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An Y, Li Y, Chang W, Gao F, Ding X, Xu W, Han D. Quantitative Evaluation of the Function of the Sensory Nerve Fibers of the Palate in Patients With Obstructive Sleep Apnea. J Clin Sleep Med 2019; 15:1347-1353. [PMID: 31538606 PMCID: PMC6760391 DOI: 10.5664/jcsm.7756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/20/2018] [Accepted: 01/14/2019] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To quantitatively evaluate the functional integrity of sensory nerve fibers of the palate in patients with obstructive sleep apnea (OSA) using the Neurometer system. METHODS A total of 32 patients with OSA and 18 healthy control patients were included in the study. All participants were selected based on medical history, physical examination, and nocturnal polysomnography (PSG) and divided into two groups. The palatal sensory status of participants was examined with a Neurometer current perception threshold (CPT) system. The system was used to deliver an electrical stimulus at three different frequencies (2,000 Hz, 250 Hz, and 5 Hz) by an investigator blinded to the PSG results. RESULTS There were no significant differences in the CPT values of the hard palate between the patients with OSA and control patients at any of the three stimulation frequencies. The differences in the CPT values of the soft palate between these groups failed to show any statistical significance at 250 Hz and 5 Hz. However, the patients with OSA showed significantly higher CPT values of the soft palate at 2,000 Hz than the age-matched healthy control patients (256.56 ± 129.34 versus 372.13 ± 152.06; P = .009). CONCLUSIONS Our study revealed an impairment of 2,000 Hz-related sensory nerve function of the soft palate among patients with OSA. The CPT test could be a useful tool for the quantitative and selective assessment of the sensory nerve function in patients with OSA. Additional research is required to evaluate the different types of sensory nerve dysfunctions among such patients. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Title: The Effects of Nasal Airflow on Upper Airway Dilator Muscles During Sleep; Identifier: NCT03506178; URL: https://clinicaltrials.gov/ct2/show/NCT03506178. CITATION An Y, Li Y, Chang W, Gao F, Ding X, Xu W, Han D. Quantitative evaluation of the function of the sensory nerve fibers of the palate in patients with obstructive sleep apnea. J Clin Sleep Med. 2019;15(9):1347-1353.
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Affiliation(s)
- Yunsong An
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University; State Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing, China
| | - Yanru Li
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University; State Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing, China
| | - Wei Chang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University; State Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing, China
| | - Fei Gao
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University; State Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing, China
| | - Xiu Ding
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University; State Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing, China
| | - Wen Xu
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University; State Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing, China
| | - Demin Han
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University; State Key Laboratory of Otolaryngology Head and Neck Surgery of Ministry of Education, Beijing, China
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Furuse N, Kimoto S, Nakashima Y, Ogawa T, Furokawa S, Okubo M, Yamaguchi H, Kawai Y. Verification of the reliability of current perception threshold and pain threshold testing by application of an electrical current stimulus to mandibular mucosa in young adults. J Oral Rehabil 2019; 46:556-562. [PMID: 30762250 DOI: 10.1111/joor.12777] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/03/2019] [Accepted: 02/07/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is little evidence regarding the reliability of CPT and PT measurements to gauge mandibular perception. Thus, this study aimed to evaluate the test-retest reliability of CPT and PT values obtained from the mandibular oral mucosa and to test the bilateral differences in CPT and PT values obtained from the mental foramen region and buccal shelf region by a single operator. METHODS CPT and PT values were obtained from the mental foramen and buccal shelf regions of 20 volunteers (10 males and 10 females; average age: 26.4 ± 2.6 years) by using the Neurometer CPT/C® device to deliver electrical stimulation. RESULTS Relative and absolute reliabilities were confirmed over two measurements of CPT and PT over a 7- to 10-day measurement interval. Intra-class correlation coefficients (ICCs) for CPT and PT table obtained from the mental foramen region were >0.8, while most ICC for the buccal shelf region were <0.8. Standard error of measurement, minimal detectable change and Bland-Altman analyses showed that the CPT and PT measurements had no systematic error and could serve as useful methods. At all frequencies, the bilateral difference in CPT and PT values at the mental foramen and buccal shelf region was not significant. CONCLUSION CPT and PT measurements using a custom-made device that applied an electrical current to the mental foramen region have appropriate reliability to assess intra-oral sensitivity to electrical stimulation in young adults.
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Affiliation(s)
- Nobuhiko Furuse
- Removable Prosthodontics, Nihon University Graduate School of Dentistry at Matsudo, Matsudo, Japan
| | - Suguru Kimoto
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Yoshio Nakashima
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Takahiro Ogawa
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - So Furokawa
- Removable Prosthodontics, Nihon University Graduate School of Dentistry at Matsudo, Matsudo, Japan
| | - Masakazu Okubo
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Hidenori Yamaguchi
- Department of Anesthesiology, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Yasuhiko Kawai
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
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Kimoto S, Furuse N, Ogawa T, Nakashima Y, Furokawa S, Okubo M, Yamaguchi H, Kawai Y. Receptivity of the mandible versus the maxilla to external stimuli in patients with complete dentures. J Prosthodont Res 2019; 63:299-302. [PMID: 30755360 DOI: 10.1016/j.jpor.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/31/2018] [Accepted: 01/08/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE This study aimed to investigate whether the mandible is more receptive to external stimuli than the maxilla in patients with complete dentures by comparing regional current perception thresholds (CPTs) and pain threshold (PTs). METHODS A single operator obtained measurements from maxillae at the incisor foramen and the left side of the greater palatine foramen region and the mandible at the left side of the mental foramen region, using the Neurometer CPT/C device, CPT and PT values from the oral mucosa of 20 edentulous individuals wearing complete dentures were analyzed. Participant characteristics such as mucosal thickness, occlusal force, age, and sex. Mucosal thickness over target regions and occlusal force were measured by the same operator using Krupp SDM and Occlusal Force-Meter GM10s devices. Differences in CPT and PT among the three measurement regions were tested with an analysis of covariance, and post hoc t-tests with the Bonferroni correction. RESULTS There were no significant differences between the mental foramen, incisor papilla, and greater palatine regions CPT values. PTs obtained at all current frequencies (2000Hz, 250Hz, and 5Hz) were lowest in the mental foramen region and highest in the greater palatine region. Covariates including sex, mucosal thickness, and occlusal force had no significant influence on CPT or PT values at all frequencies. CONCLUSIONS The mandible exhibits higher receptivity to external pain stimuli than the maxilla.
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Affiliation(s)
- Suguru Kimoto
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan.
| | - Nobuhiko Furuse
- Nihon University Graduate School of Dentistry at Matsudo, Removable Prosthodontics, Matsudo, Japan
| | - Takahiro Ogawa
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Yoshio Nakashima
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - So Furokawa
- Nihon University Graduate School of Dentistry at Matsudo, Removable Prosthodontics, Matsudo, Japan
| | - Masakazu Okubo
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Hidenori Yamaguchi
- Department of Anesthesiology, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Yasuhiko Kawai
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
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Ogawa T, Kimoto S, Nakashima Y, Furuse N, Ono M, Furokawa S, Okubo M, Yamaguchi H, Kawai Y. Differences in pain thresholds elicited by intraoral electrical stimuli between individuals with and without diabetes mellitus. J Oral Rehabil 2018; 45:235-239. [DOI: 10.1111/joor.12601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2017] [Indexed: 11/30/2022]
Affiliation(s)
- T. Ogawa
- Removable Prosthodontics; Nihon University Graduate School of Dentistry at Matsudo; Matsudo Japan
| | - S. Kimoto
- Department of Removable Prosthodontics; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| | - Y. Nakashima
- Department of Removable Prosthodontics; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| | - N. Furuse
- Removable Prosthodontics; Nihon University Graduate School of Dentistry at Matsudo; Matsudo Japan
| | - M. Ono
- Removable Prosthodontics; Nihon University Graduate School of Dentistry at Matsudo; Matsudo Japan
| | - S. Furokawa
- Removable Prosthodontics; Nihon University Graduate School of Dentistry at Matsudo; Matsudo Japan
| | - M. Okubo
- Department of Removable Prosthodontics; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| | - H. Yamaguchi
- Department of Anesthesiology; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| | - Y. Kawai
- Department of Removable Prosthodontics; Nihon University School of Dentistry at Matsudo; Matsudo Japan
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Ogawa T, Kimoto S, Nakashima Y, Furuse N, Ono M, Furokawa S, Okubo M, Yazaki T, Kawai Y. Measurement reliability of current perception threshold and pain threshold in parallel with blood sampling. Clin Exp Dent Res 2017; 3:154-159. [PMID: 29744194 PMCID: PMC5839228 DOI: 10.1002/cre2.75] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 06/19/2017] [Accepted: 06/27/2017] [Indexed: 11/16/2022] Open
Abstract
The irritation and pain associated with oral blood sampling necessary to monitor glycemic control can alter oral sensation, but no studies have measured the reliability of oral sensation testing when performed concurrently with blood sampling. The primary and secondary aims of this study were to verify the measurement reliability of current perception threshold (CPT) and pain threshold (PT) tests performed before and after blood sampling and to investigate the differences in CPTs/PTs obtained from the oral cavity, hand, and foot, respectively. CPT/PT measurements were obtained from the oral mucosa and the tips of fingers and toes of 18 volunteers (10 males and 8 females, average age = 26.3 years) using electrical stimulation at frequencies of 5, 250, and 2,000 Hz. Participants also provided blood samples by pricking their own index fingers with a small needle. All subjects completed the following 3 conditions at once-weekly intervals as follows: (a) sensory measurements followed by blood sampling (SB block); (b) blood sampling followed by sensory measurements (BS block); (c) sensory measurements without blood sampling (CO control block). Cronbach's α coefficients were over 0.78 for the SB, BS, and CO blocks, and are considered to be acceptable for assuring measurement reliability. The oral cavity had significantly lower CPT/PTs than both hands and feet, such that the threshold increased in the order oral cavity < hand < foot. CPT and PT measurements performed concurrently with blood sampling are both reliable and region specific, and for which the oral cavity is the most sensitive testing region.
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Affiliation(s)
- Takahiro Ogawa
- Removable ProsthodonticsNihon University Graduate School of Dentistry at MatsudoJapan
| | - Suguru Kimoto
- Department of Removable ProsthodonticsNihon University School of Dentistry at MatsudoJapan
| | - Yoshio Nakashima
- Removable ProsthodonticsNihon University Graduate School of Dentistry at MatsudoJapan
| | - Nobuhiko Furuse
- Removable ProsthodonticsNihon University Graduate School of Dentistry at MatsudoJapan
| | - Masanori Ono
- Removable ProsthodonticsNihon University Graduate School of Dentistry at MatsudoJapan
| | - So Furokawa
- Removable ProsthodonticsNihon University Graduate School of Dentistry at MatsudoJapan
| | - Masakazu Okubo
- Department of Removable ProsthodonticsNihon University School of Dentistry at MatsudoJapan
| | - Takahiro Yazaki
- Department of Removable ProsthodonticsNihon University School of Dentistry at MatsudoJapan
| | - Yasuhiko Kawai
- Department of Removable ProsthodonticsNihon University School of Dentistry at MatsudoJapan
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Nakashima Y, Kimoto S, Ogawa T, Furuse N, Ono M, Kawai Y. Characteristics of the pain tolerance threshold induced by electrical stimulation of the alveolar ridge. Clin Exp Dent Res 2015; 1:80-86. [PMID: 29744143 PMCID: PMC5839225 DOI: 10.1002/cre2.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 11/05/2015] [Accepted: 11/10/2015] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to determine the characteristics of the pain tolerance threshold (PTT) induced by electrical stimulation of the alveolar ridge. A total of 100 healthy volunteers studying or working at Nihon University School of Dentistry at Matsudo and patients from Nihon University School of Dentistry at Matsudo Affiliated Hospital, including 51 men (58.7 ± 17.6 years old) and 49 women (60.7 ± 17.1 years old), participated in this study. The volunteers were enrolled after obtaining written informed consent. PTT measurements were obtained using a Neurometer CPT/C® device to deliver electrical stimulation around the left greater palatine foramen at frequencies of 5 and 250 Hz. When the stimulus could no longer be tolerated, the participant released a button to automatically discontinue the stimulus. After the distribution of the PTT values was analyzed, the influence of gender, age, and Eichner index on PTT was analyzed. The Eichner index values were divided into three categories: group A (four supporting zones), group B (less than four supporting zones but with anterior tooth contact), and group C (no occlusal contact). The PTT values did not show a normal distribution. There were no significant differences in PTT between men and women. PTT was significantly associated with age (P = 0.017) at 5 Hz in men. There were no significant differences in PTT among the Eichner index groups. The characteristics of the PTT of the alveolar ridge are as follows: (1) age and PTT at 5 Hz are significantly associated with men but not with women, and (2) the Eichner index has no influence on the PTT.
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Affiliation(s)
- Yoshio Nakashima
- Department of Removable Prosthodontics Nihon University School of Dentistry at Matsudo Matsudo Japan
| | - Suguru Kimoto
- Department of Removable Prosthodontics Nihon University School of Dentistry at Matsudo Matsudo Japan
| | - Takahiro Ogawa
- Department of Removable Prosthodontics Nihon University School of Dentistry at Matsudo Matsudo Japan
| | - Nobuhiko Furuse
- Department of Removable Prosthodontics Nihon University School of Dentistry at Matsudo Matsudo Japan
| | - Masanori Ono
- Department of Removable Prosthodontics Nihon University School of Dentistry at Matsudo Matsudo Japan
| | - Yasuhiko Kawai
- Department of Removable Prosthodontics Nihon University School of Dentistry at Matsudo Matsudo Japan
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Nakashima Y, Kimoto S, Kawai Y. Reliability of pain tolerance threshold testing by applying an electrical current stimulus to the alveolar ridge. J Oral Rehabil 2014; 41:595-600. [PMID: 24814257 DOI: 10.1111/joor.12181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to assess the reliability of testing pain tolerance threshold (PTT) by applying an electrical current stimulus to the alveolar ridge. Twenty volunteers studying or working at the Nihon University School of Dentistry at Matsudo participated in this study. Participants were seated comfortably on a dental chair in a quiet room during testing. A single operator obtained mucosal PTT measurements around the right greater palatine foramen using a Neurometer CPT/C(®) device (Neurotron Inc., Baltimore, MD, USA) to deliver electrical stimulation at frequencies of 5, 250 and 2000 Hz. The participant released a button to automatically discontinue the stimulus when it could no longer be tolerated. Two types of factors were confirmed: the consistency of repeated measurements and a potential carry-over effect on PTTs. The consistency and carry-over effects of pain with regard to PTT measurements were analysed via Cronbach's coefficient α. The Cronbach's coefficient α of PTTs calculated more than 6 days of PTT testing at 5, 250 and 2000 Hz was 0.97, 0.95 and 0.97, respectively, suggesting that the consistency of the measurements was excellent. The Cronbach's coefficient α calculated when the three frequencies of 5, 250 and 2000 Hz were applied in different orders was 0.91, 0.87 and 0.90, respectively, suggesting no carry-over effect. In conclusion, the measurement of PTTs at the alveolar ridge as assessed by applying an electrical current stimulus with an electro-diagnostic device exhibited excellent reliability, and thus, it constitutes a widely available option for PTT measurement in the clinical setting.
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Affiliation(s)
- Y Nakashima
- Removable Prosthodontics, Nihon University Graduate School of Dentistry at Matsudo, Matsudo, Japan
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Kimoto S, Kimoto K, Kitamura A, Saita M, Iijima M, Kawai Y. Effect of dentist's clinical experience on treatment satisfaction of a complete denture. J Oral Rehabil 2013; 40:940-7. [PMID: 24237360 DOI: 10.1111/joor.12108] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2013] [Indexed: 11/28/2022]
Abstract
The relationship between the prosthodontic experience of dentists and satisfaction of complete denture wearers remains unknown. To investigate whether a prosthodontist's clinical experience affects treatment satisfaction of a complete denture wearer. From April 2004 to July 2006, we conducted a randomised controlled trial at two centres, including 74 edentulous patients; of these, 32 and 30 were randomly allocated to the ED or ID group, respectively. All the patients rated their satisfaction with dentures, including general satisfaction and satisfaction of chewing ability, speaking, cleaning, stability, retention, comfort and aesthetics. These satisfaction ratings were measured by a 100-mm visual analog scale (VAS). Perceived chewing ability to foods, divided into five grades, was measured using a questionnaire. The mastication index (MI) was calculated for each grade. General satisfaction and satisfaction of speaking, stability and retention were significantly higher in the ED than in the ID group (P = 0·049, 0·003, 0·019 and 0·041, respectively). No significant difference existed between the MI of the ED (71·3 ± 18·4) and ID group (64·1 ± 16·53). However, the perceived chewing ability of grade 5 food, whose texture was the hardest among all the grades, was significantly higher in the ED group than in the ID group. Within its limitations, this study showed that a clinician's prosthodontic experience affects a complete denture wearer's satisfaction ratings.
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Affiliation(s)
- S Kimoto
- Department of Removable Prosthodontics, Nihon University School of Dentistry, Matsudo, Japan
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