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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 -
The Journal of Contemporary Dental... Dec 2022Betel quid (BQ) is the fourth most commonly used psychoactive substance and its use is highly prevalent among southeast Asian countries due to the influence of...
BACKGROUND
Betel quid (BQ) is the fourth most commonly used psychoactive substance and its use is highly prevalent among southeast Asian countries due to the influence of psychosocial, behavioral, and environmental factors. As a result, even young children and women are becoming addicted and find it difficult to achieve long-term abstinence. Systematic research addressing the influence of behavioral and psychosocial factors on BQ chewing is scarce, hence pointing to the need for understanding the interplay of these factors to develop tailored intervention strategies for BQ cessation.
OBJECTIVE
The objective of this systematic review is to assess various behavioral and psychosocial risk factors from pre-existing literature that lead individuals to initiate and/or maintain BQ chewing in developed and developing countries.
MATERIALS AND METHODS
The electronic retrieval systems and databases PUBMED [MEDLINE], EMBASE, SCOPUS, WEB OF SCIENCE, GOOGLE SCHOLAR, and SCIENCE DIRECT were searched independently by two authors for relevant articles from January 2011 to July 2021 using combinations of keywords. Primary studies published in English focusing on the behavioral and psychosocial risk factors for BQ chewing were included.
RESULTS
Out of the initial 264 articles searched, 12 articles met the selection criteria. Included studies addressed the influence of behavioral and psychosocial factors toward the initiation and/or maintenance of BQ chewing. Included studies reported that dependent BQ was not able to quit BQ chewing due to habituation, addiction, and withdrawal symptoms. Few social BQ chewers in Southeast Asian countries were not willing to initiate quitting as they considered AN as an important social and cultural identifier and claimed that they could not resist chewing in a peer group, and it has become part of their social life.
CONCLUSION
In the future, studies should take into consideration behavioral and psychosocial risk factors, which are major barriers toward successful quitting. These factors should be integrated into areca nut cessation guidelines, and there is a need to develop more comprehensive culture-specific intervention approaches to achieve long-term abstinence.
Topics: Child; Humans; Female; Child, Preschool; Areca; Mastication; Developing Countries; Substance-Related Disorders; Risk Factors
PubMed: 37125526
DOI: 10.5005/jp-journals-10024-3450 -
Journal of Maxillofacial and Oral... Jun 2023Temporomandibular joint ankylosis is a disabling condition which affects joint movements causing difficulty in speech, mastication and hygiene. Over time various... (Review)
Review
BACKGROUND
Temporomandibular joint ankylosis is a disabling condition which affects joint movements causing difficulty in speech, mastication and hygiene. Over time various interposition materials like meniscus, muscle, fascia, skin, cartilage, fat, dura and alloplastic materials have been used for the treatment of ankylosis and improve joint functions.
OBJECTIVE
The objective of this systematic review is to evaluate the effectiveness of dermis fat graft and temporalis myofascial flap as an interpositional material in treatment of temporomandibular joint ankylosis and to compare the effectiveness of the two materials.
MATERIALS AND METHODS
PubMed, Google scholar, and Cochrane library search in combination with hand search of relevant journals were conducted published in English from January 2000 to August 2021. Randomized controlled trials, prospective and retrospective cohort studies were included. Outcome measure included improvement in mouth opening. Risk of bias assessment was assessed using Cochrane risk of bias tool and Newcastle-Ottawa scale.
RESULTS
A total of 144 articles were found from the primary search which on thorough assessment, duplicate and exclusion removal resulted in 9 cohort studies and 1 randomized controlled trial that fulfilled the inclusion criteria. All the studies included reported significant improvement in mouth opening after interposition of the 2 materials. Four studies compared temporalis myofascial flap with dermis fat graft, 2 studies reported dermis fat graft gives better outcomes, whereas 1 study reported temporalis myofascial flap to be better and 1 study has been inconclusive.
CONCLUSION
Definitive conclusions cannot be drawn as there are number of limitations in the studies included. However a general consensus has been toward dermis fat graft owing to fewer complications.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12663-023-01869-9.
PubMed: 37122786
DOI: 10.1007/s12663-023-01869-9 -
L' Orthodontie Francaise Apr 2023Several cross-sectional studies have shown the association of a dysfunctional orofacial environment with a greater prevalence of malocclusions. Orofacial myofunctional...
INTRODUCTION
Several cross-sectional studies have shown the association of a dysfunctional orofacial environment with a greater prevalence of malocclusions. Orofacial myofunctional reeducation (OFMR) is the rehabilitation of the muscles, functions and resting postures of the orofacial complex. It is used in the therapeutic management of orofacial dysfunction in patients of all ages and with a wide range of disorders and comorbidities. RMOF mainly uses isotonic and isometric exercises targeting the oral and oropharyngeal structures, combined with specific exercises for ventilation, swallowing and mastication. It may involve the use of prefabricated reeducation appliances (PRAs), which may also be prescribed to modify the shape and relationship of the dental arches.
OBJECTIVES
The primary objective of this systematic review of the literature was to describe and evaluate the efficacy of prefabricated reeducation appliance-assisted OFMR in orthodontics, occlusodontics and dental sleep medicine. Its secondary objective was to assess whether the use of currently available PRAs is associated with adverse effects.
MATERIALS AND METHODS
The systematic literature review was undertaken using five electronic databases: Medline (via PubMed), Web of Science, Cochrane Library, Embase, and Google Scholar, to identify studies evaluating the efficacy of PRA-assisted OFMR in the treatment of orofacial dysfunctions and parafunctions, temporo-mandibular dysfunction (TMD) or obstructive sleep apnea (OSA) in children, adolescents and adults, published until 20 March 2023. The primary outcome of interest was the therapeutic efficacy of PRA-assisted OFMR. In patients with obstructive sleep apnoea (OSA), efficacy was assessed primarily by a decrease in the apnoea/hypopnoea index (AHI) of at least five episodes per hour from baseline, improvement in subjective sleep quality, sleep quality measured by nocturnal polysomnography and subjectively measured quality of life. In patients with orofacial dysfunctions, parafunctions or TMD, efficacy was assessed mainly by electromyography (EMG), history and clinical examination. Secondary outcomes were dentoalveolar or skeletal improvements, and possible adverse effects of the PRAs used, including adverse effects on occlusion.
RESULTS
Only fourteen studies met all inclusion criteria: two randomised controlled trials, one non-randomised controlled trial, five prospective case-control studies, two retrospective case-control studies, two prospective case series and two retrospective case series. The two randomised controlled trials were assessed as "low risk of bias" according to the Cochrane Back Review Group's 12 risk of bias criteria. The methodological quality of the remaining 12 included studies was assessed using the ROBINS-I tool, according to the recommendations of the Cochrane Handbook. One was judged to have a measured risk of bias, eight a significant risk of bias and three a critical risk of bias. Based on the available evidence, PRA-assisted OFMR results in a statistically significant (p=0.0425) reduction in AHI in children with mild to moderate obstructive sleep apnea. In children with obstructive sleep apnoea undergoing adenoid and/or tonsil surgery, postoperative OFMR combined with a flexible PRA leads to a greater reduction in AHI compared to a control group and an improvement in SaO2 at 6 months and 12 months after surgery (p<0.01). It also contributes to greater improvement in sleep disturbance, physical fitness, daytime lethargy in the treated group than in the control group 6 months and 12 months after surgery (p<0.05). PRA-assisted OFMR provides correction of atypical swallowing and improvement in orofacial muscle balance. GRPs are generally less effective than activators for the treatment of Class II Division 1 malocclusions and appear to cause more adverse effects, mainly vestibuloversion of the mandibular incisors. The use of PRA-assisted OFMR for the management of TMD is not validated by current evidence.
CONCLUSIONS
Published data, albeit of uneven methodological quality, appear to show the superiority of OFMR combined with the use of a PRA, compared with the implementation of OFMR without PRA. Prospective studies with large sample sizes would be useful to better evaluate the new therapeutic possibilities brought by the combination of OFMR with a PRA. Continued attention should be paid to the monitoring of possible adverse effects of PRA-assisted OFMR on the dental arches, especially the vestibuloversion of the mandibular incisors. It might be useful to reflect on the relevance of the arguments put forward by manufacturers about the particularities of their devices and their supposed effects. PRA-assisted OFMR appears to be a necessary paradigm shift , which it seems useful to bring to our patients.
PROTOCOL REGISTRATION
This protocol was registered on March 02, 2023 in the International Prospective Register of Systematic Review (PROSPERO) and received the CRD number: CRD42023400421.
Topics: Adolescent; Adult; Child; Humans; Cross-Sectional Studies; Prospective Studies; Quality of Life; Retrospective Studies; Sleep Apnea, Obstructive; Patient Education as Topic; Malocclusion; Controlled Clinical Trials as Topic
PubMed: 37114821
DOI: 10.1684/orthodfr.2023.126 -
The Journal of Prosthetic Dentistry Mar 2023Dental agenesis is a condition in which the absence of teeth causes debilitating problems, primarily in speech, mastication, and esthetics. The optimal removable... (Review)
Review
STATEMENT OF PROBLEM
Dental agenesis is a condition in which the absence of teeth causes debilitating problems, primarily in speech, mastication, and esthetics. The optimal removable prosthetic management for the condition is unclear.
PURPOSE
The purpose of this systematic review was to evaluate the spectrum of removable prosthetic techniques with regard to the type of edentulism and to provide clinical guidance for practicing dentists.
MATERIAL AND METHODS
An electronic and manual search was conducted in the PubMed, Scopus, and Google Scholar databases. Publications of case reports and series written in English without data restrictions that reported on removable prosthodontic management of patients with oligodontia, hypodontia, or anodontia were included.
RESULTS
A total of 59 articles comprising 83 case reports were analyzed. In patients with anodontia, the most common treatment option was an acrylic resin complete denture. Hypodontia and oligodontia were commonly managed by using either a partial denture or overdenture. Irreversible hydrocolloid or alginate was the most accepted material for the preliminary impressions and elastomeric materials for definitive impressions. The tooth arrangements were modified to simulate natural dentition and improve esthetics. Modifications of conventional acrylic resin dentures have been proposed for improved denture adaptation. Good retention is essential to the long-term success of prosthetic treatment and may be achieved with a denture reline or with retention clasps. The active growth of the patients means constant maintenance, including denture renewals or repairs, emphasizing the need for long-term follow-up care.
CONCLUSIONS
Prosthodontic rehabilitation at an early age has been shown to significantly impact the overall quality of life for a child with tooth agenesis.
PubMed: 36922297
DOI: 10.1016/j.prosdent.2023.02.005 -
Journal of Oral Rehabilitation Jul 2023One of the main goals of orthognathic surgery is to improve the masticatory performance in patients with maxillofacial deformities. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
One of the main goals of orthognathic surgery is to improve the masticatory performance in patients with maxillofacial deformities.
OBJECTIVE
The aim of this study was to evaluate the literature on assessing masticatory performance before, after orthognathic surgery and normal occlusion.
METHODS
An electronic search was performed via Pubmed, Scopus, LILACs and Web of Science without any restrictions until June 2022. The articles assessing masticatory performance using a comminution assay, bite force or occlusal contact area in patients undergoing orthognathic surgery with or without comparing controls were included. The risk of bias of the selected articles was assessed using the appropriate tools according to the study design.
RESULTS
Of the 2507 records identified, 21 studies were included in the qualitative evaluation and 17 studies in the meta-analysis. Nine articles were cohort studies, and the other eight were before-after studies. Moderate to high risks of bias were found among the articles. Comparing the values before and after surgery, the meta-analysis revealed a significant improvement in the bite force and occlusal contact area at 1- and 2-year post-surgery. However, regardless of the assessed parameters, the masticatory performance in patients with normal occlusion was significantly greater than those in patients undergoing orthognathic surgery at all evaluated time points.
CONCLUSION
Although combined surgical orthodontic treatment can improve impaired masticatory function, assessed by the comminution method, bite force and occlusal contact area, the improvement may not reach that of normal occlusion.
Topics: Humans; Orthognathic Surgery; Dental Occlusion; Mastication; Bite Force; Cohort Studies
PubMed: 36920311
DOI: 10.1111/joor.13447 -
Life (Basel, Switzerland) Feb 2023The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol in the PubMed, Cochrane... (Review)
Review
The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol in the PubMed, Cochrane Library, LILACS, EBSCO, Scielo, between 2012 and 2022. The methodological quality was assessed by using the Newcastle-Ottawa Study Quality Assessment Scale. Mean differences and 95% confidence intervals were calculated and combined in meta-analyses. A total of 1202 participants were included in this systematic review (690 with TMD; 512 without TMD), with 22 articles being included in the qualitative analysis. Only three studies enabled the comparative analysis of the results. Ten articles showed a high methodological quality and a low risk of bias, and twelve had a low methodological quality and an increased risk of bias. The meta-analysis showed that the differences between the intervention and control groups were not statistically significant for the percentage overlapping coefficient of the anterior temporal muscle, for the masseter, and for the torque coefficient. The parameters analyzed with the compound technique for chewing showed altered mandibular functions in individuals with TMD. With the EMG method, it was possible to suggest that TMD in adult individuals causes compensatory muscle behaviors, and several changes in the masticatory function were found.
PubMed: 36836829
DOI: 10.3390/life13020472 -
Journal of Dentistry Feb 2023To give an overview of the evidence on the associations between oral condition factors and masticatory performance of adults, and to evaluate the direction and level of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To give an overview of the evidence on the associations between oral condition factors and masticatory performance of adults, and to evaluate the direction and level of the associations.
DATA/SOURCES
Medline (PubMed), Embase (Ovid) and CINAHL Plus (EBSCOhost) were searched up to May 2022 for cross-sectional studies on oral conditions and masticatory performance in adults. Methodological quality of the included studies was independently evaluated based on the Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies. Data on the associations between oral condition factors and masticatory performance were extracted. Meta-analysis was conducted on correlation coefficients.
STUDY SELECTION
Of the 8,035 records identified, 97 articles (88 studies) were included in the qualitative synthesis, and 18 studies were included in the meta-analyses. Among the oral condition factors that had associations with masticatory performance, the number of natural/remaining teeth or functional tooth pairs was reported by the largest number of studies, followed by perioral muscle status, dental prosthetic status, oral moisture status and periodontal status. Results of the meta-analyses showed that the positive association with the number of natural/remaining teeth was the strongest (pooled correlation coefficient: 0.51, 95%CI: 0.48 to 0.54), followed by the number of functional tooth pairs, maximum tongue force/pressure, while the association with the oral moisture status was the weakest.
CONCLUSIONS
Number of natural/remaining teeth and functional tooth pairs, perioral muscle status, oral moisture status, dental prosthetic status and periodontal status are the main oral condition factors influencing masticatory performance. Based on the limited evidence available, among these factors, the number of natural/remaining teeth has the strongest positive association, with a very low quality of evidence.
CLINICAL SIGNIFICANCE
This study provides valuable information on the oral condition factors associated with masticatory performance, which would be important for policymakers and clinical practitioners when deciding on the strategies for improving the masticatory performance of adults. This review highlights the need for standardization of measures and classifications of masticatory performance and oral conditions.
REGISTRATION
PROSPERO (registration number: CRD42021256824).
Topics: Humans; Adult; Bite Force; Mastication; Cross-Sectional Studies; Mouth, Edentulous
PubMed: 36563840
DOI: 10.1016/j.jdent.2022.104395 -
Children (Basel, Switzerland) Nov 2022Functional Chewing Training (FuCT) was designed as a holistic approach to improve chewing function by providing postural alignment, sensory and motor training, and food... (Review)
Review
Evaluation of the Effectiveness of Functional Chewing Training Compared with Standard Treatment in a Population of Children with Cerebral Palsy: A Systematic Review of Randomized Controlled Trials.
BACKGROUND
Functional Chewing Training (FuCT) was designed as a holistic approach to improve chewing function by providing postural alignment, sensory and motor training, and food and environmental adjustments. The aim of this systematic review was to evaluate the effectiveness of FuCT in improving chewing function and the severity of tongue thrust and drooling in children with cerebral palsy as compared with standard treatment.
METHODS
We conducted a systematic review of randomized controlled trials. The search was performed between October 2021 and January 2022 using the following databases: PubMed, Scopus, Web of Science, and CINAHL. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
The initial search yielded 56 articles. After reading the studies in full, 3 articles were chosen based on the inclusion criteria. Included participants were people with PCI; the studies reported a sample size ranging from 40-80 individuals, one study was on a pediatric population, while the others on adults. The selected studies were then evaluated using Jadad and PEDro scales.
CONCLUSION
Our study confirmed the value of FuCT in improving chewing function and the severity of tongue thrust and drooling. Our results may be useful in optimizing appropriate therapeutic management.
PubMed: 36553319
DOI: 10.3390/children9121876 -
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