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.

Effect of photofunctionalization on titanium bone-implant integration in ovariectomized rats.

Osteoporosis is considered a risk factor for osseointegration during implant treatment. Photofunctionalization of titanium has been shown to improve bone-based cell adhesion, proliferation, and functional expression, increasing the bone-implant contact rate and bone-implant integration strength. This study aimed to test the hypothesis that photofunctionalization is effective for implant fixation using an osteoporosis rat model. In the biomechanical push-in test, the bone-implant integration strength of the photofunctionalization treatment group was 1.53 times that of the control group (p<0.05). These values implied that photofunctionalization restored the ovariectomy-induced low bone-implant integration strength to normal states. In the micro-CT analysis, the BV/TV of the photofunctionalization treatment group was 1.32 times that of the control group (p<0.05). These values implied that photofunctionalization restored the ovariectomy-induced low peri-implant bone formation to normal states. These results indicate that photofunctionalization treatment increased peri-implant bone formation and bone-implant integration strength in ovariectomized rats.

Three-dimensional electron paramagnetic resonance imaging of mice using ascorbic acid sensitive nitroxide imaging probes.

Nitroxide compounds have been used as redox-sensitive imaging probes by electron paramagnetic resonance (EPR) for assessing oxidative stress in vivo. Fast redox reactions of nitroxide radicals are favorable for assessment of higher redox sensitivity; however, a variety of nitroxides have not been trialed for use as imaging probes due to their very rapid in vivo reduction, which cannot be captured at the slow operation speed of existing EPR imagers. To overcome this limitation, we improved our EPR system to provide a stable and highly sensitive imaging operation. We challenged the improved EPR imager to perform three-dimensional (3D) EPR imaging of mouse brain using two useful nitroxide imaging probes, 4-hydroxy-2,2,6,6-tetramethylpiperidine 1-oxyl (Tempol) and 2,6-dispiro-4',4"-dipyrane-piperidine-4-one-N-oxyl (DiPy). The second-order rate constant of DiPy with ascorbic acid is 10 times larger than that of Tempol. The improved EPR imager obtained clear 3D EPR images of mouse brain and demonstrated that Tempol could exist with an unpaired electron. The imager also successfully obtained 3D EPR images of mouse head after administration of DiPy. As 126 projections can be acquired in a period of 6 s, 3D EPR imaging can visualize the sequential process of DiPy entering the brain, being distributed within the brain, and being reduced within the brain. These improvements to the EPR imager will enable useful nitroxide imaging probes that were previously unsuitable as imaging probes due to their rapid reduction to be considered for use for sensitive redox assessment in an in vivo system.

Early detection of redox imbalance in the APPswe/PS1dE9 mouse model of Alzheimer's disease by in vivo electron paramagnetic resonance imaging.

Alzheimer's disease (AD) is a common neurodegenerative disease that causes progressive cognitive decline. Deposition of amyloid-ß (Aß) peptides is the most important pathophysiological hallmark of AD. Oxidative stress induced by the generation of reactive oxygen species (ROS) is a prominent phenomenon in AD and is known to occur early in its course. Several reports have suggested a relationship between changes in redox status and AD pathology, including progressive Aß deposition, glial cell activation, and inflammation. In the present study, we employed a newly designed three-dimensional continuous-wave digital electron paramagnetic resonance (EPR) imager with a blood-brain barrier (BBB)-permeable redox-sensitive piperidine nitroxide probe, 4-oxo-2,2,6,6-tetramethyl-piperidine-d16-1-oxyl, for early detection of changed brain redox status. Using this system, we noninvasively compared age-matched 7-month-old AD model mice with normal littermates (WT mice). The obtained brain redox images of AD and WT mice clearly showed impaired brain redox status of AD mice compared to WT, suggesting that oxidative damage had already increased in 7-month-old AD mice compared with age-matched WT mice. The pathological changes in 7-month-old mice in this study were detected earlier than in previous studies in which only AD mice older than 9 months of age could be imaged. Since EPR images suggested that oxidative damage was already increased in 7-month-old AD mice compared to age-matched WT mice, we also evaluated antioxidant levels and the activity of superoxide dismutase (SOD) in brain tissue homogenates of 7-month-old AD and WT mice. Compared to WT mice, decreased levels of glutathione and mitochondrial SOD activity were found in AD mice, which supports the EPR imaging results indicating impaired brain redox status. These results indicate that the EPR imaging method developed in this study is useful for early noninvasive detection of altered brain redox status due to oxidative disease.

Usefulness of the newly developed artificial denture plaque for practical denture care training.

OBJECTIVES: The aim of this study was to investigate whether the newly developed artificial dental plaque (A-DP) is useful as an educational tool for denture care of dental hygienist that compared it with conventional artificial dental plaque from the viewpoint of practical skills. MATERIAL AND METHODS: The 125 dental hygienist school students and 26 dental hygienists who had clinical experience were subjected a practical training of denture plaque control using the conventional denture plaque (C-DP) and the A-DP. The questionnaires based on the semantic differential method were used to survey whether the A-DP is similar to the real denture plaque (R-DP). Factor analysis by rotation of promax was carried out. RESULTS: In the results of the factor analysis, the two factors could be detected in students and three factors in dental hygienists. The total score of each denture plaque was calculated for each factor, and correlation coefficient was examined. There was significant correlation between the A-DP and the R-DP at the first factors, both students and dental hygienists. C-DP was not similar to R-DP in all factors. CONCLUSIONS: These results suggested that A-DP resembles R-DP better than C-DP. It was concluded that the A-DP was similar to the R-DP and could be a potent educational tool for practical denture care.

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.

NaOCl-mediated biofunctionalization enhances bone-titanium integration.

The aim of this study was to examine the effect of NaOCl pretreatment on the biomechanical fixation of implant at the early healing stage of a rat model. Polished titanium cylindrical implants and disks were prepared, and one-half of these samples were dual acidetched. Then, one-half of both surfaces were chemically-cleaned by pretreatment with 5% NaOCl solution for 24 h. Morphological analyses showed that there was no significant difference between before and after NaOCl treatment. The wettability measurement demonstrated that NaOCl treatment secondarily converted both titanium surfaces from hydrophobic to superhydrophilic, accompanied by the removal of hydrocarbons from the titanium surfaces. Biomechanical push-in test indicated that the bone-titanium integration strength of the NaOCl-treated implants were significantly greater than that of the untreated implants (p<0.05). These results showed that NaOCl pretreatment enhanced the osseointegration capability of titanium, indicating its potential for a simple chemical chair-side pretreatment method.

Alteration of masticatory function by diet change induces stress responses in Wistar rats.

The occlusion-mastication system has extradigestive functions; however, whether liquid feeding evokes stress responses remains unclear. In this study, reactions to low masticatory performance were analyzed using a diet-alteration model in Wistar rats. Seven days after the diet of the rats was changed from solid to liquid, serum epinephrine and norepinephrine concentrations were found to be elevated by 205% and 158% compared to baseline values, respectively. Superoxide production by peritoneal neutrophils was higher in rats fed with a liquid diet than in those fed with a solid diet. Serum superoxide dismutase activity (i.e. the potential to eradicate serum superoxide) was lower in rats fed with liquid than in those fed with a solid diet, indicating that the former experienced oxidative stress. Conversely, the oxidative stress was removed following reversion of the liquid diet to solid diet. These results suggest that liquid diet mastication can cause mental stress, including an oxidative stress response.

Relationship between periodontal status and intellectual function among community-dwelling elderly persons.

OBJECTIVE: The aim of this study was to indicate the relationship between periodontal status and intellectual function in the elderly. BACKGROUND: Periodontal status has been shown to be related to demographic, socioeconomic, and psychological status. Intellectual function is a significant indicator of health status. Nevertheless, the relationship between periodontal status and intellectual function has not been elucidated in detail among the elderly. MATERIALS AND METHODS: A total of 152 community-dwelling elderly persons, aged 70-74 years, were enrolled in the study. Periodontal status was evaluated using the WHO Community Periodontal Index of Treatment Needs (CPITN). Intellectual function was assessed by four neuropsychological tests: Raven's Coloured Progressive Matrices (RCPM) test, the Verbal Paired Associates 1 (VerPA) task and the Visual Paired Associates 1 (VirPA) task, extracted from the Wechsler Memory Scale Revised Edition, and the Block Design subtest, extracted from the Wechsler Adult Intelligence Scales, Third Edition. Correlations between CPITN and each test were examined using Spearman rank correlation coefficients. The ordinal regression model was constructed with CPITN as the dependent variable and neuropsychological test as the principal independent variable to adjust for demographic factors, general health, lifestyle and oral health behaviour. RESULTS: Significant correlations were found between the RCPM test, the VerPA task, the Visual Paired Associates 1 and CPITN. In the ordinal regression model, CPITN was significantly related to measures of RCPM after adjusting for demographic factors, general health status, lifestyle and oral health behaviour. CONCLUSION: Intellectual function is considered a significant indicator of periodontal status among community-dwelling elderly persons.

Effect of mastication on functional recoveries after permanent middle cerebral artery occlusion in rats.

OBJECTIVES: We evaluated whether solid feed is more effective for functional recoveries than liquid feed in rats with ischemic brain injury after permanent middle cerebral artery occlusion (MCAO). METHODS: A total of 36 male Wistar/ST rats were subjected to MCAO or sham surgery. After MCAO or sham surgery, all rats were provided liquid feed for 14 days. Then, all rats were divided into 3 groups: the solid feeding group, the liquid feeding group, and the solid feeding group of sham. Effect of mastication on functional recoveries after permanent MCAO in rats was evaluated by the limb placement test and Morris water maze (MWM) task. RESULTS: After surgery, limb placement test scores were equal in both MCAO groups. In the acquisition trials of MWM task, statistically significant differences in escape latency were observed between the liquid feeding group and sham groups at all days, and between the solid feeding group and sham groups at days 3 and 4 of the trials. In the probe trial, statistically significant differences in time spent were observed between the liquid feeding group and sham group. On day 5 of acquisition trials, the time spent in the periphery of the pool in MWM task was significantly different among the 3 groups. CONCLUSION: This study suggested that solid diet mastication could be effective for the rehabilitation of sensorimotor and learning/memory dysfunction induced by cerebral infarction.

Effect of wearing a palatal plate on swallowing function.

PURPOSE: The purpose of this study was to determine the effect of wearing a palatal plate on swallowing function. METHODS: The subject group consisted of 10 healthy, fully dentate males. Two experimental palatal plates (EPP) were used in this study: one was 1.4mm thick (EPP1), and the other was 2.8mm thick (EPP2). Tongue movements and swallowing sounds were simultaneously recorded. The position of the surface of the tongue was recorded by using ultrasound diagnostic equipment in the sagittal plane. Swallowing tests were performed under three conditions: without EPP (WOE), with EPP1 (WP1), and with EPP2 (WP2). Swallowing index (SI) and tongue contact time (TCT) was calculated. RESULTS: The value of SI was lowest under WOE, and highest under WP2, with a statistically significant difference. There was no statistical significance, however, between SI under WOE and that under WP1. The value of TCT was longest under WOE, and shortest under WP2, with a statistically significant difference. CONCLUSIONS: This investigation suggests that the thickness of a palatal plate influences SI and TCT, which correlate with swallowing function.

Mandibular residual ridge shape and the masticatory ability in complete denture wearers.

PURPOSE: The purpose of this study was to investigate the influence of mandibular residual ridge shape on the masticatory ability in complete denture wearers. METHODS: The subject group consisted of 199 complete denture wearers. The mandibular residual ridge of each subject was evaluated using a replica of the ridge which was obtained with heavy-body silicone impression material. The basal area of each replica was measured with a digitizer. The volume and the height of each replica were also calculated. The masticatory ability of each subject was evaluated using a-25-item food intake questionnaire method by authors. The masticatory score of each subject was calculated to represent the masticatory ability. Furthermore, all subjects were divided into three groups (S, M, L group) according to the value of the basal area. RESULTS: There were statistically significant correlations between the basal area of the residual ridge and the masticatory score (r = 0.366, p < 0.01), and also the volume of the residual ridge and the masticatory score (r = 0.314, p < 0.01). The basal area of the residual ridge, the volume of the residual ridge, and the masticatory score of the L group (29 persons) were statistically larger than those of the M group (136 persons) and the S group (34 persons) (p < 0.05), and those values in the M group were statistically larger than those of the S group (p < 0.05). CONCLUSION: It was confirmed that the basal area of denture foundation of the mandible had an influence on the masticatory ability in complete denture wearers.

CYP24 promoter activity is affected by mechanical stress and mitogen-activated protein kinase in MG63 osteoblast-like cells.

PURPOSE: For bone homeostasis, vitamin D plays an important role in the regulation of calcium. The enzyme CYP24 inactivates vitamin D and is involved in its regulation. However, the mechanism of expression of CYP24 in osteoblastic cells under mechanical stress is not clear. In this study we investigated CYP24 promoter activity in stretched osteoblastic cells and the participation of mitogen-activated protein kinase (MAPK) in expression of CYP24. METHODS: MG63 osteoblastic cells were cultured on silicon-bottomed plates. Cells were transfected with a reporter gene that contained a CYP24 promoter. After activated vitamin D, 1,25(OH)2D3, was added or not added, cells were stretched. Stretched and non-stretched cells were investigated by luciferase dual assay. Cells were also investigated similarly using medium with an ERK1/2 inhibitor or p38 inhibitor. RESULTS: The CYP24 promoter was activated by 1,25(OH)2D3 and the promoter activity decreased in stretched cells. Inhibitor of MAPK decreased CYP24 promoter activity. However, CYP24 promoter activity decreased with mechanical stress after addition of p38 inhibitor, while it did not decrease with mechanical stress after addition of ERK1/2 inhibitor. The CYP24 promoter was not activated without 1,25(OH)2D3 in any case. CONCLUSION: Mechanical stress and MAPK control CYP24 promoter activity in the presence of Vitamin D in MG63 osteoblast-like cells.

Nitric oxide activates leak K+ currents in the presumed cholinergic neuron of basal forebrain.

Learning and memory are critically dependent on basal forebrain cholinergic (BFC) neuron excitability, which is modulated profoundly by leak K(+) channels. Many neuromodulators closing leak K(+) channels have been reported, whereas their endogenous opener remained unknown. We here demonstrate that nitric oxide (NO) can be the endogenous opener of leak K(+) channels in the presumed BFC neurons. Bath application of 1 mM S-nitroso-N-acetylpenicillamine (SNAP), an NO donor, induced a long-lasting hyperpolarization, which was often interrupted by a transient depolarization. Soluble guanylyl cyclase inhibitors prevented SNAP from inducing hyperpolarization but allowed SNAP to cause depolarization, whereas bath application of 0.2 mM 8-bromoguanosine-3',5'-cyclomonophosphate (8-Br-cGMP) induced a similar long-lasting hyperpolarization alone. These observations indicate that the SNAP-induced hyperpolarization and depolarization are mediated by the cGMP-dependent and -independent processes, respectively. When examined with the ramp command pulse applied at -70 mV under the voltage-clamp condition, 8-Br-cGMP application induced the outward current that reversed at K(+) equilibrium potential (E(K)) and displayed Goldman-Hodgkin-Katz rectification, indicating the involvement of voltage-independent K(+) current. By contrast, SNAP application in the presumed BFC neurons either dialyzed with the GTP-free internal solution or in the presence of 10 muM Rp-8-bromo-beta-phenyl-1,N(2)-ethenoguanosine 3',5'-cyclic monophosphorothioate sodium salt, a protein kinase G (PKG) inhibitor, induced the inward current that reversed at potentials much more negative than E(K) and close to the reversal potential of Na(+)-K(+) pump current. These observations strongly suggest that NO activates leak K(+) channels through cGMP-PKG-dependent pathway to markedly decrease the excitability in BFC neurons, while NO simultaneously causes depolarization by the inhibition of Na(+)-K(+) pump through ATP depletion.

[Expectations for prosthetic dentistry as a health science].

Prosthodontics is a practical science based on life sciences and health sciences, and takes a role to contribute to improvement of health/welfare of peoples. By prosthodontic researches including life sciences and health science, it will be proved that the practice of prosthetic dental treatments is important to health/welfare. In addition, our research activities are expected because of the demographic change caused by the increase of aging population. The scientific research activity of our society is one of the activities for main medical/dental care demanded definitely in the 21st century. Especially, promotion of brain research is just going to be expected. From a prosthodontic treatment point of view, the improvement of diagnostic study focusing on the examining method and the inspecting method is desired. It is included in a diagnosis to predict a degree of functional recovery after prosthodontic treatments. For the evaluation of masticatory function, the evaluating method for the organ and tissue constituting stomatognathic system is necessary as well as the evaluating method for masticatory function. It is hoped that efforts will be made to establish evaluating methods for each organ and tissue in stomatognathic system will be made. As a corporate judicial person, we must build up public-interest activities. It is necessary to provide sufficient information to all dentists in order to offer a quality prosthodontic care by improvement of diagnostic and treatment abilities. Moreover, it is necessary to practice active enlightenment activity about clinical significance of prosthodontic treatment, and to develop strategies to make peoples recognize "prosthodontics as a health science" widely.

Influence of mandibular residual ridge shape on masticatory efficiency in complete denture wearers.

PURPOSE: The purpose of this study was to investigate the influence of mandibular residual ridge shape on masticatory efficiency in complete denture wearers. MATERIALS AND METHODS: Twenty-eight complete denture wearers (mean age 75.6 years, SD 4.8) who received their complete denture treatment by one of the authors and had no troubles in daily use were selected. The mandibular residual ridge was evaluated by using a replica of the ridge obtained with heavy-body silicone impression material. The basal area of the replica was measured by a digitizer. The volume and the height of the replica were calculated. Masticatory efficiency in each subject was measured by the sieving method. RESULTS: There was a significant correlation between the masticatory efficiency and basal area, volume, and height of the residual ridge. The basal area showed the strongest correlation. CONCLUSION: The basal area of the denture foundation greatly influenced the masticatory efficiency, suggesting that the masticatory efficiency in complete denture wearers was limited by their own residual ridges and that clinicians should inform their patients about the limitation of the recovery of masticatory ability before the beginning of denture treatment.