Rehabilitation of eating and swallowing functions from the viewpoint of quality of life should attempt to restore not only the physical, but also sensory function. As the size and shape of the intra-oral bolus of food provides oral sensory information important for eating and swallowing, we investigated the stereognostic ability of the tongue in 269 young adults (mean age: 24.5 years) and 60 seniors (mean age: 80.5 years); all of whom had no eating or swallowing complaints. Assessment of the stereognostic ability involved identifying 20 differently shaped test pieces placed in the oral cavity. The young adults identified a significantly higher number of differently shaped test pieces than the seniors (mean correct number of responses: 16.5 and 10.1 respectively; P < 0.001). Gender and the presence of palatal covers did not have any significant effect on stereognostic ability. The test pieces were categorized into six groups based on the shape. When the young adults misidentified a piece, they often selected another piece within the same group, almost never selecting a piece from another group. The seniors, however, chose test pieces from different groups. Moreover, to determine whether stereognosis could be improved through training, we conducted training involving four senior subjects in their 80s, who correctly identified 10 or fewer pieces. After the training, the number of correct answers increased significantly (P < 0.05). These findings indicate that seniors show decreased stereognostic ability of the tongue compared with young adults and suggest the possibility of recovering the ability using our training method.
While this study demonstrated similar self-reported compliance as previous reports, there were different side effects from those reported for custom-made appliances. Difficulty in optimal fit is considered to be the main cause of the subsequent stopping of the use of the boil and bite appliance.
FS T2-weighted imaging is useful for detection of TMJ effusion, without known causes and confirms the importance of TMJ effusion as an indicator in patients with TMJ-related pain, bone abnormalities, and disk displacement.
Low-level laser irradiation applied to the right TMJ area caused an expansion of blood vessels and an increase in blood flow volume. The same result on the contralateral side may be caused by the vasodilator reflex via the hypothalamic thermostat.
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