구조방정식을 이용한 대도시 일부 노인들의 저작능력 및 구강건강관련 삶의 질과 인지기능

신해은 ( Hae-eun Shin ),장익준 ( Ic-jun Chang ),조민정 ( Min-jeong Cho ),송근배 ( Keun-bae Song ),최연희 ( Youn-hee Choi ) 대한예방치과·구강보건학회 2018 大韓口腔保健學會誌 Vol.42 No.4

Objectives: The aim of this study was to investigate the association between masticatory ability, oral health-related quality of life, and cognitive function in an elderly population using structural equation modeling. Methods: A total of 308 subjects, aged 65 years and over, were recruited from the senior citizen center in Daegu, South Korea and provided consent for inclusion in the study. The Korean version of the Mini- Mental State Examination (K-MMSE) was used to assess the level of cognitive function. Masticatory ability was evaluated through chewing tests, patient-perceived masticatory function and, measurement of relative occlusal forces on molar teeth using the T-Scan III® system. All data were analyzed using χ² tests, t-tests, and one-way ANOVA in SPSS version 23.0 for windows. Structural equation modeling was performed using SPSS AMOS version 22.0. Results: There was a significant association between cognitive function and molar teeth occlusal force. Ability of food chewing score and patient-perceived masticatory function could affect oral health-related quality of life (P>0.05). Higher occlusal forces on molar teeth, compared to anterior teeth, positively correlated with higher cognitive function. Conclusions: These results suggest that an individual’s oral health condition could affect molar teeth occlusal forces and may be related to a risk of developing dementia. Therefore, there is a need for implementing nation-wide policies to improve oral health, such as masticatory function, in the elderly population.

Functional Anatomy of the Temporomandibular Joint and Pathologic Changes in Temporomandibular Disease Progression: A Narrative Review

이연희 대한치의학회 2024 Journal of korean dental science Vol.17 No.1

The temporomandibular joint (TMJ) is one of the most unique joints in the human body that orchestrates complex movements across different orthogonal planes and multiple axes of rotation. Comprising the articular eminence of the temporal bone and the condylar process of the mandible, the TMJ integrates five major ligaments, retrodiscal tissues, nerves, and blood and lymph systems to facilitate its function. Cooperation between the contralateral TMJ and masticatory muscles is essential for coordinated serial dynamic functions. During mouth opening, the TMJ exhibits a hinge movement, followed by gliding. The health of the masticatory system, which is intricately linked to chewing, energy intake, and communication, has become increasingly crucial with advancing age, exerting an impact on oral and systemic health and overall quality of life. For individuals to lead a healthy and pain-free life, a comprehensive understanding of the basic anatomy and functional aspects of the TMJ and masticatory muscles is imperative. Temporomandibular disorders (TMDs) encompass a spectrum of diseases and disorders associated with changes in the structure, function, or physiology of the TMJ and masticatory system. Functional and pathological alterations in the TMJ and masticatory muscles can be visualized using various imaging modalities, such as cone-beam computed tomography, magnetic resonance imaging, and bone scans. An exploration of potential pathophysiological mechanisms related to the TMJ anatomy contributes to a comprehensive understanding of TMD and informs targeted treatment strategies. Hence, this narrative review presents insights into the fundamental functional anatomy of the TMJ and pathological changes that evolve with TMD progression. [J Korean Dent Sci. 2024;17(1):14-35]

인공치아 매식술후의 교합력 변화에 관한 연구

조영철(Yeong Cheol Cho),김태규(Tae Kyu Kim) 대한구강악안면외과학회 1997 대한구강악안면외과학회지 Vol.23 No.3

In spite of continuing efforts by many researchers and clinicians to improve oral functio, the number of patients with missing teeth resulting from periodnotitis and dental caries has not substantially decreased in Korea. Patients who use removable denture have relatively insufficient masticatory function. Various dental implants have been developed by a number of researchers to improve masticatory function. This study was undertaken to investigate the maximum bite force and masticatory function after implantatioin. A total 23 patients were treated with implantation at the Dept. of oral and maxillofacial surgery, college of Dentistry, PUSAN national university. The patient had natural tooth, the contralateral sides had implant-supported prostheses. The results were follows 1. The maximum bite force was little greater in implant-supported prostheses as 39.7kg than natural tooth as 36.8kg. This is because of the lack of periodontal ligament or inhibitory-reflex mechanism, higher maximal bite force could be expected when teeth are replaced by implants. 2. The maximal bite force is greater on implant-supported prostheses than natural tooth, but the masticatory function is higher at natural tooth. All of the patients who had implant-supported prostheses were comfortable during chewing the food. But, the masticatory function decrease because of psychologic problem and character of Korean food.

고령자 환자의 임플란트 구강건강 기능별 만족도에 관한 연구

최에스더(Esther Choi),권은자(Eun-Ja Kwon),한민수(Min-Su Han) 한국의료정보교육협회 2022 보건의료생명과학논문지 Vol.10 No.2

본 연구는 충청남도 홍성 지역에 거주하는 노인들을 대상으로 임플란트 의료보험 적용 시행 후 임플란트 전· 후의 기능별 만족도 요인을 비교하여 노인들의 구강건강 관련 삶의 질을 향상하기 위한 기초자료를 제공하고자 하였다. 2020년 11월 1일부터 20211년 3월 31일까지 충청남도 홍성군에 거주하는 55세 이상을 대상으로 설문조사를 하였다. 저작, 사회적, 심리적 기능을 조사하여 Likert 5점 척도를 사용하였고 기능별 만족도 비교를 위해 paried T-test를 실시하였다. 임플란트 시술 전·후에 대한 저작 기능, 사회적 기능, 심리적 기능에 대한 모든 문항에서 임플란트 시술 전보다 시술 후에서 유의적으로 높게 나타났다(p<0.001). 임플란트 시술은 노인의 구강건강 뿐만 아니라 삶의 질 변화에도 많은 영향을 주므로 노인의 구강건강 증진을 위해서 노인들의 구강 건강 문제와 임플란트에 대한 연구가 더 많이 시행되고, 그에 따른 방안이 필요하겠다. This study aimed to provide basic data for improving the quality of life related to oral health of the elderly by comparing the satisfaction factors by function before and after implantation targeting the elderly living in Hongseong, Chungcheongnam-do. From November 1, 2020 to March 31, 2021, a survey was conducted targeting people aged 55 or older living in Hongseong-gun, Chungcheongnam-do. A Likert 5-point scale was used to investigate chewing, social, and psychological functions, and a paried T-test was conducted to compare satisfaction by function. All factors for masticatory, social, and psychological function before and after implant surgery were significantly higher after implant surgery than before implant surgery(p<0.001). Implant surgery has a great influence on not only the oral health of the elderly but also the change in the quality of life, so more research on this is needed and measures are needed accordingly.

The Effects of Masticatory Exercise Using Chewing Gum on Cognitive Function and Stress

Jinhong Kim,Junhyuck Park,Jongeun Yim 보안공학연구지원센터 2015 International Journal of Bio-Science and Bio-Techn Vol.7 No.6

Masticatory function affects energy expenditure, heart rate, working memory, choice reaction time, and psychological arousal. In other words, masticatory function is closely related to cognitive processing ability. It also influences concentration and stress. The purpose of this study was to determine whether masticatory exercise training using chewing gum can improve cognitive function and stress. The participants were recruited from Sahmyook University and were divided into a masticatory exercise group (n = 15) and a control group (n = 15) by having each of the subjects take out one card from a box containing two types of cards representing the study groups. This study used sugar-free chewing gum with xylitol for the masticatory exercise. Cognitive function and stress were assessed before and after the masticatory exercise. The Memorizing Numbers (MN), Finding a Picture by Name (FPN), and Match Card (MC) components of the COMCOG® test were used to assess cognitive function, which is closely linked to memory, attention, and concentration. Stress was measured using the SA-3000P® system. COMCOG® component scores and stress resistance (SR) and stress index (SI) scores were assessed before and after the training. The groups significantly differed in MN, FPN, MC, SR, and SI scores (p < 0.05). These findings suggest that masticatory exercise using chewing gum improves cognitive function and reduces stress.

Risk Factors of the Masticatory Function in Patients with Temporomandibular Disorders: A Cross-Sectional Cohort Study

Kim, Keon-Hyung,Park, Jo-Eun,Kim, Mee-Eun,Kim, Hye-Kyoung Korean Academy of Orofacial Pain and Oral Medicine 2019 Journal of Oral Medicine and Pain Vol.44 No.3

Purpose: To investigate the masticatory function of patients with different temporomandibular disorders (TMD) phenotypes, and to explore the risk factors for the masticatory function of TMD patients among multiple biopsychosocial variables using patient-reported outcomes (PROs). Methods: Clinical features and TMD diagnoses of 250 cases were investigated by reviewing medical records. Psychosocial factors were evaluated using four questionnaires representing pain severity and pain interference (Brief Pain Inventory), pain catastrophizing (Pain Catastrophizing Scale, PCS), psychological distress (Symptom Check List-90-Revised, SCL-90R) and kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders, TSK-TMD). Masticatory function, as a dependent variable, was determined using the Jaw Functional Limitation Scale (JFLS). Kruskal-Wallis test and Spearman's rank correlation were used for analyses. Results: A total of 145 cases were included and classified into four subgroups including group 1: TMD with internal derangement without pain (n=14), group 2: TMD with muscle pain (n=32), group 3: TMD with joint pain (n=60) and group 4: TMD with muscle-joint combined pain (n=39). Pain severity (p=0.001) and interference (p=0.022) were the highest in group 2, but the mean global score of JFLS was the highest in group 3, followed by group 4, group 2, and group 1 (p=0.013). Pain severity, pain interference, the mean global score of PCS and the mean global score of TSK-TMD showed significant and moderate correlation with the mean global score of JFLS. All subdimensions and the global severity index of SCL-90R had significant, but weak correlations with all scores of JFLS. Conclusions: The results suggest that masticatory functional limitation depends on the TMD phenotypes. Among the various PROs, pain perception, pain catastrophizing and kinesiophobia seem to be more influential risk factors on jaw function than psychological distress, such as depression and anxiety.

Risk Factors of the Masticatory Function in Patients with Temporomandibular Risk Factors of the Masticatory Function in Patients with Temporomandibular Disorders: A Cross-Sectional Cohort Study

김근형,박조은,김미은,김혜경 대한안면통증∙구강내과학회 2019 Journal of Oral Medicine and Pain Vol.44 No.3

Purpose: To investigate the masticatory function of patients with different temporomandibulardisorders (TMD) phenotypes, and to explore the risk factors for the masticatoryfunction of TMD patients among multiple biopsychosocial variables using patient-reportedoutcomes (PROs). Methods: Clinical features and TMD diagnoses of 250 cases were investigated by reviewingmedical records. Psychosocial factors were evaluated using four questionnaires representingpain severity and pain interference (Brief Pain Inventory), pain catastrophizing (Pain CatastrophizingScale, PCS), psychological distress (Symptom Check List-90-Revised, SCL-90R)and kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders, TSKTMD). Masticatory function, as a dependent variable, was determined using the Jaw FunctionalLimitation Scale (JFLS). Kruskal-Wallis test and Spearman’s rank correlation wereused for analyses. Results: A total of 145 cases were included and classified into four subgroups includinggroup 1: TMD with internal derangement without pain (n=14), group 2: TMD with musclepain (n=32), group 3: TMD with joint pain (n=60) and group 4: TMD with muscle-jointcombined pain (n=39). Pain severity (p=0.001) and interference (p=0.022) were the highestin group 2, but the mean global score of JFLS was the highest in group 3, followed bygroup 4, group 2, and group 1 (p=0.013). Pain severity, pain interference, the mean globalscore of PCS and the mean global score of TSK-TMD showed significant and moderate correlationwith the mean global score of JFLS. All subdimensions and the global severity indexof SCL-90R had significant, but weak correlations with all scores of JFLS. Conclusions: The results suggest that masticatory functional limitation depends on the TMDphenotypes. Among the various PROs, pain perception, pain catastrophizing and kinesiophobiaseem to be more influential risk factors on jaw function than psychological distress,such as depression and anxiety.

The Impact of Masticatory Function on Cognitive Impairment in Older Patients: A Population-Based Matched Case-Control Study

고경아,박진영,이중석,예병석,정의원,최성호,차재국 연세대학교의과대학 2022 Yonsei medical journal Vol.63 No.8

Purpose: The aim of this study was to investigate the association between the changes in masticatory function and cognitive im pairment by analyzing longitudinal data of older Korean patients. Materials and Methods: Patients aged over 60 years with dental records between 2005 to 2010 (baseline; T1) and 2014 to 2020(follow-up; T2) were selected in a single medical center. Based on the dementia diagnosis after T2, the cohort was classified intotwo groups, the dementia group (n=122) and the control group (n=366). Changes in masticatory function were calculated using thetotal functional tooth unit (T-FTU) in both groups. The incidence of tooth extraction (%) and the subsequent rehabilitation duringthe observation period were also evaluated. Results: In the dementia group, T-FTU significantly decreased from T1 to T2 (9.81±2.78 to 9.11±3.16, respectively, p=0.008), whileno significant change was observed in the control group. During the mean observation period of 9 years, significantly more teethwere extracted and neglected to be prosthetically restored in the dementia group than in the control group. Regression analysis re vealed that the number of missing teeth neglected [odds ratio (OR)=1.195, 95% confidence interval (CI)=1.025–1.393, p=0.023] andprevious alcohol consumption (OR=4.445, 95% CI=1.831–1.795, p=0.001) were the most significant risk factors of dementia. Conclusion: There might be a causative relationship between the neglected missing dentition and the onset of dementia.

Masticatory Function, Sex, and Risk of Dementia Among Older Adults: A Population-Based Cohort Study

Oh Dae Jong,Han Ji Won,Kim Jun Sung,Kim Tae Hui,Kwak Kyung Phil,Kim Bong Jo,Kim Shin Gyeom,Kim Jeong Lan,Moon Seok Woo,Park Joon Hyuk,Ryu Seung-Ho,Youn Jong Chul,Lee Dong Young,Lee Dong Woo,Lee Seok B 대한의학회 2024 Journal of Korean medical science Vol.39 No.36

Background: A decline in masticatory function may indicate brain dysfunction related to dementia, but the relationship between masticatory function and dementia risk remains unclear. This study aimed to investigate whether masticatory function is associated with the risk of cognitive decline and dementia. Methods: Data were obtained from the nationwide prospective cohort study of randomly sampled community-dwelling Koreans aged ≥ 60 years. The 5,064 non-demented participants, whose number of chewing cycles per bite was assessed by clinical interview, were followed for 8 years with biennial assessments of cognitive performance and clinical diagnoses of all-cause dementia and Alzheimer’s disease (AD). Structural brain magnetic resonance imaging was collected from a subset of cohort participants and their spouses for imaging analyses. Results: Males who chewed ≥ 30 cycles/bite had faster decline in global cognition and memory function and were at higher risk for incident all-cause dementia (hazard ratio [HR], 2.91; 95% confidence interval [CI], 1.18–7.18) and AD (HR, 3.22; 95% CI, 1.14–9.11) compared to males with less than 10 cycles/bite. Additionally, increased chewing cycles in males were associated with reduced brain volume, particularly in regions involved in compensatory cognitive control of mastication. There was no significant association between chewing cycles and the risk of dementia or brain volume in females. Conclusion: Older men who frequently chew their meals could be considered a notable population at risk for dementia who should be carefully assessed for their cognitive trajectories.

노인의 기능 치아 수와 구강건강평가(GOHAI)와의 관련성

조민정 ( Min Jeong Cho ),정은경 ( Eun Kyung Jung ),신해은 ( Hae Eun Shin ),신아라 ( Ah Ra Shin ),조화영 ( Hwa Young Jo ),최연희 ( Youn Hee Choi ),송근배 ( Keun Bae Song ) 한국치위생학회 2016 한국치위생학회지 Vol.16 No.3

Objectives: The purpose of the study was to investigate the association between remaining functional teeth and oral health-related quality of life using Geriatric Oral Health Assessment Index(GOHAI) in the elderly. Methods: A self-reported questionnaire was completed by 237 female elderly in Daegu from May to September, 2015. The questionnaire consisted of general characteristics of the subjects and Geriatric Oral Health Assessment Index(GOHAI). A total of 216 female elderly data were analyzed for oral health status and their GOHAI score. Data were analyzed using SPSS 23.0 version. Logistic regression analysis showed the association of functional teeth and GOHAI score. Results: Number of functional teeth can affect oral health related quality of life in the elderly. When functional teeth is small, the odds ratio(OR) was 2.119(95% CI: 1.215-3.696). After adjusting age, residence type and education, OR was 1.900(95% CI: 1.060-3.399). Policies to preserve natural tooth should be recommended for increasing quality of life in general. Conclusions: This study showed significant association between number of functional teeth and the GOHAI score of the elderly women.