Knowledge and attitude of elderly persons towards dental implantsBackground: Despite their unrivalled place in restorative treatment, dental implants are still scarcely used in elderly patients. Introduction: The aim of this survey was therefore to identify potential barriers for accepting an implant treatment. Materials and methods: Participants were recruited from a geriatric hospital, two long-term-care facilities and a private clinic. The final study sample comprised 92 persons, 61 women and 31 men with an average age of 81.2 ± 8.0 years. In a semi-structured interview, the participants' knowledge of implants and attitude towards a hypothetical treatment with dental implants were evaluated. Results: Twenty-seven participants had never heard of dental implants, and another 13 participants could not describe them. The strongest apprehensions against implants were cost, lack of perceived necessity and old age. Univariate and multiple linear regression analysis identified being women, type and quality of denture, having little knowledge on implants and being hospitalised as the risk factors for refusing implants. However, old age as such was not associated with a negative attitude. Conclusion: The acceptance of dental implants in the elderly population might be increased by providing further information and promoting oral health in general. Regardless of the age, dental implants should be placed when patients are still in good health and live independently.

The purpose of this study was to investigate the influence of chin-down posture and bolus size on tongue pressure during swallowing. Eleven healthy volunteers (7 men, 4 women; age range = 26-59 years) participated in the experiments. Tongue pressure during dry and 5- and 15-ml water swallows in neutral and chin-down postures was measured using a sensor sheet system with five measuring points on the hard palate. Sequential order, maximal magnitude, duration, and integrated value of tongue pressure at each measuring point were compared between postures and bolus sizes. Onset of tongue pressure at posterior-circumferential parts occurred earlier in dry swallow than in 5- and 15-ml water swallows in each posture. Chin-down posture was most effective for increasing tongue pressure in the 5-ml water swallow compared with dry swallow and the 15-ml water swallow, but it had almost no influence on tongue pressure with the 15-ml water swallow. These results suggest that chin-down posture increases the tongue driving force for small boluses in healthy subjects, which can be interpreted to mean that oropharyngeal swallowing in a chin-down posture requires more effort.

SUMMARY Palatal augmentation prostheses are commonly used in the treatment for dysphagia. By lowering the palatal contours, the tongue contact is increased and thus the bolus propulsion facilitated. However, the unfavourable weight of such appliances may be avoided when using lingual plates. Hence, the aim of this study is to investigate the effect of two different types of lingual plates on the vertical dimension in rest position. Eleven healthy dentate subjects with an average age of 35AE5 years (26-60 years) volunteered in this pilot study. The vertical overbites were measured on plaster models. Two different designs of the experimental lingual plates were tested in this pilot study (P-type & D-type). The inter-occlusal freeway space was measured using the electromagnetic K7 jaw-tracking system (Myotronics, USA), while the subjects were seated in an upright position. They were asked to close from rest position into maximum intercuspation for about 2 s. Recordings were performed without the plates and subsequently with each of the two plate designs in situ. All recordings were performed three times and the second closing movement of each recording was used for the analysis. After averaging the repetitions without experimental lingual plates, with P-type and D-type plates, the differences were analysed using a Kruskall-Wallis test. The results showed no significantly increased freeway space while using both types of lingual plates. Hence, it can be concluded that any altered tongue pressure during swallowing with lingual plates is not related to an increase in vertical dimension.

BackgroundAlthough palatal augmentation prostheses (PAPs) can improve dysphagia, their application is compromised in the absence of maxillary abutment teeth. Experimental lingual plates (ELPs) used for raising the tongue may be employed as alternative to PAPs.MethodsInfluence of different ELP designs, plateau (P–type) and drop-shaped (D–type), on the intra–oral pressure during swallowing were tested. Eleven healthy dentate volunteers, with a mean age of 35.5±10.5 years, participated in this study. Tongue pressure on the hard palate was measured using an ultra-thin sensor sheet with five measuring points, whilst performing dry, 5–ml and 15–ml water swallows, with and without the ELPs in situ. Additional pressure sensors were installed in the lingual aspects of the ELPs, and on the vestibular aspect of the lower molars for measuring sublingual and oral vestibule pressures, respectively. Each measurement was recorded thrice. A repeated measures ANOVA was employed to verify differences in duration, maximal magnitude and integrated value for the different experimental situations. Tukey’s post hoc test was performed for comparison testing. Statistical significance was set at p<0.05.ResultsThe sequence of tongue–palate contact on the median line of the hard palate without ELPs was maintained, except for the 15 ml P–type swallow. Tongue pressure started earlier with the D–type but reached its peak nearly at the same time as without ELPs. The peak magnitude and cumulative tongue pressure against the hard palate decreased by wearing ELPs (p<0.05), but was inconsistent between the two types of ELPs and for the different swallowing volumes. Both, maximum and cumulative vestibular pressures were mostly similar or larger with P–type than that with D–type.ConclusionD-type and P-type ELPs seem to have the inverse effect of PAPs on the palatal tongue pressure during swallowing. These first counterintuitive findings do not yet justify rejecting the basic rationale of using ELPs for the treatment of dysphagia; hence a rather biologically designed piezographic lingual plate may be more appropriate.