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1.
Bilateral balanced occlusion compared to other occlusal schemes in complete dentures: A systematic review.
Lemos, CAA, Verri, FR, Gomes, JML, Santiago Júnior, JF, Moraes, SLD, Pellizzer, EP
Journal of oral rehabilitation. 2018;(4):344-354
Abstract
No consensus has been reached regarding the best occlusal scheme for making complete dentures. Thus, the purpose of this systematic review was to compare bilateral balanced occlusion (BBO) with other occlusal schemes (canine guidance, lingualised occlusion and zero degree) in complete dentures. The schemes were compared in terms of quality of life/satisfaction and masticatory performance. Two independent reviewers performed a comprehensive search of studies published in or before October 2017 using the PubMed/MEDLINE, Scopus and Cochrane Library databases. The search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The focused question was: "In conventional complete denture, is BBO better than lingualised occlusion, canine guidance and zero degree in terms of quality of life, patient satisfaction and masticatory performance/muscle activity?" Seventeen studies were selected for analysis. In total, there were 492 patients with a mean age of 64.78 years and a mean follow-up duration of 2.96 months (range: 1-6 months). All studies compared BBO with the other occlusal schemes. Eleven studies evaluated the influence of the occlusal scheme designs on quality of life and satisfaction, and 8 studies evaluated masticatory performance and muscle activity between BBO and the other occlusion schemes. The present systematic review indicated that BBO does not confer better quality of life/satisfaction or masticatory performance and muscle activity. Thus, lingualised occlusion can be considered a predictable occlusal scheme for complete dentures in terms of quality of life/satisfaction and masticatory performance, while canine guidance can be used to reduce muscular activity.
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2.
Bite or brain: Implication of sensorimotor regulation and neuroplasticity in oral rehabilitation procedures.
Kumar, A, Kothari, M, Grigoriadis, A, Trulsson, M, Svensson, P
Journal of oral rehabilitation. 2018;(4):323-333
Abstract
Tooth loss, decreased mass and strength of the masticatory muscles leading to difficulty in chewing have been suggested as important determinants of eating and nutrition in the elderly. To compensate for the loss of teeth, in particular, a majority of the elderly rely on dental prosthesis for chewing. Chewing function is indeed an important aspect of oral health, and therefore, oral rehabilitation procedures should aim to restore or maintain adequate function. However, even if the possibilities to anatomically restore lost teeth and occlusion have never been better; conventional rehabilitation procedures may still fail to optimally restore oral functions. Perhaps this is due to the lack of focus on the importance of the brain in the rehabilitation procedures. Therefore, the aim of this narrative review was to discuss the importance of maintaining or restoring optimum chewing function in the superageing population and to summarise the emerging studies on oral motor task performance and measures of cortical neuroplasticity induced by systematic training paradigms in healthy participants. Further, brain imaging studies in patients undergoing or undergone oral rehabilitation procedures will be discussed. Overall, this information is believed to enhance the understanding and develop better rehabilitative strategies to exploit training-induced cortical neuroplasticity in individuals affected by impaired oral motor coordination and function. Training or relearning of oral motor tasks could be important to optimise masticatory performance in dental prosthesis users and may represent a much-needed paradigm shift in the approach to oral rehabilitation procedures.
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3.
Occlusal loading during biting from an experimental and simulation point of view.
Röhrle, O, Saini, H, Ackland, DC
Dental materials : official publication of the Academy of Dental Materials. 2018;(1):58-68
Abstract
OBJECTIVES Occlusal loading during clenching and biting is achieved by the action of the masticatory system, and forms the basis for the evaluation of the functional performance of prosthodontic and maxillofacial components. This review provides an overview of (i) current bite force measurement techniques and their limitations and (ii) the use of computational modelling to predict bite force. A brief simulation study highlighting the challenges of current computational dental models is also presented. METHODS Appropriate studies were used to highlight the development and current bite force measurement methodologies and state-of-the-art simulation for computing bite forces using biomechanical models. RESULTS While a number of strategies have been developed to measure occlusal forces in three-dimensions, the use of strain-gauges, piezo-electric sensors and pressure sheets remain the most widespread. In addition to experimental-based measurement techniques, bite force may be also estimated using computational models of the masticatory system. Simulations of different bite force models clearly show that the use of three-dimensional force measurements enriches the evaluation of masticatory functional performance. SIGNIFICANCE Hence, combining computational modelling with three-dimensional force measurement techniques can significantly improve the evaluation of masticatory system and the functional performance of prosthodontic components.
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4.
Does reduced mastication influence cognitive and systemic health during aging?
Miquel, S, Aspiras, M, Day, JEL
Physiology & behavior. 2018;:239-250
Abstract
There is a growing body of literature which suggests that oral health and mastication can influence cognitive and systemic health during aging. However, it is currently unclear whether oral health, masticatory efficiency, cognitive health and systemic health merely deteriorate independently with age, or whether mechanisms exist linking mastication to cognitive and systemic health directly. The aim of this paper is to review the extent to which reduced mastication influences cognitive and systemic health during aging because this knowledge may underpin future interventions that improve quality of life. Current evidence suggests that a deterioration in mastication and oral health during aging can have: 1) direct effects on systemic health through mechanisms such as the migration of the oral microbiota into the systemic environment, and 2) indirect effects on systemic health through changes nutrient intake. A loss of teeth and reduction in masticatory efficiency during aging can have: 1) direct effects on cognitive performance and potentially impact cognitive health through mechanisms such as enhanced adult hippocampal neurogenesis, and 2) indirect effects on cognitive health through changes in nutrient intake. It is concluded that oral health and masticatory efficiency are modifiable factors which influence the risk poor cognitive and systemic health during aging, although it is currently premature to propose chewing-based interventions to slow the rate of cognitive decline and improve cognitive health during aging. Future research should include large-scale longitudinal studies which control for the types of confounding factors which concurrently influence the association between mastication and cognitive and systemic health.
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5.
Salivary secretion in health and disease.
Pedersen, AML, Sørensen, CE, Proctor, GB, Carpenter, GH, Ekström, J
Journal of oral rehabilitation. 2018;(9):730-746
Abstract
Saliva is a complex fluid produced by 3 pairs of major salivary glands and by hundreds of minor salivary glands. It comprises a large variety of constituents and physicochemical properties, which are important for the maintenance of oral health. Saliva not only protects the teeth and the oropharyngeal mucosa, it also facilitates articulation of speech, and is imperative for mastication and swallowing. Furthermore, saliva plays an important role in maintaining a balanced microbiota. Thus, the multiple functions provided by saliva are essential for proper protection and functioning of the body as a whole and for the general health. A large number of diseases and medications can affect salivary secretion through different mechanisms, leading to salivary gland dysfunction and associated oral problems, including xerostomia, dental caries and fungal infections. The first part of this review article provides an updated insight into our understanding of salivary gland structure, the neural regulation of salivary gland secretion, the mechanisms underlying the formation of saliva, the various functions of saliva and factors that influence salivary secretion under normal physiological conditions. The second part focuses on how various diseases and medical treatment including commonly prescribed medications and cancer therapies can affect salivary gland structure and function. We also provide a brief insight into how to diagnose salivary gland dysfunction.
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6.
Association between mastication and cognitive status: A systematic review.
Tada, A, Miura, H
Archives of gerontology and geriatrics. 2017;:44-53
Abstract
PURPOSE A substantial number of elderly people suffer from cognitive impairment and dementia, which are considered to have various risk factors, including masticatory dysfunction; however, the association between mastication and cognition is inconclusive. The objectives of this systematic review were to provide an overview of the literature on (1) the association between mastication and cognitive function and (2) the association between mastication and dementia incidence, in elderly people. MATERIALS AND METHODS Searches were conducted on five electronic databases (PubMed, EMBASE, CINHL, Cochrane Library, and Pro Quest) and publications were selected that met the following criteria: published between 2005 and 2015, written in English, and assessed associations between mastication and cognitive function, cognitive decline and dementia among population over 40 years old. The included publications were analyzed for study design, main conclusions, and strength of evidence by two reviewers who screened all abstracts and full-text articles, abstracted data and performed quality assessments by using a critical appraisal tool. RESULTS A total of 33 articles (22 cross-sectional, and 11 prospective cohort studies) were evaluated. Poorer mastication was associated with lower cognitive function in 15 of the 17 cross-sectional studies and steeper decline in 5 of the 6 prospective studies. Poorer mastication was one of significant risk factors for having dementia or mild memory impairment (MMI) in 4 of 5 cross-sectional studies and for the incidence of dementia or MMI in 4 of 5 prospective studies. CONCLUSIONS Most studies point to a positive association between mastication and cognitive function, including dementia among elderly people.
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7.
Unlocking opportunities in food design for infants, children, and the elderly: Understanding milestones in chewing and swallowing across the lifespan for new innovations.
Cichero, JAY
Journal of texture studies. 2017;(4):271-279
Abstract
UNLABELLED Intake of a variety of foods increases the likelihood of good general health. From as early as life in utero, humans are exposed to flavor. Further flavor imprinting occurs via breast milk, increasing the likelihood of acceptance of a variety flavors when solids are introduced. While first foods need to be smooth and runny, experience managing soft lumps is required for rudimentary development of chewing skills. Texture experiences are critical to providing building blocks for food acceptance and gradual increase in the range of food textures eaten. Persistence in offering flavors and textures on multiple occasions increases the likelihood of acceptance of new foods. Opportunities exist in novel food texture use and flavor bridging to improve food variety in children. During adulthood lifestyle changes impact on chewing and gastrointestinal efficiency affecting the variety of food consumed. Foods that are moist, and encourage the consumer to slow down and savor food may reduce diseases affecting the esophagus. The aging process sees an increase in medication use with an impact on reduction in saliva flow. Further, physiologic changes in taste and olfaction that occur with aging may see elders benefit from novel food design that utilizes the intact trigeminal system. New food design opportunities exist in the areas of carbonation, dissolvable solids, microencapsulation of flavor volatiles or pressurized carbon dioxide granules. The use of standardized nomenclature for food labeling, description, and measurement methods such as that used by the International Dysphagia Diet Standardisation Initiative is advocated to accelerate food oral processing research. PRACTICAL APPLICATION The human feeding, chewing, and swallowing mechanism adapts and changes over the life span. There are opportunities to influence flavor development from as early as life in utero, and through milk feeds. Infants also need exposure to soft lumps to develop rudimentary chewing skills that lay the foundation for mature chewing. Melt-in-the-mouth textures and familiar flavors can help children to bridge to new food and diminish development of picky eating. Similar textures can also be used for the elderly particularly if used with food flavors and compounds that excite the trigeminal system to promote increased food variety. Adults taking medication with dry mouth side effects benefit from moist foods. Special populations, such as those with swallowing difficulties, may benefit from use of micro encapsulated compounds that trigger the trigeminal pathway. Introduction of a food texture labeling system is advocated.
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8.
Age-related changes in mastication.
Peyron, MA, Woda, A, Bourdiol, P, Hennequin, M
Journal of oral rehabilitation. 2017;(4):299-312
Abstract
The paper reviews human mastication, focusing on its age-related changes. The first part describes mastication adaptation in young healthy individuals. Adaptation to obtain a food bolus ready to be swallowed relies on variations in number of cycles, muscle strength and volume of emitted saliva. As a result, the food bolus displays granulometric and rheological properties, the values of which are maintained within the adaptive range of deglutition. The second part concerns healthy ageing. Some mastication parameters are slightly modified by age, but ageing itself does not impair mastication, as the adaptation possibilities remain operant. The third part reports on very aged subjects, who display frequent systemic or local diseases. Local and/or general diseases such as tooth loss, salivary defect, or motor impairment are then indistinguishably superimposed on the effects of very old age. The resulting impaired function increases the risk of aspiration and choking. Lastly, the consequences for eating behaviour and nutrition are evoked.
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9.
Oro-facial impairment in stroke patients.
Schimmel, M, Ono, T, Lam, OL, Müller, F
Journal of oral rehabilitation. 2017;(4):313-326
Abstract
Stroke is considered one of the leading causes of death and acquired disability with a peak prevalence over the age of 80 years. Stroke may cause debilitating neurological deficiencies that frequently result in sensory deficits, motor impairment, muscular atrophy, cognitive deficits and psychosocial impairment. Oro-facial impairment may occur due to the frequent involvement of the cranial nerves' cortical representation areas, central nervous system pathways or motoneuron pools. The aim of this narrative, non-systematic review was to discuss the implications of stroke on oro-facial functions and oral health-related quality of life (OHRQoL). Stroke patients demonstrate an impaired masticatory performance, possibly due to reduced tongue forces and disturbed oral sensitivity. Furthermore, facial asymmetry is common, but mostly discrete and lip restraining forces are reduced. Bite force is not different between the ipsi- and contra-lesional side. In contrast, the contra-lesional handgrip strength and tongue-palate contact during swallowing are significantly impaired. OHRQoL is significantly reduced mainly because of the functional impairment. It can be concluded that impaired chewing efficiency, dysphagia, facial asymmetry, reduced lip force and OHRQoL are quantifiable symptoms of oro-facial impairment following a stroke. In the absence of functional rehabilitation, these symptoms seem not to improve. Furthermore, stroke affects the upper limb and the masseter muscle differently, both, at a functional and a morphological level. The rehabilitation of stroke survivors should, therefore, also seek to improve the strength and co-ordination of the oro-facial musculature. This would in turn help improve OHRQoL and the masticatory function, subsequently preventing weight loss and malnutrition.
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10.
Assessment of masticatory performance by means of a color-changeable chewing gum.
Tarkowska, A, Katzer, L, Ahlers, MO
Journal of prosthodontic research. 2017;(1):9-19
Abstract
PURPOSE Previous research determined the relevance of masticatory performance with regard to nutritional status, cognitive functions, or stress management. In addition, the measurement of masticatory efficiency contributes to the evaluation of therapeutic successes within the stomatognathic system. However, the question remains unanswered as to what extent modern techniques are able to reproduce the subtle differences in masticatory efficiency within various patient groups. The purpose of this review is to provide an extensive summary of the evaluation of masticatory performance by means of a color-changeable chewing gum with regard to its clinical relevance and applicability. STUDY SELECTION A general overview describing the various methods available for this task has already been published. This review focuses in depth on the research findings available on the technique of measuring masticatory performance by means of color-changeable chewing gum. Described are the mechanism and the differentiability of the color change and methods to evaluate the color changes. Subsequently, research on masticatory performance is conducted with regard to patient age groups, the impact of general diseases and the effect of prosthetic and surgical treatment. RESULTS The studies indicate that color-changeable chewing gum is a valid and reliable method for the evaluation of masticatory function. CONCLUSION Apart from other methods, in clinical practice this technique can enhance dental diagnostics as well as the assessment of therapy outcomes.