Masticatory performance in oral function assessment: Alternative methods
Masticatory performance in oral function assessment: Alternative methods
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DOI：
10.1111/joor.13421
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发表时间：
2023-02-02
影响因子：
2.9
通讯作者：
Mueller, Frauke
中科院分区：
文献类型：
--
作者：
Imamura, Yoshiki;Chebib, Najla;Mueller, Frauke
背景：咀嚼功能随着年龄或疾病的增长而下降，这意味着咀嚼效率低下，并且经常无意识地改变不健康但容易咀嚼的饮食。及时筛查咀嚼功能可以促进早期诊断和潜在的治疗。本研究的目的是比较咀嚼功能的替代诊断工具和果冻扫描测试。材料与方法本研究招募年龄在70岁及以上的住院康复患者。总共进行了四种不同的咀嚼功能测试。以日本老年医学会葡萄糖提取试验（Jelly-scan）为参照，比较变色胶试验（Gum1-colour）以及混合能力试验与视觉（Gum2-visual）和光电（Gum2-digital）分析。使用受试者工作特征（ROC）曲线建立判别值，使用kappa值估计个体一致性，并使用Spearman检验验证相关性。结果61例患者（男23例，女38例），年龄82.4±6.8岁。平均天然牙数为16.5 +/- 10.5,34.4%的参与者佩戴活动义齿。所有试验的敏感性和特异性之和均为50 - 150%。所有测试均与Jelly-scan相关（绝对Rho >0.5）。通过Jelly-scan， 51名参与者（83.6%）被诊断为“咀嚼功能减退”。在将测试的临界值从100 mg/dL降低到65 mg/dL后，只有33名参与者（54%）符合诊断。这种事后分析增加了gum2测试的敏感性，并且所有三种测试都符合kappa >.5。结论三种检测方法均可作为有效的筛查方法。在其最初的版本，果冻扫描可能倾向于过度诊断咀嚼功能减退，因此一个新的切断与更好的协议之间的测试被建议。
BackgroundMasticatory function declines with age or disease, implicating a poor chewing efficiency and an often-unconscious change for a less healthy, yet easy to chew diet. Timely screening of masticatory function may foster an early-onset diagnosis and potential treatment. The aim of this study was to compare alternative diagnostic tools for masticatory function to a Jelly-scan test. Materials and MethodsPatients aged 70 years and older who were hospitalised for rehabilitation were recruited for this study. A total of four different tests for masticatory function were administered. The Japanese Society of Gerodontology glucose extraction test (Jelly-scan) was used as reference to compare a colour-changing gum test (Gum1-colour) as well as a mixing ability test with a visual (Gum2-visual) and opto-electronical (Gum2-digital) analyses. Receiver operating characteristic (ROC) curves were used to establish the discriminative value, kappa-values were used to estimate individual agreements and correlations were verified using Spearman's tests. ResultsSixty-one patients (Men n = 23, Women n = 38) aged 82.4 +/- 6.8 years participated in the experiments. The average number of natural teeth was 16.5 +/- 10.5, 34.4% of the participants wore removable dentures. For all tests, the sum of sensitivity and specificity was >150%. All test correlated with Jelly-scan (absolute Rho >0.5). With Jelly-scan 51 participants (83.6%) were diagnosed with "masticatory hypofunction". After reducing the cut-off value of the test from 100 mg/dL to 65 mg/dL, only 33 participants (54%) fulfilled the diagnosis. This post-hoc analysis increased the sensitivity of the Gum2-tests and the agreement to kappa >0.5 for all three tests. ConclusionAll three tests can be considered useful screening alternatives. In its original version, Jelly-scan may tend to over-diagnose masticatory hypofunction, hence a novel cut-off with better agreement between tests is suggested.