Does Masticatory Ability Contribute to Nutritional Status in Older Individuals?

Mastication plays a primary role in the process of eating. Hence, compromised masticatory ability may affect the nutrition and quality of life, which are particularly important concerns among older individuals. It remains unclear how is the masticatory ability assessed regarding the nutritional status. We examined the effect of various oral factors on three masticatory ability tests conducted among older individuals. A total of 100 older individuals were enrolled in this study. Body mass index (BMI) as an indicator of nutritional status; and age, sex, and the number of occlusal and molar occlusal supports as clinical attributes were recorded. Three masticatory ability tests (masticatory efficiency, masticatory score, and satisfaction with mastication) were conducted, and tongue pressure, cheek pressure, and occlusal force were assessed as oral functions. A significant but weak correlation was found between masticatory efficiency and the masticatory score, but not between masticatory efficiency and satisfaction score. Objective masticatory efficiency was strongly associated with objective oral factors, whereas subjective assessments of masticatory ability (masticatory score and satisfaction score) were not. Furthermore, BMI was significantly associated with subjective assessments of masticatory ability but not with objective masticatory efficiency. Both subjective and objective assessments of masticatory ability, along with considerations of nutritional formulations, are required for the maintenance and improvement of nutritional status in older individuals

コテイ ホウホウ カラ ミタ インプラント ジョウブ コウゾウ ノ リンショウテキ ブンケンテキ コウサツ

As the connection mechanism between the superstructure and implant, the cement-retained type and screw-retained type are mainly used. The choice of a screw-retained versus a cement-retained superstructure is a complex and comprehensive decision involving many points of consideration. On the other hand, various retained methods that is complementary with each retained type have been proposed. In this article, various retained types which have been reported in the literatures and developed by us, were systematically assorted from the standpoints of retreivability, and the advantages were pointed out showing case photographs. This systematical information would help the selection of retained type of the superstructure

Dental students’ levels of understanding panoramic

Background/purpose: In dentistry, panoramic radiography is an important examination technique. The Faculty of Dentistry at Tokushima University educates students about panoramic radiographic anatomical landmarks. The purpose of this study was to investigate differences in the understanding of each panoramic anatomical landmark among students. Materials and methods: This study analyzed the results of 40 fifth- and 79 sixth-year faculty students who had taken a written examination to clarify their knowledge of anatomical landmarks in 28 panoramic radiographic regions. Anatomical landmarks were classified into 3 categories: , , and to compare correct answer rates. Results: The mean overall correct answer rate by the 119 students for the 28 regions was 53%. The rate did not vary between the 2 academic years. On comparison of the 3 categories, significant differences were only observed between and , as the values for the latter were lower. Among the anatomical landmarks, the rates for the condylar head, hyoid bone, panoramic innominate line, styloid process, and nasopalatine line were higher, and those for ghost images of the contralateral nasopalatine line, the cervical vertebrae, mandibular foramen, mastoid air cell, and posterior pharyngeal wall were lower. The values for , such as the dorsum of tongue, middle and inferior nasal conche, and middle and inferior nasal meatuses, were also lower. Conclusion: These results indicate the necessity of improving educational approaches for regions with lower rates of correct answers

舌の厚みとその臨床的意義

Background: The tongue occupies most of the space in the oral cavity and it plays an important role in oral functions such as mastication, swallowing and articulation. The tongue continues to move from the time of intake to swallowing, particularly during masticating. A method for evaluating tongue thickness at rest by ultrasonography has been proposed; however, the association between tongue thickness and various oral functions remains unclear. Objective: The purpose of this study was to investigate the relation between tongue thickness and oral functions, and to clarify the clinical significance of tongue thickness measurements in oral function maintenance. Materials and Methods: Elderly outpatients were serially screened for enrollment and a total of 106 subjects (men, 54; women, 52; mean age, 75.2±6.5 years) were selected. Age, body mass index, and functional teeth number including implant and pontic of fixed partial denture number were recorded as the basic attributes. Tongue thickness, tongue pressure, tongue thrust pressure and tongue motor function were measured as tongue assessments. Cheek pressure, oral moisture and occlusal force were measured as other oral functions. Results: Subjects with thick tongue tended to have higher BMI, stronger muscle strengths and lower diadochokinesis. Diadochokinesis of/ka/, cheek pressure and functional teeth number were extracted as the independent factors affecting tongue thickness. Conclusion: Tongue thickness does not necessarily reflect oral functions in healthy elderly people except for a negative association between tongue thickness and oral diadochokinesis of /ka/. Multiple assessments of tongue would be required to evaluate oral function, and the assessment of tongue thickness might have a different clinical meaning

Changes in Image Examinations at the Department of Oral Radiology : The Number of Intraoral and Panoramic Radiographs

After the computed radiography (CR) system was developed in 1986, it became possible to acquire, view and save digital images for medical diagnosis. Around that time, panoramic radiography was digitized by the CR system, but it was limited to large hospitals. From 1994, it has been digitized at large hospitals and dental clinics. We examined the changes in the number of intraoral and panoramic radiographs in dentistry, and based on the relationships among the numbers of radiographs, patients and dental operations, we discussed the clinical significance of digitization. We extracted intraoral and panoramic radiography data, the number of dental operations and the number of patients from the database of Tokushima University Hospital from 2002 to 2017. Then, we extracted nationwide data from Statistics of Medical Care Activities in Public Health by the Ministry of Health, Labour and Welfare from 2002 to 2017. As a result, although the numbers of patients and dental operations at Tokushima University Hospital have remained constant, the number of intraoral radiographs has decreased (72%), whereas the number of panoramic radiographs has increased annually since 2011 (131%). In addition, although the number of patients and nationwide insurance points increased in a different manner than that at Tokushima University Hospital, a decrease in the number of intraoral radiographs and an increase in the number of panoramic radiographs were noted across Japan. As panoramic imaging has been improved and adapted to different settings, panoramic radiography has been used instead of intraoral radiography, and it has been widely used in screening applications such as for perioperative patients. Although digitization is progressing, the analog images are still used (intraoral radiography analog rate, 29.7%, panoramic radiography analog rate, 12.4% in 2017)

超音波画像の輝度測定は高齢者の身体的フレイルを予測できるか？

Echo intensity (EI) of the tongue in ultrasonography is an easy and quantitative assessment of tongue function. Elucidating the relationship between EI and frailty, is expected to aid in the early detection of frailty and oral hypofunction in older adults. We assessed tongue function and frailty in older outpatients visiting a hospital. The subjects were 101 individuals aged 65 or older (35 men and 66 women, mean age 76.4 ± 7.0 years). Tongue pressure and EI were measured as assessments of tongue function and grip strength, and Kihon Checklist (KCL) scores were measured as assessments of frailty. In women, a significant correlation was not found between the mean EI and grip strength, whereas a significant correlation was noted between each score of the KCL and the mean EI; the scores increased as the mean EI increased. A significant positive correlation was found between tongue pressure and grip strength, but no significant correlation was observed between tongue pressure and the KCL scores. In men, no significant correlation was found between tongue assessments and frailty, except for a significant positive correlation between tongue pressure and grip strength. The results of this study suggest that EI of the tongue is positively associated with physical frailty in women and may be useful for early detection of physical frailty status

Effect of Palatal Augmentation Prosthesis to Speech and Swallowing

Purpose: Palatal augmentation prosthesis (PAP) is used on patients with dysphagia and dysarthria. While several studies have evaluated the effects of PAP, evidence regarding the adaptation criteria, effects, and limitations of PAP are not well organized. This review aims to summarize its functions, limitations, and applications. Procedure: To investigate the adaptation criteria, effects, and limitations of PAP, we searched the English language literature published in PubMed from its inception through April 20, 2022. The leading search terms included “palatal augmentation prosthesis.” Main findings: The primary search used keywords that reflected 31 studies. Finally, nine cross-sectional studies and nine case reports were selected for full-text assessment after applying the inclusion criteria. Eleven studies described the efficacy of speech function: two for motility factors and nine for organic factors (with overlap). Thirteen studies described the effectiveness of swallowing function, four related to motility factors, and ten for organic factors (with overlap). Several studies have demonstrated that PAP effectively restores articulation and swallowing in patients with impaired tongue function after glossectomy for oropharyngeal cancer, sequelae of cranial nerve disease, or neuromuscular disease. However, few papers describe the scope of glossectomy and tongue movement restrictions, so it is impossible to describe the adaptation criteria, effects, and limitations. In this review, most case reports and cross-sectional studies did not provide information on the fabrication methods of PAP or the dentistsʼ experience. Thus, the effect of bias on palatal morphology in PAP patients remains unclear. Conclusions: The number of patients with dysarthria and dysphagia is increasing worldwide, similar to what is already occurring in Japan. Therefore, additional high-quality studies on the effects of PAP are required

Dental students’ levels of understanding normal panoramic anatomy

Background/purpose: In dentistry, panoramic radiography is an important examination technique. The Faculty of Dentistry at Tokushima University educates students about panoramic radiographic anatomical landmarks. The purpose of this study was to investigate differences in the understanding of each panoramic anatomical landmark among students. Materials and methods: This study analyzed the results of 40 fifth- and 79 sixth-year faculty students who had taken a written examination to clarify their knowledge of anatomical landmarks in 28 panoramic radiographic regions. Anatomical landmarks were classified into 3 categories: , , and  to compare correct answer rates. Results: The mean overall correct answer rate by the 119 students for the 28 regions was 53%. The rate did not vary between the 2 academic years. On comparison of the 3 categories, significant differences were only observed between  and , as the values for the latter were lower. Among the anatomical landmarks, the rates for the condylar head, hyoid bone, panoramic innominate line, styloid process, and nasopalatine line were higher, and those for ghost images of the contralateral nasopalatine line, the cervical vertebrae, mandibular foramen, mastoid air cell, and posterior pharyngeal wall were lower. The values for , such as the dorsum of tongue, middle and inferior nasal conche, and middle and inferior nasal meatuses, were also lower. Conclusion: These results indicate the necessity of improving educational approaches for regions with lower rates of correct answers. Keywords: Panoramic radiograph, Anatomical landmark, Ghost image, Educatio

Oral factors affecting titanium elution and corrosion: an in vitro study using simulated body fluid.

OBJECTIVES: Ti, which is biocompatible and resistant to corrosion, is widely used for dental implants, particularly in patients allergic to other materials. However, numerous studies have reported on Ti allergy and the in vitro corrosion of Ti. This study investigated the conditions that promote the elution of Ti ions from Ti implants. METHODS: Specimens of commercially pure Ti, pure nickel, a magnetic alloy, and a gold alloy were tested. Each specimen was immersed in a simulated body fluid (SBF) whose pH value was controlled (2.0, 3.0, 5.0, 7.4, and 9.0) using either hydrochloric or lactic acid. The parameters investigated were the following: duration of immersion, pH of the SBF, contact with a dissimilar metal, and mechanical stimulus. The amounts of Ti ions eluted were measured using a polarized Zeeman atomic absorption spectrophotometer. RESULTS: Eluted Ti ions were detected after 24 h (pH of 2.0 and 3.0) and after 48 h (pH of 9.0). However, even after 4 weeks, eluted Ti ions were not detected in SBF solutions with pH values of 5.0 and 7.4. Ti elution was affected by immersion time, pH, acid type, mechanical stimulus, and contact with a dissimilar metal. Elution of Ti ions in a Candida albicans culture medium was observed after 72 h. SIGNIFICANCE: Elution of Ti ions in the SBF was influenced by its pH and by crevice corrosion. The results of this study elucidate the conditions that lead to the elution of Ti ions in humans, which results in implant corrosion and Ti allergy

Can Measurement of Ultrasonic Echo Intensity Predict Physical Frailty in Older Adults?

Echo intensity (EI) of the tongue in ultrasonography is an easy and quantitative assessment of tongue function. Elucidating the relationship between EI and frailty, is expected to aid in the early detection of frailty and oral hypofunction in older adults. We assessed tongue function and frailty in older outpatients visiting a hospital. The subjects were 101 individuals aged 65 or older (35 men and 66 women, mean age 76.4 ± 7.0 years). Tongue pressure and EI were measured as assessments of tongue function and grip strength, and Kihon Checklist (KCL) scores were measured as assessments of frailty. In women, a significant correlation was not found between the mean EI and grip strength, whereas a significant correlation was noted between each score of the KCL and the mean EI; the scores increased as the mean EI increased. A significant positive correlation was found between tongue pressure and grip strength, but no significant correlation was observed between tongue pressure and the KCL scores. In men, no significant correlation was found between tongue assessments and frailty, except for a significant positive correlation between tongue pressure and grip strength. The results of this study suggest that EI of the tongue is positively associated with physical frailty in women and may be useful for early detection of physical frailty status