DO ORAL CARE AND REHABILITATION IMPROVE COGNITIVE FUNCTION? A SYSTEMATIC REVIEW OF CLINICAL STUDIES.

OBJECTIVES: An increasing number of studies have identified an association between oral health status and cognitive function. However, the effect of oral interventions, including oral health care, dental treatment and oral motor exercises, on cognitive function remains unclear. This systematic review examined whether oral interventions contribute to the long-term improvement of cognitive status. METHODS: Four databases were searched (MEDLINE, Web of Science, Cochrane Library, and ICHUSHI Web) to identify randomized and nonrandomized controlled trial studies and prospective cohort studies from inception until 1 September 2023, published in English or Japanese. The Cochrane risk of bias tool for randomized controlled trials and the risk of bias assessment tool for nonrandomized studies were used to assess bias risk. RESULTS: A total of 20 articles were included in the qualitative analysis; 13 articles were published in English, and 7 were published in Japanese. The implemented interventions were oral care in 8 studies, dental treatment in 8 studies, and oral motor exercise in 4 studies. One study found a significant effect on attention following oral care intervention. Some dental treatments influenced cognitive function, although a clear positive effect was not determined. In 1 study, attention and working memory improved in the chewing exercise group. CONCLUSIONS: Several studies verified the improvement effects of oral interventions, such as oral care, dental treatment, and oral motor exercise, on cognitive function or impairment. However, there was still a lack of conclusive evidence that such an intervention clearly improved cognitive function. To clarify the effects of oral interventions on cognitive function, it is necessary to examine participants, interventions, and outcome measures in detail.

Primary stability of different implant macrodesigns in a sinus floor elevation simulated model: an ex vivo study.

BACKGROUND: A novel type of implant (Straumann® BLX implant) has been developed for certain stability from the mechanical and biological aspects and is expected for the implant placement in atrophic maxilla with sinus floor elevation (SFE). PURPOSE: The aim of this study was to evaluate the primary stability in the implants with different macrodesigns in an SFE simulated model. Primary stabilities defined as maximum insertion torque (MIT) and implant stability quotient (ISQ) were compared between this novel type of implant and other types. MATERIALS AND METHODS: Five types of Straumann® 10 mm length implants (Standard Plus; SP, Tapered Effect; TE, Bone Level; BL, Bone Level Tapered; BLT and BLX) and two types of Straumann® 6 mm length implants (SP short, BLX short) were used in this study. Each implant was inserted through 5 mm-thick porcine iliac crest blocks (an SFE simulated model). Primary stability was evaluated by using MIT and ISQ. RESULTS: The mean value of MIT for BLX group showed significantly higher values than SP, BL (p < 0.01), and TE (p < 0.05) groups. The mean value of ISQ for BLX group was significantly higher than the other groups (p < 0.01). The mean value of MIT and ISQ for BLX and BLX short group were significantly higher than those for SP and SP short group (p < 0.01). CONCLUSIONS: In an SFE simulated ex vivo model, BLX group showed the highest values. These results suggest that implant selection can play a crucial role in the achievement of primary stability during SFE and simultaneous implant placement.

A retrospective cross-sectional analysis of swallowing and tongue functions in maxillectomy patients.

PURPOSE: To investigate the profiles of swallowing and tongue functions, and to identify factors influencing swallowing in maxillectomy patients. METHODS: Maxillectomy patients whose swallowing function defined by Eating Assessment Tool (EAT-10) score and tongue functions (oral diadochokinesis: ODK, maximum tongue pressure: MTP) with or without obturator prostheses had been evaluated were enrolled in this study. The effects of the history of radiotherapy and soft palate defect on swallowing function were evaluated. The effect of radiotherapy on oral dryness was also evaluated. To examine correlations of swallowing function with continuous variables, Spearman correlation coefficients were calculated. RESULTS: A total of 47 maxillectomy patients (23 males and 24 females, median age: 71 [IQR: 63-76]) were registered. The median value of EAT-10 scores was 3 [IQR: 0-14]. Patients with the history of radiotherapy, but not with soft palate defect, showed significantly declined swallowing function. ODK and MTP of patients wearing obturator prostheses were significantly improved. No significant effect of radiotherapy on oral dryness was found. A significant correlation was found between EAT-10 score and MTP (P = 0.04). CONCLUSIONS: Swallowing function in maxillectomy patients was relatively impaired and the patients with the history of radiotherapy showed lower swallowing function. Obturator prostheses could contribute to the improvement of MTP and ODK (/ta/). MTP may play a crucial role in swallowing in maxillectomy patients.

Maxillary Sinus Floor Augmentation Using Low-Crystalline Carbonate Apatite Granules With Simultaneous Implant Installation: First-in-Human Clinical Trial.

PURPOSE: Carbonate apatite (CO3Ap), an inorganic component of human bone, can be fabricated in chemically pure form from calcium carbonate block via a dissolution-precipitation reaction. A first-in-human clinical trial was conducted in which low-crystalline CO3Ap granules were evaluated for safety and efficacy in sinus floor augmentation and simultaneous implant installation. MATERIALS AND METHODS: Procedures were performed in 8 patients (9 implants) with 2 granule sizes: small (300 to 600 µm) and medium (600 to 1,000 µm). Panoramic radiographic assessment was performed immediately after augmentation, 7 ± 2 months after augmentation, 6 ± 2 months after prosthetic loading, and 12 ± 2 months after prosthetic loading. RESULTS: Postoperative healing was uniformly uneventful, with no abnormal bleeding, pain, or swelling, and all implants achieved successful osseointegration. The mean residual maxillary molar bone height was 5.2 ± 0.8 mm preoperatively and increased to 14.0 ± 1.9 mm after augmentation. Implants 9.0 to 11.5 mm in length were placed. The post-augmentation height decreased to 12.4 ± 1.3 mm at 7 ± 2 months; after prosthetic loading, it decreased to 11.9 ± 0.8 mm at 6 ± 2 months and 11.7 ± 0.6 mm at 12 ± 2 months. No abnormal bone resorption of the augmented areas was observed, and bone height supporting the implants was maintained. The overall implant survival rate was 100%, with no implant failures or complications during the first year. CONCLUSIONS: Low-crystalline CO3Ap granules were useful and safe for sinus floor augmentation and simultaneous implant installation, providing a promising bone substitute for dental implant surgery.

RhoA-Mediated Functions in C3H10T1/2 Osteoprogenitors Are Substrate Topography Dependent.

Surface topography broadly influences cellular responses. Adherent cell activities are regulated, in part, by RhoA, a member of the Rho-family of GTPases. In this study, we evaluated the influence of surface topography on RhoA activity and associated cellular functions. The murine mesenchymal stem cell line C3H10T1/2 cells (osteoprogenitor cells) were cultured on titanium substrates with smooth topography (S), microtopography (M), and nanotopography (N) to evaluate the effect of surface topography on RhoA-mediated functions (cell spreading, adhesion, migration, and osteogenic differentiation). The influence of RhoA activity in the context of surface topography was also elucidated using RhoA pharmacologic inhibitor. Following adhesion, M and N adherent cells developed multiple projections, while S adherent cells had flattened and widespread morphology. RhoA inhibitor induced remarkable longer and thinner cytoplasmic projections on all surfaces. Cell adhesion and osteogenic differentiation was topography dependent with S < M and N surfaces. RhoA inhibition increased adhesion on S and M surfaces, but not N surfaces. Cell migration in a wound healing assay was greater on S versus M versus N surfaces and RhoA inhibitor increased S adherent cell migration, but not N adherent cell migration. RhoA inhibitor enhanced osteogenic differentiation in S adherent cells, but not M or N adherent cells. RhoA activity was surface topography roughness dependent (S < M, N). RhoA activity and -mediated functions are influenced by surface topography. Smooth surface adherent cells appear highly sensitive to RhoA function, while nano-scale topography adherent cell may utilize alternative cellular signaling pathway(s) to influence adherent cellular functions regardless of RhoA activity.

Technique for identifying keratinized gingival tissue and soft tissue morphology on 3-dimensional implant-planning software images.

Preoperative 3-dimensional (3D) planning using cone beam computed tomography (CBCT) and 3D implant-planning software is used routinely for implant placement. However, despite its importance in planning surgical technique (conventional or flapless surgery) and prognosis, the distribution of keratinized gingival tissues (KGT) and soft tissue morphology cannot be identified with CBCT or planning software images. This report introduces a technique for identifying the distribution of KGT and soft tissue morphology during preoperative 3D planning.

Prosthetic aspects in adult osteopetrosis.

Osteopetrosis (OP) is a rare condition characterized by skeletal sclerosis caused by dysfunctional osteoclasts. Though many reports have described severe infantile-malignant autosomal recessive OP, few have described the prosthetic management of adult OP. This report discusses the prosthetic treatment of adult OP. Although prosthodontists should try to reconstruct occlusal function as much as possible, a conservative prosthodontic approach may be a reasonable and recommended treatment option for minimizing the risk of further osteomyelitis and osteonecrosis.

An observational study of oral functions in patients aged from 20 to 49 years.

PURPOSE: The purpose of this study was to analyze oral functions (MOF: maximum occlusal force; MTP: maximum tongue pressure; and MF: masticatory function) in Eichner A subjects aged from 20 to 49 years. METHODS: The data of three oral functions in Eichner A patients aged from 20 to 49 years were extracted. The mean values, subjects with lower values than the thresholds, and the differences among ages, and between sexes were investigated retrospectively. RESULTS: Although the mean values of these oral functions in 183 subjects were higher than the thresholds, the numbers of the subjects with lower values than the thresholds were 30 in MTP, 19 in MOF, and only three in MF. No significant effects of ages on all oral functions were identified and all functions in males were significantly higher than those in females. The subjects whose two functions were lower than the thresholds were nine females, eight of whom were associated with malalignment. CONCLUSION: Although the mean values of oral functions were higher than the thresholds, some patients showed lower values, especially in MOF and MTP, even though they were unaware of any inconvenience. Patients with malalignment might be associated with declined oral functions.

Anterior Hyperfunction by Mandibular Anterior Teeth: A Narrative Review.

"Combination syndrome", defined by Kelly in 1972, is a challenging condition observed in a patient with an edentulous maxilla and a partially edentulous mandible with only mandibular anterior teeth. "Anterior hyperfunction syndrome" is regarded as a synonym of combination syndrome and was first described in 1994. Although these terms have been well known, the definition of "anterior hyperfunction" has not been described yet. This narrative review focused on anterior hyperfunction and discussed the etiology and the clinical managements. An electronic bibliographic search for this literature review was conducted in addition to the review of our clinical cases. The previous reports indicated that combination syndrome with all five features was rarely observed. The patients with anterior hyperfunction generally showed the loss of posterior occlusal supports and the loss of vertical dimension of occlusion. To manage anterior hyperfunction, these conditions should be improved using conventional removable prostheses and implant-supported prostheses. Anterior hyperfunction is attributed to mandibular anterior teeth and some interventions for mandibular anterior teeth are required in many cases. Additionally, it must be noted that implant-supported prostheses may lead to anterior hyperfunction. In conclusion, comprehensive approaches for the remaining teeth and the prostheses will be required to manage this complex condition.

Comprehensive Analyses of Masticatory Function in Maxillectomy Patients with Functioning Removable Prostheses: A Retrospective Cross-Sectional Study.

The aim of this retrospective cross-sectional study was to comprehensively assess masticatory function in maxillectomy patients with functioning removable prostheses. Their general and oral profiles, the measurement values of their oral functions, including masticatory function, and the history of tumor therapy were extracted from medical charts. The correlations of masticatory function with numerical data and the effects of tumor therapy-related factors on masticatory function were evaluated. In addition, a stepwise conditional logistic regression analysis was performed to identify the potential predictive factors comprehensively. The data from 55 maxillectomy patients revealed that the median value of masticatory function (138.0 mg/dL) was higher than the threshold (100.0 mg/dL) based on the concept of oral hypofunction. Moderate correlations of masticatory function with the number of remaining teeth, the number of functioning occlusal supports, and maximum occlusal force were found, as well as a weak correlation with maximum tongue pressure. These variables also showed statistically significant coefficients (p < 0.01). No significant effect of each tumor therapy-related factor on masticatory function was detected. A logistic regression analysis identified the number of functioning occlusal supports as a significant predictive factor. These results implied the crucial interactions of masticatory function with various factors and the specificities of maxillectomy patients.

Evaluations of epithelial sealing and peri-implant epithelial down-growth around "step-type" implants.

OBJECTIVE: Implant designs that can stimulate and integrate with an epithelial wound-healing process may significantly enhance the efficacy of dental implants. Here, we evaluated the potential of "step-type" implant systems to improve the sealing between the peri-implant epithelium (PIE) and the implant surface, and investigated the effect of implant structure on PIE down-growth. MATERIALS AND METHODS: Right maxillary first molars were extirpated from rats and implanted with either a straight-type or a step-type implant varying in step height and/or width (N(s): 0.8 mm height, 0.1 mm width; W(s): 0.8 mm height, 0.2 mm width; H(s): 0.4 mm height, 0.1 mm width). Maxillae were harvested at various time points over 16 weeks to evaluate laminin-5 distribution as an indicator of wound healing and PIE formation, horse-radish peroxidase (HRP) penetration as a measurement of epithelial sealing, and PIE down-growth formation. RESULTS: In all implant models, the PIE formed from the oral sulcular epithelium and spread apically along the implant surface. In the W(s) group, HRP penetration was detected only in the coronal region of the PIE at 4 weeks, whereas in the straight-type, it was observed in the apical region and the connective tissue. At 16 weeks, the W(s) implants exhibited markedly less PIE down-growth than the Con, N(s) or H(s) implants, and were equivalent to that observed in natural teeth. CONCLUSION: The step-type implant system may have the potential for improving epithelial sealing at the tissue-implant interface, as well as reducing apical PIE down-growth, thus enhancing dental implant efficacy.

Oral Rehabilitation from Oral and Dental Diseases.

Oral conditions, such as the number of teeth and oral hygiene, are related to oral functions and oral health-related quality of life (QoL) [...].

The impacts of prosthetic interventions on mastication predominance in Kennedy Class â ¡ patients.

Purpose The purpose of this study was to investigate the effects of prosthetic interventions in patients with Kennedy Class Ⅱ (unilateral missing posterior teeth) on mastication predominance.Methods The subjects comprised patients with Kennedy Class II and healthy dentate volunteers (HD group). The subjects were asked to freely chew the test foods (chewing gum, beef jerky, and peanuts). Electromyographic activity of the bilateral masseter muscles was recorded twice (before and after prosthetic intervention). The chewing side (right or left) was judged by the level of the root mean square electromyographic amplitude. Mastication predominance was assessed using the mastication predominance index (MPI; range 0-100%). Each patient was restored with a removable partial denture (RPD) or an implant-supported fixed prosthesis (IFP). The effects of prosthetic interventions were statistically evaluated by the differences between MPI before and after prosthetic interventions (pre-MPI and post-MPI , respectively).Results There was a significant difference between pre-MPI of patients with Kennedy Class II and MPI of the HD group (HD-MPI) for all test foods (P < 0.0001). Statistical analysis also demonstrated a significant difference between pre-MPI and post-MPI measured with each of the three food items in both the RPD and IFP groups (P < 0.0001). Multiple comparisons revealed that post-MPI in the IFP group, but not in the RPD group, was statistically comparable with HD-MPI, although there were no significant differences among the three groups when MPIs were calculated using peanuts.Conclusions Prosthetic interventions improved mastication predominance in patients with Kennedy Class Ⅱ patients. Depending on the food type, IFP might contribute to better improvement of mastication predominance than RPD depending on food.

Analyses of Swallowing Function and Its Related Factors in Community-Dwelling Elderly Patients: A Case-Control Study.

This retrospective case-control study evaluated the prevalence of declined swallowing function and the association with oral functions and gender in community-dwelling elderly patients. Their profiles, the results of swallowing function (Eating Assessment Tool: EAT-10) and other oral functions (oral dryness, maximum occlusal force (MOF), tongue-lip motor function (oral diadochokinesis: ODK), maximum tongue pressure (MTP) and masticatory performance (MP)) were extracted for analyses. The patients were categorized into three groups according to EAT-10 score (Group 1: 0, Group 2: 1 and 2, Group 3: ≥3). In total, 242 patients were enrolled and 46 of them (19.0%) were categorized into declined swallowing function (Group 3). In two-group comparisons (Group 1, 2 versus Group 3), significant differences were identified in age and the number of remaining teeth, but they were not identified in three-group comparisons. The patients with declined swallowing function (Group 3) had significantly lower function in ODK and MTP. Multiple logistic regression analyses identified that declined swallowing function was independently associated with declined functions in ODK /ka/ (OR: 5.31, 95% CI: 1.03-27.23, p = 0.04) and in MTP (OR: 2.74, 95% CI: 1.12-6.66, p = 0.03). This study could confirm the critical role of tongue functions in swallowing in community-dwelling elderly patients.

A 3-Year Prospective Study on Radiographic Marginal Bone Evaluation Around Platform-Shifting Implants with Internal Conical Connections.

PURPOSE: To evaluate marginal bone level changes over 3 years around platform-shifting implants with internal conical connections, and to identify the factors relating to bone level changes. MATERIALS AND METHODS: Systemically healthy patients who lost one tooth or two consecutive teeth were enrolled in the study. The subjects received one or two implants with platform-shifting and internal conical connections in healed bone in a submerged manner. Digital standardized periapical radiographs were obtained at the time of implant placement, at prosthesis delivery, at 1 year, and at 3 years after the definitive restorations. Marginal bone level changes were measured at the mesial and distal aspects of each implant. Spearman correlation coefficients were calculated to examine the correlation between marginal bone level changes and clinical factors (age, vertical mucosal thickness, implant length and diameter, insertion torque value, and vertical implant position). RESULTS: Twenty-five patients with 30 implants (8 men and 17 women, mean age: 61.24 ± 13.18 years) were followed up to 3 years after the definitive restorations. The implant survival rate was 100%, and no remarkable complications were found. Mean peri-implant marginal bone level changes were -0.41 ± 0.61 mm (from placement to prosthesis delivery: C1); -0.08 ± 0.54 mm (from prosthesis delivery to 1 year: C2); -0.04 ± 0.95 mm (from prosthesis delivery to 3 years: C3); and 0.04 ± 0.60 mm (from 1 year to 3 years: C4), respectively. Statistically significant differences in bone level changes were observed between C1 and C3, and C1 and C4. Significant correlations of marginal bone level changes with implant diameter in C1 and with vertical implant position in C2 and C3 were observed. CONCLUSION: Within the limitations of this study, platform-shifting implants with internal conical connections appeared to prevent marginal bone resorption, especially after delivery of definitive prostheses, although marginal bone resorption attributed to the reestablishment of biologic width following subcrestal placement might be unavoidable.

Validation of masticatory function and related factors in maxillectomy patients based on the concept of "oral hypofunction": A retrospective cross-sectional study.

Purpose Although oral functions have been evaluated by various methods in maxillectomy patients, there exists substantial difficulty in the assessment procedures. The purpose of this study was to evaluate masticatory function, maximum occlusal force (MOF), and maximum tongue pressure (MTP) in maxillectomy patients objectively as per the "oral hypofunction" criteria, and examine the factors that correlate with masticatory function.Methods This retrospective cross-sectional study included 50 maxillectomy patients with maxillofacial prostheses (23 males and 27 females, median age, 72 years; interquartile range (IQR), 63.75-77). The records of masticatory function, MOF, and MTP as per the "oral hypofunction" criteria and their profiles (age, number of occlusal supports, and maxillary defect configuration) were reviewed. The number of patients who exceeded a threshold value of "oral hypofunction" and the effects of occlusal support and defect configuration on masticatory function and MOF were calculated. Multiple regression analysis was performed to assess the associations between masticatory function and other variables.Results The median value of masticatory function (114 mg/dL, IQR: 73-167.5) exceeded a threshold value, but not MOF (229.2 N, IQR: 110.2-419.6) and MTP (25.9 kPa, IQR: 21.4-29.0). The number of patients who exceeded each threshold value was 27 (masticatory function), 8 (MOF), and 12 (MTP), respectively. The influence of the number of occlusal supports, but not the defect configuration, was statistically significant. Multiple regression analysis revealed that MOF was independently related to masticatory function (P=0.042).Conclusions Within the limitations of this study, the median value of masticatory function in maxillectomy patients could exceed a threshold and MOF might be an independent predictor of masticatory function.

In Vitro Assessment of the Effect of Implant Position on Biomechanical Behaviors of Implant-Supported Removable Partial Dentures in Kennedy Class II Condition.

The purpose of this study was to investigate the effects of implant position and loading position on biomechanical behaviors using implant-supported removable partial denture (ISRPD) models in a simulated Kennedy class Ⅱ partially edentulous mandible. Three types of Kennedy class Ⅱ mandibular acrylic resin models (a conventional RPD without support by an implant-CRPD; models with an implant placed at first molar (#46)-MP-ISRPD- and second molar (#47)-DP-ISRPD) were used to measure vertical displacement of the RPD, mesio-distal displacement of the abutment tooth, and bending moment of the abutment tooth and implant under one-point loading. The variables at three respective loading points (#45, #46 and #47) were compared statistically. Vertical displacement was suppressed in ISRPDs compared to the CRPD, and significant effects were identified under loading at the implant position. The largest meiso-distal displacement was observed in MP-ISRPD under #47 loading. Bending moments of the abutment tooth and implant were significantly higher in MP-ISRPD than in DP-ISPRD. In MP-ISRPD, a higher bending moment of the abutment tooth under #45 and #47 loading was detected, although the bending moment in DP-ISRPD was almost zero. The results of this study suggested that MP-ISRPD shows the specific biomechanical behaviors, although DP-ISRPD might provide biomechanical benefits under all one-point loading conditions.

A Prospective Comparative Study of Mastication Predominance and Masticatory Performance in Kennedy Class I Patients.

Mastication predominance in Kennedy class I (KC I) patients has not been well defined. This study aimed to investigate mastication predominance and masticatory performance in KC I patients, including the significance of remaining posterior teeth and removable partial-denture (RPD) treatment. KC I patients who had differences in the number of posterior teeth between left and right sides (D+) and KC I patients who had no differences (D-) were enrolled. Healthy dentate (HD) subjects were also registered as a positive control. Mastication predominance, defined by mastication predominance index (MPI; range 0-100%) calculated from electromyogram activities during voluntary chewing, and masticatory performance were evaluated at pre- and post-RPD treatment. Pre-MPI in KC I D+ was significantly higher than in HD. RPD treatment could significantly improve MPI and masticatory performance in both KC I groups. However, there were significant differences in masticatory performance between each KC I group and HD, regardless of RPD treatment. It was considered that the mastication predominance in KC I patients was affected by the difference in the number of remaining posterior teeth. RPD treatment could improve mastication predominance and masticatory performance in KC I patients, although the latter was not similar to HD group.

The Significance of Posterior Occlusal Support of Teeth and Removable Prostheses in Oral Functions and Standing Motion.

The purpose of this study was to evaluate the effect of posterior occlusal support of natural teeth and artificial teeth on oral functions and standing motion. Patients who had been treated with removable prostheses were enrolled as the subjects. Their systemic conditions (body mass index (BMI) and skeletal muscle mass index (SMI)) were recorded. The subjects were classified into two groups according to a modified Eichner index: B1-3 (with posterior occlusal support) and B4C (without posterior occlusal support). Maximum occlusal force (MOF), masticatory performance (MP), and standing motion (sway and strength) were evaluated for cases with and without removable prostheses. There were no significant differences in BMI and SMI between the B1-3 group and the B4C group. The subjects with removable prostheses demonstrated significantly higher values in MOF, MP, and sway and strength than the subjects without removable prostheses. The comparison of oral functions between the B1-3 group and the B4C group revealed that the positive effect of posterior occlusal support of natural teeth and removable prostheses and the significant positive effects of posterior occlusal support on standing motion were partly observed in these comparisons. Posterior occlusal support of natural teeth and even of removable prostheses may contribute to the enhancement of oral functions and standing motion.

Masticatory performance and other oral functions in community-dwelling elderly patients without posterior occlusal support by natural teeth.

PURPOSE: To evaluate masticatory performance (MP), maximum occlusal force (MOF), maximum tongue pressure (MTP) and oral diadochokinesis (ODK) among community-dwelling elderly patients without posterior occlusal support. METHODS: This study enrolled community-dwelling elderly patients (≥65 years old) who belonged to Eichner A, B4, C1, C2, and C3. Each oral function was statistically compared among groups. Correlations between MP and other variables were examined in Eichner B4 and C patients. RESULTS: MP and MOF values in Eichner B4 and C patients were significantly lower than in Eichner A patients. There were significant differences in MTP values between Eichner "A and C2, C3", and "B4 and C2, C3". ODK in Eichner C patients showed significantly lower values compared to Eichner A patients in general. Although there were statistically significant correlations of MP with age, the number of remaining teeth and all oral functions were identified, and multiple regression analysis indicated that MOF and MTP were independently related to MP. CONCLUSION: Oral functions in Eichner B4 and C patients were lower compared to Eichner A patients. MP was significantly correlated with MOF and MTP in elderly patients without posterior occlusal support, suggesting the importance of rehabilitation of MOF and MTP in MP.