The aim of this study was to investigate the effects of swallowing exercises on oral function in independent elderly patients visiting the Department of Prosthodontics at Tokyo Dental College Chiba Hospital. Twenty-nine patients aged over 65 years (15 men and 14 women; mean age, 75.0 years) in whom treatment was completed at this college were enrolled in the study. The patients were instructed on how to perform swallowing exercises monthly (including at baseline) for the first 2 months from the start of the study and asked to perform those exercises at least once daily. At the beginning and end of the study (a 3-month study period), the Repetitive Saliva Swallowing Test was conducted and occlusal force, oral diadochokinesis, unstimulated whole saliva flow rate, stimulated whole saliva flow rate, salivary pH at rest, and salivary buffering capacity measured to determine the effects of the exercises on oral function. Analyses demonstrated significant increases in diadochokinesis rate (/ta/ and /ka/) and unstimulated whole saliva flow rate (p<0.05), suggesting that the swallowing exercises promote the maintenance and improvement of oral function in the independent elderly.

The MASA is a useful screening tool for evaluating eating and swallowing functions in dependent older adults. Geriatr Gerontol Int 2017; 17: 561-567.

The purpose of this study was to investigate the accuracy of distance measurements of implant length based on periapical radiographs compared with that of other modalities. We carried out an experimental trial to compare precision in distance measurement. Dental implant fixtures were buried in the canine and first molar regions. These were then subjected to periapical (PE) radiography, panoramic (PA) radiography, conventional (CV) and medical computed (CT) tomography. The length of the implant fixture on each film was measured by nine observers and degree of precision was statistically analyzed. The precision of both PE radiographs and CT tomograms was closest at the highest level. Standardized PE radiography, in particular, was superior to CT tomography in the first molar region. This suggests that standardized PE radiographs should be utilized as a reliable modality for longitudinal and linear distance measurement, depending on implant length at local implantation site.

Dysphagia therapy with the MDTP improves the timing of physiological events during swallowing. Temporal coordination of swallowing components after therapy approximates that of healthy adults, suggesting a normalization of swallow timing after the MDTP.

Change in oral function was evaluated longitudinally in elderly persons participating in an Exercises for Healthy Oral Function program implemented as part of the Long-Term Care Prevention Project. The participants comprised high-risk and healthy persons aged 65 yr or over. A questionnaire was used to classify them into two groups ('every day or sometimes' or 'rarely') at the end of the study for a comparison of change in repetitive saliva swallowing test (RSST) scores and oral diadochokinesis between 3 time points: at before, at immediately after, and at 1 yr after completion of the program. The average RSST score showed a decrease at 1 yr after intervention, but the difference was not statistically significant. Oral diadochokinesis showed a significant increase for all syllables upon completion of the program compared with at the beginning. This was followed by a significant decrease at 1 yr later compared with at the time of completion in the 'rarely' group for all syllables, but not in the 'every day or sometimes' group. In addition, the number of repetitions was significantly lower in the 'rarely' group than in the 'every day or sometimes' group for all syllables at 1 yr after completion. The results of the present study suggest that Long-Term Care Prevention Projects are necessary to maintain and improve oral function.

Ultrasound imaging is simple, repeatable, gives real-time feedback, and its dynamic soft tissue imaging may make it superior to other modalities for swallowing research. We tested this hypothesis and measured certain spatial and dynamic aspects of the swallowing to investigate its efficacy. Eleven healthy adults wearing a headset to stabilize the probe participated in the study. Both thickened and thin liquids were used, and liquid bolus volumes of 10 and 25 ml were administered to the subjects by using a cup. The tongue's surface was traced as a spline superimposed on a fan-shaped measurement space for every image from the time at which the tongue blade started moving up toward the palate at the start of swallowing to the time when the entire tongue was in contact with the palate. To measure depression depth, the distance (in mm) was measured along each radial fan line from the location at which the tongue's surface spline intersected the fan line to the point where the hard palate intersected the fan line at each timepoint. There were differences between individual participants in the imageability of the swallow, and so we defined quantitatively "measureable" and "unmeasurable" types. The most common type was measureable, in which we could find a clear bolus depression in the cupped tongue's surface. Indeed, with 10 ml of thin liquids, we were able to find and measure the depression depth for all participants. The average maximum radial distance from the palate to the tongue's surface was 20.9 mm (median) (IQR: 4.3 mm) for swallowing 10 ml of thin liquid compared to 24.6 mm (IQR: 3.3 mm) for 25 ml of thin liquid swallow (p < 0.001). We conclude that it is possible to use ultrasound imaging of the tongue to capture spatial aspects of swallowing.

The purpose of this study was to clarify the presence of pain and a correlation between pain and characteristics of signal intensity of mandibular bone marrow in temporomandibular joints (TMJ) with osteoarthritis (OA). A total of 196 joints in 98 patients with TMJ disorders were examined using magnetic resonance imaging (MRI). A pain score and signal intensity on mandibular bone marrow were analyzed in the TMJ with OA. TMJ with OA showed a higher degree of pain compared to those without (p<0.05). During opening, the joints in the higher signal intensity group showed a significantly higher degree of pain compared to the joints in the lower signal intensity group in those with OA on proton density weighted images (p<0.05). It was concluded that TMJ with osteoarthritis is related to pain and that a symptomatic osteoarthritic TMJ can accompany bone marrow changes in the condyle, showing an increased signal on proton density weighted images.

Magnetic resonance imaging (MRI) on patients with temporomandibular joint disorders (TMD) has revealed that a decrease and/or increase in signal intensity from retrodiscal tissue, joint effusion (the excessive accumulation of joint fluid) and articular disc displacement are related to TMD. However, the effect of aging on these phenomena has yet to be clarified. This study was carried out to explore the relationship between changes in signal intensity from retrodiscal tissue, joint fluid status and pathological disc conditions in elderly patients with TMD. Twenty patients aged over 60 years were examined. They consisted of one man and 19 women, and ranged between 60 and 79 years in age (mean, 66.0 years). The relationships between decreased signal intensity on proton-density-weighted (PDW) images and increased signal intensity on T2-weighted (T2W) MR images from retrodiscal tissue, joint fluid status and state of articular disc were examined. Joint fluid status was classified into 5 levels by extent of high signal areas in upper and lower articular spaces on T2W images. Disc displacement status was evaluated by PDW images. The Wilcoxon test was applied for the statistical analysis. The group showing increased T2W signal intensities from the retrodiscal tissue consisted of 31 out of 40 joints (77.5%). This group showed a significant difference in comparison with the other groups in which no apparent joint fluid was shown (pϽ0.05). There were no statistically significant differences among other categories. The results suggest a negative relationship between joint fluid and increased signal intensity from retrodiscal tissue due to reflection of the inflammatory reaction in TM joints.