texts were recorded using a calibrated jaw-tracking device, kinesiograph. RESULTS: Although movements were similar in both languages, a greater retrusion of the jaw in the Spanish language was shown; moreover, a tendency exists for a left-side motion envelope in this right-handedness preference sample. CONCLUSIONS: This study supports the hypothesis that speech is controlled by the central nervous system rather than by peripheral factors and that the hemispheric dominance influences the asymmetry of the speech envelope.

The neuromuscular approach towards interdisciplinary cooperation in medicine.

BACKGROUND: The contemporary approach of dentistry towards interdisciplinary cooperation is based on the neuromuscular concept. In recent years many authors have pointed out a correlation between orthopaedic and dental findings. Furthermore, there is an intimate biomechanical interrelationship of occlusion with cerebral fluid circulation, left and right equilibrium, gaze stabilisation and headache. The influence of a dental occlusion and temporomandibular joint (TMJ) status on general health has been widely analysed in the current scientific literature. AIM: The aim of this analytic study was to display the deep relationship between dentistry and other fields of medicine, and to show the necessity of wide cooperation between dentists and physicians. CONCLUSIONS: This study was based on a review of 41 sources, including specialised articles and books. The significance of different anatomical and physiological preconditions (occlusion, muscles and TMJ status) was considered and evaluated separately. However, as a result of modern concepts of general body health, extending cooperation between different fields of medicine is essential. The practical application of the principles of neuromuscular dentistry enables one to increase greatly the treatment efficiency of aches in muscles, headaches, postural dysfunctions as well as of many other diseases. However, the dentist's contribution to the development of an interdisciplinary approach is underestimated. Many theoretical aspects of the interdisciplinary relationship have not been sufficiently examined, hence the practical consequences remain unclear. Further research in the field is urgently needed.

The coarticulation/invariance scale: mutual information as a measure of coarticulation resistance, motor synergy, and articulatory invariance.

Coarticulation and invariance are two topics at the center of theorizing about speech production and speech perception. In this paper, a quantitative scale is proposed that places coarticulation and invariance at the two ends of the scale. This scale is based on physical information flow in the articulatory signal, and uses Information Theory, especially the concept of mutual information, to quantify these central concepts of speech research. Mutual Information measures the amount of physical information shared across phonological units. In the proposed quantitative scale, coarticulation corresponds to greater and invariance to lesser information sharing. The measurement scale is tested by data from three languages: German, Catalan, and English. The relation between the proposed scale and several existing theories of coarticulation is discussed, and implications for existing theories of speech production and perception are presented.

Effects of neuromuscular electrical stimulation, laser therapy and LED therapy on the masticatory system and the impact on sleep variables in cerebral palsy patients: a randomized, five arms clinical trial.

BACKGROUND: Few studies demonstrate effectiveness of therapies for oral rehabilitation of patients with cerebral palsy (CP), given the difficulties in chewing, swallowing and speech, besides the intellectual, sensory and social limitations. Due to upper airway obstruction, they are also vulnerable to sleep disorders. This study aims to assess the sleep variables, through polysomnography, and masticatory dynamics, using electromiography, before and after neuromuscular electrical stimulation, associated or not with low power laser (Gallium Arsenide- Aluminun, =780 nm) and LED (= 660 nm) irradiation in CP patients. METHODS/DESIGN: 50 patients with CP, both gender, aged between 19 and 60 years will be enrolled in this study. The inclusion criteria are: voluntary participation, patient with hemiparesis, quadriparesis or diparetic CP, with ability to understand and respond to verbal commands. The exclusion criteria are: patients undergoing/underwent orthodontic, functional maxillary orthopedic or botulinum toxin treatment. Polysomnographic and surface electromyographic exams on masseter, temporalis and suprahyoid will be carry out in all sample. Questionnaire assessing oral characteristics will be applied. The sample will be divided into 5 treatment groups: Group 1: neuromuscular electrical stimulation; Group 2: laser therapy; Group 3: LED therapy; Group 4: neuromuscular electrical stimulation and laser therapy and Group 5: neuromuscular electrical stimulation and LED therapy. All patients will be treated during 8 consecutive weeks. After treatment, polysomnographic and electromiographic exams will be collected again. DISCUSSION: This paper describes a five arm clinical trial assessing the examination of sleep quality and masticatory function in patients with CP under non-invasive therapies. TRIAL REGISTRATION: The protocol for this study is registered with the Brazilian Registry of Clinical Trials - ReBEC RBR-994XFS.

Perineural invasion and spread in head and neck cancer.

Perineural involvement is a well-recognized clinicopathologic entity found in head and neck (H&N) cancers, including mucosal epithelial carcinomas and salivary gland malignancies. Perineural disease remains a diagnostic, prognostic and therapeutic challenge for the multidisciplinary H&N oncology team. Nerves are important routes of tumor spread in H&N malignancies, yet the biology and prognostic implications of perineural tumor growth are not fully understood. On balance, the available evidence suggests that it is associated with an increased risk of locoregional recurrence but the impact on survival remains uncertain. Perineural involvement has implications for locoregional disease diagnosis and management. MRI is the best imaging modality to detect tumor extent. Advanced radiotherapy technologies such as intensity-modulated radiation therapy and image-guided radiation therapy have the potential for more accurate targeting and treatment of anatomically complex patterns of disease spread. This review is limited to nondermatologic H&N cancers.

Generation of the masticatory central pattern and its modulation by sensory feedback.

The basic pattern of rhythmic jaw movements produced during mastication is generated by a neuronal network located in the brainstem and referred to as the masticatory central pattern generator (CPG). This network composed of neurons mostly associated to the trigeminal system is found between the rostral borders of the trigeminal motor nucleus and facial nucleus. This review summarizes current knowledge on the anatomical organization, the development, the connectivity and the cellular properties of these trigeminal circuits in relation to mastication. Emphasis is put on a population of rhythmogenic neurons in the dorsal part of the trigeminal sensory nucleus. These neurons have intrinsic bursting capabilities, supported by a persistent Na(+) current (I(NaP)), which are enhanced when the extracellular concentration of Ca(2+) diminishes. Presented evidence suggest that the Ca(2+) dependency of this current combined with its voltage-dependency could provide a mechanism for cortical and sensory afferent inputs to the nucleus to interact with the rhythmogenic properties of its neurons to adjust and adapt the rhythmic output. Astrocytes are postulated to contribute to this process by modulating the extracellular Ca(2+) concentration and a model is proposed to explain how functional microdomains defined by the boundaries of astrocytic syncitia may form under the influence of incoming inputs.

The relationship between posture and equilibrium and the auriculotemporal nerve in patients with disturbed gait and balance.

Balance is defined as a state of equilibrium or parity characterized by cancellation of all forces by equal opposing factors. This is the act of maintaining an upright posture (static balance) or in locomotion (dynamic balance or gait). This system depends on vestibular function, vision, and proprioception to maintain posture, to navigate in one's surroundings, to coordinate motion of body parts, to modulate fine motor control, and to initiate the vestibuloculomotor reflexes. These parts of the vestibular system provide our brains with information about changes in head movement with respect to the pull of gravity. Besides the visual, vestibular, and skeletal systems, which contribute to balance disorders, the dental (stomatognathic) system may also contribute to balance disorders. It is when all four of these systems are in coordination with one another, that a person will maintain equilibrium and balance, proper gait, and posture. The current article demonstrates, through normal anatomical and neurological processes, how the stomatognathic system influences these activities.

Differential activation of projection neurons by two sensory pathways contributes to motor pattern selection.

Sensorimotor integration is known to occur at the level of motor circuits as well as in upstream interneurons that regulate motor activity. Here we show, using the crab stomatogastric nervous system (STNS) as a model, that different sensory systems affect the same set of projection neurons. However, they have qualitatively different effects on their activities (excitation vs. inhibition), and these differences contribute to the selection of motor patterns from multifunctional circuits. We compare the actions of the proprioceptive anterior gastric receptor (AGR) and the inferior ventricular (IV) neurons, which relay chemosensory information from the brain to the STNS, on modulatory commissural neurons 1 and 5 (MCN1 and MCN5) and commissural projection neuron 2 (CPN2) and their resulting actions on the gastric mill central pattern generating circuit in the stomatogastric ganglion. When stimulated, AGR and the IV neurons affect all three projection neurons but elicit distinct gastric mill rhythms. The effects of both sensory pathways on the projection neurons differ in the type of excitation provided to CPN2 and MCN5 (electrical vs. chemical) and the effect on MCN1 (direct inhibition by AGR vs. polysynaptic excitation by the IV neurons). The latter is functionally important because a restoration of MCN1 activity during the AGR rhythm made it more similar to that elicited by IV neuron stimulation. Our results thus support the hypothesis that sensory pathways activate different combinations of projection neurons to select distinct outputs from the same neuronal circuit.

Types of taste circuits synaptically linked to a few geniculate ganglion neurons.

The present study evaluates the central circuits that are synaptically engaged by very small subsets of the total population of geniculate ganglion cells to test the hypothesis that taste ganglion cells are heterogeneous in terms of their central connections. We used transsynaptic anterograde pseudorabies virus labeling of fungiform taste papillae to infect single or small numbers of geniculate ganglion cells, together with the central neurons with which they connect, to define differential patterns of synaptically linked neurons in the taste pathway. Labeled brain cells were localized within known gustatory regions, including the rostral central subdivision (RC) of the nucleus of the solitary tract (NST), the principal site where geniculate axons synapse, and the site containing most of the cells that project to the parabrachial nucleus (PBN) of the pons. Cells were also located in the rostral lateral NST subdivision (RL), a site of trigeminal and sparse geniculate input, and the ventral NST (V) and medullary reticular formation (RF), a caudal brainstem pathway leading to reflexive oromotor functions. Comparisons among cases, each with a random, very small subset of labeled geniculate neurons, revealed "types" of central neural circuits consistent with a differential engagement of either the ascending or the local, intramedullary pathway by different classes of ganglion cells. We conclude that taste ganglion cells are heterogeneous in terms of their central connectivity, some engaging, predominantly, the ascending "lemniscal," taste pathway, a circuit associated with higher order discriminative and homeostatic functions, others engaging the "local," intramedullary "reflex" circuit that mediates ingestion and rejection oromotor behaviors.

Pharmacology of ionotropic and metabotropic glutamate receptors on neurons involved in feeding behavior in the pond snail, Helisoma trivolvis.

Glutamate is a key regulatory neurotransmitter in the triphasic central pattern generator controlling feeding behavior in the pond snail, Helisoma trivolvis. It excites phase two motor neurons while inhibiting those in phases one and three. However, the receptors that mediate this regulation are only partially characterized. The purpose of these experiments was to further characterize the glutamate receptors on three buccal neurons modulated by glutamate. Intracellular recordings from B5, B19 and B27 neurons were taken during the perfusion of isolated buccal ganglia with agonists that are selective for different vertebrate glutamate receptors. The firing rate of all three neurons was inhibited in a dose-dependent manner by glutamate, including that of B27, a phase 2 motor neuron known to be excited by glutamate in vivo. Quisqualate also reduced the firing rate in all three neurons, and (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid (ACPD), a relatively non-selective metabotropic glutamate receptor (mGluR) agonist, reduced the firing rate in B5 neurons, but not in B19 or B27 neurons. Agonists selective for vertebrate group I, II and III mGluRs did not affect the firing rate in any of the Helisoma buccal neurons tested, suggesting that mGluR agonist binding sites on these neurons do not closely resemble those on any vertebrate mGluR subtypes. An increase in frequency of action potentials was observed in all three cell types in the presence of 100 micromol l(-1) kainate (KA), suggesting the presence of excitatory (S)-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)/KA-like receptors. However, electrotonic coupling between B19 and B27 neurons, and a lack of effect of KA on isolated B19 neurons suggest the excitatory effects of KA on this neuron are indirect. These findings suggest the presence of multiple glutamate receptor subtypes in molluscan neurons that do not always resemble vertebrate receptors pharmacologically.

Síntomas óticos referidos en desórdenes temporomandibulares. Relación con músculos masticatorios / Otological symptoms among patients with temporomandibular joint disorders

Middle ear muscles have a common embryological and functional origin with masticatory and facial muscles. Therefore, symptoms referred to the ear may originate from the stomatognathic area. When a primary otológica! cause is discarded in the diagnostic work up for tinnitus, vertigo, hypoacousia, hyperacousia, ear pain or sensation of occluded ear, a temporomandibular joint dysfunction may be the cause of these symptoms. Temporomandibular joint dysfunction is twice more common among women and has environmental, physiological and behavioral causes. Among patients with this dysfunction, the prevalence of ear pain, tinnitus and dizziness varies between 33 and 76 percent.

Organization of cortical processing for facial movements during licking in cats.

We proposed that cortical organization for the execution of adequate licking in cats was processed under the control of two kinds of affiliated groups for face and jaw & tongue movements (Hiraba H, Sato T. 2005A. Cerebral control of face, jaw, and tongue movements in awake cats: Changes in regional cerebral blood flow during lateral feeding Somatosens Mot Res 22:307-317). We assumed the cortical organization for face movements from changes in MRN (mastication-related neuron) activities recorded at area M (motor cortex) and orofacial behaviors after the lesion in the facial SI (facial region in the primary somatosensory cortex). Although we showed the relationship between facial SI (area 3b) and area M (area 4delta), the property of area C (area 3a) was not fully described. The aim of this present study is to investigate the functional role of area C (the anterior part of the coronal sulcus) that transfers somatosensory information in facial SI to area M, as shown in a previous paper (Hiraba H. 2004. The function of sensory information from the first somatosensory cortex for facial movements during ingestion in cats Somatosens Mot Res 21:87-97). We examined the properties of MRNs in area C and changes in orofacial behaviors after the area C or area M lesion. MRNs in area C had in common RFs in the lingual, perioral, and mandibular parts, and activity patterns of MRNs showed both post- and pre-movement types. Furthermore, cats with the area C lesion showed similar disorders to cats with the area M lesion, such as the dropping of food from the contralateral mouth, prolongation of the period of ingestion and mastication, and so on. From these results, we believe firmly the organization of unilateral cortical processing in facial SI, area C, and area M for face movements during licking.

[Otological symptoms among patients with temporomandibular joint disorders]. / Síntomas óticos referidos en desórdenes temporomandibulares. Relación con músculos masticatorios.

Middle ear muscles have a common embryological and functional origin with masticatory and facial muscles. Therefore, symptoms referred to the ear may originate from the stomatognathic area. When a primary otological cause is discarded in the diagnostic work up for tinnitus, vertigo, hypoacousia, hyperacousia, ear pain or sensation of occluded ear, a temporomandibular joint dysfunction may be the cause of these symptoms. Temporomandibular joint dysfunction is twice more common among women and has environmental, physiological and behavioral causes. Among patients with this dysfunction, the prevalence of ear pain, tinnitus and dizziness varies between 33 and 76%

New methods of dissecting the masticator space of the rhesus macaque ( Macaca mulatta).

The aim of our project was to develop a method to examine the deep masticator space of the rhesus macaque ( Macaca mulatta) in order to investigate the following particulars of the mandibular nerve: (1). its manner of entry into the masticator space, (2). its branching within spaces/canals in the spheno-temporal bony complex, and (3). the location of its principal divisions with reference to the lateral pterygoid plate and muscle heads. In order to access these structures it was necessary to develop novel lateral and medial approaches. These and the instruments used are described. The proximal branching of the mandibular nerve is described and contrasted with that of the human. The implications of nerve branching in humans with reference to (1). evolution, (2). electromyography and (3). anesthetic control are discussed.

Deficits of masticatory movements caused by lesions in the orofacial somatosensory cortex of the awake cat.

The purpose of this study was to determine the role of somatosensory cortex (SI) in the control of orofacial movements during eating. We identified perioral and tongue projection regions of the cat SI and destroyed cells in one region by injecting kainic acid. The effects on orofacial behavior were then studied over a period of 4-6 weeks. Cats with unilateral lesions in the perioral region (PL-cats) dropped food from the contralateral side of the mouth in the early phase. Failure in erection of the contralateral whisker hairs during masticatory movements and delay of the masticatory start were observed throughout the experimental period. Furthermore, in the late phase, PL-cats showed prolongations of the masticatory and food intake periods, which were accompanied by the increase in the number of swallows and chewing cycles. Cats with unilateral lesions in the tongue region (TL-cats) showed the prolongation of the masticatory period in the early phase, which was accompanied by the increase in the number of swallows and chewing cycles. TL-cats did not show the prolongation of the food intake period and failure in erection of the contralateral whisker hairs. In both PL- and TL-cats, masticatory and swallowing rhythms were normal.

Dual brain stem projection from the cortical masticatory area in guinea-pig.

The cortical masticatory area (CMA) in the guinea pig is subdivided into the anterior and posterior parts (A-CMA and P-CMA), based on the pattern of the CMA-induced rhythmical digastric EMG burst and the cytoarchitecture. The anterograde tracing of horseradish peroxidase from the A-CMA and P-CMA revealed, in addition to a common projection to the region around the trigeminal motor nucleus and the parvicellular reticular formation bilaterally, a massive projection to the ipsilateral superior colliculus (SC) from the A-CMA but not from the P-CMA. The results suggest a dual brain stem projection system from the CMA: the direct pyramidal route from the P-CMA and the SC-mediated indirect route from the A-CMA.