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Scientific Reports Jun 2024The present study aimed to assess the effectiveness and functional adverse effects of a single and multiple injections of botulinum toxin A (BoNT-A) for masseter... (Randomized Controlled Trial)
Randomized Controlled Trial
The present study aimed to assess the effectiveness and functional adverse effects of a single and multiple injections of botulinum toxin A (BoNT-A) for masseter hypertrophy (MH). Twenty-six women complaining about lower third facial enlargement due to MH, received 75 U of BoNT-A (abobotulinum toxin) in each masseter muscles. After 3 months, patients were randomly assigned to receive a second treatment session of Saline Solution: (G1; n = 11) or BoNT-A: (G2; n = 12). Muscle thickness (ultrasound), electrical activity (electromyography; EMG), masticatory performance, and subjective perception of MH were evaluated. Follow-up was performed at 1, 3 and 6 months. Muscle thickness, EMG activity, and masticatory performance were analyzed using ANOVA two-way and Sidak test as post-hoc. Masticatory performance was analyzed by the Friedman's test and Mann-Whitney test. Regarding inter-groups comparisons, there was a significant decrease in the left masseter muscle thickness in the G2 group at the 6 month follow-up (p < 0.02). For EMG, significant differences were evident at the 6 month assessment, with higher masseter activity for G1 (p < 0.05). For masticatory performance, no significant differences were observed throughout the study (p > 0.05) and a higher improvement in subjective perception of MH was observed in the 1 month follow-up for G2 (p < 0.05). In conclusion, BoNT-A is effective for MH, however multiple injections cause functional adverse effects in masseter muscle.
Topics: Humans; Masseter Muscle; Female; Hypertrophy; Botulinum Toxins, Type A; Adult; Electromyography; Mastication; Middle Aged; Treatment Outcome; Neuromuscular Agents; Injections, Intramuscular
PubMed: 38914688
DOI: 10.1038/s41598-024-65395-5 -
BMC Geriatrics Jun 2024Increase in functional disability in aging societies is an international medical and public health issue. Masticatory function may be a potential risk factor for... (Observational Study)
Observational Study
BACKGROUND
Increase in functional disability in aging societies is an international medical and public health issue. Masticatory function may be a potential risk factor for functional disability, but the role of frailty in the association has not been clarified.
METHODS
Forty thousand five hundred sixty-two community-dwelling older adults aged 65 years and over who were insured by public health insurance as of April 2018 were followed up for a median of 3.0 years. Masticatory function was categorized as good, moderate, or poor based on a self-reported questionnaire. The development of functional disability was defined as a new certification of the need for long-term care. A Cox proportional hazards model was used to calculate hazard ratios (HRs) and their 95% confidence intervals (CIs).
RESULTS
During the follow-up period, 1,397 individuals experienced functional disability. After adjusting for age, sex, comorbidities, medical history, and lifestyle behaviors, the HR for incident functional disability was significantly higher in the moderate and poor groups compared to the good group (moderate, HR 1.21 [95% CI, 1.07-1.37]; poor, HR 1.64 [95% CI, 1.03-2.62]). However, after additional adjustment for frailty-related factors-namely, underweight, regular exercise, and gait speed-the association was attenuated in both the moderate group (HR 1.06 [95% CI, 0.94-1.21]) and the poor group (HR 1.51 [95% CI, 0.94-2.41]).
CONCLUSIONS
Masticatory dysfunction was significantly associated with incident functional disability in a community-dwelling older Japanese population. Our findings suggest that masticatory dysfunction may be a surrogate of frailty rather than a direct cause of functional disability.
Topics: Humans; Aged; Male; Female; Frailty; Mastication; Aged, 80 and over; Independent Living; Frail Elderly; Disabled Persons; Disability Evaluation; Risk Factors; Geriatric Assessment; Japan
PubMed: 38907214
DOI: 10.1186/s12877-024-05131-w -
Unravelling the Complexities of Bite Force Determinants in Paediatric Patients: A Literature Review.Cureus May 2024The amount of maximum voluntary bite force (MVBF) is determined by the combined action of the jaw elevator muscles, which are altered jaw biomechanics and reflex... (Review)
Review
The amount of maximum voluntary bite force (MVBF) is determined by the combined action of the jaw elevator muscles, which are altered jaw biomechanics and reflex processes. Bite force (BF) measurements can yield valuable information on the activity and function of the jaw muscles. The accuracy of biting force measurements depends on several variables, including age, gender, malocclusion, dental caries, dental prostheses and temporomandibular joint (TMJ). This information is essential for evaluating the development and function of the masticatory system, identifying potential abnormalities or impairments and guiding appropriate treatment interventions for paediatric patients. The aim of this article is to review the literature on the factors affecting bite force and the importance of these factors in assessing dental development and guiding interventions for paediatric patients with bite force-related issues. Additionally, establishing normative values for bite force in different age groups can aid in monitoring growth and detecting any deviations from expected patterns. Measuring bite force in paediatric patients is significant in comprehensive oral health assessment and management.
PubMed: 38903313
DOI: 10.7759/cureus.60630 -
Proceedings. Biological Sciences Jun 2024The morphology and biomechanics of infant crania undergo significant changes between the pre- and post-weaning phases due to increasing loading of the masticatory...
The morphology and biomechanics of infant crania undergo significant changes between the pre- and post-weaning phases due to increasing loading of the masticatory system. The aims of this study were to characterize the changes in muscle forces, bite forces and the pattern of mechanical strain and stress arising from the aforementioned forces across crania in the first 48 months of life using imaging and finite element methods. A total of 51 head computed tomography scans of normal individuals were collected and analysed from a larger database of 217 individuals. The estimated mean muscle forces of temporalis, masseter and medial pterygoid increase from 30.9 to 87.0 N, 25.6 to 69.6 N and 23.1 to 58.9 N, respectively (0-48 months). Maximum bite force increases from 90.5 to 184.2 N (3-48 months). There is a change in the pattern of strain and stress from the calvaria to the face during postnatal development. Overall, this study highlights the changes in the mechanics of the craniofacial system during normal development. It further raises questions as to how and what level of changes in the mechanical forces during the development can alter the morphology of the craniofacial system.
Topics: Infant; Humans; Bite Force; Biomechanical Phenomena; Skull; Child, Preschool; Tomography, X-Ray Computed; Finite Element Analysis; Female; Male; Mastication; Adaptation, Physiological; Infant, Newborn; Stress, Mechanical; Masticatory Muscles
PubMed: 38889789
DOI: 10.1098/rspb.2024.0654 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Cancers affecting the parts of the head and neck significantly impact patients. Among head and neck cancer (HNC) patients, the visible signs and symptoms of the disease...
INTRODUCTION
Cancers affecting the parts of the head and neck significantly impact patients. Among head and neck cancer (HNC) patients, the visible signs and symptoms of the disease or the side effects of treatment modalities can cause various degrees of functional impairment such as mastication, swallowing, communication, and disfigurement.
OBJECTIVE
To assess psychological distress and quality of life in head and neck cancer patients after 3 and 6 months' post-treatment.
MATERIALS AND METHODS
A hospital-based follow-up study was conducted among head and neck cancer patients who came for routine follow-up after treatment in five cancer hospitals in Hyderabad City. Patients were categorized based on the treatment into surgery, chemotherapy, radiotherapy, and combination of all and the same subjects were followed; after 3 months, psychological distress and quality of life were assessed by distress thermometer and functional assessment of cancer therapy head and neck (FACT H and N).
RESULTS
A total of 235 participants were included in the study. Mean age was 58.2 ± 8.7 years. The mean scores of psychological distress at baseline were 4.6 ± 1.2, and after follow-up, it was 3.4 ± 1.2 and the mean scores of quality of life at baseline were 76.4 ± 15.6, and after follow-up, it was 75.5 ± 12.5.
CONCLUSION
The mean scores of psychological distress had reduced from baseline to follow-up with negligible improvement in the quality of life.
PubMed: 38882774
DOI: 10.4103/jpbs.jpbs_1039_23 -
BMC Oral Health Jun 2024This crossover clinical study aimed to evaluate and compare masticatory performance and patient satisfaction for patients rehabilitated with conventional heat-cured... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
BACKGROUND
This crossover clinical study aimed to evaluate and compare masticatory performance and patient satisfaction for patients rehabilitated with conventional heat-cured acrylic resin and 3D-printed mandibular implant overdentures retained with bar attachment.
MATERIALS AND METHODS
Sixteen completely edentulous healthy participants received new conventional dentures. In the mandible, four interforaminal implants were inserted. Following the stage of osseointegration, the bar was constructed in a trapezoidal configuration. Each patient randomly received the following overdentures using a crossover design: (1) conventional heat-cured acrylic resin overdenture and (2) 3D-printed overdenture (developed by scanning of mandibular conventional overdenture). The masticatory performance was assessed by conducting a two-colour mixing ability test at 5, 10, 20, 30, and 50 masticatory cycles. Moreover, the McGill Denture Satisfaction Questionnaire (MDSQ) was employed to assess patient satisfaction. Evaluation was performed after 3 months of using each overdenture. Paired sample t tests were used to compare the masticatory performance and MDSQ scores of patients for both prostheses.
RESULTS
No significant difference in masticatory performance was reported between the two types of overdentures. Regarding patient satisfaction, only the esthetic aspect was significantly better for conventionally processed overdentures than for printed overdentures. Insignificant differences were observed regarding other MDSQ items between the two overdentures.
CONCLUSION
Within this clinical study, 3D-printed implant overdentures showed promising results in terms of chewing efficiency and patient satisfaction compared to conventionally fabricated implant overdentures.
TRIAL REGISTRATION
Retrospectively registered at www.
CLINICALTRIALS
gov : NCT06148727.(28/11/2023).
Topics: Humans; Cross-Over Studies; Denture, Overlay; Patient Satisfaction; Mastication; Printing, Three-Dimensional; Male; Female; Dental Prosthesis, Implant-Supported; Middle Aged; Aged; Mandible; Acrylic Resins
PubMed: 38851676
DOI: 10.1186/s12903-024-04389-1 -
Molecular Genetics and Metabolism Jun 2024Information about dysarthria and dysphagia in mitochondrial diseases (MD) is scarce. However, this knowledge is needed to identify speech and swallowing problems early,...
BACKGROUND
Information about dysarthria and dysphagia in mitochondrial diseases (MD) is scarce. However, this knowledge is needed to identify speech and swallowing problems early, to monitor the disease course, and to develop and offer optimal treatment and support. This study therefore aims to examine the prevalence and severity of dysarthria and dysphagia in patients with MD and its relation to clinical phenotype and disease severity. Secondary aim is to determine clinically relevant outcome measures for natural history studies and clinical trials.
METHODS
This retrospective cross-sectional medical record study includes adults (age ≥ 18 years) diagnosed with genetically confirmed MD who participated in a multidisciplinary admission within the Radboud center for mitochondrial medicine between January 2015 and April 2023. Dysarthria and dysphagia were examined by administering the Radboud dysarthria assessment, swallowing speed, dysphagia limit, test of mastication and swallowing solids (TOMASS), and 6-min mastication test (6MMT). The disease severity was assessed using the Newcastle mitochondrial disease scale for adults (NMDAS).
RESULTS
The study included 224 patients with MD with a median age of 42 years of whom 37.5% were male. The pooled prevalence of dysarthria was 33.8% and of dysphagia 35%. Patients with MD showed a negative deviation from the norm on swallowing speed, TOMASS (total time) and the 6MMT. Furthermore, a significant moderate relation was found between the presence of dysarthria and the clinical phenotypes. There was a statistically significant difference in total time on the TOMASS between the clinical phenotypes. Finally, disease severity showed a significant moderate relation with the severity of dysarthria and a significant weak relation with the severity of dysphagia.
CONCLUSION
Dysarthria and dysphagia occur in about one-third of patients with MD. It is important for treating physicians to pay attention to this subject because of the influence of both disorders on social participation and wellbeing. Referral to a speech and language therapist should therefore be considered, especially in patients with a more severe clinical phenotype. The swallowing speed, TOMASS and 6MMT are the most clinically relevant tests to administer.
PubMed: 38843620
DOI: 10.1016/j.ymgme.2024.108510 -
CoDAS 2024To determine the relationship between mastication and malnutrition in community-dwelling older adults. (Meta-Analysis)
Meta-Analysis
PURPOSE
To determine the relationship between mastication and malnutrition in community-dwelling older adults.
RESEARCH STRATEGIES
To establish the eligibility criteria, the acronym PECOS was used: Population: non-institutionalized older adults; Exposure: older adults with malnutrition; Control: older adults without malnutrition; Outcome: masticatory problems in malnourished older adults; Study types: observational studies.
SELECTION CRITERIA
It selected studies assessing malnutrition and mastication difficulties in non-institutionalized adults over 60 years old, of both sexes. Mastication and malnutrition were evaluated with questionnaires on self-reported symptoms and clinical and instrumental assessments. There were no restrictions on language, year of publication, or ethnicity.
DATA ANALYSIS
The included studies were evaluated for methodological quality with the Joanna Briggs Institute tool for cross-sectional studies. For the cross-sectional studies included, the odds ratio (OR) was calculated with 95% confidence intervals.
RESULTS
After searching the databases, 692 references were retrieved, with three studies selected for quantitative and qualitative analysis. The values obtained in the meta-analysis for association show that malnutrition and mastication difficulties were 2.21 times as likely to occur (OR = 2.21; 95%CI = 0.93 - 5.26; I2 = 94%) as individuals without malnutrition (p < 0.001). The assessment of the risk of bias presented a high-risk, a moderate-risk, and a low-risk study. The certainty of evidence was rated very low with the GRADE tool.
CONCLUSION
Individuals at risk of malnutrition are 2.21 times as likely to have mastication difficulties.
Topics: Humans; Mastication; Malnutrition; Aged; Independent Living; Female; Cross-Sectional Studies; Male; Geriatric Assessment; Middle Aged; Aged, 80 and over
PubMed: 38836831
DOI: 10.1590/2317-1782/20242023209en -
Cureus May 2024Introduction Oral submucous fibrosis (OSMF) is a persistent, collagen metabolic disorder distinguished by the presence of fibrosis of the connective tissue stroma in the...
Introduction Oral submucous fibrosis (OSMF) is a persistent, collagen metabolic disorder distinguished by the presence of fibrosis of the connective tissue stroma in the oral mucosa with a higher malignant potential rate for oral cancer. This study aimed to analyze the utility of electromyography (EMG) as the prognostic assessment tool in the management of OSMF with conventional intralesional corticosteroid therapy. Materials and methods This study included 20 OSMF cases of age range 20 to 80 years without systemic comorbidities to assess pre-treatment and post-treatment changes with intralesional corticosteroid therapy as an intervention and to determine if it could be assessed using electromyographic study. Clinical and histopathological grading of OSMF was done. The five clinical parameters were evaluated for measuring treatment prognosis. Among them, mouth opening, tongue protrusion, and burning sensation assessments were quantitative parameters, and palpable fibrotic bands and mucosa colour were qualitative parameters. As OSMF involves changes in muscle plane in moderately advanced and advanced cases, EMG was used as an assessment tool for measuring muscle activity. Among the muscles of mastication, the masseter and temporalis were selected for evaluation. Twenty age and gender-matched healthy controls were required for this study as there are no standardized normal values for amplitude and onset of activity in muscle analysis. The EMG activity of the right and left temporalis and masseter muscles were recorded using surface electrodes and were correlated with five clinical assessment parameters. Results In the right masseter, the rest amplitude of 1.6010 µV of the OSMF was statistically significant (p-value: 0.050) when compared with 4.1275 µV of the control. The clench amplitude of 133.370 µV of the OSMF was statistically significant (p-value: 0.062) when compared with 94.310 µV of the control. In the left masseter, the rest amplitude of 1.6695 µV of the OSMF was statistically significant (p-value 0.066) when compared with 2.5735 µV of the control. In the left masseter, the onset of muscle action of 62.670 ms of the OSMF was statistically significant (p-value: 0.017) when compared with 131.835 ms of the control. The clench amplitude differences in the right masseter of 133.370 µV pre-treatment, and 102.775 µV post-treatment were statistically significant (p-value: 0.007). The clench amplitude in the left masseter of 102.535 µV pre-treatment, and 92.090 µV post-treatment were statistically significant (p-value: 0.036). The correlation was seen between tongue protrusion and rest amplitude in the right masseter in OSMF (r = 0.376, p-value: 0.023). Conclusion There was a correlation between tongue protrusion and rest amplitude in the right masseter muscle in OSMF patients before treatment. In the right and left masseter, during rest, the amplitude of the OSMF group was lesser than that of the control group. During clench, in the right masseter, the amplitude of the OSMF group was higher than that of the control group. During clench in the left masseter, the onset of muscle action was lesser in the OSMF group than in the control group. After treatment, there was a reduction in clench amplitude in OSMF patients from their pretreatment values signifying muscle relaxation and a better onset of muscle action.
PubMed: 38836143
DOI: 10.7759/cureus.59675 -
Nutrition (Burbank, Los Angeles County,... May 2024Maintaining plasma glucose homeostasis is vital for mammalian survival, but the masticatory function, which influences glucose regulation, has, to our knowledge, been...
OBJECTIVE
Maintaining plasma glucose homeostasis is vital for mammalian survival, but the masticatory function, which influences glucose regulation, has, to our knowledge, been overlooked.
RESEARCH METHODS AND PROCEDURES
In this study, we investigated the relationship between the glycemic response curve and chewing performance in a group of 8 individuals who consumed 80 g of apple. A device called "Chewing" utilizing electromyographic (EMG) technology quantitatively assesses chewing pattern, while glycemic response is analyzed using continuous glucose monitoring. We assessed chewing pattern characterizing chewing time (t), number of bites (n), work (w), power (wr), and chewing cycles (t). Moreover, we measured the principal features of the glycemic response curve, including the area under the curve (α) and the mean time to reach the glycemic peak (t). We used linear regression models to examine the correlations between these variables.
RESULTS
t, n, and wr were correlated with α (R = 0.44, P < 0.05 for t and n, P < 0.001 for wr), and t was correlated with t (R = 0.25, P < 0.05). These findings suggest that increasing chewing time and power, while reducing the number of chews, resulted in a wider glycemic curve and an earlier attainment of the glycemic peak.
CONCLUSIONS
These results emphasize the influence of proper chewing techniques on blood sugar levels. Implementing correct chewing habits could serve as an additional approach to managing the glycemic curve, particularly for individuals with diabetes.
PubMed: 38823253
DOI: 10.1016/j.nut.2024.112481