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1.
J Am Dent Assoc ; 151(2): 118-126, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32000935

RESUMO

BACKGROUND: Decreased masticatory performance leads to deterioration of overall health among older adults. However, maintaining and improving masticatory performance in ways other than maintenance of natural teeth and appropriate prosthodontic treatment remains unclear. If the factors related to the mixing and shearing abilities for masticatory performance are clarified, it may be possible to maintain and improve the masticatory performance of older adults. We aimed to clarify the association among mixing ability, shearing ability, and masticatory performance-related factors. METHODS: Of the 707 community-dwelling older adults in Kusatsu Town, Japan, 344 who had been treated for any dental defects were enrolled in this study. Masticatory performance was evaluated on the basis of mixing ability and shearing ability. The number of natural teeth and artificial teeth, occlusal force, tongue pressure, and oral diadochokinesis /ta/ were measured as masticatory performance-related factors. Their relationship with mixing ability, shearing ability, and masticatory performance-related factors was examined by means of Spearman rank correlation coefficient and path analysis. RESULTS: Among masticatory performance-related factors, the number of natural teeth, occlusal force, and tongue pressure were directly associated with both mixing ability and shearing ability. Moreover, mixing ability was also directly associated with shearing ability. CONCLUSIONS: Tongue pressure, which can be improved by means of training, is a masticatory performance-related factor associated with both mixing and shearing abilities. PRACTICAL IMPLICATIONS: Training for tongue pressure after proper prosthetic treatment may provide an effective means of maintaining and improving masticatory performance in older adults.


Assuntos
Vida Independente , Mastigação , Força de Mordida , Estudos Transversais , Japão , Pressão , Língua
2.
Int J Prosthodont ; 33(2): 224-228, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32069348

RESUMO

PURPOSE: To develop a new digital method for color-mixing analysis and to evaluate the validity of this method for quantifying masticatory performance. MATERIALS AND METHODS: Specimens of red-green (RG) chewing gum were prepared as a bicolor test food. A total of 300 specimens were masticated by 20 healthy volunteers for different numbers of mastication cycles (from 1 to 25). The boluses were flattened and scanned, and the digital images were analyzed using ImageJ software. Two parameters (spatial and value) of color mixing were measured, and multiple regression analysis was performed to estimate the number of mastication cycles. The estimated number of mastication cycles that the healthy reference cohort needed to achieve a certain degree of color mixing was proposed as the mastication index (MI). The validity of this method was assessed using Pearson correlation between the MI and concurrent measurements with ViewGum software (variance of hue) within a group of 10 healthy subjects and 10 complete denture wearers. RESULTS: Independent samples t test showed a significant difference in MI between healthy subjects and denture wearers (P < .001). A significant correlation was observed between the MI and ViewGum outcomes (r = -0.95, P < .001). CONCLUSION: The new proposed method proved to be valid and has the potential for evaluating masticatory performance in both research and clinical settings.


Assuntos
Goma de Mascar , Prótese Total , Cor , Humanos , Mastigação , Software
3.
J Oral Rehabil ; 47(4): 523-527, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31925969

RESUMO

Gustatory function is closely related to chewing and swallowing; however, there are currently no reports regarding gustatory function in persons with cerebral palsy (CP). The aim of this study was to compare the gustatory function between persons with CP and healthy controls. We investigated sweet, salty, sour and bitter tastes using the whole-mouth method and measured the electrogustometric thresholds in the chorda tympani nerve area. Twelve participants with CP (6 women and 6 men) for whom gustatory testing was possible at our facilities, and 17 age-matched controls (9 women and 8 men) were included. The mean age ± standard deviation was 58.6 ± 8.1 years and 58.5 ± 8.7 years in subjects with CP and controls, respectively. Taste detection and identification were significantly worse in persons with CP compared with the controls. Taste identification was more impaired than taste detection. At the highest concentration, taste identification was impossible 11 times out of 48 (12 persons × 4 kinds of tastes) in persons with CP but such a deficit was not observed in 68 attempts (17 persons × 4 kinds of tastes) involving controls. The electrogustometric thresholds were not significantly different between the groups. Gustatory function associated with chewing and swallowing is worse in persons with CP compared to the controls.


Assuntos
Paralisia Cerebral , Paladar , Idoso , Deglutição , Feminino , Humanos , Masculino , Mastigação , Pessoa de Meia-Idade , Boca
4.
Science ; 367(6475): 244-246, 2020 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-31949065
5.
Braz Oral Res ; 33: e121, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939500

RESUMO

The objective of the study was to analyze the surface area (SA) of the wear caused by simulated chewing on human enamel and opposing restorative material, namely: composite resin (CR), porcelain fused to metal (PFM), lithium disilicate (LD), or monolithic zirconia (MZr). Forty-eight premolars were selected as enamel specimens and divided randomly into 4 groups (n = 48; n =12) used as antagonists in chewing simulation (250,000 loading cycles) against one of the four selected test materials. Enamel and material specimens were scanned and evaluated under digital microscope, and wear SA (mm2) were recorded. Descriptive statistics, paired t-test, one-way ANOVA, and post-hoc Tukey-HSD tests were used for statistics (p < 0.05). The smallest and largest SA were exhibited by enamel against LD (0.80 mm2) and PFM (1.74 mm2), respectively. PFM (3.48 mm2) showed the largest SA and CR (2.28 mm2) showed the smallest SA. Paired t-test for SA values showed significant difference (p < 0.05) in all wear comparisons between materials and enamel antagonists. The wear of materials were greater than that of their respective enamel antagonists (p < 0.05). One-way ANOVA of the logarithmic means of wear SA revealed significant differences (P<0.05). Post-hoc Tukey test revealed significance for PFM (p < 0.05) with other materials. Wear of all test materials was greater compared to the wear of enamel antagonists. PFM and LD caused the largest and the smallest enamel wear, respectively. CR, LD, and MZr are more resistant than PFM to wear after simulated chewing against enamel.


Assuntos
Resinas Compostas/química , Esmalte Dentário/química , Porcelana Dentária/química , Mastigação , Ligas Metalo-Cerâmicas/química , Desgaste dos Dentes/etiologia , Zircônio/química , Adolescente , Adulto , Análise de Variância , Polimento Dentário/métodos , Humanos , Processamento de Imagem Assistida por Computador , Teste de Materiais , Microscopia/instrumentação , Valores de Referência , Estatísticas não Paramétricas , Propriedades de Superfície , Adulto Jovem
6.
Spec Care Dentist ; 40(2): 168-174, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31943301

RESUMO

AIMS: To compare the effect of new complete dentures (CDs) on self-perceived masticatory ability (MA) and oral health-related quality of life (OHRQoL) in frail and nonfrail elders. METHODS AND RESULTS: Twenty completely edentulous elders were assigned to two groups: frail and nonfrail (n = 10/each). MA was evaluated using a visual analogue scale. OHRQoL was assessed with the Oral Health Impact Profile (OHIP-Edent). Variables were evaluated with volunteers wearing their old and unsatisfactory CDs. Then, a new set of CDs was manufactured and all outcomes were reassessed 2 months after the insertion. Data were analyzed by repeated measures' analyses of variance and Tukey tests. MA for lettuce and peanuts was improved (P < .05) for the frail group after new CD insertion. Psychological discomfort and handicap OHIP-Edent domain improved (P < .05) for both groups after prosthetic treatment. Before treatment, controls reported greater psychological discomfort than the frail group. Meanwhile, the handicap domain score of frail patients improved to a level similar to that of the nonfrail group after treatment. Regardless of frailty, elders showed better MA scores for most food types after treatment and decreased OHIP-Edent domain values. CONCLUSION: Self-reported MA and OHRQoL of frail elderly people were greatly improved after new CD use.


Assuntos
Prótese Total , Idoso Fragilizado , Mastigação , Idoso , Humanos , Saúde Bucal , Qualidade de Vida
7.
J Oral Sci ; 62(1): 62-66, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31996525

RESUMO

This study was performed to develop a new rat model of reduced masticatory activity in order to assess the effect of this reduction on the morphology of the temporomandibular joint (TMJ) over time. Female rats were used, and ovariectomy was performed to simulate aged/postmenopausal status. Twenty-four SD rats aged 6 weeks were divided into four groups: ovariectomy/sham procedure (Ov/S); ovariectomy/reduced masticatory activity (Ov/RMA); non-Ov/S (NO/S); and non-Ov/RMA (NO/RMA). The RMA procedure involved grinding down the edges of the upper and mandibular incisors by about 3 mm and supplying the rats with a powdered diet. The bilateral TMJ was examined by micro-computed tomography at 0, 1, 2, 4, 6, and 8 weeks after the start of RMA. Condylar width was greater in the NO/S group than in the Ov/S group after the 2nd week, showing that ovariectomy reduced the width of the condyle. After the 2nd week, significant differences in condylar width were apparent between the NO/S and NO/RMA groups, and between the Ov/S and Ov/RMA groups. This RMA procedure appeared to provide a good model of reduced masticatory activity. The present findings in female rats suggest that reduction of appropriate mastication activity in the growth period results in poor growth of the mandibular condyle and immediately induces atrophy of the mandibular condyle under conditions simulating aged/postmenopausal status.


Assuntos
Côndilo Mandibular , Mastigação , Animais , Atrofia , Feminino , Modelos Animais , Ratos , Ratos Sprague-Dawley , Microtomografia por Raio-X
8.
Monogr Oral Sci ; 28: 134-147, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31940641

RESUMO

An individual's oral health status has a profound impact on his/her acquisition and utilization of nutrients and interchangeably the nutrients an individual consumes determine the state of oral health by preventing tooth loss and oral diseases. Oral diseases have a considerable impact on the masticatory function which is a critical first step in oral processing of food materials for nutrient procurement. Specifically, a section of this chapter is dedicated to the physiology of masticatory function and to the recent acknowledgement of its influence on memory and cognition, both during development and aging. A description of the occlusal and skeletal pathologies that affect the balance of the chewing pattern and related muscular activation is provided. Intact neurocognitive functions and dentition are essential in mastication to achieve coordinated movements of the teeth and tongue to help propel the food material for ingestion and subsequent nutrient absorption. The tongue is equipped with chemoreceptive, gustatory cells, which modulate taste perception and contain metabolic hormones mediating satiety. Concomitantly, salivary processes, which are stimulated with the anticipation of food ingestion and those which occur during mastication of the food material, initiate digestive enzymes in the mouth and stomach and are important in affecting appetite and food bioavailability. Therefore, oral structures such as the dentition, tongue, and saliva in the context of mastication and nutrient acquisition will be reviewed as well as their impact on food choice and subsequent nutritional status.


Assuntos
Mastigação , Saúde Bucal , Dieta , Feminino , Masculino , Percepção Gustatória
9.
Am J Orthod Dentofacial Orthop ; 157(1): 42-48.e2, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31901279

RESUMO

INTRODUCTION: Orthodontic treatments are performed to improve esthetics and masticatory functions. In general, clinical criteria are used to recommend such treatments without considering the opinion of the patient. This study aimed to evaluate the relationship between technically defined orthodontic need (normative criteria) and the need for treatment perceived by adolescent patients. METHODS: A total of 215 students aged between 15 and 19 years were selected and asked to respond to a questionnaire concerning their perception of need for orthodontic treatment and their satisfaction with their own esthetics and mastication. One trained and calibrated examiner obtained normative data using the Dental Aesthetic Index (DAI) on the need for orthodontic treatment of these students. RESULTS: Associations were found between the DAI score and the patient's perception of need for orthodontic treatment (P <0.001), satisfaction with esthetics (P = 0.003), and satisfaction with mastication (P = 0.047). When occlusal characteristics were analyzed separately, associations between several normative and perceived needs, as well as for satisfaction with esthetics, were found. Satisfaction with mastication analysis was only found to be associated with open bite malocclusion (P = 0.003). CONCLUSIONS: The DAI revealed a consistent opinion in adolescents to link their perceived malocclusion-related conditions to esthetics.


Assuntos
Má Oclusão , Satisfação Pessoal , Adolescente , Estética , Humanos , Mastigação , Adulto Jovem
10.
Int J Oral Maxillofac Implants ; 35(1): 178-186, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923300

RESUMO

PURPOSE: The aim of this investigation was to compare the chewing efficiency after immediate and delayed loading of mini-implants that served as supplementary support for removable partial dentures (RPDs). MATERIALS AND METHODS: In this four-center randomized trial, patients who had RPDs in arches with unfavorable tooth distributions, ie, no canine and at most two posterior teeth in one or both quadrants, received strategic mini-implants with ball abutments. The mini-implants in group A were loaded immediately either by housings with O-rings (insertion torque ≥ 35 Ncm) or by soft relining material (insertion torque < 35 Ncm). In group B, the RPDs were only hollowed over the balls. After 4 months, the soft relined RPDs and all RPDs of group B received the housings. Masticatory efficiency was evaluated with a validated mixing ability test of two-colored chewing gum before surgery and 14 days, 4 months (before housing pickup), 4.5 months, and 12 months after surgery. The circular variance of hue was the measure of mixing. RESULTS: From 76 participants with 79 RPDs, 38 each were randomly allocated to group A or B. In group A, the housings in six participants were picked up immediately, and the remaining RPDs were primarily soft relined. There was a significant group difference only after 4 months. The mixing ability was better after immediate loading than after delayed loading (P < .0001). In group B, the chewing efficiency was notably deteriorated after the RPDs were hollowed over the ball abutments. However, immediately after all housings were picked up, the chewing efficiency in both groups was substantially improved, and the variance of hue values after 1 year were very similar in the groups. CONCLUSION: The chewing performance can be improved by inserting supplementary mini-implants under existing RPDs with unfavorable tooth support. This improvement occurred faster by immediate loading than by delayed loading.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Prótese Parcial Removível , Carga Imediata em Implante Dentário , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Mastigação
11.
Adv Exp Med Biol ; 1232: 113-119, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893402

RESUMO

The prefrontal cortex (PFC) is sensitive to the stress exposure and involved in stress coping. And the effects of gum chewing on the stress have been studied using NIRS. However, when measuring NIRS on PFC during gum chewing, blood flows in shallow tissues (scalp, skin, muscle) might be affected. A NIRS used in the present study first, which has a short distance (1 cm) and the usual (3 cm) source-detector (S-D) regression, can allow eliminating shallow tissues effect of gum chewing. The aim of this study was to investigate the hypothesis that gum chewing activates the right prefrontal cortex (PFC) in stress coping against negative sounds (NS) from the International Affective Digitized Sounds-2 (IADS) as a mental stress task. NS showed activation in the right PFC. There was a significant difference between NS, and NS with Gum, where NS with Gum showed an increased PFC activity, increased alpha wave appearance rate, a higher value in heart rate level, and a higher VAS score indicating 'pleasant'. Gum chewing activated right PFC activity while exposed to negative sounds from IADS as a mental stress task.


Assuntos
Goma de Mascar , Mastigação , Som , Estresse Psicológico , Adaptação Psicológica , Adulto , Feminino , Humanos , Masculino , Córtex Pré-Frontal/fisiologia , Córtex Pré-Frontal/efeitos da radiação , Som/efeitos adversos , Estresse Psicológico/terapia , Adulto Jovem
12.
Adv Exp Med Biol ; 1232: 121-127, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893403

RESUMO

Changes in NIRS signals are related to changes in local cerebral blood flow or oxy-Hb concentration. On the other hand, recent studies have revealed the effect of chewing gum on cognitive performance, stress control etc. which accompanied brain activity in the prefrontal cortex (PFC). However, these relationships are still controversial. To evaluate the chewing effect on PFC, NIRS seems to be a suitable method of imaging such results. When measuring NIRS on PFC, blood volume in superficial tissues (scalp, skin, muscle) might have some affect. The aim of the present study was to clarify the effect of the anterior temporal muscle on NIRS signals during gum chewing. Eight healthy volunteers participated. Two-channel NIRS (HOT-1000, NeU, Japan), which can distinguish total-Hb concentrations in deep tissue and superficial tissue layers, was used. In addition to a conventional optode separation distance of 3.0 cm, Hot 1000 has a short distance of 1.0 cm (NEAR channel) to measure NIRS signals that originate exclusively from surface tissues. NIRS probes were placed at Fp1 and Fp2 in the normal probe setting. The headset was displaced to the left in order to allow the left probe to be placed over the left anterior temporal muscle. In the normal setting, the superficial signal curve shows no notable change; however, the neural (calculated and defined in HOT-1000) and deep curves show an increase during the gum chewing task. At the deviated setting, all three signals show marked changes during the task. Total-Hb concentration in the deviated probe setting is significantly large (p < 0.05) than that of in the normal probe setting. When using gum chewing as a task, it would be better to consider a probe position carefully so that the influence of muscle activity on NIRS signal can be distinguished.


Assuntos
Mastigação , Córtex Pré-Frontal , Espectroscopia de Luz Próxima ao Infravermelho , Adulto , Hemoglobinas/metabolismo , Humanos , Japão , Projetos Piloto , Córtex Pré-Frontal/fisiologia , Adulto Jovem
13.
J Prosthodont ; 29(1): 74-79, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28913855

RESUMO

PURPOSE: Limited information is currently available relative to the effect of masticatory loads on the retentive properties of Locator attachments. The aims of this in vitro study were to assess and compare the effect of simulated mastication on the retention of white, pink, and blue Locator inserts for overdentures retained by 2 implants. MATERIALS AND METHODS: Thirty specimens simulating a nonanatomic edentulous flat ridge with two implants and an overdenture were divided into 3 groups according to the color of the fitted insert: transparent clear group (n = 10), pink group (n = 10), and blue group (n = 10). Retention forces were measured in an axial direction initially and after 100,000 cycles of simulated masticatory loads. One-way ANOVA followed by Tukey's post hoc tests were used to compare retention values and percentage retention loss between the 3 groups with significance set at p = 0.05. RESULTS: The 3 groups presented significant differences in retention at baseline (9.95 ± 1.91 N, 15.43 ± 4.08 N, and 41.73 ± 9.29 N for the blue, pink, and clear groups, respectively) and after simulated mastication (6.37 ± 2.64 N, 14.00 ± 3.89 N, 38.20 ± 5.11 N for the blue, pink, and clear groups, respectively). Within the same group, cyclic loading did not significantly affect retention in the clear and pink groups, while the blue inserts showed a significant retention loss (-37%) after loading. CONCLUSIONS: The results suggest that short-term simulated mastication affects the extra-light blue inserts but not the more-retentive inserts.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Retenção de Dentadura , Mastigação , Projetos Piloto
14.
J Oral Rehabil ; 47(2): 180-186, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31696953

RESUMO

BACKGROUND: Preserving sufficient oral function and maintaining proper nutrition are essential to prevent frailty. Thus, we have developed "munchy" foods that contain harder textures and are rich in protein. OBJECTIVES: This study aimed to test the effects of masticating textured foods on masticatory muscle activity in young and older adults. METHODS: Twenty young and 32 community-dwelling older individuals participated in this study. After measuring oral function, we subdivided the older participants into normal and oral hypofunction (OHF) groups. Two test foods (meatloaf and chicken ball) were prepared to have a harder texture using specific ingredients (munchy) or not (control). The participants ate 10 g of the test foods in random order while being measured for masseter muscle activity with a surface electromyogram (EMG). We calculated the number of chewing cycles and integrated muscle activity of the masseter muscle from the EMG data and tested for differences by food texture or age group. RESULTS: The number of chewing cycles, mean EMG amplitude and integrated EMG activity was significantly higher for the munchy foods than for the controls for all groups. The integrated masseter muscle EMG activity was significantly increased in the normal older group than in the young group for both food types, but not significantly different between in OHF and young groups. CONCLUSIONS: Our findings suggest that eating textured foods will lead to increased masticatory load and therefore increased muscle activity, especially in older adults. Application of textured food may change dietary habits in older adults.


Assuntos
Músculo Masseter , Músculos da Mastigação , Idoso , Eletromiografia , Alimentos , Humanos , Mastigação
15.
J Oral Rehabil ; 47(3): 325-331, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31721269

RESUMO

BACKGROUND: Mastication is a complicated task that involves the teeth and perioral muscles, such as the tongue and lip. Previous studies have shown correlations between masticatory performance and perioral muscle strength (eg tongue pressure) and between masticatory performance and occlusal forces. OBJECTIVE: To investigate the relationships between masticatory performance and perioral muscle characteristics. METHODS: Forty-nine healthy young subjects (men: 24 and women: 25) with Eichner classification group A were included in this cross-sectional study. Age, body weight, masticatory performance, masseter muscle thickness, masseter muscle echo intensity, cross-sectional area of geniohyoid muscle, geniohyoid muscle echo intensity, tongue thickness (TT) and tongue echo intensity were assessed. Masticatory performance was evaluated using a colour-changeable chewing gum. The thickness and echo intensity of the masseter muscle, geniohyoid muscle and tongue were observed using an ultrasonic diagnostic apparatus. Stepwise multiple regression analysis was conducted to examine relationships between perioral muscle characteristics and masticatory performance. RESULTS: Tongue thickness (P < .01) was the sole significant explanatory variable for masticatory performance. The standard partial regression coefficient was 0.47. The multiple correlation coefficient (R) was .47, and the adjusted R2 was .20; the variance inflation factor was 1.0. This study showed that TT was related to masticatory performance, whereas perioral muscle quality was not. Moreover, perioral muscle quantity was highly correlated with perioral muscle quality. CONCLUSIONS: Tongue thickness is a predictor of masticatory performance in healthy young subjects. An ultrasonic diagnostic apparatus is useful in the evaluation of perioral muscle characteristics.


Assuntos
Força de Mordida , Língua , Músculos Faciais , Feminino , Humanos , Masculino , Músculo Masseter , Mastigação , Músculos da Mastigação , Pressão
16.
J Oral Rehabil ; 47(2): 196-203, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31442312

RESUMO

During mastication, some portion of the food bolus is gradually transported to the oropharynx before deglutition, which is known as stage II transport (STII). Although the importance of STII in mastication and deglutition has been widely acknowledged, food particle properties that are transported into the oropharynx by STII have not yet been fully specified. To reveal the food particle properties that are transported into the oropharynx by STII and to assess the usefulness of new food bolus sampling methods for the evaluation of masticatory efficiency. Twenty-two healthy volunteers participated in this study. Four different bolus sampling conditions were adopted: (a) the whole food particles were expectorated when the subject was aware of the first deglutition, (b) the last bolus to be swallowed at the end of unrestrained food intake was expectorated (aftermost bolus sample), (3) the whole food particles were expectorated when the subject felt ready to swallow after swallow-inhibited mastication (swallow-inhibited sample), (4) the particles were regurgitated from the oropharynx after the first STII (stage II-transported sample). Food particles were analysed using the homogeneity index and particle size index. There was no significant difference between food particles in the aftermost bolus sample and swallow-inhibited sample. The particles in the stage II-transported sample showed significantly more homogeneous and smaller sizes than other sampling conditions (P < .05). The food particles transferred to the oropharynx in the stage II-transported sample were smaller than those broken down by natural mastication.


Assuntos
Deglutição , Mastigação , Alimentos , Humanos , Orofaringe , Tamanho da Partícula
17.
J Prosthodont Res ; 64(1): 20-25, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31196765

RESUMO

PURPOSE: This randomised cross-over trial aimed to comparatively investigate patient preference and satisfaction with thermoplastic resin removable partial dentures (TR-RPDs) and conventional metal clasp-retained removable partial dentures (MC-RPDs). METHODS: Twenty-eight partially dentate subjects were enrolled and randomised to receive MC-RPDs followed by TR-RPDs or vice versa (n=14, each group). The subjects were asked to score overall satisfaction and denture-related parameters 3 months after delivery of each denture. Additionally, they were asked to choose their preferred denture type at the end of the trial. RESULTS: Of the 28 subjects, 24 (86%; mean age, 67.3 years) completed the trial. The overall satisfaction scores and ratings for oral appearance with TR-RPDs were significantly higher than those with MC-RPDs (P<0.05). Moreover, 75% (18/24) and 83% (20/24) of the subjects reported greater overall satisfaction and better oral appearance with TR-RPDs than with MC-RPDs (P<0.001, both). Scores for mucosal pain and food impaction were significantly better with TR-RPDs than with MC-RPDs (P<0.05). Relative to MC-RPDs, TR-RPDs provided slightly better oral comfort and speech, although the differences were not statistically significant (P>0.05). Scores for chewing ability, denture stability, and ease of denture cleaning were almost identical for both types of dentures. CONCLUSIONS: These results suggest that TR-RPDs hold an advantage over MC-RPDs in terms of oral appearance and can offer greater satisfaction than MC-RPDs in partially dentate arches with at least an occluding pair in the posterior region. CLINICAL TRIAL REGISTRATION: UMIN Clinical Trials Registry (UMIN000007310).


Assuntos
Prótese Parcial Removível , Idoso , Estudos Cross-Over , Retenção de Dentadura , Humanos , Mastigação , Satisfação do Paciente
18.
Clin Oral Investig ; 24(2): 849-856, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31201517

RESUMO

OBJECTIVES: To investigate associations between food avoidance and dental status, age, gender, and socio-economic status (SES). MATERIALS AND METHODS: The Chinese sample comprised 1463 dentulous (≥ 1 tooth in each jaw) and 124 edentulous (in one or both jaws) participants aged ≥ 40 yrs. The Vietnamese sample comprised 2820 dentulous and 253 edentulous participants aged ≥ 20 yrs. Food avoidance due to chewing difficulties was scored for regionally common 4 soft and 4 hard foods. Dental status was classified according to the multi-level hierarchical dental functional classification system (HDFC) based on the number and location of teeth and posterior occlusal pairs. Associations were analyzed using multivariate logistic regression analyses. RESULTS: For dentulous participants, the chance of avoiding foods was significantly larger with < 10 teeth in each jaw (OR = 2.26 (Chinese sample), respectively 1.74 (Vietnamese sample)), incomplete anterior region (OR = 1.78, respectively 1.84), "impaired" premolar region (OR = 2.22, respectively 1.71), or "impaired" molar region (OR = 2.46, respectively 1.84). Edentulous participants had twice the chance of avoiding foods (OR = 2.01 respectively 2.20). Avoiding foods was significantly associated with higher age. Participants of low SES (Chinese sample, OR = 1.93) and females (Vietnamese sample, OR = 1.27) had a larger chance of avoiding foods. CONCLUSIONS: Avoiding foods was significantly associated with reduced dentitions, edentulousness, and higher age; low SES only in the Chinese and being female only in the Vietnamese sample. CLINICAL RELEVANCE: Incomplete anterior regions, "impaired" premolar or molar regions, and especially edentulousness can be considered significant risk indicators for food avoidance.


Assuntos
Dentição , Boca Edêntula , Adulto , Dente Pré-Molar , Feminino , Humanos , Arcada Osseodentária , Mastigação , Dente Molar , Adulto Jovem
19.
J Oral Rehabil ; 47(3): 377-385, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31743464

RESUMO

BACKGROUND: The oral health of seniors in nursing homes is compromised. Furthermore, reduced chewing efficiency is described to be associated with reduced cognition. However, studies investigating how prosthetic status affects the chewing efficiency of nursing home residents are not available. OBJECTIVE: To evaluate associations between prosthetic status, dementia and chewing efficiency of seniors in nursing homes. METHODS: This study was performed in nine nursing homes. In addition to assessing the general and medical data of the participants, a dental examination was assessed and the severity of dementia was evaluated by use of the Clinical Dementia Rating (CDR). Furthermore, chewing efficiency was assessed by use of a two-colour mixing ability test. Descriptive and bivariate statistics, as well as linear regression models with the dependent variable chewing efficiency and possible confounders, were used to analyse data at P < .05. RESULTS: Complete target variables of 146 participants were analysed. The mean (SD) chewing efficiency of the study sample, as expressed by the variance of hue, was .590 (.250). The type of prosthesis used (P < .001), the number of occluding tooth pairs (P < .001) and the presence of dementia (P = .002) were the main variables significantly affecting chewing efficiency. The condition of removable dentures also had an effect (P = .016). Multivariate testing predominantly confirmed these associations. CONCLUSION: The chewing efficiency of seniors in nursing homes is somewhat compromised. Beyond dental aspects, suffering from dementia seems to reduce the chewing efficiency. Further interventional/longitudinal studies are, however, encouraged to verify this outcome.


Assuntos
Demência , Mastigação , Humanos , Casas de Saúde , Saúde Bucal
20.
J Oral Rehabil ; 47(3): 370-376, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31837276

RESUMO

BACKGROUND: Parkinson's disease (PD) is a progressive neurodegenerative disorder. It is associated with reduced oral health and impaired oro-facial function, but besides recommendations of dental visits and drooling treatment, there are little documented odontological treatment options. OBJECTIVES: To evaluate the effect of standardised home exercise jaw opening and chewing programmes, as well as home oral hygiene measures instructed and controlled by a trained dentist. METHODS: Twenty-nine patients (median 65 years) with moderate to advanced PD participated in the project after informed consent. They were followed at a Neurology Department, were able to cooperate, and had stable medical treatment and nine also deep brain stimulation. The interventions were individual dental hygiene instruction, training of jaw opening (JawTrainer), and lip and chewing exercises (Ulmer Oral Screen and Proxident Fluoride Gum). The study was performed as a randomised controlled study. The treatment effect was evaluated after 2 and 4 months. The primary outcome was maximum unassisted jaw opening capacity, chewing time of a standardised apple slice, and the Simplified Debris Index. Results were analysed with Wilcoxon matched pairs test and Mann-Whitney U test (significance level P < .05). RESULTS: Jaw opening, chewing time and hygiene were significantly improved 2 months from the start of the invention, respectively, 6%, 49%, and 25%, and the improvement was still significant after 4 months. No significant changes were found after the 2-month control period without intervention. CONCLUSION: The simple measures had a substantial and significant clinical effect which is promising despite the progressive nature of the PD.


Assuntos
Doença de Parkinson , Sialorreia , Humanos , Mastigação , Saúde Bucal , Higiene Bucal
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