Relationship between maximum occlusal force and gastrointestinal cancer in community-dwelling older Japanese adults

Globally, the cancer burden is expected to increase as populations are ageing. Therefore, cancer prevention among older age groups is important. This prospective cohort study examined the relationship between the number of remaining teeth, maximum occlusal force, and incidence of gastrointestinal cancer in community-dwelling older Japanese individuals using data from the Tsurugaya project; 847 participants were included. The exposure variables were the number of remaining teeth and the maximum occlusal force, with the outcome being the incidence of gastrointestinal cancer. Covariates were age, sex, medical history, smoking, alcohol consumption, educational attainment, and physical function. The Cox proportional hazard model was used to examine the relationship between the number of remaining teeth, maximum occlusal force, and incidence of gastrointestinal cancer. With a median follow-up of 7.6 years, 63 participants were confirmed to have gastrointestinal cancer. The risk of gastrointestinal cancer was significantly higher in those with an occlusal force lower than the median (hazard ratio, 2.80; 95% confidence interval, 1.54–5.10). No significant risk difference was found according to the number of remaining teeth. Low maximum occlusal force was associated with the incidence of gastrointestinal cancer in community-dwelling older Japanese adults.

DIGITAL OCCLUSAL ANALYSIS AND ORAL HEALTH-RELATED QUALITY OF LIFE OF PATIENTS WITH 3D PRINTED COMPLETE DENTURES VERSUS CONVENTIONAL DENTURES

Background: 3D printed complete dentures fabrication with computer-aided designing and computer-aided manufacturing (CAD/CAM) techniques is becoming popular nowadays. However, studies that analyzed the occlusal forces distribution using recent digital methods as T-scan III and further evaluated the dentures effect on patient`s life quality were lacking. Objectives: Evaluation of the occlusal forces distribution using T-scan III, and evaluation of the oral health-related quality of life (OHRQoL) using Oral Health Impact Profile for Edentulous Patients (OHIP-EDEN) questionnaire for 3D printed complete dentures and comparing it with conventional denture fabrication techniques. Methods: Twenty completely edentulous patients were selected and divided randomly into two equal groups according to manufacturing technique group I (patients who received conventional complete dentures), and group II (patients who received 3D printed complete dentures). For all patients, occlusal force analysis (percentage of applied occlusal force on both sides) was performed using the T-Scan III (digital occlusal analysis system). Also, OHRQoL was assessed using (OHIP-EDENT) questionnaire. Results: In the digital occlusal analysis, comparison between right and left sides regarding occlusal forces distribution revealed a significant difference in group I (conventional denture), while in group II (3D printed denture), it revealed an insignificant difference. Regarding, OHIP-EDENT patients in group I (conventional denture) revealed higher scores than group II (3D printed dentures). Also, the correlation between occlusal forces & (OHIP-EDENT) scores revealed a strong negative significant correlation. Conclusions: The 3D printed complete dentures fabricated using CAD/CAM technology proved to be more superior over conventional methods in terms of digital occlusal force analysis and Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT). However, further studies are required on more patients to decide the exact superiority of one technique over the other after long-term follow-up periods.

Oral Functions Are Associated with Muscle Strength and Physical Performance in Old-Old Japanese

Grip strength and walking speed are considered to be important indicators of physical frailty. However, no study has contemporaneously examined any association of multiple oral functions with grip strength and walking speed. The purpose of this study was to examine which oral functions are associated with muscle strength (grip strength), physical performance (walking speed) or both. The study participants were 511 community-dwelling people (254 men and 257 women) aged 77–81 years old. Six oral functions—oral wetness, occlusal force, tongue-lip motor function, tongue pressure, masticatory performance and swallowing function—were measured. Grip strength and walking speed were also measured. A partial correlation analysis, adjusted for gender, showed that occlusal force, tongue-lip motor function, masticatory performance and swallowing function were significantly associated with both grip strength and walking speed. In addition, tongue pressure was significantly associated with grip strength. A general linear model showed that tongue pressure and occlusal force were significantly associated with grip strength. Swallowing function and tongue-lip motor function were significantly associated with walking speed. It is suggested that there are different oral function measures for muscle strength and physical performance, and these oral function measures could be a useful proxy for physical frailty.

A cross-sectional study of relationships between periodontal disease and general health: The Hitachi Oral Healthcare Survey

Background This cross-sectional study performed to clarify the relationship between periodontal disease and non-communicable diseases (NCDs), such as obesity, diabetes mellitus, impaired glucose tolerance (IGT), chronic obstructive pulmonary disease (COPD), and atherosclerotic cardiovascular disease (ASCVD) by introducing dental examinations into the annual health examinations conducted by Japanese companies, and to highlights the importance of a medical system that connects dental and medical professionals. Methods A total of 1.022 Hitachi Ltd. employees were enrolled in this cross-sectional study. We examined correlations and odds ratios (ORs) between the dental and overall health of employees using stratification and multiple logistic regression analyses based on the periodontal health indicators, general health indicators, and occlusal force. Results The adjusted OR of PPD for obesity (OR, 1.42; 95% confidence interval [CI], 1.09–1.84; p = 0.009), IGT (OR, 1.48; 95% CI, 1.00–2.20; p = 0.049), and COPD (OR, 1.38; 95% CI, 1.02–1.88; p = 0.038) significantly differed. The adjusted OR of body mass index (OR, 1.28; 95% CI 1.15–1.42; p < 0.001), haemoglobin A1C (HbA1c) (OR, 4.34; 95% CI, 1.89–9.98; p < 0.001), fasting blood glucose (FBG) levels (OR, 1.08; 95% CI 1.04–1.11; p < 0.001), postbronchodilator forced expiratory volume in one second/forced vital capacity ratio (%FEV1) (OR, 0.95; 95% CI 0.91–1.00; p = 0.031) and smoking (OR, 2.32; 95% CI 1.62–3.33; p < 0.001) for severe periodontal disease also significantly differed. Occlusal force was significantly reduced in employees aged 50–59 years compared to those aged 40–49 years. Both PPD, HbA1c, FBG levels were significantly associated with occlusal force among employees with moderate/severe periodontitis. PPD was significantly associated with occlusal force among employees with and moderate COPD, and ASCVD. %FEV1 was significantly associated with occlusal force among employees with IGT. Conclusions This cross-sectional study revealed mutual relationships among periodontal disease, NCDs, and occlusal force on Japanese corporate workers. We demonstrated that a comprehensive, regional healthcare system centred on annual integrated dental and physical health examinations in the workplace will benefit employees and positively impact corporate health insurance.

Patients with mild cognitive impairment diagnosed at dementia clinic display decreased maximum occlusal force: a cross-sectional study

Background Previous research indicates that patients with mild cognitive impairment (MCI) are more likely to have poor oral health and impairments in oral functions, which may be due to few remaining teeth and impaired tongue and lip motor function. However, the oral health of those patients following comprehensive cognitive assessment by a dementia specialist has not been sufficiently investigated. Therefore, this study aimed to clarify the oral function of patients with MCI and the association between oral health and lower cognitive function. Methods This cross-sectional study included 96 participants (men: 35; women: 61; mean age: 73.3 ± 8.5 years) who visited a dementia clinic between December 2017 and January 2020. Participants’ cognitive function was assessed by a dementia specialist using neuropsychological and hematological tests and neuroimaging immediately after enrollment. The participants were divided into the healthy and MCI groups according to comprehensive cognitive assessment. Participants’ age, sex, body mass index, primary disease, education level, drinking habits, smoking habits, living environment, employment status, and exercise habits were evaluated. Moreover, oral outcomes, including the number of existing teeth, number of functional teeth (natural and prosthetic teeth which were occluded with antagonists), denture use, oral dryness, tongue and lip motor function, tongue pressure, occlusal force, masticatory ability, and swallowing ability were recorded. The Mann–Whitney U test, χ2, and Fisher’s exact tests were used for between-group comparisons. Furthermore, logistic regression analysis using MCI diagnosis as the target variable was performed. Results A comprehensive evaluation of the cognitive function of the study participants by the dementia specialist revealed that 48 participants (mean age: 69.8 ± 8.8 years) were healthy and 48 (mean age: 76.9 ± 6.7 years) had MCI. MCI participants were significantly older (p < 0.001) and had significantly fewer existing teeth (p = 0.031) and lower maximum occlusal force (p = 0.019) than healthy participants. Age (odds ratio: 1.126, p = 0.002) and maximum occlusal force (odds ratio: 0.978, p = 0.048) were significantly associated with lower cognitive function. Conclusions Patients with MCI had poorer oral health than healthy individuals. Decreased maximum occlusal force was independently associated with lower cognitive function, even when adjusted for age and sex.

Gender and age group modified association of dental health indicators with total occlusal force among Korean elders

Background This study aimed to investigate the distribution of objective total occlusal force (TOF) and its association with dental health indicators: dental status, number of natural teeth (NT), natural and rehabilitated teeth, natural posterior teeth (NT-Post), and natural and rehabilitated posterior teeth among Korean elders after controlling for various confounders encompassing socio-demographic factors, behavioral factors and health/oral health factors. Methods This cross-sectional study recruited 551 elders from the Sungbook-Gu health education cohort. TOF was measured using Prescale II as an outcome variable. Dental health indicators assessed by dentists were the main explanatory variables. Analysis of covariance and multivariable linear regression models were applied to evaluate the adjusted association of dental health indicators with TOF. Gender and age group stratified analyses were also applied. Result TOF was higher in dentate elders than denture wearers in males and younger elders. The adjusted mean of TOF and standard error was 464.24 ± 17.15 N for dentate elders, 297.15 ± 28.85 N for partial denture wearers, 280.42 ± 47.71 N for complete denture wearers. Among all dental health indicators, NT-Post showed the highest association with TOF (partial r = 0.330, p < 0.001, R2 = 0.15), followed by NT (partial r = 0.329, p < 0.001, R2 = 0.16). Older elders highlighted the association of NT (partial r = 0.37, p < 0.001, R2 = 0.18). Males decreased the association of NT (partial r = 0.30, p < 0.001, R2 = 0.20) and NT-Post (partial r = 0.29, p < 0.001, R2 = 0.20). Conclusion TOF was significantly associated with dental health indicators, and its association was modified by sex and age group.

Clinical Report of Six-Month Follow-Up After Cementing PEEK Crown On Molars

To investigate the therapeutic effect of polyetheretherketone (PEEK) crowns, a six-month clinical study on CAD/CAM-fabricated molar PEEK crowns was conducted. Twenty-three cases of PEEK crowns placed on the molars of 20 subjects (7 males and 13 females, mean age: 60.6 ± 14.4 years) were included in the study. The evaluation items were the condition of the crowns at the time of cementation and after six months, patient satisfaction, masticatory ability, and occlusal force. A Wilcoxon signed-rank test with a significance level of 5% was used to examine the difference in masticatory ability with and without PEEK crowns. The occlusion, margin fit, and contact of all 23 cases at the time of cementing was good. Six months after cementation, there was no crown desorption, no fracture or crack, and no prosthodontics was needed in the 22 cases where one patient dropped out. No wear of the dental antagonist was observed. Patient satisfaction was generally high. There was no significant difference in masticatory ability between the groups with and without PEEK crowns. The subject's occlusal force was within normal range. PEEK crowns on molars are highly therapeutic methods and can be fully used as a crown prosthetic material to replace metal.