Molar loss and powder diet leads to memory deficit and modifies the mRNA expression of brain-derived neurotrophic factor in the hippocampus of adult mice.

BACKGROUND: It is known that tooth loss is known to be a risk factor for Alzheimer's disease and soft diet feeding induces memory impairment. Recent studies have shown that brain-derived neurotrophic factor (BDNF) is associated with tooth loss or soft diet in young animal model, and that BDNF expression is decreased in patients with Alzheimer's disease. However, single or combined effect of tooth loss and/or soft diet on brain function has not fully understood. Here we examined the effect of molar loss and powder diet on memory ability and the expression of BDNF mRNA in the hippocampus of adult C57BL/6J mice. Twenty eight-weeks-old C57BL/6J mice were divided into intact molar group and extracted molar group. They were randomly divided into the I/S group (Intact upper molar teeth/Solid diet feeding), the E/S group (Extracted upper molar teeth/Solid diet feeding), the I/P group (Intact upper molar teeth/Powder diet feeding), and the E/P group (Extracted upper molar teeth/Powder diet feeding). The observation periods were 4 and 16-week. To analyze the memory ability, the step-through passive avoidance test was conducted. BDNF-related mRNA in the hippocampus was analyzed by real-time polymerase chain reaction (RT-PCR). RESULTS: At 4 weeks later, we performed memory test and isolated brains to analyze. There were no differences in memory function and BDNF mRNA level between these four groups. However, at 16 weeks later, E/S and E/P group showed memory impairment, and decreased level of BDNF mRNA. Whereas, the powder diet had no effect on memory function and BDNF mRNA level even at 16 weeks later. CONCLUSIONS: These results suggest that the effect of molar loss and powder diet on memory function and BDNF mRNA levels were different, molar loss may have a greater long-term effect on memory ability than powder diet does.

Tooth loss might not alter molecular pathogenesis in an aged transgenic Alzheimer's disease model mouse.

BACKGROUND AND OBJECTIVE: Previous studies have reported that tooth loss is a risk factor of Alzheimer's disease (AD). However, the association between tooth loss and cognition and the impact of tooth loss on the molecular pathogenesis of AD remain elusive. In this study, we tested the effect of tooth loss on learning and memory and on the molecular pathogenesis of AD in an aged AD model mice. MATERIALS AND METHODS: We divided 14-month-old amyloid precursor protein (APP) transgenic mice, an AD model mouse line, into upper molar extracted group (experimental) and molar intact group (control). At 18 months old, we analysed not only the changes of amyloid-beta (Aß), pyramidal cells in the brain but also the learning and memory ability with step-through passive avoidance test. RESULTS: The amount of Aß and the number of pyramidal cells in the hippocampus were not significantly different between the experimental and control group. Similarly, the difference of learning and memory ability could not be distinguished between the groups. CONCLUSION: Neither molecular pathogenesis of AD nor associated learning and memory were aggravated by tooth loss in these mice. The limited results of this study which used the aged mice may help the dental profession to plan and explain treatments to patients with AD, which must be designed while taking into account the severity of the AD symptoms.

Relationship between behavioral and psychological symptoms of dementia and oral health status in the elderly with vascular dementia.

OBJECTIVES: The aim of this study was to clarify the relationship between behavioral and psychological symptoms of dementia (BPSD) and oral status in the elderly with vascular dementia. BACKGROUND: There have been some reports of a relationship between disease symptoms and oral status in the elderly with Alzheimer's disease, but few reports have been conducted in the elderly with vascular dementia. Until now, the relationship between BPSD and oral status has been unknown. MATERIALS AND METHODS: An investigation was conducted concerning BPSD and oral status among 57 subjects with vascular dementia (mean age, 85.7 ± 5.5 years). The wearing of dentures and oral activities of daily living (oral ADL) were examined. RESULTS: Subjects with activity disturbances and those with aggressiveness had significantly lower rates of denture wearing than those without these two symptoms (p < 0.05). Significantly lower oral ADL scores were obtained from subjects with delusional ideas, hallucinations, activity disturbances and diurnal rhythm disturbances (p < 0.05), as well as those with affective disturbances (p< 0.01). CONCLUSION: This study indicated a relationship between BPSD and the wearing of dentures in the elderly with vascular dementia. The study also demonstrated relationships between BPSD and oral ADL.

Prosthodontic treatment can improve the ingestible food profile in Japanese adult outpatients.

PURPOSE: To investigate the effect of prosthodontic treatment on the ingestible food profile in adult Japanese outpatients, and to identify the related risk factors that can deteriorate the profile. METHODS: The participants were 277 outpatients who visited university-based specialty clinics in Japan for prosthodontic treatment. The demographic data, number of present teeth assessed via intraoral examination, and oral health-related quality of life assessed by the total Oral Health Impact Profile (OHIP-J54) scores of all participants were recorded before treatment. Ingestible food profile score (IFS) was recorded using a validated food intake questionnaire. Eligible participants who answered the questionnaire before and after treatment were categorized into five groups based on the prosthodontic treatments they received (i.e., crowns, bridges, removable partial dentures, removable complete dentures, and removable complete and partial dentures). RESULTS: Multivariate analysis of covariance revealed a statistically significant main effect of prosthodontic intervention (time course: before and after treatment) on mean IFS (P=0.035, F=4.526), even after adjusting for covariates (age, number of present teeth, and treatment modality). Multiple linear regression analysis revealed that the low number of present teeth (r=0.427, P<0.001) and a high OHIP-J54 total score (r=-0.519, P<0.001) of the patients at the baseline were significantly associated with their baseline IFSs, even after adjusting for confounding variables. CONCLUSIONS: The findings of this multicenter follow-up study indicate the importance of prosthodontic rehabilitation in improving patients' ingestible food profiles.

Inorganic polyphosphates stimulate FGF23 expression through the FGFR pathway.

Polyphosphate (polyP) is composed of linear polymers of orthophosphate residues linked by high-energy phosphoanhydride bonds. It has been reported to improve osteoblastic differentiation, stimulate periodontal tissue regeneration, and accelerate bone repair. The aim of this study was to evaluate the effect of polyP on the expression of FGF23, a hormone secreted mostly be mature osteoblasts and osteocytes. In this study, different types of polyP were synthesized and co-cultured with osteoblast-like UMR-106 cells. Real-time PCR and western blot were used to analyze the gene and protein expression of FGF23. We found that 1 mM polyP was able to increase FGF23 expression after 4 h, reaching a peak after 12-24 h, with expression decreasing by 48 h. We also found that polyP could activate the FGFR pathway, as evidenced by increased phosphorylation of FGFR, FRS2, and Erk1/2. When FGFR signaling was inhibited by the specific inhibitor SU5402, the effect of polyP on FGF23 expression was significantly reduced. Our results indicate that polyP is able to stimulate osteoblastic FGF23 expression and that this effect is associated with activation of the FGFR pathway. These findings provide support for the clinical use of polyP by indicating a mechanism for polyP in bone regeneration.

The evaluation of oral health in stroke patients.

OBJECTIVE: As tooth loss has been suggested as a potential risk factor for stroke, oral examinations were carried out on stroke patients to review the oral condition of those patients. METHOD: The subjects were patients consecutively discharged from the recovery rehabilitation unit of Hiroshima City General Rehabilitation Center between April 2008 and December 2009. All patients were offered oral examination and 358 of 443 patients accepted. Patients receiving dental examination were divided into two groups: one group comprising stroke patients and the second, patients with other disorders. These two groups were then compared for the number of remaining teeth by age group. RESULTS: Among the examined patients, the number of remaining teeth in stroke patients in their 50s and 60s was significantly lower than for patients in corresponding age groups (18.4 ± 9.4 vs. 24.5 ± 5.4 and 18.3 ± 9.2 vs. 22.2 ± 7.2, respectively, with p < 0.05 for both age groups) who were hospitalised for other conditions. In addition, the number of remaining teeth in stroke patients in their 50s was also significantly lower than the number reported in the Survey of Dental Diseases (24.1 ± 6.1; p < 0.05). CONCLUSION: The results of this study suggest an association between tooth loss and early occurrence of stroke.

Nutritional status and oral status of the elderly with dementia: a 2-year study.

OBJECTIVES: To determine the relationship between denture wearing and nutritional status in the elderly with dementia. BACKGROUND: There could be a correlation between nutrition, oral health, dietary habits, patients' satisfaction, and their socio-economic status in the elderly, and the relationship between compromised oral status and nutritional status in the elderly with dementia. SUBJECTS AND METHODS: A 2-year follow-up study of 63 elderly Japanese women with and without dentures from a nursing home was undertaken to investigate their oral, physical and mental, and nutritional status. RESULTS: Each item for 2006 and 2008 in this study showed no significant difference between 2006 and 2008, except the calories/day. The elderly with dementia without complete dentures during the 2 years of the study only significantly decreased the mean of the calories/day. CONCLUSION: The calories/day of the elderly with dementia without dentures decreased after 2 years. Denture wearing for the elderly with dementia could be necessary to maintain a satisfactory intake of calories.

Maximal voluntary tongue pressure is decreased in Japanese frail elderly persons.

BACKGROUND AND OBJECTIVE: To quantitatively estimate tongue function, we developed a handy device for intraoral pressure measurement. The objective of this study was to assess maximum voluntary tongue pressure (MVTP) in Japanese frail elderly persons receiving nursing care services. MATERIALS AND METHODS: The study included 42 men and 87 women, aged 58-100 years. To record MVTP, the participants were asked to compress the balloon (diameter: 18 mm) of the disposable intraoral pressure probe onto their palates for 7 s using the maximum voluntary effort of the tongue. Pressures were recorded three times at 1 min intervals. RESULTS: Maximum voluntary tongue pressure was successfully measured in 111 persons. Mean (standard deviation) MVTP was 18 (12) kPa, with a range of 0-63 kPa. The remaining 18 persons could not accurately follow our instructions and MVTP could not be measured. CONCLUSION: In comparison with the reported standard value using the same device, the frail elderly persons included in our study were found to exert less MVTP than healthy dentate individuals. These results suggest the need for proper quantitative evaluation of oral function, including tongue capacity, at nursing care facilities.

Detection of synthetic RGDS(PO3H2)PA peptide adsorption using a titanium surface plasmon resonance biosensor.

The purpose of this study was to measure the time-dependent chemical interaction between synthetic RGDS(PO(3)H(2))PA (P-RGD) peptide and titanium surfaces using a titanium surface plasmon resonance (SPR) biosensor and to determine the degree of peptide immobilization on the surfaces. An SPR instrument for 'single-spot' analysis was used for nanometer-scale detection of biomolecular adsorption using a He-Ne laser light according to Knoll's method. The oxidized titanium surface was etched when exposed to H(3)PO(4) solutions with a pH of 2.0 or below. The amount of P-RGD adsorbed at pH 1.9 was approximately 3.6 times as much as that at pH 3.0 (P < 0.05). P-RGD naturally adsorbed on the oxidized titanium surface as a consequence of the bonding and dissociation mechanism of the phosphate functional group. Furthermore, the control of pH played a very important role in the interaction between P-RGD and the surface. These findings show that pH control may promote progressive binding of biomolecules with the phosphate functional group to the titanium surface.

Comparison of three types of tongue pressure measurement devices.

A new tongue pressure device consisting of a simple and safe disposable probe and manometer has been developed. This report describes a study that examined the validity of the new device, comparing it to a widely used tongue pressure manometer, the Iowa Oral Performance Instrument (IOPI), and to the stable adhered three air-filled bulbs manometry system. The first test compared maximum tongue pressure measured with the new device and the IOPI (13 male, 9 female, 25.0 years). The second test compared maximum tongue pressure and swallowing tongue pressure measured with the new device and the three-bulb device (13 male, 9 female, 31.0 years). Significant correlations of maximum tongue pressure were found between the new device and the IOPI in the first test (p < 0.05). In the second test, significant correlations of maximum tongue pressure were found between the new device at the anterior and middle sensors (p < 0.05) but not at the posterior sensor of the three-bulb device. Significant correlations of swallowing tongue pressure between the new device and the three-bulb device were found (p < 0.05). These findings demonstrate that the measurements by the new simple tongue pressure device are closely equivalent to those of the IOPI and three-bulb devices, demonstrating that the new device is capable of accurately measuring the pressure generated by the whole tongue.

The degree of tongue-coating reflects lingual motor function in the elderly.

OBJECTIVES: The aim of this study was to examine the relation between the degree of tongue-coating and oral function. BACKGROUND: Tongue-coating is a moss-like deposit which forms over the tongue surface, and includes micro-organisms, food residues, and abrasive epithelia. It is considered that motor function of the tongue and lips and saliva secretion decrease in the aged and have some effect on the accumulation of tongue-coating. Although saliva secretion has been reported as a factor amongst these oral functions in contributing to tongue-coating, the correlation with the motor function of oral structures is unknown. SUBJECTS AND METHODS: The factors that contribute to the accumulation of tongue-coating were examined in 48 subjects of advanced age (mean age 80.8 +/- 7.8 years) with no severe levels of periodontal disease. Changes in the degree of tongue-coating were also examined after oral functional training in these subjects. The frequency of oral cleaning, status of oral hygiene, motor function of the tongue, and masticatory performance were examined as potential factors associated with the degree of coating. RESULTS: The results showed that tongue pressure and the frequency of oral diadochokinesis measured by pronouncing the single syllable 'ka' as an indicator were statistically significantly correlated with the degree of tongue-coating. Several factors in oral function improved with training, and also the degree of tongue-coating decreased in 27 subjects. CONCLUSION: These results suggest a correlation between the degree of tongue-coating and a reduction in lingual motor function and, in addition, possible improvement in level of coating by functional training of the tongue.

Bone formation ability of carbonate apatite-collagen scaffolds with different carbonate contents.

Hydroxyapatite and carbonate apatites with different carbonate contents were synthesized, mixed with atelocollagen, and made into sponge scaffolds. The scaffolds were implanted into the bone sockets of the femurs of male New Zealand white rabbits for 2, 3, 12 and 24 weeks. carbonate apatite-collagen scaffold with 4.8 wt% carbonate content appeared to have similar crystallinity and chemical composition to human bone. When the scaffolds were implanted into the rabbit femurs, histological observation indicated that the carbonate apatites-collagen scaffolds with relatively higher carbonate contents were gradually deformed throughout the implantation period, and showed uniform surrounding bone after 24 weeks and could not be distinguished. The carbonate apatite-collagen scaffold with 4.8 wt% carbonate content showed the highest bone area ratio of all of the scaffolds. It is suggested that a carbonate apatite-collagen scaffold with carbonate content similar to that of human bone may have optimal bone formation ability.

[Planning guidelines for prosthodontic treatment].

In recent years "practice guidelines" based on EBM techniques have even been attracting attention at a societal level, and guidelines modeled after the procedure for preparing practice guideline (described at http://www.niph.go.jp/glgl-4.3rev.htm) have begun to be drafted and made public. With the aim of ensuring the quality and presenting the basic concepts of prosthodontic therapy, the Japan Prosthodontic Society, which bears a great obligation and responsibility toward society and the Japanese public, has decided to undertake the formulation of guidelines related to prosthodontic therapy, and decided to first undertake the formulation of "Practice guideline for denture relining and rebasing", and to prepare a guideline model. We tried to prepare the guidelines according to the "Procedure for preparing practice guidelines", but because of the scientific uniqueness of prosthodontic treatment and dentistry, research to elucidate the basis of treatment has been insufficient, and we ultimately reconfirmed the current state of affairs in which it is difficult to perform. We therefore prepared the guidelines based on the limited evidence obtained in a search of the scientific literature and on the consensus of experts. The Japan Prosthodontic Society has investigated and prepared a Society guideline "model" to the extent possible at the present time, and it has prepared "Guidelines for adhesion bridge" and "Practice guidelines for denture prosthodontics" based on it. Nevertheless, the fact of the matter is that we are faced with numerous problems, and we think that in the future new bases and clinical knowledge will be accumulated by promoting scientific clinical research, and that the guidelines should be revised regularly based on them.

A multi-centered epidemiological study evaluating the validity of the treatment difficulty indices developed by the Japan Prosthodontic Society.

PURPOSE: The Japan Prosthodontic Society developed a multi-axis assessment protocol to evaluate the complex variations in patients who need prosthodontic care, and to classify the level of treatment difficulty. A previous report found the protocol to be sufficiently reliable. The purpose of this multi-center cohort study was to evaluate the validity of this multi-axis assessment protocol. METHODS: The treatment difficulty was evaluated using the multi-axis assessment protocol before starting prosthodontic treatment. The time required for active prosthodontic treatment, medical resources such as treatment cost, and changes in the oral health-related QOL before and after treatment, were evaluated after treatment completion. The construct validity of this protocol was assessed by the correlation between the dentist's pre-operative subjective assessment of the treatment difficulty, and the level of difficulty determined by this protocol. The predictive validity was assessed estimating the correlations between a "comprehensive level of treatment difficulty" based on the four axes of this protocol and total treatment cost, total treatment time, and changes in the oral health-related QOL before and after treatment. RESULTS: The construct validity of this protocol was well documented except for psychological assessment. Regarding the predictive validity, the comprehensive level of treatment difficulty assessed before treatment was significantly correlated with the three surrogate endpoints known to be related to the treatment difficulty (total treatment cost, treatment time, and improvement in the oral health-related QOL). To further clarify the validity of the protocol according to patients' oral condition, a subgroup analysis by defects was performed. Analyses revealed that treatment difficulty assessment before treatment was significantly related to one or two surrogate endpoints in the fully edentulous patients and the partially edentulous patients. No significant relationship was observed in the patients with mixture of full/partial edentulism and the patients with teeth problems, possibly due to the small sample size in these groups. CONCLUSION: This study revealed that the multi-axis assessment protocol was sufficiently valid to predict the level of treatment difficulty in prosthodontic care in patients with fully edentulous defects and with partially edentulous defects.

Development of cell-hybrid artificial bone: effect of osteogenic differentiation of bone marrow stromal stem cells on bone formation with newly developed interconnected porous calcium hydroxyapatite.

The purpose of this study was to evaluate the effect of osteogenic differentiation of bone marrow stromal stem cells (BMSCs) on bone formation in a novel interconnected porous calcium hydroxyapatite (IP-CHA). BMSCs/IP-CHA composites, as a cell-hybrid artificial bone, were made by injecting BMSCs solution into IP-CHA scaffolds. To induce osteogenic differentiation, BMSCs/IP-CHA composites were subcultured for three, seven, 10, and 14 days. At the end of each subculture period, BMSCs/IP-CHA composites were examined by SEM and ALP staining. BMSCs/IP-CHA composites of different osteogenic groups of subculture were also placed into bone sockets in the right femur of beagle dogs. After four weeks, same placement procedure was done in the left femur. BMSCs/IP-CHA subcultured for 10 and 14 days were ALP-positive as opposed to those of three and seven days. At four weeks after placement, bone formation was superior at the 10- and 14-day subculture groups. Based on the results obtained, it was suggested that osteogenic differentiation periods with 10 and 14 days of subculture for BMSCs/IP-CHA as a cell-hybrid artificial bone were beneficial in promoting bone formation.

Chemical interaction between titanium implant surface and amino acids.

The purpose of this study was to investigate the chemical interaction between titanium implant surface and amino acids. Pure titanium disks were pretreated with 10 N HCl and ultrapure water at room temperature for 30 minutes each. Disks were then modified with one of the three amino acids--L-aspartic acid, L-serine, or L-threonine--at 37 degrees C for 12 hours. Modification with oxalic acid was used as a control. By means of X-ray photoelectron spectroscopy (XPS), amino acid powders and the modified surfaces without or with ultrasonic water rinsing were chemically analyzed. It was revealed that the N 1s peak which originated from amino acids was not or hardly detected in the wide scan spectra of amino acid-modified surfaces. Moreover, the COO- peak which originated from oxalic acid could hardly be detected in the narrow scan spectrum of the C is region of oxalic acid-modified surface with ultrasonic water rinsing. Based on the results of this study, it was concluded that amino acids could not chemically bond to the titanium surface.

Development of new drug delivery system for implant bone augmentation using a basic fibroblast growth factor-gelatin hydrogel complex.

This study sought to clarify the effectiveness of bFGF-gelatin hydrogel complex on bone regeneration around implants for the development of a new drug delivery system for bone augmentation. Twenty-four titanium implants (03.3 mmX 10 mm) were placed into edentulous areas of the mandibles of four beagle dogs with the upper four screw threads exposed at buccal side. bFGF-gelatin hydrogel complex with 0, 0.1, 1, 10, 100 microg bFGF or autogenous bone (as control) then filled the bone defect site to cover the exposed screw threads. After eight weeks, tissue specimens including implants were evaluated histologically and histomorphometrically. Histological observation showed new bone formation around exposed screw threads in the groups with 1, 10, 100 microg bFGF and autogenous bone-a striking contrast to the groups with contents of 0 and 0.1 microg bFGF. These results thus suggested that bFGF-gelatin hydrogel complex using an optimum amount of bFGF was useful for bone augmentation around implants.

A stability evaluation of a novel titanium dental implant/interconnected porous hydroxyapatite complex under functional loading conditions.

The aim of this study was to evaluate the stability of implant/interconnected porous calcium hydroxyapatite complex (implant/IPCHA-complex) under functional loading. Implant/IP-CHA-complexes were placed into the mandibles of four Beagle-Labrador hybrid dogs (complex-group). On the other side, an implant was placed directly (control-group). To subject the loading, the animals were fed a hard diet throughout the loading phase of 5 months. The implant stability quotients (ISQs) and bone implant contact (BIC), and histological evaluations were performed. The ISQs of implant/IP-CHA-complex was significantly lower at placement than that of the control-implant. On the other hand, there was no significant difference between in the groups during loading. The BIC measurements, there was no significantly difference between in both groups. Histologically, newly formed bone was observed in contact with most of the implant surface in the complex-group. An IP-CHA/implant-complex would be able to achieve both bone reconstruction and implant stability under functional loading conditions.

Influence of aging and denture use on liquid swallowing in healthy dentulous and edentulous older people.

OBJECTIVES: To clarify the influence of aging and denture use on swallowing in healthy edentulous people aged 75 and older. DESIGN: A cross-sectional research design was used with participants from Hiroshima University Hospital, Hiroshima University, and Hiroshima City. SETTING: Participants were examined in Hiroshima University Hospital, Hiroshima, Japan. PARTICIPANTS: Thirteen edentulous elderly volunteers (7 male, 6 female; aged 75-86, mean age 81.2) and 19 dentulous elderly volunteers (12 male, 7 female; aged 80-87, mean age 81.2) as a control group participated in this study. Participants reported no clinical symptoms relating to dysphagia, neurological impairments, or degenerative diseases. MEASUREMENTS: Participants were asked to swallow a 10-mL barium sulfate solution three times. Edentulous older people were asked to swallow the solution while wearing dentures and with dentures removed. Functional swallowing was recorded on cine-film with a digital subtraction angiography system. Lateral cinefluorography images were obtained from seated subjects. Using a cine-projector, visual images were evaluated qualitatively and quantitatively. RESULTS: No participants exhibited aspiration. The occurrence of laryngeal penetration in the edentulous older people not wearing dentures was the only significant difference (P<.05). CONCLUSION: Only laryngeal penetration differed significantly between edentulous older people not wearing their dentures and dentulous older people.

Aspects of swallowing in healthy dentate elderly persons older than 80 years.

BACKGROUND: Although age-related changes resulting in slowing of the swallowing reflex and a decline in the neuromuscular control system have been reported, there have been few reports on swallowing function in dentate elderly persons. The purpose of this study was to clarify the primary influence of aging on swallowing in healthy dentate elderly persons older than 80 years who have more than 20 teeth. METHODS: Dentate elderly persons (12 male, 7 female; mean age: 81.2 years) and dentate young participants (9 male, 5 female; mean age: 26.8 years) as a control group participated voluntarily. Participants reported no clinical symptoms relating to dysphagia, neurologic impairments, or degenerative diseases, and were asked to swallow 10 ml of barium sulfate solution (10% w/v) three times. Functional swallowing was recorded on 35 mm cinefilm at 30 frames per second with a digital subtraction angiography system. Lateral images of cinefluorography of seated participants' mouth, pharynx, and larynx were obtained. Visual image analysis for qualitative and quantitative evaluation was made with a cine projector. RESULTS: No participants exhibited aspiration during three trials. Occurrence and frequencies of piecemeal deglutition, premature loss of liquid, oral and pharyngeal residues, and laryngeal penetration were significantly greater in dentate elderly persons (p <.05) than in the dentate young participants. Oral transit time, pharyngeal delay time, and pharyngeal transit time in dentate elderly persons were prolonged significantly compared with those in dentate young participants (p <.01). CONCLUSION: Physiological swallowing functions deteriorate even in healthy dentate elderly persons. This deterioration may be explained primarily by the influence of aging on swallowing.