Amanda Laísa de Oliveira Lima, Camila Luiz Jabr, Cibele Oliveira de Melo Rocha, Lucas Portela Oliveira, Rafael Antonio de Oliveira Ribeiro, Francisco de Assis Mollo Júnior, João Neudenir Arioli Filho
Background
The literature is unclear about how the different attachment systems for overdentures impact the maximum bite force, the masticatory efficiency and how this impact in the oral health self-perception in patients.
Objective
To evaluate the effect of two attachment systems (O-ring and Locator) for mandibular overdenture using single implant on quality of life, maximum bite force (BF) and masticatory efficiency (ME).
Methods
Twenty-eight completely edentulous denture wearers with a mandibular symphysis implant were randomly selected and allocated into two groups in a crossover study, considering O-ring and Locator attachment types. The quality of life and self-perception of oral health were assessed using the Oral Health Impact Profile (OHIP-Edent) and Geriatric Index of Determination of Oral Health (GOHAI) questionnaires, respectively. BF was measured using a gnathodynamometer and ME by chewing silicone cubes and almonds in different numbers of cycles.
Results
There was no difference between the attachment systems about self-perceived oral health and impact on quality of life (p > .05). The O-ring-type system obtained a significantly higher BF than the locator-type system (p = .04). Regardless of the food chewed, no statistically significant difference was observed with the type of attachment (p > .05). The ME was directly proportional to the masticatory cycles only for almonds (p < .01).
Conclusions
Locator and O-ring inserts had a similar impact on patients' quality of life, self-perception of oral health and ME. Additionally, the O-ring system exhibited superior properties in the BF.
{"title":"Oral health self-perception, maximum bite force and masticatory efficiency in patients with overdentures with different attachment systems—A crossover study","authors":"Amanda Laísa de Oliveira Lima, Camila Luiz Jabr, Cibele Oliveira de Melo Rocha, Lucas Portela Oliveira, Rafael Antonio de Oliveira Ribeiro, Francisco de Assis Mollo Júnior, João Neudenir Arioli Filho","doi":"10.1111/joor.13825","DOIUrl":"10.1111/joor.13825","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The literature is unclear about how the different attachment systems for overdentures impact the maximum bite force, the masticatory efficiency and how this impact in the oral health self-perception in patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effect of two attachment systems (O-ring and Locator) for mandibular overdenture using single implant on quality of life, maximum bite force (BF) and masticatory efficiency (ME).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-eight completely edentulous denture wearers with a mandibular symphysis implant were randomly selected and allocated into two groups in a crossover study, considering O-ring and Locator attachment types. The quality of life and self-perception of oral health were assessed using the Oral Health Impact Profile (OHIP-Edent) and Geriatric Index of Determination of Oral Health (GOHAI) questionnaires, respectively. BF was measured using a gnathodynamometer and ME by chewing silicone cubes and almonds in different numbers of cycles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no difference between the attachment systems about self-perceived oral health and impact on quality of life (<i>p</i> > .05). The O-ring-type system obtained a significantly higher BF than the locator-type system (<i>p</i> = .04). Regardless of the food chewed, no statistically significant difference was observed with the type of attachment (<i>p</i> > .05). The ME was directly proportional to the masticatory cycles only for almonds (<i>p</i> < .01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Locator and O-ring inserts had a similar impact on patients' quality of life, self-perception of oral health and ME. Additionally, the O-ring system exhibited superior properties in the BF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"51 11","pages":"2354-2360"},"PeriodicalIF":3.1,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valeria Calcaterra, Nicole Pizzorni, Sofia Giovanazzi, Marta Nannini, Letizia Scarponi, Sara Zanelli, Gianvincenzo Zuccotti, Antonio Schindler
Background
Masticatory function seems to play a role in the aetiology of obesity. However, literature on the association between oral myofunctional status and overweight and obesity in children and adolescents is scarce and contrasting.
Objective
To compare masticatory performance, orofacial myofunctional status and tongue strength and endurance between children and adolescents with overweight and obesity and those with normal weight.
Methods
Thirty children and adolescents with overweight and obesity and 30 subjects with normal weight matched for age and sex were recruited. All subjects were evaluated with the Test of Masticating and Swallowing Solids in Children (TOMASS-C) for masticatory performance and with the Italian Orofacial Myofunctional Evaluation with Scores (I-OMES) for the orofacial myofunctional status. Anterior and posterior maximum tongue pressures and tongue endurance were measured. Parents-reported (PRO) duration of meals was recorded. Data were compared between the groups through the paired samples t-test or the Wilcoxon signed-rank test.
Results
Children and adolescents with overweight showed significantly lower number of bites (p = .033), lower I-OMES scores (p < .05), and shorter meal duration (p = .005) compared to their peers with normal weight. No significant differences were found between the two groups for the number of swallows, the number of masticatory cycles and the total time of the TOMASS-C, and none of the tongue pressure measurements.
Conclusions
Eating in children and adolescents with overweight and obesity is characterised by a larger bolus sizes and shorter PRO meal duration. Additionally, overweight and obesity seem to be associated with poorer orofacial skills and structures in the paediatric population.
{"title":"Mastication and oral myofunctional status in excess weight children and adolescents: A cross-sectional observational study","authors":"Valeria Calcaterra, Nicole Pizzorni, Sofia Giovanazzi, Marta Nannini, Letizia Scarponi, Sara Zanelli, Gianvincenzo Zuccotti, Antonio Schindler","doi":"10.1111/joor.13838","DOIUrl":"10.1111/joor.13838","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Masticatory function seems to play a role in the aetiology of obesity. However, literature on the association between oral myofunctional status and overweight and obesity in children and adolescents is scarce and contrasting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare masticatory performance, orofacial myofunctional status and tongue strength and endurance between children and adolescents with overweight and obesity and those with normal weight.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty children and adolescents with overweight and obesity and 30 subjects with normal weight matched for age and sex were recruited. All subjects were evaluated with the Test of Masticating and Swallowing Solids in Children (TOMASS-C) for masticatory performance and with the Italian Orofacial Myofunctional Evaluation with Scores (I-OMES) for the orofacial myofunctional status. Anterior and posterior maximum tongue pressures and tongue endurance were measured. Parents-reported (PRO) duration of meals was recorded. Data were compared between the groups through the paired samples <i>t</i>-test or the Wilcoxon signed-rank test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Children and adolescents with overweight showed significantly lower number of bites (<i>p</i> = .033), lower I-OMES scores (<i>p</i> < .05), and shorter meal duration (<i>p</i> = .005) compared to their peers with normal weight. No significant differences were found between the two groups for the number of swallows, the number of masticatory cycles and the total time of the TOMASS-C, and none of the tongue pressure measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Eating in children and adolescents with overweight and obesity is characterised by a larger bolus sizes and shorter PRO meal duration. Additionally, overweight and obesity seem to be associated with poorer orofacial skills and structures in the paediatric population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"51 11","pages":"2345-2353"},"PeriodicalIF":3.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.13838","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anton Eklund, Birgitta Wiesinger, Ewa Lampa, Anders Wänman, Birgitta Häggman-Henrikson
Background
There is limited knowledge about the possible long-term effects on jaw motor function after whiplash trauma.
Objectives
The primary aim was to evaluate integrated jaw and head–neck movement amplitudes during jaw function in individuals 2 years after whiplash trauma, compared to controls. The secondary aim was to evaluate changes between the acute stage and a 2-year follow-up in terms of jaw and head–neck movement amplitudes during jaw function.
Methods
This study included 28 cases exposed to a whiplash trauma 2 years earlier (13 women) and 28 controls (13 women) without previous neck trauma. Head and jaw movement amplitudes were recorded during maximal jaw opening–closing movements using an optoelectronic 3D recording system. For a subpopulation of 12 cases and 15 controls, recordings had also been performed in the acute stage after the whiplash trauma. Jaw and head movement amplitudes were analysed using linear regression with group and sex as independent variables. The subpopulation longitudinal analysis was adjusted for movement amplitudes at baseline.
Results
Jaw movement amplitudes were significantly associated with group (coefficient: −0.359: 95% CI: −10.70 to −1.93, p = .006) with smaller amplitudes of jaw movements for whiplash cases. Head movement amplitudes were not associated with group (coefficient: −0.051, 95% CI: −4.81 to 3.20, p = .687). In the longitudinal analysis, both jaw and head movement amplitudes showed significant associations between baseline and the 2-year follow-up.
Conclusion
The present findings indicate that the effects on jaw function in terms of jaw opening capacity in the acute stage after whiplash trauma do not spontaneously recover.
{"title":"Jaw–neck motor function 2 years after whiplash trauma","authors":"Anton Eklund, Birgitta Wiesinger, Ewa Lampa, Anders Wänman, Birgitta Häggman-Henrikson","doi":"10.1111/joor.13817","DOIUrl":"10.1111/joor.13817","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is limited knowledge about the possible long-term effects on jaw motor function after whiplash trauma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary aim was to evaluate integrated jaw and head–neck movement amplitudes during jaw function in individuals 2 years after whiplash trauma, compared to controls. The secondary aim was to evaluate changes between the acute stage and a 2-year follow-up in terms of jaw and head–neck movement amplitudes during jaw function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 28 cases exposed to a whiplash trauma 2 years earlier (13 women) and 28 controls (13 women) without previous neck trauma. Head and jaw movement amplitudes were recorded during maximal jaw opening–closing movements using an optoelectronic 3D recording system. For a subpopulation of 12 cases and 15 controls, recordings had also been performed in the acute stage after the whiplash trauma. Jaw and head movement amplitudes were analysed using linear regression with group and sex as independent variables. The subpopulation longitudinal analysis was adjusted for movement amplitudes at baseline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Jaw movement amplitudes were significantly associated with group (coefficient: −0.359: 95% CI: −10.70 to −1.93, <i>p</i> = .006) with smaller amplitudes of jaw movements for whiplash cases. Head movement amplitudes were not associated with group (coefficient: −0.051, 95% CI: −4.81 to 3.20, <i>p</i> = .687). In the longitudinal analysis, both jaw and head movement amplitudes showed significant associations between baseline and the 2-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present findings indicate that the effects on jaw function in terms of jaw opening capacity in the acute stage after whiplash trauma do not spontaneously recover.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"51 11","pages":"2336-2344"},"PeriodicalIF":3.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.13817","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaohua Chen, Feng He, Hongyun Zhang, Yuanjun Ma, Jia Yu, Han Qin, Fan Wu, Zhuo Wang, Ying Zhan, Jing Zhang, Lei Lu, Mian Zhang, Shibin Yu
Background
Syndecan 4 (SDC4), a type I transmembrane proteoglycan, serves as a critical link between chondrocytes and the extracellular matrix.
Objective
This study aimed to explore the role of SDC4 in cartilage degeneration of temporomandibular joint osteoathritis (TMJOA).
Methods
Condylar chondrocytes were stimulated with varying concentrations of recombinant rat interleukin-1β (rrIL-1β) and SDC4 small interfering RNA (si-SDC4). Anti-SDC4 ectodomain-specific antibodies or IgG were intra-articularly administrated in a TMJOA model rats. SDC4 conditional knockout (SDC4-cKO) and Sdc4flox/flox mice were induced TMJOA. Cartilage degeneration was assessed using haematoxylin & eosin (H&E) and safranin O (SO) staining. Protein levels of SDC4, matrix metalloproteinases (MMPs), a disintegrin and metalloproteinase with a thrombospondin motifs 5 (ADAMTS5), tumour necrosis factor α (TNFα), type II collagen (Col-II), aggrecan (ACAN), cleaved caspase 3 (CASP3), Ki67 and related pathways in condylar cartilage were evaluated by immunohistochemical (IHC) staining or western blot assays.
Results
SDC4 expression was evidently increased in MIA-model animals compared to control groups. rrIL-1β stimulation increased the expression of SDC4, MMP3 and ADAMTS5 expression in chondrocytes, while decreasing the expression of Col-II. These effects were reversed by si-SDC4 in vitro. In vivo, SDC4 blockade reduced the death of chondrocytes and the loss of cartilage matrix, which was evidenced by increased expression of Col-II and ACAN, and a decrease in SDC4, MMP13 and cleaved-CASP3-positive cells. Furthermore, the protein levels of ACAN and Ki67 were elevated, and the ERK1/2 and P38 signalling pathways were activated following SDC4 inhibition.
Conclusions
SDC4 inhibition significantly ameliorates condylar cartilage degeneration, which was mediated, at least partly, through P38 and ERK1/2 signalling. Inhibition of SDC4 may be of great value for the treatment of TMJOA.
{"title":"Syndecan-4 inhibition attenuates cartilage degeneration in temporomandibular joint osteoarthritis","authors":"Xiaohua Chen, Feng He, Hongyun Zhang, Yuanjun Ma, Jia Yu, Han Qin, Fan Wu, Zhuo Wang, Ying Zhan, Jing Zhang, Lei Lu, Mian Zhang, Shibin Yu","doi":"10.1111/joor.13829","DOIUrl":"10.1111/joor.13829","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Syndecan 4 (SDC4), a type I transmembrane proteoglycan, serves as a critical link between chondrocytes and the extracellular matrix.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to explore the role of SDC4 in cartilage degeneration of temporomandibular joint osteoathritis (TMJOA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Condylar chondrocytes were stimulated with varying concentrations of recombinant rat interleukin-1β (rrIL-1β) and SDC4 small interfering RNA (si-SDC4). Anti-SDC4 ectodomain-specific antibodies or IgG were intra-articularly administrated in a TMJOA model rats. SDC4 conditional knockout (SDC4-cKO) and Sdc4<sup>flox/flox</sup> mice were induced TMJOA. Cartilage degeneration was assessed using haematoxylin & eosin (H&E) and safranin O (SO) staining. Protein levels of SDC4, matrix metalloproteinases (MMPs), a disintegrin and metalloproteinase with a thrombospondin motifs 5 (ADAMTS5), tumour necrosis factor α (TNFα), type II collagen (Col-II), aggrecan (ACAN), cleaved caspase 3 (CASP3), Ki67 and related pathways in condylar cartilage were evaluated by immunohistochemical (IHC) staining or western blot assays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SDC4 expression was evidently increased in MIA-model animals compared to control groups. rrIL-1β stimulation increased the expression of SDC4, MMP3 and ADAMTS5 expression in chondrocytes, while decreasing the expression of Col-II. These effects were reversed by si-SDC4 in vitro. In vivo, SDC4 blockade reduced the death of chondrocytes and the loss of cartilage matrix, which was evidenced by increased expression of Col-II and ACAN, and a decrease in SDC4, MMP13 and cleaved-CASP3-positive cells. Furthermore, the protein levels of ACAN and Ki67 were elevated, and the ERK1/2 and P38 signalling pathways were activated following SDC4 inhibition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SDC4 inhibition significantly ameliorates condylar cartilage degeneration, which was mediated, at least partly, through P38 and ERK1/2 signalling. Inhibition of SDC4 may be of great value for the treatment of TMJOA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"51 11","pages":"2324-2335"},"PeriodicalIF":3.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.13829","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francisco Mauro da Silva Girundi, Ana Luíza Gonçalves Girundi, Michele Costa de Oliveira Ribeiro, Raissa Micaella Marcelo Machado, Thais Marques Simek Vega Gonçalves, Altair Antoninha Del Bel Cury, Wander José da Silva
Purpose
To investigate the influence of different denture-bearing conditions on the masticatory function and patient-reported outcome measures (PROMs) of complete denture wearers.
Methods
Sixty edentulous patients were selected and allocated into two groups according to the American College of Prosthodontics' (ACP) classification: non-atrophic (NAT) (Classes I and II) (n = 24) and atrophic (AT) (Classes III and IV) (n = 36). All patients received new complete dentures (CDs). The objective variables (masticatory performance and swallowing threshold) were assessed as well as the PROMs (oral health-related quality of life (OHIP-EDENT), patient satisfaction) and quality of the prosthesis, at baseline (using the old CD) and after 4 months new prostheses use. Data were analyzed by Mann–Whitney test followed by the Generalized Equations Estimation (GEE), linear regression and Chi-square test.
Results
Higher masticatory performance was observed in the NAT group (p < .05) for both time points, baseline and after 4 months. However, compared to baseline, both groups showed significant masticatory improvement after 4 months (p < .05). Satisfaction and overall quality of life improved after 4 months with no difference between groups (p > .05). Regarding the quality of the CD, baseline results were significantly (p < .05) lower in the AT group, but after 4 months, no significant differences were found between groups and in intragroup analysis (p > .05).
Conclusions
The denture-bearing conditions seems to impact masticatory function, but the PROMs are barely affected.
目的：研究不同义齿支托条件对全口义齿佩戴者咀嚼功能和患者报告结果测量（PROMs）的影响：根据美国口腔修复学会（ACP）的分类，将 60 名无牙颌患者分为两组：非萎缩（NAT）（I 级和 II 级）（24 人）和萎缩（AT）（III 级和 IV 级）（36 人）。所有患者都接受了新的全口义齿（CD）。在基线（使用旧 CD）和新义齿使用 4 个月后，对客观变量（咀嚼功能和吞咽阈值）以及 PROMs（口腔健康相关生活质量（OHIP-EDENT）、患者满意度）和义齿质量进行了评估。数据分析采用曼-惠特尼检验，然后进行广义方程估计（GEE）、线性回归和卡方检验：结果：NAT组的咀嚼能力更强（P.05）。在 CD 质量方面，基线结果明显（P .05）：结论：义齿戴用条件似乎会影响咀嚼功能，但 PROMs 几乎不受影响。
{"title":"Influence of denture-bearing conditions on masticatory function and patient-reported outcomes measures","authors":"Francisco Mauro da Silva Girundi, Ana Luíza Gonçalves Girundi, Michele Costa de Oliveira Ribeiro, Raissa Micaella Marcelo Machado, Thais Marques Simek Vega Gonçalves, Altair Antoninha Del Bel Cury, Wander José da Silva","doi":"10.1111/joor.13815","DOIUrl":"10.1111/joor.13815","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the influence of different denture-bearing conditions on the masticatory function and patient-reported outcome measures (PROMs) of complete denture wearers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty edentulous patients were selected and allocated into two groups according to the American College of Prosthodontics' (ACP) classification: non-atrophic (NAT) (Classes I and II) (<i>n</i> = 24) and atrophic (AT) (Classes III and IV) (<i>n</i> = 36). All patients received new complete dentures (CDs). The objective variables (masticatory performance and swallowing threshold) were assessed as well as the PROMs (oral health-related quality of life (OHIP-EDENT), patient satisfaction) and quality of the prosthesis, at baseline (using the old CD) and after 4 months new prostheses use. Data were analyzed by Mann–Whitney test followed by the Generalized Equations Estimation (GEE), linear regression and Chi-square test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher masticatory performance was observed in the NAT group (<i>p</i> < .05) for both time points, baseline and after 4 months. However, compared to baseline, both groups showed significant masticatory improvement after 4 months (<i>p</i> < .05). Satisfaction and overall quality of life improved after 4 months with no difference between groups (<i>p</i> > .05). Regarding the quality of the CD, baseline results were significantly (<i>p</i> < .05) lower in the AT group, but after 4 months, no significant differences were found between groups and in intragroup analysis (<i>p</i> > .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The denture-bearing conditions seems to impact masticatory function, but the PROMs are barely affected.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"51 11","pages":"2316-2323"},"PeriodicalIF":3.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frank Lobbezoo, Chia-Shu Lin, Mats Trulsson, Abhishek Kumar, Merel C. Verhoeff
<p>Teeth grinding (bruxism) is commonly considered sheer jaw abuse because of its purported negative consequences like tooth wear and jaw-muscle pain. However, already in 1960, R.G. Every published a Point of View in the <i>Lancet</i> stating that bruxism-related tooth wear may be positive for the individual, the wear process being a means to sharpen the teeth to be used as tools or weapons.<span><sup>1</sup></span> Now, we would like to propose another possible positive outcome of bruxism, namely improved cognitive function. Based on a comprehensive literature review, Weijenberg et al.<span><sup>2</sup></span> concluded that both animal and human studies suggest an association between chewing and cognition. Klineberg et al.<span><sup>3</sup></span> elaborated on this conclusion by stating that the increased cerebral blood flow that is associated with mastication could explain its positive effect on cognitive function. Importantly, they also stated that impaired cognition arises from a complex interplay of multiple factors. This was confirmed by Lin<span><sup>4</sup></span> who provides some critical aspects that need to be incorporated into future research. For example, since most of the currently available clinical and epidemiological data are derived from cross-sectional studies, Lin emphasises the importance of prospective cohort studies to enable causal inferences.<span><sup>4</sup></span> Recently, Kim and Han<span><sup>5</sup></span> investigated the effects of reduced chewing ability on the incidence of cognitive impairment over 10 years in a large general population sample. Their findings, namely an about 1.3 times higher odds ratio for cognitive impairment in poor chewers as compared to good chewers, confirmed that reduced masticatory efficiency causally contributes to cognitive decline.<span><sup>5</sup></span> Since both chewing and bruxism are essentially jaw-muscle activities, that is, ways of using the jaws that both improve cerebral blood flow, we carefully assume that chewing-related findings can be extrapolated to bruxism. To further determine the evidence base for the association between jaw usage and cognition, a quick scan of the available literature was performed in PubMed on June 1, 2024, using the query “((“Mastication”[Mesh]) OR “Bruxism”[Mesh]) AND “Cognition”[Mesh].” This search yielded 115 papers, of which 56 did not deal with the topic of interest. Of the remaining 59 papers, only six reported no (or a negative) association between jaw usage and cognition, while 53 confirmed the likely presence of such associations. In some cases, even a causal relationship was claimed. Of note, only one of these 53 papers dealt with bruxism; the others with chewing. Hence, more research on bruxism in association with cognition is needed, bearing in mind that designing such studies will be a major challenge. Nevertheless, based on the above, we dare to conclude that using your jaw, either by bruxing or by chewing, not only sharpens yo
{"title":"Using your jaws sharpens your teeth… and mind!","authors":"Frank Lobbezoo, Chia-Shu Lin, Mats Trulsson, Abhishek Kumar, Merel C. Verhoeff","doi":"10.1111/joor.13826","DOIUrl":"10.1111/joor.13826","url":null,"abstract":"<p>Teeth grinding (bruxism) is commonly considered sheer jaw abuse because of its purported negative consequences like tooth wear and jaw-muscle pain. However, already in 1960, R.G. Every published a Point of View in the <i>Lancet</i> stating that bruxism-related tooth wear may be positive for the individual, the wear process being a means to sharpen the teeth to be used as tools or weapons.<span><sup>1</sup></span> Now, we would like to propose another possible positive outcome of bruxism, namely improved cognitive function. Based on a comprehensive literature review, Weijenberg et al.<span><sup>2</sup></span> concluded that both animal and human studies suggest an association between chewing and cognition. Klineberg et al.<span><sup>3</sup></span> elaborated on this conclusion by stating that the increased cerebral blood flow that is associated with mastication could explain its positive effect on cognitive function. Importantly, they also stated that impaired cognition arises from a complex interplay of multiple factors. This was confirmed by Lin<span><sup>4</sup></span> who provides some critical aspects that need to be incorporated into future research. For example, since most of the currently available clinical and epidemiological data are derived from cross-sectional studies, Lin emphasises the importance of prospective cohort studies to enable causal inferences.<span><sup>4</sup></span> Recently, Kim and Han<span><sup>5</sup></span> investigated the effects of reduced chewing ability on the incidence of cognitive impairment over 10 years in a large general population sample. Their findings, namely an about 1.3 times higher odds ratio for cognitive impairment in poor chewers as compared to good chewers, confirmed that reduced masticatory efficiency causally contributes to cognitive decline.<span><sup>5</sup></span> Since both chewing and bruxism are essentially jaw-muscle activities, that is, ways of using the jaws that both improve cerebral blood flow, we carefully assume that chewing-related findings can be extrapolated to bruxism. To further determine the evidence base for the association between jaw usage and cognition, a quick scan of the available literature was performed in PubMed on June 1, 2024, using the query “((“Mastication”[Mesh]) OR “Bruxism”[Mesh]) AND “Cognition”[Mesh].” This search yielded 115 papers, of which 56 did not deal with the topic of interest. Of the remaining 59 papers, only six reported no (or a negative) association between jaw usage and cognition, while 53 confirmed the likely presence of such associations. In some cases, even a causal relationship was claimed. Of note, only one of these 53 papers dealt with bruxism; the others with chewing. Hence, more research on bruxism in association with cognition is needed, bearing in mind that designing such studies will be a major challenge. Nevertheless, based on the above, we dare to conclude that using your jaw, either by bruxing or by chewing, not only sharpens yo","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"51 11","pages":"2498-2499"},"PeriodicalIF":3.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.13826","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chondroitin and glucosamine sulphates (CGS) are considered structure-modifying drugs and have been studied in the prevention, delay or reversal of structural morphological changes in joints caused by osteoarthritis.
Objective
The aim of the present study was to investigate the action of CGS on the progression of chemically induced osteoarthritis in the temporomandibular joint (TMJ) of rabbits by evaluating the serum levels of tumour necrosis factor (TNF-α) and collagen in the articular discs.
Materials and Methods
A sample of 36 male rabbits was divided into three groups: control (CG), osteoarthritis (OG) and treatment (TG). The disease was induced by intra-articular injection of sodium monoiodoacetate (10 mg/mL) in the OG and TG groups bilaterally. After 10 days, the TG animals received subcutaneous injection of chondroitin sulphates and glucosamine (7.5 mg/kg) and the OG and CG received saline solution (50 μL). Euthanasia times were subdivided into 40 and 100 days. Collagen quantification was performed by biochemical and histological analysis and for the quantification of serum levels of TNF-α, an enzyme immunoassay was used.
Results
The TG showed an increase in the collagen area of the articular disc when compared to the CG and the OG. The increase collagen concentration in the discs did not show a statistically significant difference between the groups. Post-treatment TNF-α levels were significantly lower in TG compared to OG.
Conclusions
The results indicate that CGS treatment delayed the degeneration of the collagen in the TMJ articular disc and reduced serum TNF-α levels, indicating a preventive effect on OA progression.
背景：软骨素和氨基葡萄糖硫酸盐（CGS）被认为是结构调节药物，已被研究用于预防、延缓或逆转骨关节炎引起的关节结构形态变化：本研究旨在通过评估血清中肿瘤坏死因子（TNF-α）和关节盘中胶原蛋白的水平，研究 CGS 对化学诱导的兔子颞下颌关节（TMJ）骨关节炎进展的作用：将 36 只雄性家兔分为三组：对照组（CG）、骨关节炎组（OG）和治疗组（TG）。在 OG 组和 TG 组的双侧关节内注射单碘乙酸钠（10 毫克/毫升）诱发疾病。10 天后，TG 组动物皮下注射硫酸软骨素和氨基葡萄糖（7.5 mg/kg），OG 组和 CG 组动物注射生理盐水（50 μL）。安乐死时间分为 40 天和 100 天。通过生化和组织学分析对胶原蛋白进行定量，并使用酶免疫测定法对血清中的 TNF-α 水平进行定量：结果：与 CG 和 OG 相比，TG 的关节盘胶原面积有所增加。椎间盘中胶原蛋白浓度的增加在各组之间没有统计学差异。治疗后，TG 组的 TNF-α 水平明显低于 OG 组：结果表明，CGS 治疗可延缓颞下颌关节椎间盘胶原蛋白的退化，降低血清 TNF-α 水平，对 OA 的进展有预防作用。
{"title":"Can treatment with chondroitin and glucosamine sulphate prevent changes in the articular disc caused by temporomandibular joint osteoarthritis?","authors":"Giulia Giacomini Malaguez, Felipe Ernesto Artuzi, Alexandre Silva Quevedo, Edela Puricelli, Deise Ponzoni","doi":"10.1111/joor.13814","DOIUrl":"10.1111/joor.13814","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chondroitin and glucosamine sulphates (CGS) are considered structure-modifying drugs and have been studied in the prevention, delay or reversal of structural morphological changes in joints caused by osteoarthritis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of the present study was to investigate the action of CGS on the progression of chemically induced osteoarthritis in the temporomandibular joint (TMJ) of rabbits by evaluating the serum levels of tumour necrosis factor (TNF-α) and collagen in the articular discs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A sample of 36 male rabbits was divided into three groups: control (CG), osteoarthritis (OG) and treatment (TG). The disease was induced by intra-articular injection of sodium monoiodoacetate (10 mg/mL) in the OG and TG groups bilaterally. After 10 days, the TG animals received subcutaneous injection of chondroitin sulphates and glucosamine (7.5 mg/kg) and the OG and CG received saline solution (50 μL). Euthanasia times were subdivided into 40 and 100 days. Collagen quantification was performed by biochemical and histological analysis and for the quantification of serum levels of TNF-α, an enzyme immunoassay was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The TG showed an increase in the collagen area of the articular disc when compared to the CG and the OG. The increase collagen concentration in the discs did not show a statistically significant difference between the groups. Post-treatment TNF-α levels were significantly lower in TG compared to OG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results indicate that CGS treatment delayed the degeneration of the collagen in the TMJ articular disc and reduced serum TNF-α levels, indicating a preventive effect on OA progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"51 11","pages":"2289-2296"},"PeriodicalIF":3.1,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Individuals who suffer from simple snoring rarely go to a doctor due to a lack of medical knowledge, but simple snoring can reduce the individual's quality of life and may cause social problems to the bed partner/family members.
Objectives
The aims of the present study are to explore the effects of online modified oropharyngeal exercises on the individuals with simple snoring and to provide a rehabilitation method for individuals with simple snoring.
Methods
This study is a double-blinded, two-arm, randomized controlled trial. Participants were enrolled and randomly assigned to the intervention group (n = 33) or the control group (n = 33). The participants in the control group received health education on snoring, while the participants in the intervention group received the modified oropharyngeal exercise besides health education on snoring. The intervention duration was 4 weeks. The primary outcomes included snoring index, snoring loudness, and snoring quantity. The secondary outcomes included self-reported snoring, sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life. All outcomes were measured at baseline, 4 weeks, and 8 weeks.
Results
Generalized estimating equations (GEE) analyses showed significant differences between the intervention group and the control group on snoring index, loudness, and quantity (p < .001). Moreover, modified oropharyngeal exercise had effects on sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life in individuals with simple snoring (p < .001). Self-reported snoring also improved at 8 weeks.
Conclusion
The modified oropharyngeal exercises were effective in improving simple snoring. It could also improve sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life.
{"title":"Effects of modified oropharyngeal exercises on individuals with simple snoring: An online randomized controlled trial","authors":"Yirou Niu, Ruiting Zhu, Chunling Dong, Wei Zhou, Saikun Wang, Jing Mao, Jingyi Zhang, Xuance Xiong, Lirong Guo","doi":"10.1111/joor.13804","DOIUrl":"10.1111/joor.13804","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Individuals who suffer from simple snoring rarely go to a doctor due to a lack of medical knowledge, but simple snoring can reduce the individual's quality of life and may cause social problems to the bed partner/family members.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aims of the present study are to explore the effects of online modified oropharyngeal exercises on the individuals with simple snoring and to provide a rehabilitation method for individuals with simple snoring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study is a double-blinded, two-arm, randomized controlled trial. Participants were enrolled and randomly assigned to the intervention group (<i>n</i> = 33) or the control group (<i>n</i> = 33). The participants in the control group received health education on snoring, while the participants in the intervention group received the modified oropharyngeal exercise besides health education on snoring. The intervention duration was 4 weeks. The primary outcomes included snoring index, snoring loudness, and snoring quantity. The secondary outcomes included self-reported snoring, sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life. All outcomes were measured at baseline, 4 weeks, and 8 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Generalized estimating equations (GEE) analyses showed significant differences between the intervention group and the control group on snoring index, loudness, and quantity (<i>p</i> < .001). Moreover, modified oropharyngeal exercise had effects on sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life in individuals with simple snoring (<i>p</i> < .001). Self-reported snoring also improved at 8 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The modified oropharyngeal exercises were effective in improving simple snoring. It could also improve sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"51 11","pages":"2297-2307"},"PeriodicalIF":3.1,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Grazia Piancino, Corrado De Biase, Laura Di Benedetto, Akhilanand Chaurasia, Teresa Vallelonga, Alessandro Tortarolo
Background
Bilateral posterior crossbite (BPXB) is a severe malocclusion associated with maxillary hypoplasia. BPXB may involve the same or a different number of teeth between the sides.
Objectives
To evaluate the masticatory function in BPXB and the association between the masticatory alterations and the occlusal features of BPXB.
Methods
This observational study included 170 participants: 130 patients with BPXB (65 occlusally symmetric BPXB, i.e. same number and type of posterior teeth in crossbite between the sides, F = 33, M = 32, median age 9.6 (8.2–13) [years.months]; 65 patients occlusally asymmetric BPXB, F = 30, M = 35, median age 9.9 (8.3–13.6)) and 40 controls (F = 25, M = 15, median age 10.2 (9.4–11.6)). The masticatory function was evaluated by the detection of the Reverse Chewing Cycles (RCCs) recorded with a kinesiograph using standardised soft and hard boluses.
Results
The frequency of RCCs was significantly increased in all BPXB patients compared to controls (p < .000). In symmetric BPXB patients, there were no significant differences in the frequency of RCCs during chewing on the left or the right side. In asymmetric BPXB patients, the frequency of RCCs was significantly increased during chewing on the side with relatively more teeth in crossbite (p < .000).
Conclusions
The masticatory function was significantly altered in all BPXB patients and it was differently affected by symmetric or asymmetric occlusal features of the malocclusion.
{"title":"Reverse chewing patterns in patients with bilateral posterior crossbite are related to the occlusal features of the malocclusion","authors":"Maria Grazia Piancino, Corrado De Biase, Laura Di Benedetto, Akhilanand Chaurasia, Teresa Vallelonga, Alessandro Tortarolo","doi":"10.1111/joor.13822","DOIUrl":"10.1111/joor.13822","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bilateral posterior crossbite (BPXB) is a severe malocclusion associated with maxillary hypoplasia. BPXB may involve the same or a different number of teeth between the sides.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the masticatory function in BPXB and the association between the masticatory alterations and the occlusal features of BPXB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational study included 170 participants: 130 patients with BPXB (65 occlusally symmetric BPXB, i.e. same number and type of posterior teeth in crossbite between the sides, F = 33, M = 32, median age 9.6 (8.2–13) [years.months]; 65 patients occlusally asymmetric BPXB, F = 30, M = 35, median age 9.9 (8.3–13.6)) and 40 controls (F = 25, M = 15, median age 10.2 (9.4–11.6)). The masticatory function was evaluated by the detection of the Reverse Chewing Cycles (RCCs) recorded with a kinesiograph using standardised soft and hard boluses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The frequency of RCCs was significantly increased in all BPXB patients compared to controls (<i>p</i> < .000). In symmetric BPXB patients, there were no significant differences in the frequency of RCCs during chewing on the left or the right side. In asymmetric BPXB patients, the frequency of RCCs was significantly increased during chewing on the side with relatively more teeth in crossbite (<i>p</i> < .000).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The masticatory function was significantly altered in all BPXB patients and it was differently affected by symmetric or asymmetric occlusal features of the malocclusion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"51 11","pages":"2308-2315"},"PeriodicalIF":3.1,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.13822","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chewing and Swallowing Training in Coffin-Lowry Syndrome: A Case Report.
Coffin-Lowry 综合征的咀嚼和吞咽训练：病例报告
{"title":"Chewing and swallowing training in Coffin–Lowry syndrome: A case report","authors":"Ayşe Kübra Söyler, Selen Serel Arslan, Numan Demir, Aynur Ayşe Karaduman, Tülin Düger","doi":"10.1111/joor.13820","DOIUrl":"10.1111/joor.13820","url":null,"abstract":"<p>Chewing and Swallowing Training in Coffin-Lowry Syndrome: A Case Report.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"51 11","pages":"2500-2502"},"PeriodicalIF":3.1,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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