Authorship：Last author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND/OBJECTIVES: Oral health is an important element of overall health and quality of life. However, few studies have evaluated the association between quality of life (QOL) and oral function, including tongue and lip movements. This study aimed to investigate the relationship between oral-related QOL and oral function, including tongue and lip movements, in independent elderly people. METHODS: The participants were 143 community-dwelling elderly people in Taiwan (40 men, 103 women; 76.4 ± 6.4 years). We used the General Oral Health Assessment Index (GOHAI) to evaluate oral-related QOL. The items used to evaluate oral function were as follows: the speed of tongue movement from side to side, maximum tongue pressure, maximum lip pressure, the repeated saliva swallowing test, oral diadochokinesis (speed and dexterity when pronouncing /pa/, /ta/, and /ka/), and masticatory performance. In addition, we surveyed the number of remaining teeth, denture use, and awareness of problems at mealtimes. For the analysis, we compared the GOHAI score for each group, divided by cutoff values. RESULTS: The univariate analysis revealed significant differences in the GOHAI score according to denture use, the number of remaining teeth, the state of occlusal support areas, the speed of tongue movement from side to side, oral diadochokinesis /ta/ and /ka/, and masticatory performance. The logistic regression analysis revealed that oral diadochokinesis /ka/ was a significant explanatory variable for low GOHAI scores (odds ratio = 13.145). CONCLUSIONS: Our results imply that lower oral-related QOL was associated with slow motor function at the rear area of the tongue.

DOI： 10.3390/healthcare13111332

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Sarcopenic obesity, defined as the concurrent loss of muscle mass and adipose tissue accumulation, is associated with reduced physical function and poor health status in older adults. Although oral function can impact the overall health of older adults, its role in the development of sarcopenic obesity remains unclear. Herein, we aimed to examine the association between oral function and the incidence of sarcopenic obesity. METHODS: This longitudinal cohort study included 597 independent older adults (aged ≥65 years) from Tamba-Sasayama, a rural region of Japan, who participated in academic studies between June 2016 and December 2023. Participants underwent surveys at least twice, with a minimum two-year interval. The participants were divided into four groups (robust, obese, sarcopenic, and sarcopenic obese) according to their health condition. Sarcopenic obesity was diagnosed based on the guidelines of the Japanese Working Group on Sarcopenic Obesity. The oral function was evaluated by assessing the number of remaining teeth, tongue pressure, occlusal force, masticatory performance, and oral diadochokinesis. Cox proportional hazards regression analysis evaluated the association between oral function and the incidence of sarcopenic obesity after adjusting for relevant confounders. RESULTS: The sarcopenic obesity group was older, had lower skeletal muscle mass, and inferior physical function. This cohort also had the highest prevalence of hypertension and significantly fewer remaining teeth. The proportion of individuals with sarcopenic obesity was 1.7% of the total population, with 2.8% in the obesity group at baseline, and 8.0% of those were diagnosed with sarcopenia progressing to sarcopenic obesity. The Cox regression model revealed that reduced tongue pressure was significantly associated with an increased risk of sarcopenic obesity, with a hazard ratio of 0.906 (95% confidence interval: 0.829-0.990; p = 0.028), independent of other variables related to sarcopenia and obesity. CONCLUSIONS: Our findings suggest that oral function is associated with the incidence of sarcopenic obesity but not with that of sarcopenia or obesity alone.

DOI： 10.3390/diseases13040109

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Patients with mandibular prognathism exhibit not only its characteristic maxillofacial morphology but also discrepancies in stomatognathic function, and understanding this morphology and function is vital for establishing a plan for surgical orthodontic treatment or providing guidance for recovery after orthognathic surgery. However, few studies have yet addressed the objective evaluation of masticatory function before and after surgical orthodontic treatment. In particular, the masticatory behaviors that show how you chew in your daily meals, including the number of chews, chewing rate, and posture during chewing, has not yet been fully studied in patients with mandibular prognathism. The aim of this study was to compare the masticatory behaviors of patients with mandibular prognathism with that of patients with individualized normal occlusion, to clarify the characteristics of masticatory behaviors in mandibular prognathism and to search for a relationship with maxillofacial morphology. METHODS: Participants were 23 patients (12 men, 11 women; mean age 17.9 years) with mandibular prognathism (patient group) and 23 patients (12 men, 11 women; mean age 24.4 years) with normal occlusion that had been achieved by orthodontic treatment (control group). Masticatory behaviors were measured by a wearable device fitted to each participant's right ear. Parameters such as number of chews, chewing rate, number of chews per bite, mealtime, and head and neck posture were recorded, while participants consumed a 100-g rice ball. Body mass index, occlusal contact area, and lateral cephalograms were also measured, and their associations with masticatory behaviors were investigated. RESULTS: In patient group, the number of chews was lower, mealtime was shorter, and the head and neck were tilted further forward. There was a significant positive correlation between overjet and anteroposterior head and neck posture and a significant negative correlation between overbite and anteroposterior head and neck posture. CONCLUSION: Due to morpho/functional discrepancies in the stomatognathic system, patient group chewed fewer times and for a shorter time and leaned further forward while chewing. The characteristics of the masticatory behaviors of patients with mandibular prognathism identified in the present study may be helpful when devising plans for changing behavior before and after orthodontic treatment or orthognathic surgery.

DOI： 10.1186/s40902-025-00458-9

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Language：English   Publishing type：Research paper (scientific journal)  

Recent studies indicate a potential link between oral health and cognitive function; however, long-term associations remain unclear. This study aimed to identify oral health factors that predict changes in cognitive function among older adults over time. The study included 583 independent older adults (201 male, 382 female) with a mean age of 72.7 years. Cognitive function was assessed using Mini-Mental State Examination (MMSE) at baseline and follow-up over two years, with relative change in MMSE (rMMSE) calculated. Baseline oral health variables included number of remaining teeth, masticatory performance, occlusal force, oral diadochokinesis and tongue pressure. Physical performance and confounding factors were also considered. The relationship between rMMSE and the variables was analyzed using Pearson's correlation, Mann-Whitney U test, and multiple linear regression analysis. Cognitive function declined in 196 subjects, with rMMSE significantly correlated with oral diadochokinesis. Regression analysis revealed significant associations between cognitive changes and oral diadochokinesis (p = 0.020) and knee extension strength as a physical performance (p = 0.047). Our findings suggest that cognitive decline may be indicated by declines in both physical and oral motor performance. Incorporating oral diadochokinesis testing into health screenings could aid early detection of cognitive decline, improving outcomes and reducing healthcare burdens.

DOI： 10.1038/s41598-024-75169-8

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Language：English   Publishing type：Research paper (scientific journal)  

Background/Objectives: An association between oral function and physical fitness, including walking capacity, has been reported. However, the association between masticatory behaviors and walking ability-both of which represent patterns of movement in daily life-has not been clarified. This study aimed to investigate the association between masticatory behaviors, oral function, and walking capacity in older people. Methods: One hundred community-dwelling older people (31 men, 69 women, mean age 75.7 ± 6.3 years) were selected to participate in this study. Age, sex, masticatory behaviors, oral functions (tongue pressure, tongue-lips motor function, occlusal force, and masticatory performance), and walking capacity were assessed. Masticatory behaviors were assessed during the consumption of one rice ball (100 g) using a wearable chewing counter, and the number of chews, chewing rate, the number of chews per bite, and meal time were recorded. Walking capacity was assessed using the timed up and go test (TUG). Spearman's rank correlation coefficients were calculated to assess the strength and direction of the association. Results: Moderate negative correlations were observed between TUG time and tongue pressure and between TUG time and tongue-lips motor function (/ta/ and /ka/) (rs = -0.33, -0.21, -0.28, respectively). In addition, moderate negative correlations between TUG time and chewing rate (rs = -0.22) and between TUG time and meal time (rs = 0.33) were observed, suggesting that lower walking capacity was associated with slower chewing rate and longer meal times. Conclusions: In community-dwelling older people, declines in mastication speed and dexterity and tongue strength are associated with lower walking capacity.

DOI： 10.3390/geriatrics9050131

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)   Publisher：Frontiers Media SA  

Introduction

The tongue plays an important role in mastication, swallowing, and articulation, but it cannot be directly observed because of its location inside the oral cavity. This study aimed to clarify detailed 3D tongue movements during chewing using electromagnetic articulography (EMA).

Materials and Methods

The participants were 10 healthy, young volunteers (average age 26.8 ± 2.1 years; 5 males, 5 females). Tongue and jaw movement during gum chewing was measured and recorded using EMA. Four EMA sensors were attached to the anterior, posterior, left, and right surfaces of the tongue, and one sensor was also attached to the mandibular left incisor. The tongue motion during the chewing cycle was spatially and sequentially analyzed based on the motion trajectories of the tongue and mandible.

Results and Discussion

The tongue moved downward and to the masticatory side in a manner similar to the movement of the jaw. The anterior tongue marker moved downward to a greater extent than the other tongue markers. However, the tongue moved forward as the jaw moved backward. The anterior marker reached the most anterior position during the jaw-opening phase and the posterior markers reached the most anterior position during the jaw-closing phase. Just before maximum jaw-opening, all markers on the tongue reached the bottom lowest position. During the jaw-closing phase, the tongue reached the dominant farthest position in the masticatory side. All the markers reached the most posterior position during the occlusal phase.

Conclusion

These findings demonstrate the sequence of tongue motion patterns during gum chewing.

DOI： 10.3389/fphys.2024.1409005

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Language：Japanese   Publisher：新潟歯学会  

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Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Food Science and Technology  

DOI： 10.3136/nskkk.nskkk-d-24-00002

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Language：English   Publishing type：Research paper (scientific journal)  

This study aimed to develop the Food Acceptance Questionnaire (FAQ) to assess the masticatory ability of Thai older adults (≥60 years). Fifty participants were interviewed using open-ended questions about food they regularly consumed and avoided due to difficulty chewing. From a list of 140 items, 100 were recruited for a trial version of the FAQ. A total of 154 participants responded to the 5-point Likert scale on their chewing perception of each food item (1, impossible to chew; 5, most easily eaten). The average response of each food item was used as the chewing index (CI). The 100 food items were ranked and divided into five grades based on their CIs. Masticatory performance (MP) was objectively assessed by a visual scoring method using gummy jelly (UHA Mikakuto). Two foods from each grade that demonstrated the highest correlation with MP were selected to form the final 10-item FAQ. The FAQ score was calculated by summarizing the responses of 10 items. MP correlated strongly with the FAQ score (r = 0.57, p < 0.001), indicating its predictive validity. Furthermore, the FAQ indicates strong internal consistency (Cronbach's alpha coefficient = 0.90), indicating high reliability. In conclusion, this newly developed 10-item FAQ is valid and reliable for assessing the masticatory ability of Thai older adults.

DOI： 10.3390/nu16101432

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Abstract

Background

Coordination among lip, cheek and tongue movements during swallowing in patients with mandibular prognathism remains unclear.

Objectives

This study aimed to identify the temporal sequences of tongue pressure and maxillofacial muscle activities during swallowing in patients with mandibular prognathism and compared characteristics with those of healthy volunteers.

Methods

Seven patients with mandibular prognathism (mandibular prognathism group) and 25 healthy volunteers with individual normal occlusion (control group) were recruited. Tongue pressures and masseter, orbicularis oris, mentalis and supra‐ and infrahyoid muscle activities while swallowing gel were measured simultaneously using a sensor sheet system with five measurement points and surface electromyography, respectively. Onset time, offset time and durations of tongue pressure and muscle activities were analysed.

Results

In the mandibular prognathism group, tongue pressure was often produced first in more peripheral parts of the palate. Offset of tongue pressure in the posteromedian and peripheral parts of the palate and maxillofacial muscle activities except for orbicularis oris were delayed. Duration of tongue pressure in the anteromedian part of the palate was significantly shorter and durations of masseter, mentalis and suprahyoid muscle activities were significantly longer. Times to onset of orbicularis oris and suprahyoid muscle activities based on first onset of tongue pressure were significantly shorter.

Conclusion

These results suggest that patients with mandibular prognathism may exhibit specific patterns of tongue pressure production and maxillofacial muscle activities during swallowing.

DOI： 10.1111/joor.13712

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Abstract

Aim

Oral function in patients with schizophrenia has not been well‐characterized. To address this, we performed a cross‐sectional study of oral function in Japanese inpatients with schizophrenia.

Methods

We measured oral function, including occlusal force, tongue–lip motor function, tongue pressure, and masticatory function in 130 Japanese inpatients with schizophrenia. We then compared the frequency of clinical signs of oral hypofunction among 63 non‐elderly and 67 elderly inpatients with schizophrenia, as well as data from 98 elderly control participants from a previous Japanese study.

Results

The frequency of reduced occlusal force was significantly higher in the elderly inpatients (76.2%) than in the non‐elderly inpatients (43.9%) and elderly controls (43.9%). The frequency of decreased tongue–lip motor function in non‐elderly inpatients (96.8%) and elderly inpatients (97.0%) was significantly higher than that in elderly controls (56.1%). The frequency of decreased tongue pressure in non‐elderly inpatients (66.1%) and elderly inpatients (80.7%) was significantly higher than that in elderly controls (43.9%). Finally, the frequency of decreased masticatory function was highest in elderly inpatients (76.5%), followed by non‐elderly inpatients (54.8%) and elderly controls (15.3%).

Conclusion

Oral function was decreased in both non‐elderly and elderly Japanese inpatients with schizophrenia compared with elderly controls.

DOI： 10.1002/npr2.12443

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Publishing type：Research paper (scientific journal)   Publisher：Informa UK Limited  

DOI： 10.1080/27705781.2024.2332037

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Language：Japanese   Publisher：(NPO)日本バイオレオロジー学会  

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Language：Japanese   Publisher：日本顎口腔機能学会  

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Publishing type：Research paper (scientific journal)   Publisher：Society of Rheology Japan  

DOI： 10.1678/rheology.52.37

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Language：English   Publishing type：Research paper (scientific journal)  

Dysphagia is a common symptom of Parkinson's disease (PD) associated with aspiration pneumonia, choking, malnutrition, and a decreased quality of life, and is a leading cause of death among patients with PD. Tongue dysfunction in patients with PD affects the oral phase of swallowing, including the formation and propulsion of a bolus into the pharynx. Assessing tongue pressure, generated between the tongue and palate, is a method that quantitatively measures tongue function and is related to dysphagia in PD. Two assessment methods are used to measure tongue pressure: tongue strength and tongue pressure during swallowing. Previous studies measuring tongue pressure in PD have reported decreased tongue strength and pressure during swallowing, as well as a prolonged tongue pressure rise time, which are symptoms associated with PD severity and dysphagia. In this mini-review, we present a method for measuring tongue pressure and discuss its relationship with dysphagia in PD. We also describe limitations and future perspectives in tongue pressure measurement research.

DOI： 10.3389/fneur.2024.1355627

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Publishing type：Research paper (scientific journal)   Publisher：Society of Rheology Japan  

DOI： 10.1678/rheology.51.295

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Abstract

Background

There is no clear objective indicator for selecting soft foods that are required for food bolus formation in older people with impaired oral function.

Objective

This study aimed to investigate the relationship between maximal isometric tongue pressure (MITP) and the mechanical properties of gels that can be crushed by the tongue.

Methods

This study included 65 healthy participants aged 22–96 (young group; 15 males, 15 females; older dentate group; 7 males, 8 females; older edentulous group; 10 males, 10 females). MITP was measured by the balloon‐probe device. Agar gel with 10 different kinds of fracture force from 10N to 100N was used. The limit of fracture force of gels (LFFG) that were crushed by the tongue was measured by the up‐and‐down method. In the older edentulous group, two items were measured with and without dentures. Spearman's rank correlation coefficient was used to evaluate the relationship between MITP and LFFG in each group (p &lt; .05).

Results

There were positive correlations between MITP and LFFG in all groups (overall groups: r_s = .66, young group: r_s = .46, older dentate group: r_s = .61, older edentulous group with dentures: r_s = .60, older edentulous group without dentures: r_s = .47).

Conclusion

MITP and LFFG were positively correlated in young, older dentate and older edentulous groups, suggesting that MITP has the potential to be an objective indicator of the range of mechanical properties of soft food that can be crushed by the tongue.

DOI： 10.1111/joor.13627

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Publishing type：Research paper (scientific journal)   Publisher：Society of Rheology Japan  

DOI： 10.1678/rheology.51.219

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Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.heliyon.2023.e16238

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Removable partial dentures have a wide range of applications as missing tooth prostheses, and the denture design can be quite diverse. However, the factors affecting masticatory function remain unclear. We investigated the effect of denture design, especially the use of indirect retainers and major connectors, on masticatory function in patients with mandibular bilateral distal extension dentures. METHODS: Fifty-three patients with mandibular Kennedy Class I and Eichner classification B occlusal support were included in this study. Masticatory performance (MP) was assessed using gummy jelly. For the dentures, the type of major connector (bar or apron), presence or absence of indirect retainers, number of rests, and number of artificial teeth were evaluated. The number of functional teeth and occlusal support, Eichner classification, maxillary denture usage, mandibular residual ridge height, and duration of denture use were also evaluated. The factors influencing on the MP were evaluated using the Mann-Whitney U test, Spearman's correlation coefficient, and logistic regression analysis. RESULTS: MP was significantly higher when the major connector was bar-type or when there was an indirect retainer than with an apron-type or no indirect retainer. MP was positively correlated with the number of functional teeth, occlusal support, and number of rests. Logistic regression analysis revealed that the number of functional teeth and the presence or absence of an indirect retainer were factors that significantly influenced the MP. CONCLUSIONS: An indirect retainer setting is useful for achieving good masticatory performance in mandibular bilateral distal extension dentures.

DOI： 10.2186/jpr.JPR_D_22_00135

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2186/jpr.JPR_D_22_00135

Web of Science

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

Evaluation of masticatory ability has become more important in an aging society because decreased masticatory ability has the potential to affect the general health of older people. A new masticatory performance test, intended for older people with low masticatory ability, has been developed using gummy jelly half the size of that used in the conventional masticatory performance test. This study aimed to investigate the compatibility between the new and conventional tests and the adaptation of the new test. The new test using the 8-grade visual score with half-size gummy jelly was performed among 137 removable denture wearers (mean age 75.8 ± 9.0 years) with low masticatory performance (a score of ≤4 on a conventional test). The correlation between the scores of half-size gummy jelly (VS-H) in the new test and those of full-size gummy jelly (VS) in the conventional test was evaluated. VS-H among the groups divided by VS were also compared. A strong positive correlation was detected between VS-H and VS (rs = 0.70). In groups with VS of 0 and 1, VS-H values were widely distributed from 0 to 7. There were significant differences in VS-H between the groups with VS of 0–2 but no significant differences in VS-H between the groups with VS of 2–4. Therefore, the masticatory performance test using half-size gummy jelly is suitable for a detailed evaluation of masticatory ability in older people with low masticatory ability when their visual score of full-size gummy jelly in the conventional test is 2 or less.

DOI： 10.3390/jcm12020593

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The state of food comminution caused by chewing is an important factor triggering the swallowing reflex. However, the impact of retronasal aroma released from comminuted food to the nose upon swallowing during food intake is poorly understood. OBJECTIVE: The present study investigated the relationship between aroma concentration and swallowing threshold while chewing a standardised test food. METHODS: Twenty healthy participants took part in this study. Concentration of retronasal aroma was measured over time through the nostrils using an odour sensor. The aroma concentration was measured while chewing an orange-flavoured gummy jelly until swallowing, and the number of chewing strokes was measured to determine the swallowing threshold. Next, the aroma concentration was measured while chewing the gummy jelly for 30 strokes, and 100% and 200% of swallowing threshold without swallowing. The surface area increase in the expectorated gummy jelly pieces was calculated using image analysis and defined as masticatory performance at 30 strokes. RESULTS: The average number of chewing strokes until the swallowing threshold was 45.1 ± 14.2. Higher masticatory performance was associated with a smaller number of chewing strokes at swallowing threshold, and a greater increase in surface area at the swallowing threshold. The number of chewing strokes and the aroma concentration were similar between the swallowing threshold and at the maximum aroma concentration while chewing at 200% of the swallowing threshold. CONCLUSION: The findings suggested that the swallowing threshold might be influenced by retronasal aroma concentration as well as the state of food comminution.

DOI： 10.1111/joor.13389

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)   Publisher：Japan Prosthodontic Society  

DOI： 10.2186/jpr.jpr_d_23_00117

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Publishing type：Research paper (scientific journal)   Publisher：Hindawi Limited  

Bolus volume is very important in the biomechanics of swallowing. By noninvasively characterizing swallow responses to volume challenges, we can gain more knowledge on swallowing and evaluate swallowing behavior easily. This study aimed to evaluate the impact of bolus volume on the biomechanical characteristics of oropharyngeal swallowing events with a noninvasive sensing system. Fifteen healthy male subjects were recruited and instructed to swallow 5, 10, and 15 ml of water. The sensing system consisted of a tongue pressure sensor sheet, bend sensor, surface electrodes, and a microphone. They were used to monitor tongue pressure, hyoid activity, surface EMG of swallowing-related muscles, and swallowing sound, respectively. In addition to the onset, the peak time and offset of the above four structures, certain characteristics, such as the duration, peak value, and interval of the structure motions, were measured during the different drinking tasks. The coordination between the hyoid movement and tongue pressure was also assessed. Although no sequence of the structural events changed with volume, most of the timings of the structural events were significantly delayed, except for certain hyoid activities. The swallowing volume did not affect the active durations of the monitored structures, the peak values, or intervals of tongue pressure and supra- and infrahyoid muscle activity, but certain hyoid kinetic phases were prolonged when a larger volume was swallowed. Additionally, sequential coordination between hyoid movement and tongue pressure was confirmed among the three volumes. These findings suggest that oropharyngeal structural movements change in response to bolus volume to facilitate safe swallowing. The noninvasive and quantitative measurements taken with the sensing system provide essential information for understanding normal oropharyngeal swallowing.

DOI： 10.1155/2022/7146947

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Other Link： http://downloads.hindawi.com/journals/abb/2022/7146947.xml

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Although many studies have shown the relationships between oral function and nutrition and health, few reports have investigated the masticatory behaviors of older people. This study aimed to clarify the relationships between oral function and the masticatory behaviors and features of masticatory behaviors with oral hypofunction. A total of 98 community-dwelling independent older adults participated. Seven oral conditions related to oral hypofunction were examined, and the masticatory behaviors when consuming a rice ball were measured. The participants were divided into two groups according to the criteria for oral hypofunction, and the masticatory behaviors were compared. Furthermore, the relationship between masticatory performance and the number of chews was investigated. The chewing rate of the oral hypofunction group was slower than that of the no oral hypofunction group, but there was no difference in the number of chews and chewing time. The decreased tongue-lip motor function group showed a slower chewing rate, and the decreased tongue pressure group showed a smaller number of chews and shorter chewing time. No significant correlation was observed between masticatory performance and behavior. In conclusion, older adults with oral hypofunction chewed slowly due to decreased dexterity, while, even if oral and masticatory function decreased, no compensatory increase in the number of chews was observed.

DOI： 10.3390/jcm11195902

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)  

DOI： 10.1177/00220345221118013

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: A rise in tongue pressure coincides with an increase in the suprahyoid muscles activity. OBJECTIVES: The aim was to investigate the effects of holding a weighted plastic bottle on tongue pressure and the suprahyoid muscles activity. METHODS: Eighteen participants (8 men and 10 women; mean age 42 ± 16 years) participated in this study. All participants had no history of speech, language, hearing, or swallowing disorders and no tooth loss, and they did not require dentures. Healthy participants held gauzes connected with a plastic bottle with increasing resistive loads of 0 g, 250 g, 500 g, and 750 g, between their palate and tongue. The maximum tongue pressure and average tongue pressure were measured during a 5-second hold. The average tongue pressure was defined as the mean tongue-pressure data in each task. The suprahyoid muscles activity was measured using the electromyogram (EMG). The root mean square of the EMG signals measured while lifting different loads and while performing the head lifting exercises were compared. All variables were examined using the Friedman's test and Wilcoxon signed-rank test. RESULTS: The maximum tongue pressure (p < .05) and average tongue pressure values (p < .05) increased gradually in the anterior-median region with increasing resistive loads, and the root mean square amplitudes for 250 g, 500 g, and 750 g were not significant compared to head lifting exercises. CONCLUSION: These results indicated that Plastic bottle holding could be a potential strength-training tool for the tongue and the suprahyoid muscles.

DOI： 10.1111/joor.13365

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: The purpose of this study was to investigate the effects of tongue-strengthening exercise (TSE) on tongue strength and effortful swallowing pressure in young healthy adults. METHOD: Thirteen young healthy volunteers (six men, seven women; M age = 20.5 ± 0.5 years) performed 8 weeks of isometric TSE 3 days per week. A tongue pressure measurement device was used to measure maximum isometric tongue pressure (MITP) and conduct the TSE, and a tactile sensor system attached to the hard palate was used to measure effortful swallowing pressure. MITP and effortful swallowing pressure were measured at baseline, after 4 and 8 weeks of training, and at 4 and 8 weeks after the last training session to examine the detraining effects. RESULTS: The results indicated that both MITP and effortful swallowing pressure increased significantly from baseline to 8 weeks after training. Although the improved MITP significantly decreased at 4 and 8 weeks after training cessation, no detraining effect was observed for effortful swallowing pressure. CONCLUSIONS: TSE is an effective method for increasing tongue pressure in wide tongue-palate contact areas during effortful swallow. The effortful swallowing pressure gained with TSE appears to be maintained for at least eight nontraining weeks.

DOI： 10.1044/2022_JSLHR-21-00331

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Language：Japanese   Publisher：(NPO)日本咀嚼学会  

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: It has been widely recognized that mastication behaviors are related to the health of the whole body and to lifestyle-related diseases. However, many studies were based on subjective questionnaires or were limited to small-scale research in the laboratory due to the lack of a device for measuring mastication behaviors during the daily meal objectively. Recently, a small wearable masticatory counter device, called bitescan (Sharp Co), for measuring masticatory behavior was developed. This wearable device is designed to assess objective masticatory behavior by being worn on the ear in daily life. OBJECTIVE: This study aimed to investigate the relation between mastication behaviors in the laboratory and in daily meals and to clarify the difference in mastication behaviors between those with metabolic syndrome (MetS) and those without (non-MetS) measured using a wearable device. METHODS: A total of 99 healthy volunteers (50 men and 49 women, mean age 36.4 [SD 11.7] years) participated in this study. The mastication behaviors (ie, number of chews and bites, number of chews per bite, and chewing rate) were measured using a wearable ear-hung device. Mastication behaviors while eating a rice ball (100 g) in the laboratory and during usual meals for an entire day were monitored, and the daily energy intake was calculated. Participants' abdominal circumference, fasting glucose concentration, blood pressure, and serum lipids were also measured. Mastication behaviors in the laboratory and during meals for 1 entire day were compared. The participants were divided into 2 groups using the Japanese criteria for MetS (positive/negative for MetS or each MetS component), and mastication behaviors were compared. RESULTS: Mastication behaviors in the laboratory and during daily meals were significantly correlated (number of chews r=0.36; P<.001; number of bites r=0.49; P<.001; number of chews per bite r=0.33; P=.001; and chewing rate r=0.51; P<.001). Although a positive correlation was observed between the number of chews during the 1-day meals and energy intake (r=0.26, P=.009), the number of chews per calorie ingested was negatively correlated with energy intake (r=-0.32, P=.002). Of the 99 participants, 8 fit the criteria for MetS and 14 for pre-MetS. The number of chews and bites for a rice ball in the pre-MetS(+) group was significantly lower than the pre-MetS(-) group (P=.02 and P=.04, respectively). Additionally, scores for the positive abdominal circumference and hypertension subgroups were also less than the counterpart groups (P=.004 and P=.01 for chews, P=.006 and P=.02 for bites, respectively). The number of chews and bites for an entire day in the hypertension subgroup were significantly lower than in the other groups (P=.02 and P=.006). Furthermore, the positive abdominal circumference and hypertension subgroups showed lower numbers of chews per calorie ingested for 1-day meals (P=.03 and P=.02, respectively). CONCLUSIONS: These results suggest a relationship between masticatory behaviors in the laboratory and those during daily meals and that masticatory behaviors are associated with MetS and MetS components. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry R000034453; https://tinyurl.com/mwzrhrua.

DOI： 10.2196/30789

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Numerous studies have evaluated the relationship between eating behavior and obesity, however few studies have objectively assessed eating behavior. Additionally, the association of masticatory behaviors with masticatory performance remains unclear. This study aimed to verify the relationship between masticatory performance and behavior measured by a wearable masticatory counter, and BMI. 365 healthy adults participated. Mastication behaviors, i.e. number of chews and bites, chewing rate, and chewing time, were measured using wearable masticatory counter while consuming one rice ball (100 g). Masticatory performance was evaluated using testing gummy jelly. Lifestyle habits including exercise, walking, and breakfast, were surveyed by questionnaire. The correlation coefficients between masticatory behaviors and performance and BMI were analyzed. Furthermore, multiple regression analysis was performed. The number of chews showed positive correlation with chewing rate, number of bites and chewing time, but no correlation with masticatory performance. BMI had weak but significant negative correlation with number of chews, bites, chewing time, and masticatory performance, but had no correlation with chewing rate. Multiple regression analysis revealed that BMI was associated with sex, age, number of chews, bites, masticatory performance, and walking speed. In conclusion, masticatory behavior and performance were not interrelated, but both were independently associated with BMI weakly.

DOI： 10.1038/s41598-022-08084-5

PubMed

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: This study aimed to verify the compatibility of masticatory performance tests using different two types of gummy jellies. BACKGROUND DATA DISCUSSING THE PRESENT STATUS OF THE FIELD: Compatibility between the glucose concentration measuring method (GC) and 10-steps visual scoring method (VS), which are masticatory performance tests for diagnosing decreased masticatory function (DMF) in oral hypofunction and the use of different types of gummy jelly, has yet to be confirmed. MATERIALS AND METHODS: The participants consisted of 134 Japanese older people (51 men and 83 women). GC, VS and the increased surface area measuring method (ISA), as an alternative analysis method for VS, were conducted to evaluate masticatory performance. Cohen's Kappa coefficient was used to verify the consistency for detecting DMF between GC and VS. Pearson's correlation coefficient was used to analyse the relationship between GC and ISA. Each masticatory performance was compared among three different groups for the number of residual teeth. Cut-off values of VS and ISA for DMF that were consistent with GC were identified. RESULTS: Glucose concentration measuring method and VS showed an excellent consistency (Kappa coefficient = 0.86). There was a high positive correlation between GC and ISA (r = .70). However, the change in masticatory performance according to the number of teeth was different between GC and VS/ISA. The cut-off values of VS and ISA were a Score of 2 and 1687 mm2 , respectively. CONCLUSION: Glucose concentration measuring method and VS/ISA remained fairly consistent for detecting DMF, which might be useful information to interconnect the various studies on masticatory performance.

DOI： 10.1111/ger.12601

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Authorship：Corresponding author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.foodhyd.2021.107323

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：(NPO)日本咀嚼学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The tongue functions by modulating according to bolus volume when swallowing; however, associated tongue dynamics are unclear. OBJECTIVE: We aimed to clarify how tongue motion and tongue pressure change with bolus volume during swallowing. METHODS: Sixteen healthy volunteers (age 29.5 ± 3.8 years; 12 males, 4 females) were recruited. Two electromagnetic articulography markers were attached, one each on the anterior and posterior parts of the tongue, to measure motion. A sensor sheet, with five pressure-sensitive points, was attached to the hard palate to measure tongue pressure. Participants were asked to swallow 3 ml and 10 ml of water. Motion trajectory, maximum velocity, vertical displacement just before contact with the hard palate, and maximum magnitude and duration of tongue pressure were analysed. RESULTS: Tongue rotation was observed in the sagittal plane; its rate of appearance was significantly higher when swallowing 3 ml of water than when swallowing 10 ml, and the rate of rotation at posterior part was significantly higher than at the anterior part. The maximum velocity and vertical displacement were significantly greater when swallowing 10 ml of water than those when swallowing 3 ml of water. There was no significant difference in either the maximum magnitude of tongue pressure or maximum duration of tongue pressure between 3 ml and 10 ml. CONCLUSION: Bolus volume influenced the pattern of tongue motion; however, there was no difference in tongue pressure.

DOI： 10.1111/joor.13248

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: During mastication, the tongue presses the bolus into the pharynx by a "squeeze-back" motion, known as stage II transport (St2Tr). However, the pressure of St2Tr tongue-palate contact has not been examined. OBJECTIVES: We aimed to clarify aspects of St2Tr occurrence and tongue-palate contact during mastication by measuring tongue pressure. METHODS: Ten healthy adults (eight men, two women, aged 26.8 ± 2.2 years) were enrolled. Tongue pressure was measured (Swallow Scan) during mastication. Sensors were placed on the palate near the incisive papilla (Ch.1), in the middle (Ch.2), at the posterior (Ch.3), and near the first molars on the habitual (Ch.H) and non-habitual (Ch.Nh) masticatory sides. Nasopharyngeal endoscopy confirmed St2Tr and swallowing. Tongue pressures were measured repeatedly, from mastication onset through the first swallow, until eight sets of data were obtained. Tongue-palate contact frequencies, integrated values of tongue pressure, and mastication times were recorded for St2Tr(+) and St2Tr(-) mastication conditions. RESULTS: St2Tr occurred in 43 of 80 trials (53.8%). St2Tr(+) exhibited the highest tongue-palate contact frequency at Ch.H; it exhibited higher contact frequencies at Ch.2, Ch.3 and Ch.H than St2Tr(-). St2Tr(+) exhibited higher tongue pressures at Ch.1, Ch.2 and Ch.H than at Ch.3; it exhibited higher tongue pressures at Ch.1 and Ch.2 than St2Tr(-). CONCLUSION: The study suggested that during St2Tr, the tongue frequently touched the palate at the central and posterior regions, as well as at its habitual masticatory side. It applies the strongest pressure at the anterior and central palate to transport the bolus to the pharynx.

DOI： 10.1111/joor.13252

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Language：Japanese   Publisher：Japanese Society of Gerodontology  

Background：There have been few reports on the relationship between tongue pressure and nutritional status. This study aimed to investigate the relationship between tongue pressure and nutritional status or diet modification in older patients admitted to a general hospital.

Method：One hundred sixty-five patients aged 65 years or older（96 males and 69 females；mean age 83.5±8.2 years）who were referred to the Department of Oral and Maxillofacial Surgery of a general hospital were included in this study, and divided into medium/severe nutritional risk and no/mild nutritional risk groups based on the Geriatric Nutritional Risk Index and normal/chopped diet and soft/paste diet groups according to the dietary patterns. Difference in maximal tongue pressure（MTP）between the groups was examined.

Results：MTP in the medium/severe nutritional risk group（n＝148, 14.1±9.6 kPa）was significantly lower than that in the no/mild nutritional risk group（19.8±10.8 kPa）（p＝0.043）. MTP in the soft/paste diet group（n＝88, 12.4±9.6 kPa）was lower than that in the normal/chopped diet group（16.9±9.6 kPa）（p＝0.001）. The cut-off values based on the ROC curve of MTP for the medium/severe nutritional risk and soft/paste diet were 18.6 kPa and 16.5 kPa, respectively.

Conclusion：Reduced maximum tongue pressure in general hospital elderly inpatients was associated with nutritional risk and low dietary patterns, and the cut-off values for predicting them were lower than that for “reduced tongue pressure” as one of the sub-symptoms of “oral-hypofunction.”

DOI： 10.11259/jsg.36.91

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Language：Japanese   Publisher：新潟歯学会  

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.3390/ijerph18126620

Scopus

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

BACKGROUND: Although various training methods have been reported for improving oral function such as occlusal force, there are few reports that show the training effect of eating hard food on the oral functions. OBJECTIVE: To examine the training effects of habitually ating hard gummy candies on oral functions. METHODS: Participants of this cohort study were recruited into a training (six women, eight men; mean age 27.6 ± 3.5 years) and control group (two women, seven men; mean age 28.3 ± 4.9 years). The training group ate nine custom-developed hard gummy candies three times per week for 3 months. Training effects were evaluated by measuring the maximal occlusal force, masticatory performance, maximal tongue pressure, number of chewing cycles until swallowing the candy, duration of chewing and cycle time before training, after 1, 2 and 3 months of training, and 1 month after stopping training. The iEMG/force, which evaluates masseter muscle hypertrophy with electromyograms (EMG), was calculated. RESULTS: Masticatory performance after 1 month (p = 0.01), maximal occlusal force after 2 months (p < 0.01) and maximal tongue pressure after 3 months of training were significantly increased (p = 0.02), and the cycle time after 2 months of training (p = 0.02) was significantly decreased compared to before the intervention. Except for masticatory performance, the other effects were maintained for 1 month after stopping training. Changes in iEMG/force were not significant, but a tendency for muscle hypertrophy was observed in the training group. CONCLUSION: Habitual eating of hard gummy candies is a task-specific training that can improve overall masticatory function, including tongue pressure.

DOI： 10.1111/joor.13208

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Although a food acceptance questionnaire is useful for subjective masticatory function assessments, its characteristics and limitations when applied to patients with removable dentures have been unclear. We therefore assessed the relationship between the subjective and objective masticatory function and explored whether or not a decreased masticatory function could be evaluated by food acceptance questionnaire. METHODS: One hundred and nineteen patients >60 years old with removable partial and/or complete dentures participated. Food acceptance score (FAS) was calculated by using Sato's questionnaire with 20 food items. Masticatory performance (MP) was assessed by a visual scoring method using a test gummy jelly (UHA Mikakuto). Simple/multiple regression analyses were performed to explain the objective masticatory function. The cut-off value of FAS was determined to predict a decreased masticatory function by sensitivity, specificity and receiver operating characteristics curve. RESULTS: No significant gender differences in MP or FAS were noted. Although both MP and FAS increased with the number of functional teeth, FAS was not significantly affected by age. The number of functional teeth, FAS and age had significant correlations with MP, with the number of functional teeth showing the strongest correlation. Multiple linear regression analyses identified the FAS as a significant explanatory variable for MP, and 70 was the optimal cut-off value for detecting a decreased masticatory function (MP score ≤ 2) in the diagnosis of 'oral hypofunction'. CONCLUSIONS: Using FAS to assess the MP was deemed appropriate, and a score of 70 was the optimal cut-off value for detecting a decreased masticatory function.

DOI： 10.1111/joor.13147

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：(NPO)日本咀嚼学会  

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Language：Japanese   Publisher：日本顎口腔機能学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J02994&link_issn=&doc_id=20220607170003&doc_link_id=%2Fex2gakuk%2F2021%2F002701%2F004%2F0014-0015%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fex2gakuk%2F2021%2F002701%2F004%2F0014-0015%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

To provide appropriate foods for elderly people with eating difficulties, it is necessary to take account of the ability of compensatory mastication such as tongue squeezing. However, the biomechanics of tongue squeezing is still unclear. The aim of present study is to investigate the effect of the initial mechanical properties of gels on the change in tongue pressure production during squeezing and swallowing. As test sample, nine kinds of gels with three fracture force and three fracture strain were prepared. Tongue pressure during squeezing and swallowing gels was measured by using an ultra-thin tongue pressure sensor with five measuring points attached on the hard palate in seven healthy participants, and analyzed at four phases; Initial squeeze, Middle squeeze, Last squeeze, and Swallowing. The maximal magnitude of tongue pressure was increased for gels with higher fracture force at most measuring points and was decreased for gels with higher fracture strain at some measuring points on the median line during Initial and Middle squeezing. However, no influence by fracture force and strain was found in magnitude during Last squeezing and Swallowing. The duration of tongue pressure increased for gels with higher force at most measuring points during Middle squeezing, although no influence by strain was found during each phase. The results clearly show how the initial fracture properties of gels influence on tongue pressure production during each phase of food oral processing, which clarified one aspect of squeezing with tongue, as the compensatory mastication.

DOI： 10.1111/jtxs.12593

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.foodhyd.2020.106353

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Prosthodontic Society  

Purpose In recent years, the chewing frequency, i.e., the number of chewing cycles, has decreased owing to changes in dietary habits. Although these changes may be related to complete body health, there is no evidence-based tool to measure the dietary habits. We developed a small ear-hung wearable device for monitoring mastication behavior. The device, worn on the ear pinna, allows the counting of the number of chewing cycles, and data are collected on a smartphone via Bluetooth. In this study, the reliability of the novel device was verified.Methods A total of 22 healthy volunteers participated in the study. During measurement, the subjects wore the novel wearable device on their right ear pinna and were asked to chew gum, gummy jellies, and rice balls. The number of chewing cycles was counted by the device. A mandibular kinesiograph (MKG) was also recorded, and the chewing activity was recorded as a video. The accuracy, precision, and recall of the ear-hung device were calculated by comparing the data obtained from the MKG and the video recording. Additionally, the factors affecting reliability were examined.Results The accuracy, precision, and recall of the novel device were 101.6 ± 13.6%, 85.3 ± 11.0%, and 84.5 ± 9.5%, respectively. Although the accuracy was not affected by any factor, precision and recall of the novel device for women were significantly worse than that for men, and were greatest when the subjects were chewing gum.Conclusions Our findings suggest that the newly developed ear-hung wearable device for counting the number of chewing cycles was sufficiently reliable.

DOI： 10.2186/jpr.jpr_d_20_00032

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Mastication is a physiological process whereby food is comminuted and mixed with saliva to form a swallowable bolus; it is also the initial process for retronasal aroma that is released from foods to receptors in the nose. However, the influence of mastication state on retronasal aroma is poorly understood. The purpose of this study was to investigate the relationship between aroma concentration and factors related to mastication state. The study design was an analytical observational study. Twelve male volunteers (age, 26.5 ± 2.7 years) were recruited and divided into five and seven participants in the low and high masticatory performance groups, respectively. The stimulated salivary flow rate was measured while participants chewed paraffin wax. First, an odor sensor was placed in the nostril, and the aroma concentration was measured over time as participants chewed an orange-flavored gummy jelly standardized for masticatory performance assessment until swallowing; chewing strokes were counted to determine swallowing thresholds. Next, participants were instructed to chew the gummy jelly for a certain number of strokes (i.e., 50 or 100% of swallowing thresholds, as well as 30 strokes) and expectorate the jelly without swallowing. The surface area of comminuted jelly at 30 chewing strokes was defined as masticatory performance. Maximum and slope of aroma concentration, surface area, number of chewing strokes, and stimulated salivary flow rate were compared between low and high masticatory performance groups. Statistical significance was set at α = 0.05. At 30 chewing strokes, the maximum aroma concentration and the slope were significantly greater in the high masticatory performance group than in the low masticatory performance group. There was a positive correlation between the maximum aroma concentration and the number of chewing strokes with aroma release in both groups. No significant correlation was found between the maximum aroma concentration and the stimulated salivary flow rate. However, multiple regression analysis (with aroma concentration as a dependent variable) showed that the increase in surface area, the number of chewing strokes, and the stimulated salivary flow rate were significant explanatory variables. The results suggested that retronasal aroma was influenced by mastication state and salivary flow rate during chewing.

DOI： 10.3389/fnut.2021.623507

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Tongue motor biomechanics during swallowing was not fully elucidated due to the technical difficulty. OBJECTIVE: To evaluate the relationship between tongue motion and tongue pressure production by simultaneously measuring tongue motion and tongue pressure during water swallowing. METHODS: In 12 healthy male participants (mean age, 30.8 ± 4.2 years), tongue pressure and tongue motion trajectory during dipper- and tipper-type swallows of 3 mL of water were measured using a sensor sheet system equipped with five sensing points and an electromagnetic articulography, respectively. The temporal correlation between motion of anterior/posterior tongue and tongue pressure production during swallowing was evaluated on the synchronised waveforms. RESULTS: In the dipper-type swallow, a similar up-and-down motion pattern in vertical direction was observed among all participants before tongue pressure production. Those motion patterns were common at the anterior and posterior tongue locations with a temporal difference in some segment of tongue motion. On the other hand, tongue directly attached to hard palate with temporal synchronicity between the anterior and posterior parts. In both types of swallow, a strong temporal correlation was found between the timing of tongue-palate contact and the Onset of tongue pressure by intra-class correlation coefficients. CONCLUSION: From the simultaneous measurement of tongue motion and tongue pressure production, the tongue motion pattern during water swallowing and the temporal correlation between tongue motion and tongue pressure production were elucidated.

DOI： 10.1111/joor.13079

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: This study investigated the impact of the renewal of a removable prosthesis on the masticatory function by subjective and objective measures and its variation among the types of occlusal support. METHODS: Seventy-eight patients who received newly fabricated removable denture patients participated in this study. For the objective assessment, masticatory performance was measured using test gummy jelly. For the subjective assessment, standardized questionnaires about food acceptability and the oral health-related quality of life (OHRQoL) were used. Pre- and post-insertion assessments were performed for each subject. Subjects were divided into three groups according to their posterior occlusion: with posterior occlusion (w/PO), without posterior occlusion (w/o PO) and edentulous. Wilcoxon's signed rank test was used to compare the pre- and post-treatment measurements of each assessment. The analysis of covariance and a multiple comparison were used to assess the effect of new dentures and differences due to occlusal support. RESULTS: The masticatory performance, OHRQoL and food acceptability following prosthodontic treatment were significantly improved by new denture insertion. The masticatory performance among groups varied to a relative degree. The rate of masticatory performance improvement for edentulous subjects was twice that in w/PO subjects. The OHRQoL was significantly lower in the w/o PO and edentulous groups with old denture than patients w/PO. The food acceptability improved most markedly in the edentulous group. CONCLUSIONS: The improvement in the masticatory performance by new denture insertion varied among types of occlusal support. Re-establishing the occlusal support of edentulous patients may help restore their OHRQoL and improve food acceptability.

DOI： 10.2186/jpr.JPR_D_20_00045

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The Clinical Oral Disorder in Elders (CODE) index was proposed in 1999 to assess the oral health status and treatment needs of older people who typically were edentate or had few natural teeth. Since then, more people are retaining natural teeth into old age and have oral disorders similar to younger adults. In addition, there has been further guidance on screening for disease that includes changes to the clinical indicators of several oral disorders and greater sensitivity to people's concerns about their oral health and care needs. METHODS: Experts in dental geriatrics assembled at a satellite symposium of the International Association of Dental Research in June 2019 to revise the objectives and content of the CODE index. Before the symposium, 139 registrants were asked for comments on the CODE index, and 11 content experts summarised current evidence and assembled reference lists of relevant information on each indicator. The reference lists provided the base for a narrative review of relevant evidence supplemented by reference tracking and direct searches of selected literature for additional evidence. RESULTS: Analysis of the evidence by consensus of the experts produced the Clinical Oral Disorders in Adults Screening Protocol (CODA-SP). CONCLUSIONS: The CODA-SP encompasses multiple domains of physical and subjective indicators with weighted severity scores. Field tests are required now to validate its effectiveness and utility in oral healthcare services, outcomes and infrastructure.

DOI： 10.1111/ger.12496

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To measure masticatory performance (MP) in partially edentulous patients when wearing removable partial dentures (RPDs) versus when not wearing RPDs, and to identify factors that could enable clinical evaluations related to differences in MP. MATERIALS AND METHODS: This study consisted of 87 partially edentulous patients (57 females, 30 males; mean age, 69.41 ± 8.85 years) categorized as Eichner classification B who habitually wore RPDs. MP was evaluated while wearing versus while not wearing RPDs using test gummy jellies. The participants were categorized into four groups by the presence of occlusal contacts in one to three of the molar and premolar regions (occlusal support), or in the anterior region only, according to the Eichner index (B1-B4). The participants were also categorized according to the jaw on which the RPDs were worn and the Kennedy classification, and evaluated in regard to changes in MP resulting from wearing RPDs. Additionally, the rate of change in MP (MP-rv) was calculated for each participant using MP when not wearing RPDs as a reference, and factors affecting MP-rv were evaluated using single or multiple regression analysis and the Kruskal-Wallis test with multiple comparisons. RESULTS: Significant increases in MP-rv were observed for all participants and for those with occlusal support in two (p = 0.006) and three regions (p = 0.019); however, no significant differences were observed when wearing and not wearing RPDs in participants with (p = 0.090) and those without occlusal support in one region (p = 0.474). With respect to the jaw on which the RPDs were worn, only maxillary or both maxillary/mandibular RPDs tended to have higher MP-rvs than did only mandibular jaws. The results of the multiple regression analysis showed that Kennedy Class I edentulous arches were a factor in increasing MP-rv (standard partial regression coefficient = 0.46, p < 0.05). CONCLUSION: According to the results of this study, among various factors on the degree of improvement in masticatory performance by wearing RPDs, bilateral missing posterior teeth might be a predictor for achieving clinical improvement.

DOI： 10.1111/jopr.13265

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Language：Japanese   Publisher：(一社)日本言語聴覚士協会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Pharyngeal residue can trigger aspiration and choking after swallowing. Various studies to assess the amount of pharyngeal residue have been conducted; however, an easy and quantitative method is yet to be established. The aroma released from the pharyngeal residue is thought to be delivered from the pharynx to the nasal cavity via velopharynx by expiration, that is, retronasal pathway. OBJECTIVE: This study verified that the amount of pharyngeal residue could be estimated by aroma intensity. METHODS: Ten healthy adult subjects had tubes in from the oral cavity to the pharynx. Varying amounts of essence were dispensed into the pharynx through the tube either at rest or after swallowing the essence. Pharyngeal residue was simulated by retention essence in the pharynx without swallowing. An odour sensor was placed in the nostril, and the aroma intensity of the retained essence was measured over time. RESULTS: The aroma intensity level flattened after a certain period of time had elapsed, and a significant correlation was found between the amount of essence dispensed and the flattened aroma intensity, both at rest and after swallowing. Furthermore, to estimate in a short period of time, changes in aroma intensity over time were estimated by fitting to a decay curve. The estimated intensity at convergence, calculated from the fitted curve from 80 to 120 seconds after swallowing, was significantly correlated to the measured intensity. CONCLUSION: The amount of pharyngeal residue can be estimated in a short period of time by measuring the aroma intensity.

DOI： 10.1111/joor.12974

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DOI： 10.1016/j.tifs.2020.02.023

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: The aim of this study was to evaluate tongue movement and its biomechanical effects during squeezing, one of the oral strategies for processing soft foods, by tongue pressure sensors, videofluorography, and surface electromyography. DESIGN: Fifteen healthy men (mean age, 31.0 ± 4.1 years) without dysphagia were recruited. A 0.1-mm-thick pressure sensor sheet with five measuring points, videofluorography, and surface electromyography were used for synchronous measurements of tongue pressure, hyoid movement, and suprahyoid muscles activity, respectively, while squeezing 5 mL of gels. Amplitude, duration, area, and their sequential order during initial squeezing were analyzed. Differences in hyoid position at the onset, peak, and offset of hyoid movement were also analyzed. RESULTS: At the beginning of initial squeezing, tongue pressure at the middle area of the hard palate, hyoid movement, and suprahyoid muscle activity appeared simultaneously, followed by tongue pressure at the anterior area and then at the posterior area. When the hyoid was in an elevated position, the amplitude of suprahyoid muscle activity and tongue pressure peaked. At the end of initial squeezing, the hyoid position at the offset of hyoid excursion was superior to that at the onset. All evaluation items of tongue pressure, hyoid movement, and suprahyoid muscle activity were modulated according to the texture of gels. CONCLUSIONS: During initial squeezing, tongue pressure, hyoid movement, and suprahyoid muscle activity were coordinated while being modulated by the food texture. At the end of initial squeezing, the hyoid was maintained in an elevated position, which might be beneficial for subsequent squeezing.

DOI： 10.1016/j.archoralbio.2019.104631

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Movement of the hyoid and laryngeal complex is critical for preventing aspiration, as well as smooth bolus passage through the pharynx. We have developed a non-invasive system for measuring laryngeal movement during swallowing with a bend sensor and have already reported the time coordination between the signal waveform from the sensor and hyoid movement. OBJECTIVE: The aim of this study was to clarify the quantitative association between the output value of the sensor and hyoid movement during swallowing. METHODS: A small bend sensor was fixed on the skin surface along the midline of the neck of 13 healthy men (mean age, 30.8 ± 4.5 years). Laryngeal and hyoid movements during swallowing of 5 mL of water were recorded synchronously by the bend sensor and videofluorography. The relationship between the bend sensor output value (LM value) and hyoid position (x- and y-axis displacements) by videofluorography from the onset to the offset of the signal waveform was analysed for all tasks and for each task using Pearson's correlation coefficients. RESULTS: There was a positive correlation between the LM value and hyoid position for all tasks (x-axis displacement: r = .647, y-axis displacement: r = .233). In particular, there was a moderate to high correlation between the LM value and x-axis displacement for each task (.453 ≤ r ≤ .934). CONCLUSION: The LM value can be a quantitative parameter of anterior hyoid movement during swallowing that might be associated with bolus flow and upper oesophageal sphincter opening.

DOI： 10.1111/joor.12906

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Language：English   Publishing type：Research paper (scientific journal)  

Lip closing is an important motor act in food acquisition. Appropriate food capture in anticipatory and early oral stages of feeding is essential for mastication and swallowing. The aim of this study was to investigate the effect of food type and quantity on lip closing pressure during food capture with a spoon, and to identify normal lip function during food acquisition in healthy young adults. Twenty young healthy males (age range: 22-30 years) participated in this study. They were asked to eat the test food freely with a spoon. Test foods were yogurt and cream cheese, which were given in quantities of 3, 5 and 10 g in weight; 3 ml water was included as a reference. A strain gauge transducer was embedded in the spoon in advance, and lip closing pressures during food capture were measured and recorded. The Vicon motion analysis system was used to collect three-dimensional kinematic data of spoon operation. Positive pressure with lip closing during capture of adhesive food, such as cream cheese, significantly increased (P < 0.001). Moreover, positive pressure significantly decreased when food quantity increased (P < 0.01), irrespective of food type. Negative pressure that preceded positive pressure appeared more frequently during cream cheese intake and increased when food quantity on the spoon increased (P < 0.001). These findings indicated that participants sucked or squeezed the spoon further during capture of adhesive food. Maximum mouth opening occurred predominantly during the spoon insertion period, while mouth closing occurred predominantly during the spoon withdrawal period. After mouth closing, all subsequent lip pressure events appeared in the withdrawal period. Our results may be useful for comprehending normal lip function during food acquisition in healthy young adults. They may also aid in the diagnosis and management of abnormal lip function in oral hypofunction and dysfunction, which can be examined in future studies.

DOI： 10.1016/j.physbeh.2019.112743

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PURPOSE: Masticatory performance can be measured through elution of glucose or beta-carotene from comminuted gummy jelly. However, these methods require special devices. Additionally, occasional/unintentional swallowing or inadequate collection of comminuted particles of gummy jelly in the oral cavity may cause measurement errors. Therefore, we devised a new photographic method to estimate the increase in surface area and weight of comminuted gummy jelly. This study aimed to verify the accuracy of this method. METHODS: Initially, fifty images depicting the comminuted pieces in a special box were prepared. Then, the increase in surface area was measured using a fully-automated method, and the weight was measured. The size and angle of each image were adjusted based on markers located at the four corners of the box. From these photographic images, the area, perimeter, color average, color deviation, side area, and amount of surface roughness for each particle was calculated, and multiple regression analysis was performed to estimate the surface area and weight. The relationship between the estimated values and the values measured with the fully-automated device and by weight were analyzed. RESULTS: The intra-class correlation coefficient between the estimated value and the value from the fully-automated method was r = 0.956. This high correlation was also obtained under different photographic conditions. Furthermore, for determining whether 80% or less gummy jelly was collected, the sensitivity was 100% and the specificity was 91%. CONCLUSIONS: The newly developed photographic method is valuable because it is accessible and may assist in achieving reliable evaluation of masticatory performance.

DOI： 10.1016/j.jpor.2019.04.010

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DOI： 10.1016/j.jds.2020.09.007

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Older adults with disorders of mastication and swallowing are often fed soft foods such as jelly or puree. The texture of such semi-solid foods allows them to be squeezed between the tongue and palate rather than being chewed. However, it is difficult to visually identify such strategies for the oral processing of food. This study aimed to test the hypothesis that there is a difference in the sequential coordination between the masseter and supra-hyoid muscles, and to identify feeding behaviors such as chewing and squeezing using electromyography. Seventeen male subjects (mean age: 30.8 years) were recruited. Four kinds of gels were prepared (two kinds of fracture force and fracture strain) as test samples. Subjects were instructed to consume the gels in three ways: squeezing with the tongue, chewing with the teeth and eating freely until swallowing. The amount of squeezing/chewing and the consumption time was unlimited. The masseter and supra-hyoid muscle activity were recorded during the entire consumption time and videofluorography was simultaneously recorded during each ingestion. Lissajous figures were made from the electromyographic activity of the two groups of muscles during the first stroke, and a regression line was made to determine the gradient of each figure to compare squeezing and chewing using the Mann-Whitney U-test. The masseter and supra-hyoid muscles were active simultaneously during squeezing with the tongue. However, the masseter was active after the supra-hyoid during chewing. The gradient of the regression line from the Lissajous figures between the masseter and supra-hyoid muscle activity was positive during squeezing, but negative during chewing. Analysis of the ROC curve showed that the cutoff value of the gradient for differentiating feeding behaviors was 0.097, with a sensitivity of 95.3% and specificity of 98.4%. When we allocated 68 free intakes into squeezing and chewing according to this cutoff value, we could distinguish with good precision, and the accuracy, sensitivity, and specificity were 86.8, 91.1, and 66.7% respectively. These results suggest that certain aspects of muscle activity differed among oral processing methods. Lissajous analysis of muscle activity was useful for identifying ingestion behaviors.

DOI： 10.3389/fphys.2020.00618

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BACKGROUND: Tongue thrusting, which often occurs during swallowing in patients with anterior open bite, is considered to show different tongue dynamics from healthy individuals, but the details are still unclear. OBJECTIVE: This study aimed to identify the effect of tongue thrusting on tongue pressure production during swallowing in patients with anterior open bite. METHODS: The subjects were 11 patients with an anterior open bite and 8 healthy volunteers with individual normal occlusion. The patients were divided into a tongue-thrusting group (n = 8) and a non-thrusting group (n = 3). Tongue pressures while swallowing jelly (4 mL) were recorded by a sensor sheet system with five measuring points (Chs1-5) attached to the palatal mucosa. The time sequences, maximum magnitude and duration of tongue pressure, and swallowing time of tongue pressure were analysed. RESULTS: Tongue pressure waveforms in the tongue-thrusting group were quite diverse compared with the other two groups. The duration at the posterior-median part in the tongue-thrusting group was significantly shorter, and the maximum magnitudes at the mid-median, posterior-median and the peripheral part were also significantly lower than in the healthy group. These results suggest that the compensatory tongue thrust action by which the tongue closes the front part of the oral cavity may make it difficult to lift the tongue and transfer the bolus. CONCLUSION: Patients with an anterior open bite and tongue thrusting at swallowing showed diversity of tongue pressure waveforms and noticeably weaker tongue pressures from mid-median to posterior-median regions than healthy individuals.

DOI： 10.1111/joor.12820

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(NPO)日本顎変形症学会  

顎矯正手術を施行した骨格性下顎前突症患者10名(全例女性)を対象に、舌圧センサシートを用いて舌の機能的特徴を解析し、過去に報告した個性正常咬合者10名および骨格性下顎前突症患者(顎矯正手術施行前)10名の結果と比較することで術後における嚥下時舌動態の傾向について検討した。術後6ヵ月経過した症例の舌圧波形は各Chの舌圧発現からそれぞれ約200〜400msec後にピーク値をむかえたが、その後もピーク値に近似した舌圧が持続的に働いた。術後群の舌圧発現順序は、舌圧発現開始時刻よりCh1、Ch4、Ch5、Ch2、Ch3の順となり健常群と同じ順序であった。舌圧発現開始時刻、舌圧ピーク発現時刻は健常群と比較し有意差を認めなかったが、Ch4、Ch5における舌圧消失時刻は遅延した。そのため、Ch4、Ch5の舌圧持続時間の延長という下突群と同じ特徴を有していたが、術後群と下突群を比較するとCh4、Ch5における舌圧消失時刻は有意に早期化していた。

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This study investigated the relationship between tongue pressure during swallowing and dysphagia in patients with Parkinson's disease (PD). A total of 24 patients with PD (12 men and 12 women, mean age 70.4 years) were studied. Their mean Hoehn and Yahr scale was 3.0 ± 1.3 (range 1-5). All participants underwent tongue pressure measurement and videofluorography during swallowing. Tongue pressure when swallowing 5 mL of barium on videofluorography was measured using a sensor sheet with five sensors. Based on the findings of videofluorography, the patients were divided into two groups: dysphagic PD group (n = 9) and non-dysphagic PD group (n = 15). The maximal magnitude (kPa), duration (s), time to peak pressure (s), and pressure gradient (kPa/s) of tongue pressure were analyzed for each part. For duration, time to peak pressure, and pressure gradient, similar values were calculated from the total waveform. There was no significant difference in maximal tongue pressure between the groups. The dysphagic PD group had prolonged duration of tongue pressure and time to peak pressure and a reduced pressure gradient compared with the non-dysphagic PD group. These results indicate that there is a clear difference in the temporal aspects of tongue pressure between the non-dysphagic and dysphagic PD patients. These differences provide the characteristics of tongue movement during swallowing in PD patients with dysphagia, which may be useful for the diagnosis and treatment of dysphagia.

DOI： 10.1007/s00455-018-9916-5

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DOI： 10.1007/s00455-017-9865-4

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The physiological mechanisms underlying Stage II transport (STII), during which comminuted solid food is transported from the oral cavity into the meso-pharynx for aggregation into a pre-swallow bolus, have yet to be clarified. The purpose of the present study was to investigate relationships between tongue-palate contact during mastication and incidence of STII by synchronised analysis of tongue pressure production on a hard palate and video-endoscopic (VE) images during mastication. Tongue pressure at 5 measuring points with an ultra-thin sensor sheet attached to the hard palate and trans-nasal VE images while masticating corned beef was recorded for 12 healthy subjects. All recordings were divided into 2 groups: mastication with STII and without STII. Tongue pressure duration was longer at the anterior-median part in the group with STII than in the group without STII. Integrated values of tongue pressure were greater at the anterior-median parts and posterior circumferential part in the group with STII. Integrated values of tongue pressure per second were greater in late-stage mastication than in early-stage mastication in the group with STII. These results suggest that the tongue-palate contacting at the anterior-median and post-circumferential parts of the hard palate is related with the incidence of STII.

DOI： 10.1111/joor.12654

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Blackwell Publishing Ltd  

DOI： 10.1111/joor.12626

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Language：Japanese   Publisher：(一社)日本言語聴覚士協会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J04306&link_issn=&doc_id=20180703130003&doc_link_id=%2Fdz7jslhr%2F2018%2F001502%2F002%2F0062-0070%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz7jslhr%2F2018%2F001502%2F002%2F0062-0070%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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DOI： 10.1016/j.physbeh.2018.03.006

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DOI： 10.1111/joor.12623

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DOI： 10.1111/jtxs.12315

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DOI： 10.1152/japplphysiol.00512.2017

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DOI： 10.1371/journal.pone.0190608

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society of Biorheology  

DOI： 10.17106/jbr.32.39

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DOI： 10.1111/jtxs.12261

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DOI： 10.1038/s41598-017-15243-6

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1111/ger.12186

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DOI： 10.1111/joor.12379

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DOI： 10.5466/ijoms.15.85

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DOI： 10.1007/s00455-015-9641-2

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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DOI： 10.1016/j.physbeh.2015.05.004

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DOI： 10.1111/jtxs.12111

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DOI： 10.1111/ggi.12315

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OBJECTIVE: To investigate the tongue pressure (TP) produced by tongue-hard palate contact in the process of normally swallowing liquid in healthy adults. METHODS: Thirteen adult male subjects were recruited to perform a single swallow of 5 ml water when sitting with upright position. The tongue pressure sensor sheet was used to monitor TP as a result of tongue-hard palate approximatation in the anteriomedian, midmedian, posteriomedian and circumferential parts, and the swallowing sound was recorded by microphone. The temporal sequence of TP at each measured part was obtained after setting the swallowing sound as the reference time. Also, the total duration, pre-peak duration, post-peak duration, maximum magnitude and integrated value of TP were recorded and compared among the measured parts. RESULTS: TP was produced from anterior to posterior along the midline of hard palate during normal swallowing of water [Ch1: (-0.40 ± 0.22) s, Ch2: (-0.36 ± 0.21) s, Ch3: (-0.24 ± 0.18) s], with the circumferential TP [Ch4: (-0.38 ± 0.23) s, Ch5: (-0.40 ± 0.23) s] occurring nearly to the anteriomedian one (P > 0.05). Before the swallowing sound (P < 0.05), TP at each part reached a peak synchronously [Ch1: (-0.12 ± 0.24) s, Ch2: (-0.16 ± 0.22) s, Ch3: (-0.13 ± 0.21) s, Ch4: (-0.16 ± 0.23) s, Ch5: (-0.17 ± 0.23) s] in a rapid manner (P > 0.05), then decreased gradually until disappeared simultaneously [Ch1: (0.32 ± 0.23) s, Ch2: (0.27 ± 0.21) s, Ch3: (0.23 ± 0.16) s, Ch4: (0.33 ± 0.31) s, Ch5: (0.33 ± 0.29) s] (P > 0.05) after the swallowing sound (P < 0.05). The TP related parameters (the total duration of TP:Ch1: (0.72 ± 0.20) s, Ch2: (0.63 ± 0.16) s, Ch3: (0.47 ± 0.17) s, Ch4: (0.70 ± 0.35) s, Ch5: (0.73 ± 0.29) s; the pre-peak duration of TP: Ch1: (0.28 ± 0.21) s, Ch2: (0.20 ± 0.16) s, Ch3: (0.12 ± 0.10) s, Ch4: (0.21 ± 0.22) s, Ch5: (0.23 ± 0.21) s; the post-peak duration of TP: Ch1: (0.44 ± 0.23) s, Ch2: (0.43 ± 0.18) s, Ch3: (0.36 ± 0.18) s, Ch4: (0.49 ± 0.25) s, Ch5: (0.50 ± 0.23) s; the maximum magnitude of TP: Ch1: (13.80 ± 7.73) kPa, Ch2: (12.40 ± 6.51) kPa, Ch3: (10.26 ± 7.15) kPa, Ch4: (12.16 ± 5.38) kPa, Ch5: (13.08 ± 5.05) kPa; the integrated value of TP: Ch1: (4.99 ± 3.69) kPa×s, Ch2: (4.25 ± 2.13) kPa×s, Ch3: (2.88 ± 1.87) kPa×s, Ch4: (4.32 ± 3.47) kPa×s, Ch5: (4.63 ± 2.49) kPa×s were significantly smaller in the posteriomedian part among all the five parts measured. No laterality was found in TP produced at the circumferential parts of the hard palate (P > 0.05). CONCLUSIONS: The TP at each part coordinates precisely during swallowing. The effective measurement of TP by tongue pressure sensor sheet will facilitate the evaluation of oral swallowing and the diagnosis of dysphagia simply and non-invasively.

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DOI： 10.1016/j.foodhyd.2014.09.029

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DOI： 10.1007/s00455-014-9556-3

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Language：Japanese   Publisher：新潟歯学会  

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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DOI： 10.1111/jtxs.12080

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Language：Japanese   Publisher：日本嚥下医学会  

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DOI： 10.1016/j.nmd.2014.03.003

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OBJECTIVE: To evaluate the effects of the application of tongue pressure sensor sheet on the signal waveform of laryngeal movement produced by the bend sensor during deglutition. METHODS: Twelve adult male subjects were recruited to perform a single swallow of 5 ml water when sitting on the dental chair with upright position. The data recorded by bend sensor was obtained with attaching tongue pressure sensor sheet simultaneously or not. Then the measured parameters by bend sensor with or without concurrent application of tongue pressure sensor sheet were compared. RESULTS: There were no significant differences between the same time point on the signal waveform produced by bend sensor whether concurrently attaching tongue pressure sensor sheet or not (P > 0.05). Additionally, we found no statistical significances between matched phases on the signal waveform recorded by bend sensor with or without application of tongue pressure sensor sheet (P > 0.05). CONCLUSION: The findings in this study suggest us that the usage of tongue pressure sensor sheet exerted no influences on the waveform of the laryngeal movement produced by bend sensor during deglutition, facilitating us to further apply tongue pressure sensor sheet and bend sensor simultaneously to record tongue pressure production and hyoid activity during deglutition.

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DOI： 10.1371/journal.pone.0091920

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DOI： 10.1093/chemse/bjt062

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DOI： 10.1007/s00455-013-9471-z

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DOI： 10.1007/s00455-014-9556-3

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DOI： 10.1111/jphp.12155

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DOI： 10.1111/jphp.12155

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DOI： 10.1155/2014/691352

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Language：English   Publishing type：Research paper (international conference proceedings)  

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DOI： 10.1016/j.nmd.2014.03.003

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DOI： 10.1155/2014/691352

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DOI： 10.1007/s00455-013-9464-y

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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The tongue is important for orofacial movements, including swallowing. Although numerous studies have focused on tongue pressure against the palate, its physiological role has not been fully evaluated. The tongue pressure generation may have the temporal coordination with the swallowing relational organs. The aim of this study was to clarify the physiological mechanisms of tongue pressure and to investigate the temporal relationship among tongue pressure, supra-hyoid muscle activity, and videofluorographic (VF) images during swallowing. Fifteen healthy young subjects participated. Tongue pressure measured using a sensor sheet with five channels, electromyographic EMG, and VF was recorded synchronously during 4-ml barium swallowing. Swallowing behavior in VF images with and without the sensor sheet was compared. Furthermore, the temporal relationship between events measured from tongue pressure, EMG, and VF was evaluated. Swallowing behavior on VF images was not affected by placement of the sensor sheet. Tongue pressure at the posterio-lateral point of the hard palate tended to have biphasic peaks. Tongue pressure production with a monophasic pattern appeared during the same period as the second peak in the biphasic pattern. The onset of tongue pressure was later than the start of hyoid movement and onset of EMG, and offset was observed between the hyoid at the up-forward position and reposition. Onset of tongue pressure at the anterior area was correlated with the start of slight hyoid elevation. Offset of tongue pressure at the posterio-lateral points was strongly time locked with the hyoid at the up-forward position. The present results suggested the temporal coordination of tongue pressure generation with the swallowing-related organs. That is, the tongue pressure was produced for bolus propulsion, and was closely related to hyoid movement temporally during swallowing. These results may contribute to clarify the clinical state with the disorder of tongue kinetics.

DOI： 10.1002/phy2.167

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DOI： 10.1016/j.jpor.2013.08.003

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DOI： 10.2334/josnusd.55.191

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Other Link： http://search.jamas.or.jp/link/ui/2015016896

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DOI： 10.2334/josnusd.55.191

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Other Link： http://search.jamas.or.jp/link/ui/2015016896

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DOI： 10.1371/journal.pone.0070850

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DOI： 10.1111/jtxs.12002

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DOI： 10.1111/j.1745-4603.2012.00364.x

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DOI： 10.1186/1743-0003-10-64

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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DOI： 10.1111/j.1365-2842.2012.02329.x

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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DOI： 10.1016/j.physbeh.2012.02.007

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DOI： 10.1016/j.physbeh.2012.02.007

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DOI： 10.1111/j.1365-2842.2011.02258.x

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DOI： 10.1016/j.physbeh.2011.07.028

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DOI： 10.1007/s00455-010-9292-2

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DOI： 10.1007/s00784-009-0338-5

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DOI： 10.1177/0022034510383692

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DOI： 10.1007/s00784-009-0338-5

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DOI： 10.1161/STROKEAHA.110.594960

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DOI： 10.1161/STROKEAHA.110.594960

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DOI： 10.1177/0022034510370801

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DOI： 10.3390/s100100176

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DOI： 10.1159/000315140

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Authorship：Lead author   Language：Japanese   Publisher：Japan Prosthodontic Society  

<B>Patient:</B> A 27-year-old female had undergone partial mandibulectomy under the diagnosis of mucoepidermoid carcinoma. The temporary denture was placed after 17days postoperatively. After the forearm flap became stable, the final denture with hand-made artificial porcelain teeth fabricated and frozen muddy porcelain method (P-C•P•F) was inserted. The patient was followed for 8 years with no complications.<br><B>Discussion:</B> Both pre-surgical impression and P-C•P•F method contributed to the recovery of appearance and function in the early post-operative stage. This method allows the preoperative state of dentition to be precisely reproduced.<br><B>Conclusion:</B> This report suggests usefulness of P-C•P•F method applied in the maxillofacial prosthetic patients who lost a lot of teeth by tumor resection.

DOI： 10.2186/ajps.1.412

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DOI： 10.1016/j.jdsr.2009.03.005

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DOI： 10.1111/j.1600-0722.2009.00637.x

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DOI： 10.1016/j.jpor.2008.08.008

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DOI： 10.1016/j.tripleo.2008.07.006

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Language：English   Publisher：Japan Prosthodontic Society  

Tongue plays an important role by making contact with palate in swallowing. This study was aimed for investigating the utility of originally developed measuring system of tongue pressure in the rehabilitation of dysphagic patients with prosthesis. Subject was a 68 years old male post-surgical laryngeal cancer patient who underwent percutaneus endoscopic gastrostomy because of dysphagia. Tongue pressure during dry swallow was recorded by using our original sensor sheet system (Nitta, Japan) with five measuring points (Chs.1-5) attached on the palatal surface of maxillary denture (RPD). Tongue impression was taken by his maxillary denture and the palatal contour was changed into palatal augmentation prosthesis (PAP), then tongue pressure with PAP was recorded and compared with that with RPD. Magnitude of tongue pressure on median line (CHs.1-3) of palatal surface of RPD was nearly 0 and that on the circumferential part (Chs.4 and 5) had laterality. In PAP, however, magnitude of tongue pressure on the median line increased and showed normal pattern (Ch.1>Ch.2>Ch.3) and that on the circumferential part showed no laterality. Improvement of the tongue pressure production described by our system might contribute to the bolus transport in oral phase of swallowing.

DOI： 10.2186/prp.7.240

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Other Link： http://search.jamas.or.jp/link/ui/2009105294

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DOI： 10.1007/s00415-007-0570-3

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DOI： 10.1111/j.1741-2358.2007.00172.x

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DOI： 10.1177/154405910708600110

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Prosthodontic Society  

<B>Purpose:</B> Little objective investigation has been published regarding factors influencing masticatory performance of post-maxillectomy patients with obturator prosthesis. This study aimed to assess the relationship between masticatory performance and sociological and post-surgical factors, and to develop a theoretical equation predicting masticatory performance using significant factors.<BR><B>Methods:</B> In 37 post-maxillectomy patients with obturator prosthesis, their age, gender, resection of hard and soft palate, number of posterior maxillary teeth, occlusal support, and mouth-opening distance on masticatory performance were investigated, and masticatory performance was measured using a gummy jelly. The influence of these items was evaluated quantitatively using multiple regression analysis (Quantification Method type I). The strength of influence of each explanatory factor on the masticatory performance, identified by the category weight and theoretical value of masticatory performance of each subject, was calculated by totaling the category weights and the constant. Pearson correlation coefficient was used to analyze the correlation between actual values and theoretical values of masticatory performance.<BR><B>Results:</B> The order of strength of influence on masticatory performance was identified by the category weights: extent of hard palate resection (1229.9) > occlusal support (1113.0) > mouth-opening distance (280.8) > age (209.0) > resection of soft palate (194.2) > number of posterior maxillary teeth (186.4). There was a high correlation (<I>R</I>²=0.863, <I>P</I><0.01) between the theoretical values calculated by the predictive equation and the actual values.<BR><B>Conclusion:</B> Masticatory performance of post-maxillectomy patients could be predicted with high accuracy in patients with soft palate defect limited to the anterior part.

DOI： 10.2186/prp.6.181

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Other Link： http://search.jamas.or.jp/link/ui/2008113040

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1177/154405910608500214

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PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: The tongue plays an important role in swallowing by contacting the palate. The aim of the present study was to investigate the characteristics of tongue pressure production during swallowing in post-stroke patients using a newly developed sensor sheet. MATERIALS AND METHODS: Ten post-stroke inpatients with hemiplegia and five healthy volunteers participated in this study. Magnitude of tongue pressure during a dry swallow was measured using a newly developed sensor sheet comprising five sensors applied directly to the palate or to the palatal surface of a maxillary denture using denture adhesive. Swallowing ability was evaluated by measuring the time taken to swallow 30 ml of water. The magnitude of tongue pressure was compared between the post-stroke patients and healthy subjects as well as between each measuring point in both groups. The relationship between tongue pressure and swallowing ability and that between tongue pressure and state of occlusal support were also examined. RESULTS: The magnitude of tongue pressure in the post-stroke patients was smaller than that of the healthy subjects at the measuring points along the median line (Welch test, p &lt; 0.05), larger i

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DOI： 10.1007/s00455-004-0010-9

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OBJECTIVES: This study was designed to determine the factors influencing eating ability of old in-patients in a rehabilitation hospital. DESIGN: Cross-sectional investigation. SETTING: Forty-six in-patients in the rehabilitation ward of Hashimoto Hospital in Kagawa Prefecture in Japan were investigated using a multidisciplinary approach. MAIN OUTCOME MEASURES: Age, gender, state of dentition, muscle activity of lip, cheek and tongue, biting force, salivary flow rate per a minute (SFR), masticatory ability for gummy jelly, swallowing ability, texture of meal, independency of walking (Functional Independence Measure = FIM) and ability to communicate. RESULTS: Bivariate analysis for the relationship between surveyed items and masticatory ability (chi-square test) identified that better masticatory ability for gummy jelly was associated with age (&lt; 85years), gender (male),state of dentition (dentate), SFR (high), activity of lip (good), biting force (high), swallowing ability (good) and activity of communication (high). Among these items, SFR (p = 0.001), gender (p = 0.004), ability to communicate (p = 0.005) and age (p = 0.012) were found having an influence on the masticatory abi

PubMed

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Language：Japanese   Publisher：(公社)日本補綴歯科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J02994&link_issn=&doc_id=20250321240002&doc_link_id=10.7144%2Fsgf.31.10&url=https%3A%2F%2Fdoi.org%2F10.7144%2Fsgf.31.10&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J02994&link_issn=&doc_id=20241105240015&doc_link_id=10.7144%2Fsgf.30.147&url=https%3A%2F%2Fdoi.org%2F10.7144%2Fsgf.30.147&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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これまで、様々なセンシング技術を使って解析した咀嚼・嚥下機能に関わる生体情報を、治療、リハビリテーション、食品開発の3つの方向へ展開してきた。これらの研究を、以下の項目に分けて述べた。1)プロセスモデルによる咀嚼・嚥下の包括的理解、2)咀嚼・嚥下時の舌圧の計測、3)嚥下における口腔と咽頭の協調性、4)舌圧測定による嚥下障害の診断、5)補綴装置による舌圧と嚥下障害の改善、6)リハビリテーション手技の効果検証、7)嚥下困難者用食品の開発、として述べた。

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Language：Japanese   Publisher：医歯薬出版(株)  

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DOI： 10.2186/ajps.9.334

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Language：Japanese   Publisher：(公社)日本リハビリテーション医学会  

DOI： 10.2490/jjrmc.54.666

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DOI： 10.2186/ajps.9.175

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DOI： 10.7144/sgf.23.138

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J02994&link_issn=&doc_id=20170814470014&doc_link_id=10.7144%2Fsgf.23.138&url=https%3A%2F%2Fdoi.org%2F10.7144%2Fsgf.23.138&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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Language：Japanese   Publisher：(一社)日本摂食嚥下リハビリテーション学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J03152&link_issn=&doc_id=20170524040003&doc_link_id=%2Fcb5dvsph%2F2016%2F002002%2F003%2F0080-0085%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb5dvsph%2F2016%2F002002%2F003%2F0080-0085%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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DOI： 10.2186/ajps.8.126

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DOI： 10.11259/jsg.31.3

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DOI： 10.7144/sgf.22.148

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J02994&link_issn=&doc_id=20160908470017&doc_link_id=%2Fex2gakuk%2F2016%2F002202%2F017%2F0148-0149%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fex2gakuk%2F2016%2F002202%2F017%2F0148-0149%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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DOI： 10.2186/ajps.8.46

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Language：Japanese   Publisher：The Japan Society of Cookery Science  

DOI： 10.11402/ajscs.28.0_43

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2015&ichushi_jid=J00999&link_issn=&doc_id=20151228460006&doc_link_id=%2Fdj2ngtdt%2F2015%2F004502%2F006%2F0081-0085%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdj2ngtdt%2F2015%2F004502%2F006%2F0081-0085%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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DOI： 10.7144/sgf.22.38

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Language：Japanese   Publisher：(NPO)日本バイオレオロジー学会  

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DOI： 10.11259/jsg.30.3

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Language：Japanese   Publisher：神戸常盤大学・神戸常盤大学短期大学部  

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Language：Japanese   Publisher：神戸常盤大学・神戸常盤大学短期大学部  

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Language：Japanese   Publisher：日本顎口腔機能学会  

DOI： 10.7144/sgf.21.122

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Language：Japanese   Publisher：The Japan Society of Cookery Science  

DOI： 10.11402/ajscs.27.0_5

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

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Language：Japanese   Publisher：(一社)日本老年歯科医学会  

J-GLOBAL

researchmap