Difficulty Chewing Research Articles

Development of a Predictive Model for Chewing Difficulty Using EuroQol-5 Dimension Among Korean Older Adults.

We aimed to develop a predictive model for chewing difficulty using the EuroQol-5 dimension measure (EQ-5D). We included 6643 individuals aged ≥ 65 years (mean age: 72.6 ± 4.96 years; women: 3761 [56.6%]) who had completed the sixth (2013-2015) and seventh (2016-2018) Korea National Health and Nutrition Examination Survey (KNHANES). The participants were further divided into young-old (65-74 years) and old-old (≥ 75 years) adults. Data from the sixth KNHANES were used to establish an internal validation model (overall, young-old and old-old adult populations were 3472, 2271 and 1201, respectively). Data from the seventh KNHANES were used to establish an external validation model (overall, young-old and old-old adult populations were 3171, 1879 and 1292 participants, respectively). We evaluated chewing difficulty using the EQ-5D (Model 1) and comparative models, subjective oral health status indicators (SOHSI) and objective oral health status indicators (OOHSI). Compared with SOHSI and OOHSI, EQ-5D showed similar predictive utility for chewing difficulty in both the internal and external validation models. Effect sizes, quantified using Cohen's d, indicated that EQ-5D parameters had a moderate impact on the prediction accuracy for chewing difficulties.

Relationship between physical activity and oral frailty among older adults in Korea

Objectives: This study aimed to investigate the effects of physical activity on oral frailty in older Korean adults. Methods: The data from 1,320 individuals aged 65 years and older, derived from the 8th Korean National Health and Nutrition Examination Survey (2019), were subjected to complex sample statistical analysis. Oral frailty was assessed based on the presence of one or more functional impairments according to the following five criteria: difficulty chewing, difficulty speaking, number of natural teeth, brushing frequency, and use of oral hygiene products. Results: Chewing discomfort and difficulty speaking were highest in the 76-80 age group at 44.5% and 18.1%, respectively (p<0.01). The proportion of patients with 20+ natural teeth decreased from 72.2% (65-70) to 45.3% (75-80) (p<0.001). The daily brushing rate was 50.2% in the 65-70 group. Chewing discomfort was reported by 26% of those who walked 4-6 days a week (p<0.01). Moderate-intensity activity was linked to lower chewing discomfort (22.9%) and speaking difficulty (7.4%) compared with higher levels in inactive individuals (30.4%, 14.9%) (p<0.01). Brushing three times daily was observed in 52.9% of walkers and 33.9% of non-walkers (p<0.001). Oral hygiene product use varied significantly according to activity level (p<0.05). Conclusions: Physical activity significantly affects oral frailty, highlighting the need for targeted training and policy development.

State of oral health in the Portuguese population and associated psychological and social aspects

Abstract Background Oral diseases are a global public health challenge and remain among the most prevalent non-communicable diseases. This study aims to characterize the self-assessment of oral health state, degree of edentulism, oral rehabilitation and the quality of life, namely chewing capacity, and the associated psychological and social aspects in the Portuguese Population. Methods Data were collected by telefone survey, on the 2nd half of 2018 and 1st half of 2019, using the Portuguese population representative, ECOS panel. Descriptive statistics, as well as prevalence estimates, were obtained with weighting for age, sex, region and sample design, for 95% confidence intervals. The modified F-statistic, a variant of the 2nd order Rao-Scott chi-square adjustment, was used to test the bivariate analyses. Results For 53% of the population, the health status of the mouth was perceived as Good or Very Good, for 37% Fair and, in 11% of cases as Bad or Very Bad. It is estimated that around 76% of the population has good oral hygiene habits, approximately 26% have all of their teeth and 8% the total absence of teeth. It is estimated that only around half (49%) underwent rehabilitation using, in the vast majority of cases (78,5%), removable prostheses. It is estimated that 32% of its users have difficulty chewing hard foods and, of these, around 20% have great difficulty or are unable to chew at all. Psychological discomfort due to oral health was higher in the Portuguese population when compared to the European population (17% vs 7 %), psychological limitations due to the appearance of teeth or dentures were equally higher (7% vs 4%), as were social limitations (8,8% vs 4%). Conclusions The oral health panorama in Portugal remains bleak, so strengthening the application and deepening of the national oral health promotion program should constitute a priority aspect in the development of public policies in the country Key messages • Integrating oral health into general health promotion strategies and assessing oral health needs to include psychological and social aspects in the Portuguese Population. • Strengthening the strategies that have been developed in the context of health promotion, prevention and early treatment of oral diseases in Portugal.

Comparison of functional impairments and discomfort with bonded labial and lingual orthodontic appliances - a questionnaire survey

ObjectiveTo compare the levels of functional impairments, discomfort and satisfaction experienced by those treated with full-mouth customized lingual appliances (Lingual appliances), full-mouth self-ligating bracket (Labial appliances), or upper lingual and lower labial appliances (Mixed appliances) using questionnaires.Materials and methodsPatients within one year of the end of treatment were included in the survey and given a questionnaire concerning different kinds of discomfort and difficulties during the treatment process. The questionnaires focused on the following aspects including speech difficulty, pain (lip, cheek or tongue), difficulty in chewing, difficulty in tooth brushing and overall aesthetics and comfortability. Ordinary one-way ANOVA Tukey’s multiple comparison tests and Kruskal–Wallis tests were employed to analyze the data.ResultsA total of 115 patients participated in the study. In terms of functional impairments and discomfort, the rate and degree of speech difficulty was significantly higher in the Lingual appliances Group than that in the Labial appliances Group. But there was no difference among the three groups for difficulty in chewing and tooth brushing. Both lingual and labial appliances caused a similar level of overall pain, however, those treated with lingual appliances experienced more tongue pain, and those treated with labial appliances experienced more cheek and lip pain. The most common sites of irritation were the tongue lateral and tongue tip in the Lingual appliances Group, tongue lateral and cheek in the Mixed appliances Group, and cheek and lower lip in the Labial appliances Group. In total, patients gave highest scores to mixed appliances for comfortability and lowest scores to labial appliances for aesthetics when it came to satisfaction.ConclusionsLingual and labial appliances caused similar level of overall pain. Taking into account the overall comfortability, aesthetics and cost, the mixed appliances may be suitable for some patients who have aesthetic and comfort pursuits.

Importance of an Evaluation Phase When Increasing the Occlusal Vertical Dimension: A Systematic Review.

To assess whether an evaluation period is necessary for patient and clinical success when increasing the occlusal vertical dimension (OVD) for a full mouth rehabilitation. A systematic search was conducted in six databases: MEDLINE, Web of Science, Scopus, CENTRAL, VHL, and EMBASE. The eligibility criteria of this systematic review used the PICO framework to address the following research question: "In dentate adults requiring an increase in occlusal vertical dimension (OVD) (P), is an evaluation period of the new OVD (I) superior to no evaluation period (C) in terms of success (O)?" Study characteristics, survival, and success rates were extracted from each article. No language restrictions were applied. Study quality was appraised using Cochrane's Risk of Bias 2 tool and Newcastle-Ottawa Scale (NOS) according to the study design. The electronic search yielded 1188 titles after duplicates were removed. One RCT and 103 non-comparative articles were found relevant to the search question. Out of the 103 articles, 80 had an evaluation phase and 23 did not. The included RCT revealed that removable devices tended to cause chewing difficulties, unclear speech, and esthetic discomfort. Therefore, the use of a removable appliance to functionally or esthetically evaluate OVD was not indicated prior to the definitive treatment. Esthetics was the highest reported parameter preoperatively for the non-comparative studies, at 85% with an evaluation and 86% without. At present, there is lack of evidence that an evaluation period improves clinical and patient-reported outcomes when increasing OVD for full mouth rehabilitations. Thus, an increase in OVD can be successful with or without an evaluation phase. The evaluation phase helps the clinician manage patient expectations and assist with the treatment sequencing. This phase is most effective with fixed restoration, such as temporary crowns or adhesive restorations. However, there is limited evidence that this phase improves clinical or patient-reported outcomes.

Fixed Prosthodontic Rehabilitation of a Patient with Cleidocranial Dysplasia: A Case Report

Introduction Cleidocranial Dysplasia (CCD) is a rare congenital disease characterized by skeletal and dental anomalies. Clinical findings of CCD patients include low facial height, pseudoprognathism, unerupted teeth, an excessive deep bite, chewing difficulties, and unsatisfied dentofacial appearance. These patients’ dental treatments present a substantial challenge. Case Representation This case report describes the prosthodontic treatment of a 29-year-old male CCD patient using porcelain-fused-to-metal restorations. The avoidance of a surgical procedure serves to minimize the potential for complications and expedites the attainment of outcomes with greater celerity. Throughout the follow-up period of 1 year, the patient maintained good periodontal health. The restoration of masticatory function and enhancement of facial esthetics were successfully achieved and the patient expressed a high degree of satisfaction with the outcome of the treatment. Conclusion The use of fixed prostheses in CCD patients is a treatment modality that resolves many of the issues caused by the surgical approach.

Consensus statement on "Oral frailty" from the Japan Geriatrics Society, the Japanese Society of Gerodontology, and the Japanese Association on Sarcopenia and Frailty.

The concept of oral frailty was first proposed in Japan in 2014 by the "Joint Working Committee on Oral Frailty," consisting of three academic societies-the Japan Geriatrics Society, the Japanese Society of Gerodontology, and the Japanese Association on Sarcopenia and Frailty-to enhance public understanding of oral frailty. Oral frailty is a state between robust oral function (a "healthy mouth") and its decline, characterized by slight declines in oral function, including tooth loss and difficulties in eating and communicating, which increase the risk of impaired oral functional capacity but can be reversed with proper intervention and treatment. Oral frailty can be assessed using the Oral Frailty 5-item Checklist (OF-5) without the need for a dental health professional. Oral frailty is defined as having at least two of the following components: (i) fewer teeth, (ii) difficulty chewing, (iii) difficulty swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. Approximately 40% of community-dwelling older adults have oral frailty. Oral frailty is associated with poor dietary variety, social isolation, physical frailty, disability, and mortality. This statement introduces the concept and definition of oral frailty, a new assessment tool (OF-5), and concept diagrams for healthcare professionals and the general public. These tools aim to promote public awareness and facilitate collaboration between medical and dental healthcare providers. Geriatr Gerontol Int 2024; ••: ••-••.

7357 Microscopic Papillary Thyroid Cancer Presenting with Cranial Nerve Palsies due to Metastatic Cervical Lymphadenopathy: A Case Report

Abstract Disclosure: N.N. Mukhtar: None. C. Zuo: None. B.R. Haugen: None. Introduction: Tumors metastasizing to head and neck are considered a rare cause of cranial nerve palsy (CNP). In this report, we describe an unusual presentation of metastatic microscopic follicular variant papillary thyroid cancer (FVPTC) presenting with CNP. Case Summary: A 68-year-old previously healthy female presented to her primary care physician with a 6-week history of difficulty speaking and chewing food. She did not notice any dysphagia, change in voice or shortness of breath. Cranial nerve examination was evident for palatal asymmetry, left-sided uvular and right-sided tongue deviations suggesting right glossopharyngeal and hypoglossal nerve palsies. Neck examination revealed a normal thyroid gland without palpable nodules however, the patient had multiple enlarged painless right cervical lymph nodes (CLN). MRI of the brain was normal. CT of the neck and chest showed enlarged, calcified right level II and III CLN (largest 4x3.5 cm) compressing the right internal jugular vein. In addition, bilateral pulmonary nodules (largest 1.7x1.5 cm) suspicious for metastasis were seen. CT-guided biopsy of left upper lobe lung nodule was consistent with metastatic thyroid cancer (positive PAX-8 and TTF-1 immunostaining). Neck ultrasound did not show any thyroid nodules, but did confirm 4 enlarged right CLN (largest 2.9 cm). The patient was referred to our multidisciplinary clinic for further evaluation. Based on the duration of her symptoms (6 weeks), her CNP was most-likely irreversible and agreement to proceed with total thyroidectomy, central and right lateral neck dissection aiming for complete resection in preparation for future treatment with radioactive iodine. Preoperative thyroglobulin level was 30.7 ng/ml (1.6-50), thyroglobulin antibody 24 U/mL (<40) and TSH 0.6 mIU/L (0.4-4.6). Intra-operatively; the patient had extensive, bulky lymphadenopathy extending to surrounding neck muscles and completely encasing right jugular vein. Histopathological examination of the resected tissue showed a unifocal right thyroid lobe microscopic (6x4x3 mm) infiltrative follicular variant papillary thyroid cancer (FVPTC). No extrathyroidal extension, necrosis, angioinvasion or lymphatic invasion were identified. Mitotic index was 3/ 2mm2. 13 out of 36 lymph nodes were positive for metastatic thyroid cancer (3/3 level II, 2/17 level III, 8/16 level IV), largest was 4.6 cm with extra-nodal extension. The patient was discharged on suppressive dose levothyroxine. Molecular studies: Next generation sequencing of the lung biopsy was negative for BRAFV[6]00E mutation and further molecular analyses are ongoing. Conclusion: This case describes two unique presentations of thyroid cancer; a microscopic FVPTC associated with large lateral cervical lymph node metastasis and, CNP as the initial presentation of thyroid cancer which to our knowledge, has not been reported previously. Presentation: 6/2/2024

The Effects of the Expansion of Dental Care Coverage for the Elderly.

Expanding dental care coverage for the elderly is globally recommended but not widely implemented due to its high costs and intangible benefits. This study examined the impact of such an expansion in Korea using the imputation-based method proposed by Borusyak et al. We analyzed data from the Korea National Health and Nutrition Examination Survey (2007-2019) on dental service utilization and chewing ability among older adults. The policy resulted in a 13.5% increase in partial denture use and a 60.5% increase in dental implants among those aged 65 and above. These changes corresponded with reductions in severe chewing difficulty by 23.3% and 13.0%, respectively. No significant changes were observed in full denture use. The price elasticity of demand for partial dentures and dental implants was estimated to be -0.19 and -0.86, respectively. These findings underscore the critical role of affordability in enhancing the utilization of dental implants among the elderly and highlight the importance of appropriately expanding dental insurance coverage to improve oral health outcomes in this population.

Identifying correlations between nutritional impact symptoms and risk factors for malnutrition in adult cancer patients with solid tumors: a cross-sectional study from a developing country.

Many cancer patients experience malnutrition, which can worsen their health and survival outcomes. However, limited research exists in our region on how common malnutrition is among hospitalized adults with solid tumors and what factors contribute to it. This study aimed to identify these factors and assess the effects of nutritional impact symptoms (NISs) caused by solid tumors on patients' nutritional status. Between July 2022 and February 2023, a cross-sectional study was carried out on the campuses of two major cancer treatment centers located in a national university hospital and a governmental hospital. Twelve NISs were adopted from the Patient-Generated Subjective Global Assessments (PG-SGA). The Nutrition Risk Screening 2002 (NRS-2002) instrument was used to thoroughly assess the risk of malnutrition. Multiple linear regressions were used to conduct a thorough study. A cohort of 294 participants was included. The prevalence of malnutrition risk (NRS score ≥ 3) was 26.9%. Parameters such as age, gender, marital status, educational level, monthly income, type of cancer and treatment modality, and the need for mealtime assistance exhibited statistically significant associations with malnutrition (p < 0.05). The results revealed a substantial inverse correlation between fluid intake and the NRS-2002 score (p < 0.001). Furthermore, symptoms related to solid tumors and their treatment, including chewing difficulties, fatigue, dry mouth, anorexia, constipation, nausea, dizziness, and a sensation of fullness, were also significantly associated with malnutrition (p < 0.05). Additional insights from the regression analysis underscored the independent correlation between the risk of malnutrition in solid malignant malignancies and factors such as anorexia (p < 0.001), colorectal cancer (p = 0.003), gender (p = 0.018), educational attainment (p = 0.049), and the need for mealtime assistance among patients (p < 0.001). Malnutrition is a major issue among adult cancer patients, particularly those with solid tumors. Anorexia, colorectal cancer, gender, educational attainment, and the need for mealtime assistance were identified as factors that led to malnutrition in our research. This study emphasizes the need for a multidisciplinary plan of care to diagnose and treat malnutrition, improve overall therapy, and reduce mortality and morbidity.

Physicochemical, antioxidant, and texture characteristics of enzymatically treated apios (Apios americana) for the elderly

ABSTRACT Apios is a legume known to be nutrient dense. However, it is difficult for older adults to consume due to chewing difficulties. In this study, we analyzed its nutritional contents and antioxidant capacity and improved its texture through enzymatic treatment (polygalacturonase, cellulase, and α-amylase) to make it more palatable for older adults. Apios has been shown to have higher antioxidant capacity than other tubers, which is beneficial for geriatric health. Enzyme treatment (ETG1 7.12 h, ETG2 9.64 h, ETG3 over 6.48 h) made the texture suitable for consumption by the elderly. SEM analysis showed that the pore size increased and the cell wall was disrupted, resulting in irregular cell tissues. These changes can facilitate mastication and improve nutrient intake. Therefore, the enzyme-treated Apios is easy to chew, so it will be able to improve the intake of nutrients that the elderly need. In addition, it is expected to contribute to the expansion of the elder-friendly food industry by applying enzyme treatment to personalized food development considering different chewing abilities of the elderly.

Enhancing smile and Altering Thrust using Modified Groper’s Appliance: A Case-Report

Early childhood caries, has a major influence on child’s lifestyle, resulting in child experiencing severe pain, premature loss of teeth, poor nutrition, difficulty chewing, speech, compromised esthetics, development of abnormal oral habits and delay in achieving normal growth and development of child. This paper presents a case report of a Four-year-old child diagnosed with Severe Early Childhood Caries. It explains treatment plan for rehabilitating child's mouth, including caries prevention and restorative procedures using appliances and making special adjustments to a child's feeding habits, combined with maintaining good oral hygiene practices. Early childhood caries is an important oral condition that requires prompt treatment and early intervention. Early diagnosis and awareness of ECC are essential for helping the child maintain a good quality of life.

Black Tea Jelly Candy (Camellia Sinensis) to Increase Salivary Volume in Elderly: Preliminary Research

Background: Physiological changes in the elderly include decreased saliva production that causes dry mouth, difficulty in chewing and swallowing. Chewing gum and candies with a chewy texture like jelly can help stimulate the salivary glands. Black tea contains some phenolic and flavonoid compounds that have antioxidant properties that can increase the saliva flow rate. Objective: To determine the gap in saliva volume of elderly subjects before and after chewing black tea jelly candy compared to the saliva production when subjects chewed non-black tea candies and the control group (no treatment). This study also determined the prevalence of xerostomia in subjects. Materials and Methods: This field experiment was conducted using a Randomized Controlled Clinical Trials design with a pretest-posttest control group design. 30 elderly subjects aged 45-90 years in the Tresna Werda Budi Mulia 1 Nursing home, Jakarta were selected based on the predetermined inclusion criteria. They signed the informed consent and answered the Summated Xerostomia Inventory Questionnaire (SXI). Salivary volume before and after chewing black tea jelly candy was measured using a measuring cup. Statistical tests consisting of Oneway ANOVA and Dependent T-Test were performed to analyze the data. Results: The prevalence of elderly who complaining of xerostomia in this research was 40%. There was a significant gap in saliva volume between the three groups with p = 0.002 (P&lt;0.05). An increase in saliva volume in the black tea jelly candy treatment group was identified. The average volume before intervention in the black tea jelly candy treatment group was 1.26 mL and after the intervention was 2.15 mL. Conclusion: Chewing black tea jelly candy increase the saliva volume in elderly subjects.

Association between self-reported difficulty in chewing or swallowing and frailty in older adults: A retrospective cohort study.

Oral frailty can contribute to physical and mental health disorders. Previous research has shown an association between frailty and self-reported difficulty in chewing or swallowing. However, their combined assessment has obscured their specific impact on frailty-related outcomes. To investigate the independent associations between difficulty in chewing or swallowing and 1-year frailty outcomes, while also examining their interactions. This retrospective cohort study utilized the DeSC database to identify older adults aged ≥ 75years who underwent health checkups between April 2014 and November 2022. Multivariate Cox regression analyses were conducted to assess the association between self-reported difficulty in chewing or swallowing and outcomes, including hospitalization due to aspiration pneumonia, all-cause hospitalization, and all-cause mortality within 1year. Interactions between chewing and swallowing difficulties were also evaluated. Among 359,111 older adults, 39.0% reported oral function difficulties. Swallowing difficulty alone lacked significant outcome association. However, chewing difficulty alone was significantly associated with higher risks of hospitalization due to aspiration pneumonia (hazard ratio (HR), 1.35; 95% confidence interval (CI), 1.15-1.58; P < 0.001), all-cause hospitalization (HR, 1.08; 95% CI, 1.05-1.11; P < 0.001), and all-cause mortality (HR, 1.28; 95% CI, 1.14-1.44; P < 0.001) compared with no self-reported difficulty. A significant positive interaction between self-reported difficulty in chewing and swallowing was observed for all-cause mortality (P = 0.009). Self-reported difficulty in chewing was significantly associated with higher risks of hospitalization due to aspiration pneumonia, all-cause hospitalization, and all-cause mortality among older adults. Chewing and swallowing difficulties showed a synergistic effect, significantly increasing all-cause mortality risk.

Oral health-related quality of life in the Myanmar population: The first national oral health survey 2016 - 2017.

To describe the oral health-related quality of life (OHRQoL) and its potential influencing factors within the Myanmar population. Data were from the first national oral health survey, involving 3,513 participants aged 15-18 years, 35-44 years, and 60-74 years from 21 selected townships in Myanmar. Self-administered questionnaire-based surveys, conducted from December 2016 to January 2017, included socio-demographics, behavioral factors, self-reported oral conditions (number of teeth present, teeth and gingival conditions), and inquiries regarding OHRQoL (a set of 12 questions with 5 response options) using the recommended questions from WHO Oral Health Surveys. The most prevalent oral health issues were difficulties in chewing (32.2%) and biting foods (30.8%). In bivariate analysis, older individuals, rural residents, and participants with higher educational levels were associated with OHRQoL. In multiple regression analysis, self-reported number of teeth, teeth and gingival conditions were strong predictors of OHRQoL in all age groups. Self-rated oral health conditions predicted quality of life due to oral problems. The development of national oral health policies and strategies is imperative to facilitate early detection of oral health problems and promote the awareness of oral health importance.

Nutritional Strategies for Chronic Craniofacial Pain and Temporomandibular Disorders: Current Clinical and Preclinical Insights.

This narrative review provides an overview of current knowledge on the impact of nutritional strategies on chronic craniofacial pain associated with temporomandibular disorders (TMDs). Individuals experiencing painful TMDs alter their dietary habits, avoiding certain foods, possibly due to chewing difficulties, which might lead to nutrient deficiencies. Our literature investigation revealed that the causal links between nutritional changes and craniofacial pain remain unclear. However, clinical and preclinical studies suggest that nutraceuticals, including vitamins, minerals, polyphenols, omega-3 fatty acids, isoprenoids, carotenoids, lectins, polysaccharides, glucosamines, and palmitoylethanolamides, could have beneficial effects on managing TMDs. This is described in 12 clinical and 38 preclinical articles since 2000. Clinical articles discussed the roles of vitamins, minerals, glucosamine, and palmitoylethanolamides. The other nutraceuticals were assessed solely in preclinical studies, using TMD models, mostly craniofacial inflammatory rodents, with 36 of the 38 articles published since 2013. Our investigation indicates that current evidence is insufficient to assess the efficacy of these nutraceuticals. However, the existing data suggest potential for therapeutic intervention in TMDs. Further support from longitudinal and randomized controlled studies and well-designed preclinical investigations is necessary to evaluate the efficacy of each nutraceutical intervention and understand their underlying mechanisms in TMDs.

Feeding and Nutritional Key Features of Crisponi/Cold-Induced Sweating Syndrome.

Feeding difficulties are constantly present in patients with Crisponi/cold-induced sweating syndrome type 1 (CS/CISS1). The aim of our study was to describe their prevalence and evolution from birth to adult age. We performed an observational study at the Department of Life Sciences and Public Health, Rome. Fourteen patients were included in this study (six M; mean age: 18 years; SD: 10.62 years; median age: 15 years; age range: 6-44 years); six were adults (43%). Data on oral motor abilities from birth were collected. Meal duration, presence of swallowing reflex, dysphagia symptoms, difficulty chewing, and drooling management were assessed. At birth, all patients needed enteral feeding. Introduction of solid food was postponed beyond the age of 18 months in 43% of patients. During childhood and adolescence, mealtime was characterized by increased duration (43%) accompanied by fatigue during chewing (43%), food spillage from the nasal cavities (21%), sialorrhea (86%), and poor/reduced appetite (57%). A mature rotatory chewing skill was never achieved. This report expands the phenotype description of CS/CISS1 and also improves the overall management and prevention of complications in this ultra-rare disease.

Surgical resection of a bilateral temporomandibular joint ankylosis and interposition gap arthroplasty using bilateral temporo-parietal fascial flap in a 5 years old child: treatment challenges and literature review

Temporomandibular joint (TMJ) ankylosis is a debilitating state that involves fusion of glenoid fossa and condyle of mandible. This can lead to restriction in mouth opening and mandibular movements. Subsequently, patient develops difficulty in chewing, speech, breathing as well as poor dental hygiene. All of these have detrimental effects on patient’s wellbeing and their quality of life. TMJ ankylosis can also have secondary effects on facial growth like asymmetry of face, retro or micrognathia, malocclusion, anterior or posterior open bite and overcrowding of teeth specially if it presents at early age. Main event that leads to TMJ ankylosis is trauma but this can occur as a secondary insult to surgery, local and systemic infections or diseases like chronic otitis media, tuberculosis, juvenile rheumatoid arthritis and septic arthritis. The management of TMJ ankylosis poses a significant challenge because of technical difficulties and a high incidence of recurrence. It is mainly managed by surgery with different options like gap and interpositional arthroplasty, reconstruction arthroplasty or distraction osteogenesis and aggressive post op physiotherapy. Here, we present a case five years old girl child with post traumatic TMJ ankylosis who was managed with excision of ankylotic mass and interpositional arthroplasty by using bilateral temporo-parietal fascial flap. She was followed for a 1 year and had adequate mouth opening and no recurrence.

Rapid Detection of Getah Virus Antibodies in Horses Using a Recombinant E2 Protein-Based Immunochromatographic Strip.

The prevalence and impact of Getah virus (GETV) are significant concerns in China. GETV can infect a wide range of animals, including horses, pigs, sheep, cattle, birds, and humans, resulting in substantial losses in the livestock and agricultural industries. GETV infection can cause the development of ulcers and inflammation in the mouth and gums of horses, which result in pain and discomfort and lead to symptoms such as reduced appetite, drooling, and difficulty chewing. As a result, there is a pressing need for efficient and rapid disease diagnosis methods. However, the currently available diagnostic methods have limitations in terms of operational time, equipment, and the experience of the individuals using them. In this study, a rapid, specific, and sensitive detection method was developed using a colloidal gold-based immunochromatographic strip (ICS) for the detection of antibodies against GETV in horses. To prepare the ICS, the antigen domain of the E2 glycoprotein of GETV was expressed using the Escherichia coli expression system after analysis with DNAstar v7.1 software. The nitrocellulose membrane was coated with rE2 protein or SPA to form the test line and control line, respectively. After optimizing the reaction conditions, the sensitivity, specificity, and repeatability of the strip were verified. The results showed that the test strip had a detection limit of up to 1:320 dilutions for GETV-positive serum, with no cross-reactivity observed with other equine-susceptible pathogens such as equine arteritis virus (EAV), equine herpesvirus-1 (EHV-I), equine infectious anemia virus (EIAV), equine influenza virus (EIV), African horse sickness virus (AHSV), and Japanese encephalitis virus (JEV). Furthermore, the ICS exhibited a concordance rate of 94.0% when testing 182 clinical serum samples compared to the virus neutralization test. Overall, this ICS diagnosis method will be an effective tool for the rapid detection of GETV in the field.

Impact of dental caries and Self-perceived oral health on daily lives of children and mothers in rural Egypt: a household survey

BackgroundThe present study assessed the impact of oral health on the daily lives of children and mothers living in a rural area in Northwestern Egypt.MethodsA cross-sectional household survey including children between 6 and 12 years old and their mothers was conducted in rural Egypt, 2019–2020. Data were collected using clinical examination and interview-based questionnaires of children and mothers. Three binary logistic regression models were used to assess the relationship between the dependent variables (oral health impact (yes, no) on avoiding smiling, chewing problems, and missing school (children) and avoiding social events (mothers)), and the explanatory variables: oral health (clinically-assessed caries experience and self-reported oral health) controlling for sociodemographic profile (child age and sex, mother’s education), daily toothbrushing and village of residence.ResultsA total of 211 households with 355 children and 211 mothers were included (91.5% response rate). About 54% of the children were girls, mean (SD) age = 8.7 (2.05) years and 82.3% did not brush their teeth daily. Mother’s mean (SD) age was 31.70 (5.45) years. Because of dental problems, 31.3% of children reported chewing difficulties, 31% avoided smiling compared to 76.3% and 43.6% of mothers. Also, 30.4% of children missed school and 76.8% of mothers reported reduced participation in social activities. In children, the number of decayed anterior teeth was associated with significantly higher odds of avoiding smiling (AOR = 1.22, 95%CI: 1.03, 1.44). In mothers, a greater number of posterior missing teeth was associated with significantly higher odds of chewing difficulties (AOR = 1.21, 95%CI: 1.01, 1.45), and a greater number of all missing teeth was associated with significantly higher odds of reduced participation in social events (AOR = 1.30, 95%CI: 1.30, 1.57). Good/ very good reported oral health in children and mothers was associated with lower odds of avoiding smiling and chewing problems (p < 0.05).ConclusionDecayed anterior teeth in children have a negative impact on smiling whereas missing teeth in mothers affect the ability to chew food and socialize. The psychological, functional, and social impacts of caries in this rural setting needs to be mitigated by improving oral health literacy and access to care.