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Journal of Prosthodontics : Official... Jan 2024This systematic review aimed to verify whether anatomic, semi-anatomic, or nonanatomic occlusal morphology of artificial teeth improves the masticatory function of... (Review)
Review
PURPOSE
This systematic review aimed to verify whether anatomic, semi-anatomic, or nonanatomic occlusal morphology of artificial teeth improves the masticatory function of complete or removable partial denture wearers.
MATERIALS AND METHODS
According to the PICO strategy, six databases and the grey literature were searched to identify randomized (RCT) and non-randomized clinical trials (N-RCT) comparing masticatory function, in terms of masticatory performance and efficiency, and muscle activity as primary outcomes; and patient-reported results (O) in individuals using removable dentures (P) with different occlusal morphologies of artificial teeth (I/C). Masticatory ability, satisfaction with the prosthetic treatment, and oral health-related quality of life (OHRQoL) were evaluated as secondary outcomes. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2.0) for RCT and Risk of Bias for non-randomized studies with intervention (ROBINS-I) for N-RCT studies. Meta-analyses were performed to compare primary outcomes and masticatory ability between the occlusal morphologies of artificial teeth of complete or removable partial dentures (α = 0.05). Certainty of the evidence was verified using the GRADE approach.
RESULTS
Eleven studies (seven RCTs and four N-RCTs) were included. The risk of bias was considered low for two studies, some concerns for five, and high for the last four studies. Meta-analyses showed that removable partial dentures with anatomic artificial teeth improved masticatory efficiency for carrot chewing (MD 6.31; 95% CI [3.39, 9.22], I = 0%). However, masseter and temporal muscle activities increased when removable partial dentures with nonanatomic teeth were used (MD -756.97; 95% CI [-892.25, -621.68], I = 100%). Masticatory ability was not influenced by occlusal morphology during chewing of all foods in complete denture users: Carrot (MD -0.88, 95% CI [-8.98, 7.23], I = 57%); sausage (MD -8.86, 95% CI [-23.05, 5.33], I = 71%); apple (MD -5.78, 95% CI [-28.82, 17.26], I = 87%); and cheese (MD -4.16, 95% CI [-15.14, 6.82], I = 62%). The certainty of evidence for all evaluated outcomes was very low, mainly due to very serious problems found in the parameters of inconsistency, indirectness, and imprecision.
CONCLUSIONS
Despite the very low certainty of evidence, the occlusal morphology of artificial teeth influences masticatory function. Anatomic teeth improved the masticatory efficiency and muscle activity of removable partial denture wearers. Nonanatomic teeth increased temporal and masseter muscle activity, which negatively affected chewing in removable partial denture users. However, patients using complete dentures with anatomic and semi-anatomic teeth presented similar masticatory ability.
PubMed: 38279686
DOI: 10.1111/jopr.13824 -
Clinical Oral Investigations Jan 2024The multifactorial aspect of malocclusions and their consequences on ingestion function is rarely described in the literature. The aims of this review are (i) to... (Review)
Review
OBJECTIVES
The multifactorial aspect of malocclusions and their consequences on ingestion function is rarely described in the literature. The aims of this review are (i) to investigate the relationship between oral ingestion and malocclusion and (ii) to gather malocclusion tools that could help screen subjects at risk of malocclusion-related ingestion disorders.
MATERIAL AND METHODS
A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P 2015) guidelines. The analysis methods and inclusion criteria have been documented in a protocol published in the Prospective International Register of Systematic Reviews (PROSPERO) under the registration number CRD42023395840. The bibliographic search involved the PubMed®, Cochrane and PROSPERO databases.
RESULTS
A total of 29 articles published between 2007 and 2023 were retained by the search criteria for the qualitative synthesis. Twenty of the studies found that the severity of malocclusion has a negative impact on oral ingestion. This review highlights that malocclusion and ingestion impairments are associated but it is not possible to determine causality due to the observational approach of many of the studies.
CONCLUSION
Malocclusion has a negative impact on ingestion function. During orthodontic consultations, particular interest should be directed towards chewing, biting, and swallowing disorders, which can affect patients' nutritional status. This review offers arguments for designing further studies assessing the extent to which malocclusions may affect nutritional status.
CLINICAL RELEVANCE
Orthodontic treatment should focus on improving patients' ingestion.
Topics: Humans; Malocclusion; Mastication; Meta-Analysis as Topic; Prospective Studies; Systematic Reviews as Topic
PubMed: 38265668
DOI: 10.1007/s00784-024-05508-6 -
BMC Oral Health Jan 2024Temporomandibular disorders (TMD) are manifested by soreness in the jaw joint area and jaw muscles, clicks or creaks when opening or closing the mouth. All these... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Temporomandibular disorders (TMD) are manifested by soreness in the jaw joint area and jaw muscles, clicks or creaks when opening or closing the mouth. All these symptoms can be disabling and occur during chewing and when the patient yawns or speaks. Several classes of drugs are used to treat symptoms. This review aims to assess which drug suits the different signs.
METHODS
Pubmed, Web of Science and Lilacs were systematically searched until 01/02/2023. Clinical trials were selected that dealt with drugs used in temporomandibular dysfunction RESULTS: Out of 830 papers, eight studies were included. The Meta-Analysis with Continuous Outcomes with Pre-Calculated Effect Sizes resulted in the rejection that there is intergroup variability (p.0.74).
CONCLUSIONS
Treatment of orofacial pain is still a significant challenge for dentistry. We can conclude that there is no drug of first choice in the treatment of temporomandibular pain. However, the clinician must distinguish the type of pain and the aetioloic cause of the pain so that the patient can be treated and managed pharmacologically.
Topics: Humans; Facial Pain; Mastication; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 38218874
DOI: 10.1186/s12903-023-03524-8 -
BMC Geriatrics Jan 2024Good oral health is an important part of healthy ageing, yet there is limited understanding regarding the status of oral health care for older people globally. This...
BACKGROUND
Good oral health is an important part of healthy ageing, yet there is limited understanding regarding the status of oral health care for older people globally. This study reviewed evidence (policies, programs, and interventions) regarding oral health care for older people.
METHODS
A systematic search of six databases for published and grey literature in the English language by the end of April 2022 was undertaken utilising Arksey and O'Malley's scoping review framework.
RESULTS
The findings from oral health policy documents (n = 17) indicated a lack of priorities in national health policies regarding oral health care for older people. The most common oral health interventions reported in the published studies (n = 62) included educational sessions and practical demonstrations on oral care for older adults, nurses, and care providers. Other interventions included exercises of facial muscles and the tongue, massage of salivary glands, and application of chemical agents, such as topical fluoride.
CONCLUSION
There is currently a gap in information and research around effective oral health care treatments and programs in geriatric dental care. Efforts must be invested in developing guidelines to assist both dental and medical healthcare professionals in integrating good oral health as part of healthy ageing. Further research is warranted in assessing the effectiveness of interventions in improving the oral health status of the elderly and informing approaches to assist the integration of oral health into geriatric care.
Topics: Aged; Humans; Databases, Factual; Educational Status; Exercise Therapy; Healthy Aging; Oral Health
PubMed: 38191307
DOI: 10.1186/s12877-023-04613-7 -
CoDAS 2023There are several types of approaches that can be used to achieve therapeutic goals in disorders related to the functions of mastication, swallowing, speech, and...
There are several types of approaches that can be used to achieve therapeutic goals in disorders related to the functions of mastication, swallowing, speech, and breathing. However, the literature lacks evidence to support their use in speech-language clinical practice. The objective of this review was to map the syntheses of evidence on speech-language pathology intervention in the areas of breathing, mastication, swallowing and speech in adults and the elderly. Only studies classified by their authors as a systematic review, studies that addressed therapy for orofacial disorders in individuals over 18 years of age were included. The procedures performed included: electronic and manual search; selection of studies; data extraction; evaluation of the quality of studies and data analysis. It was possible to observe different types of interventions mainly aimed at the swallowing function, ranging from traditional therapy to the use of devices. However, due to the limitations of the studies, the data must be interpreted with caution.
Topics: Adult; Humans; Adolescent; Aged; Deglutition; Mastication; Speech-Language Pathology; Speech; Communication Disorders
PubMed: 38126592
DOI: 10.1590/2317-1782/20232022339pt -
The relationships between mastication and cognitive function: A systematic review and meta-analysis.The Japanese Dental Science Review Dec 2023Masticatory function such as chewing is expected to modify human cognitive function, and/or the possibility of improving cognitive function is also predicted. This... (Review)
Review
Masticatory function such as chewing is expected to modify human cognitive function, and/or the possibility of improving cognitive function is also predicted. This systematic review investigated whether masticatory function affects cognitive function for older/young adults. Full articles written in English from January 2000 to April 2022 were collected using PubMed and Cochrane Library. Target outcomes were cognitive function test scores, cognitive processing speed (reaction time), and masticatory function. For each research question, two independent reviewers conducted the search and screening, data extraction, quality assessment, and risk of bias assessment. The reviewers resolved any disagreements by discussion. From 226 articles retrieved, 20 were included in this review. Older adults with lower scores on the cognitive function test had lower masticatory performance, lower chewing ability, chewing difficulty, and decreased number of teeth. An increased risk of cognitive impairment was found in older adults with masticatory dysfunction. For young adults, gum chewing significantly reduced the processing speed of cognitive tasks compared to no gum chewing. Although most of the evidence included had a low level of evidence and a high risk of bias because of the research designs, the results still suggest that mastication may be a factor in improving cognitive function.
PubMed: 38022390
DOI: 10.1016/j.jdsr.2023.10.001 -
The Journal of Prosthetic Dentistry Nov 2023Reports on digitally fabricated complete dentures are increasing. However, comprehensive evidence-based research on their cost-efficiency and patient-reported outcome... (Review)
Review
STATEMENT OF PROBLEM
Reports on digitally fabricated complete dentures are increasing. However, comprehensive evidence-based research on their cost-efficiency and patient-reported outcome measures (PROMs) is lacking.
PURPOSE
The purpose of this systematic review was to compare the cost-effectiveness and PROMs between digitally and conventionally fabricated complete dentures.
MATERIAL AND METHODS
An electronic search of publications from 2011 to mid-2023 was established using PubMed/Medline, EBSCOhost, and Google Scholar. Retrospective, prospective, randomized controlled, and randomized crossover clinical studies on at least 10 participants were included. A total of 540 articles were identified and assessed at the title, abstract, and full article level, resulting in the inclusion of 14 articles. Data on cost, number of visits, patient satisfaction, and oral health-related quality of life were examined and reported.
RESULTS
The systematic review included 572 digitally fabricated complete dentures and 939 conventionally fabricated complete dentures inserted in 1300 patients. Digitally fabricated complete dentures require less clinical time with a lower total cost, despite higher material costs compared with the conventional fabrication technique. Digitally and conventionally fabricated complete dentures were found to have significant effects on mastication efficiency, comfort, retention, stability, ease of cleaning, phonetics, and overall patient satisfaction, as well as social disability, functional limitation, psychological discomfort, physical pain, and handicap.
CONCLUSIONS
Digitally fabricated complete dentures are more cost-effective than conventionally fabricated dentures. There are various impacts of conventionally and digitally fabricated complete dentures on PROMs, and they are not better than one another.
PubMed: 38000966
DOI: 10.1016/j.prosdent.2023.10.028 -
Journal of Clinical Medicine Sep 2023This review analyzes muscle activity following mandibular condylar fracture (CF), with a focus on understanding the changes in masticatory muscles and temporomandibular... (Review)
Review
UNLABELLED
This review analyzes muscle activity following mandibular condylar fracture (CF), with a focus on understanding the changes in masticatory muscles and temporomandibular joint (TMJ) functioning.
MATERIALS AND METHODS
The review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A search was performed on online databases using the keywords "masticatory muscles" AND ("mandibular fracture" OR "condylar fracture"). The eligibility criteria included clinical trials involving human intervention and focusing on muscle activity following a condylar fracture.
RESULTS
A total of 13 relevant studies were reviewed. Various studies evaluated muscle activity using clinical evaluation, bite force measurement, electromyography (EMG), magnetic sensors and radiological examinations to assess the impact of mandibular fractures on masticatory muscles.
CONCLUSIONS
Mandibular condylar fractures can lead to significant changes in muscle activity, affecting mastication and TMJ functioning. EMG and computed tomography (CT) imaging play crucial roles in assessing muscle changes and adaptations following fractures, providing valuable information for treatment planning and post-fracture management. Further research is required to explore long-term outcomes and functional performance after oral motor rehabilitation in patients with facial fractures. Standardized classifications and treatment approaches may help improve the comparability of future studies in this field.
PubMed: 37762866
DOI: 10.3390/jcm12185925 -
Clinical Oral Implants Research Sep 2023This review evaluated the effects of rehabilitation with implant-supported prostheses on the oral function of completely edentulous adults. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This review evaluated the effects of rehabilitation with implant-supported prostheses on the oral function of completely edentulous adults.
MATERIALS AND METHODS
Systematic literature searches were performed to identify records reporting on oral function in completely edentulous adults rehabilitated with implant-supported prostheses. Meta-analyses were performed on various outcomes including bite force, masticatory performance, muscle activity, mandibular movement/chewing pattern, and salivary flow.
RESULTS
5507 records were identified. Thirty studies qualified for data extraction and analysis. The kappa (𝛋) for the search and identification strategy ranged between 0.50 and 1.00. Meta-analysis was performed grouping the studies by outcomes and split by time points of 6-12 months, 12-36 months, and >36 months after implant therapy. The meta-analyses revealed a significant improvement in oral function of completely edentulous adults after rehabilitation with implant-supported prostheses at 6-12 months (Z = -4.895, p < .001; 95% CI: -0.703, -0.301; τ = .609; Q = 114.953, df = 17, p < .001; I = 85.2%), at 12-36 months (Z = -4.886, p < .001; 95% CI: -0.580, -0.248; τ = .908; Q = 280.611, df = 35, p < .001; I = 87.5%) and at more than 36 months (Z = -9.108, p < .001; 95% CI: -1.472, -0.951; τ = .019; Q = 7.918, df = 7, p = .340; I = 11.6%). The included studies demonstrated a low to moderate risk of bias.
CONCLUSIONS
This systematic review concluded that the oral function of completely edentate adults significantly improved with implant-supported/retained prostheses, even when only one jaw received implant therapy. Therefore, implant therapy should be promoted for edentulous adults to alleviate the shortcomings of conventional complete removable dental prostheses.
Topics: Adult; Humans; Dental Prosthesis, Implant-Supported; Dental Implants; Bite Force; Mandible; Mastication; Mouth, Edentulous
PubMed: 37750517
DOI: 10.1111/clr.14068 -
The International Journal of... Jun 2024To evaluate the impact of removable partial dentures (RPDs) on masticatory performance (MP) of partially edentulous subjects.
PURPOSE
To evaluate the impact of removable partial dentures (RPDs) on masticatory performance (MP) of partially edentulous subjects.
MATERIALS AND METHODS
Electronic database and hand searches were conducted to explore clinical trials reporting the evidence of the effect of metal- and acrylic-based RPDs on mastication. The validated objective and subjective measures of assessment of mastication were included. The article selection, data extraction, and assessment of risk of bias were conducted by two reviewers independently.
RESULTS
Out of 11,200 studies, 1 randomized controlled trial and 23 clinical trials met the inclusion criteria. Positive impact on different parameters of masticatory function after RPD treatment was reported in 14 studies. Subjective evaluation of chewing ability (CA) displayed an improvement in 83.3% of studies, while improvement was evidenced only in 69.5% of studies upon objective evaluation. Most studies reported data on free-end saddles. Of the 13 studies associated with bilateral free-end saddle dentures, 9 studies showed a positive effect on masticatory efficiency. Various factors were found to have an impact on the MP of RPDs.
CONCLUSIONS
Subjective evaluation displays higher positive impact of RPDs in MP than objective evaluation. Assessment of patients' perspectives is important in clinical decision-making. Multiple factors affect the MP with RPD treatment.
Topics: Denture, Partial, Removable; Mastication; Humans; Jaw, Edentulous, Partially
PubMed: 37729477
DOI: 10.11607/ijp.8278