Kumar A, Kothari M, Grigoriadis A, Trulsson M, Svensson P
Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.
J Oral Rehabil. 2018 Apr;45(4):323-333. doi: 10.1111/joor.12603. Epub 2018 Jan 18.
Tooth loss, decreased mass and strength of the masticatory muscles leading to difficulty in chewing have been suggested as important determinants of eating and nutrition in the elderly. To compensate for the loss of teeth, in particular, a majority of the elderly rely on dental prosthesis for chewing. Chewing function is indeed an important aspect of oral health, and therefore, oral rehabilitation procedures should aim to restore or maintain adequate function. However, even if the possibilities to anatomically restore lost teeth and occlusion have never been better; conventional rehabilitation procedures may still fail to optimally restore oral functions. Perhaps this is due to the lack of focus on the importance of the brain in the rehabilitation procedures. Therefore, the aim of this narrative review was to discuss the importance of maintaining or restoring optimum chewing function in the superageing population and to summarise the emerging studies on oral motor task performance and measures of cortical neuroplasticity induced by systematic training paradigms in healthy participants. Further, brain imaging studies in patients undergoing or undergone oral rehabilitation procedures will be discussed. Overall, this information is believed to enhance the understanding and develop better rehabilitative strategies to exploit training-induced cortical neuroplasticity in individuals affected by impaired oral motor coordination and function. Training or relearning of oral motor tasks could be important to optimise masticatory performance in dental prosthesis users and may represent a much-needed paradigm shift in the approach to oral rehabilitation procedures.
牙齿脱落、咀嚼肌质量和力量下降导致咀嚼困难,这些被认为是老年人饮食和营养的重要决定因素。特别是为了弥补牙齿缺失,大多数老年人依靠假牙进行咀嚼。咀嚼功能确实是口腔健康的一个重要方面,因此,口腔修复程序应旨在恢复或维持足够的功能。然而,即使在解剖学上恢复缺失牙齿和咬合的可能性从未如此之好;传统的修复程序可能仍然无法最佳地恢复口腔功能。也许这是由于在修复程序中缺乏对大脑重要性的关注。因此,本叙述性综述的目的是讨论在超老龄人群中维持或恢复最佳咀嚼功能的重要性,并总结关于健康参与者中由系统训练范式诱导的口腔运动任务表现和皮质神经可塑性测量的新兴研究。此外,还将讨论接受或已接受口腔修复程序的患者的脑成像研究。总体而言,这些信息被认为有助于增进理解并制定更好的康复策略,以利用训练诱导的皮质神经可塑性来改善受口腔运动协调和功能受损影响的个体的情况。对口腔运动任务进行训练或重新学习对于优化假牙使用者的咀嚼性能可能很重要,并且可能代表着口腔修复程序方法中急需的范式转变。