Does Systemic Arterial Hypertension Change the Function of the Stomatognathic System?

The aim of this study was to evaluate the stomatognathic system of individuals with controlled systemic hypertension through comparison with a disease-free control group. Seventy individuals (44 female and 26 male) were divided into two groups: a controlled systemic hypertension (n=35) and a disease-free control (n=35). The individuals were evaluated on the basis of masticatory cycle efficiency of the value of the ensemble-averaged integrated linear envelope to the electromyographic signal of the masseter and temporalis muscles in the habitual (peanuts and raisins) and non-habitual chewing (Parafilm M); molar bite force (right and left) and ultrasound images from the bilateral masseter and temporal muscles at rest and maximum voluntary contraction. The data obtained were tabulated and submitted to statistical analysis (p<0.05). There was a significant difference between groups in the habitual (peanuts and raisins) and non-habitual (Parafilm M) chewing with reduced muscle activity to controlled systemic hypertension group. Muscle thickness occurred significant difference between groups at rest and maximum voluntary contraction of the temporalis muscles. There was no significant difference between groups in maximum molar bite force. The present study findings indicate that the controlled systemic hypertension promotes functional changes of the masticatory system, especially with respect to its masticatory efficiency and muscle thickness.

Alterations in masticatory cycle efficiency and bite force in individuals with periodontitis.

OBJECTIVES: The objective of this research was to evaluate the effect of periodontitis on masticatory cycle efficiency and maximum molar bite force. METHODS: Twenty-four individuals were divided into two groups: With periodontitis (Group I; mean age ± standard deviation (SD), 51.3 ± 2.8 years; n = 12) and without periodontitis (Group II; mean age ± SD, 48.9 ± 2.4 years; n = 12). Masticatory cycle efficiency was obtained from the value of the ensemble-averaged integrated linear envelope electromyographic signal of the masseter and temporalis muscles. Maximum bite force was recorded for the right and left molar regions. The data were tabulated and submitted to statistical analysis (P ≤ 0.05). RESULTS: There was a significant difference between the groups for the left masseter muscle when chewing raisins (P = 0.04), peanuts (P = 0.02), and biocapsules (P = 0.01). Multiple regression analysis demonstrated the influence of dental mobility on masticatory cycle efficiency for peanuts (P = 0.03) and biocapsules (P = 0.01). The maximum bite force for the left molar region was significantly different between the groups (P = 0.02). Dental mobility was a variable that had a greater effect on masticatory cycle efficiency. The periodontitis group had a reduced bite force. CONCLUSION: The present study findings indicate that the loss of periodontal supporting structures had a negative impact on masticatory cycle efficiency and molar bite force. This finding suggested that dental mobility should be considered when determining clinical treatments aimed at improving masticatory efficiency and bite force in individuals with the periodontal disease.

Masticatory performance with different types of rehabilitation of the edentulous mandible

Abstract Aim: To compare the masticatory performance associated with different rehabilitation strategies for patients with edentulous mandibles. Methods: one portion of the test food "Optocal" was provided to groups: Natural Dentition (n = 15), Mandibular Fixed Implant-Supported Prosthesis with Maxillary Fixed Prosthesis (n = 8), Mandibular Fixed Implant-Supported Prosthesis with Maxillary Removable Prosthesis (n = 14), Mandibular Implant-Retained Overdenture with Maxillary Removable Prosthesis (n = 16), and Complete Dentures (n = 16). The portion was collected after 40 chewing strokes, and then passed through a stack of eight sieves with decreasing apertures. Masticatory performance was determined by weighing the portion of food on each sieve. Results: the masticatory performance was: 71.00% for Natural Dentition, 41.57% for Mandibular Fixed Implant-Supported Prosthesis with Maxillary Fixed Prosthesis, 31.44% for Mandibular Fixed Implant-Supported Prosthesis with Maxillary Removable Prosthesis, 27.70% for Mandibular Implant-retained Overdenture, and 14.33% for Complete Dentures. The data were statistically compared using Student's t-test (p < 0.05). Natural Dentition and Complete Denture groups were statistically different from all other groups, with the Natural Dentition and Complete Denture groups exhibiting the highest and lowest masticatory performance values, respectively. Conclusions: Osseointegrated implants improved the masticatory performance of all implant-supported groups compared to the Complete Dentures group.

Changes in masticatory performance and quality of life in individuals with chronic periodontitis.

BACKGROUND: This study evaluates the effect of periodontitis on masticatory performance and quality of life index. METHODS: Patients (n = 24; 23 to 76 years of age) with periodontal conditions ranging from healthy to generalized disease categorized by the alveolar bone height-to-tooth length (AB/T) ratio were separated into the following two groups: control (AB/T >50%) and test (AB/T <50%). The masticatory performance was evaluated through continuous mastication of a special device called a biocapsule. The Brazilian Oral Health Impact Profile (OHIP-14Br) questionnaire was used to assess the oral health-related quality of life. The Student t test was applied for independent samples (P <0.05) to evaluate the masticatory performance, and the Mann-Whitney U test was used to determine quality of life (P <0.05). RESULTS: There was a statistically significant difference in masticatory efficiency between groups (P = 0.006). Statistically significant differences were also observed in the following parameters: 1) physical pain (P = 0.003); 2) psychologic discomfort (P = 0.008); 3) physical disability (P = 0.033); and 4) OHIP-14Br total score (P = 0.001). The control group achieved the best indicators. Both the masticatory performance and quality of life indicators showed significant correlation with the alveolar bone height. CONCLUSION: The loss of periodontal supporting structures has negative effects on the masticatory performance and quality of life.

Mandibular overdentures with immediate loading: satisfaction and quality of life.

PURPOSE: The aim of this study was to verify quality of life related to oral health and satisfaction with dentures. Conventional mandibular complete dentures were converted to overdentures retained by two implants with immediate loading (bar-clip system, n = 16). MATERIALS AND METHODS: The Brazilian short version of the Oral Health Impact Profile (OHIP-14Br) was used to evaluate the impact of oral health on quality of life. Satisfaction with the prostheses was obtained by means of a questionnaire addressing satisfaction with the present prostheses and through use of a visual analog scale (VAS). RESULTS: The results of the OHIP-14Br questionnaire were verified at 3 and 6 months after conversion from complete dentures to a mandibular overdenture. The satisfaction questionnaire for the mandibular prostheses obtained 43.75% satisfaction before conversion and 100% satisfaction at 1 week and 3 and 6 months after conversion. The satisfaction results of the prostheses, both maxillary and mandibular, were 68.75% before conversion, 93.75% at 1 week and 3 months after conversion, and 87.5% at 6 months. There was an immediate improvement in patients' satisfaction with the mandibular overdenture prostheses regarding stability and retention (Friedman test, P = .000) and quality of life (Friedman test, P = .001). CONCLUSION: The improvement seen justifies the immediate loading approach used in this study.

Overdenture with immediate load: mastication and nutrition.

Lower conventional complete dentures were converted to overdentures retained by two implants with an immediately loaded bar-clip system (n 16). The masticatory performance test was carried out using 'Optocal' after forty chewing strokes. Nutritional condition was evaluated by means of a Mini-Nutritional-Assessment questionnaire. No individual was classified as malnourished. The masticatory performance test demonstrated a statistically significant difference before conversion (baseline) and 3 and 6 months after conversion of the lower conventional complete denture to an implant-retained overdenture (paired-samples t test; P < 0·05). A statistically significant difference before and after 6 months of conversion for nutritional condition (Wilcoxon test; P < 0·05) was also observed. The association between masticatory performance and nutritional assessment demonstrated that a statistically significant difference between masticatory performance of the subgroups classified at baseline as nourished (22·43 %) and those at risk of malnutrition (3·9 %) was only evidenced before conversion (P = 0·006). After the conversion from a lower conventional complete denture to an implant-retained overdenture, at 3 months, the risk of malnutrition and nourished at baseline did not present significant differences in masticatory performance. Nonetheless, the mean masticatory performance potential was 19·86 and 31·98 % for subgroups classified at baseline as at risk of malnutrition and nourished, respectively (P = 0·187). The results before conversion were less favourable for masticatory performance and nutritional condition. The increased retention of the mandibular prosthesis allowed improvement in masticatory performance and nutritional condition.

Comparison of masticatory function between subjects with three types of dentition.

PURPOSE: The aim of this study was to evaluate the effect of an oral rehabilitation program on masticatory performance and ability as a function of the number of masticatory cycles. Subjects with a mandibular fixed implant-supported prosthesis (ISP), complete dentures (CDs), or a natural dentition (ND) were evaluated. MATERIALS AND METHODS: Masticatory performance was tested with an artificial test food (Optocal). Optocal was provided to subjects in two portions of 17 cubes and collected after both 20 and 40 masticatory cycles. The particles were collected on stacks of eight sieves. The geometric mean diameter of the chewed particles was calculated using the sieves. Questionnaires were used to assess masticatory ability before and after the fixed mandibular rehabilitation program. The geometric mean diameter of the chewed particles was compared by two-way analysis of variance followed by the Tukey test (P < .05). RESULTS: The geometric mean diameter for all groups was lower after 40 cycles versus 20 cycles. When compared to the ND group, masticatory performance for the CD and ISP groups was 12% and 28% after 20 cycles and 31% and 61% after 40 cycles, respectively. The data for the masticatory ability of the ISP group before and after fixed mandibular rehabilitation were compared by the McNemar test (P < .05), and showed that 100% of these subjects were satisfied with their chewing capacity after fixed mandibular rehabilitation. CONCLUSIONS: These results quantify the differences in masticatory function among different types of dentition. Greater masticatory function for fixed mandibular rehabilitation versus CDs was demonstrated.

Função mastigatórias de individuos reabilitados com próteses totais mucoso suportadas / Masticatoy function of subjects rehabiletated with convtional complete denture

Objetivo: Avaliar a função mastigatória de indivíduos reabilitados com próteses totais muco-suportadas,consideradas adequadas ou boas (índice de Kapur), por meio de testes objetivos e subjetivos e verificar a influência da qualidade e do tempo de uso das próteses. Método: Testes de performance mastigatória (PM), utilizando o simulador dealimento Optocal, foram realizados com 20 e 40 golpes mastigatórios em 21 indivíduos com próteses totais (grupo PT) e 15 com dentição natural (grupo DN). O índice de performance mastigatória foi obtido por meio do cálculo do Diâmetro Geométrico Médio das partículas mastigadas e tamisadas. Resultados: Após análise estatística (Tukey b, p<0,05), observou-se que o grupo PT apresentou 12 por cento e 31 por cento da performance alcançada pelos indivíduos do grupo DN, após 20e 40 golpes, respectivamente, sendo que a literatura quantifica a mesma de 20 por cento a 30 por cento da dentição natural. Não foram verificadas diferenças estatisticamente significantes (Teste-tde student, p<0,05) entre a PM e a habilidade mastigatória, bem como à qualidade das próteses do grupo PT. Em relação ao tempo de uso das próteses, usuários acima de seis meses obtiveram melhores resultados, possivelmente por estarem mais adaptados às próteses. Conclusão: No limite deste trabalho, podemos concluir que usuários de próteses totais consideradas adequadas ou boas melhoraram sua PM após seis meses de uso. Ressaltando que com 20 golpes, no referido simulador de alimento, o resultado (12 por cento) foi inferior aos descritos na literatura.