Journal of oral rehabilitation最新文献

Background: Taste sensitivity declines with age, adversely affecting dietary intake and quality of life. However, the effects of oral health and function on gustatory ability in older adults remain unclear.

Objective: To evaluate the relationship between oral health characteristics and taste sensitivity in older adults using solution and strip-based gustatory tests.

Methods: One hundred older adult participants (age: ≥ 65) were assessed for dental status, denture use, salivary flow, swallowing function, and subjective taste impairment. Taste sensitivity for five modalities was measured using solution and taste strip tests. Statistical analyses included group comparisons and correlation coefficients.

Results: Participants reporting subjective hypogeusia exhibited significantly lower total taste scores in solution and strip tests than those without (p < 0.01). Those with < 20 remaining teeth and users of mandibular dentures had lower umami scores than those with more teeth and no mandibular dentures (p < 0.05). Hyposalivation did not affect solution-based scores but was associated with lower total strip test scores (p < 0.05). Swallowing impairment was correlated with lower solution test scores, particularly for salty and umami (p < 0.01). Women had higher salivary flow and umami sensitivity, but overall gustatory function did not differ by sex. Solution and strip test scores were moderately correlated.

Conclusion: Taste perception in older adults is differentially influenced by salivary and swallowing functions, and the concordance between solution- and strip-based tests varies according to oral functional status and taste modality. Our results suggest that these methods capture complementary aspects of gustatory function and should be interpreted based on oral function in this population.

Background: Anterior disc displacement with reduction (ADDwR) is a common subtype of temporomandibular disorders (TMD). Anterior repositioning splint (ARS) serves as a key conservative treatment modality. This study aimed to compare the clinical efficacy of a novel Mono-Block splint (nMB) with that of a Twin-Block (TB) splint in the management of ADDwR.

Methods: A total of 118 patients with ADDwR were randomised to receive either an nMB or TB splint. Clinical outcomes were assessed at baseline (T0), 1 month (T1), 3 months (T3) and 6 months (T6). CBCT scans were obtained at T0 and T6, and patient satisfaction was evaluated at T6.

Results: Joint noise: The nMB group showed significantly greater improvement than the TB group at T1 and T6. Joint pain: Greater symptom relief was observed in the nMB group at the third time point (T3). MMO: The nMB splint induced a significantly greater increase in MMO only at T1. The condyle-fossa relationship: CBCT evaluation revealed comparable outcomes between the two groups, with no significant difference. Patient satisfaction: The nMB splint achieved significantly higher ratings in general satisfaction, comfort and stability, while no significant differences were noted in cleaning and retention.

Conclusion: The nMB splint demonstrated superior effectiveness in reducing joint noise and improving patient comfort compared to the TB splint, while both splints exhibited similar efficacy in relieving joint pain and enhancing MMO. The nMB design offers a promising, patient-oriented approach for conservative treatment of ADDwR. Future studies will incorporate more comprehensive assessments, including MRI evaluation, and extend the follow-up period beyond 6 months to better determine the long-term therapeutic effectiveness of the nMB splint.

Purpose: Sleep disturbances are common in temporomandibular disorders (TMD), yet insomnia-related complaints are often treated as homogeneous despite frequent co-occurrence with sleep-disordered breathing. This study examined whether sleep-pain relationships differ between insomnia alone and comorbid insomnia and sleep-disordered breathing (COMISA) in patients with chronic TMD-related orofacial pain.

Methods: In this cross-sectional study, 50 adults with chronic TMD pain were classified as having insomnia alone (n = 20) or COMISA (n = 30) using validated questionnaires and overnight pulse oximetry. Pain intensity (VAS), pain frequency (days/week), circadian pain patterns, subjective sleep quality (PSQI) and objective nocturnal respiratory and autonomic parameters were assessed. Group comparisons and within-group linear regression analyses were performed.

Results: Pain intensity did not differ between groups (7.45 ± 1.67 vs. 7.33 ± 1.90; p = 0.95). Patients with COMISA reported more frequent pain (3.37 ± 1.35 vs. 2.55 ± 1.19 days/week; p = 0.04) and more frequent morning pain (93.3% vs. 50.0%; p < 0.001). Subjective sleep quality was associated with pain intensity in COMISA (B = 0.200, r = 0.417, p = 0.022) but not in insomnia alone (p = 0.353). In COMISA, lower minimum nocturnal oxygen saturation (p = 0.043) and maximum nocturnal heart rate (p = 0.021) were associated with pain intensity; no such associations were observed in insomnia alone.

Conclusions: Sleep-pain relationships in chronic TMD vary by sleep phenotype. These findings support the need for further investigation of COMISA in relation to pain, particularly in orofacial pain and TMD populations.

Background: Despite the potential benefits of implant-supported rehabilitation, data on implant performance and peri-implant health in adults with intellectual disabilities (ID) are limited.

Objective: To evaluate dental implant outcomes in adults with non-syndromic ID and to identify variables associated with peri-implant health, complications, and implant loss.

Methods: This multicenter retrospective cohort study included adults with non-syndromic ID who received at least one dental implant and had a minimum follow-up of 36 months. Dental implants placed in 137 patients across 7 specialised centers in Spain, France, Italy, and South Korea were analysed. Standardised data were collected on patient characteristics, oral health status, implant design, prosthetic variables, and follow-up care. Clinical outcomes were categorised as peri-implant health, mucositis, peri-implantitis, or implant loss.

Results: Of the 453 implants placed, 418 (92.3%) remained functional at a mean follow-up of 75.9 ± 42.7 months (range: 36-211 months). Among the 445 implants evaluated for clinical outcomes, 63.6% were classified as healthy, 23.4% as presenting with mucositis, 4.4% with peri-implantitis, and 7.3% were lost during the follow-up period. Tissue-level implant type, cement-retained fixed prostheses, and the use of general anaesthesia during the impression step were significantly associated with peri-implant clinical outcomes. No variables were identified as statistically significant predictors of implant loss.

Conclusions: Dental implant therapy represents a viable long-term treatment option for adults with non-syndromic ID. Despite the clinical challenges of this population, high survival and success rates can be achieved, particularly when appropriate implant selection, prosthetic retention systems, and behavioural management techniques are implemented.

Background: Bruxism has garnered increasing attention in both clinical practice and scientific research, underscoring its significance for patient management and understanding of its pathophysiology.

Objective: This study aims to investigate the potential relationship between tryptophan metabolites and bruxism.

Methods: The patients were divided into bruxism and non-bruxism groups. The bruxism group was determined according to the bruxism and Diagnostic Criteria for Temporomandibular Disorders classifications. Patients who did not fit either classification were classified as a non-bruxism group. Demographic data of all patients, maximum clinical interincisal opening (IO), state and trait anxiety levels (STAI), perceived stress (PS) levels, Oral Health Impact Profile-14, and pain on palpation (PoP) were recorded. Laboratory findings included measurements of tryptophan and its metabolites.

Results: A total of 97 participants volunteered; 49 had non-bruxism, and 48 had bruxism. There were no differences between the two groups in demographic findings. In clinical findings, a difference was found between the two groups in PS (p = 0.048), IO (p < 0.01), STAI-S (p < 0.01), and PoP (p < 0.01). Regarding laboratory findings, lower kynurenine levels (p < 0.01) and higher quinolinic acid levels (p < 0.01) were found in patients in the bruxism group.

Conclusions: The findings suggest a possible role of TRP metabolites in the pathophysiology of bruxism. In particular, alterations in quinolinic acid and kynurenine may provide insight into the metabolic mechanisms involved. However, these results should be interpreted with caution, and further studies are warranted to confirm and expand upon these associations.

Trial registration: ClinicalTrials.gov identifier: NCT05760482.

Background: Measurement of bite force is important for understanding oral function.

Objectives: We aimed to clarify the relationship between the values of a newly developed one-sided measurement-type bite force meter (OBM-01 Prototype, JMS, Hiroshima) and those of a full-dentition bite force meter (Dental Prescale II, GC, Tokyo). Furthermore, we examined the intra- and inter-rater reliability (intraclass correlation coefficients; ICCs) using the OBM-01 Prototype.

Methods: Three studies were conducted. The first examined the ICC of the OBM-01 Prototype in 22 healthy adults; the second evaluated the relationship between the habitual chewing side bite force measured by the OBM-01 Prototype in 343 older adults, with or without dentures; and the third assessed the relationship between measurements obtained from the OBM-01 Prototype and Dental Prescale II in 201 older adults.

Results: The ICCs showed good reliability. A moderate correlation was observed between the OBM-01 Prototype and Dental Prescale II, regardless of sex or denture presence on the habitual chewing side (Spearman's Rho; men 0.65, women 0.51 in non-denture group, men 0.51, women 0.55 in denture group). In both men and women, compared with the non-habitual chewing side, the habitual chewing side had significantly greater bite force. Additionally, the bite forces on the habitual and non-habitual chewing sides were strongly and positively correlated with the total bite force measured using the Dental Prescale II (Spearman's Rho; men: habitual 0.676, non-habitual 0.746, women: habitual 0.705, non-habitual 0.640).

Conclusions: A correlation was observed between the measurements obtained from the OBM-01 Prototype and Dental Prescale II.

Background: Unstimulated whole saliva (UWS) sialometry is fundamental for diagnosing salivary gland hypofunction, but single-timepoint measurements are limited by physiological variability.

Objective: To evaluate intraindividual variability and reproducibility of a repeated-measures UWS collection protocol in healthy young adults, and to propose a standardised approach to improve diagnostic accuracy.

Methods: Sixty-two healthy subjects (19-33 years old) collected UWS by passive drooling three times daily (morning, afternoon and evening) over three consecutive days (nine timepoints). Data were analysed using linear mixed-effects models, intraclass correlation coefficients (ICC), Bland-Altman plots and coefficients of variation (CV%).

Results: Mean UWS flow rate collected over 5 min remained stable across days (0.38-0.39 mL/min), ranging from 0.14 to 0.93 mL/min. Aggregated daily means showed the highest reproducibility (ICC₃ = 0.890 for Days 1-2), while single timepoints were less consistent (afternoon ICC₃ = 0.524). Evening collections demonstrated the best reproducibility among individual timepoints (ICC₃ = 0.751). Bland-Altman analysis indicated low bias and acceptable agreement across days; within-subject variability (CVw%) was 32.24%.

Conclusion: Single UWS measurements are influenced by substantial physiological variability, which may lead to diagnostic misclassification. Averaging multiple standardised collections, particularly in the evening, enhances reliability and may optimise diagnostic accuracy. This protocol supports refinement of clinical guidelines and the implementation of home-based saliva testing for salivary gland dysfunction.