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Clinical Oral Investigations Jun 2024The aims of this clinical study were to investigate success rate, vital pulp survival rate, tooth survival rate and patient-reported masticatory ability by evaluating...
OBJECTIVES
The aims of this clinical study were to investigate success rate, vital pulp survival rate, tooth survival rate and patient-reported masticatory ability by evaluating the pain symptoms and signs of the cracked teeth as well as Index of Eating Difficulty (IED) and Oral Health Impact Profile-14 (OHIP-14) questionnaire after cracked teeth were restored with occlusal veneers.
MATERIALS AND METHODS
27 cracked teeth of 24 patients with cold and/or biting pains without spontaneous/nocturnal pains were recruited in this study. The cracked teeth were restored with occlusal veneers fabricated by lithium disilicate ceramic. Cold test and biting test were used to evaluate pain signs. IED and OHIP-14 questionnaire were used to evaluate masticatory ability. FDI criteria was used to evaluate restorations. The paired Wilcoxon test was used to analyze significant differences of detection rate of pain signs, OHIP scores and IED grade before and after restorations. Kaplan-Meier survival curve was used to describe the success rate, vital pulp survival rate, and tooth survival rate.
RESULTS
27 cracked teeth were restored with occlusal veneers with average of 22.4-month follow-up. Two cracked teeth had pulpitis and pain signs of the other cracked teeth completely disappeared. OHIP total scores were significantly reduced after treatment. Scores of 'pain', 'occlusal discomfort', 'uncomfortable to eat', 'diet unsatisfactory' and 'interrupted meals' reduced significantly after treatment. After treatment, IED grades of 25 vital teeth were significantly lower than those before treatment. FDI scores of 25 restorations except for 2 teeth with pulpitis were no greater than 2. The 12 months accumulated pulp survival rate of the cracked teeth was 92.6%. The 12 months accumulated tooth survival rate was 100%. The success rate at the latest recall was 92.6%.
CONCLUSION
Occlusal veneer restorations with success rate of 92.6% and the same pulp survival rate might be an effective restoration for treating the cracked teeth.
CLINICAL RELEVANCE
The occlusal veneer restorations might be an option for treating the cracked teeth when cracks only involve enamel and dentin, not dental pulp.
Topics: Humans; Female; Dental Veneers; Male; Adult; Follow-Up Studies; Cracked Tooth Syndrome; Treatment Outcome; Surveys and Questionnaires; Middle Aged; Pain Measurement; Dental Porcelain; Dental Restoration, Permanent; Mastication
PubMed: 38862733
DOI: 10.1007/s00784-024-05735-x -
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 -
Evidence-based Dentistry Jun 2024A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. PubMed and Cochrane databases were...
DATA SOURCES
A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. PubMed and Cochrane databases were searched.
STUDY SELECTION
Journal articles published between January 2007 and January 2023 were identified. Studies that assessed malocclusion indices and oral function were included. Non-English articles and irrelevant studies were excluded. A total of 480 articles were identified. Following exclusion, 29 articles were included in the systematic review.
DATA EXTRACTION AND SYNTHESIS
Data was compiled using Microsoft Excel. Information from each article was extracted including study design, evaluation criteria of malocclusion and oral function, and findings. Studies were assessed using the STROBE GRADE approach. The results were compiled in a brief narrative review investigating the type and strength of the association between malocclusion and ingestion.
RESULTS
Malocclusion was recorded using Index of Treatment Need, Dental Aesthetic Index, Goslon Yardstick Index, Index of Complexity Outcomes and Need, Peer Assessment Rating, Angle's classification, Specific Severity Score, dental inter-arch relation and cephalometric analysis. Ingestion was measured by bite force, electromyography, mixing ability index, bolus granulometric analysis, video analysis of kinetic parameters during mastication, and subjective questionnaires. Of the 29 articles identified, 20 demonstrated a negative impact of malocclusion on oral ingestion, highlighting impaired masticatory efficiency, bite force and subjective difficulties. Eight studies found no significant association. One study, which used two questionnaires, found a significant relationship between eating and malocclusion using one questionnaire but not the other.
DISCUSSION
Limitations in current research methodologies were identified, particularly the heterogeneity in assessment tools. The indicators used to assess ingestion and malocclusion are flawed, with questionable reliability. No study was able to identify which features or severity of malocclusion impact ingestion. The relationship between ingestion and malocclusion could not be quantified and the need for longitudinal and case report studies was deemed essential to establish causality.
CONCLUSION
This review underscores the importance of considering how malocclusion impacts function in orthodontic treatment planning. Future research should focus on standardised assessment methods for measuring malocclusion and oral ingestion to establish the nature of the relationship between the two. This will ultimately guide orthodontic intervention aiming to enhance oral function.
Topics: Humans; Malocclusion; Eating; Mastication; Bite Force
PubMed: 38849573
DOI: 10.1038/s41432-024-01021-7 -
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 -
Journal of Oral Rehabilitation Jun 2024It remains unclear how the salivary flow and the fat content of food affect bolus formation during mastication.
BACKGROUND
It remains unclear how the salivary flow and the fat content of food affect bolus formation during mastication.
OBJECTIVES
We aimed to clarify: (1) how hyposalivation affects jaw-closing and hyoid-elevating muscle activities in bolus formation, and (2) if the effect of hyposalivation on muscle activity depends on the fat content of food.
METHODS
Eighteen healthy male volunteers were instructed to freely ingest four test foods: Plain, Fat without seasoning, Fat with seasoning, and Soft rice crackers. Masseter and suprahyoid electromyographic activities were recorded before and 30 min after the administration of atropine sulfate, a muscarinic receptor antagonist that induces hyposalivation.
RESULTS
Hyposalivation extended the masticatory duration significantly in all the test foods except Fat with seasoning. Masticatory cycle time was significantly longer with vs without hyposalivation for the Soft (p = .011). Suprahyoid activity/cycle was significantly greater with vs without hyposalivation (p = .013). Masticatory cycle time was significantly longer at the late stage with vs without hyposalivation for the Soft (p < .001). Suprahyoid activity/cycle was significantly greater at the middle (p = .045) and late stages (p = .002) with vs without hyposalivation for the Soft and greater at the late stage with vs without hyposalivation for the Plain (p = .043). Changes in masticatory cycle time and suprahyoid activity/cycle for these foods had significantly positive relationship (p < .001).
CONCLUSION
Hyposalivation-induced changes in masticatory behaviours resulted from the middle and late stage suprahyoid activity. Fat content and seasoning compensate for salivary flow inhibition.
PubMed: 38840501
DOI: 10.1111/joor.13764 -
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 -
Computer Methods in Biomechanics and... Jun 2024Mandibular prognathism, retrusion and deviation are common mandibular deformities. They can lead to functional and aesthetic problems due to their important role in the...
Mandibular prognathism, retrusion and deviation are common mandibular deformities. They can lead to functional and aesthetic problems due to their important role in the oral system. Different from other occlusions, unilateral molar occlusion often occurs during mastication, which has a deep impact on the functions of temporomandibular joints (TMJs). Therefore, the study of unilateral molar occlusion is of great importance and significance to the daily life of patients with mandibular deformities. A total of 35 individuals were involved in this study, including 11 asymptomatic subjects, 10 patients with mandibular prognathism, 5 patients with mandibular retrusion and 9 patients with mandibular deviation. Finite element (FE) models corresponding to the unilateral molar occlusion were constructed. During unilateral molar occlusion, mandibular deformity increases the pressure on the condyle and articular disc. Compared with mandibular protrusion or retraction, facial asymmetry will significantly increase the stress of TMJ. Chewing on the non-deviated side also will lead to higher stress in the TMJ of patients with mandibular deviation. Therefore, patients with mandibular deviation have the highest risk of temporomandibular disorder (TMD), and it is recommended that patients with mandibular deviation chew bilaterally or with the deviated side.
PubMed: 38832975
DOI: 10.1080/10255842.2024.2361778 -
Clinical Oral Investigations Jun 2024This prospective clinical study aimed to assess self-reported orofacial esthetics, chewing function, and oral health-related quality of life (OHRQoL) over three years in...
Orofacial esthetics, chewing function, and oral health-related quality of life in Kennedy class I patients with mini-implant-retained removable partial dentures: A 3-year clinical prospective study.
UNLABELLED
This prospective clinical study aimed to assess self-reported orofacial esthetics, chewing function, and oral health-related quality of life (OHRQoL) over three years in the Kennedy Class I patients without posterior dentition who received free-end saddle removable partial dentures (RPDs) retained by two mini dental implants (MDIs) inserted in the canine/first premolar region. The study's robust findings reaffirm the viability of MDI-retained RPDs as a treatment modality in contemporary prosthodontics, instilling confidence in the dental community.
MATERIALS AND METHODS
92 participants with posterior edentulism in the maxilla or mandible received 184 MDIs and 92 RPDs. After one year, three participants were excluded, and another seven were excluded after three years. The final sample was 82 participants. Self-perceived orofacial esthetics was assessed by the Orofacial Esthetic Scale (OES), chewing function by the Chewing Function Questionnaire (CFQ), and the OHRQoL by the OHIP-14. Statistical analysis utilized multivariate regression analysis, standardized effect size calculation, Wilcoxon Signed Rank test, and Friedman's test.
RESULTS
OHRQoL and chewing function significantly improved (p < 0.001) one month after MDI loading by the new RPDs and continued to improve over the observation period (p < 0.05). The OES also significantly improved (p < 0.001) and remained almost unchanged over the next three years (p = 0.440).
CONCLUSION
Despite the limitations of this study, the MDI-retained RPD appears to be a viable treatment modality in contemporary prosthodontics from the patients' perspective.
Topics: Humans; Denture, Partial, Removable; Prospective Studies; Quality of Life; Male; Female; Mastication; Middle Aged; Esthetics, Dental; Dental Prosthesis, Implant-Supported; Oral Health; Surveys and Questionnaires; Jaw, Edentulous, Partially; Aged; Adult
PubMed: 38825621
DOI: 10.1007/s00784-024-05741-z -
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