Difficulty Chewing Research Articles

A Comparison of Quality of life in Patients of Mandibular Condyles Fractures Treated with Open Versus Close Reduction

Aim: The notion of quality of life pertains to the subjective assessment made by people on their overall well-being, taking into account their cultural and value orientations, as well as their goals, expectations, standards, and concerns. The notion of quality of life (QoL) within the medical field is often denoted as Health-Related Quality of Life (HR-QoL) or subjective health status. The primary objective of research on quality of life (QoL) is to evaluate the influence of sickness, disease, and their corresponding therapies on the holistic welfare of individuals. Objectives: The objectives of the study are to compare quality of life in patients of mandibular condylar fractures treated with open versus close reduction. Method: A total of 84 individuals diagnosed with subcondylar fractures of the mandible were subjected to evaluation. All fractures seen in the study exhibited displacement, either in the form of angulation ranging from 10° to 35° or a shortening of the ascending ramus by more than 2 mm. A comprehensive assessment, including both clinical and radiographic examination, was conducted at the 6-month mark after the occurrence of the trauma. The clinical characteristics assessed in this study included oral pain, difficulty in chewing, discomfort, cosmetic deformity, impact on daily routine, and symptoms of sadness. Results: The findings of the study indicate a statistically significant difference between the two groups, with a p-value of less than 0.05. The findings suggest that open reduction had superior outcomes compared to closed reduction in terms of alleviating oral pain, enhancing chewing ability, reducing discomfort, addressing cosmetic deformities, minimising disruptions to daily activities, and mitigating depressive symptoms. Conclusion: The study has determined that open therapy yields a better improvement in quality of life compared to closed treatments, and these differences are statistically significant. Keyword: Mandibular condylar fracture, open reduction, closed reduction, Quality of life

Juvenile psammomatoid ossifying fibroma: A case report and a review of the literature

Abstract Juvenile psammomatoid ossifying fibroma (OF) is a rare histological variant of OF with aggressive behavior. It is a benign fibro-osseous lesion with a high rate of recurrence. It occurs mainly in male children with paranasal sinuses and orbits the most common sites. The diagnosis depends on clinical, radiologic, and pathologic correlation. This study aims to present a case report of juvenile psammomatoid OF (JPOF) in a 9-year-old boy and to also review the relevant literature. A case of a 9-year-old boy who presented with a 1-year history of the left maxillary swelling was presented. There was no associated history of pain, ulceration, bleeding, or teeth mobility. There was no history of previous trauma to the site or teeth extraction. The patient had no difficulty in chewing, speaking, nasal blockage, or discharge. Examination revealed an ovoid left maxillary buccal mass measuring about 4 cm × 3 cm, which was hard, nontender with no teeth mobility. The diagnosis of JPOF made was confirmed through a combination of clinical, radiological, and histopathological findings. The patient had enucleation of the lesion under general anesthesia. Follow-up was satisfactory with no recurrence. JPOF is a rare histological variant of OF that is known to exhibit a high rate of recurrence. Although clinical and radiological features contribute to its diagnosis, histopathological examination has been the main diagnostic modality. Early detection and treatment are essential.

A rare neurological presentation of Ebstein-Barr virus: Isolated hypoglossal nerve palsy in a child

The isolated unilateral hypoglossal nerve palsy (HNP) is an unfamiliar clinical sign since it is rarely involved in isolation without the simultaneous involvement of other cranial nerves. It warrants a detailed history and clinical assessment. Neurologic manifestations are infrequent in infectious mononucleosis and especially hypoglossal nerve involvement is uncommon in daily practice. We report a 13-year-old girl who complained of deviation of the tongue to one side, trouble pronouncing linguals and difficulty chewing and swallowing with serologic evidence of active Epstein-Barr virus (EBV) infection. She developed transient isolated unilateral HNP manifests as parapharyngeal inflammation. Rarity and evaluation of isolated HNP pay particular attention in the pediatric field. Although HNP is an unusual neurologic complication of EBV, it should be considered in the differential diagnosis in the early evaluation of children.

Perioperative nutritional risk and its influencing factors in patients with oral cancer: a longitudinal study.

We aimed to investigate the nutritional risk status and dynamic changes in patients with perioperative oral cancer at different stages and analyze the factors influencing nutritional risk and the correlation among body mass index, nutrition-related symptoms, and nutritional risk. In total, 198 patients with oral cancer who were hospitalized in the Head & Neck Surgery Departments of a tertiary cancer hospital in Hunan Province, China, from May 2020 to January 2021, were selected as participants. The Nutritional Risk Screening 2002 scale and Head and Neck Patient Symptom Checklist were used to assess patients on admission day, 7 days post-surgery, and 1 month post-discharge. Multivariate analysis of variance, paired t-test, and generalized estimating equation were used to analyze the trajectory and influencing factors of nutritional risk in patients with perioperative oral cancer. Spearman's correlation analysis was used to explore the correlation among body mass index, symptoms, and nutritional risk. The nutritional risk scores of patients with oral cancer at the three time points were 2.30 ± 0.84, 3.21 ± 0.94, and 2.11 ± 0.84, respectively, and the differences were significant (p < 0.05). The incidences of nutritional risk were 30.3, 52.5, and 37.9%, respectively. The factors influencing nutritional risk included education level, smoking status, clinical stage, flap repair, and tracheotomy (β = -0.326, 0.386, 0.387, 0.336, and 0.240, respectively, p < 0.05). Nutritional risk was negatively correlated with body mass index (rs = -0.455, p < 0.01) and positively correlated with pain, loss of appetite, sore mouth, bothersome smells, swallowing difficulty, taste changes, depression, chewing difficulty, thick saliva, and anxiety (rs = 0.252, 0.179, 0.269, 0.155, 0.252, 0.212, 0.244, 0.384, 0.260, and 0.157, respectively, p < 0.05). The incidence of nutritional risk in patients with perioperative oral cancer was high, and the trajectory of nutritional risk changed over time. Strengthening the nutritional monitoring and management of postoperative patients or those with low education level, advanced-stage cancer, flap repair, tracheotomy, and low body mass index; strengthening tobacco control management; and controlling nutrition-related discomfort symptoms in perioperative oral cancer patients are necessary.

Utilitarian fixed space maintainer in an 8-year old with multilateral dentoalveolar abscess- A case report

Early exfoliation of primary molars is common among pediatric patients. Construction of a space maintainer should be in accordance with the age of the child and developmental status of the dentition. Pediatric dentists should not only address the space loss but also consider the functional, emotional and hygienic challenges the child might face. The subject was 8 years old and presented with multilateral dentoalveolar abscess and difficulty in chewing. Pain of the involved teeth was addressed through multidisciplinary approach followed by construction of utilitarian fixed space maintainer. The conclusion was that the construction of bilateral utilitarian fixed space maintainer not only addressed the preservation of leeway space but also restored the functional efficacy.

Linking the demographic, socio-economic and oral health status to oral health-related quality of life of the sudanese older adults: a cross sectional study

BackgroundOral Health-Related Quality of Life (OHRQoL) is an important measure of patients’ needs and progress. Identifying the links between clinical and non-clinical factors with OHRQoL in a specific population will facilitate the development of effective preventive strategies. The aim of the study was to assess the OHRQoL of Sudanese older adults, and to identify the possible relations between clinical and non-clinical predictors with OHRQoL using Wilson and Cleary model.MethodsThis cross-sectional study was conducted among older adults attending the out-patient clinics in Khartoum State’s Health Care Centers, Sudan. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Two modifications of Wilson and Cleary’s conceptual model were tested using structural equations modeling including: oral health status, symptom status, perceived difficulty of chewing, oral health perceptions, and OHRQoL.Results249 older adults participated in the study. Their mean age was 68.24 (± 6.7) years. The mean GOHAI score was 53.96 (± 6.31) and trouble biting/chewing was the most commonly reported negative impact. Wilson and Cleary models showed that pain, Perceived Difficulty Chewing (PDC), and Perceived Oral Health had a direct effect on OHRQoL. In model 1, age and gender had direct effects on oral health status, while education had direct effects on OHRQoL. In model 2, poor oral health status is associated indirectly with poor OHRQoL.ConclusionsThe OHRQoL of the studied Sudanese older adults was relatively good. The study partially confirmed Wilson and Cleary model as Oral Health Status was related directly to PDC and indirectly to OHRQoL through functional status.

Nonspecific ulcers on the edge of the tongue

A 56-year-old patient was sent to our Oral Pathology service with a chief complaint of “painful sores on her tongue”. She also complained of difficulty chewing any solid food. According to the patient, the change had been present for 6 months, but the pain had worsened in the last 2 months. She also reported frequent abdominal pain. Pain started just before the appearance of the oral lesions and weight loss in these last few months. No palpable cervical lymph nodes were found. Intraoral examination revealed ulcers on the right and left lateral border of the tongue, with red, irregular patches and raised edges. The marginal gingiva was swollen and erythematous (Figures 1A and 1B). The medical history was non-contributory.

Application of Different Techniques in Facial Nerve Reconstruction on Experimental Models

Abstract The facial nerve is the main motor nerve that activates the mimic musculature of the face. Nerve tree injuries lead to paralysis of the same half of the face. In addition to functional damage in the form of difficulty in chewing, speaking and closing the eyes, paresis is the cause of pronounced emotional and social problems in patients. The etiology of facial nerve damage is diverse, including trauma, neurological, infectious, metabolic, vascular, neoplastic processes, as well as idiopathic and iatrogenic. Of special importance to us are iatrogenic injuries of the transcranial part of the facial nerve, which most often occur as part of surgical interventions in the area of the parotid lodge, where the nerve itself branches into its final branches that innervate facial muscles. A high degree of iatrogenic damage over 40% requires the timely application of adequate techniques and materials for the purpose of neuroregeneration. Considering the delicacy of the function of the facial nerve and the consequences of its damage, previous methods described in some studies, used in the regeneration process are based on the summarized results of experimental studies on different animal models. A prerequisite for the success of an experimental study is certainly the anatomical compatibility of experimental animals and humans. Based on the analyzed research, in the last decade rats were used the most, which can be linked to acceptable maintenance costs. Nevertheless, rabbits represent an ideal experimental model due to their anatomical and functional similarities with humans, in which it is possible to successfully simulate paralysis of the facial nerve and monitor the recovery of mimic musculature using the method of movement visualization and electromyography.

A Single Center Experience: A Retrospective Study Over 10-Years Period on Mandible Fractures.

The purpose of this study was to do a retrospective analysis about patients with mandibular fracture who were treated at the department of Maxillofacial Surgery, Regional University Hospital of Ancona, Italy, between 2011 and 2021. In this study we evaluated clinical and epidemiological findings of mandible fractures focusing on the association between surgical timing, type of surgical approach and mid- and long-term outcomes. Patients were evaluated based on various parameters including age, sex, etiology, symptoms, comorbidity, clinical findings, mandible fracture type, other facial fractures, treatment, waiting time before the operation, complications and sequelae. In the period described, we recorded 1023 mandibular fractures. 93% of patients underwent surgery under general anesthesia, almost exclusively patients undergoing an open approach to internal fixation. Of the patients, 684 were male (66.86%) and 339 were female (33.13%). The average age of the patients was 42, 38years (range, 7-94years). The leading cause of these fractures was traffic accidents (27.3%) and mandibular parasymphysis fractures were the most frequent (34.1%). The most common clinical signs and symptoms were malocclusion, difficulty in chewing, limitation of the buccal opening, hypoesthesia extending through the territory of the inferior alveolar nerve, difficulty in protrusion movements and mandibular lateralization. The continuous research in epidemiology, etiology, materials, and techniques will further refine the treatments of mandible fractures, which are nowadays more and more customized according to the type of trauma.

Associations Between Abdominal Obesity, Chewing Difficulty and Cognitive Impairment in Dementia-Free Chinese Elderly.

To investigate the independent and synergistic associations between abdominal obesity, chewing difficulty and cognitive impairment in a community-dwelling older adults sample in China. Cognitive function was measured by the 5 min- Montreal Cognitive Assessment (5 min-MoCA) and abdominal obesity was measured by A Body Shape Index (ABSI) in 572 participants recruited from local communities. Chewing difficulty was assessed via a self-report questionnaire. Linear regression and general logistic regression were performed to investigate the association of chewing difficulty and abdominal obesity with cognition. Chewing difficulty score [β (95% CI) = -.30 (-.49, -.11)] and ABSI [β (95%CI) = -.30 (-.55, -.05)] were independently associated with worse performance on the 5 min-MoCA. Whilst ABSI was not associated with cognitive impairment, the co-existence of chewing difficulty and abdominal obesity [OR (95% CI) = 2.22 (1.18, 4.17)] was found associated with the presence of cognitive impairment. Chewing difficulty and abdominal obesity were independently associated with cognition. Abdominal obesity and chewing may have an additive effect on cognitive function.

A Case of Botulism After Intramuscular Injection of Botulinum Toxin (P12-7.003)

<h3>Objective:</h3> Case report <h3>Background:</h3> Botulinum toxin is a neurotoxin produced by the bacterium <i>Clostridium botulinum</i> that can result in severe flaccid paralysis. Although its therapeutic applications are well-known, botulism can occur after unintentional intramuscular injections of the toxin. Early diagnosis and management are essential as this condition can be life-threatening when untreated. <h3>Design/Methods:</h3> N/A <h3>Results:</h3> A 36-year-old female with no significant past medical history presented with 1-week history of generalized weakness. She had botulinum toxin injections into her cheeks and forehead two days prior to symptoms onset. The toxin was obtained off the internet and neither its quality nor the credentials of the administering individual could be verified. She also noticed difficulty chewing and swallowing both liquids and solids limiting her oral intake, followed by worsening lethargy and weakness. On physical exam, she had bilateral ptosis, difficulty resisting eye-opening, dysarthria, and symmetric generalized weakness. Reflexes were present and symmetric, and sensation intact to light touch. Investigations including anti-acetylcholine receptor, muscle-specific kinase, lipoprotein receptor-related protein-4 antibodies, TSH, MRI brain, and EMG were unremarkable. However, her respiratory status worsened requiring non-invasive mechanical ventilation, and she was empirically treated with pyridostigmine. The CDC was contacted, and Botulism antitoxin obtained and administered. Her symptoms then improved significantly, and she was discharged without residual deficits. <h3>Conclusions:</h3> Botulism is a rare but potentially fatal neuroparalytic disease caused by botulinum toxin. It usually occurs after ingestion of contaminated food but can be seen with improper administration of botulinum toxin. EMG is expected to show decremented response to repetitive low frequency and facilitated response to repetitive high frequency nerve stimulation with low compound muscle action potential. This was not the case of our patient whose study was confounded by pyridostigmine’s administration. This case highlights the importance of early diagnosis and treatment with antitoxin as botulism can rapidly progress to respiratory failure if untreated. <b>Disclosure:</b> Dr. Daou has nothing to disclose. Dr. Shnawa has nothing to disclose. Dr. Ariza Hutchinson has nothing to disclose. Dr. Joseph has nothing to disclose. Dr. Yakhkind has nothing to disclose.

What Is the Relationship between the Chewing Ability and Nutritional Status of the Elderly in Korea?

This study aims to determine the relationship between chewing ability and the nutritional status of the elderly in Korea. This study utilized the data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2013–2018 for persons who were ≥65 years of age. Of the 7835 subjects, 43.2% had chewing difficulty. Compared to the normal group, the chewing difficulty group had more stress, lower exercise frequency, less snack intake, a lower frequency of eating out, and a higher proportion of food insecurity. The chewing difficulty group had significantly lower food intake compared to the normal group, including various food groups such as cereals and grain, potatoes, fruits, meat, and milks and dairy products. The intake of fresh fruits was 24.5% lower and the intake of plant food (fresh fruits and nonstarchy vegetables) was 17.8% lower in the chewing difficulty group compared to the normal group. In addition, the intake of most nutrients (carbohydrates, fat, calcium, phosphorus, sodium, potassium, vitamin A, riboflavin, niacin, and vitamin C) was significantly lower in the chewing difficulty group than in the normal group. The chewing difficulty was significantly associated with undernutrition (OR = 1.63). In conclusion, chewing ability is closely related to food and nutrient intake among the elderly, which can decrease the quantity and quality of diet and is also related to undernutrition. Therefore, it is necessary to develop customized nutrition programs and aging-friendly food products that consider the chewing ability of the elderly.

Evaluation of Children’s Perceptions after Frenectomy: Diode Laser vs. Conventional Scalpel Technique

Objective: The presence of abnormal frenum may cause aesthetic or functional problems, which can be prevented by frenectomy operation. Therefore, the aim of this study is to compare children's perceptions of pain, speech and chewing difficulties after conventional scalpel technique and diode laser-assisted frenectomy operations. Material and Methods: Twenty-one patients, aged 10 to 16 years, who were indicated for Frenectomy were assigned to be treated with conventional scalpel technique or diode laser. In the comparison between both techniques, the Wong-Baker FACES Pain Rating Scale was used to evaluate pain immediately after surgery and pain, speech and chewing difficulties at days 1, 3, 7, and 10 following the procedure. Factors such as duration of surgery, use of anaesthetic, and need for analgesics were also recorded. Moreover, Corah's Dental Anxiety Scale was used to evaluate the dental anxiety levels of parents about their children. Results: When compared to the conventional scalpel technique, it was found that the surgery took shorter, and no postoperative analgesic was needed in the group that underwent Diode laser surgery. In addition, as the age of the children increased, the anxiety levels of the parents decreased. When the postoperative perceptions of pain and functional discomforts were evaluated, there was no significant difference between the groups. Conclusion: According to the results of this study, Diode laser provided benefits such as significantly shortening the operation time and not requiring surgical sutures and analgesics in children. It may also allow the use of less infiltrative anaesthetic during the operation.

Lower socio-economicstatus in adolescence is associated with poor oral health at an older age: Mediation by social and behavioural factors.

To examine the mediators between lower socio-economic status (SES) in adolescence and oral health at an older age to uncover the underlying mechanisms of the association. Participants (n = 21 536) aged ≥65 years from the Japan Gerontological Evaluation Study were evaluated. The dependent variables were self-rated chewing difficulty and having ≤19 remaining teeth. The main independent variable was self-perceived SES in adolescence. The Karlson-Holm-Breen method was used for mediation analysis. Mean age of the participants was 74.8 years (standard deviation = 6.4), and 51.5% were female. Overall, 5598 (26.0%) participants reported chewing difficulty and 9404 (43.7%) had ≤19 remaining teeth. Lower SES in adolescence was associated with a higher prevalence of chewing difficulty (odds ratio [OR] = 1.38, 95%confidence interval [CI] = 1.29-1.48; total effect). After controlling for mediators, OR for lower SES in adolescence was 1.22 (95%CI = 1.13-1.30; direct effect) and 1.13 (95%CI = 1.11-1.16; indirect effect). Mediators, prominently the number of teeth and income, explained 39.3% of the associations. Lower SES in adolescence increased the odds of ≤19 remaining teeth by OR = 1.23 (95% CI = 1.16-1.31; total effect). After controlling for mediators, the OR for lower SES in adolescence was 1.03 (95%CI = 0.97-1.10; direct effect) and 1.19 (95%CI = 1.16-1.23; indirect effect). Mediators, prominently educational attainment, explained 85.0% of the associations. Lower SES in adolescence was associated with poor oral health at an older age through mediators. Approaches that consider social determinants from the beginning of the life course are required.

The effect of xerostomia on the quality of life of controlled and uncontrolled type 2 diabetes mellitus patients

ABSTRACTIntroduction: One of type 2 diabetes mellitus oral manifestations is xerostomia. Xerostomia can cause various problems, such as difficulty of eating, chewing and swallowing, so that it can affect the quality of life. The aim of this research is to analyze the effect of xerostomia on the quality of life of controlled and uncontrolled type 2 diabetes mellitus patients. Methods: This analytical observational cross-sectional study involving 92 subjects from type 2 diabetes mellitus patients aged 21 to 50 years (Patients of controlled and uncontrolled type 2 diabetes mellitus 46 subjects each). Xerostomia data was collected by Summated Xerostomia Inventory-Dutch Version questionnaire, while the quality of life data was collected by Xerostomia-related Quality of Life Scale (XeQoLs) questionnaire. All research data were analyzed descriptively and bivariate analysis with Chi-Square test. Results: The results showed that the quality of life of controlled and uncontrolled type 2 diabetes mellitus patients was equally low (50% in controlled type 2 DM patients and 64.9% in uncontrolled type 2 DM patients). This result showed that there is no difference between each subject groups. This also can be seen from the results of statistical tests that p = 0.193 (p&gt;0.05), which means that there is no significant difference between the quality of life of controlled and uncontrolled type 2 diabetes mellitus patients. Conclusion: There was no effect between xerostomia of controlled and uncontrolled type 2 DM patients with their quality of life.Keywords: type 2 diabetes mellitus, xerostomia-related to quality of life, xerostomia

Oral status and incident functional disability: A 9-year prospective cohort study from the JAGES

IntroductionThe population-attributable risk of oral status for incident functional disability remains unknown. We investigated the impact of a range of oral statuses (number of remaining teeth, chewing difficulty, dry mouth, and choking) on incident functional disability. MethodsParticipants (n = 44,083) aged ≥ 65 years from the Japan Gerontological Evaluation Study were evaluated. The outcome variable was incident functional disability, and the explanatory variables were four select oral statuses. The possible confounders were included as covariates. Using the Cox proportional hazards model, we calculated hazard ratios (HRs), 95% confidence intervals (CIs), and their population-attributable fractions (PAFs). ResultsThe mean age of the participants was 73.7 (standard deviation=6.0) years at baseline, and 53.2% were women. A total of 8,091 participants (18.4%) developed functional disabilities during the follow-up period. Among the four oral statuses, the incidence rate of functional disability was the highest in those with chewing difficulty (3.27/100 person-years), followed by those with dry mouth (3.20/100 person-years), choking (3.10/100 person-years), and ≤19 remaining teeth (2.89/100 person-years). After adjusting for all covariates, chewing difficulty showed the highest risk of functional disability (HR=1.22, 95%CI=1.16–1.28), followed by ≤19 remaining teeth (HR=1.18, 95%CI=1.12–1.25), dry mouth (HR=1.18, 95%CI=1.12–1.24), and choking (HR=1.10, 95%CI=1.04–1.17). Regarding PAF, ≤19 remaining teeth (12.0%) were the largest, followed by chewing difficulty (7.2%), dry mouth (4.6%), and choking (1.9%). ConclusionsMaintaining a good oral status may reduce the risk of functional disability later in life. Given its population contribution, tooth loss had the largest impact among the four oral conditions.

Association Between Changes in Oral Health-Related Quality of Life and Depressive Symptoms in the Korean Elderly Population.

Objectives: The aim of this study was to examine the association between changes in oral health related quality of life (OHRQoL) and depressive symptoms in the elderly South Koreans. Methods: We used the 2018 and 2020 Korean Longitudinal Study of Ageing data. Our study population was a total of 3,604 participants aged over 65 in 2018. The independent variable of interest was the changes in the Geriatric Oral Health Assessment Index as OHRQoL between 2018 and 2020. The dependent variable was depressive symptoms in 2020. Multivariable logistic regression analyzed the associations between changes in OHRQoL and depressive symptoms. Results: Participants with improvement in OHRQoL over 2-year period were likely to have fewer depressive symptoms in 2020. Especially, changes in the oral pain and discomfort dimension score was associated with depressive symptoms. A decline in oral physical function, such as difficulty in chewing and speaking, was also associated with depressive symptoms. Conclusion: Negative change in OHRQoL is a risk factor for depression in elderly. This results suggest the importance of maintaining good oral health in later life, as a protective factor against depression.

Altered cast impression technique in the fabrication of metal frame partial dentures with distal extension: A case report

Metal frame denture is a more ideal treatment than the conventional acrylic denture for its narrower, thinner, rigid, and harder material, so that the design can be made ideally. The aim of this case report is to demonstrate the treat-ment of an edentulous case using altered cast technique to improve support for a partial denture with distal exten-tension. A 48-year-old female patient came to the Halima Dg.Sikati Makassar with complaints of chewing difficulty and lacking of confidence due to the loss of all her maxillary teeth and part of her mandibular teeth. The patient had never worn any denture and had no history of systemic disease. The patient wanted to have a denture made to resto-re the appearance and mastication. Then a panoramic x-ray was performed on the patient. Radiological images ap-pear to be missing all teeth in the maxilla, available teeth: 33, 32, 31, 41, 42 and 43, no impacted teeth, no foreign bodies, no inflammation or neoplastic tissue, good bone density, residual the roots of teeth 15 and 28. The pre-pros-thetic treatment plan was carried out by scaling and extracting the remaining roots on teeth 15 and 28. The prostho-thodontic treatment plan was the manufacture of partial metal frame dentures using the altered case molding techni-que. Altered cast is a molding technique used in the saddle free end of removable partial dentures. This impression technique can produce master case with maximum tissue support, within the limits of physiological tolerance and can accurately record the relationship between the tooth and the residual ridge. It is concluded that metal frame par-tial denture with Alter cast impression technique provides better and stable denture.

Transoral Endoscopic-Assisted Reduction and Internal Fixation of Mandibular Condylar Fractures in Children

Extraoral approaches for open reduction and fixation of condylar fractures in children are associated with serious risks of complications, including facial nerve injury, facial scarring, parotid fistula, and auriculotemporal nerve injury. The purpose of this study was to retrospectively evaluate the outcomes of transoral endoscopic-assisted open reduction and internal fixation of condylar fractures and hardware removal in pediatric patients. This study was designed as a retrospective case series. The study included pediatric patients admitted with condylar fractures that were indicated for treatment with open reduction and internal fixation. The patients were clinically and radiographically evaluated with regard to occlusion, mouth opening, lateral and protrusive movement of the mandible, pain, chewing and speech difficulties, and bone healing at the fracture site. CT images were used to assess the reduction of the fractured segment, the stability of fixation and progress of healing of the condylar fracture at follow-up visits. The same surgical treatment approach was applied to all patients. The data from the study were analyzed for a single group without any comparison to other groups. The technique was used for the treatment of 14 subcondylar fractures in 12 patients between the ages of 3 to 11years. A total of 28 transoral endoscopic-assisted approach to the condylar region either for reduction and internal fixation or hardware removal were applied. The mean operating time was 53.1 (±11.3) minutes for the fracture repair and 20 (±2.6) minutes for hardware removal, respectively. The mean follow-up time of the patients was 17.8 (±2.7) months (median: 18) months. All patients regained stable occlusion, satisfactory mandibular motion, stable fixation, and complete bone healing at the fracture site at the end of their follow-up period. There was no transient of permanent facial nerve or trigeminal nerve injury in any of the patients. Endoscopically assisted transoral approach is a reliable technique for reduction and internal fixation of condylar fracture and hardware removal in pediatric patients. The serious risks of extraoral approaches including facial nerve injury, facial scar, and parotid fistula can be eliminated by using this technique.

Oral health, frailty and physical activity levels: is there a link?

Introduction. Oral frailty is associated with decreased quality of life and general health in older adults.Objective: to assess the relationship between oral frailty, physical frailty and physical functioning decline.Methods: An epidemiological cross-sectional Eucalyptus study of adults aged 65 years and older (n=396). The main study parameters: oral health status, chronic diseases, a comprehensive geriatric assessment, complete blood count.Results: 75.5% (n=299) of participants had less than half teeth. 87% of them used removable/fixed dentures or implants. Despite the high frequency of denture use, 9.4% (n=37) of study participants reported difficulties in pronunciation of words and 19.2% (n=76) complained of pain/discomfort when chewing food due to oral health/teeth/dentures. After adjusting for sex, age, cognitive decline, number of remaining teeth, denture/implant use, nutritional status and stroke/TIA, heart failure, chewing or speech problems due to problems of the oral cavity associated with teeth / oral mucosa / dentures were associated with low grip strength with OR (95% CI) 2.738 (1.306–5.737) and 2.494 (1.045– 5.952) respectively and frailty with OR (95% CI) 2.513 (1.083–5.829) in the group of study participants with difficulty in pronunciation of words. The association between chewing difficulty and frailty was significant after adjusting for sex, age, cognitive decline, number of remaining teeth, denture/implant use, nutritional status, and stroke/TIA with OR (95% CI) 2.002 (1.020–3.931), but disappeared after adjusting for heart failure.Conclusion: Chewing or pronunciation difficulties due to oral health problems were associated with an increased risk of frailty, and low levels of physical functioning. All patients with frailty and low physical function should be consulted by a prosthodontist.