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1.
Improvement in Food Intolerance Resulting from Roux-En-Y Gastric Bypass after Speech Therapy Intervention in Chewing.
Rossi, DC, Soares, AN, Silva, KRS, Britto, ATBO, Bosco, AA
Obesity surgery. 2019;(10):3195-3201
Abstract
INTRODUCTION Food intolerance is expected during the postoperative period following gastric bypass and may be associated with inadequate chewing. OBJECTIVE To evaluate chewing before and after speech therapy intervention in subjects undergoing Roux-en-Y gastric bypass who present with food intolerance. MATERIALS AND METHODS This was a randomized controlled trial, approved by the Brazilian Ethics and Research Committee under n. 438,600. The study population was allocated into two groups: the study group (SG), who received speech therapy intervention, and the control group (CG), who did not receive any intervention, in six visits at 7, 15, 30, 60, and 90 days (v7, v15, v30, v60, and v90) after the initial visit (v0). During v0 and v90, a chewing evaluation was performed according to the MBGR protocol adapted. The significance level adopted was 5%. RESULTS A total of 30 females (88%) and 4 males (12%) were analyzed. The SG had 18 subjects, and the CG had 16, with mean ages of 50.17 ± 12.28 years and 45.69 ± 9.78 years, respectively. The postoperative time ranged from 4 to19 months. In the SG, a marked improvement in the number of episodes of food intolerance was observed (p < 0.001), an improvement in the intake of cereals and meats (p = 0.004 and p < 0.001, respectively), and an improvement in chewing capacity and swallowing (p = 0.002 and p = 0.011, respectively). CONCLUSION Speech therapy intervention in chewing led to a marked improvement of food acceptance and food intolerance resulting from Roux-en-Y gastric bypass.
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2.
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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3.
Effect of chewing rate on meal intake.
Paphangkorakit, J, Kanpittaya, K, Pawanja, N, Pitiphat, W
European journal of oral sciences. 2019;(1):40-44
Abstract
Fast eating has been shown to increase the risk of overweight in both children and adults. The objectives of the present study were to investigate the correlation between chewing rate and the number of chews per mouthful and to evaluate if they were associated with the weight of meal intake. Thirty healthy subjects, aged 18-24 yr, ate a test lunch at their habitual speed until they felt satiated. The activities of masseter and suprahyoid muscles were recorded to determine the number of chews and the moment of swallowing. The weight of meal intake was recorded along with body mass index (BMI), chewing rate, number of chews per mouthful, meal duration, ingestion rate, hunger, and food preference levels. The mean weight (±SD) of meal intake, chewing rate, and number of chews per mouthful were 261.4 ± 78.9 g, 94.4 ± 13.5 chews min-1 , 19.2 ± 6.4 chews per mouthful, respectively. Chewing rate was not correlated with the number of chews per mouthful. The multivariable linear regression showed that meal intake was significantly positively associated with chewing rate, meal duration, and BMI, but inversely associated with the number of chews per mouthful (adjusted R2 = 0.42). It was concluded that the number of chews was not associated with chewing rate but meal intake was explained by both reduced number of chews and increased chewing rate.
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4.
Chewing gum for 1 h does not change gastric volume in healthy fasting subjects. A prospective observational study.
Valencia, JA, Cubillos, J, Romero, D, Amaya, W, Moreno, J, Ferrer, L, Pabón, S, Perlas, A
Journal of clinical anesthesia. 2019;:100-105
Abstract
STUDY OBJECTIVE Perioperative fasting guidelines differ in their approaches to chewing gum in the preoperative period. Current recommendations range from canceling the surgery to proceeding with it. Given this lack of consensus, we performed gastric ultrasound assessments in healthy volunteers before and after a standardized period of chewing gum. The objective of our study was to determine if chewing gum for 1 h change the gastric volume. DESIGN Observational prospective analytical study. SETTING Bedside gastric ultrasound. PATIENTS Following institutional Review Board approval, 55 healthy (American Society of Anesthesiologists class I to II) fasted (non-surgical research) volunteers provided written informed consent to participate in the study. Morbid obesity, renal failure, diabetes mellitus, pregnancy and previous upper abdominal surgery were exclusion criteria. INTERVENTIONS Volunteers chewed gum for 1 h between the first and second assessment. MEASUREMENTS Four gastric ultrasound assessments were performed, the first one at baseline and then hourly thereafter. MAIN RESULTS Fifty-five healthy volunteers were studied. The proportion of subjects who presented a completely empty stomach (Grade 0 antrum) was similar at baseline and after 1 h of gum-chewing [81% vs. 84%, p = 0.19, CI 95% (-12%, 16%)]. Among those subjects who had visible fluid at baseline, the volume remained unchanged throughout the study period. CONCLUSIONS One hour of gum-chewing had no significant effect on the gastric fluid volume of healthy volunteers, suggesting that it may be safe for healthy subjects to chew gum prior to elective surgery.
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5.
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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6.
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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7.
Effect of implant-supported mandibular overdentures versus reline on masticatory performance and salivary flow rates in very old adults-A randomized clinical trial.
Maniewicz, S, Duvernay, E, Srinivasan, M, Perneger, T, Schimmel, M, Müller, F
Clinical oral implants research. 2019;(1):59-67
Abstract
PURPOSE To compare the masticatory efficiency (ME), maximum voluntary bite force (MBF), masseter muscle thickness (MMT), and salivary flow rates (SFR) in completely edentulous dependent elders treated either with a conversion of their existing mandibular complete removable dental prostheses (CRDPs) into a two-implant overdenture (IOD) or a conventional reline of the CRDP. MATERIAL AND METHODS Participants were randomly allocated into intervention (IG) and control (CG) groups. The IG received two implants in the mandibular canine regions, and their CRDPs were transformed into IODs. The CG received a conventional reline of their mandibular CRDPs. Outcomes were recorded at each recall visit (baseline, immediately, 3 months, 12 months after intervention, and subsequently on an annual basis). Statistical analyses used mixed linear regression models (level of significance: p < 0.05). RESULTS The IG comprised 16 participants (age = 85.0 ± 6.2 years), while the CG comprised 16 (age = 84.8 ± 5.4 years), with a mean follow-up of 2.7 ± 2.2 years (range: 3 months-7 years). A significant increase of MBF in the IG was observed with an overall gain of 80 N (p < 0.001) compared with the reline group. There were no significant long-term changes in SFR, MMT, or ME within/between groups. CONCLUSION Since dependent elders with mandibular IODs present a significant gain in MBF, but no relative increase in SFR, MMT, and ME, it seems that this increased capacity of MBF is not exploited by the elders during their habitual chewing.
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8.
Relationship between functional masticatory units and cognitive impairment in elderly persons.
Cardoso, MG, Diniz-Freitas, M, Vázquez, P, Cerqueiro, S, Diz, P, Limeres, J
Journal of oral rehabilitation. 2019;(5):417-423
Abstract
BACKGROUND Studies on the elderly have reported that the risk of cognitive impairment is affected by chewing difficulty. OBJECTIVE To determine whether there is a relationship between the number of pairs of antagonist teeth that come into contact when the mouth is closed (functional masticatory units [FMUs]) and the level of cognitive impairment. METHODS We conducted a cross-sectional observational study with 502 institutionalised White individuals older than 65 years, living in the northwest of Spain and Portugal. Through a direct visual inspection, we recorded the number of FMUs. Cognitive impairment was assessed by applying the Mini-Cognitive Examination (MCE), a test derived from the Mini-Mental State Examination. To describe the statistical relationship between the FMUs and the MCE values, a generalised linear model (GLM) was applied. We assessed the GLM predictive capacity for detecting cognitive impairment (MCE ≤23) in a new study group consisting of 156 elderly individuals. RESULTS A large number of FMUs was significantly associated with a lower probability of cognitive impairment, regardless of the nature of the contact and its location (explained deviance, 30.1%). The model's discriminatory capacity for cognitive impairment based on the FMUs was "good" (0.820). The model's predictive capacity for cognitive impairment was "acceptable" (sensitivity, 0.786; positive predictive value, 0.900; accuracy, 0.729). CONCLUSION In White, elderly institutionalised individuals, the absolute number of FMUs is significantly related to their MCE scores.
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9.
Effects of Quartz Splint Woven fiber periodontal fixtures on evaluating masticatory efficiency and efficacy.
Su, J, Cai, S
Medicine. 2018;(44):e13056
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Abstract
Masticatory efficiency is altered by mobile teeth resulting from periodontal disease. The goal of our study was to investigate changes before and after fixation of mobile teeth with a Quartz Splint Woven high-strength quartz fiber splint and evaluate the fixation effect.Forty-two patients with chronic severe periodontal disease and 2 to 3 degree tooth mobility underwent fixation with Quartz Splint Woven quartz fiber splints. Masticatory efficiency was determined before and 1 month after periodontal treatment, and 1 month after fixation. Changes in periodontal probing depth (PD) and periodontal attachment level (AL) were measured and clinical efficacy was evaluated.Masticatory efficiency significantly increased from 39.32% to 50.95% after treatment (P < .001). One month post-fixation, mastication efficiency increased to 67.99% (P < .001). At 3 months post-fixation, efficacy was 100% and at 6 months it was 95.24%; PD decreased from (4.91 ± 0.63) to (4.19 ± 0.60) mm at 1 month post-periodontal treatment, and significantly decreased to (3.73 ± 0.60) mm 1 month post-fixation (P < .001); AL decreased from (4.43 ± 0.58) to (3.96 ± 0.51) mm 1 month after periodontal treatment. One month post-fixation, AL reduced to (3.64 ± 0.46) mm (P < .001).Masticatory efficiency improved after periodontal treatment. Using Quartz Splint Woven quartz fiber periodontal splint for mobile tooth fixation can further improve mastication efficiency and periodontal condition. A stable and ideal fixation can be achieved within 6 months, which provides a clinical basis for treatment and preserving mobile teeth in severe periodontal disease. Mastication efficiency may be recommended as the index for evaluating curative effects of periodontal disease treatment.
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Effects of orofacial myofunctional therapy on masticatory function in individuals submitted to orthognathic surgery: a randomized trial.
Prado, DGA, Berretin-Felix, G, Migliorucci, RR, Bueno, MDRS, Rosa, RR, Polizel, M, Teixeira, IF, Gavião, MBD
Journal of applied oral science : revista FOB. 2018;:e20170164
Abstract
OBJECTIVES The esthetic and functional results of orthognathic surgery of severe dentofacial deformities are predictable, however there are differences regarding the effects on stomatognathic system. The aim was to investigate the effects of orofacial myofunctional therapy (OMT) on the masticatory function in individuals with dentofacial deformity submitted to orthognathic surgery (OGS). MATERIAL AND METHODS Forty-eight individuals (18-40 years) were evaluated, 14 undergoing OMT (treated group-TG), 10 without this treatment (untreated group-UTG) and 24 in a control group with normal occlusion; for clinical aspects the data of an individual was missed (n=46). Chewing was performed using the Expanded protocol of orofacial myofunctional evaluation with scores (OMES-E). Muscle tone and mobility were also analyzed before (P0), three (P1) and six months (P2) after OGS. Surface electromyography of the masseter and temporalis muscles was performed, considering the parameters amplitude and duration of act and cycle, and the number of masticatory cycles. The OMT consisted of ten therapeutic sessions along the postoperative period. The results were compared using parametric and non-parametric tests. RESULTS TG showed higher scores in P1 and P2 than P0; for the masticatory type the scores in P2 were significantly higher than P0. In addition, the proportion of individuals with adequate tone of lower lip and adequate tongue mobility for TG increased significantly from P1 and P2 in relation to P0. The EMG results showed a decrease in act and cycle duration in P2 in relation to P0 and P1 for the TG; furthermore the values were close to controls. An increase in the number of cycles from P0 to P2 was also observed, indicating faster chewing, which may be attributed to an improvement of balanced occlusion associated with OMT. CONCLUSION There were positive effects of OMT on the clinical and electromyography aspects of chewing in individual submitted to orthognathic surgery.