ABSTRACT
PURPOSE: The potential relationship between mastication ability and cognitive function in idiopathic normal pressure hydrocephalus (iNPH) patients is unclear. This report investigated the association between mastication and cognitive function in iNPH patients using the gray level of the co-occurrence matrix on the lateral pterygoid muscle. METHODS: We analyzed data from 96 unoperated iNPH patients who underwent magnetic resonance imaging (MRI) between December 2016 and February 2023. Radiomic features were extracted from T2 MRI scans of the lateral pterygoid muscle, and muscle texture parameters were correlated with the iNPH grading scale. Subgroup analysis compared the texture parameters of patients with normal cognitive function with those of patients with cognitive impairment. RESULTS: The mini-mental state examination score correlated positively with the angular second moment (P < 0.05) and negatively with entropy (P < 0.05). The dementia scale (Eide's classification) correlated negatively with gray values (P < 0.05). Gray values were higher in the cognitive impairment group (64.7 ± 16.6) when compared with the non-cognitive impairment group (57.4 ± 13.3) (P = 0.005). Entropy was higher in the cognitive impairment group (8.2 ± 0.3) than in the non-cognitive impairment group (8.0 ± 0.3) (P < 0.001). The area under the receiver operating characteristic curve was 0.681 (P = 0.003) and 0.701 (P < 0.001) for gray value and entropy, respectively. CONCLUSION: Our findings suggest an association between heterogeneity of mastication and impaired cognitive function in iNPH patients and highlight muscle texture analysis as a potential tool for predicting cognitive impairment in these patients.
Subject(s)
Cognition , Cognitive Dysfunction , Hydrocephalus, Normal Pressure , Magnetic Resonance Imaging , Pterygoid Muscles , Humans , Hydrocephalus, Normal Pressure/diagnostic imaging , Hydrocephalus, Normal Pressure/surgery , Hydrocephalus, Normal Pressure/psychology , Hydrocephalus, Normal Pressure/physiopathology , Male , Female , Aged , Aged, 80 and over , Cognition/physiology , Cognitive Dysfunction/psychology , Cognitive Dysfunction/physiopathology , Cognitive Dysfunction/diagnostic imaging , Pterygoid Muscles/diagnostic imaging , Pterygoid Muscles/pathology , Mastication/physiologyABSTRACT
BACKGROUND: Effect of aging on tissue adaptability and retention of digital obturator is still under investigation. METHODS: A maxillary Armany (class I) epoxy reference model was scanned to fabricate digital obturator fabricated from milled Co-Cr framework and 3D printed bulb. A color map of the scanned reference and digital obturator was made using Geomagic software to evaluate the accuracy of fit before and after cyclic loading using ROBOTA chewing simulator at 37,500, 75,000 and 150,000 cycles to simulate clinically 3-, 6- and 12-months chewing condition. Insertion-removal condition simulating the placement and removal of the obturator was done using repeated 360, 720 and 1440 cycles and retention was evaluated before and after the repeated cycles. Data were collected, tabulated and statistically analyzed using Statistical Package for Social Sciences (IBM SPSS Statistics 26). Student t-test and multi variable ANOVA test were used to detect significance. P-value < 0.05 was considered significant difference. RESULTS: For retention test: There was a significant difference between baseline and 3, 6 and12 months. For the tissue surface adaptation test: There was significant difference at all measured areas (P-value < 0.05) before and after application of load. CONCLUSION: digitally designed and fabricated obturator was highly retentive and has excellent tissue surface adaptation upon fabrication, After application of load; reduction of retention and lack of tissue adaptation were resulted. THE CLINICAL IMPLICATION: of this manuscript is that digital obturator can be used successfully with the shortcomings of loosening retention and adaptation afterwhile. So, clinical trials should investigate the clinical acceptance of these shortcomings.
Subject(s)
Palatal Obturators , Humans , Dental Prosthesis Design , Surface Properties , Computer-Aided Design , Printing, Three-Dimensional , Dental Prosthesis Retention , Mastication/physiology , Dental Marginal AdaptationABSTRACT
Background: This study aimed to compare the perceived masticatory ability (PrMA) in completely edentulous patients (EDPs) with thermoplastic conventional complete dentures (CDs) versus single implant-retained mandibular overdentures. Methods: The current study was conducted in the outpatient Prosthodontic Clinic, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt. PrMA was evaluated in 45 completely edentulous patients (46% males, mean age 50.4 ± 4.7 years). Each patient received a thermoplastic PMMA complete denture (Polyan IC TM Bredent GmbH & Co.KG, Germany). The PrMA was evaluated at one-month and six-month intervals of denture use. An immediate loading single implant was placed into the mid-symphyseal for each patient, and the denture was adjusted. Subsequently, the PrMA was reevaluated after one month and six months. The data were collected and statistically analyzed using the SPSS@V25 to assess the changes in PrMA. Results: The PrMA demonstrated improvement after six months of thermoplastic conventional denture use. However, this improvement was not statistically significant (p = 0.405). In addition, the PrMA showed a substantial increase following a single implant placement at one and six months (p < 0.001) of the overdenture use compared to the conventional denture. The PrMA insignificantly improved (p = 0.397) after six months of the single implant retained overdenture use. Discussion: The study's findings indicate that using immediate loading single implant-retained mandibular overdentures significantly improved PrMA in completely edentulous patients.
Subject(s)
Dental Prosthesis, Implant-Supported , Denture, Overlay , Mastication , Humans , Male , Female , Middle Aged , Prospective Studies , Mastication/physiology , Mouth, Edentulous/rehabilitation , Denture, Complete , Mandible/surgery , Egypt , Dental Implants, Single-ToothABSTRACT
Resorbed alveolar ridges, particularly in the lower jaw, have a small denture supporting area, which may cause the stress distribution of mastication load to exceed the pressure-pain threshold (PPT) and induce pain in the mucosa or potentially worsen the ridge resorption. Thus, choosing the ideal occlusal scheme among bilateral balanced (BBO), lingualized (LO), and monoplane (MO) for such conditions becomes crucial. The experiment was conducted using the finite element method on a modeling of a resorbed alveolar ridge in the lower jaw with three dentures placed on top, each of which was given different loading points according to the tooth arrangement of BBO, LO, and MO. The axial load was 100 N, and the resultant oblique loads on BBO and LO were 119 N and 106 N, respectively. The von Mises stresses for BBO, LO, and MO were observed in nine denture-supporting areas, and the results showed that the axial load did not produce stresses that exceeded the PPT value (0.64925 MPa) for BBO, LO, and MO with the highest value on area H, 0.43229 MPa, 0.39715 MPa, and 0.31576 MPa, respectively. However, the oblique load direction showed that the BBO had more areas (area E 0.80778 MPa and area H 0.76256 MPa) that exceeded the PPT than LO (area E 0.64394 MPa). The lingualized occlusal scheme is ideal for patients with resorbed alveolar ridge conditions, especially in terms of limiting interferences when the denture is functioning while maintaining comfort but still providing good masticatory performance and satisfactory esthetics.
Subject(s)
Finite Element Analysis , Humans , Alveolar Process , Dental Stress Analysis , Alveolar Bone Loss , Dental Occlusion , Mandible , Mastication/physiologyABSTRACT
OBJECTIVE: We aimed to describe jaw function characteristics in patients with anterior disc displacement without reduction (ADDWoR) using the jaw function limitation scale (JFLS), and to investigate the effects of biopsychosocial risk factors on limited jaw function. DESIGN: In this cross-sectional study of 636 patients with ADDWoR (females, 568; males, 68), we used the JFLS to assess jaw function. Behavioral, psychological, sociodemographic, and biomedical data were collected. Multivariate logistic regression analysis was used to determine risk factors affecting limited jaw function. A receiver operating characteristic curve was used to evaluate the predictive effect of these risk factors. RESULTS: ADDWoR-associated limitations included restricted jaw mobility and mastication, which exceeded median global functional limitations scale scores, especially mouth opening to bite an apple and chewing tough food. Females had greater limitations in jaw mobility, verbal and emotional communication, and overall. Multivariate logistic regression analysis findings indicated that oral behaviors, anxiety, sex, pain intensity, and maximal mouth opening (MMO) were predictive of limited jaw function (area under the curve, 72 %). CONCLUSION: Patients with ADDWoR reported mastication and jaw mobility restrictions, with females having more pronounced limitations, and specific risk factors identified as significant predictors of jaw function limitations. Along with pain relief and improvement in MMO, appropriate psychological counseling and oral behavioral correction facilitates recovery of jaw function in such patients.
Subject(s)
Anxiety , Mastication , Humans , Male , Female , Cross-Sectional Studies , Mastication/physiology , Adult , Risk Factors , Anxiety/physiopathology , Temporomandibular Joint Disc/physiopathology , Temporomandibular Joint Disorders/physiopathology , Temporomandibular Joint Disorders/psychology , Joint Dislocations/physiopathology , Sex Factors , Range of Motion, Articular/physiology , Middle AgedABSTRACT
Background: The band and loop space maintainer is used to maintain the missing space of deciduous molars which are lost early. When the second deciduous molar is lost prematurely, the stress on the first permanent molar during different degrees of development may vary when it is the abutment. The design and use of the space maintainer may also lead to damage of the loop. The purpose of this article is to use the finite element method to study the stress on the first permanent molar and the loop with or without occlusal contact, with the first permanent molar of four different degrees of development serving as the abutment. We aimed to guide the clinical design and use of the space maintainer. Methods: We developed finite element models of the mandibular first permanent molar and the band and loop space maintainer, and simulated alveolar bone, periodontal ligament (PDL), enamel and dentin. The four developmental stages were 1/2 (I), 2/3 (II), 3/4 (III) and full development (IV). Ansys Workbench was used to analyze the effects of root development and occlusal contact between the loop and the opposite jaw on abutment teeth and the loop. Abutment teeth were statically loaded vertically and obliquely with a force of 70 N. The loop was statically loaded vertically with a force of 14 N. The stress on all structures and the displacement trends of the loop were calculated. Results: The stress on enamel, dentin, PDL and alveolar bone were similar, and the concentration was consistent. But if there was occlusal contact, the loop produced maximum displacement at the near middle edge of contact with the anterior teeth. When the loop was in occlusal contact with the opposing occlusal tooth, the peak value of the equivalent stress on the space maintainer under vertical load was: group I > group IV > group III > group II, and the maximum principal stress peak change was: group I > group III > group II > group IV. The change of the equivalent stress peak value of the loop under oblique load was: group I > group III > group IV > group II, and the maximum principal stress peak change was: group III > group I > group II > group IV. When the loop was not in occlusal contact with the opposing occlusal tooth, the peak value of the equivalent stress on the space maintainer under vertical load was: group IV > group I > group II > group III, and the maximum principal stress peak change was: group IV > group I > group II > group III. The change of the equivalent stress peak value of the space maintainer under oblique load was: group I > group IV > group II > group III, and the maximum principal stress peak change was: group I > group IV > group II > group III. Conclusions: Our results suggested that whenever possible, choosing the teeth with nearly complete root development as the abutment of the space maintainer is advisable. The design and use of the band and loop space maintainer should avoid occlusal contact with the occlusal teeth to prevent deformation of the loop.
Subject(s)
Bite Force , Finite Element Analysis , Mandible , Molar , Molar/physiology , Humans , Mandible/physiology , Stress, Mechanical , Mastication/physiology , Dental Stress Analysis/methods , Periodontal Ligament/physiology , Periodontal Ligament/growth & developmentABSTRACT
This study aimed to predict dental freeway space by examining the clinical history, habits, occlusal parameters, mandibular hard tissue movement, soft tissue motion, muscle activity, and temporomandibular joint function of 66 participants. Data collection involved video-based facial landmark tracking, mandibular electrognathography, surface electromyography of mandibular range of motion, freeway space, chewing tasks, phonetic expressions, joint vibration analysis, and 3D jaw scans of occlusion. This resulted in a dataset of 121 predictor features, with freeway space as the target variable. Six models were trained on synthetic data ranging from 500 to 25,000 observations, with 65 original observations reserved for testing: Linear Regression, Random Forest, CatBoost Regressor, XGBoost Regressor, Multilayer Perceptron Neural Network (MPNN), and TabNet. Explainable AI indicated that key predictors of freeway space included phonetics, resting temporalis muscle activity, mandibular muscle activity during clenching, body weight, mandibular hard tissue lateral displacements, and dental arch parameters. CatBoost excelled with a test error of 0.65 mm using 5000 synthetic data points, while a refined MPNN achieved the best performance with 25,000 synthetic data points and 121 unique predictors, yielding an absolute error of 0.43 mm on the 65 original observations.
Subject(s)
Dental Occlusion , Electromyography , Mandible , Temporomandibular Joint , Humans , Female , Male , Mandible/physiology , Mandible/diagnostic imaging , Adult , Temporomandibular Joint/physiology , Temporomandibular Joint/diagnostic imaging , Movement/physiology , Range of Motion, Articular/physiology , Young Adult , Mastication/physiology , Neural Networks, ComputerABSTRACT
BACKGROUND Measurement of bite force plays a crucial role in assessment of the masticatory system. With a growing interest in detecting occlusal irregularities, bite force sensors have garnered attention in the biomedical field. This study aimed to introduce a hydrogel bite force sensor, based on hydroxyethyl-cellulose-fructose-water (HEC-F-water), for premolar and molar teeth, and to evaluate it using optical profilometry, infrared spectroscopy (FTIR), and Instron Tension testing system, with 2.5 cm (1 inch) margins at top, bottom, right, and left. MATERIAL AND METHODS We fabricated 20 HEC-F-water hydrogel samples sized with surface of 1×1 cm, with 2 different widths - 1 mm and 5 mm. The samples were characterized using optical profilometry and FTIR and their electrical characteristics were determined using an impedance analyzer. Aluminum (Al) electrodes, fabricated using Cutting Plotter, were used to form a HEC-F-water-based transducer, which was used for bite force sensing. The Instron tensile testing system was employed, utilizing 3D printed models of the upper and lower jaw, to simulate biting. Forces in the range between 40 N and 540 N were exerted upon the transducer, and the output change in the electrical signal was measured. RESULTS The study determined the transfer function between bite force and capacitance. The fabricated sensor exhibited a sensitivity of 3.98 pF/N, an input range of 500 N, output range of 2 nF, and accuracy of 95.9%. CONCLUSIONS This study introduces an edible bite force sensor employing an edible hydrogel as a dielectric, presenting a novel avenue in the development of edible sensorics in dentistry.
Subject(s)
Bite Force , Humans , Hydrogels/chemistry , Molar , Fructose , Mastication/physiology , Spectroscopy, Fourier Transform Infrared/methods , Cellulose/chemistry , Water , BicuspidABSTRACT
BACKGROUND: Craniosynostosis (CS), premature fusion of one or more cranial sutures, leads to abnormal skull development, impacting both facial esthetics and oral function. This study aimed to evaluate the specific orofacial and oral health characteristics, including masticatory performance, in Thai patients with CS. METHODS: A comparative study was conducted with Thai CS patients aged 6-17 years and a control group of healthy individuals with similar age distribution. Assessments included craniofacial morphology, oral health status, and masticatory performance. Intergroup comparisons utilized appropriate statistical tests. RESULTS: The study included 24 CS patients with a mean age of 10.11 ± 2.98 years and 30 controls. CS patients exhibited a significantly higher prevalence of various oral conditions compared to controls: cleft palate (20.8%), anterior open bite (41.7%), anterior crossbite (54.2%), posterior crossbite (50%), combined anterior-posterior crossbite (45.8%), dental crowding in both maxilla and mandible (50% and 45.8% respectively), congenitally missing teeth (50%), supernumerary teeth (12.5%), and eruption failure (54.2%). Furthermore, CS patients exhibited significantly higher caries prevalence and susceptibility, alongside poorer oral hygiene, compared to controls. Regarding jaw relationships, CS patients exhibited a significantly higher proportion of Angle's Class III malocclusion (50%) compared to the control group, where Class I malocclusion was predominant (50%). Masticatory performance, assessed using the two-color gum mixing ability test, showed significantly higher hue variance in CS patients (0.12 ± 0.07) compared to the control group, indicating reduced chewing performance. CONCLUSION: This study underscores the significant orofacial and oral health challenges faced by children with CS, including a high prevalence of malocclusions, dental anomalies, elevated caries experience, and compromised masticatory function. These findings emphasize the importance of tailored interventions and comprehensive oral healthcare strategies to address the unique needs of this population and improve their overall quality of life.
Subject(s)
Craniosynostoses , Mastication , Oral Health , Humans , Child , Adolescent , Male , Female , Mastication/physiology , Craniosynostoses/complications , Craniosynostoses/physiopathology , Case-Control Studies , Thailand/epidemiology , Malocclusion/complicationsABSTRACT
OBJECTIVES: The aims of this clinical study were to investigate success rate, vital pulp survival rate, tooth survival rate and patient-reported masticatory ability by evaluating the pain symptoms and signs of the cracked teeth as well as Index of Eating Difficulty (IED) and Oral Health Impact Profile-14 (OHIP-14) questionnaire after cracked teeth were restored with occlusal veneers. MATERIALS AND METHODS: 27 cracked teeth of 24 patients with cold and/or biting pains without spontaneous/nocturnal pains were recruited in this study. The cracked teeth were restored with occlusal veneers fabricated by lithium disilicate ceramic. Cold test and biting test were used to evaluate pain signs. IED and OHIP-14 questionnaire were used to evaluate masticatory ability. FDI criteria was used to evaluate restorations. The paired Wilcoxon test was used to analyze significant differences of detection rate of pain signs, OHIP scores and IED grade before and after restorations. Kaplan-Meier survival curve was used to describe the success rate, vital pulp survival rate, and tooth survival rate. RESULTS: 27 cracked teeth were restored with occlusal veneers with average of 22.4-month follow-up. Two cracked teeth had pulpitis and pain signs of the other cracked teeth completely disappeared. OHIP total scores were significantly reduced after treatment. Scores of 'pain', 'occlusal discomfort', 'uncomfortable to eat', 'diet unsatisfactory' and 'interrupted meals' reduced significantly after treatment. After treatment, IED grades of 25 vital teeth were significantly lower than those before treatment. FDI scores of 25 restorations except for 2 teeth with pulpitis were no greater than 2. The 12 months accumulated pulp survival rate of the cracked teeth was 92.6%. The 12 months accumulated tooth survival rate was 100%. The success rate at the latest recall was 92.6%. CONCLUSION: Occlusal veneer restorations with success rate of 92.6% and the same pulp survival rate might be an effective restoration for treating the cracked teeth. CLINICAL RELEVANCE: The occlusal veneer restorations might be an option for treating the cracked teeth when cracks only involve enamel and dentin, not dental pulp.
Subject(s)
Cracked Tooth Syndrome , Dental Veneers , Humans , Female , Male , Adult , Follow-Up Studies , Cracked Tooth Syndrome/therapy , Treatment Outcome , Surveys and Questionnaires , Middle Aged , Pain Measurement , Dental Porcelain , Dental Restoration, Permanent/methods , Mastication/physiologyABSTRACT
BACKGROUND: This crossover clinical study aimed to evaluate and compare masticatory performance and patient satisfaction for patients rehabilitated with conventional heat-cured acrylic resin and 3D-printed mandibular implant overdentures retained with bar attachment. MATERIALS AND METHODS: Sixteen completely edentulous healthy participants received new conventional dentures. In the mandible, four interforaminal implants were inserted. Following the stage of osseointegration, the bar was constructed in a trapezoidal configuration. Each patient randomly received the following overdentures using a crossover design: (1) conventional heat-cured acrylic resin overdenture and (2) 3D-printed overdenture (developed by scanning of mandibular conventional overdenture). The masticatory performance was assessed by conducting a two-colour mixing ability test at 5, 10, 20, 30, and 50 masticatory cycles. Moreover, the McGill Denture Satisfaction Questionnaire (MDSQ) was employed to assess patient satisfaction. Evaluation was performed after 3 months of using each overdenture. Paired sample t tests were used to compare the masticatory performance and MDSQ scores of patients for both prostheses. RESULTS: No significant difference in masticatory performance was reported between the two types of overdentures. Regarding patient satisfaction, only the esthetic aspect was significantly better for conventionally processed overdentures than for printed overdentures. Insignificant differences were observed regarding other MDSQ items between the two overdentures. CONCLUSION: Within this clinical study, 3D-printed implant overdentures showed promising results in terms of chewing efficiency and patient satisfaction compared to conventionally fabricated implant overdentures. TRIAL REGISTRATION: Retrospectively registered at www. CLINICALTRIALS: gov : NCT06148727.(28/11/2023).
Subject(s)
Cross-Over Studies , Dental Prosthesis, Implant-Supported , Denture, Overlay , Mastication , Patient Satisfaction , Printing, Three-Dimensional , Humans , Mastication/physiology , Male , Female , Middle Aged , Aged , Mandible , Acrylic ResinsABSTRACT
DATA SOURCES: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. PubMed and Cochrane databases were searched. STUDY SELECTION: Journal articles published between January 2007 and January 2023 were identified. Studies that assessed malocclusion indices and oral function were included. Non-English articles and irrelevant studies were excluded. A total of 480 articles were identified. Following exclusion, 29 articles were included in the systematic review. DATA EXTRACTION AND SYNTHESIS: Data was compiled using Microsoft Excel. Information from each article was extracted including study design, evaluation criteria of malocclusion and oral function, and findings. Studies were assessed using the STROBE GRADE approach. The results were compiled in a brief narrative review investigating the type and strength of the association between malocclusion and ingestion. RESULTS: Malocclusion was recorded using Index of Treatment Need, Dental Aesthetic Index, Goslon Yardstick Index, Index of Complexity Outcomes and Need, Peer Assessment Rating, Angle's classification, Specific Severity Score, dental inter-arch relation and cephalometric analysis. Ingestion was measured by bite force, electromyography, mixing ability index, bolus granulometric analysis, video analysis of kinetic parameters during mastication, and subjective questionnaires. Of the 29 articles identified, 20 demonstrated a negative impact of malocclusion on oral ingestion, highlighting impaired masticatory efficiency, bite force and subjective difficulties. Eight studies found no significant association. One study, which used two questionnaires, found a significant relationship between eating and malocclusion using one questionnaire but not the other. DISCUSSION: Limitations in current research methodologies were identified, particularly the heterogeneity in assessment tools. The indicators used to assess ingestion and malocclusion are flawed, with questionable reliability. No study was able to identify which features or severity of malocclusion impact ingestion. The relationship between ingestion and malocclusion could not be quantified and the need for longitudinal and case report studies was deemed essential to establish causality. CONCLUSION: This review underscores the importance of considering how malocclusion impacts function in orthodontic treatment planning. Future research should focus on standardised assessment methods for measuring malocclusion and oral ingestion to establish the nature of the relationship between the two. This will ultimately guide orthodontic intervention aiming to enhance oral function.
Subject(s)
Eating , Malocclusion , Humans , Eating/physiology , Mastication/physiology , Bite ForceABSTRACT
This study investigated and compared the consistency and compressive strength of two commercially available paraffin wax chewing gums (Aurosan (AU) and GC Europe (GC)), as well as their impact on stimulated salivary flow rate. Instrumental texture analysis was uti-lized to assess the consistency and compressive strength of AU and GC during a 7-min chewing period. Subsequently, stimulated salivary flow rate (sSFR) was evaluated in healthy subjects using AU and GC over a 7-minute period. The compressive strengths from the pre-liminary test were compared over time with the sialometry data. Eighty-one test subjects, comprising 33 men and 48 women, participated. Over the 7-min measurement period, dif-ferences were observed in the total amount of saliva accumulated per minute. Direct com-parison of AU and GC revealed that regardless of age and gender, the amount of saliva formed after 1 min was 0.63 times less with AU than with GC (95% CI: 0.56 - 0.70; P < 0.001). The accumulated saliva volume with AU was also significantly lower than that with GC in the first 4 min (P = 0.016). However, from minute 5 onwards, the two products no longer showed statistical differences in the total amount of saliva. Comparison of the com-pressive strength of AU and GC showed that the values after 1 and 2 min were significantly higher for AU than for GC (P < 0.05); for all other time points, the compressive strength was higher for GC. In the mixed-effects model after log-transformation of compressive strength and saliva volume, GC exhibited decreasing saliva volumes with increasing compressive strength (P <0.001). Conversely, the opposite was observed for AU (P = 0.019). The study suggests that the consistency or compressive strength of paraffin wax chewing gums from different manufacturers could impact sSFR.
Subject(s)
Chewing Gum , Paraffin , Saliva , Humans , Female , Male , Adult , Saliva/chemistry , Compressive Strength/physiology , Mastication/physiology , Young Adult , Middle Aged , Secretory Rate/physiology , Secretory Rate/drug effectsABSTRACT
This prospective clinical study aimed to assess self-reported orofacial esthetics, chewing function, and oral health-related quality of life (OHRQoL) over three years in the Kennedy Class I patients without posterior dentition who received free-end saddle removable partial dentures (RPDs) retained by two mini dental implants (MDIs) inserted in the canine/first premolar region. The study's robust findings reaffirm the viability of MDI-retained RPDs as a treatment modality in contemporary prosthodontics, instilling confidence in the dental community. MATERIALS AND METHODS: 92 participants with posterior edentulism in the maxilla or mandible received 184 MDIs and 92 RPDs. After one year, three participants were excluded, and another seven were excluded after three years. The final sample was 82 participants. Self-perceived orofacial esthetics was assessed by the Orofacial Esthetic Scale (OES), chewing function by the Chewing Function Questionnaire (CFQ), and the OHRQoL by the OHIP-14. Statistical analysis utilized multivariate regression analysis, standardized effect size calculation, Wilcoxon Signed Rank test, and Friedman's test. RESULTS: OHRQoL and chewing function significantly improved (p < 0.001) one month after MDI loading by the new RPDs and continued to improve over the observation period (p < 0.05). The OES also significantly improved (p < 0.001) and remained almost unchanged over the next three years (p = 0.440). CONCLUSION: Despite the limitations of this study, the MDI-retained RPD appears to be a viable treatment modality in contemporary prosthodontics from the patients' perspective.
Subject(s)
Dental Prosthesis, Implant-Supported , Denture, Partial, Removable , Esthetics, Dental , Mastication , Oral Health , Quality of Life , Humans , Prospective Studies , Male , Female , Mastication/physiology , Middle Aged , Surveys and Questionnaires , Jaw, Edentulous, Partially/rehabilitation , Aged , AdultABSTRACT
BACKGROUND: Increase in functional disability in aging societies is an international medical and public health issue. Masticatory function may be a potential risk factor for functional disability, but the role of frailty in the association has not been clarified. METHODS: Forty thousand five hundred sixty-two community-dwelling older adults aged 65 years and over who were insured by public health insurance as of April 2018 were followed up for a median of 3.0 years. Masticatory function was categorized as good, moderate, or poor based on a self-reported questionnaire. The development of functional disability was defined as a new certification of the need for long-term care. A Cox proportional hazards model was used to calculate hazard ratios (HRs) and their 95% confidence intervals (CIs). RESULTS: During the follow-up period, 1,397 individuals experienced functional disability. After adjusting for age, sex, comorbidities, medical history, and lifestyle behaviors, the HR for incident functional disability was significantly higher in the moderate and poor groups compared to the good group (moderate, HR 1.21 [95% CI, 1.07-1.37]; poor, HR 1.64 [95% CI, 1.03-2.62]). However, after additional adjustment for frailty-related factors-namely, underweight, regular exercise, and gait speed-the association was attenuated in both the moderate group (HR 1.06 [95% CI, 0.94-1.21]) and the poor group (HR 1.51 [95% CI, 0.94-2.41]). CONCLUSIONS: Masticatory dysfunction was significantly associated with incident functional disability in a community-dwelling older Japanese population. Our findings suggest that masticatory dysfunction may be a surrogate of frailty rather than a direct cause of functional disability.
Subject(s)
Frailty , Independent Living , Mastication , Humans , Aged , Male , Female , Frailty/epidemiology , Frailty/diagnosis , Frailty/physiopathology , Mastication/physiology , Aged, 80 and over , Independent Living/trends , Frail Elderly , Disabled Persons , Disability Evaluation , Risk Factors , Geriatric Assessment/methods , Japan/epidemiologyABSTRACT
BACKGROUND: Electromyographic activity (EMG) of masticatory muscles during wakefulness is understudied. It is unclear if single channel ambulatory EMG devices are sensitive enough to detect masticatory muscle activity (MMA) during wakefulness. OBJECTIVES: To compare the MMA of various oral tasks recorded with a single channel EMG device ((Grindcare4-datalogger Prototype device) (GC4-ß)) and a conventional EMG (cEMG) device. METHODS: EMG activity of 30 standardised oral tasks was recorded unilaterally from the masseter and anterior temporalis muscle in 24 healthy volunteers using GC4-ß and a cEMG device. To compare the EMG data, signal-to-noise ratios (SNR) were calculated as a way to normalise EMG activity across tasks. Analysis of variance was used to compare the SNR between the devices, muscles and oral tasks. RESULTS: SNR measured from GC4-ß was overall significantly higher than the cEMG device (p =.001). The SNR for maximum voluntary contraction (MVC) was significantly higher than all other tasks (p <.001). SNR for temporalis with GC4-ß was significantly higher for MVC, hard food, soft food, gum chewing (dominant side), rhythmic clenching and upper lip biting compared to the cEMG device (p <.021). The SNR for masseter with GC4-ß was significantly higher for hard food and gum chewing (dominant side), rhythmic clenching, rhythmic biting of an object and yawning compared to the cEMG device (p <.022). CONCLUSIONS: This study provides novel insight into the EMG patterns of numerous oral tasks enhancing knowledge of physiological differences between the masticatory muscles. Further, single channel EMG devices can effectively measure the EMG activity of various oral tasks during wakefulness.
Subject(s)
Electromyography , Mastication , Masticatory Muscles , Muscle Contraction , Signal-To-Noise Ratio , Humans , Male , Female , Mastication/physiology , Adult , Muscle Contraction/physiology , Masticatory Muscles/physiology , Healthy Volunteers , Young Adult , Masseter Muscle/physiology , Wakefulness/physiology , Temporal Muscle/physiologyABSTRACT
BACKGROUND: The use of clear aligners is becoming more common for aesthetic orthodontic treatment, but there are still concerns about how they affect mastication biomechanics in the short and long term. The clear aligners treatment (CAT) mechanism changes the position of the mandible and maxilla, especially impacting the masseter muscle. Surface electromyography (sEMG) proves to be a useful method to evaluate masticatory muscle activity (MMA). OBJECTIVES: To analyze the effect of clear aligners treatment on alterations in masticatory muscles (masseter, temporalis) using surface electromyography. SEARCH METHODS: Five databases (PubMed, Web of Science, SCOPUS, Cochrane Library, and Google Scholar) were searched up to March 2024. SELECTION CRITERIA: Studies in which MMA was evaluated after the installation of orthodontic clear aligners. DATA COLLECTION AND ANALYSIS: Screening, data extraction, and quality assessments were performed by four investigators independently. The data, which evaluated temporalis and masseter muscle characteristics during CAT using surface electromyography, was extracted, and the quality of the studies was evaluated. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: Six studies (two prospective cohort studies, three observational longitudinal studies, and one observational longitudinal case-control study) with low and moderate risk of bias were included in the qualitative synthesis. Six of these were also included in the meta-analysis. Our study investigated the dynamics of masseter and temporalis muscle activity during CAT. The results show that during maximal voluntary clenching, the masseter muscle demonstrated a significant initial increase (Pâ <â .05) followed by a subsequent non-significant decrease. It also showed that submaximal voluntary clenching consistently exhibited a significant reduction in muscle activity throughout the study period (Pâ <â .01). Assessment of muscle activity at the mandibular resting position revealed a variety of responses, with some participants showing a significant increase while others exhibited non-significant changes (Pâ <â .05, Pâ >â .05, respectively). However, the meta-analysis showed a non-significant difference in measuring masseter and temporalis muscles activity during CAT. CONCLUSIONS: Based on existing evidence, it is reasonable to conclude that CAT affected MMA. During maximal voluntary clenching, masseter muscle activity initially increased but later decreased, while temporalis muscle activity showed mixed results. Submaximal voluntary clenching revealed a consistent decrease in muscle activity over time. Mandibular resting position assessments showed both increases and no significant changes in muscle activity. However, the existing literature is insufficient to draw concrete conclusions; therefore, well-conducted further research is needed to confirm this statement. REGISTRATION: This systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42024522231).
Subject(s)
Electromyography , Masseter Muscle , Temporal Muscle , Humans , Masseter Muscle/physiology , Temporal Muscle/physiology , Adult , Masticatory Muscles/physiology , Mastication/physiology , Orthodontic Appliances, RemovableABSTRACT
OBJECTIVE: This cross-sectional pilot study evaluated the impact of age on masticatory performance among individuals aged 65 to 106 years, as part of the Heidelberg Dental Centenarian Study (HD-100Z) conducted in South-Western Germany. MATERIALS AND METHODS: A total of 31 centenarians were recruited, alongside 31 individuals each from the age groups 75-99 and 65-74, matched based on sex, prosthetic status, and number of teeth. Masticatory performance was assessed using a two-colored chewing gum test and digital image processing. Multiple linear regression analysis was performed to assess the effect of age, sex, number of teeth, type of prosthesis on the masticatory performance. RESULTS: Masticatory performance, as measured by the standard deviation of hue in the chewing gum test, decreased significantly in centenarians compared to individuals aged 75-99 years (-0.112, p = 0.037) and those aged 65-74 years (-0.274, p < 0.001). The effects of sex, number of teeth, and type of prosthesis on masticatory performance were not significant associations (p ≥ 0.135). CONCLUSION: The findings suggest that age may have a significant influence on masticatory performance in the studied age groups, challenging previous notions that aging itself has little impact on masticatory ability. The inclusion of centenarians in the study highlights the need for further investigation into masticatory function in age groups reaching up to 100 years or more. CLINICAL RELEVANCE: This study contributes to the understanding of how ageing affects oral function, which may guide dental treatment approaches for older individuals, and set the stage for more in-depth investigations in this field in the future.
Subject(s)
Mastication , Humans , Female , Mastication/physiology , Cross-Sectional Studies , Male , Aged, 80 and over , Aged , Pilot Projects , Germany , Age Factors , Chewing GumABSTRACT
PURPOSE: To determine the relationship between mastication and malnutrition in community-dwelling older adults. RESEARCH STRATEGIES: To establish the eligibility criteria, the acronym PECOS was used: Population: non-institutionalized older adults; Exposure: older adults with malnutrition; Control: older adults without malnutrition; Outcome: masticatory problems in malnourished older adults; Study types: observational studies. SELECTION CRITERIA: It selected studies assessing malnutrition and mastication difficulties in non-institutionalized adults over 60 years old, of both sexes. Mastication and malnutrition were evaluated with questionnaires on self-reported symptoms and clinical and instrumental assessments. There were no restrictions on language, year of publication, or ethnicity. DATA ANALYSIS: The included studies were evaluated for methodological quality with the Joanna Briggs Institute tool for cross-sectional studies. For the cross-sectional studies included, the odds ratio (OR) was calculated with 95% confidence intervals. RESULTS: After searching the databases, 692 references were retrieved, with three studies selected for quantitative and qualitative analysis. The values obtained in the meta-analysis for association show that malnutrition and mastication difficulties were 2.21 times as likely to occur (OR = 2.21; 95%CI = 0.93 - 5.26; I2 = 94%) as individuals without malnutrition (p < 0.001). The assessment of the risk of bias presented a high-risk, a moderate-risk, and a low-risk study. The certainty of evidence was rated very low with the GRADE tool. CONCLUSION: Individuals at risk of malnutrition are 2.21 times as likely to have mastication difficulties.
Subject(s)
Independent Living , Malnutrition , Mastication , Humans , Mastication/physiology , Aged , Female , Cross-Sectional Studies , Male , Geriatric Assessment , Middle Aged , Aged, 80 and overABSTRACT
Food bolus is the major outcome of oral processing of foods. Its structure and properties are crucial for safe swallowing and subsequent gastric digestion. However, collecting the ready-to-swallow bolus for further analysis in either normal or deficient human subjects is difficult, regulatorily or practically. Here, a novel in vitro bio-inspired oral mastication simulator (iBOMS-â ¢) was developed to be capable of replicating food boluses comparable to those in vivo. Cooked rice and roasted peanuts were used as the model foods (soft and hard) respectively. Particle size distribution, moisture content and rheology of the food boluses produced in the iBOMS-â ¢ were assessed. A conventional food blender was also employed as a non-consequential comparation. Eighteen healthy young volunteers of the ages from 20-30 years (10 male and 8 female) were invited to provide the in vivo data. For cooked rice boluses produced by the iBOMS-â ¢ with 10, 12, 14, and 20 chewing number of cycles, the moisture content exhibited minimal variation (68.3-68.8 wt%), aligning closely with values obtained from the average value of the human subjects (67.5 wt%). Similarly, the boluses from roasted peanut displayed similar moisture contents across masticatory number of cycles (36, 40, and 44 number of cycles), averaging at 35.3 %, mirroring the average in vivo results (33.8 wt%). Furthermore, the shear viscosity of both cooked rice and roasted peanut boluses exhibited minimal variations with iBOMS-â ¢ chewing number of cycles. The particle size distributions of the boluses produced with 14 and 44 chewing number of cycles matched well with the in vivo data for cooked rice and roasted peanuts, with median particle size (d50) being 1.07 and 0.78 mm, respectively. The physical properties of the food boluses collected from the food blender, with varying grinding times, differed significantly. This study demonstrates the value of the iBOMS-â ¢ in achieving realistic boluses with two very different food textures.