• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.4
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• pp.281-293
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• 2021

Patients who went through maxillectomy can have severely impaired swallowing, mastication, and pronunciation functions because of palatal defects. Leakage occurs through the nasal cavity while eating, chewing becomes difficult due to the loss of teeth and alveolar ridges, and oral and nasal passages are not separated, leading to hyper-nasal sound, and significantly reducing the quality of life. To prosthetically reconstruct the defect, the weight of the obturator should be reduced as much as possible to minimize dropout because of gravity, and the bulb of the obturator should be properly extended into the defect to get additional retention and stability. In this case of a partially edentulous patient who underwent additional maxillary resection because of tumor recurrence, a metal framework was designed by applying the basic design principles of removable partial dentures. An obturator with improved retention, stability, and support was fabricated through functional impressions. The patient was satisfied with the improved facial expression, mastication, swallowing, and pronunciation, and showed stable occlusion and oral hygiene management during the follow-up period.

• Journal of dental hygiene science
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• v.23 no.2
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• pp.142-153
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• 2023

Background: Cognitive impairment has been reported to be closely associated with poor oral health, and the relationship is bidirectional, as older adults with poor oral health and chewing function are at a higher risk of cognitive decline (CD). This cross-sectional study aimed to determine whether masticatory discomfort in Korean elderly increases the risk of daily living difficulty (DLD) related to CD and whether there is a difference in risk according to gender and age. Methods: The data used were obtained from the Korean Community Health Survey (2019). The final analysis included 22,154 people aged 65 years and older who completed the survey and responded to all items on the variables used in the study. Chi-square test, trend test, and complex sample logistic regression were performed for statistical analysis, to clarify the purpose of this study. Results: As masticatory discomfort increased, the elderly's DLD tended to increase (p-for trend, p<0.001). For logistic regression, adjusting for all covariates, participants who reported masticatory discomfort as "discomfort" (adjusted odds ratio [AOR]=2.45, 95% confidence interval [CI]=2.11~3.50) and "severe discomfort" (AOR=2.95, 95% CI=2.49~3.50) had a more than a two-fold increased risk of CD-related DLD compared to participants who reported "no discomfort at all." In age-stratified analyses, elderly men aged 75~84 years and elderly women aged 65~74 years had the highest risk of developing CD-related DLD. Conclusion: Oral care interventions to improve masticatory function in older adults may slow CD and improve CD-related DLD. We hope that this study will raise awareness among caregivers and clinical professionals regarding the importance of oral care for older adults with CD.

• Journal of dental hygiene science
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• v.24 no.1
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• pp.1-8
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• 2024

Background: Oral frailty is defined as the functional decline of the oral function due to aging, and it is associated with frailty and chronic disease. Most of the frailty intervention is for adults aged 65 years and older. However, early intervention for preventive disorder is most important. The objective of this study was to identify the age at which oral frailty surpass the "normal" range. Methods: This cross-sectional study included 719 adults (aged 30~89 years) residing in Gangwon province in May 2023. Risk of oral frailty was assessed using criteria from The Korean Academy of Geriatric Dentistry including oral function such as swallowing and mastication, and frailty. Frailty was assessed using the Kihon Checklist. To determine when oral frailty surpass the "normal" status, statistical analysis including chi-squared tests and multiple logistic regression analysis were performed using R (ver. 4.3.1). Results: There were 388 (54.0%) individuals who had a "normal" status risk of oral frailty. The risk of oral frailty was higher in the 50~54 age group compared to the 30~34 age group (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28~0.91), after adjusting for gender, education, income, occupation, and frailty (OR 0.46, 95% CI 0.22~0.94). This means that from 50~54 years old, regardless of gender, education, income, occupation, or frailty condition, there is a distinction from the "normal" status. Conclusion: We found that intervention for oral frailty is needed starting from age 50 years. This is the stage where early indications of oral frailty become apparent. Early intervention for oral frailty can lead to a decrease in the prevalence of diseases and medical expenditure. Therefore, early intervention in middle-aged adults of oral frailty is necessary to improve the quality of life related to oral health.

• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.69-77
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• 2006

Botulinum toxin injection has been used in the masticatory muscle area as an effective treatment method of various movement disorders and facial contouring, but its effects on jaw function have not been evaluated. The aims of this study were to evaluate the effects of botulinum toxin type A injection into the masseter muscle on the EMG activities of masseter and anterior temporal muscles, and the limitation of jaw function. Fourteen healthy subjects were recruited. Five subjects were injected with 80 units of botulinum toxin type A(Dysport, Ipsen, Wrexham, UK) into each side of masseter muscle, and nine subjects were injected with saline into the same site as the botulinum toxin group. The surface EMG activities at maximum voluntary contraction of masseter and anterior temporal muscles were recorded before, 1 week, 2 weeks, and 3 weeks after injection. Presence of jaw functional limitations in each subject was investigated using Korean version of Jaw Functional Limitation Scale(JFLS) questionnaire. The masseter muscle EMG was gradually decreased in the botulinum toxin group comparing with that of the control group(p<0.001), but the anterior temporal muscle EMG did not show significant changes. There was significant increases in the mastication (p<0.01), and global jaw limitation(p<0.05) subscales of JFLS at 1 week after injection, but no significant changes in the other subscales including opening, and verbal and emotional expression during the recording periods. Our results suggest that botulinum toxin injection into masseter muscle can affect modest limitation in mastication function at 1 week after injection but recovered to the baseline until 3 weeks after injection. The EMG activity of masseter muscle had been gradually decreased until 3 weeks after botulinum toxin injection but the anterior temporal muscle did not show any significant changes.

• Journal of Korean society of Dental Hygiene
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• v.11 no.5
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• pp.629-636
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• 2011

Objectives : The purpose of this study was to determine the effects of oral health on the quality of life of elderly patients with dentures or implants. It is our intention that through this analysis we can aid seniors in making the choice between dentures or implants, considering future masticatory function and the likely effects of this decision on the patients quality of life. Methods : This survey was conducted between November 1, 2010 and November 25, 2010, in Kyunggi-Do, whasung city. The research was carried out at one public health center, among elderly patients. 105 seniors were surveyed using the direct interviewing method, oral health related quality of life was measured by the Philadelphia Geriatric Center(PGC) Morale Scale. Collected data was examined using the SPSS 13.0 program, using frequency, mean, and standard deviation analysis, T-test and $x^2$ test. Results : The number of residual teeth for patients who have implants was $20.45{\pm}5.85$, while among those patients with dentures the number was considerably lower, $8.11{\pm}7.66$(p<0.05). The results of patients masticatory function, was $28.13{\pm}2.40$ for those with implants, and $25.35{\pm}4.15$ with dentures. The results were better for those with implants. Among implant patients overall satisfaction was rated $25.21{\pm}3.63$, higher than for those with dentures $20.20{\pm}6.79$(p<0.05). Quality of life was scored higher for patients with implants($12.76{\pm}2.61$) compared to those with dentures($10.47{\pm}3.52$)(p<0.05). The subjects masticatory function was highly related to the number of remaining teeth and greater masticatory function had a positive effect on patients quality of life and life satisfaction. Conclusion : Dental treatments such as dentures and implants will have a great influence on patients quality of life and life satisfaction. Implants can improve the oral health related quality of life and satisfaction and the general quality of life more than denture therapy.

• Journal of dental hygiene science
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• v.10 no.5
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• pp.315-321
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• 2010

The aim of this study was to assess change of the oral health related quality of life after fixed prosthetic treatment using implant therapy. One hundreds and twenty patients from 3 dental clinics in Seoul, Incheon and Daegu were recruited after verbal consent. The oral health related quality of life by OHIP-14, the treatment satisfaction by North Texas Periodontal Associates and the oral health interest w+ere measured before fixed prosthetic treatment using implant and one months after prosthetics. Total OHIP-14 changed significantly between pre- and post- treatment (p<0.001). Although gender(p=0.01), economic status (p=0.04) and education status (p=0.01) affect to OHIP-14 significantly before treatment, these factors didn't have effects on OHIP-14 after treatment. The subjective satisfaction in masticatory function, social function and psychological function increased significantly after treatment (p<0.001). Besides, the patients' oral health interests increased significantly after treatment (p<0.001). The fixed prosthetic treatment using implant therapy can improve the oral health related quality of life, subjective satisfaction of mastication, social function and psychological function, and oral health interest of dental patients.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.2
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• pp.181-189
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• 2021

Purpose: The purpose of this study is to investigate the stress response and sleep state of the new patients who visit the hospital for prosthodontic treatment due to tooth loss to make reference to further treatment direction. Materials and methods: Examinations, consultations, and surveys were conducted on 236 patients (94 males, 142 females, and 24-86 years old), who newly registered at the department of prosthodontics at Pusan national university hospital, for 2 years from 2018. The number of remaining teeth, edentulous arch, possibility of mastication, and future prosthetic treatment directions were recorded. The visual analogue scale (VAS), stress response inventory (SRI) and Insomnia severity index (ISI) were used as tools to measure patient's subjective discomfort, stress response, and sleep status. Results: Among the entire prosthodontic patient group, the average value of 'fatigue' was significantly higher among the 7 items of SRI, and the value of 'aggression' was significantly lower (P<.001). There are a significant difference between the edentulous and full dentition in the oral discomfort value measured by VAS (P=.004). In cases where less than 20 teeth remain, mastication is impossible, and patients who are planning treatment with removable prostheses, VAS value and 'depression' and 'fatigue' values in SRI were higher than those in the reverse case (P<.05). The patients showed severe level in VAS value have high value of 'tension', 'somatization', 'depression', 'fatigue'and 'frustration'in SRI than non-serious patients (P<.05). Clinical insomnia occurred in 11.4% of all patients, and women had significantly lower sleep quality than men (P=.044). Patients with insomnia showed significantly higher scores on the VAS value and all 7 SRI items than those of normal sleepers (P<.05). Conclusion: The new prosthetics had high 'fatigue' value among the 7 items of SRI. The oral condition, number of residual teeth and mastication function and clinical insomnia affected oral discomfort and the stress response.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.301-310
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• 2018

This study was conducted to investigate the relationship between physical function (ADL, IADL) and mental function (depression, cognitive dysfunction) and quality of life in the elderly. The subjects of this study were 524 elderly people aged 65 or older who were admitted to 15 care facilities located in D metropolitan city. Data were collected through a personal interview conducted by interviewers that visited each care facility from November 2015 to January 2016. T-tests and ANOVA were used to compare the quality of life score for each independent variable, while multiple regression was used to determine the explanatory power of independent variables that affected quality of life. Quality of life was significantly lower among those of older age, lower educational level, living alone, with lower relationships with children, lower subjective health status, disability, lower ability for mastication, without regular eating habits, without regular exercise, and without regular health checkups. In addition, quality of life was significantly lower in the ADL and IADL, as well as among those with a higher depression level and lower cognitive impairment scores than their respective counterparts. The results of this study suggest that the quality of life among elderly that have been admitted to care facilities is significantly related to physical and mental functions as well as demographic characteristics, health status and health related behavioral characteristics.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.1
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• pp.1-7
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• 2016

Mastication is the process to help digestion by chewing or grinding food. Masticatory system consists of maxilla, mandible, temporomandibular joints, ligaments, dentitions, and musculatures. Assessing the bite force can be one of the methods to estimate the masticatory system. Bite force is influenced by facial morphology, age, sex, periodontal status, temporomandibular joint disorder and dental condition, and so forth. In general, higher maximum bite force is seen in those who have a square-shaped face and in male rather than female. In addition, bite force tends to be increased by age 20, maintained constantly until age 40 - 50, and then decreased. Periodontal disease is known as a causative factor for decreased bite force while temporomandibular disorder (TMD) remains controversial as to whether it affects the force. The status of teeth is considered as an important factor to determine the maximum bite force.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.3
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• pp.319-324
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• 2017

Patients with maxillectomy defects predisposed to not only difficulty in deglutition, mastication, speech but also psychological depression from impaired facial esthetics that affect life quality. Obturator prostheses play a important role in restoring the lost form, function and the quality of life for patients with maxillectomy defects. This clinical report presents the simplified approach to predict the degree of adequate facial support by Artificial palate which reflected from a maxillary interim obturator during the stabilization period after maxillectomy.