Effect of malocclusion on jaw motor function and chewing in children: a systematic review

Objective To investigate the effects of dental/skeletal malocclusion and orthodontic treatment on four main objective parameters of chewing and jaw function (maximum occlusal bite force [MOBF], masticatory muscle electromyography [EMG], jaw kinematics, and chewing efficiency/performance) in healthy children. Materials and methods Systematic searches were conducted in MEDLINE (OVID), Embase, and the Web of Science Core Collection. Studies that examined the four parameters in healthy children with malocclusions were included. The quality of studies and overall evidence were assessed using the Joanna Briggs Institute and GRADE tools, respectively. Results The searches identified 8192 studies; 57 were finally included. The quality of included studies was high in nine studies, moderate in twenty-three studies, and low in twenty-five studies. During the primary dentition, children with malocclusions showed similar MOBF and lower chewing efficiency compared to control subjects. During mixed/permanent dentition, children with malocclusion showed lower MOBF and EMG activity and chewing efficiency compared to control subjects. The jaw kinematics of children with unilateral posterior crossbite showed a larger jaw opening angle and a higher frequency of reverse chewing cycles compared to crossbite-free children. There was a low to moderate level of evidence on the effects of orthodontic treatment in restoring normal jaw function. Conclusions Based on the limitations of the studies included, it is not entirely possible to either support or deny the influence of dental/skeletal malocclusion traits on MOBF, EMG, jaw kinematics, and masticatory performance in healthy children. Furthermore, well-designed longitudinal studies may be needed to determine whether orthodontic treatments can improve chewing function in general. Clinical relevance Comprehensive orthodontic treatment, which includes evaluation and restoration of function, may or may not mitigate the effects of malocclusion and restore normal chewing function.

Development of a New Application-Based Chewing Efficiency Test (Mini Dental Assessment) and Its Evaluation by Nursing Staff in Geriatric Care: A Pilot Study

The increasing average life expectancy worldwide results in an elderly population with significant health care needs. However, dental care is often not a focus of care. It is well known that oral and overall health are directly related. Therefore, the Mini Dental Assessment (MDA) was developed to provide a simple analysis of oral health status, although it is currently only available in paper form, with all associated drawbacks, from illegible writing to the inability to quickly search the collected forms. This study aimed to develop a digital application (app) for mobile devices that can overcome the problems associated with paper forms. After the digital MDA was developed, its usability was evaluated by nurses, a questionnaire was answered, and it was compared to the analog MDA with patients in a pilot study. The usability of the app (System Usability Scale) was 95.18 ± 4.26, representing a very high usability. Furthermore, this app showed good clinical applicability. The results also showed that the digital MDA was accepted by nurses in their daily routine and was preferred to the analog MDA. A follow-up study with a higher number of subjects is highly recommended.

Optimization of Approaches for Rehabilitation of Adentia Patients Using Modern Clinical Diagnostic Methods

After determining the need for complex types of restoration of chewing efficiency, which amounted to 22% of the total number of prosthetics performed in dental clinics in Bishkek, Kyrgyzstan, the optimal modern clinical and diagnostic methods that can be used according to the experience of the Biodent clinic, Bishkek were summarized. Cone-beam computed tomography recognized as the gold standard for radiological examination and modeling of dental implantation. The diagnostic accuracy was 99.2% versus 70.5% with orthopantomography. Treatment of the surface of dental titanium implants with nano-solutions of gold and silver, which have antiseptic and engraftment-improving properties in the clinic, leads to an improvement in the results of engraftment and functioning, confirmed by biochemical studies.

LOSS OF MASTICATORY APPARATUS INTEGRITY - DISABILITY OR DISABLEMENT?

Были обследованы 408 пациентов (151 мужчина и 257 женщин) 54-85 лет (средний возраст 73,9±4,9 года) с помощью клинических (опрос, осмотр, пальпация, перкуссия, аускультация), социологических («GOHAI»), параклинических (определение эффективности жевания, чистоты речи, исследование дефицита массы тела, ортопантомография, КТ) методов. Все пожилые пациенты были с двумя патологическими состояниями - декомпенсированным зубным рядом и полной потерей зубов. У 322 человек рабочий синдромологический диагноз - декомпенсированный зубной ряд - относился к 167 нижним челюстям, 65 верхним челюстям и у 90 человек - и к верхним, и к нижним челюстям (всего 412 зубных рядов). Эффективность жевания у контингента беззубых также была невысокой, несмотря на наличие у большинства из них съемных зубных протезов. Согласно гериатрическому показателю здоровья полости рта («GOHAI»), ответы обследуемых колебались от 7 до 25 баллов (в среднем 18,23±4,19 балла), что относилось к низкому уровню. Общими синдромами пациентов оказались грубые, уродующие, старящие изменения внешнего вида лица, значительное нарушение эстетических норм. Не менее важны инвалидизирующие факторы почти полного отсутствия способности к жеванию, звукообразования, речи, затруднённого проглатывания пищи. В силу явных морфофункциональных и психосоциальных нарушений, социальной дезадаптации, сопровождающих эти заболевания, таких пациентов следовало бы считать инвалидами для повышения доступности геронтостоматологической реабилитации и включения их в программу государственных гарантий оказания стоматологической ортопедической помощи. Необходимо также ввести квотирование имплантационного зубного протезирования для пациентов пожилого и старческого возраста, которое по своей результативности и эффективности вписывается в систему адекватной реабилитации указанного контингента лиц и является мерой профилактики инвалидности. We examined 408 patients (151 male, 257 female) in an age range from 54 to 85 years (mean age 73,9±4,9) performing clinical (anamnesis, visual analysis, palpation, percussion, auscultation) sociological (GOHAI), additional (chewing efficiency evaluation, phonetic analysis, weight deficit of body calculation, OPG, CBCT) assessment. Among 322 of examined subjects working syndromological diagnosis was «decompensated dentition» related to lower jaw in 167 cases, 65 to upper jaw, 90 to both upper and lower jaws (altogether 412 dental arches). Chewing efficiency among edentulous patients was low considering that majority of patients had dentures. Score range for Geriartric General Oral Health Assessment Index (GOHAI) was from 7 to 25 points (mean 18,23±4,19) which is attributed as low level. General syndromes among patients were rough, disfiguring, ageing changes in facial appearance, major alteration of aesthetic norms. Equally important or even more was incapacitation impact of total loss of proper mastication, speech problems, phonetic alteration, problematic food swallowing. In our research we highlighted two pathological conditions among elderly and senile age groups: decompensated dentition, and fully edentulous jaws. Taking into consideration suffering of the patients due to morphological functional and psychosocial disabling conditions, accompanying these diseases, we might consider this group of patients as handicapped and that could lead to the need to introduction of setting quotas of implant prosthetics treatment of the elderly and senile patients. The result, efficacy and efficiency of such rehabilitation are considered in compliance with the system of adequate treatment result for this part of population.