Masticatory Function Research Articles

Chewing with Co-Cr or PEEK denture frameworks: A randomized crossover clinical study.

To compare masticatory function and patient satisfaction with removable partial dentures (RPDs) with cobalt-chromium (Co-Cr) and injected polyetheretherketone (PEEK) frameworks, respectively. Twelve volunteers (7 women, 5 men; mean age, 56.6 years) with complete maxillary edentulism and partial mandibular edentulism (Kennedy Class I) first received new RPDs with PEEK (experimental group) or Co-Cr (control group) frameworks and used them for 2 months. Masticatory performance (MP) was evaluated using sieves and Optocal, with results expressed as the mean particle size (X50); maximum bite force (MBF) was measured with a force transducer and pressure sensors; and self-reported satisfaction was assessed using a visual analog scale. After the initial evaluation, a 1-week washout period was followed by group crossover and reassessment after an additional 2 months. Data were analyzed using independent-samples t-tests (α=5%). X50 values were lower for RPDs with Co-Cr frameworks than for those with PEEK frameworks (p=0.007), indicating better MP. The MBF did not differ significantly between RPD framework types. Participants' satisfaction, in terms of prosthesis stability (p=0.02) and chewing ability (p<0.001), was greater for Co-Cr RPDs. Most participants preferred to continue using Co-Cr frameworks. RPDs with injected PEEK frameworks were associated with reduced MP and patient satisfaction relative to Co-Cr frameworks.

Electroplated double-crowns on implants and teeth after up to 12 years– a retrospective clinical study

PurposeTo retrospectively evaluate the outcome of implant-supported or combined tooth-implant-supported prostheses retained by electroplated double-crowns after 1–12 years.MethodsTwenty-five patients were retrospectively examined in a private dental practice in Hamburg, Germany. All had been rehabilitated with a removable prosthesis retained by electroplated double-crowns, for at least one year. Fifteen patients had implant-supported prostheses and 10 had combined tooth-implant-supported prostheses in the maxilla or the mandible. Biological and technical complications were recorded at the clinical examination and extracted from the patient records. Kaplan–Meier implant and tooth survival rates were calculated. Potential risk factors for severe complications were identified. Oral health-related quality of life (OHRQoL) was measured by a short version of the Oral Health Impact Profile (OHIP) questionnaire. Patients reported subjective chewing function using a visual analogue scale.ResultsKaplan–Meier survival rates were 100% for natural abutments and 90.9% for implants after 11.8 years (p = 0.54). Two implants in two patients were lost at 8 and 9 years due to peri-implantitis in the "solely implant" group. The most common complications were decementation of primary crowns and wear of the prosthetic teeth. The mean OHIP score for the group “tooth-implant-supported” was 5.2 ± 5.0, whereas the mean score for the "solely implant" group was 1.7 ± 2.9 (p = 0.039). Patients rated their subjective masticatory function very high with an average score of 9.4 ± 0.8 out of a possible 10.ConclusionsImplant-supported or combined tooth-implant-supported prostheses retained by electroplated double-crowns are a viable method of treatment with a satisfactory outcome. Maintenance has been manageable and patients have reported very good subjective chewing function after several years of function.Graphical

Development and validation of an AI-driven tool to evaluate chewing function: a proof of concept.

Masticatory function is an important determinant of oral health and a contributing factor in the maintenance of general health. Currently, objective assessment of chewing function is a clinical challenge. Previously, several methods have been developed and proposed, but implementing these methods in clinics may not be feasible. Therefore, more efforts are needed for accurate assessment of chewing function and clinical use. The study aimed to establish a proof of concept for development and validation of an automated tool for evaluating masticatory function. YOLOv8, a deep neural network, was fine-tuned and trained to detect and segment food fragments. The model's performance was assessed using bounding box recall metrics, segmentation metrics, confusion matrix, and sensitivity values. Additionally, a separate conversion test set evaluated the model's segmentation performance using physical units, demonstrated with Bland-Altman diagrams. The YOLOv8-model achieved recall and sensitivity rates exceeding 90 %, effectively detecting and classifying food fragments. Out of 316 ground truth fragments, 301 were correctly classified, with 15 missed and 5 false positives. The Bland-Altman diagram indicated general agreement but suggested a systematic overestimation in measuring the size of post-masticated food fragments. Artificial intelligence presents a reliable approach for automated analysis of masticatory performance. The developed application proves to be a valuable tool for future clinical assessment of masticatory function. The current study provides a proof of concept for development of an automated tool for clinical assessment of masticatory function.

Practice and challenge of age-friendly functional restoration of stomatognathic system based on the strategy of functional tooth loss.

Geriatric oral health care encounters significant challenges with the increase in the proportion of older individuals. Age-related changes in the dentition, muscles, and joints result in a decline in objective masticatory function, subjective restoration requirements, and acceptability among the elderly population, with individual variations influenced by systemic health. Considering functional requirements, the adaptability of stomatognathic and systemic health conditions, health economics and other factors, the authors believe that it should not be limited to the conventional "one-to-one" strategy for replacing missing teeth in geriatric prosthodontics. There is an urgent need for a precise and adaptable restoration strategy that is more suitable for older individuals. The proposal of a new concept of functional tooth loss updates the minimal restoration standards for elderly patients and establishes the theory of age-friendly functional restoration. Based on the restoration strategy of functional tooth loss, this paper proposes a new concept termed "age-friendly functional restoration of the stomatognathic system", which integrates treatment considerations including endodontics, periodontology, mucosa, muscles, temporomandibular joint, and systemic health. Efforts should be made in four areas as follows. Firstly, the "assessment of accessible function" should be enhanced by considering the interrelationship between stomatognathic and systemic health. Secondly, the "evaluation of appropriate function" is supposed to be optimised in view of subjective needs and objective evaluation of the stomatognathic system. Moreover, the "formulation of treatment plans" needs to be accomplished with the aid of assistive technologies, such as artificial intelligence, to accurately exert appropriate functional restoration. Lastly, the "management and maintenance of health" is likely to be strengthened through follow-ups, propaganda and education, and preventive healthcare, so as to improve quality of life and ultimately achieve healthy ageing among older individuals.

Relationship between subjective masticatory performance assessed by food acceptance questionnaire and comprehensively assessed oral function in older outpatients at a dental hospital in Japan: a cross-sectional study

BackgroundWith the global rise in the aging population, the relationship between oral function and risk of long-term care is attracting attention. One method for subjective assessment of masticatory function is the use of a food acceptance questionnaire. Although it is hypothesized that objective oral functions such as tongue pressure and swallowing function are associated with subjective masticatory performance, this relationship has yet to be investigated. The aim of this study is to elucidate the association between overall oral function and subjective masticatory performance using a food questionnaire.MethodsPatients aged ≥ 65 years were recruited from an outpatient dental clinic at Tokyo Medical and Dental University. Subjective masticatory performance was assessed using the food acceptance score as described in a previous study. Seven oral function parameters defined by the Japanese Society of Gerodontology, were measured. Age, sex, number of functional teeth, geriatric depression, cognitive function, and oral health-related quality of life were assessed. Variables for which normality was rejected were transformed into tertile values. Multiple regression analysis was conducted with the food acceptance score as the objective variable, and each oral function parameter and other items as explanatory variables.ResultsThis study included 201 participants (87 males and 114 females). Multiple regression analysis revealed that the number of functional teeth, geriatric depression, oral health-related quality of life, objective masticatory performance, tongue pressure, and swallowing function were substantially associated with the food acceptance scores.ConclusionsThis study demonstrated that subjective masticatory performance was independently associated with tongue pressure, objective masticatory performance, swallowing function, number of functional teeth, geriatric depression, and oral health-related quality of life.

Impact of Obstructive Sleep Apnea on Masticatory Muscle Function.

How to cite this article: Russo D, Almeida LE, Ronsivalle V, et al. Impact of Obstructive Sleep Apnea on Masticatory Muscle Function. J Contemp Dent Pract 2024;25(11):997-1000. Keywords: Apnea-hypopnea index, Diabetes, Obstructive sleep apnea, Temporomandibular joint.

Effects of Capsaicin on Masticatory and Swallowing Function.

Recent studies have shown that capsaicin improves the pharyngeal swallowing reflex. However, the mechanism by which capsaicin alters mastication and oesophageal function remains unclear. This study aimed to investigate the effects of capsaicin on masticatory and oesophageal function. Participants were 12 healthy individuals (7 men, 5 women: aged 31.5 ± 3.0 years). The participants ingested five rice cakes without capsaicin and then five rice cakes containing capsaicin. Total mastication frequency, total mastication time, and mastication rate were measured. Pharyngeal and upper oesophageal sphincter (UES) parameters were evaluated using high-resolution manometry (HRM). The masticatory and HRM parameters were compared between the ingestion of capsaicin-containing and non-capsaicin containing rice cakes. The total mastication frequency and total mastication time(s) for capsaicin ingestion were significantly smaller (20.3 ± 9.4 vs. 22.4 ± 7.4; p = 0.011) and shorter (14.2 ± 7.0 vs. 15.4 ± 5.6; p = 0.038), respectively, than those for non-capsaicin ingestion. Comparison of the HRM parameters revealed significantly higher hypopharyngeal contractile integral (mmHg-s-cm) (56.6 ± 40.7 vs. 49.7 ± 43.6; p = 0.016) and proximal oesophageal contractile integral (mmHg-s-cm) (492.3 ± 292.64 vs. 381.2 ± 266; p < 0.001), significantly shorter UES basal pressure (mmHg) (93.6 ± 37.8 vs. 114.5 ± 43.4; p < 0.001), and significantly longer UES relaxation time (ms) (486.7 ± 90.7 vs. 431.2 ± 82.3; p < 0.001) for capsaicin ingestion than for non-capsaicin ingestion. Decreased mastication frequency and time, increased hypopharyngeal and proximal oesophageal contractile integral, and prolonged UES opening time with capsaicin ingestion suggests that capsaicin improves oral, pharyngeal and oesophageal phases of swallowing.

Effectiveness of Space Maintainers in Pediatric Patients: A Systematic Review and Meta-Analysis.

Background: Evaluating the effectiveness and survival rates of space maintainers is crucial for optimal pediatric dental care. The present study's goal is to evaluate the survival rate of different types of space maintainers-removable, fixed with a metal base, or fixed with a resin base-indicated for children as a consequence of premature loss of primary teeth. Methods: A systematic review was conducted in accordance with PRISMA recommendations and was previously registered in PROSPERO under registration number: CRD42024534183. The search was performed in five different databases PubMed, EMBASE, Scopus, Cochrane, and Web of Science. This was supplemented by a manual database search. From the initial electronic search of the five databases, 72 articles were identified after removing duplicates. After reading the titles and abstracts, 46 articles were excluded, leaving a total of 26 studies. Upon reading the full texts, 15 were excluded for not meeting the inclusion criteria, resulting in a total of 11 articles included in the systematic review. Results: The total number of patients treated in the studies was 479, with four observational studies and seven randomized clinical trials. Fixed space maintainers, such as band and loop (BL) or lingual arch (LA), are preferred due to their long-term stability and lower risk of loss. In contrast, removable maintainers, such as Hawley plates, are suitable temporarily but require more patient cooperation and may be less tolerated. Conclusions: Space maintainers help prevent the migration of adjacent teeth and the need for more invasive orthodontic treatments in the future. Additionally, they contribute to adequate masticatory function and speech development.

Impact of mandibular overdentures on maxillary resorption and its association with masticatory function: A prospective longitudinal study with 3 years of follow-up.

This longitudinal clinical study monitored annually the maxillary and mandibular bone remodeling and masticatory function in complete denture (CD) wearers rehabilitated with implant-retained mandibular overdentures (MO) over three years and combined radiographic and masticatory function data to assess the correlation between bone remodeling and masticatory function. Thirty-nine MO wearers were monitored annually to assess changes in: i) residual ridge in the anterior and posterior maxillary region; ii) posterior height and posterior area index (PAI) in the mandible; and iii) masticatory function. Bone remodeling was measured through linear and angular measurements using panoramic radiographs. Masticatory function was evaluated by swallowing threshold test, to determine the median particle size (X50) and homogenization index (B). A mixed-effects multilevel regression model estimated differences between radiological and masticatory parameters over time, with associations verified using Pearson's correlation test. Significant changes in mandibular bone variables (PAI and L1/R1, L2/R2, L3/R3; p ≤ 0.01) occurred when transitioning from CD to MO, showing a reduction in PAI values and slight reduction in mandibular linear measurements. Improvements in masticatory parameters were also observed, highlighting the benefits of transitioning to MO. Over three years of MO usage, significant changes in all radiographic bone parameters were found, with increased PAI and maxillary bone values in the first year. The correlations between masticatory function and radiological parameters indicated that mandibular morphology can significantly influence masticatory function especially in patients wearing CDs. Following the transition to MO, only one consistent significant correlation was observed between X50 and R3/L3 at the 1-year and 3-year intervals. Continuous changes in bone parameters were observed in MO wearers, with stabilization of maxillary ridge resorption and ongoing mandibular remodeling, alongside slight changes in masticatory function, suggesting transitory correlations between linear changes in the posterior region of mandible and masticatory function over time.

Mucosal Injection of the Silicon Phthalocyanine Pc 4 in a Rabbit Model-A Pilot Study.

The silicon phthalocyanine Pc 4 is a photosensitizing agent previously shown to be a promising treatment for cutaneous neoplasms using photodynamic therapy (PDT). Based on prior preclinical studies, we believe Pc 4-PDT has potential as a targeted treatment of human recurrent respiratory papillomatosis or laryngeal leukoplakia by direct injection into mucosal surfaces. This was a proof-of-concept pilot study assessing direct mucosal injection of Pc 4 into buccal and vocal fold mucosae in a rabbit model. Five New Zealand white rabbits underwent tattooing of bilateral buccal mucosae to delineate injection sites, followed by submucosal injections of control and Pc 4 solutions. Rabbits were monitored for post-injection tolerance. Punch biopsies were obtained from injected mucosa and assessed histopathologically. Once the buccal mucosa was found to be tolerant, vocal folds of three rabbits were injected. The rabbits were then sacrificed, and laryngeal tissue was assessed histopathologically. All rabbits tolerated injection of Pc 4 and control solutions into buccal mucosa with no evidence of gross visual inflammatory changes and no changes in behavior or masticatory function. Histopathologic analysis of Pc 4 injected buccal and control mucosal tissue revealed mild focal histological changes and no stigmata of diffuse inflammatory reactions. The histopathologic analysis of Pc 4 injected into laryngeal tissue revealed similar findings with addition of mild eosinophilia in one sample. Direct mucosal injection of Pc 4 in rabbit buccal and vocal fold mucosae appears to be well tolerated with no gross inflammatory changes, and only mild histopathologic inflammatory changes observed. NA Laryngoscope, 135:270-276, 2025.

Association between decreased occlusal support and diabetes mellitus diagnosed by the oral glucose tolerance test with and without periodontal disease: The Suita Study

Several studies have reported a close association between periodontal disease (PD) and diabetes mellitus (DM). In addition, the decline in masticatory function due to decreased occlusal support may worsen DM due to poor nutritional intake. We aimed to elucidate the relationship between PD, decreased occlusal support, and DM. We surveyed 968 participants (411 men and 557 women) aged 50-79 years in the Suita study. An oral glucose tolerance test was performed with 75 g glucose, and fasting and 2 h post-challenge plasma glucose levels were measured. The participants were classified into following four groups: normal glucose tolerance, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and DM. Occlusal support was evaluated by the Eichner Index. PD was assessed using the Community Periodontal Index, and participants were classified into two groups: without PD and with PD. Logistic regression analysis was performed using the incidence of IFG, IGT, and DM as objective variables in the without PD and PD groups. In the without PD group, body mass index (BMI) was significantly associated with IFG, IGT, and DM, and a history of hypertension was significantly associated with DM. In the PD group, male sex and BMI were significantly associated with IGT and DM, a history of hypertension was significantly associated with DM, and decreased occlusal support was significantly associated with IGT and DM. Decreased occlusal support was associated with DM in patients with PD.

A comparative analysis of older patients with chewing difficulties due to temporomandibular disorders and tooth loss

Chewing difficulty can contribute to psychological stress, which reduces the quality of life for older adults. The purpose of this study was to investigate and analyze the severity of masticatory discomfort, stress response, and sleep disturbance in older patients experiencing masticatory discomfort due to tooth loss or temporomandibular disorders (TMD), to find the further treatment direction for these patients. A total of 392 patients aged 50 years and older with mastication difficulties were analyzed. Two group of patients, those seeking prosthetic treatment due to tooth loss (n=193) and those who were referred due to TMD-related pain discomfort (n=199), were identified. Numeric rating scale (NRS), stress response inventory (SRI), and insomnia severity index (ISI) were used as tools to measure patients' subjective chewing discomfort, stress response, and sleep status. Chewing discomfort and age were found to be much higher in the prosthetic group than in the TMD group. The TMD group had significantly higher scores in five SRI parameters (tension, anger, depression, fatigue, and frustration) as well as total score and a higher percentage of clinical insomnia compared to prosthetic patients. Since the number of remaining teeth has a significant impact on the masticatory discomfort severity, restoring the occlusion through prosthodontic treatment is important to improve masticatory function. In patients with TMD, it is necessary to assess stress response and sleep quality, and a multidisciplinary treatment approach may be necessary to effectively address masticatory discomfort.

Beyond two heads: An imaging-based analysis of the lateral pterygoid muscle's heads.

The lateral pterygoid muscle (LPM) is crucial for masticatory function but exhibits significant anatomical variability that challenges traditional anatomical views. Advanced imaging techniques have revealed these variations, necessitating a reevaluation of the LPM's structure. To categorize variations in the number of LPM heads and their relationship with the maxillary artery, aiming to improve the understanding of orofacial anatomy and move beyond simplified anatomical models. Cone-beam computed tomography (CBCT) coronal sections of the LPMs were examined to identify five muscle types, ranging from the typical two-headed configuration to variants with extra or single large heads. Additionally, computed tomography angiograms (CTAs) were analyzed to classify the maxillary artery's relation to the LPM into three patterns: superficial, deep, or coursing through the LPM. A total of 271 CBCT scans were bilaterally assessed (542 sides). Variations in the number of LPM heads were observed in 36.9 % of cases. Similarly, 170 CTAs (340 sides) were analyzed. Among these, deviations in the typical superficial path of the maxillary artery were observed in 36.76 % of cases. Notably, the artery either passed deep to the LPM or, in rare instances (1.47 %), traversed through the LPM. The study challenges conventional anatomical dogmas by highlighting significant variability in LPM anatomy and its association with the maxillary artery. These findings highlight the necessity of adopting imaging-driven, personalized anatomical insights to improve clinical decision-making and outcomes, advocating for a paradigm shift in understanding human anatomy.

Dietary Counseling: An Option to Malnutrition and Masticatory Deficiency in Patients with Total Protheses? A Scoping Review.

To examine the research on the efficacy of dietary counseling in enhancing mastication and nutrition in older adults with CRP. A systematic literature review was performed in the PubMed, Trip, and Web of Science databases. 812 results were retrieved from the databases, from which 6 clinical studies that fulfilled the qualifying criteria were selected. The selected studies reported reduced nutrition in patients with CRP due to impaired masticatory function. Research suggests that employing basic dietary guidelines or simplified nutritional recommendations enhances the masticatory function of patients with CRP, thereby ensuring sufficient nutritional intake. Dietary counseling improves nutritional intake and masticatory function in patients with CRP. This would allow simple dietary advice to be given to patients with total prostheses in clinical practice. Further randomized clinical trials are recommended to increase the available evidence.

Maxillofacial injuries in women victims of domestic violence examined at the Forensic Institute: a retrospective study

Violence against women is a global public health issue. In physical aggression, the head and neck are the most affected areas and can get lifelong sequelae. The aim of this study was to analyze the type, prevalence and quantification of damage related to oral and maxillofacial injuries in women victims of domestic violence treated at the Forensic Dentistry of the Afrânio Peixoto Medical-Legal Institute (IML-AP), over a period of 5 years. A survey was carried out in the Occurrence Records and Expert Reports of the IML-AP Forensic Dentistry Service. 200 reports of female victims were evaluated, excluding cases of non-cohabiting aggressors or non-first-degree family members, child abuse, and those under legal confidentiality. The majority of victims were between 18 and 39 years old (62%), high school graduates (34%), attacked at home (64.5%) by their companions (50%) and bodily force caused the injuries (84 .5%). In 69% of the assaulted women there were injuries in the oral cavity and, mainly, to soft tissue (73.5%). Ecchymosis was the most common (59%). In dental tissues, fracture (24.5%) and dislocation (18.5%) were more prevalent, especially in the upper central incisors. In 45.5% the damage was considered mild, in 15% permanent weakness and in 7.5% permanent deformity. It is concluded that in the Forensic Dentistry Service of IML-AP, in 5 years, domestic violence against women produced simple and reversible soft tissue injuries, as well as bone and dental fractures that can impair lifelong masticatory, phonetic and aesthetic function.

Association between Hearing Difficulty, Masticatory Difficulty, and Risk of Cognitive Impairment: Analysis of the Korean Longitudinal Study of Aging Data (2006-2020)

Purpose: This study aimed to identify the association between hearing difficulty, masticatory difficulty, and cognitive impairment using data from the Korean Longitudinal Study of Aging. Methods: This secondary data analysis included 6939 Korean adults aged 45 or older with no cognitive impairment at baseline. Self-reported questionnaires measured hearing and masticatory difficulty, and cognitive impairment were assessed using the Korea Mini-Mental State Examination (K-MMSE). Cox models were used to estimate the risk of cognitive impairment associated with the coexistence of hearing and masticatory difficulty.Results: People who coexisted with hearing and masticatory difficulty were 2.4%. The incidence rate of cognitive impairment was 37.7% for the study sample and higher in females than males. Compared to people without hearing and masticatory difficulty, the total study sample with the coexistence of hearing and masticatory difficulty had a higher risk of cognitive impairment (HR: 1.26, 95% CI: 1.03–1.56), females with the coexistence of hearing and masticatory difficulty had a greater risk of cognitive impairment (HR :1.52 95% CI: 1.11–2.09). Conclusion: Coexistence of hearing and masticatory difficulty increased females' cognitive impairment risk. It is recommended to check hearing and masticatory function in a timely, which may be effective in detecting individuals at high risk of cognitive impairment.

Bibliographic analysis of the effect of upper lateral incisor agenesis on occlusion

Dental agenesis is one of the most frequent anomalies in human oral development. The congenital absence of upper lateral incisors is associated with displacement and rotation of canines and premolars, which can cause malocclusion, periodontal disease and phonation problems, among others. This article analyzes the consequences of dental agenesis on occlusion by means of a review of the literature. Databases such as PubMed and Google Scholar were consulted, covering publications from 1995 to the present, selecting 19 relevant articles. It is concluded that early detection and treatment of dental agenesis is key to preventing malocclusions, improving masticatory function and avoiding future complications in the oral health of the patient

EFFECTIVENESS OF DISTRACTION AND ORTHOGNATHIC INTERVENTION IN THE TREATMENT OF MESIAL OCCLUSION IN PATIENTS WITH MAXILLARY UNDERDEVELOPMENT

Mesial occlusion is a complex orthodontic pathology that adversely affects facial aesthetics, masticatory function, and patient quality of life, making timely treatment critical. One of the modern methods of correction is distraction osteogenesis, which allows gradual expansion of bone structures while minimizing the risk of relapse. The choice of treatment is based on the patient's clinical presentation, with distraction being a priority in cases where traditional surgery is contraindicated. Aim of the study was a detailed analysis of the effectiveness and safety of various treatment methods for mesial occlusion in adult patients with maxillary underdevelopment. Material and methods. The study included 15 adolescent patients between the ages of 19 and 23 with skeletal mesial occlusion. Baseline diagnostic data were obtained for each patient, and the volume of bone tissue in the vestibulo-oral direction at the site of planned implant placement was assessed during preparation for implant placement. Statistically significant differences between alternative quantitative characteristics with normal distributions were evaluated using Student's t-test. A difference was considered statistically significant at p&lt;0.01. The study was carried out in compliance with the main provisions of the Council of Europe Convention on Human Rights and Biomedicine (4 April 1997), the World Medical Association Declaration of Helsinki on the Ethical Principles for Scientific Medical Research Involving Human Subjects (1964-2013), ICH GCP (1996), orders of the Ministry of Health of Ukraine No. 690 of 23.09.2009, No. 944 of 14.12.2009, No. 616 of 03.08.2012. The work is a fragment of the research project “Correction of violations of osteogenesis processes in the treatment and prevention of complications of dental diseases wartime” state registration No. 0123U103247. Results. The results of the study showed that in adult patients, orthognathic surgery ensures favorable skeletal outcomes for maxillary mesialization. However, when the replacement of lateral incisors with canines is feasible, this treatment approach may reduce the number of rehabilitation stages while achieving dentoalveolar relationships that conform to normal standards. The use of distraction osteogenesis in adult patients has yielded good results and may be justified in cases of critical reduction of maxillary body dimensions or contraindications to conventional orthognathic surgery. Conclusion. Distraction osteogenesis and orthognathic procedures effectively correct mesial occlusion, ensuring a stable increase in the sagittal dimension of the maxilla and improving occlusion. Replacement of lateral incisors with canines minimizes the need for additional surgery in cases of agenesis. The choice of treatment method should be based on individual clinical indications and risk assessment for each patient.

Impact of mandibular condylar fractures on masticatory muscle function: a narrative review

Mandibular condylar fractures are common in maxillofacial trauma and can significantly affect both bone structure and masticatory muscle function. This review explores these fractures' biomechanical and functional consequences, focusing on their impact on masticatory muscles and temporomandibular joint (TMJ) function. The condylar region is particularly vulnerable due to its role as a fulcrum in jaw movement, making it susceptible to indirect forces from impacts, such as blows to the chin or lateral face. These fractures disrupt muscle coordination, decrease chewing efficiency, and lead to long-term neuromuscular adaptations. The review synthesizes research on the pathophysiology of condylar fractures, highlighting changes in muscle activity, such as compensatory overuse of contralateral muscles and atrophy of the injured side. It also discusses advanced diagnostic tools, including electromyography (EMG), computed tomography (CT), and magnetic jaw tracking, for evaluating the functional impact of these injuries. Intermaxillary fixation (IMF) and open reduction and internal fixation (ORIF) are reviewed as structural and functional recovery treatment strategies. The importance of rehabilitation, including physical therapy and neuromuscular reeducation, is emphasized. Finally, the review addresses the long-term challenges of chronic TMJ dysfunction and muscle imbalance, suggesting further research into regenerative medicine and personalized rehabilitation for better outcomes. This review provides an overview of condylar fractures, offering insights into current practices and future research directions.

Combined Effects of Dietary Guidance and Prosthodontic Rehabilitation on Nutritional Biomarkers in Edentulous Patients: A Randomized Controlled Trial.

Background Previous studies have suggested that providing dietary guidance along with denture treatment may improve dietary diversity in edentulous patients; however, none have examined the effects on nutritional blood biomarkers. This study investigated the effects of individualized dietary guidance combined with complete denture treatment on nutritional blood biomarker levels, dietary intake, and masticatory function. Materials and methods This was a prospective, randomized, open-label, controlled trial. Patients seeking new dentures with at least one edentulous arch were randomly allocated to Group A (denture treatment only) or Group B (dietary guidance followed by denture treatment). Individualized dietary guidance was provided exclusively to Group B by dentists based on baseline assessments. Baseline and post-treatment assessments included blood tests, a dietary survey using the Brief-type Self-Administered Diet History Questionnaire (BDHQ), occlusal force measurements using pressure-sensitive film, and masticatory performance tests using gummy jelly. The results from the baseline and post-treatment assessments were compared within each group, and exploratory comparisons of changes were conducted between groups. Results A total of 39 individuals completed the protocol (20 in Group A and 19 in Group B; mean age 73.4 ± 10.6 years; 17 males, 22 females). Both groups showed a significant increase in occlusal force after treatment (P = 0.007 for Group A; P = 0.011 for Group B), while no improvement in blood biomarkers was observed. In Group B, the intake of fish with bones (P = 0.035) and non-oily fish (P = 0.030), as evaluated using the BDHQ, significantly increased after treatment. Group B also showed significantly greater increases than Group A in methionine (P = 0.012), lysine (P = 0.048), and total essential amino acids (P = 0.029), as evaluated by blood tests, as well as the intake of fish with bones (P = 0.043). Conclusion Although denture treatment may increase occlusal force, combining dietary guidance with prosthetic treatment appears to further enhance dietary habits and support the nutritional status of edentulous patients.