Association of feeding behavior with jaw bone metabolism and tongue pressure

Oral health access and self-reported outcomes in patients with chronic intestinal failure requiring home intravenous support

BACKGROUND

Patients with chronic intestinal failure (CIF) may be predisposed to poor oral health outcomes. This study explored the self-reported oral health status, function, and psychological impacts of oral health of adult patients with CIF, their access to dental care, and how these compare with the broader population.

METHODS

All patients >18 years old receiving home intravenous therapies for CIF were invited to complete a self-reported questionnaire providing information on oral health status and access to oral health services. Collateral information was provided by treating clinicians. Descriptive data analysis was undertaken, including subgroup analysis of clinical characteristics, and was compared with the available population-level data.

RESULTS

Twenty-four patients participated. Short gut and dysmotility accounted for 88% of the etiologies of CIF. Respondents reported good preventative oral health behaviors (96%), accessing dental care within the last 12 months (75%), and limited barriers to receiving care. Dry mouth (96%), oral pain (59%), and temperature sensitivity (60%) were commonly reported across the cohort. Smoking history and reduced oral diet were associated with significantly worse self-reported oral health outcomes. Patients with CIF reported worse oral health outcomes despites better oral health access than the general population.

CONCLUSION

Patients with CIF appear to be at risk of poor oral health outcomes, especially where smoking or reduced oral intake are concurrently involved. Clinicians involved in CIF care should be alert to the oral health needs of this population and consider oral and dental health as part of the multidisciplinary care required for optimal CIF care.

Effect of body mass index on post-treatment oral function in patients with oral cancer: a cross-sectional study

This single-center cross-sectional study used sequential sampling to examine the influence of body mass index (BMI) on oral function after oral cancer treatment. Patients who completed primary oral cancer treatment between September 2019 and March 2023 (102 patients, 74 male [72.5%] and 28 female [27.5%]; mean age, 69.6 years) were analyzed. Patient background data were collected from electronic medical records. Post-treatment oral function measurements were conducted on all patients using six assessment tools. Statistical analysis was conducted using Pearson's correlation coefficient, one-way analysis of variance, the Jonckheere-Terpstra test, and multiple linear regression. Pre-treatment BMI showed a statistically significant relationship with postoperative oral function, particularly tongue pressure (P = 0.01). While the mean values of the groups showed no significant differences, the Jonckheere-Terpstra test revealed a statistically significant trend toward a stepwise increase in tongue pressure for each BMI group (P = 0.03). Multiple linear regression analysis revealed a statistically significant correlation between tongue pressure and pre-treatment BMI (P < 0.05). Pre-treatment BMI was significantly associated with tongue pressure. Since BMI is a variable factor that can be controlled by nutritional therapy even before treatment, nutritional intervention, weight control, and treatment strategies including reconstructive interventions to maintain tongue pressure may be important in oral cancer treatment.

Efficacy of hard gummy candy chewing in improving masticatory function in Japanese children aged 6-12 years: A clinical trial

OBJECTIVES

Japanese children have been shown to exhibit decreased masticatory function; however, limited evidence is available regarding the efficacy of certain food items in improving this issue. Therefore, this study examined the effects of chewing hard gummy candy on the masticatory function of Japanese children aged 6-12 years.

METHODS

The study included 26 participants (10 boys and 16 girls; mean age ± standard error = 9.3 ± 0.3 years) who were asked to chew hard gummy candy twice daily for 4 weeks at home. The lip-closing force, occlusal force, and masticatory performance of the participants were recorded before commencement (T1), 4 weeks after commencement (T2), and 4 weeks after completion (T3) of the training. Statistical analyses were performed using the Wilcoxon rank-sum test or the Wilcoxon signed-rank test with Bonferroni correction.

RESULTS

No significant differences in masticatory function by gender and age groups (defined based on mean age at T1) were observed at T1. The lip-closing and right occlusal forces increased significantly after 4 weeks of exercise, and the effects persisted for another 4 weeks after completion. The masticatory performance also improved after training, although these effects did not persist and deteriorated substantially 4 weeks after completion of the training.

CONCLUSIONS

Habitual mastication training using hard gummy candy markedly enhances masticatory function (e.g., lip-closing force, occlusal force, and masticatory performance) in Japanese children.

China experts' consensus on preventive and interceptive orthodontic treatments of malocclusions of children

Malocclusion is one of the three most common oral diseases reported by World Health Organization(WHO). In China, its incidence rate is rising. Malocclusion seriously affects the dental and maxillofacial function, facial appearance and growth development of nearly 260 million children in China, and what is more, it affects their physical and mental health development. Malocclusion occurrence is related to genetic and environmental factors. Early treatment of malocclusion can create a good dental and maxillofacial development environment, correct abnormal growth and control the adverse effects of abnormal genetic factors. It can effectively reduce the prevalence of children's malocclusion and enhance their physical and mental health. This is an urgent need from the economic perspective of our society, so it has great practical and social significance. Experts from the project group "standard diagnose and treatment protocols for early orthodontic intervention of malocclusions of children" which initiated by China National Health Institute of Hospital Administration wrote the "China Experts' Consensus on Preventive and Interceptive Orthodontic Treatments of Malocclusions of Children", which aims to guide and popularize the clinical practice, improve the clinical theory and practice level, and accelerate the disciplinary development of early treatment of children's malocclusion in China. The consensus elaborates the harmfulness of malocclusion and the necessity of early treatment, and brings up the principles and fundamental contents. Based on the law of dental and maxillofacial development, this paper puts forward the guiding suggestions of preventive and interceptive treatments in different stages of dental development ranging from fetus to early permanent dentition. It is a systematic project to promote and standardize the early treatment of malocclusion. Through scientific and comprehensive stratified clinical practice and professional training, the clinical system of early treatment of malocclusion in China will eventually be perfected, so as to comprehensively care for children's dental and maxillofacial health, and improve their oral and physical health in China.

Efficacy of immediate physiotherapy after surgical release of zygomatico-coronoid ankylosis in a young child: A case report

BACKGROUND

Temporomandibular joint ankylosis (TMJ ankylosis) manifests itself as a locked jaw and reduced mouth opening. We hypothesized that the efficacy of TMJ ankylosis surgery in a child may largely depend on physiotherapeutic management.

CASE DESCRIPTION

: In this case report, we present the treatment of a girl between 1 and 4 years of age, who was unable to open her jaws immediately after birth. Congenital ankylosis was diagnosed.

INTERVENTION

: Two models of therapeutic management were presented, with a surgical procedure to release bone fusion adopted as a starting point. In the first model, the rehabilitation procedure started 21 days after surgery.

OUTCOMES

: Despite rehabilitation, no clinical improvement was achieved (i.e. the child was still unable to open her jaws). In the second model, rehabilitation started from the day after surgery and management according to the second model allowed for obtaining therapeutic benefits. After therapy, the girl was able to abduct the mandible to a degree allowing for improved speech and the ability to crush food.

CONCLUSIONS

: This clinical case shows that the efficacy of surgical procedures may depend on the type of postoperative management. It was demonstrated that physiotherapy started immediately after the procedure to release the ankylosis improved the mandible mobility outcomes for this child.

Incobotulinum toxin type A for treatment of chronic myofascial pain

PURPOSE

This study assessed the effectiveness of incobotulinum toxin type A (IBTx) for chronic myofascial pain affecting the masseter and temporal muscles.

METHODS

Twenty two patients who received a diagnosis of chronic masseter and temporalis myofascial pain were evaluated by using a visual analog pain scale (VAS), digital pressure algometry, and the SF-36 Health Survey at baseline (T0), before IBTx injection. Patients were again evaluated at 2 months (T1) and 7 months (T2) after IBTx injection.

RESULTS

VAS scores for pain significantly differed (P = 0.029, Friedman test). Post-hoc tests showed a significant reduction in pain at 2 months (T0-T1) and 7 months (T0-T2) (P = 0.011 and P = 0.028, respectively; Wilcoxon test) but not between 2 and 7 months (P = 0.676; Wilcoxon test). There was no significant difference in pressure algometry values (P = 0.385, Friedman test). Quality of life (QOL) assessment showed a significant difference (P = 0.002, Friedman test). Post-hoc tests showed a significant improvement in QOLat 2 months, but no significant difference at 7 months (P = 0.004 and P = 0.260, Wilcoxon test).

CONCLUSION

IBTx injection resulted in safe, effective short-term pain relief for patients with chronic facial pain affecting the masseter and temporalis muscles.

Effects of Multi-Generational Soft Diet Consumption on Mouse Craniofacial Morphology

Variations in craniofacial morphology may arise as a result of adaptation to different environmental factors such as soft diet (SD), which lessens functional masticatory load. Prior studies have shown that changes in the masticatory muscle function associated with a switch to short-term SD led to changes in craniofacial morphology and alveolar bone architecture. However, the long-term effects of SD and the associated adaptive changes in craniofacial shape are unclear. Our novel study set out to profile prospective skull changes in mice fed with SDs over multiple generations using three-dimensional (3D) geometric morphometric analysis (GMA). Our results revealed that short-term SD consumption led to a significant decrease in craniofacial size, along with numerous shape changes. Long-term SD consumption over 15 continuous generations was not associated with changes in craniofacial size; however, shape analysis revealed mice with shortened crania and mandibles in the anteroposterior dimension, as well as relative widening in the transverse dimension compared to the average shape of all mice analyzed in our study. Moreover, changes in shape and size associated with different functional loads appeared to be independent - shape changes persisted after diets were switched for one generation, whereas size decreased after one generation and then returned to baseline size. Our study is the first to study the role of prolonged, multi-generational SD consumption in the determination of craniofacial size and shape.

Role of osteoclasts in oral homeostasis and jawbone diseases

The jawbone is a unique structure as it serves multiple functions in mastication. Given the fact that the jawbone is remodeled faster than other skeletal bones, bone cells in the jawbone may respond differently to local and systemic cues to regulate bone remodeling and adaptation. Osteoclasts are bone cells responsible for removing old bone, playing an essential role in bone remodeling. Although bone resorption by osteoclasts is required for dental tissue development, homeostasis and repair, excessive osteoclast activity is associated with oral skeletal diseases such as periodontitis. In addition, antiresorptive medications used to prevent bone homeostasis of tumors can cause osteonecrosis of the jaws that is a major concern to the dentist. Therefore, understanding of the role of osteoclasts in oral homeostasis under physiological and pathological conditions leads to better targeted therapeutic options for skeletal diseases to maintain patients' oral health. Here, we highlight the unique features of the jawbone compared to the long bone and the involvement of osteoclasts in the jawbone-specific diseases.

Relation of dietary preference to masticatory movement and masticatory exercises in Japanese children

OBJECTIVE

Modern Japanese children have decreased masticatory function, which can be explained by the dietary change to soft foods. In earlier studies involving children with mixed dentition, masticatory exercises were shown to improve masticatory function and modify dental arch growth. Grinding type of mastication with a wide path reportedly increases lateral growth of the dental arch. This study aimed to assess the relationship between masticatory movements and dietary preference, and how masticatory exercises affected masticatory movement during Hellman's dental stages IIA to IIC (period of first molar eruption).

DESIGN

In 64 Japanese pre-school children, we measured masticatory movements with foods of five different levels of hardness and investigated the dietary preference for hard foods through a questionnaire. Participants were also required to perform masticatory exercises. Masticatory movements and dietary preference for hard foods were assessed at the start (T1), conclusion (T2), and after six months of exercises (T3). Participants were allocated to Wide and Narrow groups at T1 based on their masticatory path width.

RESULTS

Baguettes and bananas resulted in the widest and narrowest masticatory paths, respectively, at T1. Results of questionnaire indicated that those eating hard foods had a broad grinding type of masticatory path. Masticatory exercises significantly widened the masticatory path in the Narrow group demonstrating that masticatory exercises help children learn to chew with grinding strokes. Moreover, the masticatory path remained stable on assessment at T3 (six-month follow-up).

CONCLUSIONS

Masticatory exercises are effective in children who are unable to grind hard foods, affecting their dietary preferences.

Forceful mastication activates osteocytes and builds a stout jawbone

Bone undergoes a constant reconstruction process of resorption and formation called bone remodeling, so that it can endure mechanical loading. During food ingestion, masticatory muscles generate the required masticatory force. The magnitude of applied masticatory force has long been believed to be closely correlated with the shape of the jawbone. However, both the mechanism underlying this correlation and evidence of causation remain largely to be determined. Here, we established a novel mouse model of increased mastication in which mice were fed with a hard diet (HD) to elicit greater masticatory force. A novel in silico computer simulation indicated that the masticatory load onto the jawbone leads to the typical bone profile seen in the individuals with strong masticatory force, which was confirmed by in vivo micro-computed tomography (micro-CT) analyses. Mechanistically, increased mastication induced Insulin–like growth factor (IGF)-1 and suppressed sclerostin in osteocytes. IGF-1 enhanced osteoblastogenesis of the cells derived from tendon. Together, these findings indicate that the osteocytes balance the cytokine expression upon the mechanical loading of increased mastication, in order to enhance bone formation. This bone formation leads to morphological change in the jawbone, so that the bone adapts to the mechanical environment to which it is exposed.