Effect of continuous sweet gustatory stimulation on salivary flow rate over time

OBJECTIVE

This study aimed to determine changes in saliva secretion and subjective taste intensity during a sustained period with continuous gustatory stimulation.

DESIGN

Twenty-two healthy adults participated in this study. The selected taste solutions were aspartame, sucralose, and acesulfame potassium, which are nonnutritive sweeteners. The concentrations of sucralose1 and acesulfame potassium were set to show the same sweetness intensity as aspartame. Sucralose2 was twice the concentration of sucralose1. The solution was continuously fed into the oral cavity at a flow rate of 0.04 mL / min through a neck-worn precise infusion system. The salivary flow rate (g/min) after 10 min of intraoral water supply from the device was used as the baseline. Salivary flow rate, subjective taste intensity evaluated by the visual analog scale (VAS), and salivary flow rate relative to the baseline were recorded at 10, 30, 60, and 120 min after the start of the test.

RESULTS

In the aspartame, sucralose1, and sucralose2 groups, the salivary flow rate increased significantly from 10 min to 120 min after the start of the test when compared to the rate at baseline (p < 0.05). The relative salivary flow rate increased and the VAS value decreased significantly over time and were affected by the time factor (p < 0.001, p = 0.013, respectively) but not by the sweetener-group factor and the interaction effects.

CONCLUSIONS

Continuous gustatory stimulation may maintain increased salivary production for a sustained period.

Does Multifunctional Acrylate's Addition to Methacrylate Improve Its Flexural Properties and Bond Ability to CAD/CAM PMMA Block?

This study investigated the effects of a multifunctional acrylate copolymer-Trimethylolpropane Triacrylate (TMPTA) and Di-pentaerythritol Polyacrylate (A-DPH)-on the mechanical properties of chemically polymerized acrylic resin and its bond strength to a CAD/CAM polymethyl methacrylate (PMMA) disk. The methyl methacrylate (MMA) samples were doped with one of the following comonomers: TMPTA, A-DPH, or Trimethylolpropane Trimethacrylate (TMPTMA). The doping ratio ranged from 10 wt% to 50 wt% in 10 wt% increments. The flexural strength (FS) and modulus (FM) of PMMA with and without comonomer doping, as well as the shear bond strength (SBS) between the comonomer-doped PMMA and CAD/CAM PMMA disk, were evaluated. The highest FS (93.2 ± 4.2 MPa) was obtained when doped with 20 wt% of TMPTA. For TMPTMA, the FS decreased with the increase in the doping ratio. For SBS, TMPTA showed almost constant values (ranging from 7.0 to 8.2 MPa) regardless of the doping amount, and A-DPH peaked at 10 wt% doping (8.7 ± 2.2 MPa). TMPTMA showed two peaks at 10 wt% (7.2 ± 2.6 MPa) and 40 wt% (6.5 ± 2.3 MPa). Regarding the failure mode, TMPTMA showed mostly adhesive failure between the CAD/CAM PMMA disk and acrylic resin while TMPTA and A-DPH showed an increased rate of cohesive or mixed failures. Acrylate's addition as a comonomer to PMMA provided improved mechanical properties and bond strength to the CAD/CAM PMMA disk.

Craniomaxillofacial Fibrous Dysplasia Improved Cosmetic and Occlusal Problem by Comprehensive Treatment: A Case Report and Review of Current Treatments

Fibrous dysplasia (FD) is a fibrous lesion of immature bone, with an incidence of 10–20% in the head and neck region. Most cases are monostotic, but when a lesion occurs on the maxillofacial region and spreads to the surrounding bone, it is classified as polyostotic, despite its localized occurrence. In some cases, surgical intervention is required to improve the cosmetic or functional disturbance of a FD in the maxillofacial region, but it is necessary to confirm symmetry of the maxillofacial region in real time, and a surgical support system is required to compensate. Furthermore, prosthetic intervention is considered when postoperative acquired defects occur or further cosmetic or occlusal function improvement is needed. A comprehensive approach by an oral surgeon and a maxillofacial prosthodontist is necessary for the successful treatment and rehabilitation of such patients. In this article, we describe the case of a craniomaxillofacial FD patient with facial asymmetry and denture incompatibility with improved quality of life measures by integrating surgical treatment using a navigation system and postoperative prosthetic rehabilitation. We also discuss recent diagnostic methods and treatment strategies for craniomaxillofacial FD in the literature.

Efficacy of soft palatal augmentation prosthesis for oral functional rehabilitation in patients with dysarthria and dysphagia: a protocol for a randomised controlled trial

INTRODUCTION

Palatal augmentation prosthesis (PAP) is used in patients with articulation and swallowing disorders caused by postoperative loss of tongue tissue due to tongue cancer, cerebrovascular disease sequelae and age-related hypofunction. We have previously reported a newly designed soft PAP fabricated using an thermoplastic material that is particularly appropriate for early intervention. However, the effect of soft PAP on oral function improvement remains to be elucidated. The aim of this study is to investigate whether soft PAP can improve dysarthria and dysphagia occurring as cerebrovascular disease sequelae.

METHODS AND ANALYSIS

This prospective, randomised, controlled trial will compare the immediate and training effects of rehabilitation using soft PAP with those of rehabilitation without using it. Primary outcomes are the single-word intelligibility test score and pharyngeal transit time (PTT). Secondary outcomes are tongue function (evaluated based on maximum tongue pressure, repetitions of tongue pressure and endurance of tongue pressure), articulation function (evaluated based on speech intelligibility, oral diadochokinesis, Voice-Related Quality of Life (V-RQOL)) and swallowing function (evaluated using Eating Assessment Tool-10). The study results will help determine the efficacy of Soft PAP in improving functional outcomes of word intelligibility and PTT. We hypothesised that early rehabilitation using Soft PAP would more effectively improve articulation and swallowing function compared with conventional rehabilitation without using soft PAP.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the Okayama University Certified Review Board. The study findings will be published in an open access, peer-reviewed journal and presented at relevant conferences and research meetings.

TRIAL REGISTRATION NUMBER

jRCTs062200054.

Effect of masseter muscle activity during wakefulness and sleep on tooth wear

PURPOSE

To investigate the effect of masseter muscle activity during wakefulness and sleep on tooth wear.

METHODS

Sixteen participants with no or mild tooth wear (NMTW group) and sixteen participants with moderate-to-severe tooth wear (MSTW group) were enrolled. The severity of tooth wear was evaluated using the occlusal and incisal indices of the tooth wear index. Surface electromyography was performed to record the electrical activity of the left masseter muscle during wakefulness and sleep. Electromyographic activity was detected using an electromyographic threshold of 5% and 20% of maximal voluntary clenching (MVC). The total duration of electromyographic activity and bruxism episodes were calculated.

RESULTS

The mean ages of the NMTW and MSTW groups were 71.75 ± 7.61 years and 71.69 ± 7.49 years, respectively. The mean cumulative duration of electromyographic activity during wakefulness using a threshold of >5% MVC was 6.44 ± 4.52 min/h and 13.62 ± 10.08 min/h for the NMTW and MSTW groups, respectively (p=0.048). The mean total durations of electromyographic activity during wakefulness and sleep using a threshold of >20% MVC were 1.08 ± 1.70 min/h and 1.05 ± 3.02 min/h, respectively, in the NMTW group and 4.78 ± 6.37 min/h and 1.61 ± 1.79 min/h, respectively, in the MSTW group (p=0.048 and p=0.003, respectively).

CONCLUSION

These results suggest that masseter electromyographic activity during wakefulness and sleep may be related to the severity of tooth wear.

Effects of food particle loss on the evaluation of masticatory ability using image analysis

PURPOSE

To examine how particle loss affects the evaluation of masticatory ability using the image analysis method.

METHODS

The subjects were divided into two groups:Y-group (healthy young adults: 10 male, 10 female; mean age 27.6 ± 1.9 years), and D-group (denture wearing older adults: 13 male, 9 female; mean age, 75.1 ± 5.3 years). Raw carrots, peanuts, and a combined test food from 5 daily food materials (mixed foods) were selected as test foods. Images of the boluses were captured and processed after the subjects freely masticated the test foods until the point of swallowing or completed half strokes of total chewing cycles. The median particle size (X₅₀) was calculated from the data for each particle. We compared X₅₀ calculated from all particles obtained from the masticatory bolus (as X_50N) with the X₅₀ of only selectively larger particles (as X_50R).

RESULTS

Significant correlations were observed between X_50N and X_50R (p < 0.01) determined in almost all masticatory conditions. In particular, for particle sizes of 2 mm or more, the correlation coefficient between X_50N and X_50R was notably strong (r > 0.75).

CONCLUSION

The method of analyzing only larger particles makes it possible to evaluate masticatory ability without losing the characteristics of the original particle size distribution of the entire bolus. This finding can be applied for the evaluation of masticatory ability, especially among older adults who have difficulty retrieving the total amount of test food due to decreased activities of daily living.

Detection of muscle fatigue caused by repeated posterior tongue lift movement from neck surface EMG: a pilot study

BACKGROUND

Fatigue is an important factor for muscle strengthening in rehabilitation medicine. Frequency analysis has been regarded as the gold standard for muscle fatigue assessment in surface electromyography (EMG). However, there are no experiments quantifying fatigue with grouped discharge (GD), which is one of the historical phenomena observed in patients having fatigue, by using high sampling rate recording of EMG.

OBJECTIVE

To investigate the effect of fatigue, which is induced by repeated posterior tongue lift movement (TLM), on the occurrence of GD peaks, thus, to provide possible basis as a parameter for future fatigue evaluation.

METHODS

Nineteen healthy adults (9 men and 10 women) participated in this study. The muscle fatigue protocol consisted of repetitive posterior TLM and maximum voluntary contractions (MVC). Bilateral N-EMG (Neck surface EMG for measuring the muscle activity of the posterior tongue) was recorded.

RESULTS

Subjective tongue fatigue at the end of the protocol was significantly higher than at beginning throughout the muscle fatigue protocol (p < .01). The frequency of occurrence of GD peaks was 0.9 ± 1.2 (per second) at the baseline in 33 of 38 subject sides, and significantly increased depending on fatigue progression (p < .01).

CONCLUSION

It was shown that fatigue due to repetitive posterior tongue lifting resulted in significant increase in the frequency of occurrence of GD peaks. Especially, the nature of GD, showing very few occurrences at non-fatigue condition, might work as an advantageous property for its use in future absolute evaluation of fatigue phenomena.

Lack of occlusal support did not impact amyloid β deposition in APP knock-in mice

PURPOSE

The lack of occlusal support is an epidemiological risk factor linked to Alzheimer's disease. This study sought to assess the relationship between amyloid β (Aβ) deposition and the lack of occlusal support in amyloid precursor protein (APP) knock-in mice.

METHODS

Sixteen experimental animals were divided into two groups. The upper molars were extracted in the extraction group (group E), and a sham operation was performed in the control group (group C). The Morris water maze test was performed 4 months after the tooth extraction. Aβ immunohistochemical staining and Nissl staining of the hippocampus were performed. Hippocampal plasma corticosterone and Aβ protein levels were measured.

RESULTS

In the maze task, the escape latency was significantly longer in group E than in group C. In the probe trials, the time elapsed in the target quadrant was significantly shorter in group E than in group C. The number of hippocampal neurons decreased in group E. There was no significant difference in the plasma corticosterone levels between the two groups, indicating that there was no effect of chronic stress on the behavioral results. Hippocampal Aβ40 and Aβ42 protein levels and Aβ deposition areas by immunohistochemical staining were not significantly different between the two groups.

CONCLUSIONS

Aβ deposition was not increased in the hippocampus of molarless APP knock-in mice. As such, it appears that cognitive impairment due to a lack of occlusal support was not related to Aβ deposition.

Newly designed flat surface artificial tongue system for speech improvement in glossectomy patients: A preliminary study

PURPOSE

To design an efficient tongue prosthesis with reproducibility and to objectively evaluate improvement in speech function.

METHODS

A silicon anatomical artificial tongue (AT) and a flat surface artificial tongue system (FTS) were used in our study. Twenty healthy participants (10 males and 10 females, 26.3 ± 1.8 years) were fitted with a tongue movement suppression appliance (TSA) that fit the dental arch to simulate the glossectomy condition. TSA, TSA + FTS, and TSA + AT simulated the state of glossectomy patients without artificial tongue, with normal artificial tongue, and newly designed artificial tongue, respectively. Three speech intelligibility tests were performed for each of the following conditions: pronouncing 100 Japanese monosyllables, 40 Japanese words, and reading a short story. One-way ANOVA, Wilcoxon signed-rank test, and Tukey-Kramer post-hoc test were used for statistical analyses.

RESULTS

Significant differences were observed for 100 Japanese monosylla bles and 40 Japanese words between the TSA + FTS, TSA, and TSA + AT conditions (p ‹ 0.05). Regarding the speech intelligibility test for reading a short story, the TSA + FTS condition resulted in a significantly higher speech intelligibility than the TSA and TSA + AT conditions (p ‹ 0.05).

CONCLUSIONS

A flat surface artificial tongue system contributed to the improvement in speech function. This structure can be easily used in cases where conventional artificial tongue are applicable, regardless of variation in the oral condition; thus, making it a widely applicable treatment option for glossectomy patients.

Coordination of surface electromyography activity in the posterior tongue region during mastication of differently textured foods

BACKGROUND

Masticatory movement occurs complicatedly and bilaterally. Although the tongue plays an important role in mastication, bilateral tongue function during mastication has not been clarified yet.

OBJECTIVE

To investigate the effect of food properties on posterior tongue activity and coordination of muscles bilaterally by electromyography (EMG).

METHODS

Twenty healthy adults (10 males and 10 females; mean age 28 years; range: 22-33 years) participated in this study. Three test foods, gummy jelly (hard food), sponge cake (soft food requiring crushing), and mashed potatoes (soft food not requiring crushing), were used. Bilateral masseter N-EMG (surface electromyography for measuring the muscle activity of posterior tongue) and submental EMG were carried out while the participants chewed three test foods. The participants were instructed to masticate three test foods only on the right side and only on the left side unilaterally.

RESULTS

In the case of gummy jelly, N-EMG activity on the mastication side was significantly larger than that on the non-mastication side (P < .01). Regarding temporal relationship between the masseter and N-EMG activity, in the case of gummy jelly, the percentage of cases where the N-EMG peak was observed during masseter muscle EMG bursts was significantly higher than those for sponge cake and mashed potatoes (P < .01).

CONCLUSION

N-EMG activity on the mastication side was significantly larger than that on the non-mastication side in the mastication of hard foods. Tongue showed activity pattern changes and coordinated with the masseter muscle depending on food texture.

Flexural properties, bond ability, and crystallographic phase of highly translucent multi-layered zirconia

This study investigated the mechanical properties, bond ability, and crystallographic forms of different sites in a highly translucent, multi-layered zirconia disk. Flexural properties, bond ability to resin cement, and phase composition were investigated at three sites of a highly translucent, multi-layered zirconia disk: incisal, middle, and cervical. Flexural strength (FS) and flexural modulus (FM) were measured with static three-point flexural test. Shear bond strength (SB) to resin cement was measured after 24 h storage (37°C). Phase composition under mechanical stress was analyzed using X-ray diffraction. Without air abrasion, FS at the incisal site yielded the lowest value and was significantly lower than the middle and cervical sites. Air abrasion lowered the FS of each site. FM at the incisal site without air abrasion showed the significantly lowest value, and air abrasion increased its FM value. At the middle and cervical sites, their FM values were higher than the incisal site but were not significantly affected by air abrasion. SB value did not show significant differences among the sites. After sintering, cubic zirconia was detected at each site. Rhombohedral phase transformation occurred after mirror polishing. In highly translucent, multi-layered zirconia which was mainly composed of cubic zirconia, rhombohedral phase transformation occurred under mechanical stress and resulted in weakened mechanical properties.

Phosphate group adsorption capacity of inorganic elements affects bond strength between CAD/CAM composite block and luting agent

This study aimed to investigate whether inorganic elements of polymer-infiltrated ceramic (PIC) and microfilled resin (MFR) for CAD/CAM would affect initial bond strength to luting agent. Inorganic elements of PIC and MFR were different with shape and ingredient observed by SEM, STEM and EDS. Microtensile bond strengths (µTBS) value of PIC was increased by 10-methacryloyloxydecyl dihydrogen phosphate (MDP) and acetic acid (AA)- or MDP-activated silane treatment, and further increased by succeeding heat treatment (HT). The µTBS of MFR was increased by MDP and MDP-activated silane, but decreased by AA-activated silane without HT. The HT improved the µTBS of MFR with AA-activated silane, but conversely for MDP-activated silane. Only in MFR, phosphoric acid (PA) application before each surface treatment dramatically decreased the µTBS of AA-activated silane. FTIR peaks in MFR shifted according to phosphate group's peak. MFR would possess high phosphate group adsorption capacity, with MDP effectively improving its bonding capability.

Differences in comminution progress during mastication in healthy dentate and denture-wearing elderly people

PURPOSE

This study aimed to investigate the effect of removable denture prostheses on the comminution progress in elderly people.

METHODS

Twenty-two denture wearers of Eichner's classification B and C (75.1±5.3 years old) and 20 young fully dentate subjects (27.6±1.9 years old) participated in the masticatory examination, which used a combined test food from 5 daily food materials. Full masticatory cycles lasting until subjects needed to swallow and the half number of the cycles were adopted as masticatory conditions. Digital images of food particles under wet conditions were obtained for each bolus, and particles were analyzed by calculating the homogeneity and particle size indices.

RESULTS

The characteristic properties of the food particles were observed using a homogeneity index in the elderly denture group for half masticatory strokes. Their homogeneity index was significantly higher than that of the young dentate group. By contrast, no significant difference was observed in the indices for particles immediately before swallowing between two groups.

CONCLUSIONS

The comminuted particle size before swallowing in healthy denture wearers was not significantly different from that in the natural dentate group. The comminution of the first-half process in denture wearers was typical and could be one possible focus for meal property specifications in future studies.

Characteristics of Grouped Discharge Waveforms Observed in Long-term Masseter Muscle Electromyographic Recording: A Preliminary Study

We investigated the characteristics of grouped discharge (GD) waveforms obtained from long-term masseter electromyogram (EMG) recording in 6 female temporomandibular disorder (TMD) patients with myofascial pain and 6 healthy females. The EMG measurement was performed from the morning of the experiment day until the subject woke up the next day. We observed a significantly larger number of GD waveforms in the TMD group compared to the control group (p=0.002). Our results indicate that the existence of GD waveforms in masseter EMGs might be a predictor of future TMD with myofascial pain.

Effects of the loss and reconstruction of molar occlusal support on memory retrieval and hippocampal neuron density in rats

PURPOSE

Animal experiments have shown that the loss of occlusal support causes impairments in spatial cognition. Many reports have focused on the memory encoding process, and only few studies have investigated the effect on memory retrieval. This study aimed to examine the effects of both the loss and reconstruction of occlusal support on the memory retrieval process and on the number of hippocampal pyramidal cells.

METHODS

The experimental animals were divided into a molarless group, in which molars were extracted, a denture-wearing molarless group with experimental dentures inserted after molar extraction, and a control group. Radial maze trials were performed for 20 consecutive days (acquisition phase). The rats were tested on long-term memory retention following the acquisition phase in eight trials every five days, and in an additional trial 20 days later (probe phase).

RESULTS

The denture-wearing molarless group showed higher levels of spatial learning and memory than the molarless group. There were no significant differences in memory retrieval during the probe phase between the denture-wearing molarless and the control group. The molarless group showed significantly worse spatial learning and memory and had fewer neurons in the hippocampus than the control group.

CONCLUSIONS

Our results suggest that the loss of occlusal support decreases the number of pyramidal cells in the hippocampus and impairs memory decoding and retrieval. However, this effect is suppressed by the reconstruction of occlusal support.

Passive Periodontal Sensation Threshold of Upper Molars in Patients with Myofascial Pain

Background and Objective:

The relationship between periodontal sensation and Myofascial Pain (MP) is not yet fully clarified. The aim of this study was to test the null hypothesis that there is no difference in the periodontal sensation threshold between subjects with MP and subjects with no Temporomandibular Disorders (TMD).

Methods:

Participants have clinically assessed in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders version 1.0 guidelines and assigned to the MP group (mean age 54.8 ± 14.8 years; 1 male and 11 females) or the control group (mean age: 63.9 ± 13.2 years; 1 male and 15 females). The Passive Periodontal Sensation Threshold (PPST) was evaluated using impulsive mechanical stimulation on the occlusal surface parallel to the tooth axis of the maxillary first molar, if present. The difference in the mean PPST between the MP group and the control group was evaluated using the Student t-test after checking for homoscedasticity.

Results:

The mean PPST value was 1050.1 ± 480.3 mN in the MP group and 712.3 ± 288.5 mN in the control group. A significant difference was observed between these mean PPST values (p = 0.045).

Conclusion:

There was a significant difference in PPST between the MP group and the control group. Although the etiology of the change of PPST is still unknown, the higher PPST value observed in MP patients suggests that future study on occlusal dysesthesia or occlusal sensation-related pathosis is warranted.

Short-Term Crossover Study on the Effect of Orthogonalized Deep-Grooved Posterior Artificial Teeth on the Masticatory Efficiency of Complete Denture Wearers

Background:

Mastication has been regarded to play an important role in achieving quality daily life for the elderly. On the occlusal surface of posterior artificial teeth, parallel grooves of 1 mm depth and 1 mm width with an inter-groove distance of 2 mm have been found to significantly improve masticatory efficiency on a mechanical simulator.

Materials and Methods:

In the present study, the effect of the grooved design on masticatory efficiency in edentulous subjects using a short-term crossover trial was evaluated. Six edentulous participants, 1 male and 5 females, were assigned into two groups. One received duplicated complete dentures with grooved molars first, and the other received duplicated complete dentures with conventional molars first. The design of the teeth was crossover after evaluating masticatory efficiency. Raw carrot, raw lettuce and mixed foodstuffs were used to evaluate masticatory efficiency. Subjects were instructed to masticate 20 strokes and arbitrary strokes until they felt like swallowing.

Results:

The number of masticatory strokes taken was significantly smaller using the grooved design (p<.05). Masticatory efficiency analysis revealed that the grooved design achieved significantly higher masticatory efficiency at 20 masticatory strokes for raw carrot and mixed foodstuffs (p<.05).

Conclusion:

Results show that compared with conventional lingualized occlusion, the grooved design accomplishes higher masticatory efficiency in vivo. Considering the distinction of this design that it can be applied to any existing denture occlusion, the design might help improve the dietary life of the elderly.

Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders

OBJECTIVES

To investigate the correlations among various temporomandibular joint (TMJ) findings on MRI and the relationships between MRI findings and symptoms.

METHODS

425 patients (850 TMJs) with temporomandibular joint disorders (TMDs) who underwent MRI were enrolled. Oblique sagittal proton density-weighted and T₂ weighted images in open- and closed-mouth positions were evaluated. MRI findings included disc configuration, disc position, condylar morphology, bone marrow pattern, and joint effusion. Symptoms included TMJ pain, TMJ noise, and limitation of mouth opening. For statistical analyses, Spearman's rank correlation coefficient and logistic regression analysis were applied.

RESULTS

Folded disc, disc displacement without reduction (DDWOR), and osteophytes had significant negative correlations with other normal MRI findings (p < 0.01). DDWOR and marrow edema were associated with TMJ pain. Conversely, osteophytes [odds ratio (OR): 0.52; 95% CI (0.30-0.90)] and combination-type condylar degeneration [OR: 0.45; 95% CI (0.24-0.83)] were associated with decreased risk of TMJ pain. Condylar flattening was positively associated with TMJ noise [OR: 5.25; 95% CI (1.44-19.07)] and negatively associated with limitation of mouth opening [OR: 0.34; 95% CI (0.11-0.99)]. High-grade joint effusion was significantly associated with TMJ pain and noise.

CONCLUSIONS

DDWOR and high-grade joint effusion (an indicator of inflammation in the articular cavity) were associated with TMD symptoms. This finding suggests that treatment strategy for DDWOR and decreasing inflammation might lessen clinical TMD symptoms. Condylar degeneration was not associated with indicators of inflammation or TMJ symptoms. These results suggest that patients with TMD symptoms should undergo initial MRI to allow rapid selection of appropriate therapies.

Ipsilateral Molar Clenching Induces Less Pain and Discomfort than Contralateral Molar Clenching in Patients with Unilateral Anterior Disc Displacement of the Temporomandibular Joint

AIMS

To assess the influence of clenching side and location (ie, tooth) on the bite force necessary to induce pain or discomfort in patients with unilateral anterior disc displacement (ADD) of the temporomandibular joint (TMJ).

METHODS

A total of 17 patients with unilateral ADD diagnosed clinically and with magnetic resonance imaging were included. A bite force meter was positioned at each of four experimental positions: the mandibular first premolars and first molars, bilaterally. Subjects were instructed to clench on the bite force meter until they felt pain or discomfort in the orofacial area and to report the location of the pain. Differences in pain location (ADD side versus contralateral side) and in the bite force thresholds for eliciting pain or discomfort were assessed by means of the paired t test and Wilcoxon signed-rank test.

RESULTS

Only 18% of subjects (3 out of 17) reported pain in the TMJ with ADD during clenching at the ipsilateral molar, whereas 65% (11 out of 17) reported joint pain during clenching on the contralateral molar (P = .005). At the molars, the mean ± standard deviation bite force necessary to induce pain was 241.2 ± 135.5 N on the side with ADD and 160.9 ± 78.0 N on the contralateral side. The mean molar bite force necessary to induce pain on the side with ADD was significantly higher than that on the contralateral side (P = .002).

CONCLUSION

Patients with unilateral ADD had fewer reports of TMJ pain and discomfort when they were molar clenching on the ipsilateral side compared to molar clenching on the contralateral side.

Validation of the optimal site in the neck region for detecting swallowing sounds

Recently, the swallowing sound has been used to detect swallowing events non-invasively. A previous study, using an accelerometer, showed that the site over the lateral border of the trachea immediately inferior to the cricoid cartilage was the optimal site for detecting swallowing sounds. However, the optimal site for detection of the swallowing sound using a microphone remains undetermined. To validate the optimal site in the neck region for detecting swallowing sounds. Fourteen healthy subjects (mean age, 27·6 ± 2·2 years; seven male and seven female) participated in this study. Twenty condenser microphones were attached to 20 sites on the left neck surface to detect swallowing sounds. Participants were instructed to swallow five different stimuli three times as follows: Resting saliva, 1 and 5 mL of Japanese tea, and 1 and 5 mL of yoghurt. Mean relative peak intensity was used to indicate the magnitude of the swallowing sound. Sound spectrograms were used to illustrate differences in the properties of swallowing sounds. Mean relative peak intensity number was highest in sites at the inferior border of the mandible just above the sternocleidomastoid muscle (site 11) and sites over the lateral border of the trachea immediately inferior to the cricoid cartilage (site 8). Comparison of spectrograms showed a greater density distribution of higher frequency components at site 11 compared with site 8. These results indicate that the inferior border of the mandible just above the sternocleidomastoid muscle is the optimal site for the detection of swallowing sounds.

Structure of a New Palatal Plate and the Artificial Tongue for Articulation Disorder in a Patient with Subtotal Glossectomy

A palatal augmentation prosthesis (PAP) is used to facilitate improvement in the speech and swallowing functions of patients with tongue resection or tongue movement disorders. However, a PAP's effect is limited in cases where articulation disorder is severe due to wide glossectomy and/or segmental mandibulectomy. In this paper, we describe speech outcomes of a patient with an articulation disorder following glossectomy and segmental mandibulectomy. We used a palatal plate (PP) based on a PAP, along with an artificial tongue (KAT). Speech improvement was evaluated by a standardized speech intelligibility test consisting of 100 syllables. The speech intelligibility score was significantly higher when the patient wore both the PP and KAT than when he wore neither (p＝0.013). The conversational intelligibility score was significantly improved with the PP and KAT than without PP and KAT (p＝0.024). These results suggest that speech function can be improved in patients with hard tissue defects with segmental mandibulectomy using both a PP and a KAT. The nature of the design of the PP and that of the KAT will allow these prostheses to address a wide range of tissue defects.

Various Effects of Sandblasting of Dental Restorative Materials

BACKGROUND

Sandblasting particles which remain on the surfaces of dental restorations are removed prior to cementation. It is probable that adhesive strength between luting material and sandblasting particle remnants might exceed that with restorative material. If that being the case, blasting particles adhere to sandblasted material surface could be instrumental to increasing adhesive strength like underlying bonding mechanism between luting material and silanized particles of tribochemical silica coating-treated surface. We hypothesize that ultrasonic cleaning of bonding surfaces, which were pretreated with sandblasting, may affect adhesive strength of a resin luting material to dental restorative materials.

METHODS

We therefore observed adhesive strength of resin luting material to aluminum oxide was greater than those to zirconia ceramic and cobalt-chromium alloy beforehand. To measure the shear bond strengths of resin luting material to zirconia ceramic and cobalt-chromium alloy, forty specimens of each restorative material were prepared. Bonding surfaces were polished with silicon abrasive paper and then treated with sandblasting. For each restorative material, 40 sandblasted specimens were equally divided into two groups: ultrasonic cleaning (USC) group and non-ultrasonic cleaning (NUSC) group. After resin luting material was polymerized on bonding surface, shear test was performed to evaluate effect of ultrasonic cleaning of bonding surfaces pretreated with sandblasting on bond strength.

RESULTS

For both zirconia ceramic and cobalt-chromium alloy, NUSC group showed significantly higher shear bond strength than USC group.

CONCLUSIONS

Ultrasonic cleaning of dental restorations after sandblasting should be avoided to retain improved bonding between these materials.

Flexural properties of polyethylene, glass and carbon fiber-reinforced resin composites for prosthetic frameworks

OBJECTIVE

High flexural properties are needed for fixed partial denture or implant prosthesis to resist susceptibility to failures caused by occlusal overload. The aim of this investigation was to clarify the effects of four different kinds of fibers on the flexural properties of fiber-reinforced composites.

MATERIALS AND METHODS

Polyethylene fiber, glass fiber and two types of carbon fibers were used for reinforcement. Seven groups of specimens, 2 × 2 × 25 mm, were prepared (n = 10 per group). Four groups of resin composite specimens were reinforced with polyethylene, glass or one type of carbon fiber. The remaining three groups served as controls, with each group comprising one brand of resin composite without any fiber. After 24-h water storage in 37°C distilled water, the flexural properties of each specimen were examined with static three-point flexural test at a crosshead speed of 0.5 mm/min.

RESULTS

Compared to the control without any fiber, glass and carbon fibers significantly increased the flexural strength (p < 0.05). On the contrary, the polyethylene fiber decreased the flexural strength (p < 0.05). Among the fibers, carbon fiber exhibited higher flexural strength than glass fiber (p < 0.05). Similar trends were observed for flexural modulus and fracture energy. However, there was no significant difference in fracture energy between carbon and glass fibers (p > 0.05).

CONCLUSION

Fibers could, therefore, improve the flexural properties of resin composite and carbon fibers in longitudinal form yielded the better effects for reinforcement.

A novel automated detection system for swallowing sounds during eating and speech under everyday conditions

The wave analysis of swallowing sounds has been receiving attention because the recording process is easy and non-invasive. However, up until now, an expert has been needed to visually examine the entire recorded wave to distinguish swallowing from other sounds. The purpose of this study was to establish a methodology to automatically distinguish the sound of swallowing from sound data recorded during a meal in the presence of everyday ambient sound. Seven healthy participants (mean age: 26·7 ± 1·3 years) participated in this study. A laryngeal microphone and a condenser microphone attached to the nostril were used for simultaneous recording. Recoding took place while participants were taking a meal and talking with a conversational partner. Participants were instructed to step on a foot pedal trigger switch when they swallowed, representing self-enumeration of swallowing, and also to achieve six additional noise-making tasks during the meal in a randomised manner. The automated analysis system correctly detected 342 out of the 352 self-enumerated swallowing events (sensitivity: 97·2%) and 479 out of the 503 semblable wave periods of swallowing (specificity: 95·2%). In this study, the automated detection system for swallowing sounds using a nostril microphone was able to detect the swallowing event with high sensitivity and specificity even under the conditions of daily life, thus showing potential utility in the diagnosis or screening of dysphagic patients in future studies.

Effect of nasal speaking valve on speech intelligibility under velopharyngeal incompetence: a questionnaire survey

Velopharyngeal incompetence is known as a contributing factor to speech disorders. Suwaki et al. reported that nasal speaking valve (NSV) could improve dysarthria by regulating nasal emission utilising one-way valve. However, disease or condition which would be susceptible to treatment by NSV has not been clarified yet. This study aimed to evaluate the effect of NSV by questionnaire survey using ready-made NSV. Subjects were recruited through the internet bulletin, and NSV survey set was sent to the applicant. Sixty-six participants, who agreed to participate in this study, used NSV and mailed back the questionnaire which included self-evaluation and third-party evaluation of speech intelligibility. Statistical analysis revealed that the use of NSV resulted in significant speech intelligibility improvement in both self-evaluation and third-party evaluation (P < 0·01). Regarding the type of underlying disease of dysarthria, significant effect of NSV on self-evaluation of speech intelligibility could be observed in cerebrovascular disease and neurodegenerative disease (P < 0·01) and that on third-party evaluation in neurodegenerative disease (P < 0·01). Eighty-six percent of subjects showed improvement of speech intelligibility by shutting up nostrils by fingers, and the significant effect of NSV on both self-evaluation and third-party evaluation of speech intelligibility was observed (P < 0·001). From the results of this study, it was suggested that NSV would be effective in cerebrovascular disease and neurodegenerative disease, as well as in subjects whose speech intelligibility was improved by closing nostrils.

Specific diurnal EMG activity pattern observed in occlusal collapse patients: relationship between diurnal bruxism and tooth loss progression

Aim

The role of parafunctional masticatory muscle activity in tooth loss has not been fully clarified. This study aimed to reveal the characteristic activity of masseter muscles in bite collapse patients while awake and asleep.

Materials and Methods

Six progressive bite collapse patients (PBC group), six age- and gender-matched control subjects (MC group), and six young control subjects (YC group) were enrolled. Electromyograms (EMG) of the masseter muscles were continuously recorded with an ambulatory EMG recorder while patients were awake and asleep. Diurnal and nocturnal parafunctional EMG activity was classified as phasic, tonic, or mixed using an EMG threshold of 20% maximal voluntary clenching.

Results

Highly extended diurnal phasic activity was observed only in the PBC group. The three groups had significantly different mean diurnal phasic episodes per hour, with 13.29±7.18 per hour in the PBC group, 0.95±0.97 per hour in the MC group, and 0.87±0.98 per hour in the YC group (p<0.01). ROC curve analysis suggested that the number of diurnal phasic episodes might be used to predict bite collapsing tooth loss.

Conclusion

Extensive bite loss might be related to diurnal masticatory muscle parafunction but not to parafunction during sleep.

Clinical Relevance: Scientific rationale for study

Although mandibular parafunction has been implicated in stomatognathic system breakdown, a causal relationship has not been established because scientific modalities to evaluate parafunctional activity have been lacking.

Principal findings

This study used a newly developed EMG recording system that evaluates masseter muscle activity throughout the day. Our results challenge the stereotypical idea of nocturnal bruxism as a strong destructive force. We found that diurnal phasic masticatory muscle activity was most characteristic in patients with progressive bite collapse.

Practical implications

The incidence of diurnal phasic contractions could be used for the prognostic evaluation of stomatognathic system stability.

Effect of occlusal rehabilitation on spatial memory and hippocampal neurons after long-term loss of molars in rats

Experimental loss of occlusal support caused by the extraction or grinding of molar teeth has been reported to foment the impairment of learning and memory in laboratory animals. The purpose of this study was to examine the effect of occlusal reconstruction after long-term loss of molars on spatial memory by using 8-arm radial maze and by assessing histopathological changes of neuron density in the hippocampus. Experimental dentures were inserted into the oral cavities of molarless rats to recover the occlusal support. Age-matched groups of control, molarless and denture-wearing rats were trained to perform the maze tasks. The difference of the error incidence in the maze task was evaluated between three groups. The difference of neuron density between three groups was also evaluated at the end of the maze task. Serum corticosterone levels were also measured to estimate the chronic stress, which could be caused by extraction, insertion of the experimental denture or any experimental procedure. The error incidence in the denture-wearing group was significantly higher than that of the control group, but significantly lower than that of the molarless group. Significant differences of neuron density were observed between three groups in each of the hippocampal CA1, CA3 and DG subfields. No significant difference of the serum corticosterone levels between three groups could be observed. From the results of this study, it was suggested that the recovery of occlusal support would bring amelioration of cognitive impairment concomitant with long period loss of molars in rats.

Masticatory efficiency in complete denture wearers with reduced dental arches--a randomised cross-over study

One obstacle to placing artificial posterior teeth in manufacturing complete dentures is a reduction of the space between the maxilla and the mandible. Occasionally, second molar placement is not performed, as it does not affect aesthetics, phonetics or comfort. The aim of this study was to compare the masticatory efficiency between patients wearing maxillary and mandibular complete dentures with reduced dental arches (without second molars) (WSM) and with full dental arches (FDA). Twenty subjects were divided into two groups and randomly received new complete dentures. Patients in Group 1 were given dentures WSM, and those in Group 2 were given dentures with FDA. After the post-placement visits, an initial masticatory efficiency test was performed with Optocal, an artificial test food. Fifteen days later, second molars were placed in Group 1 and removed from Group 2, and a new test was performed. Comminuted material was treated and sieved under vibration. The mean and standard deviation of masticatory efficiency with FDA were 10.4 and 8.1, respectively. In the tests WSM, the mean and standard deviation were 8.4 and 3.3, respectively. After removing the second molars in Group 2 and adding them in Group 1, the mean and standard deviation were 15.7 and 14.7 for Group 1 and 12.5 and 10.4 for Group 2, respectively. Within the limitations of this study, placing artificial teeth up to the first molars can be performed when needed without compromising masticatory efficiency.

The Design of Non-Occlusal Intraoral Appliances on Hard Palate and Their Effect on Masseter Muscle Activity During Sleep

This study aimed to reveal whether masseter muscle activity during sleep is affected by the difference in design of non-occlusal intraoral appliances on hard palate. Eight healthy Japanese participants were selected and wore each of the four types of appliances (horse shoe, thin, thick and medium thick) during sleep for one week with a one week interval without appliance during sleep. A masseter muscle electromyograph (EMG) was recorded during sleep. The EMG activities were analyzed by calculating the number of bursts per hour, episodes per hour, and bursts per episode. The EMG parameters with the thick type appliance were significantly lower than the baseline condition without appliance. In this study, it is suggested that a thick type appliance has an active effect on suppression of masseter muscle activity.

Differential involvement of two cortical masticatory areas in submandibular salivary secretion in rats

To evaluate the role of the masticatory area in the cerebral cortex in the masticatory-salivary reflex, we investigated submandibular salivary secretion, jaw-movement trajectory and electromyographic activity of the jaw-opener (digastric) and jaw-closer (masseter) muscles evoked by repetitive electrical stimulation of the cortical masticatory area in anesthetized rats. Rats have two cortical masticatory areas: the anterior area (A-area) in the orofacial motor cortex, and the posterior area (P-area) in the insular cortex. Our defined P-area extended more caudally than the previous reported one. P-area stimulation induced vigorous salivary secretion (about 20 µl/min) and rhythmical jaw movements (3-4 Hz) resembling masticatory movements. Salivary flow persisted even after minimizing jaw movements by curarization. A-area stimulation induced small and fast rhythmical jaw movements (6-8 Hz) resembling licking of solutions, but not salivary secretion. These findings suggest that P-area controls salivary secretion as well as mastication, and may be involved in the masticatory-salivary reflex.

Memory-related gene expression profile of the male rat hippocampus induced by teeth extraction and occlusal support recovery

OBJECTIVES

The present study aimed to identify the effect of memory-related genes on male rats tested for spatial memory with either molar teeth extraction or its restoration by occlusal support using experimental dentures.

DESIGN

Memory-related genes were detected from hippocampi of male Wistar rats (exposed to teeth extraction with or without dentures, or no extraction (control)) (7-week old) after behavioural testing (via the radial maze task) using a DNA microarray. The time course of the expression of these genes was evaluated by quantitative real-time polymerase chain reaction (PCR) (on 49-week-old rats).

RESULTS

In preliminary experiments, to determine which memory genes are affected by spatial memory training, DNA microarray analysis revealed that thyrotropin-releasing hormone (Trh) and tenascin XA (Tnxa) were up-regulated and neuronatin (Nnat) and S100a9 were down-regulated after the maze training. The expression of Tnxa, Nnat and S100a9 of 49-week-old rats (during the time course) via quantitative real-time PCR was consistent with the results of microarrays of the preliminary experiment. Expression of Trh that was evaluated by quantitative real-time PCR did not agree with the results for this gene from the microarray for all groups. Therefore, expression of Trh may have increased in only young, trained rats. The expression of S100a9 prior to the maze task was down-regulated in only the extraction group.

CONCLUSION

These results demonstrated that Trh, Tnxa and Nnat genes were affected according to the degree of memory in male rats. This study also indicated that S100a9 is a memory-related gene, which is affected by the presence of occlusal support.

Adhesive interfacial interaction affected by different carbon-chain monomers

OBJECTIVES

The functional monomer 10-methacryloxydecyl dihydrogen phosphate (10-MDP), recently used in more self-etch adhesives, chemically bonds to hydroxyapatite (HAp) and thus tooth tissue. Although the interfacial interaction of the phosphoric-acid functional group of 10-MDP with HAp-based substrates has well been documented, the effect of the long carbon-chain spacer of 10-MDP on the bonding effectiveness is far from understood.

METHODS

We investigated three phosphoric-acid monomers, 2-methacryloyloxyethyl dihydrogen phosphate (2-MEP), 6-methacryloyloxyhexyl dihydrogen phosphate (6-MHP) and 10-MDP, that only differed for the length of the carbon chain, on their chemical interaction potential with HAp and dentin, this correlatively using X-ray diffraction (XRD) and transmission electron microscopy (TEM). Commercial 6-MHP and 10-MDP containing adhesives were investigated as well.

RESULTS

XRD revealed that on HAp only 10-MDP produced monomer-calcium salts in the form of 'nano-layering', while on dentin all monomers produced 'nano-layering', but with a varying intensity in the order of 10-MDP>6-MHP>2-MEP. TEM confirmed that 10-MDP formed the thickest hybrid and adhesive layer. XRD and TEM revealed 'nano-layering' for all commercial adhesives on dentin, though less intensively for the 6-MHP containing adhesive than for the 10-MDP ones.

SIGNIFICANCE

It is concluded that not only the phosphoric-acid group but also the spacer group, and its length, affect the chemical interaction potential with HAp and dentin. In addition, the relatively strong 'etching' effect of 10-MDP forms more stable monomer-Ca salts, or 'nano-layering', than the two shorter carbon-chain monomers tested, thereby explaining, at least in part, the better bond durability documented with 10-MDP containing adhesives.

HEMA inhibits interfacial nano-layering of the functional monomer MDP

Previous research showed that the functional monomer 10-methacryloxydecyl dihydrogen phosphate (MDP) ionically bonds to hydroxyapatite (HAp) and forms a nano-layered structure at the interface with HAp-based substrates. Such hydrophobic nano-layering is considered to contribute to the long-term durability of the bond to tooth tissue. However, dental adhesives are complex mixtures usually containing different monomers. This study investigated the effect of the monomer 2-hydroxyethylmethacrylate (HEMA) on the chemical interaction of MDP with HAp by x-ray diffraction (XRD), nuclear magnetic resonance (NMR), and quartz crystal microbalance (QCM). We examined the chemical interaction of 5 experimental MDP solutions with increasing concentrations of HEMA. XRD revealed that addition of HEMA inhibits nano-layering at the interface, while NMR confirmed that MDP remained adsorbed onto the HAp surface. QCM confirmed this adsorption of MDP to HAp, as well as revealed that the demineralization rate of HAp by MDP was reduced by HEMA. It was concluded that even though the adsorption of MDP to HAp was not hindered, addition of HEMA inhibited interfacial nano-layering. Potential consequences with regard to bond durability necessitate further research.

Effect of spherical silica additions on marginal gaps and compressive strength of experimental glass-ionomer cements

PURPOSE

To clarify the effects of the addition of silanized (S) and unsilanized (U) spherical silica filler to resin-modified glass-ionomer cement and of powder-liquid ratio on (1) the early marginal gap-width of restorations in both tooth cavities and Teflon molds, (2) the gap-formation of restorations in Class V cavities, and (3) the compressive strength of the cement.

METHODS

Resin-modified glass-ionomer powder (Fuji II LC EM, GC) was modified by adding 5 and 10 wt% of powder respectively, of S and U, and then the powder-liquid ratio was increased up to 4.8. Human premolars, extracted for orthodontic reasons, were used for this study. Cylindrical cavities (1.5 mm deep, 3.5 mm in diameter; one cavity was prepared in each tooth in the coronal region and medial surface) were prepared in extracted human premolar teeth and restored with resin-modified glass-ionomer cements. Each restoration margin was inspected immediately after curing and polishing (as the immediate condition was the most severe), the maximum gap-width and the opposing width (if any) were determined microscopically (n = 10). An additional test was conducted in model Class V cavities. After finishing of restorations in model Class V cavities, each tooth was sectioned in a bucco-lingual direction through the center of the restoration, and the presence or absence of gaps along the cavity interface was evaluated (n = 10). Additionally, the maximum marginal gap-width and the opposing-width along margins of restorations in cylindrical Teflon molds were measured (n= 10). The compressive strengths of the restorative materials were determined immediately after light-activation (n = 10).

RESULTS

Marginal gap (tooth cavity: 0.32 to 0.25-0.20%, P < 0.05; Teflon cavity: 0.94 to 0.6-0.8%, P < 0.05) and cavity adaptation (no gap in the Class V: 22 to 40-50%, P < 0.05) of the restorations improved with increasing powder-liquid ratio (3.0 to 4.4-4.8) and compressive strength increased (111 to 150-170 MPa, P < 0.05). Highly significant correlation coefficients were found for the relationships between powder-liquid ratio and (1) percentage of marginal gap width in the tooth cavity (r = -0.96, P = 0.002, n = 6), (2) gap-free tooth/cement interfaces (r = 0.90, P = 0.015, n = 6), (3) percentage of marginal gap widths in the Teflon mold (r = 0.98, P = 0.0004, n = 6) and (4) compressive strengths of the cements (r = 0.95, P = 0.004, n = 6).

Nanolayering of phosphoric acid ester monomer on enamel and dentin

Following the "adhesion-decalcification" concept, specific functional monomers possess the capacity to primary chemically interact with hydroxyapatite (HAp). Such ionic bonding with synthetic HAp has been demonstrated for 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP), manifest as self-assembled "nanolayering". In continuation of that basic research this study aimed to explore whether nanolayering also occurs on enamel and dentin when a 10-MDP primer is applied following a common clinical application protocol. Therefore, the interaction of an experimental 10-MDP primer and a control, commercially available, 10-MDP-based primer (Clearfil SE Bond primer (C-SE), Kuraray) with enamel and dentin was characterized by X-ray diffraction (XRD), complemented with transmission electron microscopy interfacial ultrastructural data upon their reaction with enamel and dentin. In addition, XRD was used to study the effect of the concentration of 10-MDP on nanolayering on dentin. Finally, the stability of the nanolayers was determined by measuring the bond strength to enamel and dentin when a photoinitiator was added to the experimental primer or when interfacial polymerization depended solely on the photoinitiator supplied with the subsequently applied adhesive resin. XRD confirmed nanolayering on enamel and dentin, which was significantly greater on dentin than on enamel, and also when the surface was actively rubbed with the primer. Nanolayering was also proportional to the concentration of 10-MDP in the primer. Finally, the experimental primer needed the photoinitiator to obtain a tensile bond strength to dentin comparable with that of the control C-SE primer (which also contains a photoinitiator), but not when bonded to enamel. It is concluded that self-assembled nanolayering occurs on enamel and dentin, even when following a clinically used application protocol. The lower bonding effectiveness of mild self-etch adhesives to enamel should be ascribed in part to a lower chemical reactivity (nanolayering) with enamel HAp.