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Minoura A, Ihara Y, Kato H, Murakami K, Watanabe Y, Hirano K, Ito Y, Kokaze A. Relationships between Lip Seal Strength, Tongue Pressure, and Daytime Sleepiness in Japanese Workers: A Cross-Sectional Study. Clin Pract 2023; 13:753-762. [PMID: 37489417 PMCID: PMC10366721 DOI: 10.3390/clinpract13040068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 07/26/2023] Open
Abstract
This cross-sectional study aimed to examine the relationships between lip seal strength, tongue pressure, and daytime sleepiness in Japanese workers. A self-administered questionnaire which comprised the Epworth Sleepiness Scale (ESS) was completed by 496 workers, and excessive daytime sleepiness was defined by an ESS score of 11 or over. Lip seal strength and tongue pressure were measured in all participants, and multiple regression analyses were performed to examine the effects of lip seal strength and tongue pressure on daytime sleepiness. The median ESS score was 5.0 (25th and 75th percentiles: 2.0 and 8.0), and 42 (8.5%) workers had excessive daytime sleepiness. The median lip seal strength was 13.5 N (11.4, 16.3), and the tongue pressure was 41.7 kPa (35.2, 48.3). Workers with higher ESS scores had significantly lower levels of lip seal strength than those without, following adjustments for age and body mass index (BMI) values (β (95% confidence interval): -0.043 [-0.081, -0.004]). However, tongue pressure was not significantly associated with ESS score after adjustments for age and/or BMI. These results suggest that maintaining moderate lip seal strength may help prevent excessive daytime sleepiness in Japanese workers regardless of age or BMI.
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Affiliation(s)
- Akira Minoura
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Yoshiaki Ihara
- Division of Oral Functional Rehabilitation Medicine, Department of Special Needs Dentistry, School of Dentistry, Showa University, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan
| | - Hirotaka Kato
- Division of Oral Functional Rehabilitation Medicine, Department of Special Needs Dentistry, School of Dentistry, Showa University, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan
| | - Kouzou Murakami
- Department of Radiology, Division of Radiation Oncology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Yoshio Watanabe
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Kojiro Hirano
- Department of Otorhinolaryngology Head and Neck Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Yoshinori Ito
- Department of Radiology, Division of Radiation Oncology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
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Effect of orofacial myofunctional therapy along with preformed appliances on patients with mixed dentition and lip incompetence. BMC Oral Health 2022; 22:586. [PMID: 36494803 PMCID: PMC9733194 DOI: 10.1186/s12903-022-02645-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Various preformed early orthodontic appliances for correcting oral habits and training orofacial muscles have emerged on the market. However, there are few reports on the effectiveness of these appliances for orofacial myofunctional training. METHODS This retrospective study evaluated children with lip incompetence and mixed dentition treated at the Pediatric Dentistry Department of Shanghai Ninth People's Hospital from 2016 to 2018. A total of 109 children (54 males, 55 females; age range: 7-10 years, mean age: 8.2 years) were selected from an overall sample of 870 patients. During the first visit, all patients were instructed to perform active lip and tongue training at home daily and were divided into two groups according to the kind of appliances worn. The first group consisted of 56 subjects (30 females; 26 males), with a mean age of 8.1 years (SD 1.1 years), treated with preformed appliances. The second group consisted of 53 subjects (25 females; 28 males), with a mean age of 8.2 years (SD 1.0 years), treated with conventional early orthodontic appliances (arch expansion devices along with "2*4" local fixed appliances). For each subject in the two groups, initial (pretreatment, T1) and final (posttreatment, T2) intraoral and external photos, dental casts, lateral cephalograms, and orthopantograms were taken, and lip strength was measured. SNA, SNB, ANB, APDI, FMA, U1SN, and IMPA before and after treatment were measured by The Dolphin Imaging Cephalometric Analysis Software. The hyoid bone position was also recorded. Differences between groups were identified with an independent sample t-test (P < 0.05). RESULTS In the first group, a statistically significant forward movement of the mandible was detected by an increase in SNB of - 1.06 degrees (P < 0.01) and an increase in APDI of - 2.23 degrees (P < 0.01). The increase in IMPA (- 3.21 degrees, P < 0.01) demonstrated a statistically significant protrusion of the lower incisors. Lip strength significantly increased (- 2.44, P < 0.01). The increase in HC3 (- 1 mm, P < 0.01) and HFH (- 2.95 mm, P < 0.01) implied a forward and downward movement of the hyoid bone. In the second group, a statistically significant forward movement of the mandible was also detected by an increase in APDI of -1.96 degrees (P < 0.01). Lip strength also significantly increased (- 1.24, P < 0.01). The increase in HFH (- 2.55 mm, P < 0.01) implied a downward movement of the hyoid bone. Compared with the treatment in the second group, orofacial myofunctional therapy combined with the preformed appliances led to a statistically significant lip strength increase (- 2.30, P < 0.05). Significant differences were observed in SNB and IMPA between the two groups (P < 0.05). CONCLUSIONS Orofacial myofunctional therapy effectively improved patient lip strength and was a good option for mixed dentition patients with lip incompetence. Preformed appliances could enhance the orofacial myofunctional therapy effect and result in significant improvements in lip strength and forward movement of the mandible, which can optimize the jaw relationship.
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Ryu M, Oki T, Ohta M, Sakurai K, Ueda T. Effect of Lip-seal Resistance Training on Lip-seal Strength in Young Adults. THE BULLETIN OF TOKYO DENTAL COLLEGE 2021; 62:163-170. [PMID: 34393145 DOI: 10.2209/tdcpublication.2020-0058] [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: 11/06/2022]
Abstract
Lip-seal strength is important for articulating bilabials, capturing food during eating, maintaining fluid within the oral cavity before swallowing, and achieving swallowing pressure. The objective of this study was to investigate the effect of lip-seal resistance training on lip-seal strength in young adults. The participants comprised 15 young healthy adults aged 26-34 years, all with complete dentition. Each was required to perform lip-seal resistance training 5 weekdays a week for 4 weeks with a commercially available instrument for that purpose. The instrument was placed on the midline, left corner, and right corner of the mouth, and pulled forward, leftward, and rightward, respectively. The participants were required to pull the training instrument forcefully while resisting by closing the lips together as strongly as possible until the instrument exited the lips. Lip-seal strength was measured at before and after training using a measurement device. Change in lip-seal strength between before and after training was analyzed using the Wilcoxon signed rank test. The mean lip-seal strength was 8.9±1.5 N before training and 10.4±1.8 N after. A significant difference was observed in lip-seal strength between before and after training (p=0.003), and the mean increase during the training period was 18.1±17.6%. The results showed that lip-seal resistance training for 4 weeks increased lip-seal strength in young adults. These findings suggest that training that involves pulling not only in a forward direction, but also in bilateral directions strongly stimulates the orbicularis oris muscle, resulting in an increase in lip-seal strength.
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Affiliation(s)
- Masahiro Ryu
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College
| | - Takeshi Oki
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College
| | - Midori Ohta
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College
| | - Kaoru Sakurai
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College
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Kugimiya Y, Oki T, Ohta M, Ryu M, Kobayashi K, Sakurai K, Ueda T. Distribution of lip-seal strength and its relation to oral motor functions. Clin Exp Dent Res 2021; 7:1122-1130. [PMID: 33963687 PMCID: PMC8638310 DOI: 10.1002/cre2.440] [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] [Received: 09/01/2020] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives Lip‐seal strength, which represents the muscle strength of the lips, appears to chiefly contribute to mastication and pronunciation. However, the functional characteristics of lip‐seal strength in adults are still undefined. The present study aimed to understand not only the distribution of lip‐seal strength in adult men and women but also the effect of age on this strength and identify oral motor functions correlated with lip‐seal strength. Materials and methods The subjects included 339 participants (men: 170, age 39.2 ± 18.2 years; women: 169, age 43.1 ± 19.7 years). Oral motor function was evaluated for lip‐seal strength, oral diadochokinesis (ODK), tongue pressure, occlusal force, and masticatory performance. Statistical analyses included the Shapiro–Wilk, Mann–Whitney U, and Jonckheere–Terpstra tests, in addition to the Spearman's correlation analysis and curvilinear regression analysis. Results Lip‐seal strength did not have a normal distribution (p < 0.001). The mean ± standard deviation and median (first quartile, third quartile) of lip‐seal strength were 11.2 ± 3.4 and 10.9 (8.7, 13.2)N for the whole sample, 12.3 ± 3.4 and 11.9 (9.4, 14.4)N for men, and 10.2 ± 3.0 and 9.9 (8.0, 12.0)N for women. A significant difference was observed in lip‐seal strength between men and women (p < 0.001). Oral motor functions showed a marked correlation with lip‐seal strength, including tongue pressure, occlusal force, and masticatory performance and ODK (/pa/ and /ta/), tongue pressure, and masticatory ability in men and women, respectively. In women, lip‐seal strength declined with increase in age. Conclusions Lip‐seal strength was non‐normally distributed in both men and women, and lip‐seal strength was affected by age only in women. Lip‐seal strength and multiple oral motor functions were significantly correlated. Because the indicators of perioral muscle strength and performance were correlated with lip‐seal strength, lip‐seal strength may also partially reflect the condition of the perioral muscles.
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Affiliation(s)
- Yoshihiro Kugimiya
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Takeshi Oki
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Midori Ohta
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Masahiro Ryu
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kenichiro Kobayashi
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
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Oki T, Ohta M, Takano T, Sakurai K, Ueda T. Effective training duration and frequency for lip-seal training in older people using a self-training instrument. Gerodontology 2021; 38:422-428. [PMID: 33535274 DOI: 10.1111/ger.12540] [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] [Received: 06/11/2020] [Revised: 12/29/2020] [Accepted: 01/15/2021] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To determine the effects of the training duration and frequency on lip-seal strength (LSS) in older people. BACKGROUND Lip-seal is important for speaking, eating and swallowing. LSS decreases after training ends; therefore, continuous training is essential. MATERIALS AND METHODS Participants underwent the resistance training of LSS. Regarding training duration, eight women aged ≥65 years participated in a crossover study with trainings A (direction: 1, duration: 50 seconds) and B (directions: 3, duration: 3 minutes), daily for 4 weeks. Regarding training frequency, 40 women aged ≥65 years were divided into four groups based on frequency (everyday, every-other-day, once-a-week and control groups), and all groups excluding the control group performed training B for 4 weeks. LSS was measured at weeks 0, 2 and 4 using a digital strain gauge. Friedman's test was used, followed by Steel-Dwass test (α = 0.05). RESULTS Regarding the effects of the training duration, significant differences in LSS were noted between weeks 0 and 4 for training B, but no difference was noted for training A. Regarding training frequency, significant differences were observed between weeks 0 and 2 or 4 in the everyday and once-a-week groups. Significant differences were observed in the every-other-day group between weeks 0 and 4 and no difference in the control group. For all groups, median LSS was higher in week 2 or 4 than that in week 0. CONCLUSION Lip-seal training for 3 minutes per session everyday, every-other-day or once-a-week for 4 weeks increased LSS of older people.
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Affiliation(s)
- Takeshi Oki
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Midori Ohta
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Tomofumi Takano
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
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Takano T, Kugimiya Y, Morita K, Tazawa S, Ueda T, Sakurai K. Intra- and inter-investigator reliabilities of oral moisture measured using an oral moisture-checking device. J Oral Rehabil 2019; 47:480-484. [PMID: 31803949 DOI: 10.1111/joor.12919] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 11/10/2019] [Accepted: 11/29/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral mucosal moisture determined using oral moisture-checking devices is used as a mouth dryness evaluation method. Such devices are capable of evaluating the state of mouth dryness in a simple manner and have applicability in a wide range of subjects; however, their intra- and inter-investigator reliabilities have not yet been clarified. OBJECTIVE This study aims to investigate the intra- and inter-investigator reliabilities of measuring oral moisture using an oral moisture-checking device for a wide range of age groups. METHODS Intra- and inter-investigator reliabilities were investigated in 28 young subjects and 19 older subjects aged ≥65 years. Three trained investigators independently measured oral mucosal moisture values using an oral moisture-checking device. Intra-investigator reliability was assessed using the coefficient of variation (CV) and intraclass correlation coefficient (ICC) (1.1), and inter-investigator reliability was assessed using ICC (2.1). RESULTS Mean CV was 0.015 and 0.016, mean ICC (1.1) was 0.806 and 0.877, and ICC (2.1) was 0.873 and 0.829 in the young and older subjects, respectively. CONCLUSION In young subjects, the mean values of ICC (1.1) and ICC (2.1) of the oral moisture-checking device were 0.806 and 0.873, respectively, whereas in older subjects, these values were 0.877 and 0.829, respectively. Thus, this confirms that the examination of oral mucosal moisture using the oral moisture-checking device has sufficient intra- and inter-investigator reliabilities for a wide range of age groups.
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Affiliation(s)
- Tomofumi Takano
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Yoshihiro Kugimiya
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kuniko Morita
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Shiho Tazawa
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
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