Fig 6 - uploaded by Harini Padmanabhan
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Activation during Memory Recall Axial Image with Overlay Showing significant region of activation during recall. PFC -Prefrontal cortex. Coronal image with overlay showing significant region of activation during recall. I -Insula, TL -Temporal Lobe, H -Hippocampus.
Source publication
Purpose: This study aims to evaluate the effect of rehabilitation with complete dentures versus implant-retained overdenture on activity in various parts of the brain cognition in a geriatric edentulous population via Functional MRI (fMRI) studies and the Mini-Mental State Examination (MMSE).
Methods: Ten completely edentulous patients were rehabil...
Contexts in source publication
Context 1
... Z scores in the following regions: Prefrontal Cortex, Hippocampus, Parietal, Sensorimotor cortex, Temporal Lobe, Insula, Cerebellum, Supplementary Motor Area, Occipital, Thalamus and Corpus Callosum regions. The regions with the most significant foci of activation were the Hippocampus and the Prefrontal cortex, with the highest seen with the IODs (Fig. 6). The difference in activation resulting from memory recall between CD and IOD was statistically significant in both Prefrontal Cortex and Hippocampus. (Fig. 7). However, the activation of the insula with IOD was greater than with the CD. ...
Context 2
... Z scores in the following regions: Prefrontal Cortex, Hippocampus, Parietal, Sensorimotor cortex, Temporal Lobe, Insula, Cerebellum, Supplementary Motor Area, Occipital, Thalamus and Corpus Callosum regions. The regions with the most significant foci of activation were the Hippocampus and the Prefrontal cortex, with the highest seen with the IODs (Fig. 6). The difference in activation resulting from memory recall between CD and IOD was statistically significant in both Prefrontal Cortex and Hippocampus. (Fig. 7). However, the activation of the insula with IOD was greater than with the CD. ...
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Purpose: This comparative study was done to evaluate, radiographically, the peri-implant bone height changes when using two axial canine implants with either two short first molar implants or two premolar inclined implants for assisting mandibular complete overdenture. Materials and methods: Ten healthy completely edentulous male patients were sele...
Citations
... Conversely, a return to health has also been observed among individuals with MCI [38][39][40]. Harini et al. also reported that restoration of occlusion by implant overdenture was associated with improved MMSE scores in so-called cognitive abilities [41]. The identification of this MCI state and the postponement of the transition to dementia have become pressing social concerns in the context of an aging population. ...
Background/Objectives: The population of Japan has a high life expectancy, but there is room for improvement in terms of the country’s healthy life expectancy. The long period of care dependency among Japan’s elderly is also a major economic health challenge. Dementia is a major factor in the need for care, and its prevention is a crucial and urgent challenge. There are recent reports of a possible association between changes in oral function and cognitive impairment, but the details of this association remain unclear. To clarify the relationship between poor oral function and cognitive impairment, we conducted an exploratory investigation using a cognitive function assessment (Mini-Cog) administered in a large-scale study and its relevance to oral function. Methods: The study population was 678 community-dwelling individuals aged ≥65 years living in Tarumizu city, Japan, in 2019. Cognitive function was assessed using the Mini-Cog test, and the oral survey was a modification of the content of the Oral Hypofunction Examination as defined by the Japanese Society of Gerodontology. Results: The participants’ median age was 73 years. The oral function results revealed median scores below the oral hypofunction criterion for occlusal force, tongue pressure, oral diadochokinesis, and swallowing function. The results of a binomial logistic regression analysis indicated that tongue–lip motor function was independently associated with oral function in relation to cognitive impairment. Conclusions: The oral function associated with cognitive impairment in this study was tongue–lip motor function. Aiming to improve this function may prevent the exacerbation of cognitive impairment.
... Recently, a considerable number of studies using neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), have been conducted in humans and have shown changes in activity in many cortical areas following the installation of new prostheses [8][9][10]. However, the most popular tasks in these studies were jaw (denture teeth) clenching (voluntary movement), and gum chewing (automatic movement), which may not reflect actual mastication, such as consciously tasting food without disrupting the rhythmicity of mastication. ...
... Each study recruited approximately 4-20 patients. One study reported details on the sample size calculation [23], whereas another study simply mentioned that the "sample size was calculated to be seven" [24]. No study explicitly mentioned the socioeconomic background or ethnicity of the subjects. ...
... Two studies were cross-sectional with between-group comparisons [27,28]. Meanwhile, only three studies collected brain activity data from their patients before the experimental interventions: Two collected data while patients were wearing their old complete dentures [23,29], and one collected data while patients were completely edentulous, without dentures [24]. Brain activation in response to several tasks was assessed, with the most popular task being jaw (denture teeth) clenching and gum-chewing. ...
... For Yan et al. [27], concerns were raised regarding confounding variables, as they had compared patients who already had undergone different types of denture rehabilitations, without disclosing or accounting for the differences in the socioeconomic status between the patient groups. Significant risks were identified in the incomplete outcome data for three studies [24,28,32], as they had analyzed the fMRI data based on their subjective judgments (i.e., "no signal", "mild signal", versus "strong signal") instead of the routine statistical tests based on numerical values. Due to the heterogeneity of the studies and the lack of brain coordinates reported by the studies, a neuroimaging meta-analysis was not feasible. ...
Tooth loss may affect food ingestion and, consequently, nutrition intake. The neuroimaging literature using functional magnetic resonance imaging (fMRI) was reviewed to summarize the changes in brain functions in response to denture rehabilitation in patients with partial or complete edentulous dentition. Overall, this review covered nine fMRI studies on denture rehabilitation. Eight recruited complete edentulous patients, whereas one recruited partially edentulous patients. The risk-of-bias assessment revealed concerns regarding all nine studies. Due to the heterogeneity of the studies and the lack of brain coordinates reported, a meta-analysis could not be conducted, and this review could only summarize the findings without statistical validation. The evidence from jaw-clenching studies suggested that implant-supported fixed dentures could be the best option, as compared to implant-supported overdentures and complete dentures, as it was associated with higher brain activity levels in various brain regions, including those corresponding to the primary sensory (postcentral gyrus) and motor cortices (precentral gyrus). Gum-chewing studies indicated that perhaps the medial and middle frontal gyri were associated with food comminuting and food mixing, which could be improved by the full replacement of the dental arch, instead of only partial replacement. All the fMRI studies described the functional neuroplasticity of the patients undergoing denture rehabilitation and suggested that certain rehabilitation options were more beneficial in restoring masticatory functions, as well as their associated brain activity levels.
... La relación causa-efecto entre la masticación y DC aún no ha sido del todo aclarada, principalmente esta se basa en los datos obtenidos de las investigaciones hechas en animales (1,4,5,(14)(15)(16)(17)(18), y se ha relacionado en la población adulta con la pérdida de las piezas dentarias y edentulismo (19), el sustento de dicho enunciado se basa en que la perdida de dientes, afecta la capacidad masticatoria, la dificultad para llevar el acto de la masticación estaría relacionada con el flujo de sangre al cerebro, siendo de importancia para una amplia gama de funciones cognitivas cerebrales (20), también la capacidad masticatoria es importante para la nutrición del individuo (21), una persona que no puede masticar bien consume menos fibra, micronutrientes y a su vez opta por el consumo de alimentos blandos, fáciles de masticar, que pueden estar relacionados con el deterioro cognitivo (22). ...
... El objetivo de este artículo es explicar la posible relación de la DC con la masticación y la rehabilitación oral como medida preventiva, se ha demostrado que la rehabilitación oral, es indispensable para restaurar la armonía al masticar, teniendo una posible relación con el mejor flujo sanguíneo al cerebro (19,23). ...
... El edentulismo en adultos mayores es una de las causas de DC, debido a la inhabilitación de la masticación, los pacientes edéntulos están en peor estado que aquellos normales (19). Los pacientes edéntulos presentan una desactivación del prefrontal al masticar sin prótesis, disminuyen su actividad masticatoria (20), es decir el edentulismo podría ser una de las fuentes que contribuye al inicio y la progresión de las disfunciones cognitivas (8,19,20,24), el edentulismo de las piezas dentarias posteriores como premolares y molares se puede asociar con niveles más bajos de función cognitiva (24). ...
La disfunción cognitiva es la perdida de la memoria de forma gradual, es muy probable que pase a convertirse en demencia, y evolucionar a otras enfermedades neurodegenerativas como Alzheimer, esto se hace de manera irreversibles, por lo que encontrar una manera de trata o prevenir las disfunciones cognitivas, son importantes tanto para la salud de la persona, como para la economía familiar y del país. Para esta revisión de literatura se consultaron las siguientes bases: PubMed, Scopus y ScienceDirect, como palabras clave se usaron términos del Descriptor en Ciencias de la Salud (DeCs) como: Masticación, rehabilitación oral y disfunción cognitiva, combinados con los operadores boléanos OR, AND, NOT, seleccionándose la combinación con mejores resultados. Se revisaron un total de 168 artículos, de los cuales 31 cumplieron con todos los criterios de inclusión, siendo los 31 en el idioma inglés. Cada vez en el mundo, más personas adultas padecen de deficiencias cognitivas y muchas veces se le puede asociar a el edentulismo, perdida de dientes, periodontitis, que afectan en la masticación, la rehabilitación oral podría ser fundamental, para la restauración de la masticación y podría ser una medida para la prevención y tratamiento de enfermedades neurodegenerativas.
Objectives
An increasing number of studies have identified an association between oral health status and cognitive function. However, the effect of oral interventions, including oral health care, dental treatment and oral motor exercises, on cognitive function remains unclear. This systematic review examined whether oral interventions contribute to the long-term improvement of cognitive status.
Methods
Four databases were searched (MEDLINE, Web of Science, Cochrane Library, and ICHUSHI Web) to identify randomised and non-randomised controlled trial studies and prospective cohort studies from inception until 1 September 2023, published in English or Japanese. The Cochrane risk of bias tool for randomised controlled trials and the risk of bias assessment tool for non-randomised studies were used to assess bias risk.
Results
A total of 20 articles were included in the qualitative analysis; 13 articles were published in English, and 7 were published in Japanese. The implemented interventions were oral care in 8 studies, dental treatment in 8 studies, and oral motor exercise in 4 studies. One study found a significant effect on attention following oral care intervention. Some dental treatments influenced cognitive function, although a clear positive effect was not determined. In 1 study, attention and working memory improved in the chewing exercise group.
Conclusions
Several studies verified the improvement effects of oral interventions, such as oral care, dental treatment, and oral motor exercise, on cognitive function or impairment. However, there was still a lack of conclusive evidence that such an intervention clearly improved cognitive function. To clarify the effects of oral interventions on cognitive function, it is necessary to examine participants, interventions, and outcome measures in detail.
Objective:
To investigate the occurrence of mild cognitive impairment in edentulous patients up to 3 years after they received single-implant overdentures (1-IODs).
Methods:
This was a follow-up study for a crossover randomized controlled trial comparing 1-IODs and conventional complete dentures, with patient satisfaction as the primary outcome. In the present study, the cognitive function of the patients, measured with the Japanese version of the Montreal cognitive assessment (MoCA-J), was evaluated as the secondary outcome at baseline and 2 months, 1 year, 2 years, and 3 years after 1-IOD placement. The total and domain (memory, executive function, visuospatial skills, language, attention, and orientation) MoCA-J scores of the patients at each timepoint were analyzed and compared.
Results:
Twenty-two patients with edentulous mandibles received 1-IODs. Within-group comparisons revealed that the total MoCA-J scores at 1 year and 3 years after 1-IOD placement were significantly increased compared with baseline scores. Additionally, the memory domain scores at all timepoint were significantly increased compared with the baseline scores, and the executive function domain scores at the 2-month, 2-year and 3-year timepoint were significantly increased compared with the baseline scores.
Conclusion:
Patients with edentulous mandibles who underwent 1-IOD placement showed significantly improved total scores of MoCA-J after 1 year and 3 years of wearing 1-IODs. In addition, they showed significantly improved memory domain scores at 2 months, 1 year, 2 years, and 3 years after 1-IOD placement and executive function domain scores at 2 months, 2 years, and 3 years after 1-IOD placement.
Clinical significance:
The results of this study suggest that 1-IOD treatment for older adults, especially those with edentulous mandibles, may prevent cognitive decline regardless of the condition of the maxilla.
