Difficulty In Mastication Research Articles

FULL MOUTH RECONSTRUCTION- MALO IMPLANT BRIDGE: A CASE REPORT

In the modern era of dentistry, we aim to restore, form, and function in a natural fashion maintaining the red and white balance in the oral cavity. The selection of the treatment plan by preserving the remains is the essential need that substantially influences the outcome we met. Full filling the demands of the completely edentulous patient is always considered a difficult task. Loss of teeth is the disability due to the physiological and various dental diseases like periodontal disease, dental caries, and trauma are more common. The complete loss of teeth causes various problems like difficulty in mastication, improper phonetics, and unacceptable esthetics of patients. The good amount of density and volume of the bone following desired inter arch space available. Then Malo implant bridge prosthesis is a good treatment option to rehabilitate completely edentulous patients in less treatment cost and we can restore the pink part to enhance the esthetic of patients. In the article, we recreate the smile, form, and function of patients with Malo Implant Bridge technique.

A Prospective Randomized Study to Assess the Quality of Life in Post-Operative Recovery Phase in Patients Undergoing Surgery for Isolated Vertically Undisplaced Mandibular Parasymphysis Fracture Using Twin Mix Solution.

Trauma is a major cause for facial fractures commonly encountered by maxillofacial surgeons. Mandible is commonly involved in facial trauma resulting in an isolated fracture or associated with other facial bones due to its prominent location in the facial skeleton. This study was undertaken to investigate the quality of life (QoL) post-operatively in patients diagnosed with undisplaced parasymphysis fracture who underwent open reduction and internal fixation (ORIF) under local anesthesia (LA) using the twin mix (TM) solution. A prospective randomized clinical study was conducted among 40 patients aged between 20-55years requiring ORIF for unilateral vertically undisplaced parasymphysis fracture under LA. Group A patients (n = 20) received conventional LA solution with adrenaline, and Group B patients (n = 20) received freshly prepared TM solution for their surgical intervention as a day care procedure. Various parameters such as jaw function, ability to masticate and labialis activity (lower lip pout) were assessed. The data were collected and analyzed applying student's t test, Shapiro-Wilk test using SPSS software. All the 20 patients in Group B who received TM solution exhibited better jaw function and mouth opening with a mean score of (±SD) of 4.55 (±0.944). They also exhibited reduced difficulty in mastication and ability to purse the lower lip on third post-operative day as compared to the patients in Group A. No complications were observed among the patients post-operatively in both the groups of this study. TM solution proves to be superior as compared to the conventional LA solution as the former offers an improved clinical outcomes enhancing the QoL post-operatively in patients undergoing ORIF for undisplaced parasymphysis mandibular fracture.

Oral health related quality of life of complete denture patients treated by UG students - A university hospital based study

Oral health status of the elderly people is booming as a wide interest in dentistry. Complete dentures are the most common treatment for rehabilitation of total loss of teeth. Denture replacing the teeth helps in patients mastication, communication and aesthetics. This study aims to assess the oral health quality of patients wearing complete denture treated by undergraduate students. A questionnaire was prepared to assess the oral health-related quality of life among 107 complete denture patients who were treated by undergraduate students at Saveetha Dental College, Chennai. The questionnaire was administered to 107 respondents via telephonic conversation. The complete denture patient list was obtained by reviewing and analysing 86,000 patients record who visited the Saveetha Dental College during the time period of June 2019 to March 2020. Based on the data collected from the questionnaire, the results were tabulated and statistically analysed via the Statistical Package for Social Sciences (SPSS).In this study, it was observed that the complete denture patients on the whole experienced positive outcomes with 73.8% patients with no allergy, 36.4% with no difficulty in phonetics, 45.7% reported occasional difficulties in mastication and 46.7% reported occasional food sticking to the denture. In this study, it is observed that the complete denture patients treated by the under-graduate students, on the whole, were satisfied with their dentures.

Management of ankyloglossia using electrosurgery: A case series

Ankyloglossia, or tongue tie, is a congenital oral anomaly with short, tight and thick lingual frenum which may restrict mobility of tongue and may subsequently lead to a range of problems such as difficulties in breast feeding during infancy, difficulty in mastication, speech impairment, poor oral hygiene, malocclusion, behaviour problems during childhood, adolescence and even adulthood. In this case series, four adult patients with ankyloglossia were treated by performing lingual frenectomy using electrosurgery followed by post-operative recall and speech therapy. A marked improvement in tongue movement and speech was observed at follow-up visits in all the treated cases. Electrosurgery proved to be a safe, reliable, effective and patient-friendly alternative treatment option for ankyloglossia.

SURGICAL TREATMENT OF EXTENSIVE INTRAORAL DERMOID CYST: CASE REPORT

The aim of the present work is to report a rare case of extensive intraoral dermoid cyst in a female patient, 54 years old, who complained of volume increase at the floor of the mouth. The extraoral physical examination showed submental swelling. The intraoral examination revealed a tumor, presenting mobility and sessile base. An excisional biopsy was performed and the specimen was sent to anatomopathological analysis. Histologic sections revealed fragments of cystic capsules coated with orthokeratinized stratified squamous epithelium exhibiting hyperkeratosis, with intense accumulation of intraluminal keratin. Capsular connective tissue was dense and permeated by foci of intense mononuclear inflammatory infiltrate, and large numbers of multinucleated giant cells. Cutaneous attachments such as sebaceous glands are observed. The patient is in clinical follow-up and she has no complaints or signs of recurrence. Dermoid cysts are rare lesions in the oral cavity, but their presence may lead to dysphagia, dysphonia, and masticatory difficulties.

Surgical Management of Amlodipine Induced Gingival Enlargement - A Case Report

Amlodipine, a calcium channel blocker, used with increasing frequency as antihypertensive and anti-angina drug has been found associated with gingival enlargement. It causes unesthetic appearance and formation of new niches for periodonto-pathogenic bacteria. If severe, it causes difficulty in mastication, speech and oral hygiene maintenance. Its treatment is still largely limited to meticulous oral hygiene maintenance, drug substitution, professional scaling and root planning and surgical excision of enlarged gingival tissue. There are very few reports of amlodipine-induced gingival enlargement at a dose of 5 mg. This case report discusses amlodipine-induced gingival enlargement and its management.

Initial manifestation of parotid extra-medullary myeloma in an HIV positive patient on anti-retroviral therapy: A case report and review of the literature.

Multiple myeloma is a biologically diverse, malignant disease that involve plasma cells. Multiple myeloma is characterized by the unrestrained proliferation of monoclonal plasma cells within the bone marrow. In the present case report, the case of a human immunodeficiency virus (HIV) positive patient with an initial manifestation of extramedullary myeloma involving the parotid gland is described. The patient had been on antiretrovirals for the last two years. A Medline, Embase, Scopus and Google Scholar search was performed using the key words: ‘Parotid extramedullary myeloma AND HIV’ as part of the literature review. A 46-year-old female presented to our hospital with a 6-month history of a painful mass on the left side of the face, involving the parotid area, with rapid growth in the preceding month. There was associated fever, body pains and difficulty opening the mouth. This resulted in difficulty in mastication and she also reported pain on swallowing. She did not notice any weakness of her face on the left side. She had no complaints regarding her eyes, such as visual disturbances, eye pain, or an inability to close the eye on the affected side. The patient was diagnosed with HIV infection 2 years prior, and had been on highly active antiretroviral therapy (HAART) since the diagnosis. There is no consensus regarding a treatment protocol for HIV positive patients on HAART and multiple myeloma. However, based on the clinical case report and a review of the relevant literature, the treatment should include high doses of a combination of chemotherapeutic agents. Although multiple myeloma is considered incurable, all patients should be started on treatment with the goal of preventing further complications.

ORAL HEALTH-RELATED QUALITY OF LIFE AND SATISFACTION AMONG FIXED DENTAL PROSTHESES USERS IN A UNIVERSITY HOSPITAL, KELANTAN

Introduction: In Malaysia, edentulism has become a problem among adults and the elderly. The loss of teeth will also negatively impact their quality of life. Elderly patients with serious dental issues may face difficulties in mastication, phonation as well as engaging in social interactions which may affect their general health. Satisfaction, on the other hand, is a crucial aspect of measuring quality in health care which includes clinical outcomes, patient retention, and medical malpractice claims. Objectives: The present study was conducted to assess the level of oral health-related quality of life and satisfaction and its associated factors among fixed dental prostheses users. Methods: The short Malaysian Oral Health Impact Profile [S-OHIP(M)] and a modified satisfaction questionnaire were used to collect data from one hundred and forty patients wearing fixed prostheses. The questionnaires contained questions on the frequency of problems affecting their oral health quality of life (OHRQoL) and the patients’ perception of the overall outcome of the prosthetic treatment. Results: The results indicate that the patients almost never have any problems with their fixed prostheses and are mostly totally satisfied with the treatment. The results also show that there is a moderate positive correlation between brushing frequency (r = .241, p = .004) and the OHRQoL. It also showed that there is a negative correlation between the work status of the patient (r = -.154, p = .069) and their satisfaction. Conclusions: A majority of patients who received fixed dental prosthetic treatment at Universiti Sains Malaysia were satisfied with their fixed prosthesis and had good OHRQoL.

Enhancement in Xerostomia Patient Salivary Lubrication Using a Mucoadhesive

Oral lubrication mediated by mucin and protein containing salivary conditioning films (SCFs) with strong water retainability can get impaired due to disease such as xerostomia, that is, a subjective dry mouth feel associated with the changed salivary composition and low salivary flow rate. Aberrant SCFs in xerostomia patient cause difficulties in speech, mastication, and dental erosion while the prescribed artificial saliva is inadequate to solve the complications on a lasting basis. With the growing aging population, it is urgently needed to propose a new strategy to restore oral lubrication. Existing saliva substitutes often overwhelm the aberrant SCFs, generating inadequate relief. Here we demonstrated that the function of aberrant SCFs in a patient with Sjögren syndrome can be boosted through mucin recruitment by a simple mucoadhesive, chitosan-catechol (Chi-C). Chi-C with different conjugation degrees (Chi-C7.6%, Chi-C14.5%, Chi-C22.4%) was obtained by carbodiimide chemistry, which induced a layered structure composed of a rigid bottom and a soft secondary SCF (S-SCF) after reflow of saliva. The higher conjugation degree of Chi-C generates a higher glycosylated S-SCF by mucin recruitment and a lower friction in vitro. The layered S-SCF extends the “relief period” for Sjögren patient saliva over 7-fold, measured on an ex vivo tongue-enamel friction system. Besides lubrication, Chi-C-treated S-SCF reduces dental erosion depths from 125 to 70 μm. Chi-C shows antimicrobial activity against Streptococcus mutans. This research provides a new key insight in restoring the functionality of conditioning film at articulating tissues in living systems.

Clinical assessment of post insertion complications and satisfaction encountered among complete denture wearers

Introduction: Edentulous patients are still a matter of concern in countries like India due to less awareness of oral health care. Majority prefer complete denture for rehabilitation but here the primary challenge for a dentist is to satisfy the patient needs with successful management. The objective of the present study was to assess the post insertion complications encountered by complete denture patients and the level of satisfaction among them. Materials and Methods: 100 elderly patients provided with a new set of complete denture for both arches were selected and examined. The data was collected as per the need of customized design questionnaire. Results: Among post-insertion complaints from patients pain was the most common and almost present in more than 50% of patients. Difficulty in mastication and slurring of speech was also one of the major problems reported in denture wearers. Conclusion: Patient satisfaction is a critical determinant in the success or failure of complete denture therapy. A Prosthodontist should communicate well to adjust the treatment and pace according to the need of patient. Behavioral therapy during the visits can have a positive effect in relieving anxiety and pain of the patient. Keywords: Complete denture, Complications, Edentulous, Post-insertion, Satisfaction.

Cancellous osteoma of temporomandibular joint

Osteoma is a rare growth of bone, benign in nature, usually occurring in the craniofacial region. It usually results from the long-term deposition of compact and cancellous bone. The etiology of the tumor is not clear but can be linked with infections, inflammatory processes trauma, or/and abnormalities in growth. It manifests with symptoms of painful/painless swelling, dull pain in the preauricular region, clicking/popping and difficulty in mastication, trismus, gradual midline shift developing malocclusion, mandibular deviation of the contralateral side, and facial asymmetry. The diagnosis is mostly made by clinical and radiological imaging and is affirmed by histopathological examination. These condylar tumors have been usually treated by either resection through local excision or condylectomy with or without reconstruction. Therefore, we describe a rare case report of osteoma arising from the mandibular condylar neck of a 26-year-old female patient giving a chief complaint of difficulty in opening the mouth in the last 15 days along with pain. Radiographic images and computed tomography were suggestive of osteochondroma involving right condyle which, on excision and histopathological examination, was found to be cancellous osteoma.

Relationship between Eating and Digestive Symptoms and Respiratory Function in Advanced Duchenne Muscular Dystrophy Patients.

Background:Duchenne muscular dystrophy (DMD) patients can have various issues that affect their quality of life, including eating and digestive conditions.Objective:We sought to identify the relationship between respiratory function and various eating and digestion related symptoms in patients with advanced Duchenne muscular dystrophy (DMD).Methods:Eating and digestive symptoms, including loss of appetite, nausea, vomiting, diarrhea, constipation, swallowing difficulty, mastication difficulty, early satiety, and aspiration, were evaluated among patients with advanced DMD who were nonambulatory and required noninvasive mechanical ventilatory support. In addition, various respiratory function parameters were measured, including forced vital capacity (FVC), maximal insufflation capacity (MIC), peak cough flow (PCF), assisted PCF (APCF), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP). We then analyzed the relationship between gastrointestinal symptoms and respiratory function parameters.Results:A total of 180 patients (age, 22.3±5.0 years) were included in the analysis. Loss of appetite and early satiety showed no correlation with any of the respiratory function parameters. Constipation was correlated with MEP; swallowing difficulty was correlated with MIC, APCF, MIP and MEP; and mastication difficulty was correlated with FVC, PCF, APCF, MIP, and MEP. Notably, age did not correlate with any gastrointestinal symptoms.Conclusions:Eating and digestive symptoms are more closely correlated with respiratory function than with age in patients with DMD. We think this correlation is mainly caused by the skeletal muscle strength, which is major determinant of both digestive and respiratory function.

Medication-related osteonecrosis of the jaw

Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but well-documented, complication following the administration of anti-resorptive and anti-angiogenic drugs. MRONJ has a negative effect on quality of life, and can result in reduced social contact, pain and masticatory difficulties. Prescription of implicated medication is within the remit of GPs, and thus National Institute for Health and Care Excellence (NICE) guidelines have been published to inform prescribing. Careful consideration of the potential deleterious oral side-effects of these drugs is needed. NICE guidelines on the prescribing of bisphosphonates for osteoporosis acknowledge that osteonecrosis of the jaw was not included in the adverse events when the economic model was assessed. This article provides an overview of MRONJ, highlighting key areas for possible GP intervention when caring for patients at risk of developing MRONJ, and what to do if MRONJ is suspected.

Aspects Influencing Food Intake and Approaches towards Personalising Nutrition in the Elderly

Healthy diets have been demonstrated to complement benefits of physical activity, physical condition and mental wellbeing, all of them being important factors influencing the quality of life of elderly. Unfortunately malnutrition is a serious threat and an increasingly prevalent condition among the fast-growing elderly population. The present work addresses the identification of important factors contributing to decreased appetite and food intake as well as the development of approaches towards a healthy diet and personalised nutrition in elderly. Within the present study semi-structured interviews with elderly and elderly suffering from swallowing and mastication difficulties have been performed, results being used for the development of food provision modules and the corresponding recipes addressing the nutritional requirements of elderly. The social context and the swallowing and mastication difficulties influence the eating behaviour as well as the motivation to eat. On the other hand, it was found that texture modified foods (food which texture is adapted to the need of people with swallowing and mastication problems) could act as motivational aspect. With regard to food personalisation in the elderly the consideration of three different case scenarios based on individual independency and the degree of oral impairment seemed to be appropriate. Different aspects such as gender weight, physical activity level as well as high protein demand are important influential factors in the development of personalised recipes in elderly. In addition to the above, a conversational agent was developed as behaviour change module and can be successfully used as smart personal assistant in helping the users to understand their eating habits and adopt healthier nutrition over the long term.

Extraction of Maxillary Impacted Teeth with Simultaneous Immediate Full Mouth Loading Using Long Implant: A Case Report

Here, we describe the provision of an implant-supported prosthesis in a patient with impacted teeth in the maxilla, which complicated implant placement and necessitated utilization of the extraction sockets of previously impacted teeth and residual submerged roots. The patient was a 63-year-old man who visited our clinic with the chief complaint of difficulty in mastication. Numerous residual roots were observed in the maxilla, and radiographic imaging revealed that the residual roots of teeth #13 and #16 were fully impacted. The patient complained of a strong sensation of a foreign body in the area of a denture support overlying these residual roots. Therefore, the impacted teeth were extracted, 5 implants placed, and a temporary prosthesis provided. Given the necessity of placing the implant through the extraction socket of the impacted canine (#13), favorable initial stability was achieved using a long (>20 mm) implant. Moreover, autogenous bone obtained by osteotomy was grafted onto the extracted impacted tooth socket. The clinical condition was stable at approximately 1 year after implant placement and so the final prosthesis was delivered, with periodic check-ups being performed every 3 months thereafter. After 4 years, the patient has reported no symptoms. Clinically, there are no signs of inflammation, and the postoperative condition is deemed to be very favorable.

Gingival enlargement during orthodontic therapy and its management

Gingival enlargement is caused by gingival inflammation, fibrous overgrowth, or a combination of both, leading to adverse consequences, such as difficulty in plaque control, mastication, altered speech, and esthetic and psychological problems. A 24-year-old male reported with the chief complaint of spacing between the teeth in the front region of the jaw. This article reported a case of extreme gingival enlargement which was periodontally treated, by the removal of all gingival tissue excess using gingivectomy and gingivoplasty. After a 6-month follow-up period, the fixed orthodontic treatment is continued with monthly periodontal checkups that were scheduled to control the gingival inflammation. The collaboration between the periodontist and orthodontist is the most important key to successful treatment of hyperplasia in patients undergoing orthodontic treatment.

Preparation of easily chewable and swallowable texture-modified Dongchimi.

This study aimed to develop texture-modified Dongchimi (TMD) that is safe, well-shaped, and easy to chew and swallow. As the fermentation proceeded, the pH decreased, and the total acidity and total number of lactic acid bacteria increased. The hardness of the TMD decreased significantly by more than 96% (p < 0.05) as compared to that of the control. Significant differences in the hardness and shape were observed between two TMD samples-TMD 1 and TMD 2. Sensory evaluation showed that TMD 1 and TMD 2 were adequate for the elderly people suffering from difficulties in mastication and deglutition. Compared to TMD 1, TMD 2 showed higher values of hardness and swallowness and was more preferred by the elderly. Thus, TMD that is easy to chew and swallow has sufficient competitiveness in food safety, food taste, and food preference.

Retrospective analysis of a TMJ ankylosis protocol with a 9 year follow up

ObjectiveTemporomandibular joint ankylosis (TMJa) is a debilitating condition that causes difficulty in mastication, speech and mouth opening. Its treatment poses surgical and rehabilitative challenges along with a high incidence of reankylosis. This study was designed to assess the long-term outcomes with a new two phase physiotherapy protocol following conservative resection of the ankylotic mass. Materials and methods143 patients who were treated for TMJa were initially recruited, among whom 98 were inducted into the study and retrospectively evaluated using clinical records and 3-dimensional computed tomography. All the patients underwent a minimal pre auricular incision and conservative interpositional gap arthroplasty with collagen membrane. This was followed by the new two phase physiotherapy protocol with the use of a bite block. The primary outcome measures were the maximum interincisal distance, vertical ramus height and complications. The patients were followed up at monthly intervals during the first year, quarterly intervals during the second year, and at intervals of 6 months during subsequent follow-up years. The mean follow up period was 6.38 ± 2.36 years after ankylotic release. Paired student t test was used for statistical analysis. ResultsThe mean scores for mouth opening at T1, T2 and T3 were statistically significantly different at all intervals (p < 0.0005). The mean scores for ramal length were statistically significantly different at T1 and T2 interval (p < 0.0005) and insignificant at T2 and T3 interval. No reankylosis was observed in patients who followed the physiotherapy protocol. ConclusionsIn the management of TMJa, the success of the conservative surgical technique with interpositional arthroplasty is less dependent on the longevity and rigidity of the interpositional material but more indebted to the patient compliance in following the proposed physiotherapy protocol.

Optimization of textural and technological parameters using response surface methodology for the development of beef products for older consumers.

Red meat has a tougher texture compared with many other food products, therefore consumption is often reduced among older adults. Acidic treatments had a positive effect on WBSF values (reduced the WBSF values from 23.35 N for control to 14.83 N), and texture parameters and a combination with apple fiber and rice starch may improve the health profile of a meat product with benefits for consumers, particularly for older population. A novel meat product with a softer texture (apple fiber 0.15%, rice starch 0.30% and citric acid 0.16 M) was optimized and successfully validated in this study. The results obtained for the objective measurements of tenderness were confirmed by consumers' tenderness results (p < .05) moreover texture-optimized beef samples were found to be more acceptable by older consumers compared with control. Meat processors have an important role in increasing the availability of suitable meat products for older consumers, by developing products that will meet their nutritional and textural needs. In this study, a novel meat product with a softer texture was developed, successfully validated and the product was found to be acceptable by older consumers. Meat processors could consider using rice starch, apple fiber, and citric acid as feasible alternative to traditional ingredients used for beef injection, in order to obtain a softer product, that appeal to older consumers with difficulties in mastication.

Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta-analyses.

To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan. A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta-analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level. A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta-analyses were as high as 44.0% (95% confidence interval [CI] 35.6-52.7) for drooling, 50.4% (95% CI 36.0-64.8) for swallowing problems, and 53.5% (95% CI 40.7-65.9) for feeding problems. Group analyses for type of assessments were non-significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding. Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life. Drooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP.