Influence of simplified dietary advice combined with new complete denture fabrication on masticatory function of complete denture wearers.

BACKGROUND: Dietary advice combined with prosthetic treatment could improve dietary intake earlier than prosthetic treatment only. This early improvement might signify early adaptation to new prostheses. Therefore, dietary advice might affect functional adaptation to new prostheses. OBJECTIVE: The aim was to clarify the influence of simple dietary advice on masticatory function of elderly individuals with new complete dentures. METHODS: A randomised controlled trial was performed on 59 edentulous elderly individuals who had received new complete dentures. Participants were randomly divided into an intervention group (received simple dietary advice: 15 men and 15 women, mean age: 74.8 ± 8.0 years) or a control group (received denture care advice: 15 men and 14 women, mean age: 78.6 ± 6.8 years). Masticatory function was assessed using colour-changeable chewing gum for mixing ability and test gummy jelly for shearing ability. Mixing and shearing ability were assessed at pre-treatment, and 3 and 6 months post-treatment. At each assessment time, mixing ability was compared using Student's t test and shearing ability using Mann-Whitney's U test. Within-group differences in mixing ability were analysed using repeated-measures one-way analysis of variance and those in shearing ability were analysed using Wilcoxon signed-rank test with Bonferroni correction. RESULTS: At each assessment time, there was no significant difference in mixing or shearing ability between groups. In the intervention group, mixing and shearing ability significantly increased at 3 and 6 months post-treatment. In the control group, mixing ability significantly increased at 6 months post-treatment. CONCLUSION: Simple dietary advice might lead to relatively early improvements in masticatory function.

Changes in the nutritional statuses of edentulous elderly patients after new denture fabrication with and without providing simple dietary advice.

PURPOSE: Providing appropriate dental prostheses and dietary interventions may improve food and nutrient intake in elderly edentulous patients, but evidence to support their use is scarce. In this trial, we aimed to clarify the combined effect, on the nutritional statuses of edentulous elderly patients, of dentists providing complete dentures with dietary advice. METHODS: A randomized-controlled trial was performed on a healthy elderly population who required new complete dentures. All participants had new complete dentures fabricated and were randomly divided into an intervention or a control group. The intervention group received simple dietary advice through standardized patient information leaflets and the control group received advice on denture care only. Nutritional status was assessed using the Mini Nutritional Assessment short-form (MNA-SF) before and at 3 and 6months after treatment. At each assessment point, the MNA-SF scores were compared using the Mann-Whitney U test. The within-group differences in the MNA-SF scores were analyzed using the Wilcoxon signed-rank test with Bonferroni correction. RESULTS: In total, 59 participants completed all trial steps. At 6months after treatment, the MNA-SF score in the intervention group was significantly higher than that in the control group (p=0.01). Comparing the within-group changes in the MNA-SF score revealed that the score increased significantly from 3 to 6months in the intervention group (p=0.001, Bonferroni correction). CONCLUSIONS: Nutritional statuses of healthy edentulous elderly population might be improved by fabricating new complete dentures and providing simple dietary advice.

Combined effects of new complete denture fabrication and simplified dietary advice on nutrient intake in edentulous elderly patients for 6 months.

OBJECTIVE: The aim was to evaluate the combined effects of a new complete denture fabrication and simple dietary advice (using unique pamphlets) by dentists on nutrient intake in edentulous elderly patients. MATERIALS AND METHODS: A randomized controlled trial was performed on edentulous elderly patients who were randomly allocated to either an intervention or a control group. The intervention group received a new complete denture and simple dietary advice, whereas the control group received a new complete denture and denture care advice. The outcomes of this trial (nutrient intakes) were calculated using a brief-type self-administered diet history questionnaire (BDHQ) and assessed at three time points (pretreatment and 3 and 6 months post-treatment). RESULTS: At 3 months post-treatment, the intake of several nutrients such as proteins (p = 0.004), magnesium (p < 0.001), and vitamin B1 (p = 0.014) was significantly higher in the intervention group than the control group, whereas at 6 months post-treatment, plant protein (p = 0.028) intake was significantly higher in the intervention group than the control group. On the contrary, animal protein (p = 0.049) and vitamin B12 (p = 0.028) intakes were significantly higher in the control group. CONCLUSIONS: New complete denture fabrication with simple dietary advice might improve nutrient intake in elderly edentulous patients; however, the effect is probably short term. CLINICAL SIGNIFICANCE: New complete denture fabrication along with simple dietary advice by dentists might improve nutrient intake in edentulous elderly patients. Therefore, regular use of these interventions in the dental setting might have long-term effects on nutrient intake in elderly edentulous patients. TRIAL REGISTRATION: UMIN-CTR Clinical Trial, unique trial number: UMIN000017879.

The effect of new complete denture fabrication and simplified dietary advice on nutrient intake and masticatory function of edentulous elderly: A randomized-controlled trial.

BACKGROUND & AIM: Combination of new complete denture fabrication and tailored dietary counseling is necessary to improve nutrient intake of the edentulous elderly. However, there is no evidence on the effect of simple dietary advice combined with new complete denture fabrication on the nutrient intake of the edentulous elderly. The aim of this study was to clarify the combined effect of new complete denture fabrication and simple dietary advice, using a uniform pamphlet, on the nutrient intake and masticatory function of edentulous elderly. The null hypothesis was that there would be no difference in the nutrient intake and masticatory function between edentulous elderly patients provided with simple dietary advice and new complete dentures and those provided with new dentures alone. METHODS: A double-blind, randomized-controlled, parallel clinical trial was performed on the healthy edentulous elderly who were required to fabricate a new pair of complete denture. The participants were randomly divided into two groups, and each group received different advice: the intervention group received simple dietary advice using a uniform pamphlet, whereas the control group received denture care advice. During the process of new complete denture fabrication, two 20-min one-on-one advice sessions were conducted by a dentist. The primary outcome of this trial was protein intake, which was calculated from the responses in the brief-type self-administered diet history questionnaire (BDHQ). Secondary outcome was masticatory function, which was measured with a color-changeable chewing gum and a test gummy jelly. Outcome assessment was conducted twice, at baseline and at 3 months post-treatment. RESULTS: Among 70 participants who were randomized, 62 completed this trial. Protein intake in the intervention group significantly increased compared with that in the control group. Masticatory function was not significantly different between groups, but significantly increased at 3 months post-treatment compared with the baseline in both groups. CONCLUSION: Simple dietary advice using a uniform pamphlet and a new complete denture fabrication increased nutrient intake and masticatory function of healthy edentulous elderly. CLINICAL TRIAL REGISTRATION NUMBER: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000020716 UMIN000017879.

The effect of prosthetic rehabilitation and simple dietary counseling on food intake and oral health related quality of life among the edentulous individuals: A randomized controlled trial.

OBJECTIVE: To investigate the combined effect of complete denture renewal and simple dietary advice. METHODS: A randomized controlled trial was performed with edentulous patients who required new complete dentures. All participants received complete denture treatment. In addition, the intervention group received dietary advice in a pamphlet form, while the control group received advice pertaining to the care and maintenance of the dentures. The advice was given by dentists for each group. The participants' food intake was assessed at baseline and 3 months after intervention using a diet history questionnaire and an oral health related quality of life assessment measured using the Japanese version of the Oral Health Impact Profile for edentulous people (OHIP-EDENT-J). RESULTS: Among 70 participants who were randomized, 62 participants finished all parts of this trial. At baseline, there was no significant difference in the food intake between the two groups. At the 3-month assessment, the intervention group showed significantly greater intake of chicken (P=0.013), fish with bones (P=0.012), and carrots and pumpkins (P=0.025) compared to the control group. However, at baseline and at the 3-month assessment, there was no significant difference in the OHIP-EDENT-J scores between the groups, but the OHIP-EDENT-J scores significantly improved for both groups at the 3-month assessment. There were more significant improved dimensions of OHIP-EDENT-J in the intervention group than in the control group at the 3-month assessment. CONCLUSIONS: Simple dietary advice combined with complete denture treatment could improve food intake of edentulous patients. CLINICAL SIGNIFICANCE: The present study suggests that brief dietary advice provided by dentists can improve food intake of edentulous elderly. This simply diet advice is much easier compared to customized forms, might enable normal dentists provide patients it. The result of this study broadens possibility of nutritional counseling in daily clinical practice.

Combined effect of new complete dentures and simple dietary advice on nutritional status in edentulous patients: study protocol for a randomized controlled trial.

BACKGROUND: Individuals who are edentulous have a lower intake of fruit, vegetables, fiber, and protein compared with their dentate counterparts because tooth loss is accompanied by a decrease in ability to chew. Whether or not a combination of prosthetic rehabilitation and simple dietary advice produces improvement in dietary intake among edentulous persons is unclear. We aim to investigate the effect of a simultaneous combination of simple dietary advice delivered by dentists and provision of new complete dentures on dietary intake in edentulous individuals who request new dentures. METHODS/DESIGN: Through a double-blinded, parallel, randomized controlled trial in which 70 edentate persons who request new complete dentures will be enrolled, eligible study participants will be randomly allocated to either a dietary intervention group receiving dietary advice or to a control group receiving only advice on the care and maintenance of dentures. Outcome measures include daily intake of nutrients and food items, assessed using a brief self-administered diet history questionnaire; antioxidant capacity, determined using blood and urine samples; nutritional status, assessed with the Mini-Nutritional Assessment-Short Form; oral health-related quality of life, assessed with the Japanese version of the Oral Health Impact Profile-EDENT and the Geriatric Oral Health Assessment Index; subjective chewing ability; masticatory performance, assessed using a color-changeable chewing gum and a gummy jelly; patient self-assessment of dentures; mild cognitive impairment, assessed with the Japanese version of the Montreal Cognitive Assessment; and functional capacity, assessed with the Japan Science and Technology Agency Index of Competence. Outcome measures, except for antioxidant capacity, are to be implemented at three time points: at baseline and at 3 and 6 months following intervention. Antioxidant capacity data are to be collected twice: at baseline and at 3 months following intervention. Differences between the groups at 3 and 6 months and within-group changes are to be compared using the paired t test. DISCUSSION: Simple dietary advice that can be implemented by a dentist would be more practical in clinical practice than tailored dietary counseling. The results of this study will provide beneficial information on dietary intake changes for both edentulous individuals requesting new complete dentures and dentists. TRIAL REGISTRATION: University Hospital Medical Information Network Center Unique Trial Number: UMIN000017879 . Registered on 12 June 2015.

Genome-wide expression analysis reveals 100 adrenal gland-dependent circadian genes in the mouse liver.

Recent progress in genome-wide expression analysis has identified hundreds of circadian genes not only in the suprachiasmatic nucleus (the mammalian master clock) but also in peripheral tissues, such as heart, liver and kidney of mammals. Glucocorticoid is thought to be a circadian time cue for mammalian peripheral clocks. To identify the genes of which the circadian expression is regulated by endogenous glucocorticoids, we performed DNA microarray analysis using hepatic RNA from adrenalectomized (ADX) and sham-operated mice. We identified 169 genes that fluctuated between day and night in the livers of the sham-operated mice. Among these, 100 lost circadian rhythmicity in ADX mice. These included the genes for key enzymes of liver metabolic functions, such as glucokinase, HMG-CoA reductase and glucose-6-phosphatase. The circadian expression of Lpin1, FKBP51 and S-adenosyl methionine decarboxylase was also abolished in the ADX mice. On the other hand, although the circadian expression of clock or clock-related genes, such as mPer2, DBP, E4BP4, mDec1, Usp2 and Wee1 remained almost totally intact in the liver of ADX mice, it was extremely damped in homozygous Clock mutant mice. The present findings suggested that one type of hepatic circadian genes in mice is transcriptionally regulated by core components of the circadian clock, such as CLOCK and BMAL1, and that the other depends on the adrenal gland.

Involvement of circadian clock gene Clock in diabetes-induced circadian augmentation of plasminogen activator inhibitor-1 (PAI-1) expression in the mouse heart.

Diabetes is associated with an excess risk of cardiac events, and one of the risk factors for infarction is the elevated-levels of plasminogen activator inhibitor-1 (PAI-1). To evaluate how the molecular clock mechanism is involved in the diabetes-induced circadian augmentation of PAI-1 gene expression, we examined the expression profiles of PAI-1 mRNA in the hearts of Clock mutant mice with streptozotocin-induced diabetes. Circadian expression of PAI-1 mRNA was blunted to low levels under both normal and diabetic conditions in Clock mutant mice, although the expression rhythm was augmented in diabetic wild-type (WT) mice. Furthermore, plasma PAI-1 levels became significantly higher in WT mice than in Clock mutant mice after STZ administration. Our results suggested that the circadian clock component, CLOCK, is involved in the diabetes-induced circadian augmentation of PAI-1 expression in the mouse heart.