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Journal of Oral Rehabilitation Feb 2024Botulinum toxin-A (BTX) is a potent neurotoxin that is emerging in the scope of dental practice for its ability to temporarily paralyse musculature and reduce... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Botulinum toxin-A (BTX) is a potent neurotoxin that is emerging in the scope of dental practice for its ability to temporarily paralyse musculature and reduce hyperfunction. This may be desirable in diseases/disorders associated with hyperactive muscles such as the muscles of mastication, most implicated in painful temporomandibular disorders (TMDs). The use of BTX extends beyond its indications with off-label use in TMD's and other conditions, while potential adverse effects remain understudied. BTX is well-established hindlimb paralysis model in animals leading to significant bone loss with underlying mechanisms remaining unclear. The objective of this study is to systematically review the literature for articles investigating changes in mandibular bone following BTX injections and meta-analyse available data on reported bone outcomes.
METHODS
Comprehensive search of Medline, Embase and Web of Science retrieved 934 articles. Following the screening process, 36 articles in animals and humans were included for quantitative synthesis. Articles in human individuals (6) and three different animal species (14) presented mandibular bone outcomes that were included in the meta-analysis.
RESULTS
The masseter and temporalis muscles were frequently injected across all species. In humans, we observe a decrease of about 6% in cortical thickness of mandibular regions following BTX injection with no evident changes in either volume or density of bone structures. In animals, bone loss in the condylar region is significantly high in both cortical and trabecular compartments.
DISCUSSION
Our analysis supports the concept of BTX-induced bone-loss model in animal mandibles. Further, bone loss might be confined to the cortical compartments in humans. Most studies did not address the reality of repeated injections and excessive dosing, which occur due to the reversible action of BTX. More rigorous trials are needed to draw a full picture of potential long-term adverse effects on bone.
Topics: Animals; Humans; Botulinum Toxins, Type A; Mandible; Masseter Muscle; Muscles; Injections, Intramuscular
PubMed: 37668276
DOI: 10.1111/joor.13590 -
BMC Oral Health Aug 2023Oral hypofunction comprises 7 oral function conditions, including mastication, swallowing, pronouncing, oral hygiene, and oral dryness. However, it remains unresolved...
BACKGROUND
Oral hypofunction comprises 7 oral function conditions, including mastication, swallowing, pronouncing, oral hygiene, and oral dryness. However, it remains unresolved whether having oral hypofunction and each individual condition adversely affect general health. This study aimed to investigate the association between oral hypofunction and general health, encompassing physical, psychological, and social dimensions.
METHODS
Oral hypofunction was diagnosed following the criteria proposed by the 2016 Japan Society of Gerodontology, comprising 7 oral function conditions. Oral hypofunction was diagnosed when at least 3 conditions presented. The selected studies eligible for reviewing were based on the PI(E)CO criteria: P (population), adult and older adults; I/E (intervention/exposure), having oral hypofunction by considering overall and individual 7 oral function conditions; C (comparator), not having oral hypofunction; O (outcome), the general health status, encompassing physical, psychological, and social dimensions. Electronic search limited to English articles was performed through PubMed, Scopus, and Cochrane Database of Systematic Reviews databases from January 2016 to June 2023. The included studies were assessed for quaility and risk of bias using the modified Newcastle-Ottawa scale. Qualitative analyses were performed on the general outcome, and having oral hypofunction considering overall and individual oral function conditions.
RESULTS
Ten studies were included in the final syntheses. One was a prospective cohort, one was a case-control, and the others were cross-sectional studies. All included studies were high quality. General health outcomes were mostly frailty, sarcopenia, and malnutrition, whereas mild cognitive impairment,social withdrawal, and gastric cancer prognosis were identified in one of the included studies. The association between general health and having oral hypofunction was stronger than when considering an individual condition. The health outcomes were predominantly associated with mastication and swallowing, whereas their relationships with oral hygiene and dryness were less likely to be reported.
CONCLUSIONS
The present review found an association between the presence of oral hypofunction and impaired general health. However, the specific impact on individual physical, psychological, and social dimensions cannot be distinctly delineated. Further prospective studies are required to clarify the causal-effect relationship between oral and general health.
Topics: Aged; Humans; Cognitive Dysfunction; Databases, Factual; Frailty; Health Status; Systematic Reviews as Topic
PubMed: 37620920
DOI: 10.1186/s12903-023-03305-3 -
Journal of Gastrointestinal Surgery :... Oct 2023
Meta-Analysis
Commentary on: "Gum Chewing and Coffee Consumption But Not Caffeine Intake Improve Bowel Function After Gastrointestinal Surgery: a Systematic Review and Network Meta-analysis." J Gastrointest Surg. 2023 Jun 5. doi: 10.1007/s11605-023-05702-z.
Topics: Humans; Defecation; Coffee; Digestive System Surgical Procedures; Network Meta-Analysis; Mastication; Gastrointestinal Motility; Chewing Gum
PubMed: 37620662
DOI: 10.1007/s11605-023-05810-w -
Journal of Oral Rehabilitation Dec 2023Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing... (Review)
Review
BACKGROUND
Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food.
OBJECTIVE
To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses.
METHODS
This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches.
RESULTS
Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND.
CONCLUSIONS
Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.
Topics: Humans; Dental Prosthesis, Implant-Supported; Mouth, Edentulous; Denture, Complete; Mastication; Muscles; Dental Implants; Denture, Overlay
PubMed: 37605296
DOI: 10.1111/joor.13564 -
Maxillofacial Plastic and... Jul 2023This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation... (Review)
Review
Outcomes and influential factors in functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region: a systematic review and meta-analysis.
BACKGROUND
This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region.
MAIN TEXT
We conducted a comprehensive search of electronic databases, including MEDLINE, Web of Science, Embase, Scopus, and Cochrane's CENTRAL, as well as gray literature sources and manual searches of notable journals. The search was performed from inception until February 2023. Studies were included if they examined functional and dental rehabilitation outcomes in patients receiving maxillofacial reconstruction using microvascular fibula flaps and were retrospective or prospective cohort studies involving human subjects. Case-control studies, research involving other reconstruction methods, and animal-based studies were excluded. Data was extracted and confirmed by two independent researchers, and risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analyses were conducted for dental implant and graft success rate, with separate analyses for different factors affecting the outcome. Heterogeneity was evaluated using Cochran's Q test and the I test. The pooled success rate for implants was 92% and for grafts, 95%, with significant heterogeneity. Implants in fibular grafts had a 2.91 times higher failure rate than those in natural bones. Radiated bone and smoking were identified as factors influencing implant failure, with radiated bone having a 2.29 times higher risk and smokers having a 3.16 times higher risk compared to their respective counterparts. Patient-reported outcomes showed improvements in key areas such as dietary intake, mastication, speech, and esthetics. The success rates declined over time, emphasizing the importance of long-term follow-up.
CONCLUSIONS
Dental implants in free fibula grafts generally have favorable success rates, with minimal bone resorption, manageable probing depths, and limited bleeding on probing. Implant success is influenced by factors such as smoking and radiated bone.
PubMed: 37418121
DOI: 10.1186/s40902-023-00392-8 -
Chewing performance of patients with worn dentition before and after restorations: A scoping review.Journal of Oral Rehabilitation Jan 2024Tooth wear is a multifactorial complex process related to the loss of dental tissue, due to chemical or mechanical processes, by abrasion, attrition, erosion.... (Review)
Review
BACKGROUND
Tooth wear is a multifactorial complex process related to the loss of dental tissue, due to chemical or mechanical processes, by abrasion, attrition, erosion. Restorative treatment represents an attempt to rebuild and recreate the lost structure.
OBJECTIVE
This scoping review aims to investigate whether restorative treatment of worn dentition (either with direct or indirect adhesive composite adhesive procedures or with prosthetic techniques) can have an impact on the masticatory performance parameters.
METHODS
A scoping review was conducted on multiple databases (Pubmed, Medline CENTRAL, ICTRP), following the PRISMA guidelines. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who satisfied the inclusion and exclusion criteria.
RESULTS
Only one article meet the inclusion criteria of the review. Restorative treatment of worn dentition although have a positive impact on the self-report ability to chew, has no effect on the masticatory performance test.
CONCLUSION
At the moment, not enough evidence to comment on the actual therapeutic role of restorative treatment on tooth wear is available. Clinicians, before taking any clinical decision, should carefully discuss with patients the needs and expectations of the treatment plan.
Topics: Humans; Dentition; Dental Restoration, Permanent; Mastication; Tooth Wear
PubMed: 37370261
DOI: 10.1111/joor.13549 -
Journal of Gastrointestinal Surgery :... Aug 2023Postoperative ileus is common after gastrointestinal surgery. This network meta-analysis aimed to compare the effectiveness of gum chewing and coffee and caffeine intake... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Postoperative ileus is common after gastrointestinal surgery. This network meta-analysis aimed to compare the effectiveness of gum chewing and coffee and caffeine intake on ileus-related outcomes.
METHODS
A systematic literature review was performed to identify randomized controlled trials (RCTs) comparing noninvasive treatments for ileus after gastrointestinal surgery. The main analyses included random effects network meta-analyses using frequentist methods with simultaneous direct and indirect comparisons of time to first flatus, time to first defecation, and length of stay. Bayesian network meta-analysis using Markov chains was also used.
RESULTS
A total of 32 RCTs comparing 4999 patients were included in this network meta-analysis. Time to flatus was reduced by gum chewing (mean difference compared to control (MD): -11 h, 95% confidence interval (95% CI) - 16 to - 5 h, P < 0.001). Time to defecation was reduced by gum chewing and coffee, with MDs of -18 h (95% CI - 23 to - 13 h, P < 0.001) and -13 h (95% CI - 24 to - 1 h, P < 0.001), respectively. Length of stay was reduced by coffee and gum chewing with MDs of - 1.5 days (95% CI: - 2.5 to - 0.6 days, P < 0.001) and - 0.9 days (95% CI: - 1.3 to - 0.4 days, P < 0.001), respectively.
CONCLUSION
Coffee and gum chewing were proven to be effective noninvasive approaches for shortening the postoperative length of hospital stay and time to first defecation, especially in open gastrointestinal surgery; thus these actions should be recommended after gastrointestinal surgery.
Topics: Humans; Defecation; Coffee; Network Meta-Analysis; Mastication; Flatulence; Ileus; Postoperative Complications; Digestive System Surgical Procedures; Chewing Gum; Length of Stay; Gastrointestinal Motility
PubMed: 37277676
DOI: 10.1007/s11605-023-05702-z -
Journal of Oral Rehabilitation Aug 2023Masticatory dysfunction impacts food selection, nutritional intake and social activities; all of which play a vital role to ensure good general health and quality of... (Review)
Review
BACKGROUND
Masticatory dysfunction impacts food selection, nutritional intake and social activities; all of which play a vital role to ensure good general health and quality of life. Despite the rapidly ageing population, there is limited evidence regarding the risk factors that lead to masticatory dysfunction in older adults or protective factors which may help maintain masticatory ability. Furthermore, there is currently no consensus for a specific test which measures masticatory ability.
OBJECTIVES
The objectives of this scoping review are to identify the risk and protective factors associated with masticatory dysfunction and determine the most commonly used objective measure of masticatory performance.
DESIGN
A scoping review was performed using the PRISMA recommendations. MEDLINE (Ovid), Embase, Scopus and Web of Science databases were searched. Seventy-eight articles were included in this review. There were six randomised controlled trials, six interventional studies, one systematic review, one quasi-experimental study, five prospective cohort studies, 58 cross-sectional studies and one case-control study. Data were analysed for frequency of studies reporting on risk factors, protective factors and/or objective measures of masticatory performance.
RESULTS
This scoping review identified tooth loss as the most common risk factor for masticatory dysfunction. Other notable risk factors included musculoskeletal conditions such as frailty and sarcopenia, cognitive decline and malnutrition. Additionally, the review identified that the presence or addition of teeth was the main protective factor. Other protective factors included denture maintenance via liners and adhesives, textured foods, and oral exercises. Chewing gum was the most common objective measure of masticatory function, followed by the occlusal force and sieve methods.
CONCLUSIONS
This scoping review found that there was limited evidence for a causal link between each of the risk factors and masticatory dysfunction or the protective factors and the maintenance of masticatory ability in older adults. Establishing a standard method for measuring masticatory performance such as the commonly used chewing gum method and encouraging clinicians to routinely measure masticatory function will enable comparisons across multiple risk and protective factors, improving the evidence base and contributing to better patient care.
Topics: Humans; Aged; Cross-Sectional Studies; Quality of Life; Chewing Gum; Case-Control Studies; Prospective Studies; Mastication
PubMed: 37183339
DOI: 10.1111/joor.13493 -
Journal of Psychoactive Drugs 2024In several countries, including Ethiopia, the shrub Catha edulis (khat) leaves are chewed for their stimulant properties. The present review summarizes evidence on the... (Meta-Analysis)
Meta-Analysis
In several countries, including Ethiopia, the shrub Catha edulis (khat) leaves are chewed for their stimulant properties. The present review summarizes evidence on the prevalence of khat use in Ethiopia and forwards recommendations for future action. PubMed, Embase, and Scopus were searched for studies examining the prevalence of Khat chewing among adolescent and/or adult populations in Ethiopia. A random-effects model was employed to estimate the pooled prevalence of khat chewing. Of the 568 articles identified, 26 were included in the review. The pooled prevalence of current and lifetime khat use was 19.55% (95% CI 14.62-25.64) and 26.14% (CI 17.66-36.87), respectively. The current prevalence of khat use was higher in men, 23.72% (CI 13.42-38.41), than in women 8.45% (CI 4.94-14.08). Lifetime prevalence of khat use was higher in men, 29.8% (CI: 22.80-37.99) than in women 13.02% (CI 8.96-18.56). The results of the meta-analysis demonstrated a higher odds of current (OR = 4.00, CI 2.80-5.73) and lifetime (OR = 2.84, CI 2.50-3.23) khat use in men than in women. Our review found a high prevalence of current (19.55%) and lifetime (26.14%) khat chewing in Ethiopia and demonstrated higher odds of current and lifetime khat use in men than in women. Awareness creation and integrated management of khat use problems at the primary health-care level is highly recommended.
Topics: Humans; Catha; Ethiopia; Mastication; Plant Leaves; Prevalence
PubMed: 36508190
DOI: 10.1080/02791072.2022.2155735 -
Critical Reviews in Food Science and... Nov 2023The study aimed to evaluate the hypothesis that chewing is a mechanical and physiological contributor to swallowing, physiologic/pathologic processes of the...
The study aimed to evaluate the hypothesis that chewing is a mechanical and physiological contributor to swallowing, physiologic/pathologic processes of the gastrointestinal tract (GIT), and nutrition-related factors. A search strategy was applied to three different databases to investigate if chewing function in adults affects the swallowing, physiologic/pathologic processes of the GIT, and nutrition-related factors compared to controls with no exposure. The included studies were evaluated for methodological quality and risk of bias and certainty of evidence. The results showed 71 eligible studies. Overall, the results showed that 46 studies supported the hypothesis while 25 refuted it. However, the GRADE analysis showed low to very low certainty of the evidence to support the hypothesis that chewing is an important contributor in the swallowing process, and physiologic/pathologic processes in the GIT. The GRADE analysis also showed a moderate to very low certainty of the evidence to suggest that chewing function contributes to nutrition-related parameters. The overall results of the current study showed that a majority (64.7%) of the studies (46 out of 71) supported the hypothesis. However, robust studies with proper design, adequate sample size, and well-defined outcome parameters are needed to establish conclusive evidence.
Topics: Deglutition; Mastication; Gastrointestinal Tract; Nutritional Status
PubMed: 35837677
DOI: 10.1080/10408398.2022.2098245