The objective of the present study is to compare the HRV and sedative dose betweenolder dental patients (from 50's to 70's) and younger patients.
The thirty-onesubjects selected from oral surgical outpatients were assigned to two groups: Group 1 consisted of 12 older patients (50's to 70's) for tooth extraction or cystectomy, excluding patients with a history of circulatory and respiratory disease; Group 2 consisted of 19 younger patients. The subjects received intravenous sedation with propofol. The HRV and vital signs before, during, and after surgery were compared. The results were as follows:
1) In the comparison of values before surgery between the groups, the values measured in Group 1 for TP (total power), LF (low frequency component), and HF (high frequency component) in HRV were significantly lower compared to Group 2. This indicated that Group 1 showed a reduction in autonomic activity, and particularly in parasympathetic system activity. Group 1 demonstrated significantly higher values for blood pressure, but no significant differences were observed for heart rate, peripheral oxygen saturation, and respiratory rate.
2) In the comparison of values before and during surgery, LF/HF and LFnorm (LF/TP×100) as indications of sympathetic nerves showed a declining trend, resulting in the equalization of the autonomic balance of sympathetic and parasympathetic nerves. However, in the comparison between the groups, no significant differences were found in LF/HF and LFnorm during surgery. For vital signs, both groups demonstrated a significant decrease in blood pressure during surgery, but no significant differences were observed in heart rate. The parameters after surgery returned to pretreatment values in both groups.
3) The average continuous dosage of propofol used during surgery was significantly smaller in Group 1 than Group 2.
The results revealed a reduction in heart rate variability among older patients (50's to 70's) compared to younger patients.Consequently, a combination of intravenous sedation suggested that attention must be given to avoid excessive administration of a sedative.

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To determine if dental treatment improved not only the oral function, but also QOL and ADL in the handicapped elderly, we performed an interventional study on the effects of dentaltreatment by comparing various parameters before and after treatment.
Twelve dental associations in Japan co-operated with this study, with participation by 144dentists.Dentists performed an initial evaluation and a follow-up evaluation after an 8-week interval. They assessed the consciousness level, orientation, totalscore of 4 FIM items, pain upon eating, masticatory function and face scale. Scores were assigned for each item. Each dentist examined 2 to 4 patients who formed a treatment group and 2 to 4 patients who formed a control group (total, 527 patients; treatment group, 272; control group, 255). The former group receivedthe necessary dental treatment whereas the control group was given no treatment.
In the treatment group, improvements in the consciousness level, orientation, total score of 4 FIM items related to ADL and the face scale indicating QOL were noted. Also, objective evaluation showed improvement in halitosis and in the amount of residual food in the oral cavity. When new partial dentures were provided, improvement was greater than that resulting from other forms of dental treatment. No variations in scores in any items were noted in the control group.
From theviewpoint of rehabilitation, a deteriorated oral state can be considered a comorbidity and/or complication of great concern. We considered that improvement in the various factors examined associated with dental treatment indicated that the correction of dental problems could lead to improvement in ADL and QOL.

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Objective: The development of mouse tongue muscle has been already studied extensively, but the involvement of bone morphogenetic protein (BMP) signals in thedevelopment of tongue muscle is not fully understood. Thus, the aim of the present study is to identify if BMP signals are involved in the proliferation, differentiation and maturation processes of mouse tongue muscle.
Methods: Localization of BMP2, 4, BMP receptor (BMPR) IA, IB, II, activin receptor (ActR) IA, ActRII, and ActRIIB was analyzed in mouse tongue muscle between embryonic day 11 (Ell) and the newborn stage by immunohistochemical method.
Results: All of the BMPs and their receptors studied herein were not detected at Ell. The expressions of BMP2, BMPRIB, ActRIA, ActRII and ActRIIB were first observed at E13, while those of BMP4, BMPRIA, and BMPRII were first observed at E15. The expressions of all BMP and receptor proteins were markedly high at E15, and decreased thereafter. BMP2, BMPRIA, ActRIA, and ActRII continued to be expressed until the newborn stage.
Conclusion: The expression profiles described above suggest that 1) BMP2, BMPRIB, ActRIA, ActRII, and ActRIIB play roles in differentiation; 2) all of the BMPs and receptors studied herein are involved in the initiation of maturation; 3) only BMP2, BMPRIA, ActRIA, and ActRII are involved in the whole process of maturation.

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In order to investigate the influence of saliva secretion on to the food chewing function of the elderly, we made healthy adult subjects with normal saliva secretion chew bread, as well as fish sausage, which are even chewable for the elderly. We studied the change of physical properties of the food bolus during chewing. Weseparated the subjects into two groups: one group of 12 subjects (NG) having 2-4ml saliva secretion function and one group of 12 subjects (HG) having a large saliva secretion function, over 4ml.
1) The HG group showed significantly shorter mastication time compared to the NGgroup in either of the food test chewing before swallowing.
2) The change of physical properties of food bolus of bread during chewing was the same in both groups.However, different changes occurred in the NG group and the HG group for the adhesiveness of the fish sausage bolus.
3) No significant difference was seen between the NG and HG groups on the physical properties of bolus before swallowing, with both the bread and the fish sausage.
From these results, indicate that there is a difference in the saliva secretion of adult subjects with normal saliva secretion function. There is influence on the times of mastication and the change of physical properties of food bolus of fish sausage before swallowing. However, saliva secretion showed no influence onthe swallowing physical properties of the food bolus. And also according to the difference in the amount of saliva in the edentulous elderly the same change of physical properties of the food bolus was indicated as with the adult subjects. This suggests that further study of the adult subjects will possiblyhelp in clarifying the relationship between the amount of saliva and chewing function of the elderly.

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Objectives: Several methods and instruments have been developed forexamining xerostomia. However, the test results of patients who complain of oral dryness are not always consistent with their perceiveddegree of dryness. The purpose of this study, therefore, was to determine which objective parameters bestcorrespond to the subjective snsation of oral dryness, with special emphasis on its diurnal variation.
Methods: Twenty healthy adult subjects (mean age 28.3±2.7 years) with no specific complaints of oraldryness were included in this study. A questionnaire was given to the subjects toassess their degree oforal dryness. In addition, three obective dryness tests were performed at different times during the studyperiod: oral mucosal moisture measurement, saliva wet test and unstimulated whole saliva flow rate.Measurements were performed at ten specific times during the evaluation period: before going to bed (the1st night), just after getting up (the next morning), before and after each meal (breakfast, lunch, dinner), before going to bed (2nd night) and againjust after getting up (2nd morning).
Depending on whether or not they experiencedoral dryness, subjects were divided into dry (2 or moreepisodes of dryness as indicated in the questionnaire) or nondry groups. In the dry group, objective parameters were compared between the times the subjects felt dryness and those when hey felt no dryness.
Results: There were significant diurnal variations in every objective dryness test, the variation depending on the individual. In the “dry” group, there were significant differences in values of the unstimulatedsaliva flow rate between the instances when the subjects did and did not feel oral dryness (p<0.01).
Conclusion: Unstimulated saliva flow rate is probably the most suitable objective parameter for assess-ing subjective oral dryness. Individualization of the appropriate time for performing this test should bedone, taking into consideration each individual's dryness pattern.

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[Objectives] A decline in ADL impairs elderly persons'independence. ADL is related to nutritional status and physical performance and these may be influenced by masticatory ability. Self-assessed masticatoryability is considered to be well suited for epidemiological surveys. The purpose of the present study is toinvestigate the relationship of self-assessed masticatory ability to nutritional status and physical performance in community-dwelling elderly persons.
[Materials and Methods] The total number of participants was 315, aged 65-84. Background factors, eating behavior, BMI, serum albumin concentration, handgrip strength, one-leg standing time with eyes open, andoral conditions (Eichner index, condition of denture, self-assessed masticatory ability) were examined. Self-assessed masticatory ability was assessed by means of the following question: “Can you chew all kinds of food?” The answers were classified according to three alternatives, i.e. “Yes, all food” (Good), “Yes, somewhat hard food” (Fair) and “Only soft food” (Poor).
[Results] In males aged 65-74, mean values for BMI and serum albumin concentration were significantlylower in participants with Poor self-assessed masticatory ability than those of the Good or Fair groups. In females aged 65-74, mean values for handgrip strength were significantly lower in participants with Fairself-assessed masticatory ability than those of Good. In the participants aged 75-84, only BMI of femalesshowed a significant association with self-assessed masticatory ability. Living alone, loss of occlusal contactsof natural teeth and poor condition of denture were significantly related to impairment of self-assessed masticatory ability.
[Conclusions] In elderly persons aged 65-74, self-assessed masticatory ability is asignificant factor that isrelated to nutritional status and physical performance.

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The subjects of this study were 24 people receiving care at a nursing healthcarefacility for the elderly.To obtain data on their dietary life, including the foods served at meals, ADL, and the level of nursing care needed, a questionnaire survey was conducted. Actually the questions were answered by the nurses attheir home. In addition, an oral examination was carried out. To evaluate the state of the intraoral environment and the conditions of dentures. Contingency table analyses were made to study the relationshipsbetween the types of meal group and systemic and oral healthstates.
It was found that the denture wearing (p<0.01) and the number of functionally normal teeth differedsignificantly depending on the contents of meals. This finding seemed to suggest that any increase in thenumber of functionally normal teeth could have a favorable influence on the diet.
The number of care items related to ADL (p<0.01) and BDR (p<0.01), and the level of nursing care needed (p<0.01) varied significantly depending on the contents of their diets.Thus, significant relationships wereevident between the systemic health state, conditions requiring nursing care and dietary life.
From these findings, it could be said that dentists should clearly understandthe contents of meals the elderly eat in the nursing home before treating them. By making contact with them more positively for themaintenance and upgrading of the oral function, it was suggested, dentistscould contribute to the improvement of their dietary life and the enhancement of their quality of life.
Further study is necessary for the improvement of the oral health of people requiring nursing carewho have yet to be fitted with dentures.

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