Journal of oral rehabilitation最新文献

Background: The recently developed BruxScreen consists of two parts: BruxScreen-Q (self-report questionnaire) and BruxScreen-C (clinical assessment).

Objectives: To test the intra- and inter-rater reliability, construct validity, acceptability and feasibility of the BruxScreen-Q and BruxScreen-C and assess their concordance among Dutch dental students.

Methods: 88 out of 109 potentially eligible dental master students completed a set of questionnaires two times (Q1; Q2) and participated in two clinical workshops (CE1; CE2), using the BruxScreen-Q and BruxScreen-C, respectively. Intra-rater reliability of the BruxScreen-Q and concordance between the BruxScreen-Q and BruxScreen-C were assessed using Cohen's (weighted) Kappa. Intra- and inter-rater reliability of the BruxScreen-C were analysed using intraclass correlation coefficients calculated from generalised linear mixed-effects models. Construct validity of the BruxScreen-Q was tested using Spearman's Rank Correlation or Mann-Whitney U test based on hypothesis testing. Acceptability and feasibility of the BruxScreen were assessed using descriptive statistics.

Results: Intra-rater reliability for BruxScreen-Q was fair to substantial. Intra- and inter-rater reliability for BruxScreen-C varied from poor to excellent. BruxScreen-Q showed moderate construct validity, based on the acceptable consistency between the actual and hypothesised effect size of the questionnaire items. BruxScreen-Q (Q2) and BruxScreen-C (CE2) were found both acceptable and feasible by a majority of the students. There was no agreement between subject-based bruxism according to the BruxScreen-Q and clinically based bruxism according to the BruxScreen-C.

Conclusion: The BruxScreen demonstrates acceptable reliability, construct validity, acceptability and feasibility in assessing both subject-based bruxism and clinically based bruxism. However, there is a discrepancy between self-reported bruxism and the clinicians' diagnosis.

Background: Sex differences in oral health behaviours and function during childhood may affect long-term oral and general health. However, large-scale studies of Japanese children are limited.

Objectives: To clarify sex differences in oral hygiene, masticatory performance, and chewing habits of Japanese schoolchildren.

Methods: This cross-sectional study included 1400 fourth-grade children (686 boys and 714 girls) from public elementary schools in Osaka City. Oral examinations assessed dental plaque, gingival inflammation, and caries experience (DMFT/dmft indices). Masticatory performance was evaluated using a colour-changeable chewing gum test. Chewing and toothbrushing habits were assessed by questionnaires. Logistic regression analyses were conducted to examine associations between sex and oral health outcomes, adjusting for dental development stage and caries indices.

Results: Boys had higher prevalences of dental plaque and gingival inflammation, higher masticatory performance scores, and were more likely to eat fast and eat with the mouth full than girls. On multivariate analyses, boys were more likely to have dental plaque (odds ratio (OR) = 1.31, 95% confidence interval (CI): 1.02-1.68), gingival inflammation (OR = 1.49, 95% CI: 1.04-2.13), eat fast (OR = 3.11, 95% CI: 2.48-3.91), and eat with the mouth full (OR = 2.43, 95% CI: 1.93-3.07), and less likely to have lower masticatory performance (OR = 0.70, 95% CI: 0.55-0.90).

Conclusions: Significant sex differences were observed in oral hygiene, masticatory function, and chewing behaviour of Japanese schoolchildren. These findings highlight the need for sex-specific strategies in oral health, particularly targeting boys with poorer oral hygiene and chewing habits.

Background: Care should be neutral and equal, but normative beliefs may impact the interaction between patients and healthcare professionals in pain management.

Objectives: To explore how patients with jaw and neck pain perceive pain management and the interaction with healthcare professionals in relation to intersectionality, with a specific focus on gender.

Methods: Recruitment was performed at a specialist dentistry clinic in Sweden. Inclusion criteria were patients aged 18-70 years, reporting jaw and neck pain and understanding the Swedish language. Exclusion criteria were rheumatic disease, temporomandibular joint arthralgia or arthritis. Using purposive sampling, 16 patients (11 women) aged 19-56 were interviewed using individual semi-structured interviews. The analysis was performed using thematic analysis.

Results: The analysis resulted in the theme: 'Intersectional bias in healthcare - the inequity borne by the patients', with five subthemes that entailed different types of bias related to the participants' personal characteristics and their interaction with healthcare professionals. Health-related stigmata was one subtheme described among participants, resulting in labelling and burden in the encounter. Other subthemes also described bias in relation to biological differences among pain patients and patients not being taken seriously due to, for example, female gender and younger age. Two subthemes also described bias in relation to the healthcare professionals' gender and age.

Conclusion: Normative beliefs have a negative impact on the interaction between patients and healthcare professionals in pain management. Since patient-provider interaction should be neutral and equal, intersectional bias should be acknowledged to prevent health and care inequalities.

Background: In order to understand the psychological aspects of chronic pain, it is important to consider the relationships between pain and psychosocial factors in patients with chronic pain. While psychosocial factors are known to affect pain intensity in temporomandibular disorders, few studies have evaluated them in patients with other types of chronic orofacial pain.

Objective: The purpose of the present study was to evaluate the relationships between pain intensity and patient characteristics, diagnostic categories and psychosocial factors in chronic non-nociceptive orofacial pain patients.

Methods: In a retrospective, cross-sectional study, we collected information from the medical records of 123 patients with chronic non-nociceptive orofacial pain. Pain intensity was measured using the Brief Pain Inventory (BPI) total score. Analysis of the correlations among the variables revealed several strong correlations. Principal component analysis identified two components: the psychological distress and self-efficacy/quality of life (QOL) components. Multiple linear regression analyses of the overall study population and each ICOP pain category were also performed.

Results: In the overall sample, higher BPI scores were significantly associated with a greater psychological distress component and lower self-efficacy/QOL component. The pain category was not a significant predictor of the BPI score. In the subgroup analyses, both components were significant predictors of the BPI score in myofascial orofacial pain; whereas, only the self-efficacy/QOL component was in idiopathic orofacial pain.

Conclusion: The results indicated that pain intensity in chronic non-nociceptive orofacial pain is related to the self-efficacy/QOL psychosocial factor component. These findings suggest that assessing psychosocial factors may be clinically important for the diagnosis and treatment of chronic orofacial pain.

Background: Although females comprise the majority of patients with temporomandibular disorders (TMDs), few studies have prioritised the influence of sex on symptom severity and impact.

Objectives: This cross-sectional study investigated sex-related differences in TMD symptom severity, jaw functional limitation (JFL) and oral health-related quality of life (OHRQoL); examined their interrelationships by sex; and identified symptom-specific factors linked to high JFL and low OHRQoL.

Methods: Consecutively enrolled patients completed a survey including demographics, the Four-Dimensional Six TMD symptoms (6Ts-4D) screener, JFL Scale-8 (JFLS-8) and Oral Health Impact Profile for TMDs (OHIP-TMD). TMD diagnostic subtypes were subsequently determined according to the DC/TMD protocol. Data were evaluated using chi-square, non-parametric tests and logistic regression (α = 0.05).

Results: Among 280 participants (mean age 31.2 years [SD 11.8]), 79.3% were female. Females showed significantly higher rates of combined pain-related and intra-articular TMDs, more TMD symptoms, more severe headaches, greater JFL and poorer overall OHRQoL than males. They also demonstrated stronger correlations between global TMD severity and OHRQoL dimensions (rs = 0.38-0.66), as well as between JFL and OHRQoL (rs = 0.48-0.79). Multivariate analysis revealed that high JFL was significantly associated with jaw muscle pain (OR 1.22), jaw joint pain (OR 1.21), TMJ closed-lock (OR 1.24) and open-lock (OR 1.25), while low OHRQoL was related to jaw muscle pain (OR 1.16), jaw joint pain (OR 1.24), headache (OR 1.23) and TMJ closed-lock (OR 1.13).

Conclusions: Findings support sex-informed TMD care, though generalizability is constrained by study design and sample composition.

Objective: This study aimed to elucidate the effect of minimally invasive tooth extraction using a high-speed turbine combined with collagen sponges in patients with complex impacted teeth.

Methods: Eighty patients with complex impacted teeth were categorised into a control group (received piezosurgery extraction treatment) and an observation group (received high-speed turbine-assisted minimally invasive extraction plus medical collagen sponge treatment). Outcome measures included intraoperative blood loss, integrity of the tooth socket, degree of postoperative mouth-opening limitation, VAS scores, degree of swelling, postoperative complications and the Pink Aesthetic Score (PES).

Results: The observation group exhibited less intraoperative blood loss and superior tooth socket integrity compared to the control group (p < 0.05). The degree of mouth-opening limitation in the observation group was better than that in the control group (p < 0.05). VAS scores on postoperative Days 3 and 7 were significantly lower in the observation group compared with the control group (p < 0.05). On postoperative Day 5, the swelling rate was lower in the observation group than the control group (p < 0.05). Furthermore, the incidence of postoperative complications was reduced and the PES index was higher in the observation group compared with the control group (both p < 0.05).

Conclusion: Minimally invasive tooth extraction using a high-speed turbine combined with collagen sponges effectively reduces postoperative pain, swelling, and complications in patients with complex impacted teeth, while improving aesthetic outcomes.

Background: An overwhelming majority of root-filled teeth are asymptomatic, despite commonly exhibiting radiological signs of apical periodontitis (AP). When symptoms prevail, several sources are conceivable. This case-control study investigates underlying causes of pain from root-filled teeth.

Objectives: The aims were to (i) compare painful root-filled teeth with root-filled teeth without pain matched on sex, age, jaw and tooth type, and (ii) explore patient- and tooth-related factors that may explain the pain.

Methods: Adult participants (≥ 20 years) with root-filled teeth were investigated through anamnestic, clinical and radiographic examinations. Analyses compared painful to pain-free teeth statistically, and possible origins of pain were indicated. Clinical data and periapical radiographs were used to identify the presence of AP.

Results: Tenderness to percussion and apical palpation, probing depth ≥ 6 mm, swelling and apical radiolucency (p = 0.002-0.040) were more common with painful teeth, while density and length of root filling, unfilled canals, fracture of root and positive screening for TMD (3Q/TMD) did not differ between groups (p = 0.074-0.63). Among the 55 symptomatic teeth, AP was identified in 48 with varying diagnostic certainty. Indication of temporomandibular disorder (TMD) was present in 15 teeth, and marginal periodontitis (MP) in eight teeth. For six teeth, none of the three conditions could be identified.

Conclusions: Tenderness to percussion and apical palpation, swelling, pocket depth ≥ 6 mm, and apical radiolucency were more common with painful teeth. The pain was most frequently associated with AP, but pain due to TMD and MP may occur. For 10% of the root-filled teeth, no findings could explain the symptoms.

Background: Reduced tongue function in older adults leads to inefficient bolus transit. Tongue resistance exercises (TRE) involve isometric or isotonic tongue movements performed against an external load to improve tongue strength. Whereas, tongue strengthening exercises (TSE) involve repetitive, high-intensity tongue movements enhancing tongue pressure and swallowing coordination, contributing to safer and more efficient swallowing. However, evidence on the effectiveness of combined TRE and TSE in frail older adults with mild cognitive impairment (MCI) remains unknown.

Objective: Explore effects of combined TRE and TSE on tongue function, swallowing pressure, clinical swallowing function, and quality of life in frail older adults with MCI.

Methods: A prospective, double-blind, three-arm randomised controlled trial registered with ClinicalTrials.gov: NCT06490705. Participants were randomly assigned to (i) TRE + TSE (n = 29), (ii) TRE alone (n = 30), and (iii) cheek-bulging exercises (control group, n = 30) for 12 weeks with a follow-up 12-week booster program. The primary outcome was tongue function (IOPI), including anterior (ATS) and posterior (PTS) tongue strength, and anterior (ATE) and posterior (PTE) tongue endurance. The secondary outcomes were swallowing pressure (IOPI), including saliva (SSP) and effortful (ESP) swallowing pressure, clinical swallowing function including difficulty of oral phase (DOP) and number of saliva swallows - NRSS (repetitive saliva swallowing test, RSST), and swallowing quality of life (SWAL-QOL). Generalised estimating equation model was used for data analysis.

Results: Frail older adults with MCI (n = 89, mean age: 75.3 ± 6.9 years; 82% women) were recruited. Combined TRE + TSE significantly improved ATS [β = 9.5, 95% CI = 3.8-15.1], PTE [β = 9.7, 95% CI = 2.8-16.6], SSP [β = 8.9, 95% CI = 5.0-12.9], effortful swallow pressure (ESP) [β = 12.1, 95% CI = 6.8-17.4], NRSS [β = 4.0, 95% CI = 2.7-5.3] and SWAL-QOL [β = 29.3, 95% CI = 22.4-36.2] with sustained effects on NRSS and SWAL-QOL at 12-week follow-up compared to cheek-bulging exercises. TRE alone improved ATS, SSP, ESP, NRSS, and SWAL-QOL immediate post-test, with sustained effects on SSP, ESP, and SWAL-QOL at follow-up compared to cheek-bulging exercises. Booster training maintained these improvements over time.

Conclusion: A combined tongue training offers more comprehensive benefits than TRE alone, with booster training maintaining short-term effects.