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Mastication plays a primary role in the process of eating. Hence, compromised masticatory ability may affect the nutrition and quality of life, which are particularly important concerns among older individuals. It remains unclear how is the masticatory ability assessed regarding the nutritional status. We examined the effect of various oral factors on three masticatory ability tests conducted among older individuals. A total of 100 older individuals were enrolled in this study. Body mass index (BMI) as an indicator of nutritional status, and age, sex, and the number of occlusal and molar occlusal supports as clinical attributes were recorded. Three masticatory ability tests (masticatory efficiency, masticatory score, and satisfaction with mastication) were conducted, and tongue pressure, cheek pressure, and occlusal force were assessed as oral functions. A significant but weak correlation was found between masticatory efficiency and the masticatory score, but not between masticatory efficiency and satisfaction score. Objective masticatory efficiency was strongly associated with objective oral factors, whereas subjective assessments of masticatory ability (masticatory score and satisfaction score) were not. Furthermore, BMI was significantly associated with subjective assessments of masticatory ability but not with objective masticatory efficiency. Both subjective and objective assessments of masticatory ability, along with considerations of nutritional formulations, are required for the maintenance and improvement of nutritional status in older individuals.

We previously studied the effect of peripheral sensory information from sensory periodontal ligament receptors on prefrontal cortex (PFC) activity. In the dental field, an alternative dental implant without periodontal sensation can be applied for missing teeth. In this study, we examine whether periodontal tactile input could increase cerebral blood flow (CBF) in the PFC against elderly patients with dental implants lacking periodontal tactile (implant group), elderly individuals with natural teeth (elderly group), and young individuals with natural teeth (young group). The experimental task of maintaining occlusal force as closed-loop stimulation was performed. Compared with the young group, the elderly group showed significantly lower CBF. Contrastingly, compared with the young group, the implant group showed significantly lower CBF. There were no significant differences between the elderly and implant groups. Regarding the mean occlusal force value, compared with the young group and the elderly group, the implant group had a numerically, but not significantly, larger occlusal force exceeding the directed range. In conclusion, the periodontal tactile input does not uniquely increase PFC activity. However, increased CBF in the PFC due to the periodontal tactile input in the posterior region requires existing attention behavior function in the PFC.

The purpose of this study was to evaluate the influence of various polishing protocols on the surface roughness of polyetheretherketone (PEEK) and identify an effective polishing method of dental prostheses at the chairside. The PEEK specimens were assigned to seven groups with different protocols: no additional polishing (NT); polishing using a rubber point (C); polishing using "silky shine" (S); polishing using "aqua blue paste" (A); protocol C followed by protocol S (CS); protocol C followed by protocol A (CA); and protocol C followed by protocols S and A (CSA). The surface roughness (Sa and Ra) of the polished surfaces was measured. The surface roughness decreased in the following order of groups: NT, C, S, CS, CSA, CA, and A. In Groups C and S, wide deep pits formed by abrasive grains of SiC paper were observed, whereas only fine linear structures were observed on the surface in other groups. With respect to the polishing protocol of PEEK, clinically acceptable surface roughness was obtained using a soft polishing brush and agent for more than 3 min.

Purpose To evaluate the antifungal activity and mechanical properties of a novel antifungal tissue conditioner containing Juncus powder. Materials and methods Juncus powder was mixed with GC tissue conditioner at concentrations of 2.5%, 5.0%, and 10.0% by mass. The cylindrical specimens of Juncus-mixed tissue conditioner (dimensions: 10 mm in diameter and 2 and 6 mm in height for antimicrobial and mechanical tests, respectively) were prepared. The specimens placed on the bottom of the 24-well tissue culture plate were cultured with Candida albicans CAD1 for 2 and 4 days. The proliferation of the C. albicans in the wells was determined by measuring the optical density of fungal culture, and the surface of the specimens were also observed by scanning electron microscopy (SEM). To assess the mechanical properties of the specimens, the fluidity and hardness of Juncus-mixed tissue conditioner were measured using the methods certified according to ISO 10139-1. Results Juncus-mixed tissue conditioner significantly exhibited growth inhibitory effect in a Juncus concentration-dependent manner after both 2- and 4- day cultures. SEM observation showed that the amount of C. albicans on Juncus-mixed specimens drastically decreased, and biofilm formation was markedly inhibited. Moreover, both mechanical properties were found to be within the ranges regulated and specified by ISO. Conclusion These findings demonstrated that the tissue conditioner including Juncus powder has a significant growth inhibitory effect against C. albicans, and it is suggested that the application of Juncus-mixed tissue conditioner may prevent denture stomatitis and oral candidiasis in denture wearers.

Purpose To introduce a new clinical procedure for fabricating duplicates of complete dentures by bite pressure impression using digital technology, and to discuss its clinical significance. Methods The denture is placed on a rotary table and the 3-dimensional form of the denture is digitized using a general-purpose handheld optical scanner. The duplicate denture is made of polylactic acid by a 3-dimensional printer using the 3-dimensional data. Conclusion This procedure has the advantages of wasting less material, employing less human power, decreasing treatment time at the chair side, lowering the rates of contamination, and being readily fabricated at the time of the treatment visit.

AIM To demonstrate the usefulness of a virtual reality device that authentically portrays the emotions of dementia patients and their families (VR Dementia Experience) for encouraging an understanding of and reducing and eliminating prejudice towards dementia patients among local residents. METHOD In Prefecture T, Town N, 85 residents of Neighborhood A were chosen as the intervention group, and 95 residents of Neighborhood B were chosen as the non-intervention group. The VR Dementia Experience was provided only to the residents of Neighborhood A. Residents of both neighborhoods completed a 35-item questionnaire regarding their degree of understanding and prejudice towards dementia patients before and after the intervention. RESULTS Seventy-seven residents of Neighborhood A and 82 residents of Neighborhood B were analyzed. Their gender, age, and pre-intervention test baseline values were equivalent in the degree of understanding and prejudice. Significant increases were observed in 9 of 35 items for Neighborhood A residents (7 understanding-related, 2 prejudice-related) and 2 items for Neighborhood B residents (1 understanding-related, 1 prejudice-related). To ascertain the usefulness of the VR Dementia Experience, we compared the number of items with a significant increase: 9/35 (25.7%) in Neighborhood A and 2/35 (5.7%) in Neighborhood B. An effect (≥ 20%) was observed among the residents of Neighborhood A. Furthermore, after exposure to the VR Dementia Experience, the connection between understanding, prejudice, and dementia was strengthened among the residents of Neighborhood A compared to the residents of Neighborhood B. CONCLUSION The VR Dementia Experience is a useful tool for encouraging an understanding of and reducing and eliminating prejudice towards dementia patients among local residents. However, to encourage the widespread usage of the technology, we should compare results with other public awareness campaigns as well as make improvements to the device and its VR content.

Background: No report has yet examined the impact of oral hypofunction on physical frailty in relation to intra‐relationships of physical frailty assessment items. The purpose of this study was to verify the potential of a clinical cascade between oral hypofunction and physical frailty, and especially to support the hypothesis that the influence of oral hypofunction on physical frailty is greater than the intra‐relationships among elements of physical frailty, and that sex differences significantly affect these relationships. Methods: The participants were 272 older adults (101 men and 171 women; mean age 75.1 ± 7.5 years). Maximum occlusal force (MOF) and oral dryness (OD), as indicators of oral hypofunction, and grip strength (GS) and walking speed (WS), as indicators of physical frailty, were measured. Mutual relationship of four variables was verified using covariance structure analysis. Results: In men, three paths from MOF to WS and GS and from WS to GS were confirmed, and those from MOF to WS and from WS to GS were found to be significant (p < 0.01). In women, three paths from MOF to WS and GS and from WS to GS were also confirmed, as with the men, and those from MOF to WS and from MOF to GS were found to be significant (p < 0.01). Model adaptability was shown to be good for both men and women. Conclusion: The results suggest our hypothesis was verified, and it is expected that the early detection of oral hypofunction, that is, MOF, may be important for assessing physical frailty, especially in women.

Purpose The present study aimed to examine three methods for imaging a complete denture form and to discuss the geometric assessment and availability of these methods. Methods Three methods were used: cone-beam computed tomography (CBCT), desktop dental scanning (DDS), and handheld optical scanning (HOS). Three sides of a cuboid resin block of a known size were measured on the captured images. Ten upper and lower complete dentures were digitized using each of the three methods. The denture forms in the standard triangulated language format were reconstructed using the computer aided design software with three resolutions: 0.1, 0.5 and 1.0. The two images were superimposed through a least-square algorithm, and the mean differences were examined among the three types of imaging methods and resolutions. Results The smallest mean differences and variations were obtained for CBCT and DDS, followed by HOS in the experiment using resin block. The lengths of longitudinal and horizontal sides were shortened in CBCT and DDS, whereas the height was shortened in HOS. The variations in each direction were very small by repetitive imaging within every imaging method. The difference between the CBCT and DDS was significantly smaller than that in the other two groups in experiment using actual dentures. The influence of resolution was comparatively low. Conclusions The results suggested that CBCT and DDS had a similar geometric assessment, but that of the HOS was lower.

Denture plaque is a biofilm composed of various microorganisms aggregated with saliva. Various denture cleansers and cleaning apparatuses have been developed and studied. However, the optimum water temperature for denture cleaning is unknown. Therefore, the present study investigated the effects of water temperature during ultrasonic denture cleaning. In vitro, resin disks with artificial Candida albicans biofilm were pressed onto Candida GE media after ultrasonic cleaning with water at different temperatures for 5 min. The media were subsequently cultured at 37°C for 24 h. The colonies formed were observed and colony areas were quantified using ImageJ software (US National Institutes of Health, Bethesda, MD, USA). In situ, the bacterial count and degree of cleanliness on the tissue surface of maxillary dentures were measured before and after ultrasonic cleaning with water at different temperatures for 5 min. Changes in bacterial counts and cleanliness were calculated for each temperature. The ratio of the area occupied by bacterial colonies in vitro and reduction rates in situ after cleaning with warm water were markedly less than those observed after cleaning with cold water. Therefore, ultrasonic denture cleaning with warm water is more effective.

The purpose of this study was to survey the changes that occur in bolus texture from intake to swallowing during the mastication process for four types of food materials and to identify how texture is related to the number of chews. We recruited 15 young Japanese participants for this study. The subjects were asked to spit the food bolus just before swallowing when eating four different foods: cracker, boiled rice, hard gelatine gel, and soft gelatine gel. Three physical properties (hardness, adhesiveness, and cohesiveness) were measured in the bolus after being chewed for 25, 50, 75, 100, and 125% of the normal number of chews. Occlusal force and pressure as well as stimulated whole saliva volume were also measured. Extensive variation in the number of chews existed between subjects, but minimal intra-subject variation was observed. Hardness was observed to decrease, whereas cohesiveness and adhesiveness increased in a chew-dependent manner for the cracker, soft gelatine gel, and hard gelatine gel, but not boiled rice. Bolus texture appears to be largely related to the number of chews. Hardness also tended to be influenced by occlusion. The adhesiveness and hardness of the boiled rice were also greatly influenced by saliva volume and occlusal force, respectively. Hardness is an important rheological factor in food bolus texture and likely plays a significant role in determining the appropriate number of chews. Adhesiveness and cohesiveness appear to be secondary factors in this process. Practical applications We propose a model of oral processing for application in determining the appropriate number of chews for an individual. Hardness appears to be an important rheological factor in food bolus texture, with adhesiveness and cohesiveness being secondary aspects. When food is hard or difficult to swallow, chewing behavior will likely be more influenced by the perception of bolus texture.

The prosthetic applications of titanium have been challenging because titanium does not possess suitable properties for the conventional casting method using the lost wax technique. We have developed a production method for biomedical application of porous titanium using a moldless process. This study aimed to evaluate the physical and mechanical properties of porous titanium using various particle sizes, shapes, and mixing ratio of titanium powder to wax binder for use in prosthesis production. CP Ti powders with different particle sizes, shapes, and mixing ratios were divided into five groups. A 90:10wt% mixture of titanium powder and wax binder was prepared manually at 70°C. After debinding at 380°C, the specimen was sintered in Ar at 1100°C without a mold for 1h. The linear shrinkage ratio of sintered specimens ranged from 2.5% to 14.2%. The linear shrinkage ratio increased with decreasing particle size. While the linear shrinkage ratio of Groups 3, 4, and 5 were approximately 2%, Group 1 showed the highest shrinkage of all. The bending strength ranged from 106 to 428MPa under the influence of porosity. Groups 1 and 2 presented low porosity followed by higher strength. The shear bond strength ranged from 32 to 100MPa. The shear bond strength was also particle-size dependent. The decrease in the porosity increased the linear shrinkage ratio and bending strength. Shrinkage and mechanical strength required for prostheses were dependent on the particle size and shape of titanium powders. These findings suggested that this production method can be applied to the prosthetic framework by selecting the material design.

Simvastatin is a cholesterol-lowering drug known to affect bone formation in vivo and its sustainable administration into localized areas is of particular interest in the dental field. Two simvastatin-loaded poly(lactic-co-glycolic acid) (PLGA) formulations (PLGA microspheres and PLGA nanospheres) were compared to investigate whether a sustainable supply of simvastatin from a PLGA-based carrier is effective for bone regeneration. PLGA microspheres successfully presented sustained release of simvastatin for one month, whereas simvastatin was continuously released from PLGA nanospheres for one week. The difference of drug release pattern between two PLGA particles was confirmed by Korsmeyer–Peppas mathematical model. PLGA microspheres and simvastatin alone (no carrier) induced the proliferation MC3T3-E1 cells and increased alkaline phosphatase (ALP) activity, a differentiation marker of MC3T3-E1 cells, whereas PLGA nanospheres did not. These results suggested that PLGA nanospheres had an adverse effect on bone generation in vitro due to the production of PLGA metabolized products. Both PLGA microspheres and PLGA nanospheres provided a bone formation effect in an in vivo rat calvaria bone defect model and PLGA microspheres were superior to PLGA nanospheres. Our data suggest that simvastatin-loaded PLGA microspheres can release simvastatin sustainably and induce bone formation more efficiently than PLGA nanospheres, thus promoting bone regeneration.

Purpose There are two key considerations for successful esthetic dental treatments. This article systematically describes the two key considerations: the end points of esthetic dental treatments and assessments of esthetic outcomes, which are also important for acquiring clinical skill in esthetic dental treatments. Study selection The end point and assessment of esthetic dental treatment were discussed through literature reviews and clinical practices. Results Before designing a treatment plan, the end point of dental treatment should be established. The section entitled "End point of esthetic dental treatment" discusses treatments for maxillary anterior teeth and the restoration of facial profile with prostheses. The process of assessing treatment outcomes entitled "Assessments of esthetic dental treatment" discusses objective and subjective evaluation methods. Conclusions Practitioners should reach an agreement regarding desired end points with patients through medical interviews, and continuing improvements and developments of esthetic assessments are required to raise the therapeutic level of esthetic dental treatments.

Few studies have reported the application of digital technology to removable dentures, particularly for the process of impression and interocclusal recording for complete denture fabrication. This article describes a part-digitizing system of impression and interocclusal records for complete denture fabrication. The denture foundation area in an edentulous mouth, including the border areas and residual ridge, is outlined by tracing the surfaces with a 3-D pen-type digitizer. Specialized trays for final impressions and interocclusal records were generated using computer-aided design and manufactured using the digital data. Final impression and interocclusal records were carried out using these specialized trays. The computer-aided method using preliminary digital impressions and specialized trays would be feasible for clinical use for complete denture fabrication.

In this study, we evaluated the reliability and reproducibility of widely implemented salivary flow rate and oral dryness tests. In experiment 1, twenty young and healthy Japanese participants volunteered to participate. For each participant, the oral moisture (OM) level, unstimulated whole saliva volume (U-WSV), and stimulated whole saliva volume (S-WSV) were measured at the same time on two separate days. In experiment 2, twenty-seven patients who were over 65 years of age volunteered to participate. The OM level and U-WSV were measured at the same time on two separate days. In Experiment 1, the intra-class correlation coefficients (ICCs) corresponding to the S-WSV, U-WSV, and OM level were 0.23, 0.28, and 0.16, respectively, for the young participants. In Experiment 2, the ICCs corresponding to the U-WSV/spitting and OM level were 0.83 and 0.12, respectively, for the older participants. The results of Bland&ndash, Altman analysis confirmed the absence of systematic error, with the exception of the OM level results in Experiment 2, which indicated systematic bias. In conclusion, we believe that there is currently no consistent and reliable screening test for assessing salivary flow rate and oral dryness, although the spitting test was determined to be highly reliable.

Objective assessments of oral hygiene are important to prevent oral and systemic diseases. Two objective assessment tests are available to assess oral hygiene, (1) the adenosine triphosphate (ATP) + adenosine monophosphate (AMP) swab test, which incorporates a luciferase assay and (2) a bacteria count using the dielectrophoretic impedance measurement (DEPIM) method. In this study, we compared the two tests using a subjective visual assessment by professional clinicians and investigated the clinical significance of these tests. Twenty-seven young participants (mean age 26.3 &plusmn, 3.2 years) and twenty-seven older participants (mean age 75.1 &plusmn, 5.9 years) were recruited. Oral bacteria were sampled from three areas, including the tongue dorsum, the buccal mucosa, and the faucal mucosa, and saliva was obtained using a cotton swab. The amount of ATP + AMP and the number of bacteria were measured by each specific apparatus. Additionally, one examiner assessed the overall condition of oral hygiene using the visual analog scale (VAS). In the ATP + AMP swab test, the means were highest in saliva. For the bacteria count, the means were higher in the tongue dorsum and saliva and lower in the faucal and buccal mucosa. The results of the subjective assessment of oral hygiene indicated that the VAS-value was 3.78 &plusmn, 0.97 for the young group and 3.35 &plusmn, 0.81 for the older group. No significant difference was observed between the two groups. Additionally, no significant relationship between the values of the ATP + AMP swab test and the bacteria count was found for any of the four sample sites. In the older group, the subjective assessment of oral hygiene was significantly correlated with the values of the ATP + AMP swab test (multiple correlation coefficient = 0.723, p = 0.002). In conclusion, the values provided by the ATP + AMP swab test were not always correlated to the bacteria count. The results of this study suggest that the subjective assessment of oral hygiene was more highly correlated with the results of the ATP + AMP swab test, as compared to the bacterial count assay.

Polyetheretherketone (PEEK) is a semi-crystalline linear polycyclic thermoplastic that has been proposed as a substitute for metals in biomaterials. PEEK can also be applied to dental implant materials as a superstructure, implant abutment, or implant body. This article summarizes the current research on PEEK applications in dental implants, especially for the improvement of PEEK surface and body modifications. Although various benchmark reports on the reinforcement and surface modifications of PEEK are available, few clinical trials using PEEK for dental implant bodies have been published. Controlled clinical trials, especially for the use of PEEK in implant abutment and implant bodies, are necessary.

Background Behaviors relating to food intake, i.e., speed of chewing, number of chews, and bite size, are important for decreasing energy intake, which might reduce excess body weight and thus metabolic risk. This study aimed at investigating the influence of mouthful volume on the number of chews and food bolus properties in addition to clarifying appropriate eating behaviors related to mouthful volume. Methods Fifteen young Japanese women volunteered to participate. The subjects were asked to spit the food bolus in a glass dish just before swallowing when eating 3 different foods: boiled rice, fish sausage, and peanuts. The 3 physical properties of solidity, adhesiveness, and cohesiveness were measured in the bolus, and the number of chews was noted. Results The number of chews significantly increased with increasing mouthful volume with all 3 foods; conversely, the number of chews per unit of food weight (g) decreased significantly with boiled rice and fish sausage. Trends were observed for solidity and cohesiveness, which varied with increasing mouthful volumes. Conclusions Decreased mouthful volume resulted in a greater number of chews per weight of food and more appropriate bolus properties; therefore, a change in mouthful volume could be a useful behavior modification for regulation of energy intake.

Purpose This in vitro study investigated the effect of attachment installation conditions on the load transfer and denture movements of implant overdentures, and aims to clarify the differences among the three types of attachments, namely ball, Locator, and magnet attachments. Materials and Methods Three types of attachments, namely ball, Locator, and magnetic attachments were used. An acrylic resin mandibular edentulous model with two implants placed in the bilateral canine regions and removable overdenture were prepared. The two implants and bilateral molar ridges were connected to three-axis load-cell transducers, and a universal testing machine was used to apply a 50 N vertical force to each site of the occlusal table in the first molar region. The denture movement was measured using a G2 motion sensor. Three installation conditions, namely, the application of 0, 50, and 100 N loads were used to install each attachment on the denture base. The load transfer and denture movement were then evaluated. Results The resultant force decreased with increasing installation load for all attachments. In particular, the resultant force on implants on the loading side of the Locator attachment significantly decreased when the installation load was increased from 0 to 50 N, and that for magnetic attachment significantly decreased when the installation load was increased from 50 to 100 N. For the residual ridges on the loading side, the direction of the forces for all attachments changed to downward with increasing installation load. Furthermore, the yaw Euler angle increased with increasing installation load for the magnetic attachment. Conclusions Subject to the limitations of this study, the use of any installation load greater than 0 N is recommended for the installation of ball and Locator attachments on a denture base. Regarding magnetic attachments, our results also recommend installation on a denture base using any installation load greater than 0 N, and suggest that the resultant force acting on the implant can be decreased by increasing the installation load; however, a large installation load of 100 N should be avoided when installing the attachment on the denture base to avoid increasing the denture movement.

Ni is the most frequent cause of contact allergy induced by metals. However, the underlying mechanism of this induction is unknown. Our previous research demonstrates that activation of dendritic cells (DCs) through p38MAPK/MKK6 is required for Ni-induced allergy in mice. In the current study, we investigated the cellular and molecular mechanisms underlying Ni-induced allergy using a mouse model that involves injecting Ni into the ear, with or without Freund’s incomplete or complete adjuvants. Nickel had greater potential to cause allergic reactions compared with palladium and gold. Among the proteins expressed at higher levels in mice with Ni-induced allergy, we focused on thymic stromal lymphopoietin (TSLP), which is produced in abundance by keratinocytes. We detected increased expression of the TSLP receptor (TSLPR) in DCs from cervical lymph nodes of mice with Ni-induced allergy, suggesting that DCs in ear tissues were activated through TSLPR signaling induced by keratinocyte-derived TSLP. Furthermore, delayed-type hypersensitivity reactions in mice with Ni-induced allergy were decreased significantly by injection of a Tslp–short interfering RNA along with atelocollagen in the ear skin. These results suggest that Ni allergy may be triggered by a TSLP/TSLPR-mediated interaction between epithelial and immune cells.

The Japan Prosthodontic Society developed a multi-axis assessment protocol to evaluate the complex variations in patients who need prosthodontic care, and to classify the level of treatment difficulty. A previous report found the protocol to be sufficiently reliable. The purpose of this multi-center cohort study was to evaluate the validity of this multi-axis assessment protocol.The treatment difficulty was evaluated using the multi-axis assessment protocol before starting prosthodontic treatment. The time required for active prosthodontic treatment, medical resources such as treatment cost, and changes in the oral health-related QOL before and after treatment, were evaluated after treatment completion. The construct validity of this protocol was assessed by the correlation between the dentist's pre-operative subjective assessment of the treatment difficulty, and the level of difficulty determined by this protocol. The predictive validity was assessed estimating the correlations between a "comprehensive level of treatment difficulty" based on the four axes of this protocol and total treatment cost, total treatment time, and changes in the oral health-related QOL before and after treatment.The construct validity of this protocol was well documented except for psychological assessment. Regarding the predictive validity, the comprehensive level of treatment difficulty assessed before treatment was significantly correlated with the three surrogate endpoints known to be related to the treatment difficulty (total treatment cost, treatment time, and improvement in the oral health-related QOL). To further clarify the validity of the protocol according to patients' oral condition, a subgroup analysis by defects was performed. Analyses revealed that treatment difficulty assessment before treatment was significantly related to one or two surrogate endpoints in the fully edentulous patients and the partially edentulous patients. No significant relationship was observed in the patients with mixture of full/partial edentulism and the patients with teeth problems, possibly due to the small sample size in these groups.This study revealed that the multi-axis assessment protocol was sufficiently valid to predict the level of treatment difficulty in prosthodontic care in patients with fully edentulous defects and with partially edentulous defects.

The prefrontal cortex (PFC) plays a role in complex cognitive behavioural planning, decision-making, and social behaviours. However, the effects of sensory integration during motor tasks on PFC activation have not been studied to date. Therefore, we investigated the effect of peripheral sensory information and external information on PFC activation using functional near-infrared spectroscopy (fNIRS). Cerebral blood flow (CBF) was increased around bilateral Brodmann areas 46 and 10 during visual and auditory information integration during an occlusal force (biting) task. After local anesthesia, CBF values were significantly decreased, but occlusal force was similar. In conclusion, the effects of peripheral sensory information from the periodontal ligament and external information have minimal impacts on occlusal force maintenance but are important for PFC activation.

Clasp retainers made of metal alloys may be esthetically unappealing or cause allergic reactions. To investigate alternative materials, we used the nonfiller polyetheretherketone (PEEK) to fabricate the clasp retainer of a removable partial denture for the mandibular bilateral distal free-end abutment of an 84-year-old female. Two years later, few color and texture changes of PEEK were found macroscopically. The rest part and the clasp arm fitted well without any deformation. There were no particular occlusal or periodontal problems. Subjective satisfaction was expressed by both the practitioner and the patient.

Tailor-made porous titanium implants show great promise in both orthopedic and dental applications. However, traditional powder metallurgical processes require a high-cost mold, making them economically unviable for producing unique devices. In this study, a mixture of titanium powder and an inlay wax binder was developed for moldless forming and sintering. The formability of the mixture, the dimensional changes after sintering, and the physical and mechanical properties of the sintered porous titanium were evaluated. A 90:10 wt % mixture of Ti powder and wax binder was created manually at 70°C. After debindering, the specimen was sintered in Ar at 1100°C without any mold for 1, 5, and 10 h. The shrinkage, porosity, absorption ratio, bending and compressive strength, and elastic modulus were measured. The bending strength (135-356 MPa), compression strength (178-1226 MPa), and elastic modulus (24-54 GPa) increased with sintering time; the shrinkage also increased, whereas the porosity (from 37.1 to 29.7%) and absorption ratio decreased. The high formability of the binder/metal powder mixture presents a clear advantage for fabricating tailor-made bone and hard tissue substitution units. Moreover, the sintered compacts showed high strength and an elastic modulus comparable to that of cortical bone.

BackgroundThe diagnostic assessment of the level of difficulty in treating patients who need prosthodontic care is useful to establish a medico-economically efficient system with primary care dentists and prosthodontic specialists.Materials and methodsA multi-axis assessment protocol was established using the newly established treatment difficulty indices. The protocol contains Axis I: oral physiological conditions (e.g., teeth damage and/or missing teeth); Axis II: general health and sociological conditions (e.g., medical disorders); Axis III: oral health-related quality of life (OHRQOL; e.g., oral health impact profile: OHIP); and Axis IV: psychological health (e.g., mood, anxiety, somatoform disorders). A preliminary study on the test–retest consistency of the protocol was conducted to check the levels of reliability of the indices prior to a large-scale, multi-center cohort study on the validity of the protocol.ResultsThe test–retest consistency in terms of the oral physiological condition (Axis I) after data reduction was 0.63 for patients with teeth problems, 0.95 for partially edentulous patients, and 0.62 for edentulous patients. The reliability for general health and sociological conditions (Axis II), OHRQOL (Axis III), and psychological health (Axis IV) were 0.88, 0.74, and 0.61, respectively. These values reflect either “sufficient agreement” or “excellent agreement” in accordance with the criteria established by Landis and Koch (1977) [1].ConclusionThis protocol is the first multi-axis assessment scheme introduced for prosthodontic treatment with sufficient reliability. This new system is therefore expected to have a significant impact on future dental diagnostic nomenclature systems.

Two-implant overdentures have become the accepted treatment for restoring mandibular edentulism. The dimensions of regular implants sometimes limit their use, such as in the case of narrow ridges. Mini-implants with reduced diameters (less than 3.0 mm) enable insertion into narrow ridges. A magnet-retained two-mini-implant overdenture system was developed and is described in this paper. Additionally, we describe a clinical mandibular procedure using the system and evaluate its biomechanical performance.

We developed an innovative procedure for digitizing maxillary edentulous residual ridges with a photogrammetric system capable of estimating three-dimensional (3D) digital forms from multiple two-dimensional (2D) digital images. The aim of this study was to validate the effectiveness of the photogrammetric system.Impressions of the maxillary residual ridges of five edentulous patients were taken with four kinds of procedures: three conventional impression procedures and the photogrammetric system. Plaster models were fabricated from conventional impressions and digitized with a 3D scanner. Two 3D forms out of four forms were superimposed with 3D inspection software, and differences were evaluated using a least squares best fit algorithm.The in vitro experiment suggested that better imaging conditions were in the horizontal range of ± 15 degrees and at a vertical angle of 45 degrees. The mean difference between the photogrammetric image (Form A) and the image taken from conventional preliminarily impression (Form C) was 0.52 ± 0.22 mm. The mean difference between the image taken of final impression through a special tray (Form B) and Form C was 0.26 ± 0.06 mm. The mean difference between the image taken from conventional final impression (Form D) and Form C was 0.25 ± 0.07 mm. The difference between Forms A and C was significantly larger than the differences between Forms B and C and between Forms D and C.The results of this study suggest that obtaining digital impressions of edentulous residual ridges using a photogrammetric system is feasible and available for clinical use.

To evaluate the antifungal activity and mechanical properties of a novel antifungal tissue conditioner containing Juncus powder.Juncus powder was mixed with GC tissue conditioner at concentrations of 2.5%, 5.0%, and 10.0% by mass. The cylindrical specimens of Juncus-mixed tissue conditioner (dimensions: 10 mm in diameter and 2 and 6 mm in height for antimicrobial and mechanical tests, respectively) were prepared. The specimens placed on the bottom of the 24-well tissue culture plate were cultured with Candida albicans CAD1 for 2 and 4 days. The proliferation of the C. albicans in the wells was determined by measuring the optical density of fungal culture, and the surface of the specimens were also observed by scanning electron microscopy (SEM). To assess the mechanical properties of the specimens, the fluidity and hardness of Juncus-mixed tissue conditioner were measured using the methods certified according to ISO 10139-1.Juncus-mixed tissue conditioner significantly exhibited growth inhibitory effect in a Juncus concentration-dependent manner after both 2- and 4- day cultures. SEM observation showed that the amount of C. albicans on Juncus-mixed specimens drastically decreased, and biofilm formation was markedly inhibited. Moreover, both mechanical properties were found to be within the ranges regulated and specified by ISO.These findings demonstrated that the tissue conditioner including Juncus powder has a significant growth inhibitory effect against C. albicans, and it is suggested that the application of Juncus-mixed tissue conditioner may prevent denture stomatitis and oral candidiasis in denture wearers.

Candida albicans is a commonly found member of the human microflora and is a major human opportunistic fungal pathogen. A perturbation of the microbiome can lead to infectious diseases caused by various micro-organisms, including C. albicans. Moreover, the interactions between C. albicans and bacteria are considered to play critical roles in human health. The major biological feature of C. albicans, which impacts human health, resides in its ability to form biofilms. In particular, the extracellular matrix (ECM) of Candida biofilm plays a multifaceted role and therefore may be considered as a highly attractive target to combat biofilm-related infectious diseases. In addition, extracellular DNA (eDNA) also plays a crucial role in Candida biofilm formation and its structural integrity and induces the morphological transition from yeast to the hyphal growth form during C. albicans biofilm development. This review focuses on pathogenic factors such as eDNA in Candida biofilm formation and its ECM production and provides meaningful information for future studies to develop a novel strategy to battle infectious diseases elicited by Candida-formed biofilm.

Porous titanium has long been desired as a bone substitute material because of its ability to reduce the stress shielding in supporting bone. In order to achieve the various pore structures, we have evolved a moldless process combined with a space holder technique to fabricate porous titanium. This study aims to evaluate which pore size is most suitable for bone regeneration using our process. The mixture comprising Ti powder, wax binder and PMMA spacer was prepared manually at 70 °C which depended on the mixing ratio of each group. Group 1 had an average pore size of 60 μm, group 2 had a maximum pore size of 100 μm, group 3 had a maximum pore size of 200 μm and group 4 had a maximum pore size of 600 μm. These specimens were implanted into rabbit calvaria for three and 20 weeks. Thereafter, histomorphometrical evaluation was performed. In the histomorphometrical evaluation after three weeks, the group with a 600 μm pore size showed a tendency to greater bone ingrowth. However, after 20 weeks the group with a pore size of 100 μm showed significantly greater bone ingrowth than the other groups. This study suggested that bone regeneration into porous titanium scaffolds is pore size-dependent, while bone ingrowth was most prominent for the group with 100 μm-sized pores after 20 weeks in vivo.

The 'main occluding area', the location where food crushing occurs during the first stroke of mastication, is reported to be an important concept; however, it is currently limited to findings in individuals with normal dentition. The purpose of this study was to assess the changes in the location, area and bite force of the main occluding area before and after implant treatments. We enrolled 50 partially edentulous and 22 normally dentate subjects. To identify the location of the main occluding area, each subject was instructed to freely bite once on a dental stopping using the partially edentulous side or the normally dentate area. The location, occluding contact area and bite force of the main occluding area before and after the implant treatments were analysed. The main occluding area was located at a reproducible location in the partially edentulous and normally dentate subjects. This location was principally the first molar region, and for the partially edentulous patients with missing teeth in the molar regions, it moved from the premolar region to the first molar region after treatment. The occluding contact area and bite force for the main occluding area increased (P < 0·05) after the implant treatment in the partially edentulous patients with missing teeth in the molar regions. These results suggest that the main occluding area can be restored to the first molar region after implant treatment and may be an important factor in the assessment of prosthodontic treatment.

Purpose Assessment of swallowing dysfunction, particularly the risk of aspiration, is extremely important to clinicians because it provides crucial information for preventing morbidity and mortality from dysphagia. The purpose of this study was to describe a magneto-impedance sensor-aided screening system (MISS) for assessing swallowing function and clarify its effectiveness with the repetitive saliva-swallowing test (RSST). Methods An MI sensor attached to the skin over the sternum detected the distance from a magnet attached to the skin over the thyroid cartilage during swallowing as the change of magnetic fields. The MISS was validated by videofluoroscopic and videoendoscopic observations. Further, the swallowing behavior of 93 individuals was assessed by using the MISS and then analyzed with the RSST. Swallowing behavior can be recorded and investigated objectively by signal inspection in the MISS compared with the conventional methods. The MISS is a simple and straightforward method for recording and safe because of dry swallow. The MISS system was validated by using simultaneous recordings with videofluoroscopic or videoendoscopic examinations, and compared with the conventional RSST method. Conclusions The MISS combined with the RSST is an effective screening test for swallowing function.

The purpose of this study was to survey the changes that occur in bolus texture from intake to swallowing during the mastication process for four types of food materials and to identify how texture is related to the number of chews. We recruited 15 young Japanese participants for this study. The subjects were asked to spit the food bolus just before swallowing when eating four different foods: cracker, boiled rice, hard gelatine gel, and soft gelatine gel. Three physical properties (hardness, adhesiveness, and cohesiveness) were measured in the bolus after being chewed for 25, 50, 75, 100, and 125% of the normal number of chews. Occlusal force and pressure as well as stimulated whole saliva volume were also measured. Extensive variation in the number of chews existed between subjects, but minimal intra-subject variation was observed. Hardness was observed to decrease, whereas cohesiveness and adhesiveness increased in a chew-dependent manner for the cracker, soft gelatine gel, and hard gelatine gel, but not boiled rice. Bolus texture appears to be largely related to the number of chews. Hardness also tended to be influenced by occlusion. The adhesiveness and hardness of the boiled rice were also greatly influenced by saliva volume and occlusal force, respectively. Hardness is an important rheological factor in food bolus texture and likely plays a significant role in determining the appropriate number of chews. Adhesiveness and cohesiveness appear to be secondary factors in this process.We propose a model of oral processing for application in determining the appropriate number of chews for an individual. Hardness appears to be an important rheological factor in food bolus texture, with adhesiveness and cohesiveness being secondary aspects. When food is hard or difficult to swallow, chewing behavior will likely be more influenced by the perception of bolus texture.

Purpose The purpose of this retrospective study was to assess the implant survival rate and the risk factors associated with implant failure in patients who had undergone immediate implant restoration. Materials and methods We performed a retrospective review and an outcome assessment of all patients who received immediate implant restoration between 2000 and 2010 in our department at Tokushima University Hospital. The patients were divided into groups on the basis of the predictor variables: age, gender, implant location, and number of implants per jaw. The cumulative implant survival rate in the paired groups was determined by using Kaplan–Meier analysis and the log-rank test. Cox proportional hazards model was subsequently used to identify exposures associated with implant failure. Results Using the Kaplan–Meier method, the survival rates at 1, 3, and 9 years were calculated to be 98.8%, 98.0%, and 94.7%, respectively. No statistically significant association was observed between the implant survival rates and the predictor variables: gender, age, location, and number of implants. Conclusions Immediate implant restoration is a reliable prosthetic procedure with an acceptable survival rate compared to the conventional implant procedure.

目的：漂白剤としての二酸化チタンを塗布したエナメル質に対して青紫色半導体レーザー照射を行ったときの色素分解能について検討を行った．方法：光源として青紫色半導体レーザー（日亜化学），ライトサージ（オサダ）およびオペレーザー（ヨシダ製作所）の3種類を光源として使用し，ヒトの抜去歯エナメル質表面に二酸化チタン塗布後にレーザー照射を行った．色調変化の測定にはL＊a＊b＊表色系を用いた，処置前後のエナメル質の算術平均粗さを測定し，表面性状の変化を評価した．結果：色調の変化を示すΔE の値は青紫色半導体レーザーを使用した場合，他の光源と比較し有意に大きくなった．すべてのグループでレーザー照射前後でのエナメル質の算術平均粗さに有意な差は生じなかった．結論：実験結果より二酸化チタンに青紫色半導体レーザー照射を組み合わせることによって漂白効果が促進されることが示唆された．

Aims: The major objective of the study was to evaluate the enhanced germicidal effects of low-frequency pulsed ultraviolet A (UVA)-light-emitting diode (LED) on biofilms. Methods and Results: The germicidal effects of UVA-LED irradiation (365 nm, 0·28 mW cm−2, in pulsed or continuous mode) on Candida albicans or Escherichia coli biofilms were evaluated by determining colony-forming units. The morphological change of microbial cells in biofilms was observed using scanning electron microscopy. After 5-min irradiation, over 90% of viable micro-organisms in biofilms had been killed, and pulsed irradiation (1–1000 Hz) had significantly greater germicidal ability than continuous irradiation. Pulsed irradiation (100 Hz, 60 min) almost completely killed micro-organisms in biofilm (>99·9%), and 20-min irradiation greatly damaged both microbial species. Interestingly, few hyphae were found in irradiated Candida biofilms. Moreover, mannitol treatment, a scavenger of hydroxyl radicals (OH•), significantly protected viable micro-organisms in biofilms from UVA-LED irradiation. Conclusions: The study demonstrated that pulsed UVA-LED irradiation has a strong germicidal effect (maximum at 100 Hz, over 5-min irradiation) and causes the disappearance of hyphal forms of Candida. Significance and Impact of the Study: This study can assist in developing a low-frequency pulsed UVA-LED system to be applied to pathogenic biofilms for disinfection.

A biofilm composed of various microorganisms including Candida is found on denture surfaces and is likely to be involved in the etiology of denture-induced stomatitis. The purpose of this study was to examine the role of hydrophobic interactions in candidal adherence to acrylic surfaces, particularly that of the hyphal form of Candida albicans. Candida clinical isolates were used. Acrylic plates coated with carrageenan and hydrocolloid (Hitachi chemical, Tokyo, Japan) were used as a hydrophilic substratum. A microbial suspension was placed on each acrylic plate and incubated. All plates were washed in phosphate-buffered saline containing CaCl(2) and MgCl(2) [PBS (+)] and cells still adhering to the acrylic surface were collected by 0.25% trypsin treatment. Cell-surface hydrophobicity was estimated using a modification of the technique used to measure adherence to hydrocarbons. When the acrylic plates were coated with hydrophilic materials, the adherence of hydrophobic clinical isolates of Candida and the hydrophobic hyphal C. albicans decreased, whereas the adherence of non-hydrophobic Candida was not affected or increased. We suggest that hydrophilic coating of denture surfaces could be a potent method for reduction of the adherence of relatively hydrophobic fungal cells, particularly hyphal C. albicans, which causes denture stomatitis and related infections.