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1.
Improvements in oral functions of elderly after simple oral exercise.
Kim, HJ, Lee, JY, Lee, ES, Jung, HJ, Ahn, HJ, Kim, BI
Clinical interventions in aging. 2019;:915-924
Abstract
Purpose: Conventional oral exercises in previous studies are considered impractical for continuous use in the elderly because of the extended duration needed for effective outcomes. Therefore, in the present study, a simple oral exercise (SOE) was developed to reduce performance time, focusing on improvements in mastication, salivation, and swallowing functions. The aim of this study was to determine the short-term effects of the SOE with respect to improving mastication, salivation, and swallowing function in elderly subjects ≥65 years of age. Patients and methods: The study included 84 subjects, all of whom performed the SOE 2 times per day for 1 week. Masticatory performance was assessed using the mixing ability index (MAI). Unstimulated saliva and the degree of moisture of the tongue/buccal mucosa were evaluated, and the repetitive saliva swallowing test was performed. On the basis of each of these four measurements, subjects were dichotomized into two groups with high (good) and low (poor) conditions. The same evaluations were conducted before and immediately after intervention, as well as after 1 week of intervention. A subjective evaluation with questionnaires was performed after 1 week of intervention. The changes were analyzed using repeated-measures ANOVA, Cochran's Q test, and McNemar's test. Results: The mean MAI increased by 6% immediately after the intervention, and by 16% in the poor-chewing group. Similarly, the amount of unstimulated saliva increased by 0.1 ml/min immediately after the SOE, and by 29% in the poor-salivation group. The degree of tongue moisture increased by 3% and was maintained. In the poor-swallowing group, 25% and 40% of the subjects were upgraded to the good-swallowing group immediately after intervention, as well as after 1 week of intervention, respectively. The subjects experienced less discomfort as their oral function improved. Conclusion: The SOE was effective in immediately improving oral functions, and improvement was maintained for 1 week.
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2.
Influence of lower complete denture use on masseter muscles and masticatory function: A longitudinal study.
Carletti, TM, Pinheiro, MA, Gonçalves, TMSV, Rodrigues Garcia, RCM
Journal of oral rehabilitation. 2019;(2):127-133
Abstract
BACKGROUND Edentulism can reduce mastication, leading to changes in food pattern, with possible consequences to masticatory muscle thickness. OBJECTIVES This study verified masticatory function and oral perception in subjects who did not use lower CDs, and whether the insertion of new upper and lower CDs would improve such variables. METHODS Fifteen edentulous elderly who wore only the upper CD were selected and received new upper and lower CD. Volunteers were evaluated at baseline and after 1, 3 and 6 months of new prosthesis use. Masticatory performance (MP) was assessed by the sieving method (X50 values). Masseter thickness (MT) was evaluated by ultrasonography. Oral sensorial ability (OSA) was assessed by oral stereognosis test and maximum tongue pressure (MTP) was verified by pressure sensors. Data were submitted to repeated measures ANOVA and Tukey-Kramer posthoc tests (α = 0.05). Correlation between OSA and MTP was verified by Person's correlation. RESULTS X50 and MTP decreased (P < 0.05) after 1 month and remained stable (P > 0.05) for next assessments. After 3 months, MT in rest position was increased (P < 0.05), while during maximum voluntary contraction 1 month was enough to increase MT (P < 0.05). There were no differences for OSA (P > 0.05) and no correlation between OSA and MTP. CONCLUSION Masticatory performance and masseter thickness of elderly who did not use the lower dentures were improved after 2 months using new upper and lower CDs. However, new CDs in both dental arch decreased MTP. Brazilian Registry of Clinical Trials (ReBEC #RBR-37gdst).
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3.
Morning Mastication Enhances Postprandial Glucose Metabolism in Healthy Young Subjects.
Sato, A, Ohtsuka, Y, Yamanaka, Y
The Tohoku journal of experimental medicine. 2019;(3):193-201
Abstract
Postprandial glucose concentration is dependent on the time of day and its concentration in the morning is lower than in the evening. However, whether it is dependent on mastication at different times of the day has not been studied before. We hypothesized that mastication affects insulin-mediated glucose metabolism differently in the morning and evening in healthy individuals. Firstly, nine healthy male volunteers (22.0 ± 0.7 SEM years, body mass index 22.0 ± 1.0 kg/m2) performed a 75-g oral glucose tolerance test (OGTT). One week after the OGTT, they participated in a high-carbohydrate food (rice) consumption test with 10 or 40 chews per mouthful. Each experiment was conducted in the morning (0800 h) and evening (2000 h) on the same day. Blood samples were collected before and at 30-min intervals for 120 min after glucose or rice consumption. The incremental area under the curve (iAUC) for glucose in the OGTT was significantly lower in the morning than in the evening, whereas the iAUC for insulin was similar at both times. In participants who chewed 40 times, the iAUC for glucose after rice consumption was significantly lower in the morning than in the evening but was similar at both times in individuals who chewed 10 times. Chewing 40 times in the morning (but not the evening) significantly increased insulin secretion at 30 min. This suggests that morning mastication improves early-phase insulin secretion after rice consumption. This novel finding may aid in reducing the incidence of obesity and type 2 diabetes mellitus.
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4.
Prospective evaluation of relationships between radiotherapy dose to masticatory apparatus and trismus.
Hague, C, Beasley, W, Garcez, K, Lee, LW, McPartlin, A, McWilliam, A, Ryder, D, Sykes, AJ, Thomson, D, van Herk, M, et al
Acta oncologica (Stockholm, Sweden). 2018;(8):1038-1042
Abstract
AIMS: This feasibility study aimed to identify relationships between radiation doses to the masticatory apparatus as a combined block or as individual subunits with changes in trismus following radiotherapy. MATERIAL AND METHODS Twenty patients from a single center were recruited prospectively as part of a randomized trial comparing proactive exercises in the management of trismus. Patients with stage III/IV oral cavity or oropharyngeal squamous cell cancers received intensity-modulated radiotherapy with concurrent systemic therapy. All patients had trismus prior to radiotherapy. Maximal inter-incisor distance (MID) was measured pre- and 6 months from the start of radiotherapy. Bilateral muscles of mastication: medial and lateral pterygoids (MP and LP), masseters (M), temporalis (T), temporomandibular joint (TMJ) were contoured on CT images. The block comprised all muscles excluding the TMJ below the orbital floor. Mean dose, equivalent uniform dose (EUD) and V35-V60 Gy were compared with change in MID. RESULTS In six patients, the MID deteriorated at 6 months from the start of radiotherapy compared with 14 whose MID improved. No significant association was observed between age, gender, smoking, alcohol status, exercise compliance, cisplatin, tumor site, stage, V35-V60 Gy or EUD with change in MID. A clinical outlier was excluded. Without the outlier (n = 19), a significant association was seen between mean dose and change in MID at 6 months for the ipsilateral block (p = .01), LP (p = .04) and M (p < .01). All patients where trismus deteriorated at 6 months received mean doses >40 Gy to the block. CONCLUSION Higher mean radiation doses to the ipsilateral block, LP and M were significantly associated with deterioration in trismus. Limiting dose to these structures to ≤40 Gy for tumors not invading the masticatory muscles may improve treatment-related sequelae. The ipsilateral block, LP and M should be studied further as possible alternative avoidance structures in radiotherapy treatment planning.
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5.
Bioelectric activity of mastication muscles and the functional impairment risk groups concerning the masticatory muscles.
Zieliński, G, Suwała, M, Ginszt, M, Szkutnik, J, Majcher, P
Acta of bioengineering and biomechanics. 2018;(4):161-166
Abstract
PURPOSE Temporomandibular disorders affect from 5 to 12 percent of the population, occurring almost twice as often in women than in men. The painful form of temporomandibular disorders is one of the most common musculoskeletal disorders causing pain. The chronic form is associated with changes in activity of the masticatory muscles and can lead to sleep problems, reduction of emotional state and worsening of quality of life. METHODS 66 women were included in the study group. The study was composed of a clinical evaluation of temporomandibular disorders and assessment of the masticatory muscle activities using surface electromyography. The anterior part of the temporalis muscle and the superficial part of the masseter muscle were evaluated during teeth clenching on cotton rolls. The symmetric activity index was calculated from the results of electromyographic activity. Based on the activity and symmetric activity index values, subjects were qualified to the risk group of temporomandibular disorders. RESULTS Twenty people (30.3 percent) qualified for the temporomandibular disorders risk group. In the temporomandibular disorders risk group, the mean symmetric activity index value of the anterior part of the temporal muscle was 72.6 percent and the mean electromyographic activity was 143.94 microvolts. In the masseter muscle, the mean symmetric activity index value was 67.7 percent and the mean electromyographic activity was 155.33 microvolts. CONCLUSIONS Temporomandibular disorders may develop in 30.3 percent of examined women. The research should be continued to determine the temporomandibular disorders risk group, which may enable for the appropriate prevention of the development of dysfunctions in the stomatognathic system.
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6.
Chemical effects of chewing sticks made of Salvadora persica.
Albabtain, R, Ibrahim, L, Bhangra, S, Rosengren, A, Gustafsson, A
International journal of dental hygiene. 2018;(4):535-540
Abstract
OBJECTIVE The chewing sticks are widely used in many regions of Asia and Africa as a traditional tool to maintain oral hygiene. Salvadora persica L. (S. persica), also known as Arak or Miswak, a member of the salvadoraceae family. Chewing sticks, made up from S. persica, have chemical antibacterial properties and mechanical effects. The study aimed to investigate possible chemical effects of S. persica on dental plaque, sub-gingival microbiota and gingival inflammation. In order to achieve this, we inactivated some sticks through boiling to be used as inactive, but mechanically comparable control sticks. METHODS In a double-blinded crossover trial, 24 patients with mild-to-moderate periodontitis were randomly allocated to use either fresh activated Miswak or inactivated Miswak for 3-week period. Plaque index (PI), gingival index (GI), visual plaque index (VPI) and bleeding on probing (BOP) were evaluated before and immediately following the experimental period. Sub-gingival plaque samples were analysed using DNA-DNA hybridization technique. The study was repeated with the participants switching the type of Miswak they used after a 7-week of "washout" period. RESULTS There were no significant differences in the microflora after using active and inactive Miswak. Sixteen species of bacteria showed an increase (P < 0.05) after the usage of inactive Miswak, as compared to pretreatment values. No species showed a similar change after the use of active Miswak. There were no significant differences between active and inactive Miswak regarding the registered clinical variables. CONCLUSION This study has not shown any clinical effect of the chemically active Miswak, but there was a tendency towards an effect on the microflora.
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7.
Effect of masticatory stimulation on the quantity and quality of saliva and the salivary metabolomic profile.
Okuma, N, Saita, M, Hoshi, N, Soga, T, Tomita, M, Sugimoto, M, Kimoto, K
PloS one. 2017;(8):e0183109
Abstract
BACKGROUND This study characterized the changes in quality and quantity of saliva, and changes in the salivary metabolomic profile, to understand the effects of masticatory stimulation. METHODS Stimulated and unstimulated saliva samples were collected from 55 subjects and salivary hydrophilic metabolites were comprehensively quantified using capillary electrophoresis-time-of-flight mass spectrometry. RESULTS In total, 137 metabolites were identified and quantified. The concentrations of 44 metabolites in stimulated saliva were significantly higher than those in unstimulated saliva. Pathway analysis identified the upregulation of the urea cycle and synthesis and degradation pathways of glycine, serine, cysteine and threonine in stimulated saliva. A principal component analysis revealed that the effect of masticatory stimulation on salivary metabolomic profiles was less dependent on sample population sex, age, and smoking. The concentrations of only 1 metabolite in unstimulated saliva, and of 3 metabolites stimulated saliva, showed significant correlation with salivary secretion volume, indicating that the salivary metabolomic profile and salivary secretion volume were independent factors. CONCLUSIONS Masticatory stimulation affected not only salivary secretion volume, but also metabolite concentration patterns. A low correlation between the secretion volume and these patterns supports the conclusion that the salivary metabolomic profile may be a new indicator to characterize masticatory stimulation.
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8.
Parkinson's disease impairs masticatory function.
Ribeiro, GR, Campos, CH, Rodrigues Garcia, RCM
Clinical oral investigations. 2017;(4):1149-1156
Abstract
OBJECTIVE To evaluate masticatory function in individuals with Parkinson's disease (PD) during levodopa "on" period using new removable dental prosthesis. MATERIALS AND METHODS A total of 34 elderly individuals with PD (n = 17, mean age = 69.41 ± 4.65 years) or without PD (n = 17, mean age = 70.71 ± 4.65 years) were recruited for this study. Participants received new complete dentures and/or removable partial dentures. Two months after the subjects were free of any prostheses discomfort, masticatory function was assessed. A kinesiographic device was used to measure the range of jaw motion and jaw movements while chewing a silicone test material (Optocal). Masticatory performance was determined by median particle size (X50) of the Optocal after 40 masticatory cycles. Maximum bite force was assessed by a strain sensor placed in the bilateral first molars region. Data were analyzed by t test (P < 0.05). RESULTS The PD group showed a decreased range of jaw motion, longer duration and slower velocity of the masticatory cycle (P < 0.05), higher X50 value, and lower maximum bite force (P < 0.05). CONCLUSION PD patients have impaired masticatory function during levodopa "on" periods compared to controls. CLINICAL RELEVANCE Knowledge that PD is associated with impaired masticatory function is important to dental professionals in decision making related to prosthetics and general dental treatment.
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9.
An innovative masticatory efficiency test using odour intensity in the mouth as a target marker: a feasibility study.
Goto, T, Higaki, N, Yagi, K, Ishida, Y, Watanabe, M, Nagao, K, Ichikawa, T
Journal of oral rehabilitation. 2016;(12):883-888
Abstract
A large number of studies have reported the findings for masticatory efficiency tests; however, some objective masticatory efficiency tests have a drawback, in that subjects are required to spit out the test material. This study examined the possibility of a masticatory efficiency test that evaluates the intensity of odours released when chewing an odour compound-containing material. A total of 20 volunteers were used in this study. The odour intensity in the breath after chewing a gum was measured by portable odour sensor device. The odour intensity after chewing the gum was measured over four chewing durations and at four intervals between spitting out and measurement of the odour intensity. The volume of stimulated saliva was measured by calculating the difference in the weight of the gauze before and after chewing to examine the effect of saliva flow. With an increase in chewing duration, odour intensity reduced. The odour intensity was the highest immediately after chewing. There was a positive correlation between odour intensity and gummy jelly-related masticatory efficiency test value (G-METV), which was significant for 10-s chewing. The regression equation was calculated from three objective variables of odour intensity and G-METV as dependent variable. Pearson's correlation coefficient between G-METV and the odour intensity-related masticatory efficiency value (O-METV) was 0·68. The coefficient of variation of O-METV was significantly lower than that of G-METV. These results suggest that the masticatory performance can be estimated by measuring the odour intensity immediately after chewing food containing odour compounds for 10 s.
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10.
Kinesiographic study of masticatory movements in denture wearers with normal and resorbed denture-bearing areas.
Gonçalves, TM, Vilanova, LS, Gonçalves, LM, Garcia, RC
The Journal of prosthetic dentistry. 2014;(6):1343-8
Abstract
STATEMENT OF PROBLEM An unfavorable denture-bearing area could compromise denture retention and stability, limit mastication, and possibly alter masticatory motion. PURPOSE The purpose of this study was to evaluate the masticatory movements of denture wearers with normal and resorbed denture-bearing areas. MATERIAL AND METHODS Completely edentulous participants who received new complete dentures were selected and divided into 2 groups (n=15) according to the condition of their denture-bearing areas as classified by the Kapur method: a normal group (control) (mean age, 65.9 ± 7.8 years) and a resorbed group (mean age, 70.2 ± 7.6 years). Masticatory motion was recorded and analyzed with a kinesiographic device. The patients masticated peanuts and Optocal. The masticatory movements evaluated were the durations of opening, closing, and occlusion; duration of the masticatory cycle; maximum velocities and angles of opening and closing; total masticatory area; and amplitudes of the masticatory cycle. The data were analyzed by 2-way ANOVA and the Tukey honestly significant difference post hoc test (α=.05). RESULTS The group with a resorbed denture-bearing area had a smaller total masticatory area in the frontal plane and shorter horizontal masticatory amplitude than the group with normal denture-bearing area (P<.05). CONCLUSIONS Denture wearers with resorbed denture-bearing areas showed reduced jaw motion during mastication.