Degree of adaptability of the somatosensory cortex to change: Prospects for integration of bone-mounted dental prostheses

The topographic representation of the body surface in the somatosensory cortex provides an important model system for the in vivo study of neuronal plasticity, induced changes in somatotopy providing a direct measure of plasticity not available in most parts of the central nervous system. Over the past two decades, animal experimentation in a number of laboratories has shown a remarkable degree of adaptability of the cortical representation following peripheral lesions and has had a widespread influence by challenging the once-accepted dogma that the brain is a structurally fixed organ. Although some aspects of original stimulation will be missing, it is likely that receptors stimulated through bone conduction and compression by bone-mounted dental prostheses preserve some of the geometric and temporal relationships of original stimulation. By analogy with data obtained from the forearm representations, it would be expected that many features of the original cortical representations will be recreated. There are also examples in the literature of perceptual learning without gross changes to the cortical representation (some being within a class of adaptability known as gain control) and it is likely that perceptual integration of many dental prostheses occurs within the limits of these neural adaptation mechanisms.