Kan Nagao, Keiko Fujimoto, Hideki Suito, Takaharu Goto, Yuichi Ishida, Megumi Watanabe and Tetsuo Ichikawa : Effect of Palatal Augmentation Prosthesis on Speech and Swallowing in Tongue Dysfunction:A Literature Review, Journal of Oral Health and Biosciences, Vol.35, No.2, 39-46, 2023.
(要約)
Purpose: Palatal augmentation prosthesis (PAP) is used on patients with dysphagia and dysarthria. While several studies have evaluated the effects of PAP, evidence regarding the adaptation criteria, effects, and limitations of PAP are not well organized. This review aims to summarize its functions, limitations, and applications. Procedure: To investigate the adaptation criteria, effects, and limitations of PAP, we searched the English language literature published in PubMed from its inception through April 20, 2022. The leading search terms included ``palatal augmentation prosthesis.'' Main findings: The primary search used keywords that reflected 31 studies. Finally, nine cross-sectional studies and nine case reports were selected for full-text assessment after applying the inclusion criteria. Eleven studies described the efficacy of speech function: two for motility factors and nine for organic factors (with overlap). Thirteen studies described the effectiveness of swallowing function, four related to motility factors, and ten for organic factors (with overlap). Several studies have demonstrated that PAP effectively restores articulation and swallowing in patients with impaired tongue function after glossectomy for oropharyngeal cancer, sequelae of cranial nerve disease, or neuromuscular disease. However, few papers describe the scope of glossectomy and tongue movement restrictions, so it is impossible to describe the adaptation criteria, effects, and limitations. In this review, most case reports and cross-sectional studies did not provide information on the fabrication methods of PAP or the dentistsʼ experience. Thus, the effect of bias on palatal morphology in PAP patients remains unclear. Conclusions: The number of patients with dysarthria and dysphagia is increasing worldwide, similar to what is already occurring in Japan. Therefore, additional high-quality studies on the effects of PAP are required.
(キーワード)
Palatal augmentation prosthesis / Tongue dysfunction / Literature review
Yoshihiro Tagami, Keiko Fujimoto, Takaharu Goto, Hideki Suito, Kan Nagao and Tetsuo Ichikawa : Can Measurement of Ultrasonic Echo Intensity Predict Physical Frailty in Older Adults?, Diagnostics, Vol.13, No.4, 675, 2023.
(要約)
Echo intensity (EI) of the tongue in ultrasonography is an easy and quantitative assessment of tongue function. Elucidating the relationship between EI and frailty, is expected to aid in the early detection of frailty and oral hypofunction in older adults. We assessed tongue function and frailty in older outpatients visiting a hospital. The subjects were 101 individuals aged 65 or older (35 men and 66 women, mean age 76.4 ± 7.0 years). Tongue pressure and EI were measured as assessments of tongue function and grip strength, and Kihon Checklist (KCL) scores were measured as assessments of frailty. In women, a significant correlation was not found between the mean EI and grip strength, whereas a significant correlation was noted between each score of the KCL and the mean EI; the scores increased as the mean EI increased. A significant positive correlation was found between tongue pressure and grip strength, but no significant correlation was observed between tongue pressure and the KCL scores. In men, no significant correlation was found between tongue assessments and frailty, except for a significant positive correlation between tongue pressure and grip strength. The results of this study suggest that EI of the tongue is positively associated with physical frailty in women and may be useful for early detection of physical frailty status.
Application of cream-type denture adhesives effectively improves the denture retention and occlusal force in complete denture wearers with a moderate degree of difficulty during edentulism treatment.
Hideki Suito, Keiko Fujimoto, Takaharu Goto, Kan Nagao, Hidehiko Hosoki and Tetsuo Ichikawa : Effective use of an extraoral vacuum in preventing the dispersal of particulate matter from metal dental materials., Journal of Occupational Health, Vol.65, No.1, e12412, 2023.
(要約)
When dentists adjust prostheses at the dental chairside, particulate matter (PM) from the dental material is dispersed. Little is known about the effective use of an extraoral vacuum (EOV) in preventing PM dispersal. This study aimed to evaluate the effective use of an EOV in preventing the dispersal of metal PM in dental offices. The following experimental conditions were planned: the distance from the EOV to the metallic materials (50, 100, 150, and 200 mm), the horizontal angle between the long axis of the micromotor handpiece and EOV (0°, 45°, and 90°), and the operating time of the EOV (during grinding, during grinding and 1 min thereafter, during grinding and the preceding 1 min, 1 min before and after grinding, and during grinding). Carborundum and silicone points were used for grinding and PM dispersal. Diameters (0.3, 0.5, 1.0, and 3.0 μm) were measured using a laser particle counter. Depending on the instrument used to grind, there were undetectable PMs of different diameters (Carborundum point: 0.3 and 0.5 μm, Silicone point: 0.3 μm). PMNs were reduced as the distance from the EOV to metal materials decreased. Operating the EOV before grinding along the long axis of the micromotor handpiece was effective in reducing the PMNs. PMNs dispersed when grinding metals were effectively reduced by positioning the EOV closer to the grinding surface (within 150 mm) along the long axis of the micromotor handpiece and operating the EOV before grinding.
Yoshihiro Tagami, Keiko Fujimoto, Takaharu Goto, Hideki Suito, Kan Nagao and Tetsuo Ichikawa : Measurement of ultrasonic echo intensity predicts the mass and strength of the tongue muscles in the elderly, Journal of Oral Science, Vol.64, No.1, 44-48, 2022.
<p><b>Purpose </b>To investigate the difference in improvement of oral health-related quality of life (OHR-QoL) depending on the oral and denture conditions of a complete denture wearer when using a cream or powder type denture adhesive in a 10-center parallel randomized clinical trial.</p><p><b>Methods </b>Two hundred edentulous subjects who wore complete dentures were allocated to each of the three groups according to denture adhesive type: cream, powder, and control (saline solution). The materials were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention were collected. OHR-QoL was assessed using the Japanese version of the modified Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT-J) scale for outcome. Multivariate analysis was used to investigate improvements in OHR-QoL according to participant characteristics among complete denture wearers using these materials.</p><p><b>Results </b>OHIP-EDENT-J scores were significantly decreased in all groups after the intervention (p < 0.05); however, there were no statistically significant differences among the groups. Multiple logistic regression analysis revealed a significant association between the vertical height of the maxillary and mandibular alveolar ridge and OHIP-EDENT-J scores in the cream-type denture adhesive group. In contrast, there were no significant association between participant characteristics and OHIP-EDENT-J scores in the powder-type adhesive and control groups.</p><p><b>Conclusions </b>The use of denture adhesives could improve OHR-QoL for complete denture wearers. The cream-type denture adhesives may be expected to improve OHR-QoL in patients with poor residual ridge conditions compared with patients with good residual ridge conditions.</p>
Keiko Fujimoto, Hideki Suito, Kan Nagao and Tetsuo Ichikawa : Does Masticatory Ability Contribute to Nutritional Status in Older Individuals?, International Journal of Environmental Research and Public Health, Vol.17, No.20, 2020.
(要約)
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.
(キーワード)
Aged / Female / Humans / Male / Mastication / Nutritional Status / Pressure / Quality of Life / Tongue
Y Nishi, T Nomura, M Murakami, Y Kawai, M Nishimura, H Kondo, Y Ito, A Tsuboi, G Hong, S Kimoto, A Gunji, A Suzuki, G Ohwada, S Minakuchi, Y Sato, T Suzuki, K Kimoto, N Hoshi, M Saita, Y Yoneyama, Y Sato, M Morokuma, J Okazaki, T Maeda, K Nakai, Tetsuo Ichikawa, Kan Nagao, Keiko Fujimoto, H Murata, T Kurogi, K Yoshida, T Hosoi and T Hamada : Effect of denture adhesives on oral moisture: A multicenter randomized controlled trial, Journal of Prosthodontic Research, Vol.64, No.3, 281-288, 2020.
(要約)
The purpose of this study was to investigate the effect of denture adhesives on oral moisture in a 10-center parallel randomized clinical trial. Two hundred edentulous subjects wearing complete dentures were allocated into three groups: cream-type adhesive, powder-type adhesive and control groups. The adhesives (and saline solution in the control group) were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention for eight meals over 4 days were obtained. For the main outcome, oral moisture was measured with a moisture checking device. Secondary outcomes were denture satisfaction, masticatory performance, denture retention, and occlusal force. In addition to between-group and within-group comparisons of oral moisture, investigations for secondary outcomes were undertaken in subgroups classified according to the degree of oral moisture at baseline (normal subgroup and dry mouth subgroup). Intention-to-treat analysis was also performed. Between-group and within-group comparisons of oral moisture showed no significant differences. The cream-type and powder-type denture adhesives were significantly effective in the dry mouth group for denture satisfaction ratings of ability to masticate, stability, retention, and comfort of mandibular dentures (p<0.05). The masticatory performance and retentive force of the dry mouth denture adhesive using groups were significantly improved after intervention (p<0.05). The oral moisture of complete denture wearers was not influenced by the use of denture adhesives. Our findings showed that denture adhesives improved subjective denture satisfaction, masticatory performance, and retention for complete denture patients with oral dryness.
G Ohwada, S Minakuchi, Yuji Sato, A Tsuboi, Tetsuo Ichikawa, Kan Nagao and Keiko Fujimoto : Subjective Evaluation of Denture Adhesives: A Multicenter Randomized Controlled Trial., JDR Clinical and Translational Research, Vol.5, No.1, 50-61, 2019.
(要約)
Many reports show that denture adhesives improve the retention and stability of dentures. However, few randomized controlled trials have examined the effects of denture adhesives. This 10-center randomized controlled trial with parallel groups involving 200 edentulous patients wearing complete dentures aimed to evaluate the effects of short-term use of cream and powder denture adhesives. Patients were allocated into 2 cream- and powder-type adhesive groups and 1 control group. Intervention groups were treated with the 2 adhesives (1 each), and the control group received saline solution. Adhesive or control was applied to the denture-mucosal surface for 4 d, and data at baseline and after day 4 of intervention (i.e., 8 meals) were obtained. Patient satisfaction was evaluated with a 100-mm visual analog scale. Oral health-related quality of life was measured with the Japanese version of the Oral Health Impact Profile for Edentulous Patients. Perceived chewing ability was evaluated by a questionnaire regarding ease of chewing and swallowing food. Between-group comparisons were performed with Kruskal-Wallis tests with the Mann-Whitney test adjusted by Bonferroni correction. Within-group comparisons of pre- and postintervention measurements were performed with the Wilcoxon signed-rank test. Intention-to-treat analysis was also performed. Between-group comparisons showed no significant differences for general satisfaction or Oral Health Impact Profile for Edentulous Patients. However, significant differences in satisfaction with various denture functions with cream- and powder-type adhesives were seen in pre- and postintervention comparisons ( < 0.05). Significant differences were also observed for perceived chewing ability of hard foods ( < 0.05). These results suggest that although denture adhesives do not invariably improve denture function, they do affect subjective evaluations and possibly chewing of hard foods. Therefore, the effects of denture adhesive use are insufficient to resolve any fundamental dissatisfaction with dentures ( ClinicalTrials.gov NCT01712802 ). The results of this study suggest that denture adhesives should be applied under certain conditions; however, an appropriate diagnosis is important before application. These practice-based data provide information to establish evidence-based guidelines for applying denture adhesives.
Keiko Fujimoto, Tsuyoshi Honda, Hideki Suito, Kan Nagao and Tetsuo Ichikawa : Tongue thickness and its clinical significance, Journal of Oral Health and Biosciences, Vol.31, No.1, 32-38, 2018.
Takaharu Goto, Tsukasa Hihara, Keiko Fujimoto, Kan Nagao and Tetsuo Ichikawa : Sex difference of clinical cascade from oral hypofunction to physical frailty, The 7th Biennial Joint Congress of KAP-CPS-JPS, Mar. 2019.