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Malocclusion, Mastication and the Gastrointestinal System
Abstract
The relationship between malocclusion and the gastrointestinal system has only been examined occasionally, while several pertinent studies have addressed the chewing function as a functional link between oral structures and the gastrointestinal tract. Following an overview of the physiological masticatory process, the available evidence regarding associations among dental status, chewing function and gastrointestinal disorders are summarized. Finally, a review of the relationships between orthodontic deformities and mastication is presented.
... 11 Studies have shown a relationship between masticatory performance and malocclusion with gastrointestinal disorders. [12][13] Few studies have been conducted on the relationship between tooth loss and upper GI disorders including functional dyspepsia and GERD. Some studies have shown an association between masticatory performance and FD but no association was found with the number of occlusal pairs. ...
... Gastritis and ulcers have long been reported in subjects with impaired masticatory function. 13 Previous investigations in Iran have documented a linkage between GERD, dental erosion and dental hygiene. [17][18][19] A cross-sectional study among three groups of Iranian healthy adults, those who were suspected for GERD, and positive GERD patients showed that the prevalence of dental erosion in GERD patients (22.6%) was higher than the suspected (5.3%) and the healthy (7%) individuals. ...
... However, tooth loss may lead saliva which may result in inadequate pre-fermentation, impaired bolus formation, digestive disorders such as early satiation, postprandial fullness and epigastric pain. 13 In the present study, we used Rome III criteria to assess FGIDs. This questionnaire was introduced as a standard tool to diagnose and classify functional gastrointestinal disorders. ...
Background:
Few studies have assessed the relationship between tooth loss and upper gastro-intestinal (GI) disorders including functional dyspepsia (FD) and gastro-esophageal reflux disease (GERD). This study aimed to investigate the relation between dental status and FD, its components and GERD among a large group of Isfahani adults.
Methods:
In a cross-sectional study from April to May 2010, the dental status of 4109 Isfahani adults was evaluated using a self-administered questionnaire. Participants were categorized into three main groups: those with full dentition, individual who had lost 1-5 teeth and those who had lost >5 teeth. FD, its components and GERD were defined using Rome III criteria. Multivariable logistic regression was used to examine the relationship between dental status and gastrointestinal disorders.
Results:
After adjustment for potential confounders, we found no significant association between dental status, FD and GERD. However, individuals who had lost 1-5 teeth and >5 teeth had 34% and 109% greater odds for early satiation, respectively. In addition, individuals who had lost 1-5 teeth were 24% likely to have postprandial fullness and epigastric pain. Stratified analyses by gender also revealed a significant association between dental status and GERD as well as FD in females; such that those who had lost 1-5 teeth had 33% greater chance for GERD and those who had lost >5 teeth were 101% more likely to have FD compared with those with full dentition.
Conclusion:
We found significant positive associations between tooth loss, GERD and FD in women, but not in men. We also found significant relations between tooth loss and components of FD, especially early satiety in the entire population.
... Despite the progress in the prevention and early treatment, tooth loss remains highly prevalent worldwide (4). Insufficient breakdown of food and decreased exposure to saliva lead to inadequate pre-fermentation, impaired bolus formation, insufficient secretion of gastric juice acid and, as a result, to digestive disorders and compromised nutritional status (5)(6)(7). Findings from animal studies have provided evidence indicating a moderate effect of mastication on food digestion (4). The current evidence in this regard is inconsistent (5)(6)(7)(8)(9)(10). ...
... Findings from animal studies have provided evidence indicating a moderate effect of mastication on food digestion (4). The current evidence in this regard is inconsistent (5)(6)(7)(8)(9)(10). In a case-control study of patients in geriatric facilities, it was shown that insufficient masticatory function significantly increased the risk of gastrointestinal dis-orders (8). ...
... On the other hand, the presence of teeth and the number of functional teeth can affect masticatory function. The relation between masticatory function and gastrointestinal disorders was also evaluated in several studies (5,(8)(9)(10). Tooth loss has been associated with increased risk of upper gastrointestinal tract cancers especially non-cardia gastric cancer (19). ...
Although the relationship between number of teeth and gastric disturbances has been recognised, limited data are available linking tooth loss and irritable bowel syndrome (IBS). This study aimed to investigate the relation between dental status and IBS among Iranian adults. In a cross-sectional study on 4669 Iranian adults, dental status was evaluated using a self-administered questionnaire. Participants were categorised into five main groups: those with full dentition (without denture), those with denture, individual who had lost 1–2 teeth, 3–5 teeth and half of one jaw or more. IBS and its subtypes were defined using Rome III criteria. After adjusting for different confounding variables, those who had lost 1–2 and 3–5 teeth had 1·35 and 1·33 times greater odds for IBS than fully dentate subjects, respectively. After controlling for different confounders, individuals who had denture had 103% greater odds to have constipation-predominant IBS than those with full dentition (95% confidence interval: 1·29–3·21). Neither in crude nor in adjusted models were any significant association between dental status and other subtypes of IBS. In addition, we did not find any association between losing half of one jaw or more and IBS. We found that losing 1–2 or 3–5 teeth might significantly be associated with increased risk of IBS. Having denture might be related to constipation-predominant IBS. There should be further prospective studies to confirm these findings.
... Interakcija genetskih i okolišnih čimbenika odgovorna je za varijabilnost u ekspresiji malokluzija i širok spek-trum of clinical pictures in affected individuals. Severe forms of malocclusion lead to distorted appearance, impaired masticatory function, and decreased quality of life (1,6,7). Better understanding of the underlying etiological mechanism of malocclusion is important for the progress in prevention and treatment of orthodontic anomalies. ...
... tar kliničke slike. Teški oblici malokluzija narušavaju izgled, poremećene su mastikatorne funkcije i smanjena kvaliteta života (1,6,7). Bolje razumijevanje temeljnog etiološkog mehanizma malokluzije važno je za napredak u prevenciji i liječenju ortodontskih anomalija. ...
Objective
To compare the degree of dental arch fluctuating asymmetry (FA) among patients with Class I, II, and III malocclusions.
Subjects and methods
The sample comprised randomly selected plaster casts of 131 patients: 39 Class I (19 males and 20 females), 57 Class II (23 males and 34 females), and 35 Class III (20 males and 15 females). Dental models were scanned and digitized using ATOS II SO. The measurements of the teeth and dental arches were taken using the ATOS viewer version 6.A.2 software. Six arch widths and five arch depths were measured. The FA was assessed as a composite index of total weighted asymmetry (TWA). The analysis of variance was used to determine whether there were any statistically significant differences between the groups.
Results
Composite TWA measures of fluctuating asymmetry for dental arch variables were the highest in Class III, and lowest in Class I malocclusion. Males displayed a higher degree of asymmetry than females. The asymmetry degree was higher in the mandibular dental arches than in the maxillary dental arches in all malocclusion groups.
Conclusion
The TWA values were low but they differed significantly between the groups of malocclusion. Class III malocclusion displayed higher FA values than Class I and Class II malocclusion. Higher FA of dental arches in Angle’s Class III can be considered an indicator of increased developmental instability in this malocclusion due to high levels of genetic and environmental stress during the period of early development.
... [2][3] La hipótesis de que una inadecuada masticación por pérdida de dientes, sin una rehabilitación protésica oportuna y gradual, favorezca la progresión a lo largo de la vida de trastornos del TDS, ha sido poco investigada y sus resultados aún no son concluyentes. [4][5][6] OBJETIVO Determinar la posible influencia del desdentamiento progresivo, sin rehabilitación protésica oportuna, en la aparición de trastornos del TDS. ...
... 4 Sin embargo, ambos autores coinciden con Ishikawa en las diferencias de la eficiencia masticatoria entre portadores de prótesis totales y dentados naturales. 6,8 Existe entonces una asociación importante entre el desdentamiento, o la incorrecta masticación por falta de dientes, y la presencia de síntomas y desórdenes del TDS; por tanto, prevenir el desdentamiento, o al menos rehabilitar oportunamente los dientes perdidos, puede influir en la conservación de la salud del TDS. ...
Introduction: Mastication is considered an essential proceeding on digestive function, even the first phase of it.
Objective: To determine the risk factors for teeth loss and its association with disorders of the upper digestive tract due to a late prosthetic rehabilitation.
Methods: One-hundred patients aged between 40 and 65 years old (50 edentulous patients and 50 with complete dentition) were interviewed and assessed at the Faculty of Dentistry, University of Medical Sciences Havana, 2007-2009.
Results: The occurrence of odontopathies, deficient dental health education, educational level, oral hygiene, access to dental services, and advanced age were found to be risk factors for significant tooth loss, p = 0.05. Statistically and clinically significant differences (p = 0.05) favoring the edentulous patients were found regarding digestive symptoms, more than three symptoms, regurgitation, dysphagia, retrosternal pain, pyrosis, repletion, and late tooth loss. Edentulous patients were 7.2 years older, showed on average 2.3 more digestive symptoms, and delayed 12 months longer without prosthetic rehabilitation (median), as compared to patients with complete dentition (p = 0.05). In edentulous patients, a statically and clinically significant association was found between a delay of 25-144 months in starting prosthetic rehabilitation and the appearance of three or more symptoms (p=0.051), dysphagia, pyrosis, and heartburn (p = 0.05). Conclusions: Several risk factors were confirmed, and a statistical association was found between tooth loss, time without prosthetic treatment, and symptoms of the upper digestive tract.
http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1729-519X2012000400007
... Gastrite e úlceras foram reportadas em pacientes com função mastigatória comprometida 13 . A ingestão de ar aumentada, salivação diminuída e retardo do esvaziamento gástrico, devido à ingestão de partículas alimentares maiores a serem digeridas no estômago, foram relacionadas como causas de desordens gastrointestinais e, consequentemente, ao comprometimento do estado nutricional em indivíduos com disfunção mastigatória [14][15][16][17] . Ressaltase que tanto a má absorção de nutrientes, quanto às desordens gastrointestinais podem aumentar o risco de doenças 11 . ...
Objetivo: Avaliar a relação entre as maloclusões e queixas de problemas mastigatórios e gastrointestinais em crianças. Métodos: Realizou-se um estudo transversal com uma amostra intencional de 232 crianças de ambos os sexos, com idades entre 6 e 12 anos, provenientes de uma amostra de 634 crianças de 3 a 12 anos examinadas durante um levantamento de saúde bucal na cidade do Recife/PE. Participaram do estudo apenas as crianças livres de cárie. Foram excluídas as crianças com síndromes associadas a deformidades craniofaciais, as crianças submetidas a tratamento ortodôntico ou ortopédico facial prévio, crianças com presença de desgastes acentuados nas faces oclusais dos elementos dentários e crianças com alterações dentárias de forma, número ou tamanho. Os dados foram coletados através de dois instrumentos: entrevistas com os responsáveis e exames clínicos. As maloclusões foram avaliadas a partir da classificação de Angle e da observação da ocorrência de mordida aberta anterior, mordida cruzada anterior e mordida cruzada posterior. Foi utilizada ficha clínica padrão da Organização Mundial de Saúde. A análise estatística foi realizada utilizando-se os testes Quiquadrado de Pearson e Exato de Fisher. Resultados: Os sintomas de distúrbios gastrointestinais ocorreram em 19,8% das crianças, sendo a prisão de ventre a queixa mais citada (9,9%). Os sintomas gastrointestinais não foram associados à presença das maloclusões. A mordida cruzada anterior foi associada à dificuldade para mastigar (p < 0,05) e à necessidade de ingerir líquidos durante as refeições (p=0,017). Conclusão: As crianças com mordida cruzada anterior apresentaram maiores dificuldades mastigatórias em relação ao grupo sem esta maloclusão. Descritores: Má oclusão. Criança. Mastigação. Trato gastrointestinal. Inter-relação.
... The present patient had significantly poor preoperative oral hygiene management which did not improve despite regular tooth brushing instruction, and she required continuous daily oral cleaning by an oral surgical hygienist after her surgery and then intervention by a hygienist at the patient's orthodontic clinic after discharge. Oral disease and its various related factors are significantly associated with the pathology and severity of IBS, as seen in the effects of oral disease and gastrointestinal disorders including H. pylori infection, peptic ulcers, constipation, diarrhea, and dyspepsia [40][41][42]. To reduce the severity of IBS, it is necessary to avoid poor oral hygiene. ...
Introduction:
In the disease irritable bowel syndrome (IBS), gastrointestinal function is worsened even though no organic abnormalities are observed in the gastrointestinal mucosa. We report the case of an orthognathic surgery patient with suspected irritable bowel syndrome.
Case:
In September 2017, a 15-year-old Japanese female was referred to us with dental crowding, malocclusion, and mandibular protrusion. In June 2019, a disagreement with classmates led to abdominal pain, diarrhea, and hemorrhage; in August 2019, a preoperative blood test showed sudden anemia, and her surgery was thus postponed. Subsequent upper and lower gastrointestinal endoscopy revealed no organic abnormality, and no definitive diagnosis was made. In March 2020, after an improvement in anemia was observed, a segmental Le Fort I osteotomy and bilateral sagittal split ramus osteotomy (BSSRO) were performed under general anesthesia. On the third post-operative day, due to the mucosal dehiscence adjacent to the suture part, the titanium plate was exposed, and irrigation of the wound with normal saline solution and oral hygiene instruction was continued daily for 2 weeks. Two years and eight months have passed since the surgery, and the healing of the oral mucosa and bone has been uneventful.
Discussion:
The relationship between IBS and post-operative impaired healing associated with the fragility of the oral mucosa is unknown. However, psychological stress has been reported as a cause of IBS and to be related to oral microorganisms.
Conclusion:
Reducing risk factors for IBS and maintaining proper perioperative oral hygiene is essential in managing similar cases.
... The semi-automatic, rhythmic act of mastication is initiated by the central nervous system and fine-tuned by inputs from receptors embedded in the orofacial area [1]. The process of mastication and the coordination of masticatory movements depend largely on the harmonious interaction between the peripheral inputs and the higher centers of the brain [2][3][4][5]. In general, the process of mastication involves the proper placement of food morsels in between the teeth, crushing (the food) into smaller pieces, and mixing them with saliva to form a coherent and swallowable bolus Abdulrahman Alshammari and Nabeel Almotairy contributed equally to this work. ...
Objective
To investigate the effects of dental/skeletal malocclusion and orthodontic treatment on four main objective parameters of chewing and jaw function (maximum occlusal bite force [MOBF], masticatory muscle electromyography [EMG], jaw kinematics, and chewing efficiency/performance) in healthy children.
Materials and methods
Systematic searches were conducted in MEDLINE (OVID), Embase, and the Web of Science Core Collection. Studies that examined the four parameters in healthy children with malocclusions were included. The quality of studies and overall evidence were assessed using the Joanna Briggs Institute and GRADE tools, respectively.
Results
The searches identified 8192 studies; 57 were finally included. The quality of included studies was high in nine studies, moderate in twenty-three studies, and low in twenty-five studies. During the primary dentition, children with malocclusions showed similar MOBF and lower chewing efficiency compared to control subjects. During mixed/permanent dentition, children with malocclusion showed lower MOBF and EMG activity and chewing efficiency compared to control subjects. The jaw kinematics of children with unilateral posterior crossbite showed a larger jaw opening angle and a higher frequency of reverse chewing cycles compared to crossbite-free children. There was a low to moderate level of evidence on the effects of orthodontic treatment in restoring normal jaw function.
Conclusions
Based on the limitations of the studies included, it is not entirely possible to either support or deny the influence of dental/skeletal malocclusion traits on MOBF, EMG, jaw kinematics, and masticatory performance in healthy children. Furthermore, well-designed longitudinal studies may be needed to determine whether orthodontic treatments can improve chewing function in general.
Clinical relevance
Comprehensive orthodontic treatment, which includes evaluation and restoration of function, may or may not mitigate the effects of malocclusion and restore normal chewing function.
... L'importance de la mastication pour une bonne (a) Structures de la zone maxillo-faciale (dessin de W. Spalteholz ; theodora.com/anatomy). digestion a déjà été mise en lumière et est régulièrement rappelée par les professionnels de santé [104]. Les dents, étant dans la partie externe du corps (comme tout le tube digestif), subissent donc de multiples contraintes, d'ordre mécanique (mastication, fractures, poussée dentaire), d'ordre physicochimique (pH variable dû aux aliments, à la salive et aux boissons, action enzymatique) mais aussi d'ordre micro-biologique lorsque surviennent des caries ou des abcès. ...
La tomographie à faisceau conique (CBCT) est devenue la modalité de référence pour les praticiens du domaine dentaire. Sa relative nouveauté et ses spécificités impliquent que le domaine du traitement de ces images est peu développé à l’heure actuelle. En partenariat industriel avec Carestream Dental, le premier volet de la thèse a conduit à développer une méthode de segmentation semi-automatique de chaque dent, reposant sur l’utilisation de contraintes de forme et d’intensité, et formulée comme un problème de minimisation d’énergie résolu par coupure de graphe. Les résultats montrent une bonne qualité de segmentation avec un coefficient de Dice moyen de 0, 958. Une application logicielle a été réalisée pour la mise en œuvre de la méthode de segmentation auprès des praticiens, en tenant compte des contraintes techniques et temporelles imposées par le contexte clinique, ainsi que du profil des utilisateurs. Un travail préliminaire d’extension de l’approche par coupure de graphe pour segmenter simultanément plusieurs dents à été réalisé, montrant la nécessité de rendre les contraintes de formes plus adaptées aux images et de modifier la méthode d’optimisation pour atteindre des temps de calcul compatibles avec la pratique clinique. Un second volet prospectif des travaux concerne la constitution d’un modèle structurel de la région maxillo-faciale pour formaliser les connaissances a priori sur les organes et leurs interactions. Ce modèle est un graphe conceptuel où sont représentés les concepts des structures et des relations. En particulier, les relations d’alignement et “le long de” ont été modélisées en 3D dans le cadre des ensembles flous.
... Several studies have revealed that inadequate masticatory and chewing function significantly increased the risk of gastrointestinal disorders (21,40,41). Insufficient chewing, decreased breakdown of food and reduced exposure to saliva might be related to inadequate gastric secretion, impaired bolus formation and consequent digestive disorders (42). Poor mastication and swallowing foods is also associated with reduced autonomic nervous activity, resulting in impaired gastric motor and excretion function (43). ...
BACKGROUNDS AND AIMS
There is limited evidence regarding the relationship between dietary behaviors and irritable bowel syndrome (IBS). This study aimed to explore the association between diet-related practices and prevalence of IBS.
METHODS
The study was conducted among 988 adolescent girls living in Iran. Dietary behaviors were pre-defined and assessed in nine domains using a pre-tested questionnaire. To investigate the association between diet-related practices and the presence of IBS, we used logistic regression analysis in crude and adjusted models.
RESULTS
The prevalence of IBS was 16.9% in this population. Compared with individuals who did not consume fluid with their meal, those who always consumed fluid with meals had a greater chance of IBS (OR: 2.91; P: 0.01). We found a direct relationship between a greater intake of spicy food and IBS prevalence (OR: 5.28; P: 0.02). The individuals who ate fried foods every day also had a greater risk of IBS compared with those who did not consume fried foods (OR: 1.65; P: 0.01). The subjects who had lost ≥5 teeth had 2.23 times greater odds for IBS than the individual who had lost ≤1 tooth (OR: 2.23; P: 0.01) was a significant inverse relationship between the chewing sufficiency and the risk of IBS (OR: 4.04; P: 0.02). These associations remained significant after controlling for potential confounder
CONCLUSIONS
Intra-meal fluid intake, chewing insufficiency, higher tooth loss and the consumption of spicy and fried food were associated with increased risk of IBS. Prospective studies are needed to confirm these findings.
... Human malocclusion is a disarrangement of teeth and jaws that may lead to distorted facial appearance, limited masticatory function, increased risk for dental trauma, and compromise quality of life (1,2). ...
Malocclusions affect individuals worldwide, resulting in compromised function and esthetics. Understanding the etiological factors contributing to the variation in dentofacial morphology associated with malocclusions is the key to develop novel treatment approaches. Advances in dentofacial phenotyping, which is the comprehensive characterization of hard and soft tissue variation in the craniofacial complex, together with the acquisition of large-scale genomic data have started to unravel genetic mechanisms underlying facial variation. Knowledge on the genetics of human malocclusion is limited even though results attained thus far are encouraging, with promising opportunities for future research. This review summarizes the most common dentofacial variations associated with malocclusions and reviews the current knowledge of the roles of genes in the development of malocclusions. Lastly, this review will describe ways to advance malocclusion research, following examples from the expanding fields of phenomics and genomic medicine, which aim to better patient outcomes.
© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
... . Nos intrínsecos evidenciam-se o género 2,14 , a dentição 2,3 , o tipo de oclusão, o uso de prótese1 , a idade 2 , o fluxo salivar 2 e o padrão facial 4 . Nos extrínsecos evidenciam-se as características reológicas dos alimentos como a textura, a dureza, o sabor, o tamanho e a forma, que podem influenciar os ciclos mastigatórios 2,5,6 . ...
Objective
The aim of this study was to determine the influence that head position, during mastication, may have on the cranio-cervico-mandibular complex, particularly in terms of the masticatory muscles.
Methods
The study involved twenty-one young students from the Faculty of Dental Medicine of Oporto University, healthy individuals, without temporomandibular disorders (confirmed by the Research Diagnosis Criteria/Temporomandibular Disorders) and with full dentition. This was a convenience sample. Bioelectrical potentials were recorded from the masseter and anterior temporalis, when chewing carrot, peanuts, gum and chewy hard candy (Sugus®) in three different head positions, controlled by an accelerometer. The data were collected by BioEMGII software, from BioReserch, and in a SPSS database we proceeded to the standardization of the electromiographic records and also to apply different statistical tests (U Mann-Whitney test and Friedman test, with statistical significance of 95%) to verify if the differences were significant or not.
Results
There were significant differences in muscle activity during chewing some food, when chewed with the head in a horizontal position, retro or pro-tilted. Women have a higher recruitment of muscle activity than man.
Conclusion
The position of the head has, in fact, influence on the amount of muscle activity required, noticing that the muscle activity was higher when the head was in a horizontal position and lower in pro-tilted position.
... However, the relevance of malocclusions for chewing ability has been dismissed as minor and cannot be considered a general health risk. 22,199,200 The masticatory performance is more related to the posterior occlusal contacts and near contact areas. 5 As Proff 200 concluded the evidence of a possible link between impaired masticatory function/malocclusion and either nutritional disorders or gastrointestinal diseases is inconsistent. ...
To date, there is no evidence-based method of quantification for malocclusion. Consequently, how deviant occlusal traits should be scored and weighted relative to one another is a matter of serious debate. Orthodontic Treatment Need Indices (OTNI) use the subjective opinion of the experts, as their foundation, to define the pathological boundaries (cut-offs) of occlusal traits. This paper reviews the evidence relating malocclusions or deviated occlusal traits to oral health problems, and investigates if this evidence supports the cut-off points and the rationale used for OTNI.
The relevant cited studies and reviews from the MEDLINE, Web of Science, Scopus, Cochrane databases, and scientific textbooks were used. The citation rate was confirmed by using the Google Scholar.
So far, the evidence for harmful effects of deviated occlusal traits on oral health is either lacking or exists as cross-sectional (mostly) and longitudinal (a few and primarily short-term) studies. When an association was reported between a deviated occlusal trait and an oral health problem, either the strength of that association was weak, or due to methodological issues, findings were not conclusive. Consequently, establishing a cause and effect relationship is difficult. Further, commonly used OTNI do not record a full spectrum of occlusal traits, and relating their ranking or scoring systems to the available evidence is difficult. Therefore, there is little evidence to suggest that individuals with a high need (high score), as measured by OTNI, will necessarily put at risk their oral health if they turn down orthodontic therapy.
OTNI have a role in the epidemiology and can be used for resource planning, but their predictive value to detect the future objective functional deficits or oral health problems is questionable. OTNI will need revalidation overtime with emerging research findings.
Background and aim:
We investigated whether oral-dental conditions may be associated with the prevalence of irritable bowel syndrome (IBS) in a cross-sectional study in Japan.
Methods:
Information on lifestyle and abdominal symptoms was collected, and oral-dental examinations were performed from 2013 to 2017. To investigate the association between oral-dental conditions and IBS, this study used logistic regression analyses adjusted for relevant confounding factors, such as age, sex, BMI, stress, and eating between meals.
Results:
The prevalence of IBS was 484 (13.4%) among 3626 participants. The mean maximum occlusal force in the IBS group was significantly lower than that in the non-IBS group (0.306±0.192 kN vs. 0.329±0.205 kN, p =0.014). The maximum occlusal force of the constipation-type IBS was significantly lower than that of other types of IBS without constipation type (0.269±0.164 kN vs. 0.317±0.198 kN, p =0.010). Compared with those who had high values of maximum occlusal force (≧0.265 kN), those with a low value of maximum occlusal force (<0.265 kN) had a significantly greater risk for IBS (OR, 1.426; 95%CI, 1.135-1.792; p=0.002), by multivariate analyses, across different categories of oral-dental condition in women, not in men. Women who had lowest third occlusal force (<0.206 kN) had approximately 35% significanlty greater odds of having IBS compared with those who had highest third occlusal force (≧0.386 kN).
Conclusions:
Results suggest that a reduction in the maximum occlusal force increases the risk of IBS in Japanese women.
Background:
Caries and periodontal disease may cause tooth losses and chewing difficulty, especially in the elderly. Ingesting poorly chewed food may delay gastric emptying and favor the development of gastroesophageal reflux disease (GERD).
Objective:
This study investigated the association between masticatory dysfunction and GERD in the elderly from a rural area in southern Brazil.
Methods:
This census invited all 489 elderly from a city to participate. The study used a GERD symptoms questionnaire, followed by an oral examination. Masticatory dysfunction was analyzed based on the chewing difficulty for some food groups. Tooth loss and chewing self-perception were also considered as exposure variables. Poisson regression determined the association among variables by calculating the prevalence ratio [PR(95% confidence interval)].
Results:
The response rate was 93.1% (n=455, average age of 70.9 years, 50.5% men). The prevalence of GERD in this population was 36.9%. GERD was associated with chewing difficulty for vegetables (PR=1.54), meats (PR=1.34), and cereals (PR=1.43) but not with poor chewing self-perception (PR=0.80) and tooth loss (PR=1.22). GERD was also associated with xerostomia (PR=1.63) and the female gender (PR=1.35).
Conclusions:
Elderly people from a rural area with a reduced number of teeth present chewing difficulty and a high prevalence of GERD, indicating an association between GERD and masticatory dysfunction.
Background
Difficulties and limitations on masticatory function are among the main reasons why patients with temporomandibular disorder (TMD) seek care.
Objective
to evaluate the masticatory behavior and perception of chewing difficulties in adults with mild TMD of recent onset, considering the presence of malocclusion.
Methods
81 young adults were divided into groups according to the presence of TMD and malocclusion: Non TMD Normal Occlusion (n=18), Non TMD Malocclusion (n=22), TMD Normal Occlusion (n=18), and TMD Malocclusion (n=23). TMD was assessed using the TMD Research Diagnostic Criteria and volunteers also answered questionnaires regarding their perception about jaw functional limitation and difficulty to chew foods of different textures. Masticatory and swallowing behaviors were assessed using the Orofacial Myofunctional Evaluation with Scores (OMES) protocol. Chewing time and chewing frequency taken to ingest the test‐food were also obtained. Two‐way‐ANOVA was used to analyze the TMD, occlusion and TMD*occlusion interaction effects.
Results
TMD effect was observed on vertical jaw mobility and jaw function limitation total scores, meaning that groups differed in the perception of opening limitation and mandibular limitation according to TMD status with a medium effect size. Also, more changes in chewing function (OMES‐Chewing score) and higher chewing frequency was observed in the presence of TMD (p<0.05). Occlusion effect was only observed on OMES‐Swallowing score and no TMD*occlusion interaction effect was observed.
Conclusion
Changes in chewing behavior, frequency and perception of mandibular limitation was observed in the presence of TMD, pointing out the importance of functional evaluation when planning and establishing a treatment plan.
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CONTENTS
Keynote Papers....................................................................................
History of Thermology and Thermography: Pioneers and Progress (Ring EFJ)...3
Thermography in Plastic Surgery (Mercer JB, de Weerd L, Weum S)...................9
Thermography in Viticulture (Grant OM).................................................................16 OralPresentations.............................................................................................................Papers....................................................................................................................................
Accuracy When Assessing and Evaluating Body Temperature in Clinical Practice: Time for a Change?
(Sund-Levander M, Grodzinsky E)............................................................25
Core Body Temperature Evaluation: Suitability of Measurement Procedures
(Quelhas Costa E, Guedes JC, Baptista JS).....................................................................................33
Potential Errors in Mean Skin Temperature Calculation Due to Thermister Placement as Determined
by Infrared Thermography (Pascoe DD, Barberio MD, Elmer DJ, Laird Wolfe RH)......................................................................................................................................42
Using a Climatic Chamber to Measure the Human Psychophysiological Response Under Different Combinations of Temperature and Humidity (Guedes JC, Quelhas Costa E, Baptista JS)........................................................................................................................................49
Application of Cold Provocation for Breast Cancer Screening Using IR Thermography
(Lääperi E, Lääperi A-L, Strakowska M, Wiecek B, Przymusiala P)..........................................................................................................................................55
The Effect of Whole-body Vibration in the Skin Temperature of Lower Extremities in Healthy Subjects
(Seixas A, Silva A, Gabriel J, Vardasca R)......................................................................................................................................59
Using Clinical Thermography as Diagnostic Complementary Procedure for Hand Arm Vibration
Syndrome (Vardasca R, Ring EFJ, Plassmann P, Jones CD, Gabriel J)..................................................................67
Screening Fever, A New Approach (Cardoso A).....................................................................................................76
Integrating Medical Thermography on a RIS Using DICOM Standard
(Vardasca T, Martins HMG, Vardasca R, Gabriel J).................................................................................................79
Histographic Method as a Tool of Thermal Image Processing (Benkö I, Köteles GJ).........................................82
Thermographic Examination for Hypothermia (Usuki H, Tai C, Hamano T, Kondo A, Sakabe M, Nishimura M, Asano E, Ohshima M, Kashiwagi H, Nishizawa Y, Yamamoto N, Akamoto S, Fujiwara M, Okano K, Suzuki Y)...88
Scrotal Infrared Digital Thermography for Detection of Subclinical Varicocele
(Gabrielli D, Cardone D, Di Donato L, Pompa P, Cotroneo AR, Romani GL, Merla A).............................................91
The Highly Focalized Thermotherapy in the Treatment of Solid Tumors: Temperature Monitoring Using Thermography (Portela A, Vasconcelos M, Silva A, Gabriel J, Cavalheiro J).....................................................,,..95
Thermography as an Alternative Tool to Determine Pressure Distribution on the Stump of Transfemoral Amputees (Mendes E, Silva A, Correia R, Crisóstomo C, Vaz F, Gabriel J)...........................................................99
Thermal Effect during Ketamine Anesthesia in Laboratorial Mice
(Ribeiro P, Silva A, Antunes L, Gabriel J)................................................................................................................105
Thermography of Facial Skin Temperature in Healthy Subjects During Cooling of the Face with
Hilotherapy (Howell KJ, Collier JM).......................................................................................................................110
Infrared Thermography in Plastic Surgery: A Comparative Study of Pre and Post - Operatory Abdominal
Skin Circulation after Different Techniques – The Effect of Undermining
Vicari Nogueira CHF, Barros CF, Scherdel EP, Nerin JPB, Brioschi ML)...............................................................114
Infrared Thermography Assessment of Infantile Hemangioma Treatment by Propranolol
(Kalicki B, Jung A, Ring F, Rustecka A, Maślany A, Żuber J, Murawski P, Bilska K, Woźniak W)........................117
Facial Imprints of Autonomic Contagion in Mother and Child: A Thermal Imaging Study
(Ebisch SJ, Aureli T, Bafunno D, Cardone D, Manini B, Ioannou S, Romani GL, Gallese V, Merla A)...................121
Reliability and Reproducibility of Skin Temperature of Overweight Subjects by an Infrared Thermography Software Designed for Human Beings
(Fernández-Cuevas I, Marins JC, Carmona PG, García-Concepción MA, Arnaiz Lastras J, Sillero Quintana....130
Thermographic Evolution of Bone Temperature Evolution (Ribeiro TP, Silva A, Gabriel J).................................138
Effect of Yoga and Swimming on Body Temperature of Pregnant Women
(Sillero-Quintana M, Conde-Pascual E, Gomez-Carmona PM, Fernandez-Cuevas I, García-Pastor T)..............143
Legality Associated with the Use of Infrared Thermal Imaging in Veterinary Medicine
(Purohit RC, Schumacher J, Pascoe DD, Caldwell JM, Wolfe DF).......................................................................150
The Use of Thermography to Evaluate Back Musculoskeletal Responses of Young Racehorses to Training (Soroko M, Jodkowska E, Zabłocka M)................................................................................................................152
Effect of High Regional Nerve Blocks on the Thermographic Patterns in the Limbs of Horses
(Schumacher J, Aswani K, Pascoe DD, Purohit RC).............................................................................................157
Thermography and Oral Pathology (Mostovoy A).................................................................................................159
Poster Presentation Papers
Infrared Imaging of the Crânio-Cervico-Mandibular Complex in Bruxism Patients
(Castro V, Clemente M, Silva A, Gabriel J, Pinho.J)...............................................................................................162
Evaluation of the Masticatory Muscles Temperature by Thermal Imaging During Mastication
(Barbosa L, Clemente M, Silva A, Gabriel J, Pinho J)............................................................................................166
Diagnostic Evaluation of Chronic Venous Insufficiency Cases Using Thermal Imaging
(Martins MCF, Ribeiro LMF, Cury J)........................................................................................................................169
Infrared Precision agriculture matches inputs to crop demands, enhancing crop yields and product quality, of-fering economic benefits to the producer, and reducing resource wastage and pollution. Dwindling water resources make precision irrigation an area of particular interest. Precision irrigation is especially appealing in viticulture, where precise regulation of vine water status is necessary to optimize yield and grape (and hence wine) quality simultaneously. Precision irrigation requires monitoring of both spatial and temporal variation in vine water status. Closure of stomata, the pores on the leaf surface through which gas exchange takes place, is a rapid response to water deficit. Detection of stomatal closure could alert the viticulturist to the need to irrigate. Monitoring stomatal aperture, however, until recently was a very slow process. When stomata are open, transpiration cools the leaves, but when the stomata close, there is no longer any stomatal cooling. As a result, leaf temperature is a good indicator of transpiration rate or stomatal conductance, or conversely of water stress, when environmental conditions are constant. Much progress has been made in determining the impact of a range of variables (meteorological, leaf surface radiative properties etc.) on leaf temperature. This means that even under varying environmental conditions, stomatal conductance can now be estimated from leaf temperature. Thermal imaging means that the temperature of large numbers of leaves, plants, rows of crops, or even whole fields can be assessed rapidly. Therefore in theory it should be possible to use thermal imaging to detect individual vines that require irrigation, and to determine changing irrigation requirements over time. In practice, there is still some way to go before thermal imaging is used routinely for irrigation scheduling. Whole crops do not behave identically to individual leaves, variation in temperature caused by variability in crop structure can be difficult to separate from variation caused by differences in transpiration, and the best means of removing the effect of variation in meteorological conditions is still unclear. There are additional challenges relating to grapevine. Firstly, it is not a continuous crop, meaning that in overhead images leaf temperatures need to be separated from the temperatures of the soil or ground herbage in corridors between vine rows. Secondly, for many cultivars understanding of grapevine physiology has been derived from measurement on the vertical leaves facing into the corridors, whereas aerial or satellite imaging captures horizontal leaves at the top of vine canopies. Nonetheless, grapevine is one of the best studied crops with respect to thermal imaging under field conditions, and the potential of thermal imaging for detection of spatial variation in vine water status has been amply proven. With sufficient focusing of effort and collaboration between disciplines, the remaining technical problems should not be insurmountable. There has recently also been some interest in utilizing thermal imaging to better understand different physiological responses in different cultivars, and there is no reason why thermal imaging could not be used for large-scale screening of different genotypes under particular environmental conditions, as is being undertaken as part of genetic improvement programs in other crops. Thermal imaging has also been shown to be useful for pre-visualization detection of pathogen infection and for monitoring the temperature of developing grapes (an important determinant of final grape, and wine, quality). Diverse uses of thermal imaging in other disciplines, such as ecology, may also be found to be relevant to enhancing modern viticulture. Additionally, it is likely that thermography will increasingly be combined with other imaging techniques (near infra-red, chlorophyll fluorescence, multi/hyperspectral, laser-induced) for a more complete understanding of vine, or vineyard, behaviour.
The paper presents a methodology for determining the chewing efficiency by using the developed computer program, created on the basis of multivariate data analysis. This method allows to explore the chewing efficiency by means of occlusion scans obtained on wax. The accuracy of the chewing efficiency estimation using the computer program is compared with modern functional chewing probes.
The present study aimed at investigating whether maternal empathy is accompanied by a synchrony in
autonomic responses. We simultaneously recorded, in an ecological context with contact free
methodology, the facial thermal imprints of mother and child, while the former observed the latter
when involved in a distressing situation. The results showed a situation-specific parallelism between
mothers’ and children’s facial temperature variations, providing preliminary evidence for a direct
affective sharing involving autonomic responding. These findings support a multidimensional
approach for the comprehension of emotional parent–child relationships. Thermal infrared imaging
offers the possibility of recording non-verbal interactions among individuals, thus paving the way to
new studies and methodologies in neuropsychology.
The goal of this work was to conduct a survey of oral health-related quality of life (OHRQoL) among skeletal malocclusion patients who had undergone orthodontic treatment combined with orthognathic surgery.
The study included 28 patients who had undergone orthodontic therapy combined with orthognathic surgery (surgical repositioning osteotomy) to treat skeletal malocclusion. OHRQoL was assessed based on a 14-item German version of the Oral Health Impact Profile (OHIP-G14) and an additional questionnaire developed by the authors to evaluate aspects of quality of life specific to skeletal malocclusion patients.
The mean OHIP-G14 score demonstrates that the malocclusion patients have a lower OHRQoL than the general population. The information collected via our skeletal malocclusion questionnaire correlates with the patients' perceived esthetic and functional outcomes of treatment as well as their psychological state and social interactions. Satisfaction with treatment outcomes and improved social interactions correlated with high OHRQoL scores. High OHRQoL scores significantly correlated with enhanced well-being and the intensification of social contacts.
Our skeletal malocclusion questionnaire provides useful additional information on specific aspects of skeletal malocclusion patients, mapping in a detailed fashion aspects of function, esthetics, psychological condition, and social interactions. OHIP-G14 scores correlated negatively with OHRQoL.
The kings of the Spanish Habsburg dynasty (1516-1700) frequently married close relatives in such a way that uncle-niece, first cousins and other consanguineous unions were prevalent in that dynasty. In the historical literature, it has been suggested that inbreeding was a major cause responsible for the extinction of the dynasty when the king Charles II, physically and mentally disabled, died in 1700 and no children were born from his two marriages, but this hypothesis has not been examined from a genetic perspective. In this article, this hypothesis is checked by computing the inbreeding coefficient (F) of the Spanish Habsburg kings from an extended pedigree up to 16 generations in depth and involving more than 3,000 individuals. The inbreeding coefficient of the Spanish Habsburg kings increased strongly along generations from 0.025 for king Philip I, the founder of the dynasty, to 0.254 for Charles II and several members of the dynasty had inbreeding coefficients higher than 0.20. In addition to inbreeding due to unions between close relatives, ancestral inbreeding from multiple remote ancestors makes a substantial contribution to the inbreeding coefficient of most kings. A statistically significant inbreeding depression for survival to 10 years is detected in the progenies of the Spanish Habsburg kings. The results indicate that inbreeding at the level of first cousin (F = 0.0625) exerted an adverse effect on survival of 17.8%+/-12.3. It is speculated that the simultaneous occurrence in Charles II (F = 0.254) of two different genetic disorders: combined pituitary hormone deficiency and distal renal tubular acidosis, determined by recessive alleles at two unlinked loci, could explain most of the complex clinical profile of this king, including his impotence/infertility which in last instance led to the extinction of the dynasty.
Chewing efficiency, defined as the ability to grind a certain portion of a test food during a given time, was tested in 139 Skolt Lapps, ages 14-65. 94 persons had natural teeth and the remaining 45 wore dentures (partial and/or complete). The test food was almonds. Number of chewing strokes, swallowings and chewing time was denoted. The chewing efficiency was classified after a scale from 1 to 5 where 1 meant very good and 5 very poor ability to reduce the particle size of the test food. Clear associations were found between chewing efficiency and dental state. Number of occluding pairs of teeth was closely correlated with chewing efficiency and individuals with less than 20 teeth had a higher index score than those with more than 20 teeth. The values noted for number of chewing strokes, swallowings and chewing time were smaller for those with a good chewing efficiency, but the variation was not linear and not always significant. Denture wearers had statistically significantly higher chewing efficiency score than those with natural teeth, without dentures, and needed more chewing time before swallowing.
51 healthy dentate subjects aged between 20 and 60 years were evaluated with regard to their masticatory efficiency using a sieving test. A subjective evaluation of difficulty in chewing different kinds of food was also obtained by means of a questionnaire. The occlusal and restorative status were assessed using specific indices. The masticatory efficiency was shown to be lower with increasing age 20-39 years, mean = 39.8 and 40-60 years, mean = 27.1, respectively (p < 0.05). Males had a statistically significantly higher masticatory efficiency index than females. Multiple regression analysis showed that age, sex, the number of occluding teeth and the orthodontic treatment need index can predict half the variance in masticatory efficiency. It is concluded that it is more appropriate to describe masticatory efficiency with an average value for different age groups.
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MALHOTRA SL. PEPTIC ULCER IN INDIA AND ITS AETIOLOGY. Gut. 1964 Oct;5:412–416. [PMC free article] [PubMed]
Motivation for starting treatment and satisfaction with treatment results were evaluated on the basis of replies to a 14-item questionnaire and clinical examination of 28 orthognathic patients from 6 months to 2 years after treatment.
The most common reasons for seeking professional help were problems in biting and chewing (68 per cent). Another major reason was dissatisfaction with facial appearance (36 per cent). Many patients also complained of temporomandibular joint symptoms (32 per cent) and headache (32 per cent). Women (8/19) were more often dissatisfied with their facial appearance than men (2/9), but the difference was not statistically significant.
In agreement with earlier studies, the results of orthognathic treatment fulfilled the expectations of almost every patient. Nearly 100 per cent of the patients (27/28) were satisfied with treatment results, although 40 per cent experienced some degree of numbness in the lips and/or jaw 1 year post-operatively. The most satisfied patients were those who stated temporomandibular disorders as the main reason for seeking treatment and whose PAR-index had improved greatly.
The majority of the patients experienced the orthodontic treatment as painful and as the most unpleasant part of the whole treatment, but all the patients were satisfied with the pre-treatment information they were given on orthodontics.
Orthodontic-surgical therapy should be of a high professional standard technically, but the psychological aspects are equally important in the treatment protocol. The professionals should make efforts to understand the patient's motivations for and expectations of treatment. Patients should be well prepared for the surgery and supported for a long time after to help them to adjust to post-surgical changes.
Until fairly recent times, human populations were characterized by worn, well-aligned dentitions. Epidemiological data show that the decrease in dental wear and the increase in malocclusion took place simultaneously with the adoption of a modern lifestyle. There is strong evidence indicating that these changes were caused by a decrease in masticatory-functional demands. As such, the epidemiological findings are not compatible with the evolutionary-genetic explanations. The recent increase in occlusal variation demonstrates the high plasticity of occlusal characteristics and suggests that humans possess a genetic makeup that is sufficient for the development of a normal occlusion, given the correct environmental circumstances. External influences can be considered as tertiary inductors of the genomic processes that are involved in the growth of the craniofacial structures and development of the occlusion. Only those facial structures that are able to react to epigenetic factors, ie, show developmental plasticity, can be influenced by orthodontic therapy. Because the plasticity of each characteristic establishes the limits of therapeutic actions, orthodontic treatment should be based on an understanding of how the genetic and epigenetic factors interact during growth and development.
Helkimo, E. Carlsson, G.E. & Helkimo, M. Chewing efficiency and state of dentition. Acta Odont. Scand. 36, 33–41Chewing efficiency, defined as the ability to grind a certain portion of a test food during a given time, was tested in 139 Skolt Lapps, aged 14–65. 94 persons had natural teeth and the remaining 45 wore dentures (partial and/or complete). The test food was almonds. Number of chewing strokes, swallowings and chewing time was denoted. The chewing efficiency was classified after a scale from 1 to 5 where 1 meant very good and 5 very poor ability to reduce the particle size of the test food. Clear associations were found between chewing efficiency and dental state. Number of occluding pairs of teeth was closely correlated with chewing efficiency and individuals with less than 20 teeth had a higher index score than those with more than 20 teeth. The values noted for number of chewing strokes, swallowings and chewing time were smaller for those with a good chewing efficiency, but the variation was no...
Zusammenfassung Mit dieser Arbeit sollte vor allem die Frage geklärt werden, inwiefern der Kaueffekt bei der Distalbißbehandlung mit dem Aktivator beeinflußt wird. Das Probandengut bestand aus 60 Kindern, Jugendlichen und Erwachsenen: zwölf Kinder (zehn Jahre alt) mit einem Distalbiß vom TypAngle-Klasse II/1 wurden mit dem Aktivator zu einem Regelbiß behandelt (16 Jahre alt). Je zwölf Probanden mit einem Regelbiß im Alter von zehn Jahren, 16 Jahren und 29 Jahren sowie zwölf Probanden mit einem unbehandelten Distalbiß im Alter von 16 Jahren dienten als Vergleichsgruppen zu den Aktivatorpatienten. Die Kauleistung wurde mittels einer Kaueffektprüfung untersucht. Die Gebißverhältnisse wurden an kieferorthopädischen Modellen beurteilt. Registriert wurden die Anzahl durchgebrochener Zähne, Anzahl der okklusalen Zahnkontakte, Overjet und Overbite. Die Untersuchung ergab, daß sich der Kaueffekt bei den Aktivatorpatienten vom zehnten bis zum 16. Lebensjahr verdoppelte. Da der Kaueffekt bei Probanden mit unbehandeltem Regelbiß sowie Distalbiß bei 16jährigen größer als bei Zehnjährigen war und 16jährigen Probanden mit unbehandeltem Regelbiß, Regelbiß nach Aktivatorbehandlung und unbehandeltem Distalbiß einen gleich großen Kaueffekt hatten, konnte die Untersuchung nicht klären, inwiefern der Bißausgleich per se während der Aktivatorbehandlung zu einem erhöhten Kaueffekt führte. Weiter lag bei den Patienten der Aktivatorgruppe keine direkte Beziehung zwischen Verbesserung des Kaueffekts auf der einen Seite und erhöhter Anzahl durchgebrochener Zähne, erhöhter Anzahl okklusaler Zahnkontakte, verkleinertem Overjet und Overbite auf der anderen Seite vor. Die Vermutung besteht, daß der Kaueffekt zum Teil altersbedingt ist. Die Bißlage scheint keine entscheidende Rolle für die Kauleistung zu spielen. Dagegen ist ein harmonisches Zusammenspiel der okkludierenden Zähne und der sie beeinflussenden Muskulatur (Kau-, Zungen-, Lippen-Wangen-Muskulatur) sicherlich von Bedeutung.
Die vorliegende Arbeit geht der Frage nach, ob der Mensch Zäh- ne braucht. Häufig genannte Gründe wie Ästhetik, Abstützung des Kiefergelenks, Sprachbildung und Kauvermögen werden an- hand der Literatur unter verschiedenen Gesichtspunkten analy- siert. Es lässt sich folgendes Fazit ziehen: Ohne Zähne kann der Mensch sicherlich leben. Aber seine Lebensqualität sinkt ein- deutig mit zunehmenden Zahnverlust. Patienten mit stark redu- ziertem Zahnbestand sind häufiger krank, im Alltagsleben weni- ger aktiv und in ihren sprachlichen Ausdrucksvermögen einge- schränkt. Mit Zähnen bzw. Zahnersatz ist eine Ernährung mög- lich, die die Allgemeingesundheit fördert, und es verbessern sich Lebensqualität und Sprachvermögen. Es ist aber nicht eindeutig geklärt, ob und ab wann ein reduzierter Zahnbestand ein ver- mindertes Kauvermögen oder degenerative Veränderungen des Kiefergelenks zur Folge hat. Zusammenfassend lässt sich fest- stellen: Der Mensch braucht Zähne. Schlüsselwörter: Ästhetik, Kauleistung, Kauvermögen, Kieferge- lenkserkrankung, Lebensqualität, Sprachlautbildung, Zähne Does the man need teeth? This article investigates the ques- tion whether the man needs teeth. The most often discussed reasons such as esthetics, support of the temporomandibular joint, speech and mastication performance were analysed using the available literature. It was concluded that generally man can survive without teeth. However, with teeth or dentures he will live more healthy. Degenerative changings in the temporoman- dibular joint caused by lost posterior teeth was controversely discussed in the literature and (concerning this point) a final de- cision cannot be drawn. As an active member of our society which is determined by new information and communication systems, man needs the ability to be proficient in languages. In order to perform this, a functional speech body is necessary which cannot work without teeth. Quality of life research indicates that the quality of life will be markedly reduced in cases of partial or complete tooth lost. The results suggest: the man needs teeth.
This report describes the chewing patterns of individuals with normal occlusion and several types of malocclusion. Frontal movement patterns of the lower mid-incisor point were recorded during chewing of test foods in groups of subjects with Angle Class I normal occlusion, Class II malocclusion, as well as deep-bite and cross-bite malocclusions. Mandibular prognathic and retrognathic patients corrected to Angle Class I occlusions were also examined before and after orthognathic surgery. Chewing patterns were classified by using a catalogue of eight basic movement types. In none of the groups examined could chewing behavior be characterized by only one specific type of movement, but rather by different frequency distributions of pattern types. The Angle Class I, Class II, deep-bite, and presurgical retrognathism groups were characterized by chewing patterns with normal sequencing and grinding features and, to a minor extent, by self-crossing movements having no unique pattern of sequencing. Reversed sequencing did not occur in these four groups. In presurgical prognathic patients, drop-shaped patterns with steep closing movements predominated. Cross-bite malocclusion was characterized by drop-shaped and reversed sequencing patterns. The pattern distribution in prognathic patients did not change after surgery. In retrognathic patients the therapeutically altered occlusion caused a decrease in the frequency of grinding movements and an increase in the frequency of drop-shaped patterns.
A group of 129 hospital patients were categorized according to whether they possessed masticating efficiency, which was represented by the presence or absence of posterior teeth. It was determined by examining the records of their hospital stays that masticating efficiency, as defined, did not significantly affect the occurrence of gastric distress.
In summarizing, it may be said that the studies on masticatory efficiency just reviewed have not been extensive enough, nor have they been sufficiently well controlled to allow any definite conclusions. The importance of mastication and fine partition of the food for salivary and gastric secretion, the digestion and the evacuation time of the stomach has been emphasized by some workers. But disagreement exists in observations on the utilization of food following mastication with dentitions of various degrees of efficiency. While some workers have shown that insufficient mastication is responsible for undigested food in the feces, the bulk of the evidence indicates that the condition and number of the teeth make no difference in the degree of food utilization, at least not so far as modern diets are concerned. However, such studies have been done on very few subjects, and since all were human individuals without sufficient controls, individual variations have not been taken into account. Methods to measure the efficiency of the teeth in masticating food have been developed, but employed by only a few workers. With respect to the mechanical breakdown of the food during mastication, such work has tended to justify the maintenance of healthy teeth and replacement of lost teeth. But the importance of a complete dentition, natural or artificial, in promoting digestion and utilization of food, has not been adequately demonstrated.
The evaluation of 200 questionnaires for patients and their parents showed the following:
- As was previously known, aesthetic considerations are dominating factors in motivating patients to undergo orthodontic treatment, however it has been found that greater attention is given to the health aspects.
- The difference in value of aesthetic considerations between girls and boys has recently decreased.
- The personal and environmental reflection of malocclusion is determined within specific objective parameters.
Um die kieferorthopdische Behandlung Erwachsener bezglich Information, Motivation und retrospektiver Beurteilung zu analysieren, wurde eine Befragung bei 225 Patienten durchgefhrt, die zum berwiegenden Anteil Multibandapparaturen trugen. Der Zahnarzt nahm als Informationsvermittler eine Schlsselstellung eine. Der Behandlungsentschlu lie sich sowohl auf sthetische als auch auf funktionelle Grnde zurckfhren. Dabei war die Ausprgung der jeweiligen Motive von Alter, Familienstand, Schulbildung und Mitarbeit abhngig. Interesse und Einsicht in funktionelle Verbesserungen, die vor allem bei einem gehobenen Bildungsstand vorlagen, waren entscheidend fr ein dauerhaftes Engagement bei der Behandlung. Rein sthetische Beweggrnde waren keine Voraussetzung fr eine gute Mitarbeit.In order to analyze orthodontic treatment of adults concerning information, motives and retrospective evaluation 225 patients with fixed appliances were questionned. The dentist had a key position as a mediator of information. The decision to an orthodontic treatment was led by esthetical and functional motives. The extent of the respective motives depended from age, personal status, education and cooperation. Interest and understanding in functional improvements as they could be found above all by people with a higher education level were decisive for a durable regard of the treatment.
An Hand von Kaufunktionsprfungen wurden bei 86 Patienten die Wechselbeziehungen zwischen dem Zerkleinerungsvermgen von Pinienkernen und dem Gebizustand untersucht. Die Beurteilung des Zahnsystems erfolgte nach folgenden Kriterien: Ausprgungsgrad der Anomalie, Zahl der Kaueinheiten und Antagonistenbeziehungen. Es konnte ein signifikanter Unterschied zwischen dem Zerkleinerungsvermgen des Gebisses und den obigen Kriterien festgestellt werden. Als besonders eindeutig in der Beurteilung erwies sich die Klassifikation nach Antagonistenbeziehungen.Basing on experiments of the masticatory function 86 patients chewed stone-pine kernels into small pieces and the results, with the state of the occlusion were analysed. The assessment of the occlusion was carried out according to the following criteria: 1. degree of anomaly, 2. number of masticatory units and 3. relationship between opposing teeth. A significant difference was revealed between the degree of pulverization of the kernels and the above criteria. In the analysis the classification of the relationship between antagonists proved to be particularly obvious.On a examin sur une base fonctionnelle la corrlation entre la capacit de mcher des noyaux de pin et l'tat des mchoires de 86 patients. Le systme dentaire est tudi selon les critres suivants: degr de l'anomalie, nombre d'units masticatrices, relation des antagonistes. Une diffrence importante est apparue entre la capacit de mastication et les critres noncs prcdemment. C'est la classification selon les relations des antagonistes qui a t particulirement dterminante dans cette dissemblance.
Surgical correction of retrognathism may influence chewing performance and its underlying mechanisms selection and breakage of food particles. In this study we examined the hypothesis that treatment of this anomaly improves chewing performance. Furthermore, we determined to what extent this change can be attributed to selection and breakage of food particles. Eleven patients were tested before and 1-1.5 years after surgery. To determine chewing performance, eight cubes of 8 mm of a silicone rubber (Optosil) were used as a test food. Selection and breakage were determined in one-chew experiments using three particle sizes. On average, no differences were found for chewing performance, selection or breakage. However, on an individual basis, patients with a poor chewing performance before surgery tended to improve, whereas no improvement was observed for patients with a good chewing performance. The change in chewing performance was mainly due to a change in breakage of the food particles.
Um den Einfluss einer Distalbissbehandlung sowie einer kombiniert kieferorthopädisch-chirurgischen Behandlung auf die Kaufähigkeit näher zu untersuchen, wurde bei 103 Probanden mit einer Kaueffektivitätsprüfung das Zerkleinerungsvermögen von Erdnüssen getestet. Hierzu wurden eine erwachsene Kontrollgruppe mit Regelbiss, eine Gruppe nach erfolgreicher Behandlung des Distalbisses mit bleibendem Gebiss, eine Probandengruppe mindestens sechs Monate nach erfolgreicher kieferorthopädisch-kieferchirurgischer Operation, Probanden im Wechselgebiss/Ruhephase mit Regelbiss und Probanden im Wechselgebiss/Ruhephase mit Distalbiss untersucht. Ausserdem wurde die Bedeutung verschiedener Einflussfaktoren wie Alter, Geschlecht, okkludierende Seitenzähne, okklusale Kontaktpunkte sowie Okklusionsfläche geprüft. Es konnte kein signifikanter Einfluss von Alter und Geschlecht auf die Kaueffektivität gefunden werden. Die Anzahl okkludierender Seitenzähne sowie die Okklusionsfläche hingegen stellten wichtige Einflussfaktoren für die Kaueffektivität dar. Der Vergleich von Probanden im Wechselgebiss mit Regelbiss und Probanden im gleichen Alter mit Distalbiss zeigte, dass dieser nicht zu einer geringeren Kaueffektivität führte. Die Kaueffektivität nach einer Distalbissbehandlung war relativ gut, erreichte aber nicht das Niveau von Probanden ohne Behandlung mit neutraler Okklusion. Nach einer kieferorthopädisch-kieferchirurgischen Behandlung blieb der Kaueffekt weiterhin niedriger als bei nicht operierten Probanden mit Regelbiss.
Patients with masticatory dysfunction have a higher incidence of gastrointestinal disorders including gastroesophageal reflux disease (GERD). Masticatory function is significantly lower in patients with skeletal Class III malocclusion than in those with normal occlusion. However, GERD symptoms in patients with skeletal Class III malocclusion are still unknown. The purpose of this study was to examine GERD symptoms and masticatory functions in patients with skeletal Class III malocclusion.
Nineteen adult patients with severe skeletal Class III malocclusion (Class III group) and 20 adults with normal occlusion (control group) participated in this study. The results of the Carlsson-Dent self-administered questionnaire (QUEST) and the frequency scale for the symptoms of GERD (FSSG) were compared between the 2 groups, along with occlusal contact area, maximal voluntary bite force, and salivary flow rate.
The QUEST and FSSG scores were significantly higher in the Class III group. Occlusal contact area and maximal voluntary bite force were significantly smaller in the Class III group. There was no significant difference in the salivary flow rates between the groups.
GERD symptoms were observed more often in patients with skeletal Class III malocclusion than in normal subjects as determined by the questionnaires.
This was a national population-based case-control study in Norway. CASE AND CONTROL SELECTION: Cases consisted of all newborn infants born from 1996-2001 who had been referred for surgical treatment of a cleft [either cleft lip with or without cleft palate (377 children) or cleft palate only (196 children)]. Controls (763) were a randomly selected at an average of four per 1000 live births (identified through the medical birth registry of Norway).
Data were collected using questionnaires. Crude odds ratios (OR) were calculated and adjustments for potential confounders (diet and multivitamins, mother's education, mother's employment during early pregnancy, smoking, alcohol consumption, and year of baby's birth) were made.
Folic acid supplementation during early pregnancy (400 microg/day) was associated with a reduced risk of isolated cleft lip with or without cleft palate after adjustment for multivitamins, smoking, and other potential confounding factors [adjusted OR, 0.61; 95% confidence interval (CI), 0.39-0.96]. Independent of supplements, diets rich in fruits, vegetables and other high-folate-containing foods reduced the risk somewhat (adjusted OR, 0.75; 95% CI, 0.50-1.11). The lowest risk of cleft lip was among women who ate folate-rich diets who also took folic acid supplements and multivitamins (adjusted OR, 0.36; 95% CI, 0.17-0.77). Folic acid provided no protection against cleft palate alone (adjusted OR, 1.07; 95% CI, 0.56-2.03).
Folic acid supplements during early pregnancy seem to reduce the risk of isolated cleft lip (with or without cleft palate) by about a third. Other vitamins and dietary factors may provide additional benefit.
In dentistry 3 aspects may lead to an improvement in the quality of life: pain reduction, aesthetic adjustments, and improvement of masticatory performance. Only the improvement of masticatory performance can be assessed objectively. Althougn orthodontists often claim that they improve masticatory performance, they seldom initiate treatment on the basis of functional limitations. Patients also often express the expectation that orthodontic treatment will improve their oral functions. Chewing is dependent on various anatomical, physiological and physical factors. The combination of all of these factors can reduce food particles to a greater or lesser extent. The magnitude of food reduction is known as masticatory performance. The masticatory performance is related to quality of life since it influences food selection, the quality of digestion, and the experience or enjoyment of eating. The smaller food particles are the easier will be the subsequent enzymatic food digestion during the later phases of digestion. Because it is clear that malocclusions cause functional limitations, it is concluded that orthodontists should integrate functional goals in their treatments in order to improve the quality of life of their patients.
A follow-up study was performed on 44 patients operated with sagittal splitting of the mandibular ramus for correction of a mandibular protrusion. The study included clinical examination, electromyography and masticatory efficiency test as well as radiography of the temporomandibular joint. The maximum opening capacity and protrusion of the mandible decreased one to three years after the operation. The activity of the temporal muscle decreased in rest position after the operation. Masticatory efficiency was unchanged. The position of the condyle in the fossa was unchanged postoperatively, while a posterior and superior condylar movement occurred during the fixation period. Normalization of the condylar position tended to occur one year after the operation. In 37 of 86 condyles, a double contour was seen on the postesuperior margin of the condyle one year after the operation. Possible mechanism behind the development of the new condylar bone layer is discussed.
Many factors influence the food selection and nutritional status of elderly individuals. In this brief review, it is hypothesized that the functional status of dental prostheses is a prime determinant in the food selection, dietary fibre intake and prevalence of gastrointestinal disorders in edentulous elderly subjects.
Electromyographic activities of the temporalis and masseter muscles during mastication were measured in patients who visited this clinic for orthodontic treatment of progenia. The results obtained were compared with those previously obtained in patients with other types of malocclusion and relationships between types of malocclusion and activities of the masticatory muscles were examined. Several interesting results were obtained, including: 1) the muscle activities were significantly higher in patients with deep bite than in patients with any other types of malocclusion and 2) inefficient mastication patterns, evidenced by higher temporalis muscle activities on the balancing side than on the working side, were most frequently observed in patients with edge bite. These results indicate that the clinical evaluation of masticatory muscle activities may be useful in improving orthodontic treatment and in determining a proper retention period after the treatment. The results also suggest that orthodontic treatment should include some type of dynamic myofunctional therapy in addition to the correction of static structural abnormalities.
One hundred and forty-two female patients consulting a prosthodontic clinic for masticatory disturbances and suffering from mandibular ridge atrophy were systematically interrogated for the presence of digestive symptoms. Eight-five subjects (60% of the studied population) reported current digestive complaints; 32 had abdominal pain (burning sensation, bloating or cramps), 12 presented stool transit alteration (constipation or diarrhoea) and 41 reported both abdominal pain and stool transit abnormalities. A prospective evaluation of the digestive symptoms was obtained following surgical reconstruction of the atrophic mandibular ridge and insertion of functional dental prostheses to correct masticatory dysfunction. One year after jaw surgery, 62 of 73 patients (85%) initially complaining of abdominal pain reported symptomatic improvement of their condition, while a marked amelioration in stool habits was noted in 34 of 53 patients (64%) initially suffering intestinal transit alteration. The high incidence of digestive complaints in our patients with dental deficits and the improvement of these symptoms after jaw reconstruction support a case for masticatory failure in the development of digestive symptoms.
In order to analyze orthodontic treatment of adults concerning information, motives and retrospective evaluation 225 patients with fixed appliances were questioned. The dentist had a key position as a mediator of information. The decision to an orthodontic treatment was led by esthetic and functional motives. The extent of the respective motives depended from age, personal status, education and cooperation. Interest and understanding in functional improvements as they could be found above all by people with a higher education level were decisive for a durable regard of the treatment.
The aim of this study was to analyse the influence of activator treatment on chewing efficiency. The subject material consisted of 60 children, adolescents and adults: Twelve children (ten years of age) with a Class II, Division 1 malocclusion were treated successfully with activators to a normal occlusion (16 years of age). Three normal occlusion samples, ten years (n = 12), 16 years (n = 12) and 29 years (n = 12) of age as well as an untreated Class II sample (n = 12), 16 years of age, served as control groups to the activator patients. The chewing ability was evaluated with the aid of a chewing efficiency test. The dental occlusion was appraised on dental casts. Recordings were made of number of erupted teeth, number of intermaxillary occlusal tooth contacts, overjet and overbite. The results revealed that chewing efficiency in activator patients was doubled from ten to 16 years of age. When comparing untreated subjects 16 years and ten years of age a greater chewing efficiency was seen in the older subjects. This was true for both Class II malocclusion and normal occlusion cases. Furthermore, in 16 year old subjects the chewing efficiency was comparable in treated and untreated normal occlusions as well as untreated Class II malocclusions. Thus, the investigation did not ascertain whether activator treatment per se resulted in an improved chewing efficiency. Furthermore, in the activator group no direct association existed between improvement in chewing efficiency and increased number of erupted teeth on one hand and increased number of intermaxillary occlusal tooth contacts, reduced overjet and overbite on the other. It is suggested that chewing efficiency is partly age related. The sagittal intermaxillary dental arch relationship doesn't seem to play an important role in determining chewing ability. However, harmonious interplay between the occluding teeth and the muscles influencing them (the muscles of mastication, the tongue-, lip- and cheek-musculature) is certainly of importance.
A sample consisting of 50 adult subjects aged between 21–23 years was assessed for their masticatory ability, by the use of a masticatory efficiency test. The occlusal status was assessed from study models using five occlusal indices. The scores obtained from the masticatory efficiency tests were correlated to those obtained from the occlusal analyses, using a correlation coefficient test. Significant correlations were found between the two scores.
A multiple regression analysis was used to predict the masticatory efficiency from the occlusal scores. The findings revealed that only a small proportion of the masticatory efficiency could be predicted. This suggested that factors other than those used in these indices may have an effect on the masticatory efficiency.
Masticatory efficiency, the subjective experience of masticatory performance, and dietary intake were measured for 43 subjects who were provided with new complete dentures. The subjects were tested on three occasions: with the old complete dentures, with the new complete dentures when free from symptoms, and with the new dentures about 4 months after insertion. Masticatory efficiency and the subjective experience of masticatory performance increased significantly when the subjects were provided with new dentures, but no changes were found in the dietary intake. With the new dentures the masticatory efficiency and the subjective experience of masticatory performance were correlated to each other.
Using both quartz- and foil-based piezo-electric force transducers, occlusal forces during swallow, simulated chewing, and maximum effort were evaluated in 19 long-face and 21 normal individuals. Forces were measured at 2.5 mm and 6.0 mm molar separation. Long-face individuals have significantly less occlusal force during maximum effort, simulated chewing, and swallowing than do individuals with normal vertical facial dimensions. No differences in forces between 2.5- and 6.0-mm jaw separation were observed for either group.
Human food selection is dependent on a complex interaction of biological, environmental, cultural and behavioural influences. Numerous studies have provided evidence that food choice is guided neither by physiologic need nor item availability. The widespread prevalence of tooth loss seen in the elderly and the impact of impaired masticatory ability on food selection patterns is often overlooked. Available information suggests that declining masticatory function is, in a large part, responsible for the elderly consuming predominantly soft, easy to chew foods, which, in turn, can induce poor dietary practices and marginal nutritional intakes. It appears that with appreciable tooth loss there is a related decline in masticatory function; significant alterations also take place in certain perceptual and sensory measures. Generally, these perceptual changes reflect alterations in taste and texture preferences; phenomena which persist even after appropriate restorative dental therapy for missing teeth, with either removable partial or complete dentures. It has long been known that full denture wearers experience a reduction in flavour perception after the insertion of their prostheses. In the elderly the generalized decrease in ability to enjoy food has, in part, been attributed to flavour disturbances associated with their dentures. Whether the sensory loss is, to a large degree, due to the prostheses, or primarily reflects age-associated changes in the gustatory and olfactory receptors, is still being explored. The information presented suggests that persons with impaired dentitions , both with and without a dental prosthesis, may impose upon themselves certain dietary restrictions which, in time, can compromise their nutritional status and ultimately place them at health risk.
The effect of continuous bite jumping on the masticatory system was investigated in 20 boys with Class II, Division 1 malocclusion treated with the Herbst appliance for six months. The range of mandibular movement and dysfunction symptoms in the TMJ and associated musculature were examined clinically. Masticatory function was evaluated by a masticatory efficiency test combined with EMG registrations of temporal and masseter muscle activity.
Lateral mandibular movement capacity was reduced by an average of 1.9 mm during six months of bite jumping, but increased to the pre-treatment level twelve months after appliance removal. The frequency of joint muscle tenderness increased during the first three months of bite jumping. After six months of treatment most symptoms had subsided.
Masticatory efficiency and temporal and masseter muscle activity were markedly reduced during the first three months of bite jumping but increased, on average, to pre-treatment values after six months of treatment. Subjectively, the patients experienced chewing and biting difficulties only during the first 7–10 days of treatment.
It was concluded that treatment of Class II malocclusions by continuous bite jumping with the Herbst appliance resulted in minor functional disturbances in the masticatory system. These disturbances were temporary, appearing mainly at the beginning of treatment.
To acquire more information concerning the changes of the oral functions in shortened dental arches, a cross-sectional clinical investigation was carried out among 118 subjects. They were classified into six classes, according to the degree and the symmetry of the shortened condition. The method was based on the measuring of variables which were derived from the oral function. The results showed two patterns of change in oral functions: oral functions that change slowly until four occlusal units are left and then change rapidly, and oral functions that change progressively without a sudden change. The preliminary conclusion is that there is sufficient adaptive capacity to maintain adequate oral function in shortened dental arches when at least four occlusal units are left, preferably in a symmetrical position.
Individuals with developmental deformities of the jaws may be less efficient at chewing food. Previous studies have reported masticatory deficiency in patients with such deformities. This study was designed to detect any changes in masticatory performance that accompany orthognathic surgery.
Masticatory performance was tested in 18 patients with various jaw deformities before application of orthodontic appliances and 2 to 3 years after surgical correction of their malocclusion. A control group was tested at three 6-month intervals. The subjects chewed carrots and masticatory performance was measured using a standard sieve technique. The Rosin-Rammler equation was used to calculate the median particle size and broadness index of each set of carrots. The number of chewing cycles required for each subject to swallow one piece of carrot was also recorded.
A statistically significant difference in median particle size between patients and controls was found both preoperatively and postoperatively (P < .05), but no difference in median particle size or broadness index was seen between trials for controls or patients (P > .05).
It was concluded that before surgery patients have a lower level of performance than controls and surgical correction of the malocclusion does not significantly enhance performance.
This study tested the null hypothesis that there are no differences in dietary patterns or adequacy between edentulous patients and individuals with nearly complete dentitions. The research design involved comparing the dietary patterns and adequacies of 34 edentulous subjects who regularly wear dentures with 38 subjects who had nearly complete dentitions. The subjects were between the ages of 51 and 83 years and were sampled from patients attending Case Western Reserve University Dental Clinic. Although edentulous subjects were more likely to claim that they had trouble chewing their food, they were not more likely to select easy-to-chew foods. On the other hand, the diet of dentate subjects tended to be superior to that of edentulous subjects, as indicated by a lower fat and cholesterol consumption and a higher consumption of protein and all of the vitamins and minerals (significantly or nearly significantly for vitamin A, ascorbic acid, calcium, and riboflavin).