No abstract

To clarify the effect of early dysphagia rehabilitation, early rehabilitation was started within 2 days of admission by speech-language-hearing therapists in patients with severe aspiration pneumonia. Methods: The subjects were inpatients with severe aspiration pneumonia (A-DROP≥3) admitted to our hospital between April 2014 and March 2019. We retrospectively investigated patient age, sex, A-DROP score, community-acquired or nursing-and healthcareassociated pneumonia, invasive and noninvasive ventilation, comorbidities, nutritional risk, admission from nursing home, discharge to nursing home, walking ability before admission and at discharge, Food Intake LEVEL Scale (FILS) score at the start of rehabilitation and at discharge, the achievement of oral intake, alternative nutrition in use at discharge, number of days from admission to the start of rehabilitation, and number of days from admission to oral intake. We compared the patient characteristics and rehabilitation outcomes between 159 patients who underwent early dysphagia rehabilitation and 67 patients who underwent later dysphagia rehabilitation. To assess the association between alternative nutrition at discharge and early dysphagia rehabilitation, binominal logistic regression analysis was performed. Results: Early dysphagia rehabilitation was significantly associated with shorter hospital stays, fewer discharges to nursing homes, higher likelihood of oral intake, the removal of alternative nutrition at discharge, fewer days from admission to oral intake, and higher FILS scores at discharge. Early dysphagia rehabilitation was significantly associated with no alternative nutrition at discharge in binominal logistic regression analysis (odds ratio 3.26; P <0.01). Conclusions: This study suggested that early dysphagia rehabilitation was effective in improving outcomes of severe aspiration pneumonia including the removal of alternative nutrition at discharge.

The plaque formation on the buccal surface is not dependent on the types of clasps. It is effective to prepare a guide plane as close to the gingival margin as possible to reduce the plaque accumulation on the distoproximal surface.

In this study, we confirmed that the principle of rigid support was indispensable for RPD design from the evaluation of a clinical education program. On the other hand, we found out that an objective assessment of the educational system or RPD is necessary to improve the RPD clinical educational program. AbstractPurpose: The aim of this study was to survey the undergraduate removable partial denture (RPD) clinical program and RPD's fabricated by students in 2006, and to identify the problems to be solved in the future. Methods:Sixty-nine students in their final semester at Tokyo Medical and Dental University (TMDU) recorded the following preoperative data: age, gender, chief complaint, and Kennedy and Eichner classifications. The students were requested to present their treated cases and were subjected to an oral examination by the professor to determine the treatment plan and prosthetic design of denture. Additionally, the students surveyed the chewing function score and visual analogue scale (VAS) regarding esthetics and stability of RPD, and the material used for RPD frameworks was summarized. Results: The patients included 35 men and 34women, and their chief complaints were mostly dissatisfaction with their current dentures. More than 80% of cases were classified as Kennedy I or II, and about one-fourth were classified as Eichner B4 or C1, in which the occlusal supports could not easily be reconstructed. Chewing function score significantly improved compared to preoperative state (P<0.05) and postoperative VAS was clinically acceptable. 89% of frameworks, were cast with Co-Cr alloy in one piece and a palatal strap or bar and a lingual bar were applied in 77% of treated RPDs. Conclusion:It is thought that our educational methods for delivery of RPDs are adequate. Since it is suggested by an objective assessment of them that they are unsatisfactory, we should deal with that problem without delay.