Usefulness of Telemedicine for Disabled Children Receiving Feeding Therapy

We performed a retrospective cohort study using medical records of 374 pediatric patients who visited a university dental clinic specializing in dysphagia rehabilitation in Japan between 2019 and 2020 to clarify the usefulness of telemedicine among disabled children receiving feeding therapy. The primary outcome was the feeding developmental stage confirmed at the final evaluation. Propensity score matching was performed between individuals in two treatment groups (in-person and telemedicine) before the final analysis using patients' age, sex, primary disease, gross motor function, and feeding developmental stage as covariates. A total of 36 patients were enrolled in each of the in-person and telemedicine groups. The initial evaluation for the propensity score matched population using the χ² test showed no significant difference between the two groups in any parameter. The feeding developmental stage evaluated at the final evaluation using the Wilcoxon signed-rank test significantly improved compared with the stage at the initial evaluation in both groups (in-parson group, p = 0.007; telemedicine group, p = 0.013). The difference in level achieved at the final evaluation revealed that the most common level was "unchanged," followed by "improvement by one level" in both groups, indicating that there was no significant difference in the efficacy of feeding therapy between the two groups (p = 0.314). Our results show that telemedicine can achieve the same therapeutic outcomes as in-person therapy to improve feeding function in children with disabilities when receiving feeding therapy.

Relationship between maintenance of occlusal support achieved by home-visit dental treatment and prognosis in home-care patients-a preliminary study

AIM

To determine whether occlusal maintenance and reconstruction by dental intervention is associated with the prognosis of older home-care patients.

METHODS

The study participants were 289 older home-care patients (101 males, mean age 82.2 ± 7.7 years) who received visiting dental treatment from dental clinics in the region between 2012 and 2018. The participants were followed up for 1000 days after receiving the necessary dental treatment in a home-visit setting. The participants were divided into three groups: those with natural tooth occlusion, those whose molar occlusion was maintained or reconstructed by dentures, and those whose occlusion was not reconstructed. Factors associated with prognosis were determined using the Cox proportional hazard model, with occlusal status, comorbidities, the activity of daily living, and residence status as explanatory variables.

RESULTS

In the overall population, occlusal status (hazard ratio [HR] of those with occlusal disintegration versus those with natural tooth occlusion: 2.1, confidence interval [95% CI]: 1.18-3.82) and age (HR: 2.28, 95% CI: 1.44-3.61) were identified as significant factors. In the group of participants aged <85 years, only occlusal status (HR of those with occlusal disintegration versus those with natural tooth occlusion: 3.4, 95% CI: 1.34-8.68) was a significant factor. In the group of participants aged ≥85 years, occlusal status was not significantly associated with prognosis.

CONCLUSIONS

The maintenance and acquisition of occlusal support achieved by dental treatment contribute to improved prognosis in older patients younger than 85 years requiring home nursing care. Geriatr Gerontol Int 2022; 22: 976-981.

[Effects of periodontopathic bacterial components on phagocytic activity of rat peritoneal macrophages. Examination using ELISA]

This study examined the phagocytic activity of rat peritoneal resident macrophages to determine the movement of macrophages in local inflammation in periodontal disease. We studied phagocytic activity by enzymelinked immunosorbent assay (ELISA) and used the peroxidase-anti-peroxidase soluble complex (PAP; soluble immune complex) as a marker in. We also determined the basic conditions of this examination and studied the effects of bacterial components and the supernatants of sonicated periodontopathic bacterias. We obtained the number of applied macrophages, the concentration of PAP to use and the incubation time. The phagocytic activity of macrophages was enhanced significantly by the bacterial components lipopolysaccharide (LPS) and muramyldipeptide (MDP). Phagocytic activity was also enhanced by the addition of the supernatant of sonicated Bacteroides gingivalis at 40 micrograms/ml (concentration of protein) and significantly suppressed at 320 micrograms/ml. Moreover, activity was significantly enhanced by the supernatant of sonicated Capnocytophaga suputigena at 40 micrograms/ml and 160 micrograms/ml, and suppressed by the supernatant of Fusobacterium nucleatum at a low concentration of protein (5 micrograms/ml). These results suggested that LPS of gram-negative bacteria's endotoxicity and MDP on pivotal structure of peptidoglycans, which are bacterial cell surface components, exerted an effect on phagocytic activity. It was further indicated that the phagocytic activity of macrophages varied with the effects of each periodontopathic bacteria.