Journal of oral rehabilitation最新文献

Background: Functional dentition may be associated with sarcopenia by affecting chewing activity.

Objectives: The objective of this study is to determine the sarcopenia status of participants using computed tomography (CT)-based data and to investigate the association of sarcopenia with functional dentition, as well as denture condition.

Methods: The study included 309 patients. The number of teeth was recorded. Functional dentition was evaluated based on the following parameters: (1) ≥ 1 tooth in the maxilla and mandible; (2) ≥ 10 teeth in each arch; (3) the presence of 12 anterior teeth; (4) 3-4 premolar posterior occlusal pairs (POPs) and (5) ≥ 1 molar POP bilaterally. The denture condition was also evaluated. CT-based assessment of sarcopenia was performed via measurement of the psoas muscle area at the level of the L3 vertebra and its hounsfield unit (HU) radiodensity on non-contrast-enhanced images. HU average calculation (HUAC), which is an imaging marker of sarcopenia, was performed. Gender-specific quartiles were then generated, and the lowest quartile of HUAC scores within each gender group was set as the cut-off point.

Results: A total of 76 (24.5%) of the patients had sarcopenia, and 233 (75.5%) did not have sarcopenia. The mean number of teeth in the sarcopenia group was 17.12 ± 8.39, compared to 22.24 ± 6.72 in those without sarcopenia (p < 0.001). The relationship between functional dentition and sarcopenia was also significant. There was a positive relationship between ill-fitting dentures and sarcopenia (p < 0.001).

Conclusions: This unique perspective of the study contributes to the existing knowledge regarding the role of tooth loss in sarcopenia, highlighting the importance of functional occlusion.

Aim: To evaluate conditioned pain modulation (CPM) in burning mouth syndrome (BMS) patients with different pain mechanisms.

Materials and methods: Twenty BMS patients (52.0 ± 6.8 years, 17 women and 3 men) and age- and gender-matched 22 healthy controls were enrolled in this randomised controlled trial. The patients received an active lingual nerve block (lidocaine) and a placebo injection (saline) randomly with an interval of 1 week in a double-blinded manner. Patients evaluated their pain intensity on a 0- to 10-cm visual analogue scale (VAS) before and after each injection, with or without CPM. Based on the anaesthesia effect, BMS patients were divided into two groups with presumed different pain mechanisms; a 'central subgroup (n = 11)' with pain relief less than 1 cm and 'peripheral subgroup (n = 9)' with pain relief more than 1 cm on the VAS. Mechanical pain threshold (MPT) and wind-up ratio (WUR) were investigated at two oral mucosa regions: the region with most intense symptoms and a control region for the patient group; tongue and buccal region for the control group. CPM was induced by immersing the left hand into cold water. A moderate level of pain (around five on the VAS) was obtained by adjusting the water temperature. MPT and WUR were measured twice for all the participants with and without CPM, which was analysed and presented as relative change in MPT and WUR. Differences between groups were analysed using two-way ANOVA. Differences within group between tests were assessed by paired t-test.

Results: At baseline, there were no significant group differences for MPT or WUR between BMS patients and healthy controls (p ≥ 0.156). The mean bath temperature to evoke moderate pain for the BMS group was significantly lower than that for the healthy control group (8.9°C vs. 11.9°C, p = 0.003). The CPM evoked an inhibitory modulation in 18.2%-44.4% of BMS patients, while for the healthy group, the ratio was 68.2%-81.8%. Central BMS patients had smaller CPM effects than healthy participants at the painful site and control site, which indicated a decreased CPM function (p ≤ 0.034). Peripheral BMS patients had lower CPM effects than healthy participants only at the painful site (p = 0.037).

Conclusions: The present findings documented impairment of central nociceptive inhibition processing in BMS patients which was more extensive in central BMS than peripheral BMS. These findings add to the suggestion that BMS may a heterogeneous pain condition with at least two different phenotypes.

Aims: To investigate the effect of a lingual nerve block on spontaneous pain in patients with burning mouth syndrome (BMS) and to estimate associated somatosensory abnormalities by quantitative sensory testing (QST).

Protocol and methods: A standardised QST battery including cold detection threshold (CDT), warmth detection threshold (WDT), thermal sensory limen (TSL), paradoxical heat sensation (PHS), cold pain threshold (CPT), heat pain threshold (HPT), mechanical pain threshold (MPT), wind-up ratio (WUR) and pressure pain threshold (PPT) was performed at the oral mucosa of the most painful site and intraoral control site in 20 BMS patients, and at the tongue and cheek mucosa in 22 age- and gender-matched healthy controls. The effect of a lingual nerve block on spontaneous burning pain reported by the BMS patients on a 0-10 cm visual analogue scale (VAS) was investigated in a randomised double-blind crossover design using (1 mL) lidocaine (lido) or saline (sal) with an interval of 1 week. The BMS patients were grouped into 'central' and 'peripheral' mechanisms based on the effect of the lingual nerve injections. For each BMS patient, Z-scores and Loss/Gain scores were computed. Differences among groups and sites were analysed using a two-way ANOVA. Differences within group were assessed by paired t-test.

Results: The 20 BMS patients were characterised on the basis of VAS changes (ΔLido-ΔSal) as a peripheral BMS subgroup (n = 9) with pain relief more than 1 cm on the VAS and a central BMS subgroup (n = 11) with pain relief less than 1 cm. BMS patients (n = 20) had lower sensitivity to thermal stimuli (i.e., CDT, WDT, TSL, CPT, HPT and PPT) and higher sensitivity to mechanical stimuli (i.e., PPT) compared with controls (p ≤ 0.007). Based on Loss/Gain coding, L1G0 (loss of thermal somatosensory function with no somatosensory gain, 55.0%) was the most frequent coding in the BMS group, which was higher than 11.4% in the control group (p < 0.001). Surprisingly, there was no significant difference between the peripheral and central BMS subgroups with regard to the Z-scores of any of the nine QST parameters (p > 0.097).

Conclusions: The results of the lingual nerve blocks demonstrated two distinct phenotypes with either peripheral or central mechanisms but no direct impact on somatosensory function. Overall, somatosensory function in BMS patients seems abnormal in the painful areas compared to matched controls with a conspicuous loss of thermosensory function.

Background: A notable obstacle in applying the findings of hyaluronic acid (HA)-related randomised controlled trials (RCTs) to real-world patient treatment is trial waste (TW). To date, the extent of TW in RCTs for HA is not clear.

Objectives: To analyse the extents of TW within HA-RCTs and identify protective factors against TW.

Methods: In July 2024, we searched the ClinicalTrials database using the 'hyaluronic acid' as keyword. We documented the data available and then explored PubMed and Scopus for the publication status. Reporting adequacy was evaluated using the CONSORT checklist. Design limitations were analysed based on bias risk and whether the article referenced a relevant systematic review. Subsequently, we evaluated extent of TW (unpublished studies, insufficient reporting and design flaws).

Results: One hundred and eighty-four RCTs met the inclusion criteria. The analysis of TW excluded 53 RCTs completed after June 2020 that remained unpublished. Among the remaining 131 RCTs, 72 were published, 47 had adequate reporting and 19 had design limitations. Taken together, 96 RCTs (73.3%) exhibited at least one characteristic of TW. Characteristics of these RCTs included early registration (p < 0.001) and the absence of a multi-blind approach (p = 0.007). Registration prior to 2014 (p < 0.001) and the open-label or single-blinding design (p = 0.003) emerged as independent risk factor for TW.

Conclusion: We delineated the features of 184 HA-related RCTs. 73.3% of the RCTs included in TW analysis exhibited TW. The diverse traits of the different TW indicators identified could serve as valuable insights for conducting future HA-RCTs more rationally and efficiently.

Introduction: Palateless overdentures (PLODs) provide advantages of improved taste perception and retention over conventional dentures. We aimed to evaluate 5-year outcomes of four implant maxillary PLODs.

Methods: In this prospective observational study, edentulous participants were enrolled. A new conventional maxillary denture was prepared followed by implant placement and insertion of four implant retained maxillary PLOD. Oral health quality of life was assessed using the 49-item Oral Health Impact Profile (OHIP-49) at multiple intervals over 5 years along with biological and mechanical outcomes.

Results: Nine patients were evaluated at year 5. The mean age was 68 years, and six of the nine patients were males. The cumulative survival rate of implants was 100% while the implant success rate was 86%. Nylon retentive replacement was the most common encountered complication noted approximately four times per patient over 5 years. From a mean OHIP-49 severity score of 71.2 at baseline, severity scores decreased to 23.9 (p < 0.001) at year 1, denoting a clinically meaningful and statistically significant improvement in oral health quality of life. The lowered OHIP-49 severity scores remained stable throughout 5 years of follow-up.

Conclusion: Four implant supported maxillary overdenture appears to have good patient perceived, biological and mechanical outcomes over 5 years. Fully powered studies are needed to replicate these findings.

Background and objectives: Weight loss is a critical health issue among the older population. This study aimed to explore the association between weight loss and oral health in older adults.

Methods: We used cross-sectional data from the Uonuma Chronic Kidney Disease Cohort Study. The binary logistic regression models were fitted to estimate the relationship between weight loss and independent variables including the number of teeth present.

Results: The participants included 1656 females and 1625 males. There were 1217 females (73.4%) and 1236 males (76.0%) with normal BMI (18.5 ≤ BMI < 25) in the previous year. Weight loss was determined over a 12-month period. Individuals with normal BMI in previous year, and those with weight loss (≥ 5%) or those whom maintained a stable weight were further analysed. The regression analysis (model 3, fully adjusted) showed that females with 0 and 1-10 teeth present had a higher likelihood of losing weight (OR = 4.07; 95% CI = 1.85-8.93, OR = 2.33; 95% CI = 1.24-4.39) compared with those with 20 or more teeth. Current smokers had a higher likelihood of losing weight (OR = 3.15; 95% CI = 1.01-9.76) than lifelong abstainers. Among males, both current and previous smokers showed a higher likelihood of losing weight (OR = 4.94; 95%CI = 1.76-13.8, OR = 3.35; 95% CI = 1.29-8.68) than those who never smoked.

Conclusions: This study indicates that the number of teeth and smoking are both linked to weight loss in females. However, in males, the association between the number of teeth and weight loss may be compromised due to the high prevalence of smoking in this group.

Objectives: Structured patient-centred assessment is critical for improving care. OHIP-TMDs are a validated English-language outcome measure for temporomandibular disorders (TMD) which evaluates the biopsychosocial impact of TMD. Due to language and cultural changes, the original instrument's phrasing of its items may change when translated to Spanish. This study cross-culturally adapted and validated OHIP-TMDs for Spanish-speaking individuals with TMD.

Methods: OHIP-TMDs was forward-backward translated into Spanish (OHIP-TMDs-Sp) and cross-culturally adapted to a Hispanic population with TMD (Diagnostic Criteria for TMD n = 154) according to international norms. All patients completed the OHIP-TMDs-Sp, the Graded Chronic Pain Scale (GCPS), and Jaw Functional Limitation Scale (JFLS-20). A subsample (n = 30) recompleted the OHIP-TMDs-Sp after a 3-week washout to measure test-retest reliability using an intra-class correlation coefficient (ICC 2.1). OHIP-TMDs-Sp, JFLS-20, and GCPS were analysed for convergent validity and internal consistency.

Results: The sample with articular and muscular TMD diagnoses was 85.7% female with a mean age of 29.5. (SD 9.01). OHIP-TMDs-Sp had high internal reliability (Cronbach's Alpha = 0.95) and good test-retest reliability (ICC = 0.82; 95% CI = 0.57-0.93). In terms of convergent validity, the OHIP-TMDs-Sp demonstrated moderate to large positive correlations with the total JLFS-20 score (ρ = 0.72; p < 0.01), Mastication (ρ = 0.68; p < 0.01), Communication (ρ = 0.68; p < 0.001), as well to GCPS disability score (ρ = 0.59; p < 0.01), and characteristic pain intensity (ρ = 0.69; p < 0.01).

Conclusions: The total score of OHIP-TMDs-Sp is reliable for assessing quality-of-life in Spanish-speaking TMD patients.

The idea of classifying and defining bruxism according to ontological principles may be interesting, but currently we just do not have enough information to label in a black or white manner the many facets of bruxism. In an era in which general knowledge on bruxism by the dental communities is surely in need of improvement, efforts to clarify the road map tracked by the current panelists who drafted the definition should be appraised carefully. The recent introduction of a standardized multidimensional evaluation system (i.e., Standardized Tool for the Assessment of Bruxism [STAB]) and a screening instrument for bruxism (i.e., BruxScreen) should be viewed as the starting points to enter a new era in the discipline of bruxism, in which non-hierarchical and non-preconceived approaches are used to collect data. Artificial intelligence strategies to mine data gathered with the above instruments might help building predictive models along the etiology-status-consequences trajectory, as recently suggested in a model for awake bruxism metrics. Until then, proposals to adopt ontological principles to classify bruxism will be merely based on speculations rather than on facts.

Background: Temporomandibular disorders (TMD) are multifactorial musculoskeletal pain and dysfunctions in temporomandibular joints (TMJs) and masticatory muscles. Genetic factors play a role in TMD-related pain, but only a few genome-wide association studies (GWAS) have been conducted.

Objective: The aim of this GWAS was to explore genetic factors associated with painful TMD in Finnish populations.

Methods: Data from two epidemiological surveys, the Northern Finland Birth Cohort 1966 (NFBC1966) and the Health 2000 Survey in Finland, including altogether 468 cases and 6833 controls, were used. Case definition was based on pain on palpation of masticatory muscles and/or TMJs. GWASs of the whole data and stratified by sex were conducted from both cohorts using additive models, followed by meta-analysis of the two cohorts. Replications of the previously reported TMD risk loci (rs73460075, DMD; rs4794106, SGCA; rs73271865, SP4; rs60249166, RXP2; rs1531554, BAHCCI; rs5862730, OTUD4/SMAD1; rs10092633, SFRP1; rs34612513, SOX14/CLDN18; rs878962, TSPAN9) were also investigated.

Results: Four genome-wide significant loci were found in sex-stratified analysis of NFBC1966, including associations at three loci in males (rs1023114, PRIM2, p = 5 × 10^-9; rs4244867, ALG10, p = 3 × 10^-8; rs79841648, ADCYAP1, p = 4 × 10^-9) and one locus in females (rs148476652, DNER, p = 4 × 10^-9). However, the results could not be replicated in the Health 2000 Survey or in the meta-analysis of these two cohorts. The previous TMD GWAS associations did not replicate in our data either.

Conclusion: Several TMD pain-associated variants were found in sex-stratified analysis of NFBC1966, suggesting the role of neuroendocrine stress responses and central nervous system. These findings need to be confirmed in future studies.