Effect of rapid maxillary expansion on masticatory and swallowing functions in children with posterior crossbite

OBJECTIVE

Investigate the influence of posterior crossbite on masticatory and swallowing functions by videofluoroscopy examination and to analyze the effects of Rapid Maxillary Expansion (RME) on the same functions.

METHODS

A prospective longitudinal study was conducted on 32 children, 21 of them with posterior crossbite (10 girls and 11 boys, mean age 9.2 years, study group) and 11 children with no occlusal changes (6 girls and 5 boys, mean age 9.3 years, control group). The children were evaluated by an orthodontist for diagnosis, group characterization and occlusal treatment, by the otorhinolaryngology team for the assessment of respiratory symptoms, and by a speech therapist for videofluoroscopic evaluation of masticatory and swallowing parameters. The children with posterior crossbite were treated orthodontic ally using the Haas disjunctor for approximately six months and re-evaluated 5-months after removal of the appliance. Data were analyzed statistically by the Studentt-test for independent samples for comparison of the crossbite and control groups before and after treatment.

RESULTS

There was no significant difference in oral preparatory and oral transit times, nor in cycles and masticatory frequency, between the pre and post orthodontic treatment groups and the control group.

CONCLUSION

Rapid maxillary expansion did not influence the masticatory and swallowing variables studied by videofluoroscopy. However, the data require caution in interpretation.

Buccal films: A review of therapeutic opportunities, formulations & relevant evaluation approaches

The potential of the mucoadhesive film technology is hard to ignore, owing to perceived superior patient acceptability versus buccal tablets, and significant therapeutic opportunities compared to conventional oral drug delivery systems, especially for those who suffer from dysphagia. In spite of this, current translation from published literature into the commercial marketplace is virtually non-existent, with no authorised mucoadhesive buccal films available in the UK and very few available in the USA. This review seeks to provide an overview of the mucoadhesive buccal film technology and identify key areas upon which to focus scientific efforts to facilitate the wider adoption of this patient-centric dosage form. Several indications and opportunities for development were identified, while discussing the patient-related factors influencing the use of these dosage forms. In addition, an overview of the technologies behind the manufacturing of these films was provided, highlighting manufacturing methods like solvent casting, hot melt extrusion, inkjet printing and three-dimensional printing. Over thirty mucoadhesive polymers were identified as being used in film formulations, with details surrounding their mucoadhesive capabilities as well as their inclusion alongside other key formulation constituents provided. Lastly, the importance of physiologically relevant in vitro evaluation methodologies was emphasised, which seek to improve in vivo correlations, potentially leading to better translation of mucoadhesive buccal films from the literature into the commercial marketplace.

Comparison of oral physiological and salivary rheological properties of Chinese Mongolian and Han young adults

OBJECTIVES

Consumers' oral physiology and salivary properties are greatly dependent on dietary backgrounds, and this in turn may impact food perception and preferences. Scarce studies are available on the oral physiology and salivary rheology of Chinese participants with different dietary and ethnic backgrounds.

DESIGN

This study examined two ethnic groups, Chinese Han and Chinese Mongolian healthy young adults, and explored the differences in oral physiology and salivary rheological properties. Official data suggested that Chinese Mongolians tend to consume more red meat and dairy, and Chinese Han tend to consume more carbohydrates. 200 Han and 104 Mongolian participants were evaluated for the oral physiological and salivary rheological parameters (maximum bite force of incisor and molar teeth, maximum tongue pressure and maximum oral volume; the surface tension, shear viscosity and extensional viscosity of unstimulated and stimulated whole saliva samples).

RESULTS

Distinct differences between two ethnic groups were found, particularly in their bite forces and salivary physical properties. Chinese Mongolian participants had significantly higher incisor bite force (168 N) than Chinese Han (146 N). In addition, Chinese Han had significantly lower unstimulated whole saliva flow rate than Chinese Mongolians; and significantly higher salivary surface tension, shear viscosity and extensional viscosity, in both unstimulated and stimulated whole saliva samples.

CONCLUSIONS

Chinese Han and Chinese Mongolian participants exhibited different oral physiological and salivary rheological properties; and considering the dietary differences between the two ethnicities, the findings from this study suggest possible associations between dietary habits and oral physiological & saliva rheological properties.

Relating oral physiology and anatomy of consumers varying in age, gender and ethnicity to food oral processing behavior

The aim of this study was to link parameters describing oral physiology and anatomy of consumers varying in age, gender and ethnicity to food oral processing behavior. Three groups of healthy consumers were compared: Dutch, Caucasian adults (18-30 yrs, n =32), Chinese, Asian adults (18-30 yrs, n =32) and Dutch, Caucasian older adults (65-85 yrs, n =32). Mastication performance, salivary flow rate (stimulated and unstimulated) and dental status were quantified to characterize oral physiology. Volume of oral cavity, tongue dimensions, facial anthropometry, height and weight were quantified to characterize anatomy. Oral processing behavior of three solid foods (carrot, cheese and sausage) was quantified by video recordings and eating rate (g/s), average consumption time (s), chews per bite (-) and average bite size (g) were determined. Dutch, Caucasian older adults had smaller volume of oral cavity, lower number of teeth and larger head width compared to Dutch, Caucasian adults. Chinese, Asian adults showed significantly higher mastication performance and larger head width compared to Dutch, Caucasian consumers, while dental status did not significantly differ between groups. Males had significantly larger volumes of oral cavity and larger head height and width compared to females. Dutch, Caucasian adults had a shorter average consumption time (s), less chews per bite and consumed the three foods with higher eating rate (g/s) compared to Dutch, Caucasian older adults. Chinese, Asian adults had a significantly longer average consumption time (s), more chews per bite, smaller average bite size (g) and lower eating rate (g/s) compared to Dutch, Caucasian adults. Twenty-one significant relationships were found between oral physiological and anatomical parameters and oral processing behavior. Body weight resulted in the largest β-values, indicating to be the anatomical parameter of largest influence on oral processing behavior. We conclude that only few oral physiological and anatomical parameters related with food oral processing behavior. We suggest that other factors, including cultural factors contribute to variation in food oral processing behavior between different consumer groups more than saliva flow, volume of oral cavity, mastication performance and dental status.

Smartphone use while eating increases caloric ingestion

The use of smartphones during meals may possibly influence the number of ingested calories. We evaluated the influence of smartphones' distraction during eating on caloric intake. Physical (masticatory parameters, sex and body mass index - BMI); environmental (with or without distraction) and psychological (stress levels) variables were evaluated as confounding factors. Sixty-two adults were recruited for experimental snack tests performed on four different days. At baseline, we evaluated masticatory performance, swallowing threshold, masticatory frequency and body mass index (BMI). In the following three sessions, volunteers were presented a snack test in which participants ate under three experimental conditions: no distraction, using their smartphones, or reading a printed text. At the end of each session, total and nutritional compound stratified caloric intake was measured. Three-way mixed model ANOVA was used to test the effect of experimental condition on the total, carbohydrate and lipid caloric intakes. Hierarchical multiple linear regression models were used to estimate the influence of confounding factors on the total caloric intake. We found an effect of the condition (no distraction, smartphone or reading) on the total caloric (p = .007) and lipid intake (p = .002). When eating without distraction, the mean caloric intake was 535 (±164) kcal, in comparison to 591 (±203) kcal using smartphone (p = .05) and 622 (±226) kcal (p = .002) reading a text (no significant difference between distracters). Eating with distracters increased approximately 15% caloric ingestion. An interaction condition*sex effect was observed on lipid intake (p = .020). Energy intake was found to be dependent on sex and age, in which older men ingested more calories. Smartphone use during a meal increased caloric and lipid intake, depending on sex and age in young adults with complete dentition.

A Novel Three-Dimensional Analysis of Tongue Movement During Water and Saliva Deglutition: A Preliminary Study on Swallowing Patterns

Deglutition is a complex oral function, and the study of the whole process requires a precise analysis of the elements involved, especially of the tongue biomechanics. We described a three-dimensional analysis of tongue movements during both saliva and water deglutition in participants with normal occlusion. Fourteen participants (25.36 ± 4.85 years) were evaluated, and the movements of anterior, middle, and posterior portions of the tongue were recorded using AG501 3D-electromagnetic articulograph. An average volume (AVS) for water deglutition was determined for each participant. Saliva deglutition was classified according to Bourdiol et al. 35.71% was type I, 14.29% type II, and 50% type III. The greatest displacement on the inferior-superior axis was in the posterior portion, followed by the middle and anterior portions. In the posterior-anterior axis, smallest movement was in the anterior portion. During water deglutition, on the inferior-superior axis, there were statistical differences for 1-AVS between the anterior/middle and anterior/posterior portions of the tongue. There were statistical differences for both ½-AVS and ¼-AVS between the anterior/posterior portions of the tongue. On the posterior-anterior axis, there were no statistical differences among any volume-portion relations. On the medial-lateral axis, there was statistical difference for the ½-AVS between middle and posterior portions. The movement of the tongue portions was influenced by the volume and the element to be swallowed. The amplitude of the movement was directly proportional to the volume of water swallowed.

The association between Occlusion Time and Temporomandibular Disorders

INTRODUCTION

Recently, some published studies show there is a multifactorial origin for Temporomandibular Disorders, but the dental occlusion's contribution to the development of Temporomandibular Disorders, and how it may influence the adaptive capacity of the Stomatognathic system, it's still unclear. The aim of this study is to evaluate the correlation between the Occlusion Time and Temporomandibular Disorders.

METHODS

A total of 54 patients were enrolled in the study (24 males and 30 females, mean age 27.94 ± 8.21 years). The TMD group (8 males and 10 females) consisted of subjects who presented with at least 1 of the following signs of Temporomandibular Disorders: Temporomandibular Joint sounds (clicking or crepitation), Temporomandibular Joint locking episodes, limited mandibular opening, painful limitation of mandibular movements, pain to palpation of the Temporomandibular Joint or of the masticatory muscles. The control group (16 males and 20 females) presented as free from Temporomandibular Disorders. The T-Scan III computerized occlusal analysis system was to record the subjects' Occlusion. Times during eight mandibular opening-closing movements.

RESULTS

The two-ways ANOVA test analyzed the variations for group and sex, showing that the TMD group mean Occlusion Time (0.64 ± 0.21s) was statistically significantly longer than the control group mean Occlusion Time (0.45 ± 0.17s) (p<0.001). Significant differences were also found for gender where the mean OT of female subjects was longer than males one with statistical significance (p-value<0.01).

CONCLUSIONS

The computerized analysis of the Occlusion Time in patients affected by TMJ problems has to be carefully considered as adjunctive instrumental device.