Influence of oral health condition on swallowing and oral intake level for patients affected by chronic stroke.

BACKGROUND: According to the literature, the occurrence of dysphagia is high in cases of stroke, and its severity can be enhanced by loss of teeth and the use of poorly fitting prostheses. OBJECTIVE: To verify that the status of oral health influences the level of oral intake and the degree of swallowing dysfunction in elderly patients with stroke in chronic phase. METHODS: Thirty elderly individuals affected by stroke in chronic phase participated. All subjects underwent assessment of their oral condition, with classification from the Functional Oral Intake Scale (FOIS) and nasoendoscopic swallowing assessment to classify the degree of dysphagia. The statistical analysis examined a heterogeneous group (HG, n=30) and two groups designated by the affected body part, right (RHG, n=8) and left (LHG, n=11), excluding totally dentate or edentulous individuals without rehabilitation with more than one episode of stroke. RESULTS: There was a negative correlation between the need for replacement prostheses and the FOIS scale for the HG (P=0.02) and RHG (P=0.01). Differences in FOIS between types of prostheses of the upper dental arch in the LHG (P=0.01) and lower dental arch in the RHG (P=0.04). A negative correlation was found between the number of teeth present and the degree of dysfunction in swallowing liquid in the LHG (P=0.05). There were differences in the performance in swallowing solids between individuals without prosthesis and those with partial prosthesis in the inferior dental arch (P=0.04) for the HG. CONCLUSION: The need for replacement prostheses, type of prostheses, and the number of teeth of elderly patients poststroke in chronic phase showed an association with the level of oral intake and the degree of oropharyngeal dysphagia.

Influence of ceramic shades on surface hardness of different resin cements.

OBJETIVES: The aim of this study was to evaluate the effect of different ceramic spacer shades on the Knoop hardness (KH) of dual-cure resin cements (RelyX ARC RLX, 3M ESPE; Variolink II VLK, Ivoclar Vivadent) cured for 20 seconds with an LED light-curing unit. MATERIALS: Eight groups (n equals 15) were tested as follows: RelyX Control (light-cured without ceramic spacer); RelyX-2M2 ceramic spacer; RelyX-5M3 ceramic spacer; RelyX self-cured. Similar conditions were used with Variolink II cement. A microhardness tester was used to measure the KH values. Specimens were subjected to five 50 g/15 s indentations following curing at 0, 1, 2, 3, 4, 6, 24, 168, and 336 hours in order to determine the point at which the cements reach the maximum KH values. RESULTS: Control groups exhibited significantly higher KH values than the other groups (P less than 0.001) at 0 h following light curing. The KH values for RelyX-2M2 were not significantly different than the control group (P greater than 0.05) after 336 hours. All groups tested with 5M3 spacers had KH values that were not significantly different from the groups with self-cure mode, P greater than 0.05. The KH values for RelyX self-cure cement were significantly higher than Variolink II self-cure, P equals 0.003. RelyX-2M2 had KH values that were not significantly different from that of Variolink-2M2, P greater than 0.05. CONCLUSIONS: Ceramic spacer shades have tremendous effect on the KH values of RelyX and Variolink II. Darker ceramic shades (5M3 spacers) interfere with the absorption of light by the cements tested. In addition, the chemical portion in the self-cured mode is not sufficient to achieve optimum microhardness.