Today, with the extensive development of dental implant technology, the osseointegration, biomechanics, aesthetics and microbiology of implants have been extensively studied. However, the “physiological integration” of the implant and the prosthesis that travels with it in the oral cavity has not received much attention. It has been reported that amputees are able to distinguish the type of soil under the prosthesis they are walking on by anchoring the lower limb prosthesis in the bone, just like the dental implants in which osseointegration occurs. Clinical observations also showed that patients implanted with dental implants were determined to have a specific sensory perception function. The underlying mechanism for this phenomenon, known as “bone perception” in implant-supported prostheses, is still uncertain due to the recovery of functional peri-implant innervation after implant placement. In this paper, we present an overview of the clinical implications of oral implants, including bone perception and other neuropsychological aspects, such as reflex function. Function of pulp and periodontal membrane receptors and changes after tooth loss It is well known that natural teeth have extremely sensitive peripheral stimulus receptors in the pulp and periodontal membrane, and the function and role of these receptors in periodontal nerve feedback signals are widely recognized as being extremely important. The central nervous system (CNS) has two mechanisms to obtain oral kinesthetic information, the first is by monitoring the association of downstream nerve impulses issued to the muscles. The second is the excitation of mechanically stimulated receptors during jaw movements and different changes in jaw position. The presence of the periodontium is a key factor in the proprioceptive action, and after tooth extraction, both the periodontium and the intra-dental receptors are removed. This could explain the reduction in afferent nerve fibers found in the mandibular nerve canal of some experimental cats that had their teeth removed. The impact of the disruption of these sensory feedback pathways on oral perceptual function is considerable. The loss of this function not only affects the accuracy of masticatory function in terms of strength and direction during feeding and reduces the efficiency of mastication by decreasing the ability to discriminate the shape and hardness of food, but also affects the role of regulating the synaptic load and the ratio of maximum synaptic force due to the inability to transmit synaptic force through the proprioceptors to the sensory cortex. After tooth loss, if a removable or fixed denture restoration is used, it is obvious that the load and force signaling of the natural teeth cannot be fully compensated. This peripheral transmission mechanism is limited, and the mechanoreceptor function of the mucosa is much less effective than that of the periodontium, so the oral function is still not well restored after conventional denture restoration. Perceptivity at the implant-bone interface “bone perception” There is a hypothesis that implants directly connected to bone (e.g. osseointegrated dental implants), can replace part of the lost sensation. If this feedback mechanism is restored, it would be an extremely important step for the success of in vivo integrated prostheses worldwide. It has been reported that dental implant patients can acquire some specific sensations around the implants placed in the bone. Psychophysical threshold tests have determined that patients can acquire the sensation of mechanical stimuli applied to them through the osseointegrated implants within the bone. Thus, for the specific context of these implant denture patients, “bone perception” was first introduced by P-I Branemark to recognize this oral motor perceptual capacity. In the absence of functional periodontal mechanical stimulus input signals, the CNS receives input signals that may come from the temporomandibular joint (TMJ), muscles, skin, mucosa and/or periosteum or intraosseous mechanical stimuli. Thereby, the CNS provides mechanosensory information for oral motor perception associated with mandibular movements and artificial tooth contact. However, the contribution or role of these different mechanoreceptors related to bone perception is not known. However, although periodontal receptors remain partially in the bone in the vicinity of the implant after tooth loss, it seems unlikely that they would play a role in bone perception. It follows that the specific sensations in dental implant patients may arise partly from the impulsive forces at the implant-bone interface, partly from the cushioning effect of the cutaneous mucosal denture gingival cuff, or from nerve endings within the bone or in the periosteum. However, specific measurements may require somatosensory evoked potentials (SEPs) tests to locate the source of sensory phenomena during stimulation, or techniques such as magnetic resonance imaging (fMRI). Evidence in support of bone perception 1. Neurovascularization of the jaw bone The jaw bone is rich in vascular nerves, especially after surgical procedures (e.g., implant placement). The rich innervation is beneficial in sensing the mechanical deformation during loading after oral implant placement, as well as in restoring the periodontal feedback after implant placement of missing teeth. 2. Histological background Tooth loss leads to the loss of a large number of sensory nerve fibers, just like amputation. After tooth extraction, the amount of myelinated fibers of the inferior alveolar nerve is reduced by 20% . Linden and Scott successfully stimulated nerves of periodontal origin located within the healed extraction wound, which means that some nerve endings are still functional, but most of the surviving mechanoreceptive nerves in the midbrain nuclei may have lost some of their function. These experimental studies provide the basis for a long-standing debate as to whether sensory nerve fibers are present or potentially functional in the peri-implant and bone. Intraosseous implants may be subject to degeneration of environmental nerve fibers due to surgical trauma, but the sprouting of new fibers and the gradual increase of a large number of free nerve endings close to the bone interface close to the implant can be seen in the first postoperative week. A more recent study also succeeded in forming a partial periodontal membrane on the surface of one implant in experimental dogs. However, whether these induced a recovery of the periodontal nerve feedback pathway has not been investigated. On the other hand, mechanoreceptors in the periosteum also play an important role in implant stimulation, as oral implants provide a different loading and force transmission than natural teeth, and the direct contact of bone with the implant replaces the viscoelastic properties of the periodontium, so that the force applied to the implant is transferred directly to the bone, and the deformation of the bone leads to the excitation of receptors on the peri-implant and its adjacent periosteum. The excitation of the peri-implant and its adjacent periosteum. The cerebral cortex governs the activities of the different parts of the body. After an extraction, the cerebral cortex needs to acquire a new target in a region that has lost its target organ, so the cortical or subcortical tissues begin to undergo alterations. This potential cortical adaptation or plasticity has not been fully understood. In an interesting study, the right lower incisor was extracted from a mole rat, and 5-8 months later nerves in the area of the cortex formerly used to express the lower teeth produced rapid sensing of tactile signals around the oromaxillofacial structures. This may confirm that important changes may occur in the cortex innervating that tooth after tooth loss. However, similar evidence has not been obtained in human clinical studies to date. Restoration of sensory function and proprioception after total tooth loss There are significant functional effects and psychosocial consequences of replacing a patient with a total denture after tooth loss. The loss of intra- and periodontal mechanical stimulus perception is accompanied by the loss of a complete denture, which alters the good proprioceptive control of the mandible and affects the ratio of masticatory action in terms of size, direction and dentition load. If a normal full denture is used, this is only a restoration method for storing partial functions. Implant-supported prostheses, on the other hand, better restore jaw function because they improve the difference in psychophysiological distinctions caused by missing teeth and enhance the three-dimensional perception of the oromandibular system. Bone perception is thought to be dependent on central influences from associative emissions. These associative emissions are in turn derived from adrenocortical hormone-driven instructions to the jaw muscle groups. The understanding of the plasticity of efferent neural excitatory mechanisms during adaptation to edentulous and periodontal input signals will be considered together with the process of central influences. The importance of periodontal mechanical stimuli in functional and sensory differentiation is well established, and patients with implant-supported prostheses have better tactile differentiation, although their perceptual and differentiation abilities are not comparable to those of individuals with natural dentition. Bone perception was identified as the perception of mechanical stimuli following the absence of functional periodontal mechanoreceptive input signals, while also acquiring mechanoreceptors of the TMJ, muscle, skin, mucosa and periosteum, which provide the ability to perceive oral muscle movement perception associated with mandibular function and artificial tooth contact. In the text, peripheral mechanical stimulus perception and peripheral afferent processes to the center are considered. It is clear that with the loss of dental and periodontal mechanoreception, other peripheral receptors dominate the afferent projections to the sensorimotor cortex and provide the neural basis for the cognitive abilities of patients with implant-supported prostheses. Previously, valid evidence on CNS plasticity provided a possible neural basis for our understanding of patient adaptation under altered dental conditions. Nevertheless, a well-designed implant-supported restoration better mimics the pre-deficient condition and more appropriately restores optimal drive and sensory function of the masticatory system. A comparative study of the level of coaptation force in patients with full dentures and those with implant-supported prostheses revealed a significant increase in maximum coaptation force in individuals with implants. In addition, the amount of decrease in occlusal force was directly proportional to the duration of edentulism. Clinical Implant-Mediated Sensory-Driven Interactions In psycho-psychological tests of various bone-anchored prostheses it was shown that improved haptic function promotes better physiological integration of the prosthesis. If the perception of implant stimuli is good, good peripheral feedback mechanisms will be repaired and allow for more refined motor conditioning. This implant-mediated sensory-driven interaction will help to achieve a more natural function with the artificial prosthesis (denture). Considering the increasing tactile threshold levels of oral implants to stimuli, we can gain some clinical insights. The dentist cannot rely on the patient’s perception of occlusion when restoring a patient with a missing tooth through an implant-supported denture, but must also be aware of the gradual recovery of tactile function during the healing process after implant placement. This may be particularly important in cases of immediate loading. In order to avoid exceeding any excessive loading, the patient will be asked to eat softer foods to limit the amount of occlusal pressure during the healing phase. In addition, dysfunctional habits, such as clenching or grinding, may have a detrimental effect during the healing phase of the implant. Therefore, patients with nocturnal edentulism are considered a contraindication for immediate load implants. Conclusion Currently, intraosseous implants are widely used to restore missing teeth or amputated patients. In order to achieve satisfactory clinical function of these prostheses (prostheses), the implants should achieve physical and psychological integration. Clinical studies on patients with oral implants have shown that after a period of time the perception of dental implants does exist, i.e. “bone perception”. Although controversial, many studies have shown that implant-mediated sensory-driven interactions can achieve both physiological and psychological integration of the implant in the body. The latter can help to re-establish peripheral neurofeedback pathways and thus restore a more natural function. It can even be assumed that such physiological integration promotes biocompatibility and improves psychological integration. This is an important step towards the integration of the entire implant-organism. Thus, it will be of great importance for clinical patients how to use bone perception for better restoration of function of the denture (prosthesis) or how to promote further development of this perception. It is also very encouraging for the research on the practical use of new bone-anchored prostheses (prostheses) or bioengineered prostheses.