A 5-year longitudinal study of association of maximum bite force with development of frailty in community-dwelling older adults.

To determine whether maximum bite force (MBF), an objective measure of oral function, is associated with development of frailty in community-dwelling older adults. This prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Baseline MBF was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up examinations, including physical fitness and anthropometric evaluation and structured questionnaires, were administered annually over a 5-year period to determine the incidence of frailty, which was defined by the presence of 3 or more of the following 5 components derived from the Cardiovascular Health Study: low level of mobility, low physical activity level, weakness, shrinking and poor endurance and energy. Adjusted hazard ratios (HRs) of incidence of frailty according to sex-stratified tertiles of baseline MBF were calculated using Cox proportional hazards regression models. During the follow-up, 49 participants (15.2%) developed frailty. Participants in the lower tertile of MBF exhibited a significantly greater risk of frailty than those in the upper tertile. After adjustment for sex, depression, diabetes and Eichner index, the adjusted HRs for frailty in the upper through lower tertiles of MBF were 1.00 (reference), 1.27 (95% confidence interval [CI]: 0.50-3.20) and 2.78 (95% CI: 1.15-6.72), respectively (P for trend = .01). Poor oral function, as indicated by low MBF, increases the risk of development of frailty among elderly men and women.

The association between dentition status and sarcopenia in Japanese adults aged ≥75 years.

Sarcopenia is an age-related loss of muscle mass and muscle strength or physical performance. There are limited data on the association between oral health and sarcopenia. To test the hypothesis that impaired dentition status was associated with sarcopenia, we conducted a cross-sectional study. A total of 272 community-dwelling Japanese adults aged ≥75 years for whom data were available from comprehensive health examinations conducted in 2015 were included in this study. During dental examination, the number of natural teeth and occluding pairs of natural teeth was counted. In denture wearers, the fit of the removable dentures was also evaluated. The criteria proposed by the Asian Working Group for Sarcopenia were used to define sarcopenia. A multivariable logistic regression model was used to evaluate the association between dentition status and the presence of sarcopenia. The prevalence of sarcopenia was 25·7% (70/272). Compared to individuals with ≥10 occluding pairs of natural teeth, those with no occluding pairs of natural teeth had significantly higher risk of having sarcopenia (adjusted odds ratio, 3·37; 95% confidence interval, 1·07-10·61), after adjusting for possible confounders. In addition, compared to individuals with well-fitting dentures, those with ill-fitting dentures had significantly higher risk of having sarcopenia (adjusted odds ratio, 5·07; 95% confidence interval, 1·59-16·19). Our findings suggest that impaired dentition status is significantly associated with sarcopenia among community-dwelling Japanese adults aged ≥75 years. Future longitudinal studies with larger, more diverse populations are necessary to validate our findings.

Longitudinal association of dentition status with dietary intake in Japanese adults aged 75 to 80 years.

Limited information is available on the temporal association between dentition status and dietary intake. The aim of this 5-year prospective cohort study was to investigate whether impaired dentition was associated with subsequent decline in dietary intake in older Japanese adults. Two hundred and eighty-six community-dwelling Japanese individuals, all aged 75 years at baseline, were included in the study. Functional tooth units (FTUs), defined as a pair of opposing natural or prosthetic teeth excluding third molars (range: 0-14), were counted on the basis of baseline dental examinations. Individuals with ≤5 FTUs were defined as having impaired dentition. Dietary intake was assessed at baseline and 5 years later, using a validated dietary questionnaire. Robust regression analyses were used to evaluate the differences in change in dietary intake between participants with and without impaired functional dentition, after adjustment for potential confounders. Sixty-one study participants (21·3 %) were defined as having impaired dentition. Overall, mean values for all estimated dietary variables (energy, nutrients and food groups) declined over time. Notably, individuals with impaired dentition demonstrated a significantly (P < 0·05) greater degree of decline in the intake of multiple nutrients (protein, sodium, potassium, calcium, vitamin A, vitamin E and dietary fibre) and food groups (vegetable and meat) than those without impaired dentition, after adjusting for potential confounders. The results of this study describe the temporal association of impaired dentition with the decline in selected nutrient and food group intake among older Japanese adults.

Maximum bite force at age 70 years predicts all-cause mortality during the following 13 years in Japanese men.

There is limited information on the impact of oral function on mortality among older adults. The aim of this prospective cohort study was to examine whether an objective measure of oral function, maximum bite force (MBF), is associated with mortality in older adults during a 13-year follow-up period. Five hundred and fifty-nine community-dwelling Japanese (282 men and 277 women) aged 70 years at baseline were included in the study. Medical and dental examinations and a questionnaire survey were conducted at baseline. Maximum bite force was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up investigation to ascertain vital status was conducted 13 years after baseline examinations. Survival rates among MBF tertiles were compared using Cox proportional hazards regression models stratified by sex. There were a total of 111 deaths (82 events for men and 29 for women). Univariable analysis revealed that male participants in the lower MBF tertile had increased risk of all-cause mortality [hazard ratio (HR) = 1·94, 95% confidence interval (CI) = 1·13-3·34] compared with those in the upper MBF tertile. This association remained significant after adjustment for confounders (adjusted HR = 1·84, 95% CI = 1·07-3·19). Conversely, no association between MBF and all-cause mortality was observed in female participants. Maximum bite force was independently associated with all-cause mortality in older Japanese male adults. These data provide additional evidence for the association between oral function and geriatric health.

Longitudinal relationship of severe periodontitis with cognitive decline in older Japanese.

BACKGROUND AND OBJECTIVE: Epidemiologic data examining the longitudinal relationship between periodontitis and cognitive status are very limited, especially in Asian populations. The present study examined the longitudinal relationship of periodontitis with cognitive decline in 85 Japanese community-dwelling individuals (average age: 79.3 years) for whom data were available from comprehensive health examinations conducted in 2010 and 2013. MATERIAL AND METHODS: Based on a baseline full-mouth periodontal examination, severe periodontitis was defined using a Centers for Disease Control and Prevention/American Academy of Periodontology definition. Cognitive decline during the 3-year study period was defined using the results of the Mini-Mental State Examination (MMSE). Information on age, gender, education, depression, body mass index, smoking status, alcohol use, exercise, hypertension, diabetes, history of cardiovascular disease and stroke, and baseline MMSE scores were obtained and tested as potential confounders in the statistical models. RESULTS: Among 85 study participants, 21 (24.7%) were defined as having severe periodontitis. Multivariable Poisson regression analyses revealed that severe periodontitis was significantly associated with an increased risk of cognitive decline [adjusted relative risk = 2.2; 95% confidence interval (95% CI): 1.1-4.5]. Furthermore, multivariable linear regression analyses revealed that participants with severe periodontitis had a 1.8-point greater decrease (95% CI: -3.3 to -0.2) in MMSE score than those without severe periodontitis. CONCLUSION: Within the limitations related to its small sample size, the findings of the present study suggest that severe periodontitis is significantly associated with future decline in cognitive function among community-dwelling older Japanese subjects.

Periodontal disease and gene-expression levels of metalloendopeptidases in human buccal mucosal epithelium.

BACKGROUND AND OBJECTIVE: Endopeptidases, such as neutral endopeptidase (NEP), endothelin-converting enzyme-1 (ECE-1) and a disintegrin and metalloprotease 17 (ADAM17), are believed to have various important roles in oral mucosal and epidermal tissue for the regulation of defensive biological responses in the oral cavity, and their expression and activity are influenced by various factors, including oral diseases. However, knowledge concerning these endopeptidases in the oral cavity has been minimal until now. This study focused on three metalloendopeptidases - NEP, ECE-1 and ADAM17 - in the oral buccal mucosal epithelium of patients with periodontal diseases and investigated the relationship between their gene-expression levels and periodontal disease. MATERIAL AND METHODS: The levels of expression of NEP, ECE-1 and ADAM17 mRNAs in tissue samples collected from the oral buccal mucosal epithelium of 61 patients were investigated by relative quantification using real-time RT-PCR analysis. information on oral and systemic health was obtained from the clinical record of each patient. RESULTS: Among the three groups, classified based on the diagnosis of periodontal diseases (healthy/gingivitis, early periodontitis and moderate/advanced periodontitis), the relative expression level of NEP mRNA was significantly increased in the early periodontitis group and in the moderate/advanced periodontitis group compared with that in the healthy/gingivitis group. Moreover, the relative expression levels of ECE1 and ADAM17 mRNAs were significantly increased in the moderate/advanced periodontitis group compared with those in the healthy/gingivitis group. The correlation coefficients between the mean relative expression levels of NEP and ECE1 mRNAs, NEP and ADAM17 mRNAs, and ECE1 and ADAM17 mRNAs were r = 0.758, r = 0.707 and r = 0.934, respectively (p < 0.001). Furthermore, among the oral-related factors, there was a significant correlation between the number of sites with probing pocket depths of more than 4 mm and of more than 6 mm and the relative expression levels of NEP, ECE1 and ADAM17 mRNAs. In stepwise logistic regression models, high relative expression levels of ECE1 and ADAM17 mRNAs were significantly associated with moderate/advanced periodontitis. CONCLUSION: The present study suggests that the severity of periodontal disease may be associated with the expression of metalloendopeptidase genes, including NEP, ECE1 and ADAM17, in the buccal mucosal epithelium.

Streptococcus anginosus l-cysteine desulfhydrase gene expression is associated with abscess formation in BALB/c mice.

Streptococcus anginosus, an anginosus group bacterium, is frequently isolated from odontogenic abscesses, and is the oral bacterium that is primarily responsible for producing hydrogen sulfide from l-cysteine through the action of its l-cysteine desulfhydrase (ßC-S lyase) enzyme. However, the relationship between its production of hydrogen sulfide and abscess formation has not been investigated. To elucidate the etiological role of hydrogen sulfide in abscess formation, we initially measured, using specific primers, expression of the lcd gene, which encodes ßC-S lyase, in the pus of abscesses that formed in BALB/c mice following subcutaneous injection of S. anginosus into the dorsa. Expression of lcd was >15-fold higher when l-cysteine was present than when it was absent. A mouse virulence assay revealed that the mean diameter of abscesses caused by S. anginosus FW73 plus l-cysteine was greater than that of abscesses caused by S. anginosus FW73 in the absence of l-cysteine. These findings demonstrate that the lcd gene of S. anginosus is upregulated in mouse abscesses and that hydrogen sulfide, the product of a reaction catalyzed by ßC-S lyase, plays an etiological role in odontogenic abscess formation.

Cognitive function and number of teeth in a community-dwelling elderly population without dementia.

Although the number of sound or decayed teeth has been reported to be associated with cognitive function in elderly populations with dementia, little is known about this association in elderly populations without dementia. We evaluated this relationship, with adjustment for confounding factors, in Japanese populations of 60-year-old (n = 270; 120 males and 150 females) and 65-year-old (n = 123; 57 males and 66 females) individuals residing in Fukuoka Prefecture of Japan. Dental examinations were performed in all subjects, along with the Mini-mental state examination (MMSE) for assessing cognitive function. Among the total of 393 subjects, the mean MMSE score was 27.9 +/- 1.9, and 391 subjects scored 24 or higher. The mean numbers of sound and decayed teeth were 12.0 +/- 6.3 and 0.5 +/- 1.2, respectively. Associations were found between the numbers of sound and decayed teeth and MMSE in total subjects and males, but not in females, by multiple regression analysis adjusted for gender, age, level of education, marital status, smoking, alcohol drinking, working status, systolic blood pressure and blood glucose. An association was also found between MMSE and the number of sound teeth in a logistic regression analysis. In conclusion, associations were found between normal-range cognitive function and the numbers of sound and decayed teeth, after adjustment for various confounding factors, in an elderly Japanese population.

Small salivary gland size in patients with xerostomia of unknown etiology.

OBJECTIVE: We have recently reported that flow rates of whole saliva in young healthy humans correlate positively with salivary gland sizes. The low rate of salivary secretion in xerostomia patients may be related to the small size of the salivary glands. To investigate this possibility, relationships between salivary secretions and salivary gland sizes were investigated in unknown-etiology xerostomia patients and healthy controls. DESIGN: The sizes of the three major salivary glands in seven xerostomia patients and seven age- and gender-matched healthy controls who have no previous disease history and prescription medication related to xerostomia, were measured by use of a magnetic resonance imaging technique. The salivary glands of all subjects failed to show any pathological aspects in magnetic resonance images. The flow rates of unstimulated and chewing-stimulated whole saliva were also measured. RESULTS: Flow rates of unstimulated and chewing-stimulated whole saliva and the sizes of the parotid and submandibular glands were significantly lower and smaller in xerostomia patients of unknown etiology when compared with healthy controls. In addition, salivary flow rates per size of the combined three major salivary glands were also significantly lower in the xerostomia patients of unknown etiology. CONCLUSIONS: The smaller salivary gland size in xerostomia patients of unknown etiology may be one of the causes of the reduced salivary secretion. The secretion rates as a function of gland sizes were also lower, and so it is likely that functional impairments of the salivary gland are also present in patients with xerostomia of unknown etiology.

Physical fitness and cognitive function in an 85-year-old community-dwelling population.

BACKGROUND: Little is known about the association between physical fitness and cognitive function in very elderly people (over 80 years of age). OBJECTIVES: To evaluate that relationship in 85-year-old community-dwelling individuals. METHODS: Out of 207 participants (90 males, 117 females) who were 85 years old and community-dwelling, 205 completed the Mini-Mental State Examination (MMSE) for evaluating cognitive function. The numbers of subjects who completed physical fitness measurements such as hand-grip strength, isometric leg extensor strength, one-leg standing time, stepping rate, and walking speed were 198, 159, 169, 168, and 151, respectively. RESULTS: There were significant associations in MMSE with hand-grip strength (right or left hand), isometric leg extensor strength, stepping rate, and walking speed by simple regression analysis. MMSE was still significantly associated with hand-grip strength (beta = 0.305, p = 0.005 for right side; beta = 0.309, p = 0.004 for left side), stepping rate (beta = 0.183, p = 0.046), and walking speed (beta = -0.222, p = 0.014) by multiple regression analysis after adjustments for the amount of education, gender, smoking, drinking, complication of stroke, body weight, body height, regular medical care, serum albumin, blood HbA1c, and marital status. By logistic regression analysis, the prevalence of a normal MMSE score (MMSE >or=24) was increased by 9% with each 1-kg increase in hand-grip strength of the left hand (OR 1.087, 95% CI 1.003-1.179, p = 0.042), and was increased by 6% with each step per 10 s in stepping rate (OR 1.060, 95% CI 1.000-1.122, p = 0.048). CONCLUSION: In a very elderly population of 85-year-olds, cognitive function was associated with some physical fitness measurements, independent of confounding factors.

Oral health and mortality risk from pneumonia in the elderly.

Although poor oral health influences the occurrence of pulmonary infection in elderly people, it is unclear how the degree of oral health is linked to mortality from pulmonary infection. Therefore, we evaluated the relationship between oral health and four-year mortality from pneumonia in an elderly Japanese population. The study population consisted of 697 (277 males, 420 females) of the 1282 individuals who were 80 years old in 1997. Data on oral and systemic health were obtained by means of questionnaires, physical examinations, and laboratory blood tests. One hundred eight of the study persons died between 1998 and 2002. Of these, 22 deaths were due to pneumonia. The adjusted mortality due to pneumonia was 3.9 times higher in persons with 10 or more teeth with a probing depth exceeding 4 mm (periodontal pocket) than in those without periodontal pockets. Therefore, the increase in teeth with periodontal pockets in the elderly may be associated with increased mortality from pneumonia.

Identification of the genes associated with a virulent strain of Porphyromonas gingivalis using the subtractive hybridization technique.

BACKGROUND/AIMS: Porphyromonas gingivalis, a major etiological organism implicated in periodontal disease, can be classified into virulent and avirulent strains. Our aim was to identify a gene for the virulence of P. gingivalis. METHODS: The subtractive hybridization technique was employed to identify the genes specific to P. gingivalis W83, a virulent strain. In this study, P. gingivalis W83 was used as the tester strain, and P. gingivalis ATCC 33277 was the driver strain. The prevalence of W83-specific genes was determined by Southern blot analysis of several P. gingivalis strains. RESULTS: We obtained 575 colonies using the subtractive hybridization technique. From among these, 26 DNA fragments were subjected to a homology search using the BLAST program. Compared with strain ATCC 33277, strain W83 contained 12 unique clones. The specificities of the isolated DNA fragments were analyzed among four P. gingivalis strains by Southern blot analysis. Five genes showed specificity for strain W83 compared with strain ATCC 33277. All five genes were also identified in strain W50. CONCLUSIONS: The subtractive hybridization technique was effective in screening the two strains for specific DNA sequences, some of which might be responsible for determining virulence. The results suggested that several genes specific to strain W83 were associated with its virulence. Further analysis of these DNA fragments will provide important information on the pathogenesis of virulent P. gingivalis strains.

Number of teeth and serum lipid peroxide in 85-year-olds.

OBJECTIVES: To investigate influence of dental status on systemic oxidative stress, we evaluated the association between number of teeth and serum lipid peroxide, an oxidative stress index, in 85-years old residents of Japan. METHODS: In October 2003, 207 subjects 85-years old agreed to participate in the present follow-up study after five years from the 8020 Data Bank Survey of Fukuoka prefecture in 1998. Dental health condition including number of teeth was examined by dentists. Data from 204 subjects (88 male, 116 female) who completed nonfasting venous blood examination including lipid peroxide and blood chemistry were analyzed. The examination included a medical questionnaire regarding smoking history, physical activity, alcohol consumption, educational duration, and regular dental care, anthropometric and manometric measurements. RESULTS: Albumin, lipids, and lipid peroxide in serum all were within the normal range. Number of teeth correlated positively with height and white blood cell count, and correlated negatively with lipid peroxide. In a multiple regression analysis to adjust for confounding factors, tooth number retained this correlation with lipid peroxide. By analysis of variance with a Bonferroni-Dunn correction, edentulous subjects showed significantly higher lipid peroxide than those retaining 20 teeth or more. CONCLUSION: The negative association between number of teeth and lipid peroxide links more teeth remaining with less oxidative stress in an 85-year-old population; this may decrease risk of atherosclerotic complications.

Rapid detection of the cariogenic pathogens Streptococcus mutans and Streptococcus sobrinus using loop-mediated isothermal amplification.

INTRODUCTION: Streptococcus mutans and Streptococcus sobrinus are associated with the development of dental caries in humans. In this study, we developed a rapid, sensitive method for detecting these major cariogenic pathogens using loop-mediated isothermal amplification (LAMP). The assay procedure is quite simple: the amplification is carried out in a single tube under isothermal conditions at 63 degrees C, and the result can be obtained in less than 1 h. METHODS: Initially, a set of six primers was designed by targeting S. mutans-specific and S. sobrinus-specific regions, identified using the genomic subtractive hybridization technique. We evaluated the specificities and sensitivities of these assays. Furthermore, we detected and quantified these bacteria in saliva and carious dentin from eight children. RESULTS: The sensitivities of the S. mutans-specific and S. sobrinus-specific LAMP methods, examined using agarose gel electrophoresis, were each one cell for a 30-min reaction. The detection limits using real-time turbidimetry analysis were 1 to 10(7) cells (3.28 x 10(1) to 3.28 x 10(8) fg S. mutans template DNA) per reaction tube and 1 to 10(5) cells (2.72 x 10(3) to 2.72 x 10(8) fg S. sobrinus template DNA) per reaction tube. Using these assays, we detected and quantified these cariogenic bacteria for evaluation of the LAMP assay for clinical diagnosis. CONCLUSIONS: Our results suggest that the LAMP-based assay in combination with subtractive hybridization is valuable for preparing species-specific primers for closely related species. Furthermore, the LAMP-based assay will be a useful tool for the rapid and sensitive prediction of dental caries.

Rapid detection of Actinobacillus actinomycetemcomitans using a loop-mediated isothermal amplification method.

INTRODUCTION: Actinobacillus actinomycetemcomitans has been implicated in the etiology of aggressive periodontitis. In this study, we applied a novel nucleic acid amplification method, called loop-mediated isothermal amplification (LAMP), which amplifies DNA with high specificity, efficiency and rapidity under isothermal conditions, allowing the rapid detection of A. actinomycetemcomitans. METHODS: We designed the primers for detecting A. actinomycetemcomitans and evaluated the specificity and sensitivity of the assay. RESULTS: The LAMP primers used in this study successfully amplified serotypes a-e of A. actinomycetemcomitans, while other oral bacteria were not amplified. By measuring the precipitation of magnesium pyrophosphate, we could quantify the chromosomal DNA of A. actinomycetemcomitans. The detection limits using the real-time turbidimetry analysis were 5.8 x 10(2)-5.8 x 10(7) copies of A. actinomycetemcomitans template DNA per reaction tube. In addition, the LAMP assay was used for the rapid detection of A. actinomycetemcomitans in clinical specimens from eight individuals. The results with the LAMP method were similar to those using conventional polymerase chain reaction. CONCLUSION: Our results suggest that the LAMP-based assay is very useful for the rapid detection of A. actinomycetemcomitans.

Loop-mediated isothermal amplification method for the rapid detection of Enterococcus faecalis in infected root canals.

INTRODUCTION: Enterococcus faecalis is a major pathogen in the etiology of apical periodontitis after root canal treatment. A loop-mediated isothermal amplification method, which amplifies DNA with high specificity, efficiency and rapidity under isothermal conditions using a set of four specially designed primers and a DNA polymerase with strand-displacement activity, was developed for the rapid detection of E. faecalis in clinical specimens from root canals. METHODS: Primers for detecting E. faecalis from the azoA gene were designed. The specificity of this assay was evaluated using various oral bacteria and the sensitivity was evaluated using serially diluted E. faecalis chromosomal DNA. In addition, loop-mediated isothermal amplification assays were applied to the rapid detection of E. faecalis from endodontic samples. RESULTS: The loop-mediated isothermal amplification products amplified with the primer set were specific for E. faecalis. To confirm the specificity of the amplicon, the amplified products were digested with the restriction endonuclease Sau3AI. The lower detection limit of the E. faecalis primer set without the loop primer set was 10 microg/tube for a 50-min loop-mediated isothermal amplification reaction. Using loop primers increased the detection sensitivity by several orders of magnitude. Furthermore, E. faecalis was detected with the loop-mediated isothermal amplification assay in four root canals from 18 individuals and the detection results were consistent with those of conventional polymerase chain reactions. CONCLUSION: These results indicate that the loop-mediated isothermal amplification assay is very useful for rapid detection of E. faecalis and diagnosis of endodontic infection.

Relationship between chewing ability and 4-year mortality in a cohort of 80-year-old Japanese people.

OBJECTIVE: Poor oral health has been reported to be a risk indicator of mortality, however, few data are available regarding the relationship between chewing ability and mortality. We examined the relationship between self-assessed chewing ability and mortality in elderly subjects. DESIGN: Prospective study. SUBJECTS AND METHODS: Participating in the study were 697 people (277 males, 420 females) from 1282 individuals (80 years old) residing in Fukuoka Prefecture, Japan. Data on oral and systemic health status through questionnaires, accompanied by physical and laboratory blood examinations were obtained. Chewing ability was assessed based on the number of types of food each subject reported as able to chew by questionnaire. RESULTS: A total of 108 subjects died between 1998 and 2002. Those with the lowest number of chewable foods were associated with higher risk of mortality than those with the ability to chew all of the 15 types of food surveyed [hazard ratio (HR) = 2.38, 95% confidence interval (95% CI) = 1.07-5.29], though other parameters including current smoking, low serum albumin, and poor physical health status were more significant. Further, reduced chewing ability of soft foods increased the risk (HR = 2.65, 95% CI = 1.20-5.87). CONCLUSION: Chewing ability was associated with mortality in a population of 80-year-old community residents, and may be a predictor for survival rate.

Dynamic magnetic resonance sialography as a new diagnostic technique for patients with Sjögren's syndrome.

OBJECTIVE: To evaluate the clinical utility of dynamic magnetic resonance (MR) sialographic images as a diagnostic tool for patients with Sjögren's syndrome. METHODS: The morphological findings and various kinds of functional parameters in volunteers on dynamic MR sialographic images were compared with those in five patients with definite Sjögren's syndrome. RESULTS: On the MR sialographs of all five patients with Sjögren's syndrome, the so-called 'apple-tree appearance' was seen. The difference in two functional parameters using the dynamic MR sialographic data was elucidated between the two groups. The maximum area of the detectable ducts in the group of patients was significantly smaller (P < 0.001) than that in the group of volunteers. The ratio of change in the detectable ducts in the group of patients was significantly lower (P = 0.011) than that in the group of volunteers. CONCLUSIONS: Our study suggests that dynamic MR sialographic data in addition to MR sialographic images might be useful for the diagnosis of Sjögren's syndrome.

Clinical significance and variation of the advanced calcified stylohyoid complex detected by panoramic radiographs among 80-year-old subjects.

OBJECTIVES: To evaluate the clinical significance and variation of a calcified stylohyoid complex associated with advanced calcification as detected on panoramic radiographs among 80-year-old subjects. METHODS: Panoramic radiographs of 659 patients (262 men and 397 women) and data of their general and dental health conditions were used for the evaluation of the relationship between a calcified stylohyoid complex and general health among 80-year-olds. This study was part of the 8020 Data Bank Survey, which was designed to collect the baseline data of general and dental health conditions in 80-year-old subjects. The morphology of the calcified stylohyoid complexes was allocated to one of 12 patterns. The lengths of the calcified stylohyoid complex were measured directly on the radiographs from the caudal margin of the tympanic plate to the tip of the styloid process. RESULTS: All of the stylohyoid complexes from the 659 panoramic radiographs could be allocated to one of 12 morphological patterns, and some of their radiographic findings suggested calcification of the carotid artery and lymph nodes. In 80-year-old subjects, the average length of the calcified stylohyoid complexes was 36.7 mm, and ranged from 0.0 mm to 153.0 mm. There appeared to be correlations between the length of the calcified stylohyoid complex and serum calcium concentration and heel bone density, but not with the Community Periodontal Index (CPI). CONCLUSIONS: Dentists should recognize the existence of morphological variation in calcified stylohyoid complexes, especially in length, apparent on panoramic radiographs of 80-year-old patients. In addition, the longer length of the calcified stylohyoid complexes in 80-year-old patients may be a predictor of bone density and high serum calcium concentration level. The findings from the present study may provide potentially life-saving information about elderly people.

Chewing ability and quality of life in an 80-year-old population.

As quality of life (QOL) could be influenced by oral status in the elderly, we examined whether chewing ability or number of teeth affected QOL in 80-year olds. A cross-sectional survey included dental examination, chewing self-assessment, and a QOL questionnaire. A total of 823 people who were 80 years old participated in this study. QOL was assessed in terms of satisfaction with physical condition, meals, daily living and social interactions, and with face-scale scores. After adjustment for gender, spouse and activities of daily living, dissatisfaction with social interactions was 3.9 times more prevalent in individuals able to chew four foods or fewer than in those chewing 15. Dissatisfaction with physical condition, meals and daily living, and poor face-scale scores, were 2.7, 2.4, 3.4, and 2.4 times more prevalent, respectively, in subjects chewing four foods or fewer. The number of teeth showed little effect. In conclusion, self-assessed chewing ability but not number of teeth was associated with QOL in 80-year-old subjects.