In Japan, the number of dependent elderly people has been increasing, and it is thought that among them those receiving enteral nutrition also have been increasing. Recently, dental staff members have had opportunities to participate in oral care for dependent elderly people, some of whom are receiving enteral nutrition. Ghrelin is a peptide hormone secreted mainly from the stomach and has been shown to stimulate growth hormone and increase food intake. Those effects are expected to contribute to gerontology and rehabilitation. With regard to the association of chewing stimulation and gastric motor response, some studies suggested that oral sensation and salivary secretion triggered by functional oral care contribute to ghrelin secretion. In this study, we carried out functional oral care for dependent elderly people receiving enteral nutrition, and investigated its influence on plasma active ghrelin dynamics. The plasma active ghrelin dynamics among these participants before the intervention showed a flat curve without periprandial pulsatile response. In contrast, dynamics 1 month after the intervention showed a periprandial pulsatile curve. As a result, functional oral care for dependent elderly people receiving enteral nutrition could be seen to improve patientsʼ plasma active ghrelin dynamics. In addition, our original oral assessment scores and oral condition scores were related to the data of plasma active ghrelin concentrations. We concluded that this study suggested that functional oral care contribute to the improvement of periprandial plasma active ghrelin dynamics.

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Occlusal adjustment when a prosthesis is inserted unilaterally is usually done by first inserting apiece of articulating paper into the interocclusal surface on the same side, and checking the contact point on the occlusal surface in order to adjust incorrect contact. However, there is a possibility that the lower jaw can deviate against the bite side, and there is thus a risk of incorrect occlusal adjustment. To evaluate the differences in occlusal conditions between unilateral bites and bilateral bites, forty normal subjects were asked to bite a sheet of Dental Prescale unilaterally and bilaterally. Then, the sheets were examined using an Occluzer to evaluate occlusal contact area, occlusal force, and center of occlusal balance. Results were as follows; 1. Unilateral bites increased significantly in occlusal contact area compared with bilateral bites and the average value of increase was about 4.3mm2. 2. Unilateral bites increased significantly in occlusal force compared with bilateral bites and the average value of increase was about 160N. 3. Right side bites deviated to the left side significantly in the lateral center of occlusal balance compared with bilateral bites and the average value of increase was about 2mm. 4. Unilateral bites deviated to the distal side significantly in mesio-distal center of occlusal balance compared with bilateral bites and the average value of increase was about 3mm. These results suggested that occlusal adjustment in the intercuspal position, even with a unilateral region, should be done by inserting an articulating paper bilaterally.

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In cases of single crown or unilateral bridge treatment，unilateral bite-taking is often observed．When a crown or unilateral bridge is fabricated using this bite-taking method，there is a risk of jaw deviation and temporomandibular disorders．The purpose of this study was to evaluate the influence of different bite- taking methods on the temporomandibular joint．Fourteen subjects were given three kinds of lateral oblique transcranial X-rays: bite without bite materia（l CO），bite with bilateral bite material（BC），and bite with unilateral（right）bite registration（RC）．After taking these X-rays，joint space was measured and results were compared among the three positions．Results were as follows; １．As it was found that the joint space distance of BC was significantly reduced compared to CO on both sides，it was suggested that patients with bite material on the bilateral molar regions clench stronger than without bite material on the bilateral molar regions. ２．As it was found that the joint space distance of RC was significantly reduced compared to CO on the right side and the joint space distance of RC had a tendency for increase compared to CO on the left side，it was suggested that patients with bite material on the unilateral molar region clench stronger than without bite material on the bilateral molar regions，and that this condition causes a deviation backward and upward in comparison to the case without bite material side． ３．As it was found that the joint space distance of RC had a tendency for reduction compared to BC on the right side and the joint space distance of RC was significantly increased compared to BC on the left side，it was suggested that patients with bite material on the unilateral molar region clench stronger than with bite material on the bilateral molar regions，and that this condition clearly causes a deviation backward and upward in comparison to the case without bite material side，obviously． These results suggested that we should conduct bilateral bite-taking without strong clenching even if only unilateral prosthetic treatment is involved．

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[in Japanese]

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