Generation of masticatory rhythm in the brainstem

Influence of restricted mastication on swallowing function

BACKGROUND

Oral food processing is an important part of daily food intake. A major part of this process is mastication, which prepares a bolus of food for swallowing by mechanically crushing and grinding ingested food between the teeth using rhythmic movements. Masticatory dysfunction is common in the elderly and in some neurological disorders and can have serious negative health consequences.

OBJECTIVE

This study investigated the effect of restricted mastication, achieved by experimentally reducing the duration of mastication, on masticatory patterns and subsequent swallowing function.

METHODS

Thirty healthy men (25 ± 3 years old) were instructed to chew gum jelly with a free mastication duration (G100), a half and a quarter duration of G100. Masseter and digastric electromyographic (EMG) activity was recorded to assess mastication and swallowing activity, respectively. In addition, the acceleration of the thyroid cartilage ridge was measured with an accelerometer. The root mean square (RMS) of muscle EMG activity in the masseter and digastric muscles, the number of masseter EMG bursts, time to peak and total duration of each masseter EMG burst, swallowing duration and laryngeal elevation latency were analysed.

RESULTS

Restricting masticatory duration reduced the number of mastication cycles (p < .001), prolonged the time to peak (p < .001) and total duration of masseter EMG bursts (p < .001) and resulted in an overall increased RMS score of masseter muscle activity (p = .017). Furthermore, restricted masticatory duration led to a decrease in both swallowing duration (p = .001) and laryngeal elevation latency (p = .012), with a significant increase in the RMS score of digastric muscle activity (p < .001).

CONCLUSIONS

Under the experimental conditions of restricted mastication, several adaptation features were observed, including changes in masticatory cycle characteristics and swallowing duration. Thus, although the overall masticatory efficiency was reduced, these adaptations allowed healthy individuals to still swallow safely.

Impact of salivary flow inhibition on masticatory behaviours in healthy individuals

BACKGROUND

It remains unclear how the salivary flow and the fat content of food affect bolus formation during mastication.

OBJECTIVES

We aimed to clarify: (1) how hyposalivation affects jaw-closing and hyoid-elevating muscle activities in bolus formation, and (2) if the effect of hyposalivation on muscle activity depends on the fat content of food.

METHODS

Eighteen healthy male volunteers were instructed to freely ingest four test foods: Plain, Fat without seasoning, Fat with seasoning, and Soft rice crackers. Masseter and suprahyoid electromyographic activities were recorded before and 30 min after the administration of atropine sulfate, a muscarinic receptor antagonist that induces hyposalivation.

RESULTS

Hyposalivation extended the masticatory duration significantly in all the test foods except Fat with seasoning. Masticatory cycle time was significantly longer with vs without hyposalivation for the Soft (p = .011). Suprahyoid activity/cycle was significantly greater with vs without hyposalivation (p = .013). Masticatory cycle time was significantly longer at the late stage with vs without hyposalivation for the Soft (p < .001). Suprahyoid activity/cycle was significantly greater at the middle (p = .045) and late stages (p = .002) with vs without hyposalivation for the Soft and greater at the late stage with vs without hyposalivation for the Plain (p = .043). Changes in masticatory cycle time and suprahyoid activity/cycle for these foods had significantly positive relationship (p < .001).

CONCLUSION

Hyposalivation-induced changes in masticatory behaviours resulted from the middle and late stage suprahyoid activity. Fat content and seasoning compensate for salivary flow inhibition.

Neuroanatomical frameworks for volitional control of breathing and orofacial behaviors

Breathing is the only vital function that can be volitionally controlled. However, a detailed understanding how volitional (cortical) motor commands can transform vital breathing activity into adaptive breathing patterns that accommodate orofacial behaviors such as swallowing, vocalization or sniffing remains to be developed. Recent neuroanatomical tract tracing studies have identified patterns and origins of descending forebrain projections that target brain nuclei involved in laryngeal adductor function which is critically involved in orofacial behavior. These nuclei include the midbrain periaqueductal gray and nuclei of the respiratory rhythm and pattern generating network in the brainstem, specifically including the pontine Kölliker-Fuse nucleus and the pre-Bötzinger complex in the medulla oblongata. This review discusses the functional implications of the forebrain-brainstem anatomical connectivity that could underlie the volitional control and coordination of orofacial behaviors with breathing.

Factors Related to Masticatory Rhythm in Patients with Oral Tumors

Background: Older adults who have undergone surgery for oral tumors are at increased risk of impaired masticatory rhythm. This study investigated the correlations between masticatory rhythm, objective masticatory performance, and subjective masticatory performance as well as factors related to masticatory rhythm. Methods: The participants were 44 adults (24 men, 20 women; age range 42~90 years old) who had undergone maxillectomy, mandibulectomy, or glossectomy and were rehabilitated with a maxillofacial prosthesis. The number of functional contact teeth pairs was confirmed by intraoral examination. Chewing rate, cycle duration, coefficient of variation (CV) for cycle duration (reflecting the stability of masticatory rhythm), and mixing ability were measured simultaneously using a mastication movement rhythm tracking device during gum chewing. Maximum occlusal force was measured using the dental prescale system. Patients' perception of chewing ability was rated using a questionnaire. Results: The Spearman's rank correlation test revealed that mixing ability, patient-rated masticatory scores, cycle duration, CV for cycle duration, and maximum occlusal force showed significant correlations with chewing rate. Multiple linear regression analysis identified mixing ability and the CV for cycle duration as significant predictors of masticatory rhythm. Conclusions: Factors associated with a faster chewing rate were higher mixing ability and masticatory scores, greater maximum occlusal force, shorter cycle duration, and smaller CV for cycle duration. Stable masticatory rhythm and mixing ability are significant predictors of chewing rate. Poor masticatory performance and unstable masticatory rhythm can result in slower chewing and thus a higher risk of inadequate dietary intake.

Effects of different food hardness on cognitive inhibitory control function

Mastication leads to an immediate enhancement in cognitive functions, including inhibitory control. Furthermore, the hardness of the food increases sympathetic nerve activity during and immediately after mastication. Hence, the cognitive function could be enhanced by increased sympathetic nerve activity. The present study aimed to investigate the effects of food hardness on cognitive inhibitory control function in humans. The participants were 23 healthy adults (19-22 years old). Experiments were conducted with two types of gummies (soft and hard). The participants ingested 13 g of gummies and performed a stop-signal task to measure cognitive inhibitory control function after they rested for 5 min. The reaction time for the stop-signal task after gummy consumption was significantly shorter in the hard gummy condition compared to the soft gummy condition (p < .05). Furthermore, the accuracy rate of the responses was also significantly higher in the hard gummy condition compared to the soft gummy condition (p < .05). The results of the present study suggest that food hardness enhances cognitive inhibitory control function in humans.

Modulation of reflex responses of the anterior and posterior bellies of the digastric muscle in freely moving rats

BACKGROUND

Chewing and licking are primarily activated by central pattern generator (CPG) neuronal circuits in the brainstem and when activated trigger repetitive rhythmic orofacial movements such as chewing, licking and swallowing. These CPGs are reported to modulate orofacial reflex responses in functions such as chewing.

OBJECTIVE

This study explored the modulation of reflex responses in the anterior and posterior bellies (ant-Dig and post-Dig, respectively) of the digastric muscle evoked by low-intensity trigeminal stimulation in conscious rats.

METHODS

The ant-Dig and post-Dig reflexes were evoked by using low-intensity electrical stimulation applied to either the right or left inferior alveolar nerve. Peak-to-peak amplitudes and onset latencies were measured.

RESULTS

No difference was observed between threshold and onset latency for evoking ant-Dig and post-Dig reflexes, suggesting that the latter was also evoked disynaptically. The peak-to-peak amplitude of both reflexes was significantly reduced during chewing, licking and swallowing as compared to resting period and was lowest during the jaw-closing phase of chewing and licking. Onset latency was significantly largest during the jaw-closing phase. Inhibitory level was similar between the ant-Dig and post-Dig reflex responses and between the ipsilateral and contralateral sides.

CONCLUSION

These results suggest that both the ant-Dig and post-Dig reflex responses were significantly inhibited, probably due to CPG activation during feeding behaviours to maintain coordination of jaw and hyoid movements and hence ensure smooth feeding mechanics.

A change in behavioral state switches the pattern of motor output that underlies rhythmic head and orofacial movements

The breathing rhythm serves as a reference that paces orofacial motor actions and orchestrates active sensing. Past work has reported that pacing occurs solely at a fixed phase relative to sniffing. We re-evaluated this constraint as a function of exploratory behavior. Allocentric and egocentric rotations of the head and the electromyogenic activity of the motoneurons for head and orofacial movements were recorded in free-ranging rats as they searched for food. We found that a change in state from foraging to rearing is accompanied by a large phase shift in muscular activation relative to sniffing, and a concurrent change in the frequency of sniffing, so that pacing now occurs at one of the two phases. Further, head turning is biased such that an animal gathers a novel sample of its environment upon inhalation. In total, the coordination of active sensing has a previously unrealized computational complexity. This can emerge from hindbrain circuits with fixed architecture and credible synaptic time delays.

Chewing modulates the human cortical swallowing motor pathways

When eating, mastication is always followed by swallowing. The present study assessed the effect of mastication on swallowing-related neural pathways in humans. Twenty healthy volunteers participated and underwent baseline transcranial magnetic stimulation to evaluate cortico-pharyngeal and cortico-hand motor-evoked potentials (MEPs). Next, they performed a chewing task and a swallowing task. Repeated-measures ANOVA revealed that pharyngeal MEPs were significantly higher after the swallowing task than after the chewing task, even though the number of swallows across tasks was matched. This implies that chewing movements suppress swallowing-related activity in the pharyngeal motor circuit.

Integrative Hedonic and Homeostatic Food Intake Regulation by the Central Nervous System: Insights from Neuroimaging

Food intake regulation in humans is a complex process controlled by the dynamic interaction of homeostatic and hedonic systems. Homeostatic regulation is controlled by appetitive signals from the gut, adipose tissue, and the vagus nerve, while conscious and unconscious reward processes orchestrate hedonic regulation. On the one hand, sight, smell, taste, and texture perception deliver potent food-related feedback to the central nervous system (CNS) and influence brain areas related to food reward. On the other hand, macronutrient composition stimulates the release of appetite signals from the gut, which are translated in the CNS into unconscious reward processes. This multi-level regulation process of food intake shapes and regulates human ingestive behavior. Identifying the interface between hormones, neurotransmitters, and brain areas is critical to advance our understanding of conditions like obesity and develop better therapeutical interventions. Neuroimaging studies allow us to take a glance into the central nervous system (CNS) while these processes take place. This review focuses on the available neuroimaging evidence to describe this interaction between the homeostatic and hedonic components in human food intake regulation.

Astrocytic modulation of central pattern generating motor circuits

Central pattern generators (CPGs) generate the rhythmic and coordinated neural features necessary for the proper conduction of complex behaviors. In particular, CPGs are crucial for complex motor behaviors such as locomotion, mastication, respiration, and vocal production. While the importance of these networks in modulating behavior is evident, the mechanisms driving these CPGs are still not fully understood. On the other hand, accumulating evidence suggests that astrocytes have a significant role in regulating the function of some of these CPGs. Here, we review the location, function, and role of astrocytes in locomotion, respiration, and mastication CPGs and propose that, similarly, astrocytes may also play a significant role in the vocalization CPG.

Postnatal Maturation of Glutamatergic Inputs onto Rat Jaw-closing and Jaw-opening Motoneurons

Motoneurons that innervate the jaw-closing and jaw-opening muscles play a critical role in oro-facial behaviors, including mastication, suckling, and swallowing. These motoneurons can alter their physiological properties through the postnatal period during which feeding behavior shifts from suckling to mastication; however, the functional synaptic properties of developmental changes in these neurons remain unknown. Thus, we explored the postnatal changes in glutamatergic synaptic transmission onto the motoneurons that innervate the jaw-closing and jaw-opening musculatures during early postnatal development in rats. We measured miniature excitatory postsynaptic currents (mEPSCs) mediated by non-NMDA receptors (non-NMDA mEPSCs) and NMDA receptors in the masseter and digastric motoneurons. The amplitude, frequency, and rise time of non-NMDA mEPSCs remained unchanged among postnatal day (P)2-5, P9-12, and P14-17 age groups in masseter motoneurons, whereas the decay time dramatically decreased with age. The properties of the NMDA mEPSCs were more predominant at P2-5 masseter motoneurons, followed by reduction as neurons matured. The decay time of NMDA mEPSCs of masseter motoneurons also shortened remarkably across development. Furthermore, the proportion of NMDA/non-NMDA EPSCs induced in response to the electrical stimulation of the supratrigeminal region was quite high in P2-5 masseter motoneurons, and then decreased toward P14-17. In contrast to masseter motoneurons, digastric motoneurons showed unchanged properties in non-NMDA and NMDA EPSCs throughout postnatal development. Our results suggest that the developmental patterns of non-NMDA and NMDA receptor-mediated inputs vary among jaw-closing and jaw-opening motoneurons, possibly related to distinct roles of respective motoneurons in postnatal development of feeding behavior.

A hypothalamomedullary network for physiological responses to environmental stresses

Various environmental stressors, such as extreme temperatures (hot and cold), pathogens, predators and insufficient food, can threaten life. Remarkable progress has recently been made in understanding the central circuit mechanisms of physiological responses to such stressors. A hypothalamomedullary neural pathway from the dorsomedial hypothalamus (DMH) to the rostral medullary raphe region (rMR) regulates sympathetic outflows to effector organs for homeostasis. Thermal and infection stress inputs to the preoptic area dynamically alter the DMH → rMR transmission to elicit thermoregulatory, febrile and cardiovascular responses. Psychological stress signalling from a ventromedial prefrontal cortical area to the DMH drives sympathetic and behavioural responses for stress coping, representing a psychosomatic connection from the corticolimbic emotion circuit to the autonomic and somatic motor systems. Under starvation stress, medullary reticular neurons activated by hunger signalling from the hypothalamus suppress thermogenic drive from the rMR for energy saving and prime mastication to promote food intake. This Perspective presents a combined neural network for environmental stress responses, providing insights into the central circuit mechanism for the integrative regulation of systemic organs.

Textural properties and muscle activities during mastication of normal and ultrasonically softened sticky rice aimed for consumers with swallowing disorder: A pilot study

Ultrasonication was used to develop softer sticky rice for elder adults. Textural properties of original sticky rice (oSR) and ultrasonically modified sticky rice (mSR) were determined. In addition, jaw muscle activities during mastication of both oSR and mSR were investigated. Twenty-seven healthy elderly subjects, age 68.9 ± 7.6 years, were asked to masticate both types of sticky rice in random sequence for three times with a 5-min rest between each test. Activities of bilateral masseter and suprahyoid muscles were recorded. Root mean square (RMS) and mastication duration were analyzed. After mastication trials, subjects were asked to rate preference and softness of the samples. mSR exhibited significantly lower hardness than oSR, while cohesiveness and adhesiveness values of the two samples were not significantly different. Interestingly, all the muscle activities were not significantly different between masticating oSR and mSR, whereas the number of chewing cycles while chewing the mSR was larger. However, 92% of the subjects preferred mSR and felt that it was softer. mSR may therefore be regarded as having potential for elder people who have difficulty masticating hard solid foods based on its lower hardness and higher level of preference compared to oSR.

Technical note: Artificial Resynthesis Technology for the experimental formation of dental microwear textures

Dental microwear formation on the posterior dentition is largely attributed to an organism's diet. However, some have suggested that dietary and environmental abrasives contribute more to the formation process than food, calling into question the applicability of dental microwear to the reconstruction of diet in the fossil record. Creating microwear under controlled conditions would benefit this debate, but requires accurately replicating the oral environment. This study tests the applicability of Artificial Resynthesis Technology (ART 5) to create microwear textures while mitigating the challenges of past research. ART 5 is a simulator that replicates the chewing cycle, responds to changes in food texture, and simulates the actions of the oral cavity. Surgically extracted, occluding pairs of third molars (n = 2 pairs) were used in two chewing experiments: one with dried beef and another with sand added to the dried beef. High-resolution molds were taken at 0, 50, 100, 2500, and 5000 simulated chewing cycles, which equates to approximately 1 week of chewing. Preliminary results show that ART 5 produces microwear textures. Meat alone may produce enamel prism rod exposure at 5000 cycles, although attrition cannot be ruled out. Meat with sand accelerates the wear formation process, with enamel prism rods quickly obliterated and "pit-and-scratch" microwear forming at approximately 2500 cycles. Future work with ART 5 will incorporate a more thorough experimental protocol with improved controls, pH of the simulated oral environment, and grit measurements; however, these results indicate the potential of ART 5 in untangling the complex variables of dental microwear formation.

Changes in cortical, cardiac, and respiratory activities in relation to spontaneous rhythmic jaw movements in ketamine-anesthetized guinea pigs

It has been reported that rhythmic jaw movements (RJMs) spontaneously occur in ketamine-anesthetized animals. The present study investigated the physiological processes that occur during the cortical, cardiac, and respiratory events which contribute to the genesis of RJMs in animals after supplemental ketamine injections. Fourteen guinea pigs were prepared to allow electroencephalographic, electrocardiographic, and electromyographic activities to be recorded from the digastric muscle, measurement of jaw movements, and nasal expiratory airflow under ketamine-xylazine anesthesia. Rhythmic jaw movements spontaneously occurred with rhythmic digastric muscle contractions, 23-29 minutes after injection of supplemental ketamine (12.5 and 25.0 mg kg^-1 , intravenously). The cycle length of RJMs did not differ significantly between the two doses of ketamine (mean±SD: 12.5 mg kg^-1 , 326.5 ± 60.0 ms; 25 mg kg^-1 , 278.5 ± 45.1 ms). Following injection of ketamine, digastric muscle activity, heart and respiratory rates, and cortical beta power significantly decreased, while cortical delta and theta power significantly increased. These changes were significantly larger in animals given 25.0 mg kg^-1 of ketamine than in those given 12.5 mg kg^-1 . With the onset of RJMs, the levels of these variables returned to pre-injection levels, regardless of the dose of ketamine administered. These results suggest that, following supplemental ketamine injections, spontaneous RJMs occur during a specific period when the pharmacological effects of ketamine wear off, and that these RJMs are characterized by stereotypical changes in cardiac, respiratory, and cortical activities.

Centric relation critically revisited-What are the clinical implications?

PURPOSE OF THE ARTICLE

Centric relation is a dental term that has undergone many alterations over the years, which in turn have led to significant clinical controversies. These continuing changes in the meaning of the term CR have not only led to confusion, but they also have resulted in a variety of unnecessary diagnostic and therapeutic procedures. Analysis of the dental literature reveals ongoing misunderstanding and disagreement regarding that term among both clinicians and academic dentists.

MATERIALS AND METHODS

A search of the PubMed database was performed with the following search terms: "centric relation", "masticatory muscles", "maxillomandibular relationship" and "condylar position." Relevant literature from the past 70 years until the present day was meticulously scrutinised.

RESULTS

As expected, the literature review on the topic of CR revealed a problematic pattern of changing definitions and clinical disagreements, all of which have had a significant impact on the practice of dentistry.

CONCLUSION

There are semantic, conceptual and practical reasons for concluding that the term 'centric relation' is flawed. Those flaws have a significant impact on dental practice. Based on our analysis, argumentation is provided to conclude that the term 'centric relation' should be abandoned. Instead, it appears that every individual has a unique temporomandibular joint relationship which cannot be described by any singular term. In healthy dentate patients, this relationship is determined by the maximum intercuspation of the teeth and should therefore be considered as biologically acceptable.

Effects of low occlusal loading on the neuromuscular behavioral development of cortically-elicited jaw movements in growing rats

The effect of altered occlusal force on masticatory-related neuromuscular control, which projects from the anterior part of the cortical masticatory area (A-CMA), during growth remains unclear. This study sought to evaluate the effect of occlusal hypofunction on neuromuscular development of jaw muscle activities and cortically-induced rhythmic jaw movements (RJMs) in growing rats. Sixty-four 2-week-old male albino Wistar rats were divided into the control (fed normal diet) and experimental (fed soft diet) groups soon after weaning. Electromyographic activity was recorded at 5, 7, 9, and 11 weeks from the right masseter and anterior digastric along with RJMs. We found a significantly longer onset latency and smaller peak-to-peak amplitude in the experimental group than that in the control group. The RJMs showed an increase in gape size and lateral excursion until up to 9 weeks in both groups. However, both the average gape size and lateral excursion were significantly smaller in the experimental group than that in the control group after 9 weeks. The jaw movement pattern also showed a significant decrease at the maximum opening period in the experimental group. Our findings indicate that inadequate occlusal function during growth alters neuromuscular control of masticatory behaviors and impairs the pattern of RJMs.

Coordinated features in jaw and neck muscle activities induced by chewing of soft and hard gum in healthy subjects

Backgrounds

Jaw and neck muscles may be activated by chewing load using a hard food. However, it remains unclear how effects the gum hardness to the coordinated features in jaw and neck muscle activities during chewing performance.

Objectives

This study was conducted to quantitatively elucidate the effects of the hardness of the gum on coordinated features in jaw and neck muscle activities using intermuscular EMG–EMG transfer function and EMG–EMG coherence function analyses in 18 healthy subjects.

Methods

Jaw and neck muscle activities were aggregated into the first peak frequency of the power spectrum, and power, gain, phase, and coherence parameters between jaw and neck muscle activities were examined in the first peak frequencies during soft and hard gum chewing.

Results

The first peak frequency was not significantly different between soft and hard gum chewing. In contrast, power values of the jaw and neck muscles were significantly increased by chewing of hard gum as compared with soft gum, whereas gain, phase, and coherence were not significantly changed by gum hardness.

Conclusions

The chewing rhythm, the quantitative and temporal coordination, and the functional coordination in jaw and neck muscle activities were not changed during soft and hard gum chewing, as well as increased jaw and neck muscles activities. It is therefore concluded that the chewing rhythmicity and jaw and neck muscles coordination accompanied with the increased jaw and neck muscle activities are maintained under the condition of the chewing load using gum hardness in the healthy individuals.

Brain-derived neurotrophic factor is related to stress and chewing in saliva and salivary glands

Chewing is one of the most important orofacial functions. During this process, food is reduced in size, while saliva moistens the food and binds it into a bolus that can be easily swallowed. Characteristics of the oral system, including the number of teeth, bite force, and salivary flow, influence the masticatory process. In addition, salivary glands produce several cell growth factors and play an important role in human health. The nerve growth factor (NGF) family consists of NGF, brain-derived neurotrophic factor (BDNF), and neurotrophins-3 to 7. BDNF is a well-studied neurotrophin involved in the neurogenesis, differentiation, and maintenance of select peripheral and central neuronal cell populations during development and adulthood. However, there has been no detailed description of the expression of neurotrophins other than NGF in the salivary gland. We previously studied the effect of immobilization stress + chewing on BDNF secretion and its receptor, tyrosine receptor kinase B, in rat submandibular glands and found increased BDNF expression in duct cells under these conditions. In this review, we describe recent advances in understanding the role of stress and chewing-related BDNF in the saliva and salivary glands.

Suppression of the Swallowing Reflex during Rhythmic Jaw Movements Induced by Repetitive Electrical Stimulation of the Dorsomedial Part of the Central Amygdaloid Nucleus in Rats

A previous study indicated that the swallowing reflex is inhibited during rhythmic jaw movements induced by electrical stimulation of the anterior cortical masticatory area. Rhythmic jaw movements were induced by electrical stimulation of the central amygdaloid nucleus (CeA). The swallowing central pattern generator is the nucleus of the solitary tract (NTS) and the lateral reticular formation in the medulla. Morphological studies have reported that the CeA projects to the NTS and the lateral reticular formation. It is therefore likely that the CeA is related to the control of the swallowing reflex. The purpose of this study was to determine if rhythmic jaw movements driven by CeA had inhibitory roles in the swallowing reflex induced by electrical stimulation of the superior laryngeal nerve (SLN). Rats were anesthetised with urethane. The SLN was solely stimulated for 10 s, and the swallowing reflex was recorded (SLN stimulation before SLN + CeA stimulation). Next, the SLN and the CeA were electrically stimulated at the same time for 10 s, and the swallowing reflex was recorded during rhythmic jaw movements (SLN + CeA stimulation). Finally, the SLN was solely stimulated (SLN stimulation following SLN + CeA stimulation). The number of swallows was reduced during rhythmic jaw movements. The onset latency of the first swallow was significantly longer in the SLN + CeA stimulation than in the SLN stimulation before SLN + CeA stimulation and SLN stimulation following SLN + CeA stimulation. These results support the idea that the coordination of swallowing reflex with rhythmic jaw movements could be regulated by the CeA.

A limited range of vagus nerve stimulation intensities produce motor cortex reorganization when delivered during training

Pairing vagus nerve stimulation (VNS) with rehabilitation has emerged as a potential strategy to improve recovery after neurological injury, an effect ascribed to VNS-dependent enhancement of synaptic plasticity. Previous studies demonstrate that pairing VNS with forelimb training increases forelimb movement representations in motor cortex. However, it is not known whether VNS-dependent enhancement of plasticity is restricted to forelimb training or whether VNS paired with other movements could induce plasticity of other motor representations. We tested the hypothesis that VNS paired with orofacial movements associated with chewing during an unskilled task would drive a specific increase in jaw representation in motor cortex compared to equivalent behavioral experience without VNS. Rats performed a behavioral task in which VNS at a specified intensity between 0 and 1.2 mA was paired with chewing 200 times per day for five days. Intracortical microstimulation (ICMS) was then used to document movement representations in motor cortex. VNS paired with chewing at 0.8 mA significantly increased motor cortex jaw representation compared to equivalent behavioral training without stimulation (Bonferroni-corrected unpaired t-test, p < 0.01). Higher and lower intensities failed to alter cortical plasticity. No changes in other movement representations or total motor cortex area were observed between groups. These results demonstrate that 0.8 mA VNS paired with training drives robust plasticity specific to the paired movement, is not restricted to forelimb representations, and occurs with training on an unskilled task. This suggests that moderate intensity VNS may be a useful adjuvant to enhance plasticity and support benefits of rehabilitative therapies targeting functions beyond upper limb movement.

Prefrontal Consolidation and Compensation as a Function of Wearing Denture in Partially Edentulous Elderly Patients

Background

The cognitive effects of wearing a denture are not well understood. This study was conducted to clarify the effects of denture use on prefrontal and chewing muscle activities, occlusal state, and subjective chewing ability in partially edentulous elderly individuals.

Methods

A total of 16 partially edentulous patients were enrolled. Chewing-related prefrontal cortex and jaw muscle activities were simultaneously examined using a functional near-infrared spectroscopy (fNIRS) device and electromyography, under the conditions of unwearing, and wearing a denture. Occlusal state and masticatory score were also determined under both conditions. Using multiple linear regression analysis, associations between prefrontal and chewing activities with wearing were examined using change rates.

Results

Chewing rhythmicity was maintained under both conditions. As compared with unwearing, the wearing condition was associated with improved prefrontal cortex and chewing muscle activities, occlusal state in regard to force and area, and masticatory score. Also, prefrontal activities were positively associated with burst duration and peak amplitude in masseter (Mm) and temporal muscle activities, as well as masticatory scores. In contrast, prefrontal activities were negatively associated with occlusal force.

Conclusion

Wearing a denture induced a positive association between burst duration and peak amplitude in Mm and temporal muscle activities and prefrontal activity, which may indicate a parallel consolidation of prefrontal cortex and rhythmical chewing activities, as well as masticatory scores. On the other hand, denture use induced a negative association of occlusal force with prefrontal activities, which might suggest that prefrontal compensative associations for the physiocognitive acquisition depended on biomechanical efficacy gained by wearing a denture.

Functional Analysis of Rhythmic Jaw Movements Evoked by Electrical Stimulation of the Cortical Masticatory Area During Low Occlusal Loading in Growing Rats

The maturation of rhythmic jaw movements (RJMs) and related neuromuscular control has rarely been studied in animals, though this process is essential for regulating the development of stomatognathic functions. Previous studies have shown that occlusal hypofunction during growth alters masticatory performance. However, little is known about patterns of cortically-induced RJMs under conditions of soft-diet feeding during development. The aim of this study is to clarify the effect of low occlusal loading on the pattern of cortically induced RJMs and related neuromuscular responses in growing rats. Sixty-four 2-week-old male albino Wistar rats were randomly divided into two groups and fed on either a normal diet (control) or soft diet (experimental) soon after weaning. At 5, 7, 9, and 11 weeks of age, electromyographic (EMG) activity was recorded from the right masseter and anterior digastric muscles along with corresponding kinematic images in RJMs during repetitive intracortical microstimulation of the left cortical masticatory area (CMA). Rats in both groups showed an increase in gape size and lateral excursion until 9 weeks of age. The vertical jaw movement speed in both groups showed no significant difference between 5 and 7 weeks of age but increased with age from 9 to 11 weeks. Compared to the control group, the average gape size and vertical speed were significantly lower in the experimental group, and the pattern and rhythm of the jaw movement cycle were similar between both groups at each recording age. EMG recordings showed no age-related significant differences in onset latency, duration, and peak-to-peak amplitude. Moreover, we found significantly longer onset latency, smaller peak-to-peak amplitude, and greater drop-off mean and median frequencies in the experimental group than in the control group, while there was no significant difference in the duration between groups. These findings indicate that a lack of enough occlusal function in infancy impedes the development of patterns of RJMs and delays the neuromuscular response from specific stimulation of the CMA.

Quantitative analyses of jaw-opening muscle activity during the active phase of jaw-closing muscles in sleep bruxism

Rhythmic masticatory muscle activity (RMMA), which is defined as three or more consecutive phasic bursts, accounts for a large part of sleep bruxism (SB). RMMA is thought to be characterized by co-contraction, a jaw muscle activity in which jaw-opening muscles contract during the active phase of jaw-closing muscles, which is different from that during mastication. However, there has been limited information about co-contraction. The aim of the present study was to clarify the amplitudes and patterns of jaw-opening muscle activity during the active phase of jaw-closing muscles in RMMA. Data from 14 healthy volunteers with bruxism, which was diagnosed by using polysomnographic recording with audio-video, were analysed. RMMA with electromyographic amplitudes of more than two times the baseline amplitude was selected. From the selected RMMA, burst groups consisting of five or more consecutive phasic bursts, including tonic bursts, were selected for analyses. Electromyographic activities during gum chewing were also recorded before sleeping. The minimum, maximum and average value of the amplitudes of jaw-opening muscle activity during the active phase of jaw-closing muscles were calculated. Jaw-opening muscle activity during the active phase of jaw-closing muscles in RMMA was closer to the baseline than that in gum chewing. The minimum, maximum and average values of amplitudes of jaw-opening muscle activity during the phase were significantly smaller than those of gum chewing. Contrary to our hypothesis prior to the study, the obtained results suggested that the pattern of electromyogram activity of jaw-opening and jaw-closing muscles in RMMA was not necessarily co-contraction.

Central pattern generators in the brainstem and spinal cord: an overview of basic principles, similarities and differences

Central pattern generators (CPGs) are generally defined as networks of neurons capable of enabling the production of central commands, specifically controlling stereotyped, rhythmic motor behaviors. Several CPGs localized in brainstem and spinal cord areas have been shown to underlie the expression of complex behaviors such as deglutition, mastication, respiration, defecation, micturition, ejaculation, and locomotion. Their pivotal roles have clearly been demonstrated although their organization and cellular properties remain incompletely characterized. In recent years, insightful findings about CPGs have been made mainly because (1) several complementary animal models were developed; (2) these models enabled a wide variety of techniques to be used and, hence, a plethora of characteristics to be discovered; and (3) organizations, functions, and cell properties across all models and species studied thus far were generally found to be well-preserved phylogenetically. This article aims at providing an overview for non-experts of the most important findings made on CPGs in in vivo animal models, in vitro preparations from invertebrate and vertebrate species as well as in primates. Data about CPG functions, adaptation, organization, and cellular properties will be summarized with a special attention paid to the network for locomotion given its advanced level of characterization compared with some of the other CPGs. Similarities and differences between these networks will also be highlighted.

Temporal change in the occlusal vertical dimension and its involvement in modulation of jaw movement in bite-reduced animals

The occlusal vertical dimension (OVD) in guinea pigs is maintained by tooth eruption and grinding. It has been reported that the experimentally raised OVD recovers to the innate OVD within a few days in guinea pigs. However, the mechanisms underlying OVD adjustment are not entirely understood. This study thus aimed to clarify whether the experimentally reduced OVD would recover. Bite-reduced guinea pigs were created by applying bilateral intermaxillary elastics for 10 days. Guinea pigs without elastics were used as a control. The OVD after removal of the elastics in the experimental group was compared with that of the control group. Jaw movement during chewing was also compared between the experimental and control groups. After removal of the elastics, the experimentally reduced OVD did not recover fully and a significant difference was observed between the experimental and control groups for up to 25 days during the recording period. The minimum closed position during chewing was significantly higher in the experimental group than in the control group, whereas the maximum open position was no different between the groups. The present findings indicated that the experimentally reduced OVD could not be fully recovered, suggesting that reduction of the OVD may have limited influence on jaw movement.

Effect of peripherally and cortically evoked swallows on jaw reflex responses in anesthetized rabbits

This study aimed to investigate whether the jaw-opening (JOR) and jaw-closing reflexes (JCR) are modulated during not only peripherally, but also centrally, evoked swallowing. Experiments were carried out on 24 adult male Japanese white rabbits. JORs were evoked by trigeminal stimulation at 1 Hz for 30 s. In the middle 10 s, either the superior laryngeal nerve (SLN) or cortical swallowing area (Cx) was simultaneously stimulated to evoke swallowing. The peak-to-peak JOR amplitude was reduced during the middle and late 10-s periods (i.e., during and after SLN or Cx stimulation), and the reduction was dependent on the current intensity of SLN/Cx stimulation: greater SLN/Cx stimulus current resulted in greater JOR inhibition. The reduction rate was significantly greater during Cx stimulation than during SLN stimulation. The amplitude returned to baseline 2 min after 10-s SLN/Cx stimulation. The effect of co-stimulation of SLN and Cx was significantly greater than that of SLN stimulation alone. There were no significant differences in any parameters of the JCR between conditions. These results clearly showed that JOR responses were significantly suppressed, not only during peripherally evoked swallowing but also during centrally evoked swallowing, and that the inhibitory effect is likely to be larger during centrally compared with peripherally evoked swallowing. The functional implications of these results are discussed.

Individuality of masticatory performance and of masticatory muscle temporal parameters

OBJECTIVE

Mammalian mastication serves to improve intra-oral food reduction. Insufficient food reduction creates potential swallowing problems, whereas over-reduction may accelerate tooth wear and increase feeding time. Either extreme has consequences. The study's objectives were: (1) to study the relationship between food reduction, number of chews in a sequence, and chewing rate, (2) to study how controlling the number of chews and chewing rate variability affects food reduction, and (3) to assess how dentoskeletal morphological and electromyographical (EMG) characteristics impact food reduction.

DESIGN

Twenty-three healthy, fully-dentate adults chewed a standardized test food under three conditions: (1) no control, (2) number of chews controlled, and (3) number of chews and chewing rate controlled. EMG activity was sampled from masseter and temporalis muscles bilaterally. Demographic, occlusal contact area in maximum intercuspation, and cephalometric data were obtained.

RESULTS

In uncontrolled conditions, food reduction and bout duration varied more than expected across subjects. Subjects with poor reduction under controlled conditions were those with poor reduction under uncontrolled conditions. Only occlusal contact area correlated with chewing performance under uncontrolled conditions. Chewing cycle duration, EMG burst duration, and EMG peak onset latency increased when the number of chews was restricted. EMG amplitude, a surrogate for bite force, increased in tasks controlling the number of chews and chewing rate. Chewing rate variability was difficult to diminish below individual-specific levels.

CONCLUSIONS

Results: provided evidence that bite force, chewing rate, chewing performance and chewing bout duration reflected individual preferences. Future work will determine whether similar findings occur among other mammals.

The Palatability of Lopinavir and Ritonavir Delivered by an Innovative Freeze-Dried Fast-Dissolving Tablet Formulation

Negative hedonic sensory qualities of HIV antiretroviral drugs often reduce patient adherence particularly in pediatric populations requiring oral consumption. This study examines the palatability of an innovative delivery mechanism utilizing a freeze-drying-in-blister approach to create fast-dissolving tablets (FDTs) containing a fixed-dose combination of lopinavir and ritonavir (LPV/r). Consumption patterns of solutions during brief-access and long-term testing and baby foodstuff consumption were analyzed to evaluate the orosensory detection and avoidance of placebo FDTs containing no LPV/r (FDT-) and FDTs containing LPV/r (FDT+). Rats showed no change in consumption patterns for the placebo FDT- compared with control solutions. Rats can detect but do not avoid FDT+ at body-weight-adjusted dosages in both brief-access (30-s) and long-term (23 h) consumption tests. There is an aversive response to concentrated doses of FDT+ during brief-access tests that cannot be masked by 25% sucrose. However, the strongest FDT+ concentration was not rejected when mixed with 50 g of applesauce, banana sauce, or rice cereal baby foodstuffs. The averseness of the FDT+ was associated with the presence of LPV/r and not the FDT- formulation itself. The novel FDT formulation appears to be a palatable delivery mechanism for oral antiretroviral pharmaceuticals especially when mixed with baby foodstuffs.

Circuits in the rodent brainstem that control whisking in concert with other orofacial motor actions

The world view of rodents is largely determined by sensation on two length scales. One is within the animal's peri-personal space; sensorimotor control on this scale involves active movements of the nose, tongue, head, and vibrissa, along with sniffing to determine olfactory clues. The second scale involves the detection of more distant space through vision and audition; these detection processes also impact repositioning of the head, eyes, and ears. Here we focus on orofacial motor actions, primarily vibrissa-based touch but including nose twitching, head bobbing, and licking, that control sensation at short, peri-personal distances. The orofacial nuclei for control of the motor plants, as well as primary and secondary sensory nuclei associated with these motor actions, lie within the hindbrain. The current data support three themes: First, the position of the sensors is determined by the summation of two drive signals, i.e., a fast rhythmic component and an evolving orienting component. Second, the rhythmic component is coordinated across all orofacial motor actions and is phase-locked to sniffing as the animal explores. Reverse engineering reveals that the preBötzinger inspiratory complex provides the reset to the relevant premotor oscillators. Third, direct feedback from somatosensory trigeminal nuclei can rapidly alter motion of the sensors. This feedback is disynaptic and can be tuned by high-level inputs. A holistic model for the coordination of orofacial motor actions into behaviors will encompass feedback pathways through the midbrain and forebrain, as well as hindbrain areas.

Central regulation of brown adipose tissue thermogenesis and energy homeostasis dependent on food availability

Energy homeostasis of mammals is maintained by balancing energy expenditure within the body and energy intake through feeding. Several lines of evidence indicate that brown adipose tissue (BAT), a sympathetically activated thermogenic organ, turns excess energy into heat to maintain the energy balance in rodents and humans, in addition to its thermoregulatory role for the defense of body core temperature in cold environments. Elucidating the central circuit mechanism controlling BAT thermogenesis dependent on nutritional conditions and food availability in relation to energy homeostasis is essential to understand the etiology of symptoms caused by energy imbalance, such as obesity. The central thermogenic command outflow to BAT descends through an excitatory neural pathway mediated by hypothalamic, medullary and spinal sites. This sympathoexcitatory thermogenic drive is controlled by tonic GABAergic inhibitory signaling from the thermoregulatory center in the preoptic area, whose tone is altered by body core and cutaneous thermosensory inputs. This circuit controlling BAT thermogenesis for cold defense also functions for the development of fever and psychological stress-induced hyperthermia, indicating its important role in the defense from a variety of environmental stressors. When food is unavailable, hunger-driven neural signaling from the hypothalamus activates GABAergic neurons in the medullary reticular formation, which then block the sympathoexcitatory thermogenic outflow to BAT to reduce energy expenditure and simultaneously command the masticatory motor system to promote food intake—effectively commanding responses to survive starvation. This article reviews the central mechanism controlling BAT thermogenesis in relation to the regulation of energy and thermal homeostasis dependent on food availability.

Modification of Masticatory Rhythmicity Leading to the Initiation of the Swallowing Reflex in Humans

Modification of movements by proprioceptive feedback during mastication has an important role in shifting from the oral to the pharyngeal phase of swallowing. The aim of this study was to investigate the kinetics of masticatory muscles throughout a sequence of oropharyngeal swallowing and to present a hypothetical model of the involvement of the nervous system in the transition from mastication to the swallowing reflex. Surface electromyographic signals were recorded from the jaw-closing masseter muscles and the jaw-opening suprahyoid muscle group when a piece of bread (3-5 g) was ingested. Participants were not provided any additional instruction regarding how to chew and swallow. In the final stage of mastication, compared with other stages of mastication, the duration between sequential peak times of rhythmic activity of the masseter muscles was prolonged. Electromyography revealed no significant change in the suprahyoid muscle group. Accordingly, contraction of the jaw-closing muscles and the jaw-opening muscles altered from out-of-phase to in-phase. We have presented a hypothetical model based on the results of the present study, in which mastication shifts to the swallowing reflex when feed-forward inputs from rhythm generators for the jaw-closing and the jaw-opening muscles converge onto an assumed "convertor" neuron group concurrently. This model should contribute to understanding the pathophysiology of dysphagia.

A new evaluation of masticatory ability in patients with dysphagia: The Saku-Saku Test

OBJECTIVE

In the elderly and patients with dysphagia, masticatory problems often cause aspiration or choking. Although simple methods to predict aspiration and silent aspiration exist, methods for evaluating the masticatory function of patients with dysphagia are lacking. Accordingly, we developed a simple test to assess the chewing and swallowing ability of patients with dysphagia.

METHODS

One hundred and five patients with dysphagia were included. We used the Saku-Saku Test (SST), in which patients were asked to eat a rice cracker, and evaluated the quality of mandibular rotation during mastication. We studied the participants' ability to grind, aggregate, and swallow using videoendoscopic evaluation (VE) and investigated its association with mandibular rotation.

RESULTS

The SST showed good reliability between two examiners, with a kappa coefficient of 0.80. 92.4% of the patients ate the rice cracker without aspiration. The SST showed a high sensitivity of 73.3% and specificity of 93.3% for the degree of grinding. The degree of food bolus aggregation had a sensitivity of 45.0% and specificity of 90.6%, and aspiration had a sensitivity of 25.0% and specificity of 84.5%, both of which showed high specificity.

CONCLUSIONS

The results of this study suggested that the SST might be simple and useful for identifying patients with dysphagia who are able to masticate, even if they do not eat foods that need chewing and could be used before starting these patients on foods that need chewing.

Distinctive features of Phox2b-expressing neurons in the rat reticular formation dorsal to the trigeminal motor nucleus

Phox2b encodes a paired-like homeodomain-containing transcription factor essential for development of the autonomic nervous system. Phox2b-expressing (Phox2b⁺) neurons are present in the reticular formation dorsal to the trigeminal motor nucleus (RdV) as well as the nucleus of the solitary tract and parafacial respiratory group. However, the nature of Phox2b⁺ RdV neurons is still unclear. We investigated the physiological and morphological properties of Phox2b⁺ RdV neurons using postnatal day 2-7 transgenic rats expressing yellow fluorescent protein under the control of Phox2b. Almost all of Phox2b⁺ RdV neurons were glutamatergic, whereas Phox2b-negative (Phox2b^-) RdV neurons consisted of a few glutamatergic, many GABAergic, and many glycinergic neurons. The majority (48/56) of Phox2b⁺ neurons showed low-frequency firing (LF), while most of Phox2b^- neurons (35/42) exhibited high-frequency firing (HF) in response to intracellularly injected currents. All, but one, Phox2b⁺ neurons (55/56) did not fire spontaneously, whereas three-fourths of the Phox2b^- neurons (31/42) were spontaneously active. K⁺ channel and persistent Na⁺ current blockers affected the firing of LF and HF neurons. The majority of Phox2b⁺ (35/46) and half of the Phox2b^- neurons (19/40) did not respond to stimulations of the mesencephalic trigeminal nucleus, the trigeminal tract, and the principal sensory trigeminal nucleus. Biocytin labeling revealed that about half of the Phox2b⁺ (5/12) and Phox2b^- RdV neurons (5/10) send their axons to the trigeminal motor nucleus. These results suggest that Phox2b⁺ RdV neurons have distinct neurotransmitter phenotypes and firing properties from Phox2b^- RdV neurons and might play important roles in feeding-related functions including suckling and possibly mastication.

Review of imaging network activities in developing rodent cerebral cortex in vivo

The combination of voltage-sensitive dye imaging (VSDI) with multielectrode array (MEA) recordings in the rodent cerebral cortex in vivo allows the simultaneous analysis of large-scale network interactions and electrophysiological single-unit recordings. Using this approach, distinct patterns of spontaneous and sensory-evoked activity can be recorded in the primary somatosensory (S1) and motor cortex (M1) of newborn rats. Already at the day of birth, gamma oscillations and spindle bursts in the barrel cortex synchronize the activity of a local columnar ensemble, thereby generating an early topographic representation of the sensory periphery. During the first postnatal week, both cortical activity patterns undergo developmental changes in their spatiotemporal properties and spread into neighboring cortical columns. Simultaneous VSDI and MEA recordings in S1 and M1 demonstrate that the immature motor cortex receives information from the somatosensory system and that M1 may trigger movements of the periphery, which subsequently evoke gamma oscillations and spindle bursts in S1. These early activity patterns not only play an important role in the development of the cortical columnar architecture, they also control the ratio of surviving versus dying neurons in an activity-dependent manner, making these processes most vulnerable to pathophysiological disturbances during early developmental stages.

Circuit feedback increases activity level of a circuit input through interactions with intrinsic properties

Central pattern generator (CPG) motor circuits underlying rhythmic behaviors provide feedback to the projection neuron inputs that drive these circuits. This feedback elicits projection neuron bursting linked to CPG rhythms. The brief periodic interruptions in projection neuron activity in turn influence CPG output, gate sensory input, and enable coordination of multiple target CPGs. However, despite the importance of the projection neuron activity level for circuit output, it remains unknown whether feedback also regulates projection neuron intraburst firing rates. I addressed this issue using identified neurons in the stomatogastric nervous system of the crab, Cancer borealis, a small motor system controlling chewing and filtering of food. Mechanosensory input triggers long-lasting activation of two projection neurons to elicit a chewing rhythm, during which their activity is patterned by circuit feedback. Here I show that feedback increases the intraburst firing rate of only one of the two projection neurons (commissural projection neuron 2: CPN2). Furthermore, this is not a fixed property because the CPN2 intraburst firing rate is decreased instead of increased by feedback when a chewing rhythm is activated by a different modulatory input. I establish that a feedback pathway that does not impact the CPN2 activity level in the control state inhibits CPN2 sufficiently to trigger postinhibitory rebound following mechanosensory stimulation. The rebound increases the CPN2 intraburst firing rate above the rate due only to mechanosensory activation of CPN2. Thus in addition to patterning projection neuron activity, circuit feedback can adjust the intraburst firing rate, demonstrating a novel functional role for circuit feedback to central projection neurons.NEW & NOTEWORTHY Feedback from central pattern generator (CPG) circuits patterns activity of their projection neuron inputs. However, whether the intraburst firing rate between rhythmic feedback inhibition is also impacted by CPG feedback was not known. I establish that CPG feedback can alter the projection neuron intraburst firing rate through interactions with projection neuron intrinsic properties. The contribution of feedback to projection neuron activity level is specific to the modulatory condition, demonstrating a state dependence for this novel role of circuit feedback.

Mechanism of motor coordination of masseter and temporalis muscles for increased masticatory efficiency in mice

The demand for the use of mice as animal models for elucidating the pathophysiologies and pathogeneses of oral motor disorders has been increasing in recent years, as more and more kinds of genetically modified mice that express functional disorders of the stomatognathic system become available. However, the fundamental characteristics of mouse jaw movements during mastication have yet to be fully elucidated. The purpose of this study was to investigate the roles of the masseter and temporalis muscles, and the mechanisms of motor coordination of these muscles for increasing masticatory efficiency in the closing phase in mice. Twenty-two male Jcl:ICR mice were divided into control (n = 8), masseter-hypofunction (n = 7) and temporalis-hypofunction groups (n = 7). Botulinum neurotoxin type A (BoNT⁄A) was used to induce muscle hypofunction. The masticatory movement path in the horizontal direction during the occlusal phase became unstable after BoNT⁄A injection into the masseter muscle. BoNT⁄A injection into the temporalis muscle decreased antero-posterior excursion of the late-closing phase corresponding to the power phase of the chewing cycle. These results suggest that the masseter plays an important role in stabilizing the grinding path, where the food bolus is ground by sliding the posterior teeth from back to front during the occlusal phase. The temporalis plays a major role in retracting the mandible more posteriorly in the early phase of closing, extending the grinding path. Masticatory efficiency is thus increased based on the coordination of activities by the masseter and temporalis muscles.

Childhood intelligence and early tooth wear patterns

OBJECTIVE

The aim of this study is to explore the relationships between early dental wear patterns and preschool IQ (Intelligence Quotient, by Stanford-Binet) of the child to illuminate the historic relationship of mental queries and bruxism.

METHODS

The dental study participants were 864 Euro-American preschool and school children whose IQs were tested for school maturity purposes at the age of 4 years, followed by dental data in a cross-sectional manner at the mean age of 7.8 years. Worn dentitions were classified as "symmetric" or "right-" and "left-sided," based on the faceting of the teeth.

RESULTS

In general, the relationships of tooth wear and intelligence were scarce, reflecting social background factors. Statistically significant results between asymmetric wear and gender groups suggest that direction of jaw function has a role in the regulation of processes responsible for individual mental performance in childhood.

DISCUSSION

Increased left-side tooth wear and early advantage in the intelligence test in girls is intriguing due to the fact that they reach maturity earlier than boys in verbal articulation, controlled in most cases by the limited area on the left side of the brain.