Search

Objective: This review aimed to examine differences in outcomes with the use of intra-articular hyaluronic acid vs corticosteroids after temporomandibular joint arthrocentesis. Method and materials: Studies were searched on PubMed, Embase, Web of Science, and Google Scholar up to 15th January 2024. Randomized controlled trials comparing hyaluronic acid with corticosteroids after TMJ arthrocentesis were included. The outcomes were pain and maximal mouth opening. Results: Ten articles corresponding to nine randomized clinical trials were included. There was no statistically significant difference in pain scores at 1 week (mean difference [MD] -0.30, 95% CI -1.25 to 0.65, I2 = 0%), 1 month (MD -0.55, 95% CI -1.23 to 0.13, I2 = 0%), and 6 months (MD -0.57, 95% CI -2.10 to 0.96, I2 = 58%) between the two groups. However, pain scores were found to be significantly lower in the hyaluronic acid group at 3 months (MD -1.07, 95% CI -1.84 to -0.31, I2 = 0%). No statistically significant difference was noted in maximal mouth opening at 1 week (MD 0.78, 95% CI -1.79 to 3.35, I2 = 0%), 1 month (MD 0.32, 95% CI -1.83 to 2.46, I2 = 0%), and 3 months (MD -0.41, 95% CI -3.90 to 3.07, I2 = 0%) between the two groups. Descriptive analysis for studies not included in the meta-analysis also presented similar results. Conclusions: Low-quality evidence suggests that both intra-articular hyaluronic acid and corticosteroids have similar efficacy in improving pain scores and maximal mouth opening after temporomandibular joint arthrocentesis. [ABSTRACT FROM AUTHOR]

Background: The present study analyzed the relationship between oral motor and cognitive functions in community-dwelling older Korean adults. Methods: Study participants included 113 community-dwelling older adults with a mean age of 73.84 years. Subjects' cognition was assessed using the Korean version of the Montreal Cognitive Assessment, and tongue, cheek, and lip pressures were assessed using the Iowa Oral Performance Instrument. Tongue and masseter thicknesses were measured using an ultrasound device (Sonon, Healcerion, Roseville, CA, USA). The occlusal force was measured using a specialized device (Innobyte, Kube Innovation, Montreal, QC, Canada), and the number of lost teeth was directly verified by a dental hygienist. Results: Results of analysis of cognitive function according to demographic characteristics of older community-dwelling adults revealed a significant difference in cognitive function according to education level and employment status. Cognitive function demonstrated a positive correlation with oral motor function, including pressure on the cheek, lips, and tongue, thickness of the masseter and tongue, occlusal force, number of lost teeth, and age. Hierarchical regression analysis revealed that demographic characteristics and cheek, lip, tongue, and masseter functions did not affect cognition, whereas occlusal force and number of lost teeth significantly affected cognition. In this study, oral motor function, excluding occlusal force and number of lost teeth, did not affect cognition. Conclusions: Future studies, however, are required to analyze the relationship between oral motor function and cognition in older adults with a wider range of such functions. [ABSTRACT FROM AUTHOR]

Background: Spending time away from bed is important in older adults. Not doing so can lead to functional decline rapidly. Objective: To investigate the association between oral function and time spent away from bed in older adults living in nursing homes. Methods: We enrolled 748 adults aged ≥65 years across eight nursing homes between April 2022 and March 2023. 'Problems with oral hygiene' and 'problems with oral function' were the dependent variables in the multiple regression analyses to determine their association with time spent away from bed. Results: We selected 304 participants (76 men; mean age, 86.3 ± 7.5 years) and divided them into three groups: group S (< 4 h), group M (4 to < 6 h) and group L (≥ 6 h), with 28, 23 and 253 participants, respectively. Comparison of the characteristics between the groups demonstrated significant differences in the Barthel index (p <.001), time spent away from bed (p <.001), history of aspiration pneumonia (p <.001), confirmation of meals and food forms (p =.010), problems with oral hygiene (p =.014), and problems with oral function (p =.002). Based on multiple regression analyses, 'problems with oral hygiene' (p <.001) and 'problems with oral function' (p <.001) were significantly associated with time spent away from bed. Conclusions: The time spent away from bed was significantly associated with both oral hygiene and function in older adults, suggesting the importance of extending the time that older adults spend away from bed. [ABSTRACT FROM AUTHOR]

Objective: Few studies investigated the influence of oral parafunctional habits during the COVID‐19 pandemic. Since some studies have demonstrated that signs and symptoms of temporomandibular disorder (TMD), as well as psychological alterations, increased during the COVID‐19 pandemic lockdown, the aim of this study was to investigate whether social isolation is a situation that increases the prevalence of oral parafunctional habits. Methods: This was an observational case–control study. An online survey with questions about TMD symptoms (Diagnostic Criteria Symptom Questionnaire) and oral parafunctional habits (Oral Behaviours Checklist [OBC]) was administered to Brazilian residents at two different times (2020 and 2021). The participants were divided according to social isolation practices into study groups (GI: 2020, n = 507; GIII: 2021, n = 282) and control groups (GII: 2020, n = 98; GIV: 2021, n = 202). Result: In each group, we evaluated the association of the frequency of oral parafunctional habits with the symptoms of TMD, and we observed that individuals with a greater presence of painful TMD present a greater number of oral parafunctional habits. Despite the literature showing that individuals who practiced social isolation developed more oral parafunctional habits, when analysing the association of the OBC questions in Groups GI × GII and GIII × GIV, only 'sustained talking' (p =.0022) and 'hold telephone between your hand and shoulders' (p =.0124) showed a significant difference in GI × GII. Kendall's coefficient of concordance revealed that there was a very strong concordance (GI × GII 0.9515 (p =.0087) and GIII × GIV 0.9655 (p =.0074)) between the ranks of the analysed oral parafunctional habits in all groups. Conclusion: We can state that Individuals who practiced social isolation did not present more oral parafunctional habits than individuals who did not. [ABSTRACT FROM AUTHOR]

Background: Mandibular range of motion (MROM) variables are widely used to evaluate oral function. Objective: The aim of this study was to establish the reliability of MROM variables in healthy children. Methods: In this cross‐sectional study, healthy children were examined 2 weeks apart. The following MROM variables were established: active maximum interincisal opening (AMIO), passive maximum interincisal opening (PMIO), protrusion and left and right laterotrusion. The reliability of the MROM measurements was determined by analysing the intra‐class correlation coefficient (ICC), standard error of measurement (SEM), smallest detectable change (SDC) and limits of agreement (LoA). Results: A total of 167 healthy children were examined. The ICC indicated good reliability for AMIO (0.885); excellent reliability for PMIO (0.925); and moderate reliability for protrusion (0.578), laterotrusion left (0.601) and laterotrusion right (0.634). The SDC was 0.9 mm for AMIO, 0.4 mm for PMIO, 2.2 mm for protrusion, 1.6 mm for laterotrusion left and 1.4 mm for laterotrusion right. The LoA was −5.67 to 5.82 for AMIO, −3.90 to 3.57 for PMIO, −3.89 to 3.55 for protrusion, −2.99 to 2.77 for laterotrusion left, and − 2.71 to 2.77 for laterotrusion right. Conclusions: AMIO and PMIO measurements are both highly reliable in healthy children. The low SDC indicate that AMIO and PMIO are promising longitudinal measurements. Protrusion and laterotrusion measurements had moderate reliability. These results support our clinical recommendation to measure AMIO rather than PMIO, as PMIO is more difficult and more time‐consuming to perform than AMIO. [ABSTRACT FROM AUTHOR]

Background: A quantitative approach to predict expected muscle activity and mandibular movement from non‐invasive hard tissue assessments remains unexplored. Objectives: This study investigated the predictive potential of normalised muscle activity during various jaw movements combined with temporomandibular joint (TMJ) vibration analyses to predict expected maximum lateral deviation during mouth opening. Method: Sixty‐six participants underwent electrognathography (EGN), surface electromyography (EMG) and joint vibration analyses (JVA). They performed maximum mouth opening, lateral excursion and anterior protrusion as jaw movement activities in a single session. Multiple predictive models were trained from synthetic observations generated from the 66 human observations. Muscle function intensity and activity duration were normalised and a decision support system with branching logic was developed to predict lateral deviation. Performance of the models in predicting temporalis, masseter and digastric muscle activity from hard tissue data was evaluated through root mean squared error (RMSE) and mean absolute error. Results: Temporalis muscle intensity ranged from 0.135 ± 0.056, masseter from 0.111 ± 0.053 and digastric from 0.120 ± 0.051. Muscle activity duration varied with temporalis at 112.23 ± 126.81 ms, masseter at 101.02 ± 121.34 ms and digastric at 168.13 ± 222.82 ms. XGBoost predicted muscle intensity and activity duration and scored an RMSE of 0.03–0.05. Jaw deviations were successfully predicted with a MAE of 0.9 mm. Conclusion: Applying deep learning to EGN, EMG and JVA data can establish a quantifiable relationship between muscles and hard tissue movement within the TMJ complex and can predict jaw deviations. [ABSTRACT FROM AUTHOR]

Introduction: The development of temporomandibular disorders specifically emphasizes the biochemical changes occurring in the synovial fluid at different stages of temporomandibular joint disease. Research has indicated that inflammation may be a primary reason behind the pain and dysfunction in temporomandibular joint diseases. Since its clearance several years ago, MESNA (sodium 2-mercaptoethanesulfonate) has been used in various formulations as a mucolytic drug in the respiratory domain. It operates by disrupting the disulfide bonds present between polypeptide chains within mucus. MESNA exhibits minimal tissue distribution, with the material being swiftly and thoroughly eliminated via the kidneys. Objectives: To assess the efficacy of injecting MESNA directly into the Temporomandibular Joint to treat internal derangement. Materials and methods: A randomized clinical trial was conducted on sixty patients who exhibited non-responsiveness to conventional treatment and were diagnosed with TMJ anterior disc displacement with reduction. The patients were chosen from the outpatient clinic of the Oral and Maxillofacial Surgery Department at Tanta University Faculty of Dentistry. Two equal groups of patients were randomly assigned to each other. Group I (Mesna group) received intra-articular injection with MESNA solution. Group II (Standard group) received arthrocentesis with lactated ringer solution followed by injection of Hyaluronic Acid (HA). The data was gathered by functional examinations such as maximum interincisal opening (MIO) and clicking. A Visual Analogue Scale (VAS) assessed pain severity before and after treatments. Results: Both MESNA and HA showed significant improvement up to six months of the follow-up compared to preoperative status, as evidenced by better mouth opening, lateral excursion, lower clicking, and reduced pain score in patients with TMDs. MESNA showed significant improvement during follow-up compared to HA. Conclusion: Compared to HA, MESNA showed a more noticeable improvement during the follow-up period. [ABSTRACT FROM AUTHOR]

Background: Few studies have been conducted on treating temporomandibular disorders (TMDs) with new digital occlusal splints, which has increasingly attracted wide attention. Methods: To evaluate the clinical efficacy and quality of life (QoL) of Kovacs digital occlusal splint (KDOS) treatment in patients with TMD. Materials and methods: Eighty-nine patients with TMD who were treated using KDOS were analyzed. The patients were divided into three groups according to the Wilkes stage. The clinical symptoms and QoL scores of the patients in each group were recorded before and at least three months after treatment, and the data were statistically analyzed and compared. The relationships between the disease severity, sex, age, and level of QoL before treatment and improvement in the clinical symptoms were analyzed using binary logistic regression. Results: The mean age and follow-up period of the patients were 28.0 ± 10.4 years and 4.9 ± 2.1 months, respectively. After KDOS treatment, the improvement rates of joint noise and pain were 80.4% and 69.8%, respectively. Additionally, the patients' maximum mouth opening and global QoL mean scores significantly improved compared to those before treatment (p < 0.001). Binary logistic regression analysis revealed that the factors affecting the improvement in the clinical symptoms were disease severity and level of QoL before treatment. Conclusions: KDOS can improve the clinical symptoms and QoL of patients with TMD. Moreover, patients without osteoarthritis and with low pretreatment QoL levels are more likely to demonstrate clinical improvement. Trial registration: The trial was registered with Chinese Clinical Trial Registry (ChiCTR) (ID: ChiCTR2300076518) on 11/10/2023. [ABSTRACT FROM AUTHOR]

Background: Jaw clenching improves dynamic reactive balance on an oscillating platform during forward acceleration and is associated with decreased mean sway speed of different body regions. Objective: It is suggested that jaw clenching as a concurrent muscle activity facilitates human motor excitability, increasing the neural drive to distal muscles. The underlying mechanism behind this phenomenon was studied based on leg and trunk muscle activity (iEMG) and co‐contraction ratio (CCR). Methods: Forty‐eight physically active and healthy adults were assigned to three groups, performing three oral motor tasks (jaw clenching, tongue pressing against the palate or habitual lower jaw position) during a dynamic one‐legged stance reactive balance task on an oscillating platform. The iEMG and CCR of posture‐relevant muscles and muscle pairs were analysed during platform forward acceleration. Results: Tongue pressing caused an adjustment of co‐contraction patterns of distal muscle groups based on changes in biomechanical coupling between the head and trunk during static balancing at the beginning of the experiment. Neither iEMG nor CCR measurement helped detect a general neuromuscular effect of jaw clenching on the dynamic reactive balance. Conclusion: The findings might indicate the existence of robust fixed patterns of rapid postural responses during the important initial phases of balance recovery. [ABSTRACT FROM AUTHOR]

Objectives: Cerebral palsy (CP) can cause motor, sensory, cognitive, and communicative problems and poor feeding performances in children. Feeding problems could be lifethreatening and negatively affect cognitive and physical growth. This study investigates the frequency of response to oral motor skills, the frequency and severity of feeding problems, and the relationship between age and oral motor skills with feeding problems in children with CP aged 2 to 7 years. Methods: This was an observational and cross-sectional study. The participants were 60 children (26 girls and 34 boys) with CP with a mean age of 4.76±1.71 years. The screening tool for eating problems and oral motor assessment scale assessed participants' feeding and oral motor skills. The Spearman test determined the correlation between age and oral motor dysfunctions with feeding problems. Results: The present study revealed that 80% of participants indicated feeding problems in the screening tool of the eating problems test. Problems with feeding skills (51.5%) were the most frequent. Furthermore, the most frequent response of participants to "closing the lips while feeding with a spoon" was 46.7%, and "sucking with straw," equaled 55.0%," which was passive. For other items, the most frequent response of the examinees was "functional." Finally, the results showed no significant correlation (P<0.05) between age and mean scores of frequency and severity of feeding problems. A significant negative correlation was found between mean scores of oral motor skill with frequency (P<0.001, r=-0.476) and severity (P=0.001, r=-0.424) of feeding problems. Discussion: The majority of children with CP have problems with feeding and oral motor skills. Some skills in the fields of feeding and oral motor should be noticed more by speechlanguage pathologists and included in their therapeutic program, especially "feeding skills," "closing the lips while feeding with a spoon," and "sucking with straw." [ABSTRACT FROM AUTHOR]

Purpose: Inspiratory muscle strength training (IMST) can improve exercise performance. Increased maximal inspiratory mouth pressure (MIP) could be beneficial for swimmers to enhance their performance. This study aimed to clarify the effect of high-intensity IMST for 6 weeks on MIP and swimming performance in highly trained competitive swimmers. Methods: Thirty male highly trained competitive swimmers were assigned to high-intensity IMST (HI; n = 10), moderate-intensity IMST (MOD; n = 10), and control (n = 10) groups. The 6-week IMST intervention comprised twice daily sessions for 6 d/wk at inspiratory pressure threshold loads equivalent to 75% MIP (HI) and 50% MIP (MOD). Before and after the intervention, MIP and swimming performance were assessed. Swimming performance was evaluated in free and controlled frequency breathing 100-m freestyle swimming time trials in a 25-m pool. For controlled frequency breathing, participants took 1 breath every 6 strokes. Results: The MIP values after 2 and 6 weeks of IMST in the HI and MOD groups were significantly higher than those before IMST (P =.0001). The magnitudes of the MIP increases after 6 weeks of IMST did not differ between the HI (13.4% [8.7%]) and MOD (13.1% [10.1%]) groups (P =.44). The 100-m freestyle swimming times under the controlled frequency condition were significantly shorter after IMST than those before IMST in both the HI (P =.046) and MOD (P =.042) groups. Conclusions: Inspiratory pressure threshold load equivalent to 50% MIP could be sufficient to improve MIP and swimming performance under the controlled frequency breathing condition in highly trained competitive swimmers. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess patient‐reported outcomes (PROs) 8 years after dental implant rehabilitation in a sample with tooth loss due to periodontitis (TLP) and a sample with missing teeth for other reasons (MTOR). Materials and Methods: The Norwegian National Insurance Scheme registry of subsidized dental implant therapy was searched, and patients (n = 3083) rehabilitated with dental implants in 2014 were mailed a questionnaire. PROs were described by relative frequencies, and the TLP and MTOR subsamples were compared using chi‐square test. Multiple linear regression analyses were used to investigate variables potentially predicting PROs. Results: Of the respondents (n = 1299), more than 90% were partly or fully satisfied with the treatment outcome. Complications were reported by 44.2%. Patients who lost teeth due to periodontitis (n = 784) reported greater oral function improvement and better pre‐treatment information, and were more likely to experience complications when compared with patients who lost teeth for other reasons (n = 515). Age, level of education, self‐funded cost, pre‐treatment information, history of complications and the reason for missing teeth were found to predict PROs. Conclusions: In a Norwegian population rehabilitated with dental implants in 2014, satisfaction with the treatment outcome and the aesthetic outcome was high, irrespective of the reason for missing teeth. Self‐report of complications and lack of pre‐treatment information were the strongest predictors of inferior patient satisfaction and also predicted inferior oral function. [ABSTRACT FROM AUTHOR]

Background: Oral diadochokinesis (OD) test is an articulation test that analyses fine movements of the lips, cheeks and tongue. It is difficult to perform the test accurately in older people with reduced physical and cognitive functions. Objectives: This study aimed to investigate the number of older adults who could not be tested for OD and to investigate their characteristics. Methods: The participants included 145 older residents of an aged care nursing home. They were divided into two groups: those who could be tested for OD and those who could not, and their characteristics were compared. The degree of requiring long‐term care was classified into five levels. The degree of dementia was classified into five levels. Those having difficulty in performing daily activities alone and having degree III or higher dementia were considered to have severe dementia. Results: The participants included 41 men and 104 women with a median age of 89 years (range, 64–105 years). Sixty‐eight participants failed the OD test (46.9%). In univariate and multivariate analyses, degree of dementia and oral care (among other characteristics in univariate analysis) showed statistically significant differences between the two groups. Cut‐off values for older adults who could not perform OD test were level 4 or higher in need of care and degree III or higher in dementia. Conclusion: This study suggests that additional assessment tools for oral function should be considered for older adults requiring a nursing care level of 4 or higher and a dementia degree of III or higher. [ABSTRACT FROM AUTHOR]

Fascial space abscess is a condition in which infections spread into fascial spaces. It is a severe and life-threatening disease unless treated at an early stage. Due to the similarity of clinical symptoms, fascial space abscesses in the orofacial area are often disguised as other diseases, such as temporomandibular disorder (TMD). In this case series, we report three cases of fascial space abscesses disguised as TMD. In all cases, patients complained of severely limited mouth opening and pain in the temporomandibular joint (TMJ) and masseter muscles, which led clinicians to diagnose them with TMD. After two patients showed facial swelling and the third complained of dyspnea, clinicians realized the possibility of an orofacial fascial space abscess. On further evaluation, all patients showed increased C-reactive protein in blood tests, and the location of the fascial space abscess was confirmed by enhanced computed tomography images. Moreover, all patients had suspicious sources of odontogenic infections in panoramic images, periapical abscess on maxillary molars and periodontal disease on maxillary and mandibular molars, which were not appropriately evaluated at the first visit. This case series emphasizes the need for clinicians to realize the possibility of orofacial fascial space abscesses based on: clinical symptoms of severely limited mouth opening (< 15 mm) with pain in the facial area, including TMJ or masseter muscle, and possible sources of infection such as odontogenic infection, other infectious lesions, trauma, or invasive treatments. These clinical insights will enable the early detection of fascial space abscesses. [ABSTRACT FROM AUTHOR]

In Head and Neck surgery Transoral Robotic Surgery (TORS) is evolving as a key treatment option for benign and malignant lesions in the oropharynx. Even so, postoperative pain is one of the primary early complaints following TORS. Well established evidence-based procedure specific pain treatment guidelines are available for a variety of other surgical specialties. However, there are no guidelines for TORS This review describes the available data of early pain intensity following TORS during rest and procedure related activity. Literature concerning pain in the immediate postoperative phase following TORS were obtained from two literature databases Most data on pain intensity following TORS are based upon a numeric rating scale, e.g. the Visual Analogue Scale and/or analgesic demands. Only one randomized clinical trial is available reflecting that the literature is mainly based on retrospective and a few prospective studies. Only one study analyzed pain during relevant functionality, i.e. swallowing. Overall, the studies suffer from a non-standardized approach and there is a need for transparent information concerning the timing of pain ratings and methodology The evidence for optimal pain control is limited, particularly during surgical relevant activity. Postoperative pain rating during activity is a fundamental element in pain trials in order to enhance recovery thereby calling for future consensus on assessment methodology [ABSTRACT FROM AUTHOR]

Aim: To assess the validity of self-reported articulatory oral motor skill against objectively measured repetitive articulatory rate (oral diadochokinesis [oral-DDK]) as a gold standard index for articulatory oral motor skill in community-dwelling older Japanese adults. Methods: This cross-sectional study included 607 Japanese adults (mean age = 73.9 years). A single-item self-report questionnaire for articulatory oral motor skill was developed. Study participants completed a 1-month-interval test-retest protocol to assess reliability of the questionnaire, and the protocol was tested by the kappa statistic. Oral-DDK with/ta/(i.e., the number of repetitions of the monosyllable/ta/per second) was measured during the on-site examination. Low oral-DDK performance was defined as <5.2 times/s in men and <5.4 times/s in women. Oral-DDK performance, oral functions other than articulatory oral motor skill, and physical frailty were compared in the groups with and without self-reported low articulatory oral motor skill as determined by the response to the questionnaire. Results: Self-reported low articulatory oral motor skill was identified in 18.5% of the study population. The self-report questionnaire had good test-retest reliability, with a kappa statistic of 0.71. Self-reported low articulatory oral motor skill was significantly associated with a lower value of oral-DDK with/ta/and a higher proportion of low oral-DDK performance, difficulties in chewing and swallowing, dry mouth, and physical frailty. Self-report had high specificity (83.1%) but low sensitivity (42.1%) for detecting low oral-DDK performance. Conclusions: A single-item self-report questionnaire for articulatory oral motor skill had acceptable test-retest reliability and was associated with objectively measured articulatory oral motor skill. [ABSTRACT FROM AUTHOR]

There are numerous anatomical, physiological, and clinical differences between pediatric and adult airway management. Airway obstruction in children is unquestionably a stressful situation for the medical staff and the patient's family. Therefore, caregivers must be able to accurately assess the risk of such an occurrence. To date, there is no consensus on a single ideal pediatric airway assessment scale that could help identify children with the highest risk for intubation-related adverse events. Instead, a few classifications and methods were proposed, with some employing the same techniques proven effective for adults and others emphasizing the differences in the pediatric population. This article compares the data used to support the use of various perioperative airway assessment techniques in pediatric patients. The majority of these remedies rely on anatomical measurements, bedside tests, and in-depth patient histories. This narrative review highlights the need for standardized and reliable pediatric airway assessment scales and stresses the significance of structured airway assessment in pediatric patients. [ABSTRACT FROM AUTHOR]

Background: The difficulties and challenges faced by people with Parkinson's disease (PD) in performing daily orofacial function are not systematically investigated. In this study, specific orofacial non-motor and motor symptoms and functions were systematically examined in PD patients in comparison to a matched control group. Methods: The clinical case-controlled study was conducted from May 2021 to October 2022 and included persons with PD and age- and gender-matched persons without PD. The participants with PD were outpatients diagnosed with PD at the Department of Neurology at Bispebjerg University Hospital in Copenhagen, Denmark. The participants underwent a systematic clinical and relevant self-assessment of the orofacial function and temporomandibular disorders (TMD). The primary outcomes were objective and subjective assessments of the general orofacial function, mastication, swallowing, xerostomia and drooling. The secondary outcomes were the prevalence of TMD and orofacial pain. The difference in outcome measures between the two groups was analysed using chi-square and Mann–Whitney U test. Results: The study included 20 persons with PD and 20 age- and gender-matched persons without PD. Both objectively and subjectively, persons with PD had poorer orofacial function than the control group. Persons with PD had also a significantly more severe limitation of jaw mobility and jaw function. The objective masticatory function was also significantly reduced for persons with PD compared to the control group, and 60% of persons with PD found it difficult to eat foods with certain consistencies while 0% of the control group reported that problem. Persons with PD could swallow less water per second and the average swallowing event was significantly longer for PD persons. Even though PD persons reported more xerostomia (58% for persons with PD and 20% for control persons), they also reported significantly more drooling than the control group. Additionally, orofacial pain was more prevalent in PD persons. Conclusions: Persons with PD have a compromised orofacial function. Furthermore, the study indicates a link between PD and orofacial pain. In order to screen and treat persons with PD accordingly, healthcare professionals should be aware of and address these limitations and symptoms. Trial registration: The trial was approved by the Regional Committee on Research Health Ethics of the Capital Region (H-20,047,464), the Danish Data Protection Agency (514 − 0510/20-3000), and registered at ClinicalTrials.gov (NCT05356845). [ABSTRACT FROM AUTHOR]

PURPOSE: To assess the performance of premature infant oral motor intervention for transition from gavage to full spoon feeding in preterm infants. METHODS: Preterm neonates born between 28 + 0–32 + 6 weeks gestation (n = 32) were randomised into an intervention group (premature infant oral motor intervention) for five minutes twice a day along with routine care (n = 16) and a control group (routine care, n = 16) once they reached a feed volume of at least 150 ml/kg/day administered by gavage method. The primary outcome measure was time (in days) to transition from gavage to full spoon feeds. RESULTS: The mean (SD) time to transition from gavage to full spoon feeds was attained significantly earlier in the intervention group than the control group (9.93 [5.83] vs 16.43 [10.46] days; mean difference, -6.5 days; 95% CI, -12.58 to -0.41). There was no significant difference between the two groups in terms of the duration of hospital stay, rates of physiological stability, and culture positive sepsis. CONCLUSION: Premature infant oral motor intervention, as used in this specific population, significantly reduces the time to transition to full spoon feeds without increasing culture positive sepsis and physiological instability. [ABSTRACT FROM AUTHOR]

Objective: To analyse the effectiveness of exercise therapy in improving pain and active or passive maximum mouth opening in patients with temporomandibular disorders. Data sources: PubMed Medline, Web of Science, Scopus, CINAHL Complete and Physiotherapy Evidence Database, until April 2022, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Review methods: We included randomized controlled trials evaluating the effect of exercise therapy on pain and on active and passive maximum mouth opening in patients with temporomandibular disorders. Effect size was calculated using Cohen's standardized mean difference (SMD) and their 95% confidence interval (95% CI) in a random-effects model. Results: A total of 16 studies with 812 participants were included. Exercise therapy is effective in reducing pain (SMD: −0.58; 95% CI: −1.01 to −0.12) and increasing the pain pressure threshold (SMD: 0.45; 95% CI: 0.14–0.76), active and passive maximum mouth opening (SMD: 0.43; 95% CI: 0.14–0.71 and SMD: 0.4; 95% CI: 0.06–0.75, respectively). Subgroup analyses showed more effect of exercise therapy more splints versus splints on pain (SMD: −0.5; 95% CI: −0.73 to −0.26), active and passive maximum mouth opening (SMD: 1.14; 95% CI: 0.22–2.07 and SMD: 0.56; 95% CI: 0.06–1.06, respectively). On pain pressure threshold, exercise therapy was better than physiotherapy approach (manual therapy and electrotherapy) (SMD: 0.48; 95% CI: 0.09–0.87). Conclusions: Therapeutic exercise is an effective therapy to reduce pain and increase pain pressure threshold and active and passive maximum mouth opening in patients with temporomandibular disorders. [ABSTRACT FROM AUTHOR]

Aims: To examine the effect of manual therapy applied to the cervical joint for reducing pain and improving mouth opening and jaw function in people with TMDs. Methods: A systematic review of randomized controlled trials was performed. Participants were adults diagnosed with TMDs. The experimental intervention was manual therapy applied to the cervical joint compared to no intervention/placebo. Outcome data relating to orofacial pain intensity, pressure pain threshold (PPT), maximum mouth opening, and jaw function were extracted and combined in meta-analyses. Results: The review included five trials involving 213 participants, of which 90% were women. Manual therapy applied to the cervical joint decreased orofacial pain (mean difference: -1.8 cm; 95% CI: -2.8 to -0.9) and improved PPT (mean difference: 0.64 kg/cm²; 95% CI: 0.02 to 1.26) and jaw function (standardized mean difference: 0.65; 95% CI: 0.3 to 1.0). Conclusion: Manual therapy applied to the cervical joint had short-term benefits for reducing pain intensity and improving jaw function in women with TMDs. Further studies are needed to improve the quality of the evidence and to investigate the maintenance of benefits beyond the intervention period. [ABSTRACT FROM AUTHOR]

Background: There is a lack of consensus regarding the best treatment option, including physical exercise, available for temporomandibular degenerative joint disease (DJD) that affect the older patients. Herein, we aimed to study and compare the efficacy of a combined approach using injection and home physical exercise with physical therapy alone as well as explored an optimal treatment strategy for older patients with DJD. Methods: We included 213 older patients with DJD treated at our medical centre from June 2020 to June 2021, 64 of whom were selected for analysis. Of these 64 patients, 32 received injections combined with home physical exercise, and the other 32 received physical therapy alone. Propensity score matching was used to ensure that the two groups did not differ significantly in categorical and continuous variables. Measurements included pain intensity, maximum mouth opening, joint crepitus, jaw functional limitation scale (JFLS) scores, treatment times, and treatment durations. Improvement in each measurement was compared between the two groups 2, 4, and 12 weeks after the treatment commenced, as were the final treatment times and durations. Results: Pain intensity, maximum mouth opening, and JFLS scores in the two groups improved 2, 4, and 12 weeks after treatment (all p < 0.05). The crepitus ratio improved significantly only in the combined treatment group after 12 weeks. Compared with the physical therapy group, pain while opening the mouth improved after 2, 4, and 12 weeks in the combined treatment group. Furthermore, 2 weeks after treatment, the physical therapy group showed significant improvement in maximal mouth opening compared with the combined treatment group. No significant between-group differences were observed regarding improvement in joint crepitus and JFLS scores at each observation point. The combined treatment group had a significantly lower number of visits than the physical therapy group; however, the treatment duration was longer. Conclusion: Compared with physical therapy, pain while opening the mouth is significantly improved by the combined treatment within 12 weeks, and the number of required visits is fewer. Physical therapy improves the patients' mouth-opening capabilities in a short time (2 weeks), and the treatment cycle is short. [ABSTRACT FROM AUTHOR]

Simple Summary: Social eating problems may affect lives of people with head and neck cancer (HNC) during and after (chemo)radiotherapy treatment. This study aimed at investigating if people with HNC experience social eating problems from diagnosis up to 24 months after (chemo)radiotherapy and if their change over time is associated with swallowing, oral function, and nutritional status, in addition to the clinical, personal, physical, psychological, social, and lifestyle dimensions. We found that social eating problems worsened three months after treatment and improved to baseline levels up to 24 months. The change in social eating problems over time was associated with swallowing, nutritional status, tumor subsite, age, muscle strength, hearing problems, and depressive symptoms. Results are relevant to research and clinical practice for improving personalized supportive care targeting social eating problems. This study aimed at investigating the change in social eating problems from diagnosis to 24 months after primary (chemo)radiotherapy and its associations with swallowing, oral function, and nutritional status, in addition to the clinical, personal, physical, psychological, social, and lifestyle dimensions. Adult patients from the NETherlands QUality of life and BIomedical Cohort (NET-QUBIC) treated with curative intent with primary (chemo)radiotherapy for newly-diagnosed HNC and who provided baseline social eating data were included. Social eating problems were measured at baseline and at 3-, 6-, 12-, and 24-month follow-up, with hypothesized associated variables at baseline and at 6 months. Associations were analyzed through linear mixed models. Included patients were 361 (male: 281 (77.8%), age: mean = 63.3, SD = 8.6). Social eating problems increased at the 3-month follow-up and decreased up to 24 months (F = 33.134, p < 0.001). The baseline-to-24 month change in social eating problems was associated with baseline swallowing-related quality of life (F = 9.906, p < 0.001) and symptoms (F = 4.173, p = 0.002), nutritional status (F = 4.692, p = 0.001), tumor site (F = 2.724, p = 0.001), age (F = 3.627, p = 0.006), and depressive symptoms (F = 5.914, p < 0.001). The 6–24-month change in social eating problems was associated with a 6-month nutritional status (F = 6.089, p = 0.002), age (F = 5.727, p = 0.004), muscle strength (F = 5.218, p = 0.006), and hearing problems (F = 5.155, p = 0.006). Results suggest monitoring social eating problems until 12-month follow-up and basing interventions on patients' features. [ABSTRACT FROM AUTHOR]

This study aimed to determine the characteristics of occlusal force, lip strength, and tongue pressure in older and young females. We included 16 healthy young female university students and 16 community-dwelling females aged >65 years. Age, occlusal force, lip strength, tongue pressure, and grip strength were confirmed using Spearman's rank correlation coefficient. Differences in these functions between young and older females were analyzed using the Mann–Whitney U test. The occlusal force was associated with grip strength (ρ = 0.64) and tongue pressure (ρ = 0.59). Tongue pressure and occlusal force showed significant differences between older and young women. However, there was no significant difference in lip-closing strength. The results of this study suggest that occlusal force, lip strength, and tongue pressure should be measured, respectively, in order to evaluate oral function in female. [ABSTRACT FROM AUTHOR]

Based on the physical facial features available to visual perception, mouth features play an essential role in perceiving and recognizing facial expressions, but they have not been as widely studied as eye features. The NimStim set provides a more extended and popularized version of the basic expressions with open mouth and closed mouth. In this study, 209 Chinese college students were recruited to identify and evaluate the feelings of seven facial expressions in the NimStim, and we explored the influence of open mouth on gender and cultural differences. The results were as follows: (1) The open mouth did not always correspond to a higher recognition rate. The neutral and sad expressions had a higher correct rate with the mouth closed, and the happy expression had a higher correct rate with the mouth slightly open. (2) In addition to neutral expressions, females showed an advantage in recognizing emotional expressions. The female advantage in recognizing sad expressions was more prominent in the closed-mouth, and in recognizing fear (open mouth) was more prominent when the actor was male. Our results advanced the role of mouth opening and closing in facial expression perception. We also revealed that the observer's gender affects the facial expression perception in Chinese culture. [ABSTRACT FROM AUTHOR]

Background: Evaluating mouth rinsing skills is useful for assessing oral function, however current evaluation methods are subjective. Objectives: This study compared mouth rinsing between adults and children using a contactless camera to capture lip motion. Methods: The subjects comprised 16 adults and 13 children with no oral dysfunction. A compact vital sensing camera adapted from a Microsoft Xbox One Kinect Sensor® (Kinect) was placed 100 cm from the floor and 120 cm from the subject; 5, 10 and 15 ml of water were used as samples. Participants were instructed to hold the sample in the oral cavity, close the lips and move the sample alternatively left and right for 15 s. Maximum/minimum displacement from the reference plane and rinsing cycle for each sample were analysed by one‐way analysis of variance. Results: In adults, there was no significant difference in the maximum/minimum displacement between the left and right sides of the angulus oris due to differences in sample amount. In children, the right maximum significantly differed between the 5‐ and 15‐ml and 10‐ and 15‐ml samples, while the left maximum significantly differed between the 5‐ and 10‐ml and 5‐ and 15‐ml samples. The right minimum significantly differed between the 5‐ and 10‐ml samples, as did the duration of mouth rinsing between the 5‐ and 15‐ml samples. Conclusions: In children, lip movement and mouth rinsing duration tended to decrease with increasing sample volume. Evaluating lip movement using a contactless vital sensing camera is useful for assessing children's development of oral function. [ABSTRACT FROM AUTHOR]

• Sex differences: females had lower MMOS than males among healthy elderly individuals. • Age impact: MMOS decreases with age, indicating reduced mouth-opening strength. • Dysphagia impact: dysphagic individuals showed significantly lower MMOS compared to healthy elderly. • Data insufficiency : limited reliable data on mouth-opening strength across populations. • Research need: further studies are needed to understand mouth-opening performance. To characterize mouth-opening muscular performance (MOMP) in adults and elderly individuals with dysphagia and healthy controls. We searched the PubMed, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science databases from inception to Jan. 26, 2023. Two independent researchers considered the titles, abstracts, and full texts of potentially eligible papers from 1451 search results. Twenty-five studies that evaluated mouth-opening maximal strength (MOMS) in healthy adults, elderly individuals, and patients with dysphagia met the inclusion criteria. We found comparable, reliable values with significant sex differences in maximal mouth opening strength (MMOS) in the meta-analysis for healthy elderly patients (females 5.31 ± 0.47 kg vs. males 7.04 ± 0.70 kg; mean difference of 0.84 kg). Age has also emerged as an essential factor in reducing strength. There was a significant reduction in the MMOS score in the only study that compared dysphagic individuals to healthy elderly individuals. In another study, the MMOS score was comparable to the meta-analysis of healthy elderly individuals. Both sex and age play significant roles in the MMOS. There is no reliable data on the normal mouth-opening strength and endurance of healthy adults, patients with dysphagia, or individuals with other relevant clinical problems. [ABSTRACT FROM AUTHOR]

Nina Garlo explores the links between athletes' oral health and their performance. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to assess the effect of topical applications of an amino acid and sodium hyaluronate gel after mandibular third molar extraction. Method and Materials: 136 patients requiring mandibular third molar extraction were enrolled. An amino acid and sodium hyaluronate gel was applied to the sockets of patients in the test group immediately following the extraction. The sockets of controls were simply flushed with a sterile saline solution. Patients' outcomes and postoperative complications were assessed 7 and 14 days after surgery. The cumulative incidence of dehiscence and secondary outcome measures were analyzed using a chi-square test. Results: Concerning the primary outcome, the incidence of dehiscence was 27.4% after 7 days in the treatment group and 36.4% in the controls (P = .28), and at 14 days it was 21.4% and 36.0%, respectively (P = .10). No statistically significant differences emerged in other variables (mouth opening range, appearance of soft tissue, presence of pus, pain on palpation of the alveolar socket, alveolitis, local lymphadenopathy, and adverse reactions). Pain perception was always lower in the treatment group during the first 7 days after surgery. Conclusion: Topical applications of an amino acid and sodium hyaluronate gel after mandibular third molar extraction made no statistically significant difference to the variables examined in the test and control groups. Clinical Relevance: This trial focused on postoperative complications after surgical third molar extraction. The use of a gel containing amino acid and sodium hyaluronate was investigated for the management of post operative pain, edema, alveolitis, wound dehiscence and swelling. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether pretreatment patient-related factors are associated with the outcomes of dental implant treatment through multidimensional evaluations of oral health–related quality of life and health-related quality of life using the Oral Health Impact Profile (OHIP) and the 36-Item Short Form Health Survey (SF-36) developed from the Medical Outcomes Study, respectively. Materials and Methods: Oral health–related quality of life was evaluated using the Japanese version of the OHIP, and health-related quality of life was evaluated using scores for the mental component summary (MCS) and physical component summary (PCS) dimensions of the SF-36. Data were collected before treatment (baseline) and 1 month after delivery of the prostheses (follow-up). Stepwise multivariate regression analysis was used to explore the associations of posttreatment OHIP and SF-36 scores and changes in these scores after treatment (dependent variables) with age, sex, educational background, number of missing teeth, Eichner’s classification, pretreatment state, site of the embedded implant, number of implants, types of definitive prostheses, and baseline OHIP and SF-36 scores (independent variables). Results: Data from 150 consecutive patients (mean age: 58.1 ± 11.5 years) who underwent dental implant treatment between April 2008 and April 2016 were analyzed. The mean OHIP summary score, OHIP dimension scores (oral function, orofacial pain, orofacial appearance, and psychosocial impact), and MCS score showed significant improvements after treatment (P < .05). The baseline OHIP and SF-36 scores were consistently and significantly associated with the treatment outcome (ie, dependent) variables (P < .05). Moreover, the site of the embedded implant was identified as a significant predictor of the posttreatment status and changes in the OHIP summary score, oral function and orofacial appearance dimension scores (OHIP), and MCS score. Conclusion: These results suggest that patient perceptions of health and oral health conditions may help in the prediction of the outcomes of dental implant treatment. [ABSTRACT FROM AUTHOR]

Objective: Probiotics participate in regulating oral microbiota and reducing the prevalence of oral diseases; however, clinical research on probiotics is insufficient. Therefore, in this study, we performed in vitro screening of potential oral protective probiotic strains and then evaluated the clinical efficacy of the selected strains on maintaining oral health. Materials and methods: Fifty healthy individuals were recruited and randomly assigned into the placebo group and probiotics group, which included three strains of probiotics, Lactobacillus salivarius subs. salicinius AP‐32, Lactobacillus paracasei ET‐66, and Lactobacillus plantarum LPL28. Each group was blindly administered placebo or probiotics for four weeks. Results: Next‐generation sequencing results showed that the oral microbiota of Lactobacillus salivarius in the oral cavity were significantly increased in subjects supplemented with mixed probiotic lozenges. The anti‐bacterial activities of viable probiotics were observed within two weeks. Both IgA levels and Lactobacillus and Bifidobacterium abundances in the oral cavity were significantly increased in the experimental groups, along with a reduced formation of plaque. Most participants reported that their oral health conditions and intestinal symptoms had improved. Conclusions: Overall, our clinical study suggests that oral probiotic lozenges may enhance oral immunity, modulate oral microbiota, and improve oral health. [ABSTRACT FROM AUTHOR]

Objectives: Investigating the prevalence of speech and language disorders and the contributing factors can help determine the best treatment options suited to the needs of these patients. So far, no comprehensive study has been conducted on screening speech and reading disorders and Problems in the Structure and Function of Articulation Organs (PSFAOs) in children in Mashhad City, Iran. This study aims to screen for these disorders and investigate the effects of demographic factors on such disorders. Methods: Via the stratified-cluster sampling method, 2770 native Persian-speaking children participated in this study, of whom 1381 were girls and 1389 were boys, ranging from preschool to the third grade (3 to 9 years old). After obtaining the demographic information, the PSFAOs screening was performed for all participants using a semi-structured questionnaire taken from Paul et al.'s report (2017). Screening for a grade of dysphonia was then carried out for children with suspected voice disorders using the grade, roughness, breathiness, asthenia, and strain test. Fluency of speech screening for children with suspected fluency disorders was performed using the stuttering severity instrument - fourth edition test, and screening of reading skills for school children was performed using the screening inventory reading test. Analytical analysis was performed via the Chi-square test between study variables, including disorders and other variables. Two types of logistic regression models were used. The data were analyzed using survey data analysis of the Stata software, version 14.1, and P<0.05 was considered significant. Results: The prevalence of articulation disorders, voice disorders, stuttering, PSFAOs, reading disorders, and multiple disorders (presence of two or more disorders per person) was 1.62%, 1.99%, 1.69%, 1.1%, 8.21%, and 14.89%, respectively. Descriptive analysis showed that the prevalence of articulation disorders, voice disorders, stuttering, and multiple disorders was higher in boys compared to girls (P=0.000), while the prevalence of reading disorders and PSFAOs was higher in girls (P=0.000). Furthermore, articulation disorders and reading disorders were more common in first-graders. The prevalence of voice disorders, stuttering, and PSFAOs were higher in the third graders. The logistic regression analysis showed that boys were more likely to develop speech and language disorders compared to girls (OR=1.3, P=0.01), and first-, second-, and third-graders were less likely to have such disorders when compared to preschoolers (OR=0.8, P=0.03). Discussion: Compared to previous studies, the different rates of prevalence of the disorders studied in this investigation are related to differences in their methodology, the number of samples, age, linguistic and cultural characteristics of the subjects, and individual factors. In this study, the prevalence of the studied disorders was higher in boys, first-graders, and children with families of 4 or more. The development of speech and language skills is different between genders; slower maturation of male brains seems to predispose them to slower development of speech skills. The lower prevalence in school-age children may be because these disorders gradually resolve during the early years of childhood. Moreover, low family socioeconomic status and family size may be the contributing factors to speech and language disorders. [ABSTRACT FROM AUTHOR]

Background: Although intraoral scanning is highly reliable, little is known about its accuracy in young children with limited mouth-opening ability., Aim: To determine the accuracy of intraoral scans based on the degree of mouth opening., Design: To simulate mouth opening in children with primary dentition, three groups (n = 5 per group) were allocated by maximum mouth opening of 30, 37 and 40 mm. After the primary dentition model was connected to a dental phantom, intraoral scanning was performed using iTero and TRIOS4. The scanned files were digitally evaluated. Root mean square values were calculated to assess trueness and precision., Results: iTero showed deviations of three-dimensional trueness of 0.067 ± 0.008, 0.063 ± 0.001 and 0.065 ± 0.005 mm, and TRIOS4 of 0.07 ± 0.002, 0.064 ± 0.003 and 0.066 ± 0.002 mm in the 30, 37 and 40 mm groups, respectively. There were no significant differences in either mouth opening (p > .017) or the intraoral scanners (p > .05). The same statistical results were obtained for precision, with the exception of the 30 mm of mouth opening., Conclusions: Within the limits of this study, limited mouth opening hardly influenced the accuracy of intraoral scanning., (© 2024 The Authors. International Journal of Paediatric Dentistry published by BSPD, IAPD and John Wiley & Sons Ltd.)

With a growing global population and ageing demographics, the food industry stands at a pivotal crossroads, necessitating bespoke solutions and groundbreaking innovations. In vitro experiments can help understanding food oral processing and formulating products meeting the specific needs of different populations. However, current in vitro models do not reproduce well human oral anatomy and tongue biomechanics, essential for assessing the behaviour of novel and texturized foods under physiologically relevant oral conditions. In response, we unveil a novel 3D biomimetic artificial mouth, showcasing a pneumatic multi-degree-of-freedom artificial tongue meticulously crafted to mirror the mechanical properties and wettability of the human tongue. This cutting-edge technology, featuring tongue surface papillae, is capable of performing lifelike movements. The comparison with in vivo data demonstrates that it accurately reproduces oral processing of three, vastly different, soft foods. Textural characteristics (firmness, adhesive and cohesive properties) and shear viscosities-measured at oral and oropharyngeal-relevant shear rates-of in vitro food boli closely mirrored those observed in vivo. This in vitro device presents unprecedented opportunities for studying the dynamics of food transformation in the mouth, to adapt texture towards food that can be swallowed with ease and to improve food palatability, accommodating specific health needs critical for older adults (e.g., reduced salivary secretion, tongue weakness or poor coordination)., (© 2024. The Author(s).)

This study investigates the forces exerted on organs during swallowing, specifically focusing on identifying forces other than those resulting from direct organ contact. Using a swallowing simulator based on the moving particle method, we simulated the swallowing process of healthy individuals upon the ingestion of thickened foods, which were simulated as shear-thinning flow without yield stress. We extracted the resultant force vectors acting on the organs and shape of the bolus at each time interval. The simulation results confirmed that the bolus originates from tongue movement and is transferred between the oral cavity and pharynx, with each organ's coordinated movements with the tongue occurring at their respective positions, as indicated by the balance of the resultant force vectors. Utilizing the information about the resultant force vectors obtained through simulations, we calculated the physical parameters of impulse, energy, and power. The variations in these physical parameters were aligned with the behaviors of both the biological system and the food bolus during swallowing. The force values calculated from the simulations closely approximate the theoretical values. Furthermore, the forces calculated from the simulations were relatively smaller than the force values derived from pressure information, such as that from high-resolution manometry and tongue pressure sensors. This difference can be attributed to the simulations extracting only the forces exerted on the organ by the food bolus. Force information on organs has the potential to provide a new interpretation of conventional mechanical indicators such as manometry and tongue pressure sensors., (© 2024 The Author(s). Journal of Texture Studies published by Wiley Periodicals LLC.)

A masticatory simulator is a mechanical device that mimics the physiological structures of the human oral cavity, chewing movement system, and functions. The advantage of this device lies in real-time tracking and analysis of food boluses within a sealed oral space, offering a direct validation platform for food experiments without constraints related to time, space, and individual variations. The degree to which the masticatory simulator simulates physiological structures reflects its efficacy in replicating oral physiological processes. This review mainly discusses the physiological structures of the oral cavity, the simulation of biomimetic components, and the development, feasibility assessment, applications, and prospects of masticatory simulators in food. The highlight of this review is the analogy of biomimetic component designs in masticatory simulators over the past 15 years. It summarizes the limitations of masticatory simulators and their biomimetic components, proposing potential directions for future development. The purpose of this review is to assist readers in understanding the research progress and latest literature findings on masticatory simulators while also offering insights into the design and innovation of masticatory simulators., (© 2024 Wiley Periodicals LLC.)

Currently, the number of vehicles in circulation continues to increase steadily, leading to a parallel increase in vehicular accidents. Among the many causes of these accidents, human factors such as driver drowsiness play a fundamental role. In this context, one solution to address the challenge of drowsiness detection is to anticipate drowsiness by alerting drivers in a timely and effective manner. Thus, this paper presents a Convolutional Neural Network (CNN)-based approach for drowsiness detection by analyzing the eye region and Mouth Aspect Ratio (MAR) for yawning detection. As part of this approach, endpoint delineation is optimized for extraction of the region of interest (ROI) around the eyes. An NVIDIA Jetson Nano-based device and near-infrared (NIR) camera are used for real-time applications. A Driver Drowsiness Artificial Intelligence (DD-AI) architecture is proposed for the eye state detection procedure. In a performance analysis, the results of the proposed approach were compared with architectures based on InceptionV3, VGG16, and ResNet50V2. Night-Time Yawning-Microsleep-Eyeblink-Driver Distraction (NITYMED) was used for training, validation, and testing of the architectures. The proposed DD-AI network achieved an accuracy of 99.88% with the NITYMED test data, proving superior to the other networks. In the hardware implementation, tests were conducted in a real environment, resulting in 96.55% and 14 fps on average for the DD-AI network, thereby confirming its superior performance.

Background: As general spontaneous movements at the writhing and fidgety ages have been important for the early identification of neurodevelopmental impairment of both full-term and preterm infants, the knowledge of the spontaneous orofacial movements at these ages also seems to be important for the diagnosis of oral function, particularly in preterm infants. Therefore, we decided to first classify preterm and full-term infants according to general movements ages, and then to record, describe, compare, and discuss their spontaneous orofacial movements. Methods: This cross-sectional study included 51 preterm infants (born between 28 and 36 weeks) and 43 full-term infants who were classified at the writhing and fidgety ages of Prechtl's method of general movements assessment. Their spontaneous orofacial movements were recorded on video, and The Observer XT software (Noldus) was used to record the quantitative values of the movements. Results: Poor repertoires of writhing movements were more frequent in the preterm infants (90.9%) compared to full-term ones (57.9%). Positive fidgety movements were observed in 100% of both preterm and full-term infants. Oral movements were similar for both preterm and full-term infants, regardless of their movement stage. Conclusion: All spontaneous orofacial movements were present both in preterm and full-term infants, albeit with higher frequency, intensity, and variability at fidgety age. [ABSTRACT FROM AUTHOR]

Background: There have been no standard protocols of oral exercises for maintaining and improving oral function for people with dementia. Objective: This study aimed to determine the effects of home‐based oral exercises on the oral function of people with mild to moderate dementia. Methods: Twenty‐two participants at King Chulalongkorn Memorial Hospital were randomly assigned to the exercise group (n = 11) or control group (n = 11). The exercise group was instructed to do three home‐based oral exercises, consisting of tongue‐strengthening, oral diadochokinesis (ODK) and mouth‐opening exercises, for 3 months, while the control group received advice on oral health care. The maximum tongue pressure (MTP) was the primary outcome. MTP, ODK rates of /pa/, /ta/, /ka/, modified water swallowing test (MWST) and oral moisture were measured at baseline, and after 1, 2 and 3 months of training. The generalised estimating equation analysis was used to evaluate the effects of oral exercises on the oral function. Results: The MTP and all ODK rates in the exercise group were significantly increased after 3 months of training. There were significant interaction effects between time and intervention in MTP and all ODK rates. No significant interaction effects between time and intervention in oral moisture were found. The MWST scores in both groups did not change through the end of study, and no adverse effects were reported. Conclusion: Home‐based oral exercises were found to be effective for improving tongue strength and tongue‐lip motor function in people with mild to moderate dementia. [ABSTRACT FROM AUTHOR]

Commissural or lateral facial cleft (macrosomia), classified at Tessier number 7 craniofacial clefts, is a rare congenital anomaly usually associated with deformities of other structures developed from the first and second branchial arches. It affects the esthetics and functional aspect of the oral cavity. Bilateral transverse cleft occurring alone is uncommon and it's with tracheoesophageal fistula (TEF) has not been reported to the best of our knowledge. We report a case of esophageal atresia (EA) and TEF with macrosomia. EA was repaired, and the patient was discharged on full feeds. He is awaiting cleft repair. [ABSTRACT FROM AUTHOR]

Aim: To assess the levels of agreement between parents and adolescents about young adolescents' orthodontic treatment demand and to what extent is treatment demand conditioned by family and psychosocial impacts and oral function. Design: This cross‐sectional study included 221 adolescents (11–14 years, 54% female) and their parents. A 5‐point scale was used to assess orthodontic treatment demand. Adolescents self‐administered the Child Perceptions Questionnaire, and parents self‐administered the Parental‐Caregivers Perceptions Questionnaire and Family Impact Scale. The Index of Orthodontic Treatment Need Dental Health Component (IOTN DHC) was used for determining malocclusion severity. Intraclass correlation coefficient and Cohen's kappa coefficient were used for the assessment of agreement between two informants. Results: The parent‐child agreement on children's orthodontic treatment demand was weak, concording in 67.4% of cases. The most common reasons for seeking orthodontic treatment derive from the emotional (EW) and social well‐being domains for both informants. In linear regression, the adolescent's reporting of impaired EW and IOTN DHC was the only significant linear predictor of orthodontic treatment demand. Conclusion: Parents cannot correctly assess the orthodontic treatment demand of their children. Impaired EW is the most significant self‐reported determinant of adolescents' demand for orthodontic treatment. Family relationships and parental perspective have a low influence. [ABSTRACT FROM AUTHOR]

Background: A 60‐year‐old female patient reported with a chief complaint of pain in bilateral temporomandibular joints (TMJ) region since 11/2 years. The pain was initially reported to be insidious in onset, moderate in intensity, aggravated on chewing food and during excessive mouth opening. On examination her mouth opening was found to be less than 8 mm and standard head and neck examination showed grade 2 tenderness with swelling on bilateral TMJ and forward neck posture with rounded shoulders. The patient reported her pain to be 6 at rest in NPRS (with 0 being no pain and 10 being maximum) and 8 out of 10 on mouth opening. Methodology/Management: A 4‐week Physiotherapy Intervention program, which consisted of Ultrasound Therapy at varying intensity, TMJ manipulation, Cervical Range of Motion Exercises and Manual Cervical traction was administered. Repeated evaluation of pain and other functional outcomes were done on a weekly basis. Results: There was significant improvement in her mouth opening (41 mm), restoration of masticatory functions, complete resolution of pain and overall improvement in quality of life after the 4 weeks intervention program. Conclusion: A structured Physiotherapy intervention program consisting of Non‐thermal Ultrasound, Manipulation and exercise targeting TMJ and Upper quarter, proved to be highly effective in increasing functions and reducing signs and symptoms in Chronic TMJ Dysfunction which can be highly disabling. The recovery observed in this patient, who was not on any standard treatment for almost 18 months, hence the severe limitations she encountered, is a testament to the need of designing individualized treatment protocols addressing the many facets of impairment in TMJ Disorders. Highlights: Physiotherapy could possibly be beneficial in the management of, and functional restoration in long standing TMJ dysfunctions with internal derangementTo the best of our knowledge there exist no published literature where an eclectic approach with the same interventions have been used for TMJ disorder. The meaningful differences we achieved warrants further study on the effect of individualized protocols developed with similar contents on TMJ disorder [ABSTRACT FROM AUTHOR]

Background: The mouth‐opening muscular performance in patients with temporomandibular disorders (TMDs) is unclear. Understanding the impairments of this muscle group within specific TMDs is important to develop proper management strategies. Objective: To characterise the mouth‐opening muscular performance in adults with and without TMDs. Methods: PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane databases were searched from inception to 12 November 2020. Bibliographies were searched for additional articles, including grey literature. Case‐control, cross‐sectional and interventional studies reporting mouth‐opening muscular strength and/or endurance were included. Risk of bias was assessed by the SIGN checklist for case‐control studies and by the NIH quality assessment tool for cross‐sectional studies. Results were pooled with a random‐effects model. Confidence in cumulative evidence was determined by means of the GRADE guidelines. Results: Fourteen studies were included; most were rated as having a moderate risk of bias. Only three studies assessed patients with TMDs and the other 11 assessed healthy adults. Significant sex differences in muscular performance were found for healthy adults in the review (strength deficit for females versus males). There was a significant reduction in maximal mouth opening performance (strength and endurance) in the three studies that assessed patients with temporomandibular disorders. Conclusion: Sex plays a significant role in maximal mouth opening strength. There is a lack of reliable data on the normal mouth‐opening strength and endurance of healthy adults as well as for patients with TMDs. Implications: Lack of reliable TMDs patient data and comparable healthy adult data highlight future direction for research. [ABSTRACT FROM AUTHOR]

Aims: To perform a scoping review of the literature to elucidate the occurrence of nerve damage related to dental implant placement and the factors causing the sensory changes. Methods: An extensive electronic search was conducted using the Cochrane Library, Medline via Ovid, PubMed, Wiley Online, Science Direct, CINAHL, and the Google Scholar databases from the year 1950 to 2020. Results: The search resulted in 1,067 articles, out of which 76 were selected for this review. The articles were categorized as literature review articles, retrospective studies, prospective studies, and case series/case reports. Altogether, 2,526 subjects were assessed retrospectively, with 5.27% transient and 1.39% persistent sensory changes, and a cohort of 2,750 subjects were followed prospectively, with 6.22% transient and 1.31% persistent sensory changes. A total of 336 subjects were enrolled in various case reports and case series, with 5.95% transient sensory changes and 84.52% persistent neurosensory changes. The articles included were not of high quality and have variations in their study designs and reporting procedures, with limited sensory change data to include in this study. Conclusion: After surgical placement of dental implants in 5,612 patients, the incidence of transient sensory changes was 5.63%, and the incidence of persistent sensory changes was 6.33%. Factors affecting the incidence were: mandibular location of the implant, with the inferior alveolar nerve as the most commonly affected nerve. The common symptoms reported were paresthesia and dysesthesia. Age and gender were among other factors, for which data were not available in all the articles. [ABSTRACT FROM AUTHOR]

Background: Muscle‐related temporomandibular disorders (TMD) may affect the masticatory function. Chewing function can be assessed objectively using bolus‐kneading tests, such as two‐colour chewing‐gum mixing ability test. Objective: The aim was to compare the masticatory function with a two‐colour chewing‐gum test before and after treatment of the masticatory muscle‐related temporomandibular disorder. Methods: Twenty‐one patients with masticatory muscle disorder according to Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were recruited as an experimental group, and further twenty‐one participants without any TMD were included as controls. Pain intensity (scored on a visual‐analogue scale) and maximum mouth opening (MMO) were recorded. Jaw Functional Limitation Scale‐8 (JFLS‐8) was conducted on all patients. Before and after treatment, masticatory function was evaluated with a validated bolus‐kneading test, using two‐colour chewing gum. Results: There was no statistically significant difference in chewing function before and after treatment in the experimental group (p =.715). When these values were compared with the control group, there were no statistically significant differences (p =.489, p =.890). There was no correlation between masticatory function and VAS, MMO, JFLS‐8 before and after treatment in the experimental group. Conclusion: The two‐colour chewing‐gum test is not sensitive when the masticatory performance is not severely impaired. [ABSTRACT FROM AUTHOR]

Background: Pacifiers have been shown to affect maxillary growth related to the anatomic structure of the palate and forces placed upon it during sucking. This study compares and evaluates the mechanical behavior of pacifiers of different design and size (i.e., fit), identified by brand and size, positioned in age-specific palatal models with respect to both contact area and force when subjected to peristaltic tongue function and intraoral pressure related to non-nutritive sucking. Methods: Nonlinear finite element analyses were used to simulate dynamic mechanical interaction between the pacifiers and palates. Time-varying, external pressure loads were applied which represent intraoral pressure arising from non-nutritive sucking and peristaltic behavior of the tongue. The silicone rubber pacifier bulb was represented using a hyperelastic material model. Results: Results from the finite element analyses include deformation, stress, strain, contact area, and contact force. Mechanical interaction was evaluated in terms of the spatial distribution of the contact area and force between the pacifier and the palate. The resulting palatal interaction profiles were quantitatively compared to assess how pacifier fit specifically affects the support provided to two areas of the palate, the palatal vault and the Tektal wall. Conclusions: Pacifiers interact with the palate differently based on their fit (i.e., design and size) regardless of whether they are labeled conventional or orthodontic. Finite element analysis is an effective tool for evaluating how a pacifier's design affects functional mechanics and for providing guidance on biometric sizing. [ABSTRACT FROM AUTHOR]

Background: Many physical functions decline with aging, but it is not known whether oral functions vary according to sex or decline with aging, as it occurs with physical functions. The present study aimed to examine the association of sex, age, and elapsed years with occlusal force and tongue pressure using a generalized linear mixed‐effect model (GLMM) over a 3‐year period among old‐old Japanese adults. Methods: Participants were community‐dwelling older adults who participated in a survey (June 2014–March 2017) and a follow‐up survey (July 2017–December 2019) after 3 years (n = 951: 70‐year group, n = 466; 80‐year group, n = 391; 90‐year group, n = 94). Dental examinations including the number of teeth, occlusal force, and tongue pressure were conducted, and a GLMM was used to estimate the association of sex, age, and elapsed years with occlusal force and tongue pressure, adjusting for the number of teeth. Results: The GLMM showed that occlusal force was significantly associated with sex (reference; male, non‐standardized coefficient: B = −66.9 [female], p < 0.001), age (reference; 70‐year group, B = −81.7 [80‐year group], p < 0.001, B = −87.2 [90‐year group], p < 0.001), and the number of teeth (B = 13.8, p < 0.001), but did not significantly decrease with elapsed years. Tongue pressure was significantly associated with sex (reference; male, B = −0.94 [female], p = 0.034) and age (reference; 70‐year group, B = −1.78 [80‐year group], p < 0.001, B = −5.47 [90‐year group], p < 0.001). Tongue pressure decreased significantly with elapsed years (B = −0.82, p < 0.001). Conclusions: These findings suggest that tongue pressure significantly decreased over time, but occlusal force did not. Tongue‐related muscles may be more susceptible to aging than masticatory muscles. [ABSTRACT FROM AUTHOR]

Eating with the mouth is one of the basic joys of life. However, some 450,000 people currently live with nasogastric tubes in Taiwan. The causes of dysphagia disorders are complicated. Caring effectively for these cases requires interdisciplinary medical cooperation. Taiwan is expected to become a super-aged society in 2025. In Taiwan, people over 65 years old, residents of long-term care institutions, and stroke cases experience high rates of dysphagia. Every case of dysphagia has a potential risk of aspiration pneumonia, with pneumonia ranking as the third leading cause of death in people over 65 years old. Therefore, this issue demands the attention and assistance of medical care personnel. The integrated care model used at Kaohsiung Siaogang Hospital to promote the reconstruction of dysphagia functions is introduced in this article to help give medical teams interested in assisting cases a deeper understanding of this model. Integrating the resources and manpower of multiple disciplines helps cases improve dysphagia functions and reduces the need for indwelling nasogastric tubes and the incidence of aspiration pneumonia. Let us protect the everyday happiness of eating and improve quality of life. [ABSTRACT FROM AUTHOR]