Periodontium and Temporomandibular Joint

Abstract

The periodontal tissues are all too frequently considered within a structural framework. It is not too surprising in view of their very important role in providing support for the teeth that considerable research (clinical, anatomical, electronmicroscopical, etc.) has been devoted to the structures making up the periodontium, viz., the lamina propria of the gingiva, connective tissues of the periodontal “space” between the tooth and its bony socket, the cementum of the tooth, and the bony socket (the alveolar bone). But little is known of the physiology of this structure, in particular the peripheral and central neural mechanisms that contribute to the sensory and reflex functions that it subserves. These functions include (a) the tactile sensibility of the teeth and related sensory functions such as oral stereognosis; (b) discriminability of size, shape, texture, and hardness of foodstuffs and other objects or appliances placed in the mouth; and (c) a role in a variety of reflex motor functions that are of considerable functional significance in terms of occlusion, masticatory and swallowing patterns and habits, speech, protective reflexes of the oral-facial area, etc. Jerge (1965) and Crum and Loiselle (1972) have stressed the importance of our understanding of the neural mechanisms associated with the innervation of the teeth in view of its relevance to many clinical situations and problems, e.g., bony lesions and tooth support, abutment tooth selection for fixed or removable prosthesis, splinting of teeth, occlusal harmony, etc.