Functional tooth units and masticatory ability in elderly population

Introduction: The elders are the ones that most often experience tooth loss which affects masticatory function. Masticatory function can be evaluated subjectively through masticatory ability assessment. The masticatory function is influenced by the number of posterior occluding pairs; this also may be called as functional tooth units (FTUs). The purpose of this study was to describe FTUs and masticatory ability in the elderly. Methods: This research was a descriptive study with a cross-sectional study design. Subjects were taken by purposive sampling technique. The study was conducted in the Lebakgede Sub-district, Bandung City. Data mentioned were obtained by conducting interviews regarding data on subject characteristics and questionnaires of masticatory ability, as well as examining the oral cavity to obtain FTUs data. Results: Subjects obtained were 74 people consisting of 63 women (85.14%) and 11 men (14.86%). Based on the results, the average age of the research subjects was 68.49 years, and those with good masticatory ability status were 26 elderly (35.14%) with an average FTU value of 5.9 while 48 elderly (64.86%) had poor masticatory ability status with an average FTU score of 1.5, even 31 subjects (41.89%) had a zero FTU score. Conclusion: The majority of the elderly in this research mostly had a low total FTUs score which means that the masticatory ability status in the elderly tended to be poor.

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.

Masticatory Ability and Oral Health Related Quality of Life in Partially Edentulous Patients Involving Posterior Teeth after Rehabilitation with Tooth-Supported Fixed Dental Prosthesis

Background: Loss of teeth affects the masticatory ability and overall health of the patient especially posterior teeth as they contribute more to mastication as compared to anteriors. Loss of teeth can lead to undesirable consequences and early rehabilitation with any type of prosthesis can lead to desirable changes and thus missing teeth should be replaced as soon as possible. Aims and Objectives: To determine the change in masticatory ability and quality of life (QoL) after replacement of missing posterior teeth by fixed dental prosthesis. Methodology: Maximum bite force was recorded before and after treatment. Also a self-perceived questionnaire was filled by the patient to assess the change in QoL. Patients with missing posterior teeth were included. Patients with acute infections or systemic diseases were excluded. Results: Significant change (p=0.0001) in both masticatory ability and QoL of the patient was seen. The co-relation of both was clinically significant while statistically non-significant (p=0.77). Results were significant for both the studied parameters but co-relation between them was no significant. It is because of the patients perceived satisfaction of the overall treatment. Conclusion: Rehabilitation of posterior teeth improves mastication and also overall oral health related QoL.

Masticatory Ability for a Single Implant Mandibular Overdenture Retained by Two Different Attachments: A Randomized Controlled Trial

Objective. The aim of this randomized clinical trial was to compare the masticatory ability subjectively between ball and Cendres+Métaux Locator (CM-LOC) attachment for a single implant retained mandibular overdenture throughout a 24-month follow-up period. Materials and Methods. Eighty completely edentulous patients were recruited. All patients received new complete dentures, and masticatory ability was recorded using a questionnaire (baseline record). All patients received a single implant in the midline of the completely edentulous mandible. After 3-month healing period, patients were randomized using sealed envelopes into two groups: ball or CM-LOC attachment. The same masticatory ability questionnaire was used to record masticatory ability for both groups after 2 weeks of pickup and 3-, 6-, 9-, 12-, and 24-month follow-up. Comparison between the study groups was done using Mann–Whitney U test for independent samples. Two-sided P values less than 0.05 were considered statistically significant. Results. The mean masticatory scores improved for both attachments, with no statistically significant difference between them throughout the 24-month follow-up. The CM-LOC attachment group showed a greater improvement change in masticatory ability after 6- and 12-month follow-up (−12.47 ± 12.006, −11.46 ± 14.625; P = 0.826 ), while the ball attachment group showed a slight improvement after the 24-month follow-up (−11.72 ± 12.368, −10.88 ± 11.963; P = 0.778 ). Conclusion. Single implant retained mandibular overdenture improved masticatory ability subjectively with no significant difference between both attachments used although the ball attachment showed better masticatory ability scores after 24-month follow-up.

The effectiveness of early intervention on malocclusion and its impact on craniofacial growth: A systematic review

This review aims to assess the available evidence related to the effectiveness of early interventions on malocclusion and its impact on the craniofacial structure among children under six years of age. Furthermore, we aimed to evaluate the correlation between nutritive sucking behavior mechanisms on the oral facial components. We searched Medline, Embase, Cochrane Library, Scopus, and the LILACS from inception to December 10, 2020, to identify published randomized and non-randomized controlled trials that investigated the broad spectrum of early interventions for the treatment of malocclusions among pediatric patients under six years old. We have also included studies that evaluated the impact or the relationship between feeding alternatives, malocclusion, and craniofacial growth. Reviewers working in pairs investigators independently performed title and abstract screening, full-text screening, data extraction, risk of bias assessment using ROBINS-I tool, and rated the certainty of evidence using GRADE. Seven studies were included (783 patients), with an overall risk of bias classified as critical. Early treatment was shown to improve facial asymmetry, particularly in the lower part of the face, along with an increase of palatal volume and palatal surface. Early treatment showed important reduction of mandibular protrusion and length, leading to favorable sagittal growth of the maxilla. Furthermore, the early intervention significantly enhanced the average bite force magnitude (from 318.20 N to 382.79 N) and increased the general thickness of facial muscles. Our findings suggest that the benefits generated by early orthodontic interventions are related to the improvement of craniofacial symmetry/bone structure, and refinement of masticatory ability and performance. Notwithstanding, there is still a need for further studies appraising patient-important outcomes, such as quality of life and nutritional features.

Autism Spectrum Disorder in a Dental Office - A Review

Over the last few years there has been a growing interest to cater to the requirements of children with special health care needs, especially those with autism spectrum disorder (ASD). ASD is a neurodevelopmental condition characterized by limited communication skills and an obsessive need for structured patterns. Individuals with a genetic predilection to autism can be provoked by the various prenatal, natal, or post-natal environmental factors. Drugs such as thalidomide, valproic acid and consumption of antidepressants during pregnancy as well as high maternal age and viral infections are known to be prenatal triggers for autism. Autism affects 1 in every 110 children with a significant preponderance of boys to girls with a ratio of 4:1. According to Caries Risk Assessment tool (CAT) adapted by the American Academy of Paediatric Dentistry, children with ASD are at a high risk for dental caries due to their preference for carious food, pouching of food due to poor masticatory ability combined with inadequate maintenance of oral hygiene and help required for tooth brushing. These children do not behave positively to sudden changes in their environment thus a dental operatory might be intimidating to them. A thorough understanding of the individual’s needs of these patients along with combining various behaviour management techniques will help make their dental treatment a pleasant one. This articles reviews literature on the aetiology and diagnosis of Autism Spectrum Disorder with a special emphasis on the health status and issues encountered while treating these children. This study is also an update on the various strategies such as using Applied Behaviour management approaches, Picture Exchange Communication System, Video Pedagogy, Social stories as well as pharmacological ways to communicate and also manage a child with ASD in the dental clinic. KEY WORDS Autism, Oral Health Status, Behaviour Management, Dental Management

Effect of isometric exercises on the masseter muscle in older adults with missing dentition: a randomized controlled trial

Maintaining oral function in older individuals with missing teeth is important for leading a healthy and independent life. This study aimed to evaluate whether simple isometric exercises can maintain and improve the oral function [maximum occlusal force (MOF) and masticatory ability (MA)] and the masticatory muscle properties [masseter muscle thickness (MMT) and echo intensity (MMEI)] in older adults during the maintenance phase of removable prosthetic treatment. Participants were randomly categorized into the intervention and control groups. The mouthpieces were distributed, and participants were instructed to use them for exercising. The intervention group was instructed to perform maximum clenching for 10 s, whereas the control group was instructed to tap the teeth at an arbitrary speed for 10 s. Both were repeated five times at an interval of 5 s between each activity and twice daily for 4 weeks. The outcomes were measured after a month of exercise. The intervention group showed a significant improvement in the MOF, MMT during contraction, MMT at rest and MMEI during contraction. There were no significant differences in the MA and MMEI at rest. In the control group, no improvement was observed in any of the parameters. When the isometric exercises were performed using a mouthpiece, there was an improvement in the oral function and masseter muscle properties in older individuals with Eichner B status who used dentures.

Perceived general health in relation to oral health status in a rural Kenyan elderly population

Background This study aimed to determine the present oral health status of the rural Kenyan elderly population and to investigate whether oral health status is associated with the perceived general health. Methods A total of 131 individuals aged 65 years and over in Mbita Constituency, Homa Bay County in Kenya were randomly selected and visited at home. The home visit study, which was conducted from 2014 to 2016, included oral examination by a dentist and administration of a self-reporting questionnaire. The number of teeth present and functional tooth unit (FTU) points were calculated using the dental chart. Perceived general health, subjective masticatory ability, and self-reported periodontal symptoms were collected using a questionnaire sheet. Fisher’s exact test and nonparametric test were used to determine the difference in percentage and means. The odds ratio of good general health based on the participants’ masticatory satisfaction was calculated by logistic analysis. Results Satisfactory mastication was dependent on the number of teeth present, FTU points, and self-reported “gum bleeding” and “tooth mobility”. Furthermore, satisfactory mastication was associated with perceived general health status independent of sex and age. The adjusted odds ratio of good perceived general health was 2.29 (95% confidence interval 1.05–4.99) for participants who had the subjective masticatory ability. Conclusion Among the Kenyan elderly population, satisfactory mastication was related to the number of teeth present, FTU points, and self-reported periodontal symptoms. Furthermore, satisfactory mastication was associated with perceived general health status independently.

Association between denture use, chewing ability, and all-cause mortality in middle-aged and older adults who exercised regularly in Korea

Herein, using data from the Korean Longitudinal Study of Aging (2006–2018), we evaluated denture use and chewing ability to determine the status of oral health in middle-aged adults who exercised regularly; further, we investigated the relationship of oral health with all-cause mortality. From the basic survey conducted in 2006, we interviewed 10,254 participants who were followed up until death. The participants were grouped based on regular exercise into REG (n = 3921) and non-REG (n = 6290) groups. The mortality rate was higher in the non-REG group than in the REG group (35.8% versus 26.9%; p < 0.001). The mortality rate was higher in denture users (versus non-denture users), non-drinkers (versus alcohol drinkers), and those on medical aid (versus national health insurance). The mortality rate was higher in participants with poor masticatory ability, lower education level, and poor subjective health perception (p < 0.001). Denture use and masticatory discomfort were not significant risk factors for mortality in the non-REG group (p > 0.05). In conclusion, masticatory discomfort was a risk factor for increased mortality in middle-aged Korean adults who exercised regularly, at least once a week. Thus, assessment of masticatory ability could be a useful indicator of life expectancy in middle-aged adults.