Department of Endodontics School of Dental Medicine University of Pennsylvania Philadelphia, Pennsylvania, USA.
Kaohsiung J Med Sci. 2018 Apr;34(4):231-237. doi: 10.1016/j.kjms.2018.01.013. Epub 2018 Feb 8.
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.
在过去的几十年中，神经生物学和人类大脑成像研究极大地促进了我们对支持感知和记忆的大脑机制的理解，以及它们在日常活动中的功能。近年来，对口颌系统去传入的神经生物学机制的认识也大大扩展了。特别是，目前的研究表明，口颌系统的外周去传入可能会被投射到中枢神经系统（CNS）中，并成为引发和加重神经退行性疾病的相关关键因素。本综述探讨了与口颌系统去传入相关的基本神经生物学机制。进一步讨论了牙齿缺失和其他牙齿去传入（DD）机制，重点讨论了与大脑功能相关的牙齿和咀嚼器官，这些机制可能是衰老大脑中观察到的变化的基础。提出了一个新的假说，即 DD 以及牙齿和咀嚼器官功能的变化可能会导致大脑损伤，原因是大脑循环改变和内稳态功能障碍。此外，大脑的多次反复重组可能是阿尔茨海默病（AD）等神经退行性疾病发病和进展的触发或促成风险因素。对口颌系统去传入与大脑衰老之间关系的认识不断提高，可能为治疗和预防认知能力下降和神经退行性疾病提供解决方案。
