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Nagasaki T, Kurihara-Okawa K, Okawa J, Nihara J, Takahashi K, Hori K, Fukui T, Ono T, Saito I. Tongue pressure and maxillofacial muscle activities during swallowing in patients with mandibular prognathism. J Oral Rehabil 2024; 51:1413-1421. [PMID: 38661389 DOI: 10.1111/joor.13712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 12/28/2023] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Coordination among lip, cheek and tongue movements during swallowing in patients with mandibular prognathism remains unclear. OBJECTIVES This study aimed to identify the temporal sequences of tongue pressure and maxillofacial muscle activities during swallowing in patients with mandibular prognathism and compared characteristics with those of healthy volunteers. METHODS Seven patients with mandibular prognathism (mandibular prognathism group) and 25 healthy volunteers with individual normal occlusion (control group) were recruited. Tongue pressures and masseter, orbicularis oris, mentalis and supra- and infrahyoid muscle activities while swallowing gel were measured simultaneously using a sensor sheet system with five measurement points and surface electromyography, respectively. Onset time, offset time and durations of tongue pressure and muscle activities were analysed. RESULTS In the mandibular prognathism group, tongue pressure was often produced first in more peripheral parts of the palate. Offset of tongue pressure in the posteromedian and peripheral parts of the palate and maxillofacial muscle activities except for orbicularis oris were delayed. Duration of tongue pressure in the anteromedian part of the palate was significantly shorter and durations of masseter, mentalis and suprahyoid muscle activities were significantly longer. Times to onset of orbicularis oris and suprahyoid muscle activities based on first onset of tongue pressure were significantly shorter. CONCLUSION These results suggest that patients with mandibular prognathism may exhibit specific patterns of tongue pressure production and maxillofacial muscle activities during swallowing.
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Affiliation(s)
- Tsukasa Nagasaki
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kanako Kurihara-Okawa
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Jumpei Okawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Jun Nihara
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kojiro Takahashi
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tadao Fukui
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- FUKUI Orthodontic Office, Niigata, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Geriatric Dentistry, Faculty of Dentistry, Osaka Dental University, Osaka, Japan
| | - Isao Saito
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Gomi K, Moroi A, Yoshizawa K, Iguchi R, Ueki K. Evaluation of tongue pressure and lip closing force in bimaxillary orthognathic surgery: A retrospective study. J Craniomaxillofac Surg 2023; 51:696-701. [PMID: 37652849 DOI: 10.1016/j.jcms.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/27/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023] Open
Abstract
The purpose of this study was to quantitatively compare changes in tongue pressure and lip closing force among skeletal Class II and Class III patients, who had undergone orthognathic surgery, and a control group. Maximum tongue pressure and lip closing forces were measured preoperatively and at 6 and 12 months postoperatively. Time-course changes were analyzed and compared among the groups. The control group involved 40 skeletal Class I occlusion volunteers (20 male and 20 female), the Class II group involved 20 female patients, and the skeletal Class III group involved 40 patients, who were subdivided by sex into two groups comprising 20 males and 20 females, respectively. Time-course changes in tongue pressure were not significantly different between and within groups. However, postoperative lip closing forces became gradually higher in the Class III group female and male subjects compared with the control group, although this was not observed in the Class II group. There were significant correlations between tongue pressure and lip closing force before and after surgery (p = 0.001), and these correlations increased over time. Although there was no significant increase in maximum tongue pressure after orthognathic surgery, there was an associated increase in perioral muscle strength. This suggests that an increase in perioral muscle strength may contribute more to the stability of postoperative jaw morphology.
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Affiliation(s)
- Karen Gomi
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Clinical Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo-shi, Yamanashi, 409-3898, Japan.
| | - Akinori Moroi
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Clinical Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo-shi, Yamanashi, 409-3898, Japan
| | - Kunio Yoshizawa
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Clinical Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo-shi, Yamanashi, 409-3898, Japan
| | - Ran Iguchi
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Clinical Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo-shi, Yamanashi, 409-3898, Japan
| | - Koichiro Ueki
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. K Ueki), Division of Clinical Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo-shi, Yamanashi, 409-3898, Japan
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Rodrigues R, Sassi FC, Silva APD, Andrade CRFD. Correlation between findings of the oral myofunctional clinical assessment, pressure and electromyographic activity of the tongue during swallowing in individuals with different orofacial myofunctional disorders. Codas 2023; 35:e20220053. [PMID: 37820097 DOI: 10.1590/2317-1782/20232022053pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 10/10/2022] [Indexed: 10/13/2023] Open
Abstract
PURPOSE To correlate the findings regarding the myofunctional orofacial examination, tongue pressure and surface electromyography (sEMG) of deglutition in individuals with different orofacial myofunctional disorders. METHODS 44 patients (20 males and 24 females, aged between 17 and 63 years old) with different orofacial myofunctional changes were clinically assessed using the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E). In addition, the range of mandibular movements and facial anthropometry were measured, along with the assessment of the tongue pressure (tip and dorsum) and of the electrical activity of the suprahyoid muscles during deglutition, using surface electromyography (sEMG). RESULTS The statistical analysis found weak correlations between tongue dorsum pressure values, suggesting that the greater the measurement of the lower third of the face, the lower the pressure of the tongue dorsum; the greater the measurement of the overlaps (vertical and horizontal), the higher the pressure of the tongue dorsum; the higher the score from the orofacial evaluation and orofacial functions assessment, the higher the pressure of the tongue dorsum; and the higher the pressure of the tongue dorsum, the higher the pressure of the tongue tip. CONCLUSION The present study results indicate that the orofacial myofunctional changes found in different groups of patients are more related to the maxillomandibular discrepancies than to the pathologies investigated herein.
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Affiliation(s)
- Robson Rodrigues
- Divisão de Fonoaudiologia, Hospital das Clínicas - HC, Faculdade de Medicina - FM, Universidade de São Paulo - USP - São Paulo (SP), Brasil
| | - Fernanda Chiarion Sassi
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - FM, Universidade de São Paulo - USP - São Paulo (SP), Brasil
| | - Amanda Pagliotto da Silva
- Divisão de Fonoaudiologia, Hospital das Clínicas - HC, Faculdade de Medicina - FM, Universidade de São Paulo - USP - São Paulo (SP), Brasil
| | - Claudia Regina Furquim de Andrade
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - FM, Universidade de São Paulo - USP - São Paulo (SP), Brasil
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Kaku M, Kagawa H, Yamamoto T, Kojima S, Kamiya T, Shimoe S, Mine Y, Murayama T, Yamamoto I, Tanimoto K. The Physiological Function of Deglutition and Swallowing in Patients With Maxillary Protrusion After Mandibular Advancement. J Craniofac Surg 2023; 34:1966-1970. [PMID: 37352383 DOI: 10.1097/scs.0000000000009479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/25/2023] [Indexed: 06/25/2023] Open
Abstract
The objective of this study was to determine the tongue-palatal contact changes in patients with skeletal maxillary protrusion after sagittal split ramus osteotomy (SSRO) during swallowing. In this study, 15 patients with maxillary protrusion and 10 normal subjects participated. Before and 3 months after surgery, tongue-palatal contact patterns during swallowing of patients with maxillary protrusion as well as controls were evaluated by electropalatography. The electrode contact number in the alveolar, palatal, and velar parts was examined. The swallowing duration of each phase was also evaluated. In the lateral area of the velar part, incomplete electrode contact was shown at 0.3 seconds in patients with maxillary protrusion. The electrode contact number in the velar part at 0.3 seconds before tongue-palatal complete contact was significantly less in the preoperative patients compared with the controls ( P < 0.05). A small increase in the electrode contact number of the velar part was shown in the postoperative patients at 0.3 and 0.2 seconds before tongue-palatal complete contact ( P < 0.05). The pharyngeal phase duration was significantly larger in the patients with maxillary protrusion before SSRO compared with the controls ( P < 0.05). After SSRO, the pharyngeal phase duration was significantly shortened. It was shown that the tongue-palatal contact pattern during swallowing in patients with maxillary protrusion improved after orthognathic surgery, and the pharyngeal phase duration was also shortened. It is suggested that the changes in the mesiodistal mandibular position by orthognathic surgery can improve tongue posture and movement during swallowing.
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Affiliation(s)
- Masato Kaku
- Division of Oral Health Sciences, Department of Anatomy and Functional Restorations, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Haruka Kagawa
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical and Health Sciences
| | - Taeko Yamamoto
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical and Health Sciences
| | | | | | - Saiji Shimoe
- Division of Oral Health Sciences, Department of Anatomy and Functional Restorations, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yuichi Mine
- Department of Medical System Engineering, Division of Oral Health Sciences, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima
| | - Takeshi Murayama
- Department of Medical System Engineering, Division of Oral Health Sciences, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima
| | - Ichiro Yamamoto
- EPG Research Center, Yamamoto Dental Clinic, Nishinomiya, Japan
| | - Kotaro Tanimoto
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical and Health Sciences
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Zohud O, Lone IM, Midlej K, Obaida A, Masarwa S, Schröder A, Küchler EC, Nashef A, Kassem F, Reiser V, Chaushu G, Mott R, Krohn S, Kirschneck C, Proff P, Watted N, Iraqi FA. Towards Genetic Dissection of Skeletal Class III Malocclusion: A Review of Genetic Variations Underlying the Phenotype in Humans and Future Directions. J Clin Med 2023; 12:jcm12093212. [PMID: 37176653 PMCID: PMC10179046 DOI: 10.3390/jcm12093212] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/13/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION Skeletal abnormalities and malocclusions have varied features that impact populations globally, impairing aesthetics and lowering life quality. The prevalence of the Skeletal Class III disease is the lowest among all angle malocclusions, with varied prevalence across nations. Environmental, genetic, and societal factors play a role in its numerous etiologies. In this study, we conducted a thorough search across the published data relating to quantitative trait loci (QTL) and the genes associated with Class III progression in humans, discussed these findings and their limitations, and proposed future directions and strategies for studying this phenotype. METHODS An inclusive search of published papers in the PubMed and Google Scholar search engines using the following terms: 1. Human skeletal Class III; 2. Genetics of Human skeletal Class III; 3. QTL mapping and gene associated with human skeletal Class III; 4. enriched skeletal Class-III-malocclusion-associated pathways. RESULTS Our search has found 53 genes linked with skeletal Class III malocclusion reported in humans, genes associated with epigenetics and phenomena, and the top 20 enriched pathways associated with skeletal Class III malocclusion. CONCLUSIONS The human investigations yielded some contentious conclusions. We conducted a genome-wide association study (GWAS), an epigenetics-wide association study (EWAS), RNA-seq analysis, integrating GWAS and expression quantitative trait loci (eQTL), micro- and small-RNA, and long non-coding RNA analysis in tissues connected to skeletal Class III malocclusion phenotype in tissues connected with the skeletal phenotype. Finally, we invite regional, national, and international orthodontists and surgeons to join this effort by contributing human samples with skeletal Class III malocclusion following the accepted Helsinki ethical protocol to challenge these phenomena jointly.
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Affiliation(s)
- Osayd Zohud
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Iqbal M Lone
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Kareem Midlej
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Awadi Obaida
- Center for Dentistry Research and Aesthetics, Jatt 4491800, Israel
| | - Samir Masarwa
- Center for Dentistry Research and Aesthetics, Jatt 4491800, Israel
| | - Agnes Schröder
- Department of Orthodontics, University Hospital of Regensburg, University of Regensburg, 93047 Regensburg, Germany
- Institute for Clinical Microbiology and Hygiene, 93053 Regensburg, Germany
| | - Erika C Küchler
- Department of Orthodontics, University Hospital of Regensburg, University of Regensburg, 93047 Regensburg, Germany
| | - Aysar Nashef
- Department of Oral and Maxillofacial Surgery, Baruch Padeh Medical Center, Poriya, Tabaria 1520800, Israel
| | - Firas Kassem
- Department of Otorhinolaryngology, Head and Neck Surgery, Meir Medical Center, Kfar Saba 4428164, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Vadim Reiser
- Department of Oral & Maxillofacial Surgery, Rabin Medical Center, Beilinson Campus, Petah Tikva 4941492, Israel
| | - Gavriel Chaushu
- Department of Oral & Maxillofacial Surgery, Rabin Medical Center, Beilinson Campus, Petah Tikva 4941492, Israel
- School of Dental Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Richard Mott
- Department of Genetics, University College of London, London SE1 7EH, UK
| | - Sebastian Krohn
- Department of Orthodontics, University Hospital of Regensburg, University of Regensburg, 93047 Regensburg, Germany
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital of Regensburg, University of Regensburg, 93047 Regensburg, Germany
| | - Peter Proff
- Department of Orthodontics, University Hospital of Regensburg, University of Regensburg, 93047 Regensburg, Germany
| | - Nezar Watted
- Center for Dentistry Research and Aesthetics, Jatt 4491800, Israel
- Department of Orthodontics, Faculty of Dentistry, Arab America University, Jenin 34567, Palestine
- Gathering for Prosperity Initiative, Jatt 4491800, Israel
| | - Fuad A Iraqi
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
- Department of Orthodontics, University Hospital of Regensburg, University of Regensburg, 93047 Regensburg, Germany
- Gathering for Prosperity Initiative, Jatt 4491800, Israel
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Impact of Maximum Tongue Pressure in Patients with Jaw Deformities Who Underwent Orthognathic Surgery. Diagnostics (Basel) 2022; 12:diagnostics12020404. [PMID: 35204495 PMCID: PMC8871112 DOI: 10.3390/diagnostics12020404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 02/01/2023] Open
Abstract
Malocclusion and morphological abnormalities of the jawbone often affect the stomatognathic function and long-term postoperative stability in patients with jaw deformities. There are few reports on the effect of maximum tongue pressure (MTP) in these patients. We investigated the relationship between the MTP and jawbone morphology and the effect of the MTP on surgery in 42 patients with jaw deformity who underwent surgical orthodontic treatment at Hiroshima University Hospital. The MTP was measured using a tongue pressure measurement device; the average value was considered as the MTP. Based on the MTP measured before surgery, patients were classified into the high- or the low-MTP group. The clinical findings and results of the cephalometric analysis were compared. Posterior movement of the mandible in the high-MTP group was significantly lower than that in the low-MTP group. The ANB angle, overjet, and overbite in the high-MTP group were significantly smaller than those in the low-MTP group. On the other hand, there was no difference between the two groups in the measured values, indicating a labial inclination of the anterior teeth (U1 to SN, U1 to FH, IMPA, and FMIA). MTP has been suggested to affect mandibular prognathism in patients with jaw deformities.
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Genes and Pathways Associated with Skeletal Sagittal Malocclusions: A Systematic Review. Int J Mol Sci 2021; 22:ijms222313037. [PMID: 34884839 PMCID: PMC8657482 DOI: 10.3390/ijms222313037] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/06/2021] [Accepted: 11/30/2021] [Indexed: 12/15/2022] Open
Abstract
Skeletal class II and III malocclusions are craniofacial disorders that negatively impact people’s quality of life worldwide. Unfortunately, the growth patterns of skeletal malocclusions and their clinical correction prognoses are difficult to predict largely due to lack of knowledge of their precise etiology. Inspired by the strong inheritance pattern of a specific type of skeletal malocclusion, previous genome-wide association studies (GWAS) were reanalyzed, resulting in the identification of 19 skeletal class II malocclusion-associated and 53 skeletal class III malocclusion-associated genes. Functional enrichment of these genes created a signal pathway atlas in which most of the genes were associated with bone and cartilage growth and development, as expected, while some were characterized by functions related to skeletal muscle maturation and construction. Interestingly, several genes and enriched pathways are involved in both skeletal class II and III malocclusions, indicating the key regulatory effects of these genes and pathways in craniofacial development. There is no doubt that further investigation is necessary to validate these recognized genes’ and pathways’ specific function(s) related to maxillary and mandibular development. In summary, this systematic review provides initial insight on developing novel gene-based treatment strategies for skeletal malocclusions and paves the path for precision medicine where dental care providers can make an accurate prediction of the craniofacial growth of an individual patient based on his/her genetic profile.
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Changes in tongue-palatal contact during swallowing in patients with skeletal mandibular prognathism after orthognathic surgery. PLoS One 2021; 16:e0251759. [PMID: 34010318 PMCID: PMC8133420 DOI: 10.1371/journal.pone.0251759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/30/2021] [Indexed: 02/06/2023] Open
Abstract
This study aimed to evaluate improvement of tongue-palatal contact patterns during swallowing after orthognathic surgery in mandibular prognathism patients. Thirty patients with mandibular prognathism treated by orthognathic surgery (average age of 27 years, 3 months) and 10 controls (average age 29 years, 6 months) participated in this study. Tongue-palatal contact patterns of patients before and three months after surgery were evaluated by electropalatography (EPG) as well as controls. Whole total of tongue-palatal contact at 0.3, 0.2, and 0.1 sec before complete tongue-palatal contact during swallowing were evaluated. The duration of swallowing phases was also examined. Complete contact of tongue-tip in the alveolar part of individual artificial EPG plate were shown at 0.3, 0.2, and 0.1 sec before complete tongue-palatal contact in the controls, although incomplete contact in the alveolar part were shown at 0.3 sec in mandibular prognathism patients. Whole total of tongue-palatal contact at 0.3 and 0.2 sec before complete tongue-palatal contact was significantly lower in the patients before surgery than in the controls (p<0.05). However, these values increased after surgery. The duration of oral and pharyngeal phase was significantly longer in the patients before surgery than in the controls and the patients after surgery (p<0.01). This study demonstrated that the tongue-palatal contact pattern improved and the duration of oral and pharyngeal phase was shortened in mandibular prognathism patients during swallowing after orthognathic surgery. It is suggested that changes in maxillofacial morphology by orthognathic surgery can induce normal tongue movement during swallowing. (The data underlying this study have been uploaded to figshare and are accessible using the following DOI: https://doi.org/10.6084/m9.figshare.14101616.v1).
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Kurihara K, Fukui T, Sakaue K, Hori K, Ono T, Saito I. The effect of tongue thrusting on tongue pressure production during swallowing in adult anterior open bite cases. J Oral Rehabil 2019; 46:895-902. [PMID: 31081951 DOI: 10.1111/joor.12820] [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: 10/28/2018] [Revised: 04/24/2019] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Tongue thrusting, which often occurs during swallowing in patients with anterior open bite, is considered to show different tongue dynamics from healthy individuals, but the details are still unclear. OBJECTIVE This study aimed to identify the effect of tongue thrusting on tongue pressure production during swallowing in patients with anterior open bite. METHODS The subjects were 11 patients with an anterior open bite and 8 healthy volunteers with individual normal occlusion. The patients were divided into a tongue-thrusting group (n = 8) and a non-thrusting group (n = 3). Tongue pressures while swallowing jelly (4 mL) were recorded by a sensor sheet system with five measuring points (Chs1-5) attached to the palatal mucosa. The time sequences, maximum magnitude and duration of tongue pressure, and swallowing time of tongue pressure were analysed. RESULTS Tongue pressure waveforms in the tongue-thrusting group were quite diverse compared with the other two groups. The duration at the posterior-median part in the tongue-thrusting group was significantly shorter, and the maximum magnitudes at the mid-median, posterior-median and the peripheral part were also significantly lower than in the healthy group. These results suggest that the compensatory tongue thrust action by which the tongue closes the front part of the oral cavity may make it difficult to lift the tongue and transfer the bolus. CONCLUSION Patients with an anterior open bite and tongue thrusting at swallowing showed diversity of tongue pressure waveforms and noticeably weaker tongue pressures from mid-median to posterior-median regions than healthy individuals.
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Affiliation(s)
- Kanako Kurihara
- Division of Orthodontics, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Tadao Fukui
- Division of Orthodontics, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Kei Sakaue
- Division of Orthodontics, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Kazuhiro Hori
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Isao Saito
- Division of Orthodontics, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
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Barikroo A, Hegland K, Carnaby G, Bolser D, Manini T, Crary M. The Effects of Electrical Stimulation Pulse Duration on Lingual Palatal Pressure Measures During Swallowing in Healthy Older Adults. Dysphagia 2019; 34:529-539. [PMID: 30820657 DOI: 10.1007/s00455-019-09991-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 02/23/2019] [Indexed: 11/28/2022]
Abstract
Limited research in swallowing physiology has suggested that the most common existing transcutaneous electrical stimulation (TES) protocol (VitalStim) may not penetrate to layers of tissue to affect deep swallowing muscles. TES amplitude is the primary parameter that determines the depth of electrical current penetration (DECP). Preliminary work suggests that replacing a long-pulse duration with a short-pulse duration can increase maximum amplitude tolerance (MAT) within subjects' comfort level. Increasing MAT may indicate a higher DECP. The current study evaluates this premise in reference to the effects of varying pulse duration on lingual-palatal pressure during swallowing. Thirty healthy older adults (60-70 years of age) participated in this study. Each subject swallowed three trials of 10 mL pudding under three TES conditions: no stimulation, short-pulse duration, and long-pulse duration. TES was delivered using two pairs of surface electrodes on the submental muscles. MAT and perceived discomfort levels were identified separately for short and long-pulse TES conditions. Lingual-palatal peak pressure, pressure integral, and pressure duration were measured under each condition. Two-way repeated measures ANOVAs were conducted to identify within subject effects of TES condition and tongue bulb location. Lingual-palatal pressure and pressure integral were significantly reduced in the short-pulse duration condition. MAT was significantly higher in the short-pulse duration versus the long-pulse duration condition. Furthermore, MAT was significantly correlated with lingual-palatal pressure. Changing pulse duration had no significant impact on tongue pressure duration. Results suggest that a short-pulse duration may penetrate deeper into muscles involved in swallowing. The specific impact is reflected in a reduced upward pressure of the tongue on the palate during swallowing. This 'restrictive' effect of TES on tongue pressure may have the potential to be used during a resistive exercise paradigm for tongue elevation during swallowing.
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Affiliation(s)
- Ali Barikroo
- Speech Pathology and Audiology Program, Swallowing Physiology & Rehabilitation Research Laboratory, School of Health Sciences, Kent State University, PO Box 5190, Kent, OH, 44242-0001, USA.
| | - Karen Hegland
- Department of Speech, Language, and Hearing Sciences, Upper Airway Dysfunction Lab, Gainesville, FL, USA
| | - Giselle Carnaby
- Department of Communication Sciences and Disorders, Swallowing Research Laboratory, University of Central Florida, Orlando, USA
| | - Donald Bolser
- Department of Physiological Sciences, University of Florida, Gainesville, USA
| | - Todd Manini
- Institute on Aging and the Department of Aging and Geriatric Research, University of Florida, Gainesville, USA
| | - Michael Crary
- Department of Communication Sciences and Disorders, Swallowing Research Laboratory, University of Central Florida, Orlando, USA
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Vanderwegen J, Van Nuffelen G, Elen R, De Bodt M. The Influence of Age, Sex, Visual Feedback, Bulb Position, and the Order of Testing on Maximum Anterior and Posterior Tongue Strength in Healthy Belgian Children. Dysphagia 2019; 34:834-851. [DOI: 10.1007/s00455-019-09976-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 01/02/2019] [Indexed: 02/06/2023]
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