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Inamochi Y, Ogino Y, Harada K, Fueki K, Ayukawa Y, Nishimura M, Maekawa K, Kang Y, Hirai T, Kuboki T. DO ORAL CARE AND REHABILITATION IMPROVE COGNITIVE FUNCTION? A SYSTEMATIC REVIEW OF CLINICAL STUDIES. J Evid Based Dent Pract 2024; 24:101948. [PMID: 38448117 DOI: 10.1016/j.jebdp.2023.101948] [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: 02/15/2023] [Revised: 09/19/2023] [Accepted: 10/16/2023] [Indexed: 03/08/2024]
Abstract
OBJECTIVES An increasing number of studies have identified an association between oral health status and cognitive function. However, the effect of oral interventions, including oral health care, dental treatment and oral motor exercises, on cognitive function remains unclear. This systematic review examined whether oral interventions contribute to the long-term improvement of cognitive status. METHODS Four databases were searched (MEDLINE, Web of Science, Cochrane Library, and ICHUSHI Web) to identify randomized and nonrandomized controlled trial studies and prospective cohort studies from inception until 1 September 2023, published in English or Japanese. The Cochrane risk of bias tool for randomized controlled trials and the risk of bias assessment tool for nonrandomized studies were used to assess bias risk. RESULTS A total of 20 articles were included in the qualitative analysis; 13 articles were published in English, and 7 were published in Japanese. The implemented interventions were oral care in 8 studies, dental treatment in 8 studies, and oral motor exercise in 4 studies. One study found a significant effect on attention following oral care intervention. Some dental treatments influenced cognitive function, although a clear positive effect was not determined. In 1 study, attention and working memory improved in the chewing exercise group. CONCLUSIONS Several studies verified the improvement effects of oral interventions, such as oral care, dental treatment, and oral motor exercise, on cognitive function or impairment. However, there was still a lack of conclusive evidence that such an intervention clearly improved cognitive function. To clarify the effects of oral interventions on cognitive function, it is necessary to examine participants, interventions, and outcome measures in detail.
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Affiliation(s)
- Yuka Inamochi
- Department of Masticatory Function and Health Science, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Yoichiro Ogino
- Division of Oral Rehabilitation, Faculty of Dental Science, Section of Fixed Prosthodontics, Kyushu University, Fukuoka, Japan
| | - Kae Harada
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kenji Fueki
- Department of Masticatory Function and Health Science, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasunori Ayukawa
- Division of Oral Rehabilitation, Faculty of Dental Science, Section of Fixed Prosthodontics, Kyushu University, Fukuoka, Japan
| | - Masahiro Nishimura
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kenji Maekawa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Osaka, Japan
| | - Youngnam Kang
- Department of Behavioral Sciences, Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan
| | - Toshihiro Hirai
- Department of Dentistry, Removable Prosthodontics, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Takuo Kuboki
- Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Esmaeili A, Ebrahimpour S, Hefshejani KF, Esmaeili A. Molecular mechanisms underlying the effect of tooth shortening on memory dysfunction in Wistar male rat. Arch Oral Biol 2024; 159:105878. [PMID: 38171058 DOI: 10.1016/j.archoralbio.2023.105878] [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: 11/18/2023] [Revised: 12/15/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE We investigated the effects of molar tooth shortening on the mRNA expression of the AβPP/BACE1, BDNF/TrkB, and Bax/Bcl-2 signaling pathways in the Wistar male rat hippocampal regions. DESIGN Four groups (n = 5 per group) of male Wistar rats (control, SRM (shortened right molar), SLM (shortened left molar), and SBM (shortened bilateral molar)) were used. RNA was isolated from the hippocampus and transformed into cDNA. Real-time quantitative PCR was used to evaluate the mRNA expression levels of AβPP, BACE1, Bax, Bcl-2, BDNF, and TrkB. RESULTS Differential mRNA expression was observed in rat groups. SBM significantly upregulated the AβPP, BACE1, and Bax mRNA expressions, whereas the expression levels of Bcl-2, BDNF, and TrkB were decreased. SRM and SLM approximately had the same effect on the expression enhancement of AβPP, BACE1, and Bax; however, SRM was more effective than SLM in increasing the expression of these genes. CONCLUSIONS Symmetrical molar teeth shortening affected the mRNA expression of AβPP and BACE1, which is related to learning and memory dysfunction.
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Affiliation(s)
- Ali Esmaeili
- Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shiva Ebrahimpour
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | | | - Abolghasem Esmaeili
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran.
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Monaco A, Cattaneo R, Di Nicolantonio S, Strada M, Altamura S, Ortu E. Central effects of trigeminal electrical stimulation. Cranio 2023:1-24. [PMID: 38032105 DOI: 10.1080/08869634.2023.2280153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
This is a review of the literature on the main neuromodulation techniques, focusing on the possibility of introducing sensory threshold ULFTENS into them. Electro neuromodulation techniques have been in use for many years as promising methods of therapy for cognitive and emotional disorders. One of the most widely used forms of stimulation for orofacial pain is transcutaneous trigeminal stimulation on three levels: supraorbital area, dorsal surface of the tongue, and anterior skin area of the tragus. The purpose of this review is to trigger interest on using dental ULFTENS as an additional trigeminal neurostimulation and neuromodulation technique in the context of TMD. In particular, we point out the possibility of using ULFTENS at a lower activation level than that required to trigger a muscle contraction that is capable of triggering effects at the level of the autonomic nervous system, with extreme ease of execution and few side effects.
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Affiliation(s)
- Annalisa Monaco
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | - Ruggero Cattaneo
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | | | - Marco Strada
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | - Serena Altamura
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | - Eleonora Ortu
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
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O'Toole R, Watson D. Manual cervical therapy and vestibular migraine: A case series. HEALTH OPEN RESEARCH 2023; 5:12. [PMID: 38708034 PMCID: PMC11065132 DOI: 10.12688/healthopenres.13319.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 05/07/2024]
Abstract
Background Vestibular migraine (VM) is a relatively new diagnostic entity with incomplete knowledge regarding pathophysiological mechanisms and therapeutic guidelines. By reporting the effect of manual cervical therapy (MCT) on people with VM, we suggest a possible role for upper cervical afferents in VM treatment and/or pathogenesis. The objective was to describe the change in clinical presentation and self-reported symptoms of VM corresponding to MCT and followed up to six months. Methods A nonrandomised *ABA design was utilised to consecutively and prospectively evaluate selected patients with diagnosed VM. Symptom characteristics (frequency and intensity) were recorded along with standardised patient-reported outcomes (PROs) to document the response to MCT. Results Three patients were recruited who met the diagnostic criteria for VM. All three patients demonstrated improvement in both migraine attack and interictal symptom frequency. These improvements mirrored changes in PROs and were sustained over a six-month follow-up period. Conclusions The improvement that coincided with the intervention including MCT was rapid, observable and sustained. This suggests that the upper cervical spine could be a therapeutic target in VM and may have implications for future research into the pathogenesis of VM.
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Affiliation(s)
- Roger O'Toole
- Melbourne Headache Centre, Melbourne, Victoria, 3000, Australia
| | - Dean Watson
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Ebrahimpour S, Esmaeili A, Esmaeili A, Sattari K, Forouzandeh Hafshejani K. Molar tooth shortening induces learning and memory impairment in Wistar rat. Oral Dis 2023; 29:1356-1366. [PMID: 34862999 DOI: 10.1111/odi.14093] [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: 08/14/2021] [Revised: 10/26/2021] [Accepted: 11/28/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between different patterns of molar crown loss and the association between symmetrical and asymmetrical shortening molar teeth with memory impairment. MATERIALS AND METHODS Male Wistar rats were divided into four groups (n = 10) including control, SLM (shortened left molar), SRM (shortened right molar), and SBM (shortened bilateral molar) groups. Morris water maze (MWM) and passive avoidance test (PAT) were performed to assess spatial and fear memory, respectively. Besides, histological assessment of hippocampus and gingival tissues was done. RESULTS In the MWM test, SBM and SLM groups had higher escape latency over training trials and spent less time in the target quadrant in the probe trial (p < 0.01). In the PAT, step-through latency was significantly reduced in three groups, and time spent in the dark compartment increased in SBM (p < 0.01) and SLM (p < 0.05) groups. In addition, each teeth shortening group indicated a reduction in density (p < 0.01) and thickness layer (p < 0.05) of pyramidal cells. Gingival was normal after shortening of the molar crown. CONCLUSIONS Different patterns of molar teeth shortening induced learning and memory impairment; however, symmetrical molar teeth shortening has more effects on memory impairment.
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Affiliation(s)
- Shiva Ebrahimpour
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - Abolghasem Esmaeili
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - Ali Esmaeili
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kimiya Sattari
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Yamada Y, Hirabayashi R, Okada Y, Yokota H, Sekine C, Edama M. Effects of remote facilitation on ankle joint movement: Focusing on occlusal strength and balance. Health Sci Rep 2023; 6:e1098. [PMID: 36778778 PMCID: PMC9898801 DOI: 10.1002/hsr2.1098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023] Open
Abstract
Background Remote facilitation refers to teeth occlusion-activated spinal cord activity resulting in increased trunk and limb muscle strength. Facilitation depends on dentition-related pressure during occlusion and masticatory muscle contraction strength. Aims This study aimed to clarify the neurophysiological phenomenon and mechanisms by which occlusal strength and balance affect leg muscle activity and smooth joint movement execution. Materials & Methods To examine occlusal strength, three conditions were set: no contact between teeth and Moderate- and Maximum-strength occlusion (No-bite, Moderate, and Max conditions, respectively). To assess occlusal balance, we measured occlusal forces and calculated the left-right force ratio. We designated the sides with higher and lower occlusal pressure as hypertonic and hypotonic, respectively. We assessed ankle dorsiflexion movements with joint movement and isometric tasks. Results The rate of joint development and peak ankle dorsiflexion torque were significantly higher under occlusion (moderate and max compared to No-bite conditions), and the joint movement performance time was significantly shorter under Moderate compared to No-bite conditions. The joint movement execution time change rate from No-bite to Moderate condition was significantly lower on the Hypertonic side. Joint movement function was most improved under Moderate conditions. Discussion While remote facilitation improves with higher occlusal strength, leading to increased muscle strength, there is optimal occlusion intensity in joint movement. Moreover, an occlusal balance-dependent imbalance exists in remote facilitation between the Hyper- and Hypotonic sides. Conclusion Thus, low-intensity occlusion is optimal for smooth joint movement, and unbalanced occlusion results in asymmetrical motor function facilitation.
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Affiliation(s)
- Yuki Yamada
- Institute for Human Movement and Medical SciencesNiigata University of Health and WelfareNiigataJapan
| | - Ryo Hirabayashi
- Institute for Human Movement and Medical SciencesNiigata University of Health and WelfareNiigataJapan
| | - Yoshiyuki Okada
- Department of Special Care DentistryHiroshima UniversityHiroshimaJapan
| | - Hirotake Yokota
- Institute for Human Movement and Medical SciencesNiigata University of Health and WelfareNiigataJapan
| | - Chie Sekine
- Institute for Human Movement and Medical SciencesNiigata University of Health and WelfareNiigataJapan
| | - Mutsuaki Edama
- Institute for Human Movement and Medical SciencesNiigata University of Health and WelfareNiigataJapan
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Assessment of subjective and objective masticatory function among elderly individuals with mild cognitive impairment. Aging Clin Exp Res 2023; 35:107-115. [PMID: 36367631 PMCID: PMC9816292 DOI: 10.1007/s40520-022-02290-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/19/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Masticatory function is known to be related to cognitive ability; therefore, factors for improving masticatory function should be identified. AIMS This study aimed to identify factors influencing masticatory function associated with mild cognitive impairment (MCI) in elderly individuals. METHODS A total of 123 elderly participants [mean age: 76.5 ± 6.5 years; 82 females (66.7%), 41 males (33.3%)] were included. Cognitive function was evaluated by the Korean version of the Mini-Mental State Examination (KMMSE). Questionnaires for subjective evaluation were administered, and dynamic objective masticatory function evaluations, including chewing tests and bite force measurements, were performed. Intergroup differences were evaluated by the Wilcoxon rank-sum and chi-square test, and correlations between cognitive ability and masticatory function were evaluated by multilinear logistic regression. RESULTS The number of teeth, number of posterior teeth, bite force, masticatory ability index (MAI) and posterior support status showed significant differences between the normal (KMMSE > 23) and MCI (KMMSE ≤ 23) groups. However, only the MAI, representing dynamic masticatory performance, was significantly associated with MCI regardless of age, sex and removable prostheses. The number of teeth and posterior teeth, bite force, subjective masticatory ability and posterior occlusal support showed no significant association with MCI. DISCUSSION These results suggested the importance of chewing function for preventing the progression of cognitive impairment. CONCLUSIONS Considering that only the MAI was significantly associated with MCI, it is more important to improve chewing efficiency by harmonizing therapeutic prosthetics with the surrounding masticatory system than simply increasing the number of teeth to prevent or delay cognitive impairment in elderly individuals.
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Jockusch J, Hahnel S, Sobotta BBAJ, Nitschke I. The Effect of a Masticatory Muscle Training Program on Chewing Efficiency and Bite Force in People with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073778. [PMID: 35409460 PMCID: PMC8997984 DOI: 10.3390/ijerph19073778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 12/04/2022]
Abstract
Until now, no study has investigated the effects of masticatory muscle training on chewing function in people with dementia. This study aimed to investigate whether physiotherapeutic exercises for the masticatory muscles have an influence on chewing efficiency and bite force in people with dementia. In a clinical trial with stratified randomization subjects were assigned to three groups based on the Mini Mental State Examination (MMSE: group 1—28–30, group 2—25–27, group 3—18–24). Each group was divided into an experimental (ExpG, intervention) and control group (ConG, no intervention). As intervention a Masticatory Muscle Training (MaMuT) (part 1: three physiotherapeutic treatments and daily home exercises, part 2: daily home exercises only) was carried out. Chewing efficiency and bite force were recorded. The MaMuT influenced the masticatory performance regardless of the cognitive state. Bite force increased in ExpG 1 and 2. Without further training, however, the effect disappeared. Chewing efficiency increased in all ExpG. After completion of the training, the ExpG 2 and 3 showed a decrease to initial values. Subjects of ExpG 1 showed a training effect at the final examination, but a tendency toward the initial values was observed. ExpG 3 seemed to benefit most from the physiotherapeutic exercises in terms of improving chewing efficiency by the end of the intervention phase. ExpG 1 showed the greatest gain in bite force. The MaMuT program is a potential method of improving masticatory performance in people with cognitive impairment or dementia when used on a daily basis.
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Affiliation(s)
- Julia Jockusch
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Andreasstrasse 15/Box 2, 8050 Zurich, Switzerland
- Correspondence: or
| | - Sebastian Hahnel
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
| | - Bernhard B. A. J. Sobotta
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
| | - Ina Nitschke
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103 Leipzig, Germany; (S.H.); (B.B.A.J.S.); (I.N.)
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
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Tramonti Fantozzi MP, De Cicco V, De Cicco D, d'Ascanio P, Cataldo E, Bruschini L, Faraguna U, Manzoni D. Chewing and Cognitive Improvement: The Side Matters. Front Syst Neurosci 2022; 15:749444. [PMID: 35002642 PMCID: PMC8734061 DOI: 10.3389/fnsys.2021.749444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/24/2021] [Indexed: 11/13/2022] Open
Abstract
Chewing improves cognitive performance, which is impaired in subjects showing an asymmetry in electromyographic (EMG) masseter activity during clenching. In these subjects, the simultaneous presence of an asymmetry in pupil size (anisocoria) at rest indicates an imbalance in Ascending Reticular Activating System (ARAS) influencing arousal and pupil size. The aim of the present study was to verify whether a trigeminal EMG asymmetry may bias the stimulating effect of chewing on cognition. Cognitive performance and pupil size at rest were recorded before and after 1 min of unilateral chewing in 20 subjects with anisocoria, showing an EMG asymmetry during clenching. Unilateral chewing stimulated performance mainly when it occurred on the side of lower EMG activity (and smaller pupil size). Following chewing on the hypotonic side, changes in cognitive performance were negatively and positively correlated with those in anisocoria and pupil size, respectively. We propose that, following chewing on the hypotonic side, the arousing effects of trigeminal stimulation on performance are enhanced by a rebalancing of ARAS structures. At variance, following chewing on the hypertonic side, the arousing effect of trigeminal stimulation could be partially or completely prevented by the simultaneous increase in ARAS imbalance.
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Affiliation(s)
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Paola d'Ascanio
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | | | - Luca Bruschini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.,Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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Coupling between Trigeminal-Induced Asymmetries in Locus Coeruleus Activity and Cognitive Performance. Symmetry (Basel) 2021. [DOI: 10.3390/sym13091676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In humans, the asymmetry in the masseter electromyographic (EMG) activity during clenching is positively correlated with the degree of pupil size asymmetry (anisocoria) at rest. Anisocoria reveals an asymmetry in LC activity, which may lead to an imbalance in cortical excitability, detrimental to performance. Hereby, we investigated, in individual subjects, the possibility that occlusal correction, which decreases EMG asymmetry, improves performance by balancing LC activity. Cognitive performance, task-related mydriasis, and pupil size at rest were modified by changing the occlusal condition. Occlusal-related changes in performance and mydriasis were negatively correlated with anisocoria changes in only 12/20 subjects. Within this population, spontaneous fluctuations in mydriasis and anisocoria also appeared negatively coupled. Occlusal-related changes in performance and mydriasis were negatively correlated with those in average pupil size (a proxy of average LC activity) in 19/20 subjects. The strongest association was observed for the pupil changes occurring on the side with higher EMG activity during clenching. These findings indicate that the effects of occlusal conditions on cognitive performance were coupled to changes in the asymmetry of LC activity in about half of the subjects, while they were related to changes in the average tonic LC activity in virtually all of them.
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De Cicco D, Tartaro G, Ciardiello F, Fasano M, Rauso R, Fiore F, Spuntarelli C, Troiano A, Lo Giudice G, Colella G. Health-Related Quality of Life in Oral Cancer Patients: Scoping Review and Critical Appraisal of Investigated Determinants. Cancers (Basel) 2021; 13:cancers13174398. [PMID: 34503208 PMCID: PMC8431462 DOI: 10.3390/cancers13174398] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 12/27/2022] Open
Abstract
Simple Summary Oral cancer may strongly impair patients’ quality of life. Huge efforts have been made during recent decades in trying to improve the treatment outcomes in terms of patients’ survival, self-perception, and satisfaction. Consequently, the investigation into health-related quality of life (HRQOL) became an established and worldwide practice. Hundreds of studies tried to clarify which could be the most important variables that impact HRQOL in head and neck cancer patients. However, such a complex topic may be influenced by a multitude of interconnected aspects and several controversies were reported. In this study the current literature was reviewed to identify all those possible sources of bias that may be encountered in trying to correlate HRQOL to patient-specific or disease/treatment-specific aspects. As a result, a list of recommendations was reported to enhance the evidence of future studies. Abstract Background: health-related quality of life (HRQOL) represents a secondary endpoint of medical interventions in oncological patients. Our aim was to highlight potential sources of bias that could be encountered when evaluating HRQOL in oral cancer patients. Methods: this review followed PRISMA-ScR recommendations. Participants: patients treated for oral cancer. Concept: HRQOL assessed by EORTC QLQ-C30 and QLQ-H&N35/QLQ-H&N43. A critical appraisal of included studies was performed to evaluate the accuracy of data stratification with respect to HRQOL determinants. Results: overall, 30 studies met the inclusion criteria, totaling 1833 patients. In total, 8 sociodemographic (SDG) and 15 disease/treatment-specific (DT) HRQOL determinants (independent variables) were identified. The mean number of the independent variables was 6.1 (SD, 4.3)—5.0 (SD, 4.0) DT-related and 1.1 (SD, 1.8) SDG-related variables per article. None of the included papers considered all the identified determinants simultaneously. Conclusions: a substantial lack of evidence regarding HRQOL determinants was demonstrated. This strongly weakens the reliability of the reported findings due to the challenging presence of baseline confounding, selection, and omitted variable biases. The proposed approach recommends the use of further evaluation tools that gather more variables in a single score together with a selection of more homogeneous, reproducible, and comparable cohorts based on the identified baseline confounding.
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Affiliation(s)
- Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
| | - Gianpaolo Tartaro
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (R.R.); (G.C.)
| | - Fortunato Ciardiello
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.C.); (M.F.)
| | - Morena Fasano
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.C.); (M.F.)
| | - Raffaele Rauso
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (R.R.); (G.C.)
| | - Francesca Fiore
- Department of Internal and Polyspecialist Medicine, A.O.U. “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Chiara Spuntarelli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
| | - Antonio Troiano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
- Correspondence:
| | - Giorgio Lo Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
| | - Giuseppe Colella
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (R.R.); (G.C.)
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Bagis N, Kurt MH, Evli C, Camgoz M, Atakan C, Peker Ozturk H, Orhan K. Evaluation of a metal artifact reduction algorithm and an adaptive image noise optimization filter in the estimation of peri-implant fenestration defects using cone beam computed tomography: an in-vitro study. Oral Radiol 2021; 38:325-335. [PMID: 34387842 DOI: 10.1007/s11282-021-00561-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study is to assess the effects of metal artifact reduction (MAR) and adaptive image noise enhancer (AINO) in CBCT imaging on the detection accuracy of artificially created fenestration defects in proximity to titanium and zirconium implants in sheep jaw. METHODS Six zirconium and 10 titanium implants were planted on mandibular jaws of three sheep, and artificial defects were created. All images were obtained with a standard voxel size (0.150 mm3) and with 4 scan modes: (1) without MAR/without AINO; (2) with MAR/without AINO; (3) without MAR/with AINO; and (4) with MAR/with AINO during CBCT scanning. A total of 60 CBCT scans were produced. RESULTS For all types of implants, intra- and inter-observer kappa values were the highest for MAR filter. The scan mode of with MAR filter was found to have the highest area under the curve (AUC), whereas the scan mode of without both MAR and AINO filters was found to have the lowest AUC values with statistical significance (p ≤ 0.05). Titanium implants were found to have higher AUC values than zirconium (p ≤ 0.05). CONCLUSION Both MAR module and AINO filters enhance the accuracy of the detection of peri-implant fenestrations; however, the use of MAR filter solely can be recommended for detection of peri-implant fenestrations.
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Affiliation(s)
- Nilsun Bagis
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Mehmet Hakan Kurt
- Department of Dentoaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Cengiz Evli
- Department of Dentoaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Melike Camgoz
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Cemal Atakan
- Department of Statistics, Faculty of Science, Ankara University, Ankara, Turkey
| | - Hilal Peker Ozturk
- Department of Dentomaxillofacial Radiology, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Kaan Orhan
- Department of Dentoaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.,Ankara University Medical Design Application and Research Center (MEDITAM), Ankara, Turkey
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13
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Brighenti T, Malerba M, Cozzini T, Marcon A, Vedovi E, Nocini R, Formentini D, Pedrotti E, Nocini PF. Effects of oral function on pupil response: a new view on bruxism pathophysiology. Minerva Dent Oral Sci 2021; 70:233-238. [PMID: 33908745 DOI: 10.23736/s2724-6329.21.04506-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND There are increasing evidences of the influence of the oropharyngeal stimulations on the autonomic nervous system and an easy approach to evaluate the balance between parasympathetic and sympathetic system is the measurement of the pupil diameter. The aim of this analytic observational study is to define the effects of clenching and swallowing on pupil diameter, and how an oral appliance can affect the outcome of these tasks, to establish their influence on the sympathetic-parasympathetic balance. METHODS We measured the pupil diameter in 30 healthy subjects during clenching and swallowing, both with and without oral appliance. We compared the results with the mandibular rest position. The respective positions with and without oral appliance were also compared. RESULTS Pupillometry showed a mydriatic effect of swallowing (rest=6.94 mm, swallowing=7.26 mm, p=0.04) and oral appliance, more relevant in scotopic conditions. On the contrary, clenching seemed to enhance miosis, especially in intense brightness condition (rest=3.95 mm, clenching=3.83 mm, p=0.02). CONCLUSIONS Swallowing and oral appliance facilitate the sympathetic system, while clenching activates the parasympathetic branch. We argue that probably the locus coeruleus is the main hub. These results could have practical implications in bruxism physiology, because it could be an attempt to counteract the activation of the sympathetic system.
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Affiliation(s)
- Tommaso Brighenti
- Department of Neuroscience, Biomedicine and Movement Sciences, Eye Clinic, University of Verona, Verona, Italy -
| | - Mauro Malerba
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona, Italy
| | - Tiziano Cozzini
- Department of Neuroscience, Biomedicine and Movement Sciences, Eye Clinic, University of Verona, Verona, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Ermes Vedovi
- UOC Rehabilitation, Department of Neuroscience, Verona University Hospital, Verona, Italy
| | - Riccardo Nocini
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Verona, Verona, Italy
| | - Daniele Formentini
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona, Italy
| | - Emilio Pedrotti
- Department of Neuroscience, Biomedicine and Movement Sciences, Eye Clinic, University of Verona, Verona, Italy
| | - Pier Francesco Nocini
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona, Italy
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14
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Popovac A, Mladenović I, Krunić J, Trifković B, Todorović A, Milašin J, Despotović N, Stančić I. Apolipoprotein ɛ4 Allele and Dental Occlusion Deficiency as Risk Factors for Alzheimer's Disease. J Alzheimers Dis 2021; 74:797-802. [PMID: 32116259 DOI: 10.3233/jad-191283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Compromised dentition has been suggested to pose a significant risk factor for dementia. It was mainly investigated through insufficient tooth number, disregarding contact between opposing teeth (dental occlusion). The ɛ4 allele of apolipoprotein (APOE4) is the primary genetic marker for the late onset of Alzheimer's disease (AD). However, APOE4 and dental occlusion have not yet been investigated as possible associated risk factors for AD. The study was aimed to examine the impact of dental status and different APOE gene variants on AD occurrence. Secondly, sociodemographic variables were investigated as factors potentially associated with AD. The case-control study included two groups: 116 patients with AD (according to the NINDS-ADRDA criteria) and 63 controls (Mini-Mental State Examination scores ≥24). The analysis of APOE gene polymorphism was conducted through PCR reaction. Dental examination included recording of number of teeth, presence of fixed or removable dentures, and number of functional tooth units (FTU). Regression analysis was used to investigate the joint effect of the clinical and genetic variables on AD. Results showed that patients with AD were more often carriers of ɛ3/ɛ4 genotype and ɛ4 allele, had lower number of teeth and FTU, and were less likely to be married, live in home, and had less chronic diseases, compared to the controls. Regression analysis showed that presence of APOE4 allele and the number of total FTU remained associated with AD, even when adjusted for age, sex, and level of education. In conclusion, deficient dental occlusion and presence of APOE4 may independently increase risk for AD.
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Affiliation(s)
- Aleksandra Popovac
- Department for Prosthetic Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Irena Mladenović
- Department of Oral Rehabilitation, Faculty of Medicine, University of East Sarajevo, Foča, Bosnia and Herzegovina
| | - Jelena Krunić
- Department of Dental Pathology, Faculty of Medicine, University of East Sarajevo, Foča, Bosnia and Herzegovina
| | - Branka Trifković
- Department for Prosthetic Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ana Todorović
- Department for Prosthetic Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Milašin
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Nebojša Despotović
- Department of Geriatric Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivica Stančić
- Department for Prosthetic Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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15
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Tramonti Fantozzi MP, Lazzarini G, De Cicco V, Briganti A, Argento S, De Cicco D, Barresi M, Cataldo E, Bruschini L, d'Ascanio P, Pirone A, Lenzi C, Vannozzi I, Miragliotta V, Faraguna U, Manzoni D. The path from trigeminal asymmetry to cognitive impairment: a behavioral and molecular study. Sci Rep 2021; 11:4744. [PMID: 33637775 PMCID: PMC7910455 DOI: 10.1038/s41598-021-82265-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/15/2021] [Indexed: 01/02/2023] Open
Abstract
Trigeminal input exerts acute and chronic effects on the brain, modulating cognitive functions. Here, new data from humans and animals suggest that these effects are caused by trigeminal influences on the Locus Coeruleus (LC). In humans subjects clenching with masseter asymmetric activity, occlusal correction improved cognition, alongside with reductions in pupil size and anisocoria, proxies of LC activity and asymmetry, respectively. Notably, reductions in pupil size at rest on the hypertonic side predicted cognitive improvements. In adult rats, a distal unilateral section of the trigeminal mandibular branch reduced, on the contralateral side, the expression of c-Fos (brainstem) and BDNF (brainstem, hippocampus, frontal cortex). This counterintuitive finding can be explained by the following model: teeth contact perception loss on the lesioned side results in an increased occlusal effort, which enhances afferent inputs from muscle spindles and posterior periodontal receptors, spared by the distal lesion. Such effort leads to a reduced engagement of the intact side, with a corresponding reduction in the afferent inputs to the LC and in c-Fos and BDNF gene expression. In conclusion, acute effects of malocclusion on performance seem mediated by the LC, which could also contribute to the chronic trophic dysfunction induced by loss of trigeminal input.
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Affiliation(s)
- Maria Paola Tramonti Fantozzi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
| | - Giulia Lazzarini
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
| | - Angela Briganti
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Serena Argento
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
| | - Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Massimo Barresi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
| | | | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and CriticalCare Medicine, University of Pisa, Pisa, Italy
| | - Paola d'Ascanio
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
| | - Andrea Pirone
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Carla Lenzi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Iacopo Vannozzi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | | | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy.
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16
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Tramonti Fantozzi MP, Artoni F, Di Galante M, Briscese L, De Cicco V, Bruschini L, d'Ascanio P, Manzoni D, Faraguna U, Carboncini MC. Effect of the Trigeminal Nerve Stimulation on Auditory Event-Related Potentials. Cereb Cortex Commun 2021; 2:tgab012. [PMID: 34296158 PMCID: PMC8153017 DOI: 10.1093/texcom/tgab012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 11/25/2022] Open
Abstract
Trigeminal sensorimotor activity stimulates arousal and cognitive performance, likely through activation of the locus coeruleus (LC). In this study we investigated, in normal subjects, the effects of bilateral trigeminal nerve stimulation (TNS) on the LC-dependent P300 wave, elicited by an acoustic oddball paradigm. Pupil size, a proxy of LC activity, and electroencephalographic power changes were also investigated. Before TNS/sham-TNS, pupil size did not correlate with P300 amplitude across subjects. After TNS but not sham-TNS, a positive correlation emerged between P300 amplitude and pupil size within frontal and median cortical regions. TNS also reduced P300 amplitude in several cortical areas. In both groups, before and after TNS/sham-TNS, subjects correctly indicated all the target stimuli. We propose that TNS activates LC, increasing the cortical norepinephrine release and the dependence of the P300 upon basal LC activity. Enhancing the signal-to-noise ratio of cortical neurons, norepinephrine may improve the sensory processing, allowing the subject to reach the best discriminative performance with a lower level of neural activation (i.e., a lower P300 amplitude). The study suggests that TNS could be used for improving cognitive performance in patients affected by cognitive disorders or arousal dysfunctions.
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Affiliation(s)
- Maria Paola Tramonti Fantozzi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Fiorenzo Artoni
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Genève 1202, Switzerland
| | | | - Lucia Briscese
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa 56123, Italy
| | - Paola d'Ascanio
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Maria Chiara Carboncini
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
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17
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Lopez-Chaichio L, Padial-Molina M, O'Valle F, Gil-Montoya JA, Catena A, Galindo-Moreno P. Oral health and healthy chewing for healthy cognitive ageing: A comprehensive narrative review. Gerodontology 2020; 38:126-135. [PMID: 33179281 DOI: 10.1111/ger.12510] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 09/11/2020] [Accepted: 10/24/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Ageing leads to physiological cognitive decline that it is worsened in people with neurodegenerative diseases such as Alzheimer's disease. Despite the ongoing search for a solution to this cognitive decline, no effective remedies have been established. It has been determined that modifiable external factors, such as oral health and occlusal function, prevent cognitive decline. OBJECTIVE To analyse the primary interactions between occlusal function and cognitive functions. MAIN FINDINGS Masticatory function is related to cognitive functions. In particular, current evidence, from both animal and human studies, suggests that the activation of masticatory muscles and proper mastication, with natural teeth or dental prosthesis, induces the release of several mediators and the activation of specific brain areas. Together, they result in higher neuronal activity, neurotrophic support, blood flow and the prevention of amyloid-beta plaque formation. Thus, all the components of the masticatory system must work together in order to preserve cognitive function. CONCLUSIONS Available evidence suggests that oral and cognitive health are more interconnected than previously thought. Therefore, maintenance and adequate restoration of the whole masticatory system are important for the prevention of cognitive decline. In summary, oral and chewing health lead to healthy cognitive ageing.
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Affiliation(s)
- Lucia Lopez-Chaichio
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Francisco O'Valle
- Department of Pathology and IBIMER, School of Medicine, University of Granada, Granada, Spain.,Biosanitary Institute of Granada (ibs.Granada), University of Granada, Granada, Spain
| | - Jose Antonio Gil-Montoya
- Biosanitary Institute of Granada (ibs.Granada), University of Granada, Granada, Spain.,Department of Gerodontology, School of Dentistry, University of Granada, Granada, Spain
| | - Andres Catena
- Mind, Brain and Behavior Research Center, University of Granada, Granada, Spain
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
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18
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Trigeminal input, pupil size and cognitive performance: From oral to brain matter. Brain Res 2020; 1751:147194. [PMID: 33159973 DOI: 10.1016/j.brainres.2020.147194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/14/2020] [Accepted: 10/30/2020] [Indexed: 12/19/2022]
Abstract
It has been observed that, in patients affected by temporomandibular disorders (TMDs) and edentulism, a left-right asymmetry in electromyographic (EMG) activity of masseter muscles during clenching and in pupil size at rest (anisocoria) is present. Both are greatly reduced by an orthotic-prosthetic correction. In parallel, the correction significantly improves cognitive performance. These effects are possibly due to the recovery of a cortical balance, via Locus Coeruleus (LC) modulation, whose activity is powerfully affected by the sensorimotor trigeminal input. The role of this functional axis was further investigated in subjects without overt occlusal or dental problems. In these individuals, the EMG asymmetry was significantly correlated to anisocoria at rest, with the dental arches open or in contact. Also in normal subjects, both the EMG and the pupil asymmetry during clenching could be significantly reduced by an orthotic (bite) correction. Closing the arches without bite increased anisocoria and reduced performance in the Spinnler-Tognoni matrices test, as well as the mydriasis induced by a haptic task. When the bite was interposed, anisocoria was reduced, while both performance and task-related mydriasis were enhanced. Since pupil size is considered a proxy of the LC activity, these results suggest that asymmetric occlusion biases the LC discharge and the hemispheric excitability, possibly via a sensorimotor trigeminal imbalance. Removing the anisocoria through bite correction re-establishes a symmetric LC discharge, improving performance and enhancing task-related mydriasis. Therefore, occlusal balancing may represent a tool for improving subjective performance and may be exploited for training and rehabilitative purposes.
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19
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Tan D, Foster S, Korgaonkar MS, Oxenham V, Whittle T, Klineberg I. The role of progressive oral implant rehabilitation in mastication, cognition and oral health‐related quality of life outcomes—A pilot to define the protocol. J Oral Rehabil 2020; 47:1368-1381. [DOI: 10.1111/joor.13085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Daniel Tan
- Department of Oral Rehabilitation School of Dentistry Faculty of Medicine and Health University of Sydney Sydney Australia
| | - Sheryl Foster
- School of Health Sciences Faculty of Medicine and Health University of Sydney Sydney Australia
- Radiology Department Westmead Hospital Sydney Australia
| | - Mayuresh S. Korgaonkar
- School of Health Sciences Faculty of Medicine and Health University of Sydney Sydney Australia
- Brain Dynamics Centre Westmead Institute for Medical Research, University of Sydney Sydney Australia
| | - Vincent Oxenham
- Department of Psychology Faculty of Medicine, Health and Human Sciences Macquarie University Sydney Australia
| | - Terry Whittle
- Department of Oral Rehabilitation School of Dentistry Faculty of Medicine and Health University of Sydney Sydney Australia
| | - Iven Klineberg
- Department of Oral Rehabilitation School of Dentistry Faculty of Medicine and Health University of Sydney Sydney Australia
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20
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Abstract
Dementia is a major contributor to dependence and disability in older people, with aging societies characterized by growing numbers of people living with the condition. Dementia rates are highest in those with low education early in life, midlife hypertension, midlife hearing loss, depression, obesity, loneliness, a sedentary lifestyle, or sustained exposure to smoking or diabetes. Tooth loss is a putative risk factor for dementia which has received increasing research attention, but systematic review findings are mixed. Three main mechanisms have been proposed, involving 1) tooth loss leading to compromised nutrition and then leading to poorer central nervous system (CNS) function; 2) tooth loss resulting in fewer interocclusal contacts and so less somatosensory feedback to the CNS, leading to impaired cognition; and (3) chronic periodontitis resulting in tooth loss, but not before the inflammation has affected the CNS, impairing cognition. None of these is supported by compelling empirical evidence. Here, we use the life course approach to propose a plausible, empirically supported explanation for the associations between missing teeth and poorer cognitive function in older people. Evidence from longstanding cohort studies demonstrates that the putative association arises from cognitive function much earlier in life, in childhood. People with better childhood cognitive function have better oral health and access to routine dental care as they go through life, losing fewer teeth along the life course. They are also much more likely to have better cognitive function in old age. Their less cognitively able childhood counterparts will experience higher disease rates and poorer access to care, resulting in greater incremental tooth loss. Comparison of the 2 groups at any age from the mid-20s on will show greater numbers of missing teeth in the group who were less cognitively able in childhood. Those differences will be most pronounced in old age.
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Affiliation(s)
- W M Thomson
- Department of Oral Sciences, Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Y Barak
- Department of Psychological Medicine, Dunedin School of Medicine, The University of Otago, Dunedin, New Zealand
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21
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Saikia UP, Chander NG, Balasubramanian M. Effect of fixed dental prosthesis on the brain functions of partially edentulous patients - pilot study with power spectrum density analysis. Eur Oral Res 2020; 54:114-118. [PMID: 33543115 PMCID: PMC7837703 DOI: 10.26650/eor.20200032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: This study was done to analyse the influence of fixed dental prosthesis (FDP) on
brain function by analysing power spectral density of partially edentulous patients. Materials and methods: The study included unilateral missing mandibular molar replacement patients. The
patients were restored with three-unit metal ceramic FDP restorations. The cognitive
function was analysed with a mental state questionnaire. Power spectral density
(PSD) analysis of EEG alpha waves was made pre- treatment, post treatment and 3
months after FDP treatment to analyse the brain function. The data in various phases
were obtained before and after chewing. The results were statistically analysed. Results: The mean pre and post treatment PSD was 0.0175 (SD ±0.0132) and 0.0178 (SD
±0.0135). The mean post treatment PSD after three months was 0.024 (SD± 0.019).
The results were analysed with repeated ANOVA and were statistically significant.
(p<0.01). Conclusion: The study displayed improvement in brain function of partially edentulous patients
with FDP rehabilitation.
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Affiliation(s)
| | - N Gopi Chander
- Department of Prosthodontics, SRM Dental College, Ramapuram, Chennai, Tamilnadu,India
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22
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Ki S, Yun J, Kim J, Lee Y. Association Between Dental Implants and Cognitive Function in Community-dwelling Older Adults in Korea. J Prev Med Public Health 2019; 52:333-343. [PMID: 31588703 PMCID: PMC6780296 DOI: 10.3961/jpmph.19.163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 09/10/2019] [Indexed: 12/30/2022] Open
Abstract
Objectives This study aimed to evaluate the association between dental implants and cognitive function in community-dwelling older adults. Methods Data were collected from the baseline survey (2016-2017) of the Korean Frailty and Aging Cohort Study. The study sample comprised 1115 community-dwelling people aged 70 years to 84 years who had 0-19 natural teeth. Dental implants and natural teeth were identified by panoramic radiography, while the cognitive function was assessed by the Korean version of the Mini-Mental State Examination (MMSE-KC). The association between dental implants and cognitive function was analyzed by multiple linear regression. Sensitivity analysis was performed to test for potential bias. Results The mean number of natural teeth in the study population was 9.50 (standard deviation [SD], 6.42), and the mean MMSE-KC score was 24.93 (SD, 3.55). In the simple univariate analysis, tooth replacement, age, sex, smoking status, alcohol consumption, body mass index, osteoporosis, number of natural teeth, periodontitis, chewing discomfort, tooth-brushing frequency, education level, monthly household income, participation in economic activity, living alone, and marital status had a significant impact on the association. After adjusting for confounders, the association between dental implants and cognitive function remained significant (B, 0.85; standard error, 0.40; p<0.05). Age, body mass index, periodontitis, tooth-brushing frequency, and education level were also significantly associated with cognitive function. The results of the sensitivity analyses were consistent with those of the primary analysis. Conclusions Dental implants were associated with cognitive function in older adults living in the community. Dental implants as tooth replacements may play a role in preserving cognitive function.
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Affiliation(s)
- Seungkook Ki
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Jihye Yun
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Jinhee Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.,Institute on Aging, Ajou University Medical Center, Suwon, Korea
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23
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Tramonti Fantozzi MP, Diciotti S, Tessa C, Castagna B, Chiesa D, Barresi M, Ravenna G, Faraguna U, Vignali C, De Cicco V, Manzoni D. Unbalanced Occlusion Modifies the Pattern of Brain Activity During Execution of a Finger to Thumb Motor Task. Front Neurosci 2019; 13:499. [PMID: 31156377 PMCID: PMC6533560 DOI: 10.3389/fnins.2019.00499] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 04/30/2019] [Indexed: 12/20/2022] Open
Abstract
In order to assess possible influences of occlusion on motor performance, we studied by functional magnetic resonance imaging (fMRI) the changes in the blood oxygenation level dependent (BOLD) signal induced at brain level by a finger to thumb motor task in a population of subjects characterized by an asymmetric activation of jaw muscles during clenching (malocclusion). In these subjects, appropriate occlusal correction by an oral orthotic (bite) reduced the masticatory asymmetry. The finger to thumb task was performed while the subject's dental arches were touching, in two conditions: (a) with the teeth in direct contact (Bite OFF) and (b) with the bite interposed between the arches (Bite ON). Both conditions required only a very slight activation of masticatory muscles. Maps of the BOLD signal recorded during the movement were contrasted with the resting condition (activation maps). Between conditions comparison of the activation maps (Bite OFF/Bite ON) showed that, in Bite OFF, the BOLD signal was significantly higher in the trigeminal sensorimotor region, the premotor cortex, the cerebellum, the inferior temporal and occipital cortex, the calcarine cortex, the precuneus on both sides, as well as in the right posterior cingulate cortex. These data are consistent with the hypothesis that malocclusion makes movement performance more difficult, leading to a stronger activation of (a) sensorimotor areas not dealing with the control of the involved body part, (b) regions planning the motor sequence, and (c) the cerebellum, which is essential in motor coordination. Moreover, the findings of a higher activation of temporo-occipital cortex and precuneus/cingulus, respectively, suggest that, during malocclusion, the movement occurs with an increased visual imagery activity, and requires a stronger attentive effort.
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Affiliation(s)
| | - Stefano Diciotti
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi," University of Bologna, Cesena, Italy
| | - Carlo Tessa
- Department of Radiology, Versilia Hospital, Azienda USL Toscana Nord Ovest, Camaiore, Italy
| | | | - Daniele Chiesa
- Department of Orthopedics, University of Genoa, Genoa, Italy
| | - Massimo Barresi
- Institut des Maladies Neurodégénératives, Université de Bordeaux, Bordeaux, France
| | - Giulio Ravenna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.,Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Claudio Vignali
- Department of Radiology, Versilia Hospital, Azienda USL Toscana Nord Ovest, Camaiore, Italy
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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Kato H, Takahashi Y, Iseki C, Igari R, Sato H, Sato H, Koyama S, Tobita M, Kawanami T, Iino M, Ishizawa K, Kato T. Tooth Loss-associated Cognitive Impairment in the Elderly: A Community-based Study in Japan. Intern Med 2019; 58:1411-1416. [PMID: 30626824 PMCID: PMC6548929 DOI: 10.2169/internalmedicine.1896-18] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective Dementia is a major cause of disruption for a healthy life expectancy in Japan. It has been suggested that the number of teeth is a modifiable risk factor for cognitive impairment and dementia. We therefore examined the possible association between the cognitive function and the number of natural and artificial teeth in community-dwelling Japanese elderly individuals. Methods Among the participants in our prospective, community-based study, 210 elderly individuals (103 men and 107 women; 78.1±4.9 years; mean age±standard deviation) underwent both dental examinations and a Mini-Mental State Examination (MMSE), as well as various medical checkups, in 2016 and 2017. Results The number of natural teeth was significantly associated with an individual's MMSE score. The percentage of cognitively normal subjects (MMSE scores: 27-30) decreased significantly with a decrease in the number of natural teeth. Among the MMSE items, the calculation ability was significantly and independently associated with the number of natural teeth. Regression was calculated as the predicted score of MMSE =21+0.3× (years of schooling) +0.1× (number of natural teeth). Among individuals with 19 or fewer natural teeth, those who had a total of 20 teeth or more, including both natural and artificial teeth, had significantly higher MMSE scores than those who had 19 or fewer natural and artificial teeth combined. Conclusion The number of natural teeth was significantly associated with the cognitive function, especially the calculation ability, and the use of artificial teeth was associated with the preservation of the cognitive function in community-dwelling elderly individuals.
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Affiliation(s)
- Hajime Kato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Yamagata University Faculty of Medicine, Japan
- National Hospital Organization Yonezawa Hospital, Japan
| | - Yoshimi Takahashi
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Chifumi Iseki
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Ryosuke Igari
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Hidenori Sato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Hiroyasu Sato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Shingo Koyama
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | | | - Toru Kawanami
- National Hospital Organization Yamagata Hospital, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Yamagata University Faculty of Medicine, Japan
| | - Kenichi Ishizawa
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
| | - Takeo Kato
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan
- Yamagata City Office, Japan
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25
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Weijenberg RAF, Delwel S, Ho BV, van der Maarel-Wierink CD, Lobbezoo F. Mind your teeth-The relationship between mastication and cognition. Gerodontology 2018; 36:2-7. [PMID: 30480331 PMCID: PMC7380285 DOI: 10.1111/ger.12380] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 10/08/2018] [Accepted: 10/20/2018] [Indexed: 12/22/2022]
Abstract
This article explores the multifactorial relationship between mastication and cognition, with a focus on dementia. Older persons, especially those with dementia, are at great risk of suffering from oral health problems such as orofacial pain and loss of natural teeth. A possible explanation could be that the cognitive and motor impairments resulting from dementia cause a decrease in self‐care and as such, a worsening of oral health. An alternative explanation is that cognition and oral health influence each other. Animal studies show that a decrease in masticatory activity, for example, due to a soft diet or loss of teeth, causes memory loss and neuronal degeneration. The relationship between mastication and cognition has also been researched in human studies, but a cause‐effect relationship has not been proven. It is likely that multiple factors play a role in this relationship, such as self‐care, nutrition, stress and pain.
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Affiliation(s)
- Roxane A F Weijenberg
- Oral Kinesiology, Academisch Centrum Tandheelkunde Amsterdam, Amsterdam, The Netherlands
| | - Suzanne Delwel
- Oral Kinesiology, Academisch Centrum Tandheelkunde Amsterdam, Amsterdam, The Netherlands.,Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bach Van Ho
- Oral Kinesiology, Academisch Centrum Tandheelkunde Amsterdam, Amsterdam, The Netherlands
| | | | - Frank Lobbezoo
- Oral Kinesiology, Academisch Centrum Tandheelkunde Amsterdam, Amsterdam, The Netherlands
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26
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Morita K, Tsuka H, Kato K, Mori T, Nishimura R, Yoshida M, Tsuga K. Factors related to masticatory performance in healthy elderly individuals. J Prosthodont Res 2018; 62:432-435. [DOI: 10.1016/j.jpor.2018.03.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/25/2018] [Accepted: 03/29/2018] [Indexed: 11/25/2022]
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27
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Leon M, Woo C. Environmental Enrichment and Successful Aging. Front Behav Neurosci 2018; 12:155. [PMID: 30083097 PMCID: PMC6065351 DOI: 10.3389/fnbeh.2018.00155] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/04/2018] [Indexed: 12/18/2022] Open
Abstract
The human brain sustains a slow but progressive decline in function as it ages and these changes are particularly profound in cognitive processing. A potential contributor to this deterioration is the gradual decline in the functioning of multiple sensory systems and the effects they have on areas of the brain that mediate cognitive function. In older adults, diminished capacity is typically observed in the visual, auditory, masticatory, olfactory, and motor systems, and these age-related declines are associated with both a decline in cognitive proficiency, and a loss of neurons in regions of the brain. We will review how the loss of hearing, vision, mastication skills, olfactory impairment, and motoric decline accompany cognitive loss, and how improved functioning of these systems may aid in the restoration of the cognitive abilities in older adults. The human brain appears to require a great deal of stimulation to maintain its cognitive efficacy as people age and environmental enrichment may aid in its maintenance and recovery.
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Affiliation(s)
- Michael Leon
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Cynthia Woo
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
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28
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Oh B, Han DH, Han KT, Liu X, Ukken J, Chang C, Dounis K, Yoo JW. Association between residual teeth number in later life and incidence of dementia: A systematic review and meta-analysis. BMC Geriatr 2018; 18:48. [PMID: 29454307 PMCID: PMC5816354 DOI: 10.1186/s12877-018-0729-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 01/23/2018] [Indexed: 12/20/2022] Open
Abstract
Background It has been suggested that tooth loss in later life might increase dementia incidence. The objective of this analysis is to systematically review the current evidence on the relationship between the number of remaining teeth and dementia occurrence in later life. Methods A search of multiple databases of scientific literature was conducted with relevant parameters for articles published up to March 25th, 2017. Multiple cohort studies that reported the incidence of dementia and residual teeth in later life were found with observation periods ranging from 2.4 to 32 years. Random-effects pooled odds ratios (OR) and 95% confidence intervals (CI) were estimated to examine whether high residual tooth number in later life was associated with a decreased risk of dementia. Heterogeneity was measured by I2. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to assess the overall quality of evidence. Results The literature search initially yielded 419 articles and 11 studies (aged 52 to 75 at study enrollment, n = 28,894) were finally included for analysis. Compared to the low residual teeth number group, the high residual teeth number group was associated with a decreased risk of dementia by approximately 50% (pooled OR = 0.483; 95% CI 0.315 to 0.740; p < 0.001; I2 = 92.421%). The overall quality of evidence, however, was rated as very low. Conclusion Despite limited scientific strength, the current meta-analysis reported that a higher number of residual teeth was associated with having a lower risk of dementia occurrence in later life. Electronic supplementary material The online version of this article (10.1186/s12877-018-0729-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bumjo Oh
- Department of Family Medicine, SMG-SNG Boramae Medical Center, Seoul, South Korea
| | - Dong-Hun Han
- Department of Preventive & Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
| | - Kyu-Tae Han
- Research and Analysis Team, Ilsan National Health Insurance Hospital, Gyeonggi-do, Goyang-si, South Korea
| | - Xibei Liu
- Department of Medicine, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Johnson Ukken
- University of Nevada School of Medicine, Reno, Nevada, USA
| | - Carina Chang
- University of Nevada School of Medicine, Reno, Nevada, USA
| | - Kiki Dounis
- Veterans Affairs Southern Nevada Healthcare System, North Las Vegas, Nevada, USA
| | - Ji Won Yoo
- Departmemnt of Internal Medicine, University of Nevada Las Vegas School of Medicine, 1701 W Charleston Blvd. #230, Las Vegas, Nevada, 89102, USA.
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29
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De Cicco V, Tramonti Fantozzi MP, Cataldo E, Barresi M, Bruschini L, Faraguna U, Manzoni D. Trigeminal, Visceral and Vestibular Inputs May Improve Cognitive Functions by Acting through the Locus Coeruleus and the Ascending Reticular Activating System: A New Hypothesis. Front Neuroanat 2018; 11:130. [PMID: 29358907 PMCID: PMC5766640 DOI: 10.3389/fnana.2017.00130] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 12/15/2017] [Indexed: 12/25/2022] Open
Abstract
It is known that sensory signals sustain the background discharge of the ascending reticular activating system (ARAS) which includes the noradrenergic locus coeruleus (LC) neurons and controls the level of attention and alertness. Moreover, LC neurons influence brain metabolic activity, gene expression and brain inflammatory processes. As a consequence of the sensory control of ARAS/LC, stimulation of a sensory channel may potential influence neuronal activity and trophic state all over the brain, supporting cognitive functions and exerting a neuroprotective action. On the other hand, an imbalance of the same input on the two sides may lead to an asymmetric hemispheric excitability, leading to an impairment in cognitive functions. Among the inputs that may drive LC neurons and ARAS, those arising from the trigeminal region, from visceral organs and, possibly, from the vestibular system seem to be particularly relevant in regulating their activity. The trigeminal, visceral and vestibular control of ARAS/LC activity may explain why these input signals: (1) affect sensorimotor and cognitive functions which are not directly related to their specific informational content; and (2) are effective in relieving the symptoms of some brain pathologies, thus prompting peripheral activation of these input systems as a complementary approach for the treatment of cognitive impairments and neurodegenerative disorders.
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Affiliation(s)
- Vincenzo De Cicco
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Maria P Tramonti Fantozzi
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | | | - Massimo Barresi
- Institut des Maladie Neurodégénératives, University of Bordeaux, Bordeaux, France
| | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.,Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Diego Manzoni
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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30
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Central Sensitization-Based Classification for Temporomandibular Disorders: A Pathogenetic Hypothesis. Pain Res Manag 2017; 2017:5957076. [PMID: 28932132 PMCID: PMC5592418 DOI: 10.1155/2017/5957076] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/03/2017] [Accepted: 07/09/2017] [Indexed: 12/15/2022]
Abstract
Dysregulation of Autonomic Nervous System (ANS) and central pain pathways in temporomandibular disorders (TMD) is a growing evidence. Authors include some forms of TMD among central sensitization syndromes (CSS), a group of pathologies characterized by central morphofunctional alterations. Central Sensitization Inventory (CSI) is useful for clinical diagnosis. Clinical examination and CSI cannot identify the central site(s) affected in these diseases. Ultralow frequency transcutaneous electrical nerve stimulation (ULFTENS) is extensively used in TMD and in dental clinical practice, because of its effects on descending pain modulation pathways. The Diagnostic Criteria for TMD (DC/TMD) are the most accurate tool for diagnosis and classification of TMD. However, it includes CSI to investigate central aspects of TMD. Preliminary data on sensory ULFTENS show it is a reliable tool for the study of central and autonomic pathways in TMD. An alternative classification based on the presence of Central Sensitization and on individual response to sensory ULFTENS is proposed. TMD may be classified into 4 groups: (a) TMD with Central Sensitization ULFTENS Responders; (b) TMD with Central Sensitization ULFTENS Nonresponders; (c) TMD without Central Sensitization ULFTENS Responders; (d) TMD without Central Sensitization ULFTENS Nonresponders. This pathogenic classification of TMD may help to differentiate therapy and aetiology.
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31
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Tramonti Fantozzi MP, De Cicco V, Barresi M, Cataldo E, Faraguna U, Bruschini L, Manzoni D. Short-Term Effects of Chewing on Task Performance and Task-Induced Mydriasis: Trigeminal Influence on the Arousal Systems. Front Neuroanat 2017; 11:68. [PMID: 28848404 PMCID: PMC5550729 DOI: 10.3389/fnana.2017.00068] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/24/2017] [Indexed: 12/19/2022] Open
Abstract
Trigeminal input to the ascending activating system is important for the maintenance of arousal and may affect the discharge of the noradrenergic neurons of the locus coeruleus (LC), whose activity influences both vigilance state and pupil size, inducing mydriasis. For this reason, pupil size evaluation is now considered an indicator of LC activity. Since mastication activates trigeminal afferent neurons, the aims of the present study, conducted on healthy adult participants, were to investigate whether chewing a bolus of different hardness may: (1) differentially affect the performance on a cognitive task (consisting in the retrieval of specific target numbers within numerical matrices) and (2) increase the dilatation of the pupil (mydriasis) induced by a haptic task, suggesting a change in LC activation. Results show that chewing significantly increased both the velocity of number retrieval (without affecting the number of errors) and the mydriasis associated with the haptic task, whereas simple task repetition did not modify either retrieval or mydriasis. Handgrip exercise, instead, significantly decreased both parameters. Effects were significantly stronger and longer lasting when subjects chewed hard pellets. Finally, chewing-induced improvements in performance and changes in mydriasis were positively correlated, which suggests that trigeminal signals enhanced by chewing may boost the cognitive performance by increasing LC activity.
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Affiliation(s)
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of PisaPisa, Italy
| | - Massimo Barresi
- Institut des Maladies Neurodégénératives, University of BordeauxBordeaux, France
| | | | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of PisaPisa, Italy.,Department of Developmental Neuroscience, IRCCS Foundation Stella MarisPisa, Italy
| | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of PisaPisa, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of PisaPisa, Italy
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32
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Li J, Xu H, Pan W, Wu B. Association between tooth loss and cognitive decline: A 13-year longitudinal study of Chinese older adults. PLoS One 2017; 12:e0171404. [PMID: 28158261 PMCID: PMC5291434 DOI: 10.1371/journal.pone.0171404] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 01/18/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To examine the association between the number of teeth remaining and cognitive decline among Chinese older adults over a 13-year period. DESIGN A large national longitudinal survey of Chinese older adults. SETTING The Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998-2011). PARTICIPANTS A total of 8,153 eligible participants aged 60+ interviewed in up to six waves. MEASUREMENTS Cognitive function and teeth number were measured at each interview. Cognitive function was measured by the Mini-Mental Status Examination (MMSE). Number of natural teeth was self-reported. Individuals with severe cognitive impairment were excluded. Covariates included demographic characteristics, adult socioeconomic status characteristics, childhood socioeconomic status, health conditions, and health behaviors. Linear mixed models were applied in the analysis. RESULTS The mean teeth number at baseline was 17.5(SD = 0.1), and the mean of baseline cognitive function was 27.3(SD = 0.0). Cognitive function declined over time (β = -0.19, P < .001) after controlling covariates. But, regardless of time, more teeth were associated with better cognitive function (β = 0.01, P < .001). The interaction of teeth number and time was significant (β = 0.01, P < .001), suggesting that the participants who had more teeth showed a slower pace of cognitive decline over time than those with fewer teeth after controlling for other covariates. CONCLUSION This study showed that tooth loss was associated with cognitive decline among Chinese older adults. Further studies are needed to examine the linkages between cognitive decline and oral health status using clinical examination data.
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Affiliation(s)
- Juan Li
- Nursing School of Second Military Medical University, Shanghai, China
- Duke University School of Nursing, Durham, United States of America
| | - Hanzhang Xu
- Duke University School of Nursing, Durham, United States of America
- Duke Global Health Institute, Durham, United States of America
| | - Wei Pan
- Duke University School of Nursing, Durham, United States of America
| | - Bei Wu
- New York University Rory Meyers College of Nursing, New York, United States of America
- * E-mail:
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33
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Ko YC, Huang HL, Shen YW, Cai JY, Fuh LJ, Hsu JT. Variations in crestal cortical bone thickness at dental implant sites in different regions of the jawbone. Clin Implant Dent Relat Res 2017; 19:440-446. [PMID: 28074591 DOI: 10.1111/cid.12468] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/20/2016] [Accepted: 11/19/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Dental implants have become reliable and predictable tools for treating missing teeth. The survival rate of dental implants is markedly influenced by the host bone quality and quantity of the jawbone. A better host bone provides higher initial stability of the dental implant, resulting in better osseointegration and a higher success rate. Host bone quality and quantity are determined by the crestal cortical bone thickness and inner cancellous bone density. OBJECTIVE The purpose of this study was to determine the crestal cortical bone thickness at dental implant sites in different regions of the jawbone through the use of dental cone-beam computed tomographic (CBCT) images. MATERIALS AND METHODS A total of 661 dental implant sites (81 in the anterior mandible, 122 in the anterior maxilla, 224 in the posterior mandible, and 234 in the posterior maxilla) were obtained from the jawbones of 173 humans. The data were subjected to statistical analysis to determine any correlation between crestal cortical bone thicknesses and jawbone regions using one-way analysis of variance with Tukey's post-test. RESULTS The crestal cortical bone thicknesses at dental implant sites in the four regions decreased in the following order: posterior mandible (1.07 ± 0.47 mm, mean ± SD) >anterior mandible (0.99 ± 0.36 mm) >anterior maxilla (0.82 ± 0.30 mm) >posterior maxilla (0.75 ± 0.35 mm). CONCLUSION The dental CBCT data demonstrate that crestal cortical bone thickness varies markedly between dental implant sites in the four regions of the jawbone.
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Affiliation(s)
- Yi-Chun Ko
- School of Dentistry, College of Medicine, China Medical University, Taichung, 404, Taiwan
| | - Heng-Li Huang
- School of Dentistry, College of Medicine, China Medical University, Taichung, 404, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 413, Taiwan
| | - Yen-Wen Shen
- School of Dentistry, College of Medicine, China Medical University, Taichung, 404, Taiwan.,Department of Dentistry, China Medical University and Hospital, Taichung, 404, Taiwan
| | - Jyun-Yi Cai
- School of Dentistry, College of Medicine, China Medical University, Taichung, 404, Taiwan.,Department of Dentistry, China Medical University and Hospital, Taichung, 404, Taiwan
| | - Lih-Jyh Fuh
- School of Dentistry, College of Medicine, China Medical University, Taichung, 404, Taiwan.,Department of Dentistry, China Medical University and Hospital, Taichung, 404, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, College of Medicine, China Medical University, Taichung, 404, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 413, Taiwan
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