Oral Stereognosis Research Articles

ОПТИМИЗАЦИЯ СТЕРЕОГНОСТИЧЕСКОЙ СПОСОБНОСТИ ЯЗЫКА В АДАПТАЦИИ ПАЦИЕНТОВ К ПОЛНЫМ СЪЁМНЫМ ПРОТЕЗАМ

Assessing a patient's ability to adapt to new dentures is still a challenge in orthopedic dentistry. The term oral stereognosy refers to the ability of a person to adequately assess the shape and geometric dimensions of solid objects using tactile receptors of different oral tissues. Oral stereognostic ability assesses human oral function and also determines patient response to various orthopedic treatments. This is achieved by the association of more than one group of mechanoreceptors distributed simultaneously across multiple oral structures. At the same time, sensory abilities vary greatly in different structures of the oral cavity depending on the concentration of sensory afferent nerve endings in each of these tissues. In the tongue, the anterior part and tip are more sensitive than the posterior part, similarly, the middle part shows greater tactile sensitivity than the lateral parts. Surface mechanoreceptors usually adapt rapidly and are known to play an exceptional role in exteroceptive tactile recognition and, accordingly, in tactile examination of objects in an intraoral manner. At the same time, a number of studies indicate significant deviations of tongue functions that form in conditions of complete absence of teeth, the most demonstrative of which is the violation of stereognosy. In this regard, the topic of oral stereognosis is closely related to the general state of the human oral cavity, to the process of dental orthopedic treatment and adaptation to it - all this requires special study.of dental orthopedic treatment and adaptation to it - all this requires special study.

Assessment of Oral Stereognosis and Denture Satisfaction in Old Denture Wearers: A Retrospective Study

Assessment of Oral Stereognosis and Denture Satisfaction in Old Denture Wearers: A Retrospective Study

Proprioception and osseoperception in prosthodontics – A review

The masticatory system receives neural inputs by means of proprioception and perception. Defective proprioceptive or perceptive input results in dysfunctional or pathological conditions. The prognosis of a prosthodontic restoration depends on the integration of proprioceptive input and motor output. The absence of intradental and periodontal mechanoreception accompanying tooth loss alters the fine proprioceptive control feedback. Complete denture rehabilitation is a compromised restoration which restores function with many lacunae. In contrast to conventional dentures, implant-supported prostheses restore jaw function with improved psychophysiological discriminatory ability, oral stereognosis, and osseoperception.

Effects of tongue lesions and palatal coverage on oral sensory functions

Statement of problemOral stereognosis (OS) plays a significant role in the oral rehabilitation of patients with edentulism, as it influences their adaptation to new prostheses. Because of the essentially tactile characteristic of oral sensory perception, the tongue and palate appear to have a crucial function in OS. However, little is known about the influence of tongue lesions on OS and sensorial function. In addition, controversies remain regarding the role of the palate. PurposeThe purpose of this clinical study was to evaluate whether tongue lesions and palatal coverage are disruptive to OS and gustatory function. Material and methodsSeventy participants (mean age=30.7 ±6.7 years) were divided into a tongue lesion group (experimental; n=35) and a control group (n=35). The tongue lesion group included participants with geographic, fissured, or hairy tongue. OS was evaluated with the oral stereognosis ability (OSA) test. Gustatory function was assessed with exposure to flavored solutions. After completing the above tests, the participants received a palate covering device, and then OS and gustatory function were immediately reevaluated. Data were analyzed with the Mann-Whitney and Wilcoxon tests (α=.05). ResultsOSA and gustatory function scores did not differ among the tongue lesion and control groups with and without palatal coverage (all P>.05). After palatal coverage, the tongue lesion group took more time to perform the OSA test than the control group (P<.05). ConclusionsNeither the presence of tongue lesions nor palatal coverage influenced OS or gustatory function. The OSA test response times were longer for the tongue lesion group after they had received palatal coverage.

Auditory and Somatosensory Development for Speech in Later Childhood.

This study collected measures of auditory-perceptual and oral somatosensory acuity in typically developing children and adolescents aged 9-15 years. We aimed to establish reference data that can be used as a point of comparison for individuals with residual speech sound disorder (RSSD), especially for RSSD affecting American English rhotics. We examined concurrent validity between tasks and hypothesized that performance on at least some tasks would show a significant association with age, reflecting ongoing refinement of sensory function in later childhood. We also tested for an inverse relationship between performance on auditory and somatosensory tasks, which would support the hypothesis of a trade-off between sensory domains. Ninety-eight children completed three auditory-perceptual tasks (identification and discrimination of stimuli from a "rake"-"wake" continuum and category goodness judgment for naturally produced words containing rhotics) and three oral somatosensory tasks (bite block with auditory masking, oral stereognosis, and articulatory awareness, which involved explicit judgments of relative tongue position for different speech sounds). Pairwise associations were examined between tasks within each domain and between task performance and age. Composite measures of auditory-perceptual and somatosensory functions were used to investigate the possibility of a sensory trade-off. Statistically significant associations were observed between the identification and discrimination tasks and the bite block and articulatory awareness tasks. In addition, significant associations with age were found for the category goodness and bite block tasks. There was no statistically significant evidence of a trade-off between auditory-perceptual and somatosensory domains. This study provided a multidimensional characterization of speech-related sensory function in older children/adolescents. Complete materials to administer all experimental tasks have been shared, along with measures of central tendency and dispersion for scores in two subgroups of age. Ultimately, we hope to apply this information to make customized treatment recommendations for children with RSSD based on sensory profiles.

Neural Correlates of Oral Stereognosis—An fMRI Study

Oral stereognosis is the ability to recognize, discriminate and localize a bolus in the oral cavity. Clinical observation indicates deficits in oral stereognosis in patients with vascular or neurodegenerative diseases particularly affecting the parietal lobes. However, the precise neural representation of oral stereognosis remains unclear whereas the neural network of manual stereognosis has already been identified. We hypothesize that oral and manual stereognosis share common neuronal substrates whilst also showing somatotopic distribution. Functional magnetic resonance images (fMRI; Siemens Prisma 3 T) from 20 healthy right-handed participants (11 female; mean age 25.7 years) using a cross-modal task of oral and manual spatial object manipulation were acquired. Data were analyzed using FSL software using a block design and standard analytical and statistical procedures. A conjunction analysis targeted the common neuronal substrate for stereognosis. Activations associated with manual and oral stereognosis were found in partially overlapping fronto-parietal networks in a somatotopic fashion, where oral stereognosis is located caudally from manual stereognosis. A significant overlap was seen in the left anterior intraparietal sulcus. Additionally, cerebellar activations were shown particularly for the oral condition. Spatial arrangement of shaped boli in the oral cavity is associated with neuronal activity in fronto-parietal networks and the cerebellum. These findings have significant implications for clinical diagnostics and management of patients with lesions or atrophy in parietal lobule (e.g. Alzheimer’s disease, stroke). More studies are required to investigate the clinical effect of damage to these areas, such as loss of oral stereognosis or an impaired oral phase.

Characterizing sensorimotor profiles in children with residual speech sound disorder: a pilot study

PurposeChildren with speech errors who have reduced motor skill may be more likely to develop residual errors associated with lifelong challenges. Drawing on models of speech production that highlight the role of somatosensory acuity in updating motor plans, this pilot study explored the relationship between motor skill and speech accuracy, and between somatosensory acuity and motor skill in children. Understanding the connections among sensorimotor measures and speech outcomes may offer insight into how somatosensation and motor skill cooperate during speech production, which could inform treatment decisions for this population. MethodTwenty-five children (ages 9-14) produced syllables in an /ɹ/ stimulability task before and after an ultrasound biofeedback treatment program targeting rhotics. We first tested whether motor skill (as measured by two ultrasound-based metrics of tongue shape complexity) predicted acoustically measured accuracy (the normalized difference between the second and third formant frequencies). We then tested whether somatosensory acuity (as measured by an oral stereognosis task) predicted motor skill, while controlling for auditory acuity. ResultsOne measure of tongue shape complexity was a significant predictor of accuracy, such that higher tongue shape complexity was associated with lower accuracy at pre-treatment but higher accuracy at post-treatment. Based on the same measure, children with better somatosensory acuity produced /ɹ/ tongue shapes that were more complex, but this relationship was only present at post-treatment. ConclusionThe predicted relationships among somatosensory acuity, motor skill, and acoustically measured /ɹ/ production accuracy were observed after treatment, but unexpectedly did not hold before treatment. The surprising finding that greater tongue shape complexity was associated with lower accuracy at pre-treatment highlights the importance of evaluating tongue shape patterns (e.g., using ultrasound) prior to treatment, and has the potential to suggest that children with high tongue shape complexity at pre-treatment may be good candidates for ultrasound-based treatment.

Evaluation of the Association of Oral Stereognosis with Malocclusion in Children.

Aim and objectiveTo evaluate the association between oral stereognosis with malocclusion in children.Materials and methodsStereognostic investigation was made with a set of seven different geometric configurations (circle, square, triangle, star, clover, diamond, and heart shapes) cut out from fresh, raw carrots using preformed iron molds. Any five of the seven geometric forms were randomly placed inside the mouth on the dorsum of the tongue by the investigator with the subject's eyes closed. A minimum of three shapes correctly identified out of the five offered to each child was considered as an indicator of the adequate stereognostic ability of that particular child.ResultsAmong the children under Index of Orthodontic Treatment Needs (IOTN) grade I group, 82.4% of children came under the positive response group. Among IOTN grades II, III, and IV, the percentages of children with positive responses were 72.1%, 58.1%, and 18.8%, respectively. There is a statistically significant (p < 0.001) decrease in positive response with increasing IOTN grades.ConclusionThe observations from the present study show that there is altered oral sensory perception in children graded as with malocclusion according to the index used and belonging to the age group selected in the study.Clinical significanceSensory and motor components of the orofacial region, like any other part of the human body, are inseparable in their structure and function, the association between orofacial growth and development and sensory maturation cannot be overlooked.How to cite this articleJanardhanan R, Soman A, George S, et al. Evaluation of the Association of Oral Stereognosis with Malocclusion in Children. Int J Clin Pediatr Dent 2021;14(S-1):S18–S21.

Predicting feeding-tube dependence in patients following endotracheal extubation: a two-item swallowing screen

BackgroundTo meet the surging demands for intubation and invasive ventilation as more COVID-19 patients begin their recovery, clinicians are challenged to find an ultra-brief and minimally invasive screen for postextubation dysphagia predicting feeding-tube dependence persisting for 72 h after extubation.MethodsThis study examined the predictive validity of a two-item swallowing screen on feeding-tube dependence over 72 h in patients following endotracheal extubation. Intensive-care-unit (ICU) patients (≥ 20 years) successfully extubated after ≥ 48 h endotracheal intubation were screened by trained nurses using the swallowing screen (comprising oral stereognosis and cough-reflex tests) 24 h postextubation. Feeding-tube dependence persisting for 72 h postextubation was abstracted from the medical record by an independent rater. To verify the results and cross-check whether the screen predicted penetration and/or aspiration during fiberoptic endoscopic evaluation of swallowing (FEES), participants agreeing to receive FEES were analyzed within 30 min of screening.ResultsThe results showed that 95/123 participants (77.2%) failed the screen, which predicted ICU patients’ prolonged (> 72 h) feeding-tube dependence, yielding sensitivity of 0.83, specificity of 0.35, and accuracy of 0.68. Failed-screen participants had 2.96-fold higher odds of feeding-tube dependence (95% CI, 1.13–7.76). For the 38 participants receiving FEES, the swallowing screen had 0.89 sensitivity to detect feeding-tube dependence and 0.86 sensitivity to predict penetration/aspiration, although specificity had room for improvement (0.36 and 0.21, respectively).ConclusionThis ultra-brief swallowing screen is sufficiently sensitive to identify high-risk patients for feeding-tube dependence persisting over 72 h after extubation. Once identified, a further assessment and care are indicated to ensure the prompt return of patients’ oral feeding.Trial registrationNCT03284892, registered on September 15, 2017.

健常者における口腔立体認知 ―口腔知覚判定研究用キットDF8 を用いた検討―

健常者における口腔立体認知 ―口腔知覚判定研究用キットDF8 を用いた検討―

Chew on this! Oral stereognosis predicts visual word recognition in typical adults

Much work has been conducted that reports on the strong relationships between speech production and reading behaviour. However, disentangling the relative contribution of the various underlying speech mechanisms (i.e., articulation, somatosensory and/or auditory) that contribute to this relationship remains unknown. Oral stereognosis refers to the ability to discriminate shapes using our tongue/mouth, in the absence of seeing the shape beforehand, and is a measure of the somatosensory sub-system of the speech mechanism. In this work, we aimed to address the extent to which oral stereognosis predicted visual word recognition. Methods: Healthy participants ranging from 18 to 51 years old (N = 60; Mage = 22.7) completed the Florida Oral Recognition Measurement (FORM) task and two visual word recognition tasks. The FORM required participants to identify carrots that were cut into the following letters’ shapes: E, R, T, S, L, N, O, V. Carrot letters were randomly presented to participants. With respect to the visual word recognition tasks, participants were required to press a button: 1) if the letter string spelled a word or 2) if the letter string sounded like a word. Response time and accuracy were measured for all tasks. Results: Participants were divided into high (accuracy >50%) vs. low (accuracy ≦ 50%) oral stereognosis recognition groups. For the high FORM group, oral stereognosis recognition predicted visual word recognition in the spell task (Adj R2 = .114). For the low FORM group, oral stereognosis recognition predicted visual word recognition in the sound task (Adj R2 = .307). Together, these findings provide evidence that oral stereognosis is predictive of word recognition performance, and that performance on the FORM differentially predicts word recognition tasks (spell vs. sound). Overall, these findings inform current print-to-speech frameworks by identifying a relationship between sensorimotor information, specifically, oral stereognosis ability, and reading performance.

Toward an index of oral somatosensory acuity: Comparison of three measures in adults.

Somatosensory targets and feedback are instrumental in ensuring accurate speech production. Individuals differ in their ability to access and respond to somatosensory information, but there is no established standard for measuring somatosensory acuity. The primary objective of this study was to determine which of three measures of somatosensory acuity had the strongest association with change in production accuracy in a vowel learning task, while controlling for the better-studied covariate of auditory acuity. Three somatosensory tasks were administered to 20 female college students: an oral stereognosis task, a bite block task with auditory masking, and a novel phonetic awareness task. Individual scores from the tasks were compared to their performance on a speech learning task in which participants were trained to produce novel Mandarin vowels with visual biofeedback. Of the three tasks, only bite block adaptation with auditory masking was significantly associated with performance in the speech learning task. Participants with weaker somatosensory acuity tended to demonstrate larger increases in production accuracy over the course of training. The bite block adaptation task measures proprioceptive awareness rather than tactile acuity and assesses somatosensory knowledge implicitly, with limited metalinguistic demands. This small-scale study provides preliminary evidence that these characteristics may be desirable for the assessment of oral somatosensory acuity, at least in the context of vowel learning tasks. Well-normed somatosensory measures could be of clinical utility by informing diagnosis/prognosis and treatment planning.

Effect of complete dentures on oral stereognostic ability in edentulous patients: A systematic review.

Aim:Oral stereognosis is an important sensation for a human being to percept any type of materials that are introduced in the oral cavity. It is defined as the ability of an individual to recognize objects using only tactile sensation without using vision, audition, balance, somatic function, taste, or smell. The primary purpose of this review was to evaluate the effect of complete dentures on oral stereognostic ability in edentulous subjects.Settings and Design:Systematic review based on PRISMA guidelines.Materials and Methods:A systematic search of the electronic databases like PubMed and Web of Science was done using keywords – “stereognosis,” “oral stereognosis,” “complete denture,” and “complete edentulism.” In addition to this, a manual search of references mentioned in the articles and gray literature was done. Data extraction and assessment were done by two independent reviewers.Statistical Analysis Used:Qualitative analysis.Results:The literature search yielded a total of 61 articles. Thirteen duplicate articles were removed and 36 articles were rejected after initial screening of titles and abstracts. A total of 12 articles were selected for full text reading and 5 of them were included for qualitative analysis.Conclusion:All the included studies showed complete denture treatment therapy improved stereognostic ability in terms of correct identification of test pieces and time taken to identify the objects. There is also a direct relationship between the adaptability of dentures and stereognostic ability.

노인의 구강 입체인지와 인지, 수단적 일상생활, 삶의 질과의 관계 : 예비연구

본 연구는 노인을 대상으로 구강 입체인지 검사를 시행한 후 그 특징을 알아보고 인지, 수단적 일상생활, 삶의 질과의 연관성을 확인하고자 하였다. 경기도에 거주하는 75세 이상의 노인 20명을 대상으로 구강 입체인지를 평가하고, 인지는 MoCA-K, 수단적 일상생활수준은 K-IADL, 삶의 질은 GQOL을 사용하여 평가 하였다. 구강 입체인지는 연령이 높아짐에 따라 정확성이 감소되며, 교육수준에는 영향을 받지 않았다. 여러 가지 도형 중 모서리가 명확하고 면적이 넓은 도형이 인식하기 좋은 것으로 나타났다. 구강 입체인지는 인지, 수단적 일상생활, 삶의 질과 관련성이 있어 본 연구를 통해 노인의 구강 입체인지는 인지를 포함한 노인의 기능 수준과 삶의 질을 예측할 수 있는 것으로 나타났다. 따라서 구강을 통한 노인의 신체적, 정신적 건강 관리의 기초자료로 활용될 수 있을 것으로 사료되고, 대규모의 대상자를 통한 노인용 구강 입체인지 평가도구의 개발이 이루어져야 할 것이다.

Mastication and oral sensory function in frail edentulous elderly: a case–control study

To evaluate the maximum bite force (MBF), masticatory performance and oral sensory function (OSF) of frail edentulous elderly. The correlation of MBF with maximum grip strength (MGS) was also assessed. Twenty edentulous elderly [10 with and 10 without the frailty phenotype (FP)] were selected to participate in this case-control study. The FP was diagnosed using the criteria of Fried etal., which consider weight loss, exhaustion, physical activity level, weakness and slowness to the evaluation. All volunteers received new complete dentures (CDs) to standardise the occlusal status, and after 2months of use with no complaint, all variables were assessed. MBF was measured by pressure sensors positioned bilaterally on the first artificial molars. Masticatory performance was assessed using the sieving method and was expressed as the median particle size (X50 ) of Optocal after 40 masticatory cycles. OSF was evaluated using the oral stereognosis test, and MGS was measured using a dynamometer. Groups were compared using one-way analysis of variance. The Pearson coefficient of correlation between MBF and MGS was calculated. Frail elderly people showed reduced MBF (P=0.0431) and larger X50 values (P=0.0053) than did non-frail elders, while OSF did not differ between the groups. MBF had a moderate positive correlation with MGS (r=0.690, P=0.003). Frail elderly had reduced MBF and impaired mastication. On the other hand, OSF does not seem to be affected by frailty. MBF was moderately correlated with MGS.

Oral Stereognosis in Completely Edentulous Patient With Maxillary Tori

Oral Stereognosis in Completely Edentulous Patient With Maxillary Tori

Evaluation of oral stereognosis, masticatory efficiency, and salivary flow rate in complete denture wearers.

Aim:The aim of the present study was to evaluate the improvement in oral stereognostic ability, masticatory efficiency, and difference in salivary flow rate in nonexperienced denture wearers, before, after, and 6 months after rehabilitation with complete dentures.Settings and Design:Invivo – Observational study.Materials and Methods:Seventy edentulous subjects were selected who came for rehabilitation with complete dentures for the first time. The study was conducted in three stages–before denture insertion, after denture insertion, and 6 months after denture insertion. Oral stereognostic ability was evaluated by asking the subjects to identify six heat cured acrylic resin samples by oral manipulation without seeing it. The unstimulated salivary flow rate was estimated by measuring the time taken to collect 5 ml of the whole saliva. Masticatory efficiency of the subjects was assessed with the help of preweighed chewing gums. The chewing gums were desiccated after the chewing strokes and weighed again.Statistical Analyses Used:Data were tabulated and analyzed statistically using pairedt-test, one-way ANOVA test, and the post hoc test.Results:Oral stereognostic ability increased immediately on insertion of complete dentures and was still higher 6 months post insertion of dentures. Comparison of the means of masticatory efficiency after denture insertion and 6 months after denture usage gave highly significant values (p< 0.001). The salivary flow which increased immediately following denture insertion returned to almost normal 6 months after denture insertion.Conclusion:The study support the hypothesis that the presence of dentures improve oral sterognostic ability and masticatory efficiency.

The Use of the Test for Oral Muscular Coordination Ability to Increase the Level of Adaptive Capacity of Oral Cavity Organs to Prosthodontic Treatment of Patients with Completely Absent Dentition

Increase in the level of adaptive capacity of oral cavity organs to the prosthodontic treatment of patients with completely absent dentition is one of the urgent problems of modern dentistry. In order to increase the level of adaptability to complete removable laminar dentures, a set of standard samples according to H. Landt was used to test the ability for precise coordination of masticatory muscles – the MA-test (Muscular-Ability) as a means of a group of muscles stimulation providing precise coordination of masticatory muscles. This adaptation process was called MA-stimulation. The level of adaptive capacity of the oral cavity organs was studied using oral stereognosis. The criteria for oral stereognosis assessment included the average time of one sample determination (sec) and the correctness of the samples determination (%). In order to achieve the objective, we conducted a study of tactile sensitivity in the oral cavity using oral stereognosis in 90 patients with completely absent dentition who applied for the prosthodontic retreatment. The patients’ age ranged from 45 to 89 years. The patients were divided into two groups. Group I included 30 patients who underwent the prosthodontic treatment without preliminary MA-stimulation. Group II included 60 patients who underwent MA-stimulation for 14 days before the prosthodontic treatment.&#x0D; According to the results of oral stereognosis in Group II of patients, the average time of one sample determination after fourteen days of MA-stimulation decreased by 24.5% (p˂0.05) and the index of correctness of the samples determination increased by 32.0% (р˂0.001); the average time of one sample determination decreased by another 19.3% in 1 month after the prosthodontic treatment, and it decreased by 17.4% (р˂0.05) in 3 months after the prosthodontic treatment; the index of the correctness of the samples determination increased by 17.5% (p˂0.001) and 10.5% (p˂0.01) respectively in 1 and 3 months after the prosthodontic treatment.&#x0D; Oral stereognosis indices changed significantly only in 1 month after the prosthodontic treatment in Group I of patients who did not undergo MA-stimulation: the average time of one sample determination decreased only by 14.7% (p˂0.05), and the index of correctness of the samples determination increased only by 24.5 (p˂0.05).&#x0D; According to the results of the research, MA-stimulation is advisable to be included into the prosthodontic treatment of the patients with completely absent dentition as a means of increasing the adaptive capacity of the oral organs.

Comparative study of evaluation of the oral stereognostic ability between diabetic and nondiabetic complete denture wearers with and without denture

The diabetic subjects would have impaired oral stereognostic ability (OSA) compared with normal subjects due to diabetic neuropathy and microcirculatory disturbances. This study was conducted to compare the OSA between diabetic and nondiabetic complete denture wearers with and without denture. In this in vivo study the present comparative study comprised of seventy edentulous subjects (36 males and 34 females), aged from 35 to 84 rehabilitated with complete dentures (among them 35 were diabetic and 35 subjects were nondiabetic complete denture wearer). The OSA tests were conducted using acrylic test samples of 12 shaped forms, which were placed in patient's mouth for a given period of time for identification and scored according to three-point scale as OSA score and the identification time was also recorded. The data obtained were analyzed using Chi-square test, t-test, and Pearson's correlation coefficient (P < 0.05). In this study, diabetic complete denture wearers got the mean OSA score of 12.43 ± 3.93 without dentures, which was lower than nondiabetic complete denture wearer group (14.82 ± 4.44). There was a significant difference (P = 0.020*) in the identification of test pieces. Within limitations of this study, diabetic complete denture wearers showed decreased OSA than nondiabetic subjects, particularly it was significant while not wearing dentures. Oral stereognosis may be used as one of the clinical aids in predicting patient's performance to a prosthesis. Based on their response, we can educate the patient about the prognosis.

Masticatory function and oral sensorimotor ability in Parkinson's disease: Levodopa on versus off periods.

To evaluate masticatory function and oral sensorimotor ability (OSA) in elders with Parkinson's disease (PD) during the levodopa on and off-periods. Participants were 11 partially and completely edentulous elders with PD. Masticatory function was evaluated by mandibular movements, maximum bite force (MBF), and masticatory performance (MP). Mandibular movements reflecting jaw range of motion (ROM) and jaw movements while chewing silicone test material (Optocal), were evaluated using a kinesiograph. MBF was assessed by strain sensors, and MP was determined using the median Optocal particle size (X50 ) after 40 masticatory cycles. OSA was evaluated using oral stereognosis test scores and response time. Evaluations were carried out 30min before levodopa intake (off-period) and within a 3-day interval 1 h after levodopa intake (on-period). Data were analyzed by Student's t-test, considering a significance level of 5%. During the levodopa off-period, elders showed decreased ROM during protrusion and lateral movements, while no difference was found in maximum opening and mandibular movements during chewing. MBF was lower and X50 was higher during the off-period, indicating worse mastication. However, OSA did not differ between the evaluated times. Elders with PD had impaired mastication during the levodopa off-period, although OSA was not altered.