Structure and Validity of Questionnaire for Oral Frail Screening.

Oral frailty is defined as the mild decline in oral function and located at the early and reversible stage of frailty. Therefore, early detection and early treatment of oral frailty is very useful. Simple and easy questionnaires, such as an oral frailty checklist, have been widely used for the screening and enlightenment of oral frailty of the Japanese people. We evaluate the structure and validity of the oral frailty checklist. The questionnaire of oral frailty was distributed for the citizens more than 50 years old from December 2018 to January 2019. The structural validity of the questionnaire is analyzed by structural equation modeling (SEM). The characteristics of the items are analyzed by Item Response Theory (IRT). The data of 725 subjects (360 men, 359 women, 6 no answer, mean age 71.3 ± 9.05) are analyzed. The questionnaire consisted of three latent variables. Items of "Brushing teeth at least twice a day", "Regular attendance of dental clinic", and "Using denture", had low discrimination ability. The questionnaire used in this study is a useful tool for the screening of oral frailty. However, its scoring system needs to be improved.

Does Last Year's Cost Predict the Present Cost? An Application of Machine Leaning for the Japanese Area-Basis Public Health Insurance Database.

The increasing healthcare cost imposes a large economic burden for the Japanese government. Predicting the healthcare cost may be a useful tool for policy making. A database of the area-basis public health insurance of one city was analyzed to predict the medical healthcare cost by the dental healthcare cost with a machine learning strategy. The 30,340 subjects who had continued registration of the area-basis public health insurance of Ebina city during April 2017 to September 2018 were analyzed. The sum of the healthcare cost was JPY 13,548,831,930. The per capita healthcare cost was JPY 446,567. The proportion of medical healthcare cost, medication cost, and dental healthcare cost was 78%, 15%, and 7%, respectively. By the results of the neural network model, the medical healthcare cost proportionally depended on the medical healthcare cost of the previous year. The dental healthcare cost of the previous year had a reducing effect on the medical healthcare cost. However, the effect was very small. Oral health may be a risk for chronic diseases. However, when evaluated by the healthcare cost, its effect was very small during the observation period.

Nutritional Status and Oral Frailty: A Community Based Study.

Compromised oral health can alter food choices. Poor masticatory function leads to imbalanced food intake and undesirable nutritional status. The associations among nutritional status, oral health behavior, and self-assessed oral functions status were investigated using a community-based survey. In total, 701 subjects more than 50 years old living Ebina city located southwest of the capital Tokyo were investigated. The number of remaining teeth was counted by dental hygienists. Oral health behavior and self-assessed oral functions were evaluated by oral frailty checklist. Nutritional status was evaluated by the brief-type self-administered diet history questionnaire using Dietary Reference Intakes for Japanese as reference. More than 80% of subjects' intakes of vitamin B12, pantothenic acid, copper, and proteins were sufficient. In contrast, only 19% of subjects' intake of vitamin A was sufficient and 35.5% for vitamin B1. More than 90% of subjects' intakes of vitamin D and vitamin K were sufficient. Only 35.5% of subjects' intakes of dietary fiber were sufficient. Overall, 88.9% of subjects had excess salt. The number of remaining teeth was not correlated with nutritional intakes. Oral health behavior significantly correlated with nutritional intakes. Oral functions are important for food choice; however, oral functions were not directly correlated with nutritional intakes. Comprehensive health instructions including nutrition and oral health education is necessary for health promotion.

Primary Palatoplasty for Unilateral Cleft Lip and Palate Using Mucosal Grafts and Flaps.

The mucosal graft and flaps method (MG method) is a palatoplasty technique that was developed for the purpose of improving maxillary growth in patients with cleft palate. In the MG method, full-thickness buccal mucosa is grafted onto the raw surface created by pushback palatoplasty. The method is unlikely to result in severe scarring and has a favorable effect on maxillary growth. In addition, it is unlikely to result in oronasal fistula and provides good speech results. Overall, postive long-term treatment results have been obtained. Although the MG method is technically difficult and requires a lengthy surgery, the technique is considered to be effective for palate closure in terms of speech and maxillary growth.

Characterization of acoustic cavitation in water and molten aluminum alloy.

High-intensive ultrasonic vibrations have been recognized as an attractive tool for refining the grain structure of metals in casting technology. However, the practical application of ultrasonics in this area remains rather limited. One of the reasons is a lack of data needed to optimize the ultrasonic treatment conditions, particularly those concerning characteristics of cavitation zone in molten aluminum. The main aim of the present study was to investigate the intensity and spectral characteristics of cavitation noise generated during radiation of ultrasonic waves into water and molten aluminum alloys, and to establish a measure for evaluating the cavitation intensity. The measurements were performed by using a high temperature cavitometer capable of measuring the level of cavitation noise within five frequency bands from 0.01 to 10MHz. The effect of cavitation treatment was verified by applying high-intense ultrasonic vibrations to a DC caster to refine the primary silicon grains of a model Al-17Si alloy. It was found that the level of high frequency noise components is the most adequate parameter for evaluating the cavitation intensity. Based on this finding, it was concluded that implosions of cavitation bubbles play a decisive role in refinement of the alloy structure.

Modulation of masticatory muscle activity by tongue position.

The purpose of this study was to test whether the tongue position affects the electromyographic (EMG) activities of masticatory muscles. We recorded the EMG activities of the masseter and anterior temporalis muscles in 10 skeletal Class I adults. Tongue position was monitored by two pressure transducers embedded in the midpalatal region and the lingual flange of a custom-made acrylic monoblock. We instructed subjects to assume three different tongue positions: rest, superior, and anterior. Friedman's test and Sheffe's F-test were used to statistically examine differences in muscle activities induced by changes in tongue position. Significant differences were found in masseter muscle activity between the rest and anterior positions and in anterior temporalis muscle activity between the rest and both the anterior and the superior tongue positions. We concluded that masticatory muscle activity is affected by tongue position.

Modulation of voluntary swallowing by visual inputs in humans.

The purpose of this study was to test the hypothesis that a stimulus which strengthens a central input to a swallowing-related cortical area, given before voluntary swallowing, could facilitate subsequent swallowing movements. The subjects consisted of seven healthy volunteers. We used visual images to strengthen central input. The subjects voluntarily performed either dry swallowing or water swallowing after presentation of the visual images. Under the water-swallowing condition, the latency was significantly shorter and the maximum amplitude of the suprahyoid electromyographic (EMG) activity was significantly smaller in subjects who received drink-related visual input. However, there were no similar differences under the dry-swallowing condition. In addition, there were no significant differences in the mean EMG amplitude or the duration of EMG activity between subjects who did and did not receive drink-related visual input under either swallowing condition. We concluded that drink-related visual inputs prior to voluntary swallowing facilitate the initiation of swallowing and enhance swallowing-related muscle activity in the presence of peripheral inputs.

Effects of experimental nasal obstruction on human masseter and suprahyoid muscle activities during sleep.

The effect of nasal obstruction on nocturnal masseter and suprahyoid muscle activities using a newly developed portable electromygram (EMG)-recording unit was examined. Ten healthy Japanese males participated in this study. EMG activities of both the right masseter and bilateral suprahyoid muscles were recorded with a portable EMG-recording unit. At midnight, the subject was asked to lie on a bed after complete preparation with surface electrodes. After maximal clenching and jaw-opening effort (100% maximum voluntary contribution), the subject was allowed to fall asleep. In the first half of the night, EMG activities were recorded for about three hours of sleep without nasal obstruction. In the second half of the night, EMG activities were recorded for about three hours of sleep with nasal obstruction. In both muscles, there were no significant changes in either the maximal EMG activities or the number of events beyond 40% MVC with nasal obstruction. But in an evaluation based on the distribution of muscle activities, the EMG activity of the masseter muscle tended to decrease (P = .07) and that of the suprahyoid muscles increased significantly (P = .02) with nasal obstruction. These results suggest that nasal obstruction could modulate the activities of the masseter and suprahyoid muscles during sleep.

Comparison of the sizes of adenoidal tissues and upper airways of subjects with and without cleft lip and palate.

The purpose of this retrospective study was to compare 2-dimensionally the sizes of the adenoidal tissues and the upper airways in juvenile and adolescent males with and without cleft lip and palate (CLP). Two paired groups of age-matched boys were used: (1) 90 juveniles with CLP (CLP/j) and without CLP (control/j) and (2) 40 adolescents with CLP (CLP/a) and without CLP (control/a). Measurements of adenoidal tissues and upper airways were determined by using lateral cephalograms. The adenoidal tissue was significantly larger in the CLP/j group than in the control/j group, but there was no significant difference between the CLP/a and control/a groups. The adenoidal tissue was significantly smaller in the CLP/a group than in the CLP/j group. The upper airway in the CLP/j group was significantly smaller than that in the control/j group, and that in the CLP/a group was also significantly smaller than that in the control/a group. Moreover, the upper airway in the CLP/a group was significantly larger than that in the CLP/j group, and that in the control/a group was significantly larger than that in the control/j group. However, the upper airway in the CLP/a group was significantly smaller than that in the control/a group. These results suggest that the larger adenoidal tissues in the CLP/j group, compared with those in the control/j group, decreased to a similar size with aging. However, the more restricted upper airway in the CLP/j group, compared with that in the control/j group, appeared to persist until adolescence.

Nocturnal masseter and suprahyoid muscle activity induced by wearing a bionator.

The purpose of this study was to examine the effect of a bionator on masseter and suprahyoid muscle activities during sleep. Ten healthy Japanese males (mean age: 26.3 years) participated in this study. Electromyographic (EMG) activities of the right masseter and bilateral suprahyoid muscles were recorded during sleep with and without a bionator. Although no significant changes were observed in the maximal EMG activities of these muscles, the maximal EMG activity of suprahyoid muscles tended to decrease while wearing the bionator. The number of events over 40% maximal voluntary contraction (MVC) tended to decrease in these muscles with a bionator, but these changes were not statistically significant. These findings indicate that there are no significant changes or there is only a tendency to decrease the activities of the masseter and suprahyoid muscles while wearing a bionator during sleep.

Effects of mandibular position and body posture on nasal patency in normal awake subjects.

The purpose of this study was to examine the changes in nasal patency induced by forward mandibular displacement or changes in body posture. Fifteen healthy adults participated in this study. To examine the influence of mandibular position, nasal resistance was recorded in intercuspal, middle, and maximum forward positions. To evaluate the effect of body posture, nasal resistance was recorded in the four postures of sitting erect, 30 degrees and 60 degrees dorsally reclined, and supine. The nasal patencies recorded in the middle and maximum forward mandibular positions were significantly higher than those recorded in the intercuspal position. Regarding the effect of body posture, the nasal patency showed a progressive decrease from the sitting erect position to the supine position. These results suggest that changes in mandibular position and body posture significantly affect nasal patency and that mandibular position and body posture should be considered basic information in the treatment of obstructive sleep apnea.