Biomedical subjects

A van der Bilt

Publications and source records attributed to A van der Bilt.

At least 19 recordsLinked to original sources

PubMed2005

The influence of orthognathic surgery on masticatory performance in retrognathic patients.

Surgical correction of retrognathism may influence chewing performance and its underlying mechanisms selection and breakage of food particles. In this study we examined the hypothesis that treatment of this anomaly improves chewing performance. Furthermore, we determined to what extent this change can be attributed to selection and breakage of food particles. Eleven patients were tested before and 1-1.5 years after surgery. To determine chewing performance, eight cubes of 8 mm of a silicone rubber (Optosil) were used as a test food. Selection and breakage were determined in one-chew experiments using three particle sizes. On average, no differences were found for chewing performance, selection or breakage. However, on an individual basis, patients with a poor chewing performance before surgery tended to improve, whereas no improvement was observed for patients with a good chewing performance. The change in chewing performance was mainly due to a change in breakage of the food particles.

Adult↗

PubMed2004

Swallowing threshold and masticatory performance in dentate adults.

A variety of both natural and artificial foods are commonly used for the evaluation of masticatory function. We compared swallowing thresholds of three natural foods (peanuts, cheese and carrots) to those of a standardized artificial test food (Optocal Plus) and examined the relationship between masticatory performance and the swallowing threshold. Eighty-seven healthy dentate subjects participated (25 men and 62 women, aged 42.0+/-12.1 years). We evaluated the dental state, registered the number of chewing strokes used before swallowing, analyzed the chewed particles and determined median particle sizes (X50) for Optocal Plus after 15 chewing strokes and at the moment of swallowing. The results show that the number of strokes used before swallowing each natural food linearly increased with volume (P<0.001), and that carrots required more strokes than peanuts and cheese (P<0.001). The number of chewing strokes used before swallowing Optocal Plus was comparable to the number used for carrots. Masticatory performance was significantly influenced by dental state, but not by age or gender. Significant correlations were observed for: (1) the number of chewing strokes used before swallowing natural foods and Optocal Plus; (2) the median particle sizes after 15 strokes and before swallowing; (3) the number of chewing strokes before swallowing and the corresponding median particle size. However, median particle sizes as obtained after 15 strokes did not correlate with the number of strokes used before swallowing (r=0.02). Thus, bad chewers did not necessarily chew longer before swallowing than good chewers. As a consequence bad chewers would, on average, swallow larger food particles.

Adult↗

PubMed2004

Exteroceptive reflexes in jaw-closing muscle EMG during rhythmic jaw closing and clenching in man.

Exteroceptive jaw reflexes might play a role in normal functions of the mouth such as mastication. Until now these reflexes have only been studied under isometric conditions. The aim of this study was to compare exteroceptive reflexes in jaw muscle EMG during the closing phase of rhythmic open-close movements and clenching, at the same jaw gape and with similar muscle EMG. Reflexes consisting of successive waves of decreased and increased muscle activity (the Q, R, S and T waves of the post-stimulus electromyographic complex (PSEC)), evoked by light noxious electrical stimulation of the vermillion border of the lower lip, were recorded from the jaw closing muscles of 17 subjects. Differences between the two tasks occurred in two phases of the PSEC: (1) in an early phase, around the R wave, there was significantly less EMG during jaw closing (mean EMG ratio between jaw-closing and clenching 0.71), and (2) in a late phase, around the transition between the S to the T wave, there was significantly more EMG during jaw closing (mean EMG ratio: 1.40). The decrease in EMG activity around the R wave during jaw closing may be due to a change in reflex sensitivity at an interneuron level. The increase in EMG activity around the transition between the S and T waves during jaw closing might, at least in part, be due to a proprioceptive stretch reflex. This reflex is mediated by muscles spindles that are activated by the deceleration of the jaw evoked by the lip stimulus. The finding of inhibitory reflex mechanisms that predominate more during rhythmic jaw movements than during clenching in an early phase of the PSEC might be related to protecting oral tissues from trauma when the jaw is closing with potentially a large muscle force. In contrast, when food is held between the teeth, a possible inhibitory influence of light noxious stimuli is diminished.

Adolescent↗

PubMed2004

Comparison of single and multiple sieve methods for the determination of masticatory performance.

In the majority of studies on masticatory performance, the degree of food breakdown has been determined by sieving the food with one or more sieves. The aim of the present study was to compare the results obtained with a single and a multiple sieve method, as these methods have never been compared. We analysed the chewed food of 176 dentate subjects with a single and a multiple sieve method. Furthermore, we quantified the influence of age, gender, and dental status on the masticatory performance in order to compare the sensitivity of both methods. We observed a significant influence of the number of occlusal units on the masticatory performance for both methods. The single sieve method is less reliable than the multiple sieve method if the sieve diameter is not close enough to the median particle size of the chewed food. Therefore, we recommend the multiple sieve method.

Adult↗

PubMed2004

Comparison of single and multiple sieve methods for the determination of masticatory performance.

Adult↗

PubMed2004

Relationship between oral sensitivity and masticatory performance.

The size of a bolus determines how it will be manipulated in the mouth and swallowed. We hypothesized that mucosal sensitivity would be important for masticatory function. The accuracy of solid object size perception, spatial acuity, and food particle size reduction during mastication were measured in 22 healthy adults with/without topical anesthesia of their oral mucosa. Topical anesthesia had no effect on the perception of sphere sizes, but significantly reduced spatial sensitivity. Without anesthesia, there was a correlation between an individual's ability to perceive the sizes of steel spheres (diameter, 4-9 mm) and the sizes of food particles chewed for 15 cycles and at swallowing. There was no correlation between spatial sensitivity and food particle size. We suggest that the stimuli used to test two-point discrimination stimulates only superficial receptors, which involve light touch and are easily anesthetized, while the spheres might excite more deeply-set receptors. The latter appear to be more important for masticatory performance and swallowing.

Adult↗

PubMed2004

Masticatory function with implant-supported overdentures.

The type of attachment that is used in implant-supported mandibular overdentures may influence the retention and stability of the prosthesis and, thus, masticatory function. In this within-subject cross-over clinical trial, we examined the hypothesis that greater retention and stability of the overdenture improve the masticatory function. Eighteen edentulous subjects received 2 oral implants, a new overdenture, and, successively, 3 different suprastructure modalities: magnet, ball, and bar-clip. Masticatory performance, masticatory efficiency, and swallowing threshold were measured. The masticatory function significantly improved after implant treatment with each of the 3 attachments. We observed small differences in masticatory function among the 3 attachment types: slightly better masticatory performance with ball and bar-clip than with magnet attachments. The number of chewing cycles until swallowing hardly decreased after implant treatment. We conclude that significantly better masticatory performance, combined with a slightly smaller number of chewing cycles after implant treatment, results in smaller food particles being swallowed.

Adult↗

PubMed2002

Masticatory performance in patients with myasthenia gravis.

Masticatory muscle electromyograms (EMGs) were recorded while patients with bulbar myasthenia gravis chewed artificial food and compared with those of patients with ocular myasthenia gravis, patients in clinical remission who had previously suffered from bulbar myasthenia gravis and healthy individuals. Masticatory performance and EMGs were significantly smaller in the bulbar group. There were no indications of subclinical masticatory muscle weakness in patients with bulbar myasthenia gravis in remission and in patients with ocular myasthenia gravis. Patients with bulbar myasthenia gravis barely compensated for muscular weakness by chewing at a higher percentage of their maximal EMG. These quantitative findings, when combined with subjective reports of masticatory muscle weakness, show that a need to support the jaw is characteristic of patients with bulbar myasthenia gravis who produce low EMG activity.

Adult↗

PubMed2002

The influence of orthodontics on selection and breakage underlying food comminution in pre-orthognathic surgery patients.

Comminution of food is the composite result of selection and breakage. Selection is characterized by the chance that a food particle will at least be damaged by the teeth during a chew. For any particle size, this chance equals the ratio between the weight of damaged and broken particles and that of all initial particles. The breakage process refers to fracturing of selected particles. Since orthodontic treatment applied to patients before orthognathic surgery has an effect on the position and orientation of teeth, it may alter chewing efficiency by influencing selection and/or breakage. The effect of such orthodontic treatment on chewing efficiency was examined using eight cubes of 8.0 mm of a silicone-rubber (Optosil) as a test food for determining the number of chews required to halve the initial particle size (N(1/2)) in 12 patients. Three particle sizes (2.4, 4.8 and 8.0 mm) were used for determining selection and breakage in one-chew experiments. Orthodontic treatment had no effect on the chewing efficiency and the selection chances of all particle sizes whereas the degree of breakage was significantly (P<0.05) increased only for a particle size of 8.0 mm. These findings suggest that presurgical orthodontics has only a minor effect on food comminution.

Adult↗

PubMed2002

The influence of various attachment types in mandibular implant-retained overdentures on maximum bite force and EMG.

The type of attachment that is used in oral rehabilitation by means of implant-retained mandibular overdentures may influence the retention and the stability of the denture. In this study, we examined the hypothesis that a better retention and stability of the denture improve the oral function. Eighteen edentulous subjects received 2 permucosal implants, a new denture, and, successively, 3 suprastructure modalities. Maximum bite force and electrical activity of the masseter and temporalis muscles were measured. The maximum bite force nearly doubled after treatment for each of the 3 attachments. However, the average bite force after treatment was still only two-thirds of the value obtained for dentate subjects. No large differences in maximum bite force and muscle activity were found among the 3 attachment types. Temporalis activity was significantly lower than masseter activity when subjects clenched without implant support. There was no difference in activity when subjects clenched with implant support.

Adult↗

PubMed2001

Controlled study of EMG activity of the jaw closers and openers during mastication in patients with myasthenia gravis.

Mastication was evaluated in patients with bulbar myasthenia gravis and compared with that of patients with ocular myasthenia gravis, patients in remission who previously suffered from bulbar symptoms, and healthy controls. Bulbar myasthenia gravis may impair mastication due to weakness of the masticatory muscles. The aim of the study was to objectively evaluate the influence of myasthenia gravis on mastication. The subjects chewed a piece of breakfast cake and chewed 1 min on a piece of chewing gum. Surface EMG of the masseter muscle, temporalis muscle and jaw opener muscles was recorded. Statistical analysis revealed that bulbar patients produced significantly less EMG activity in the closing phase of a chewing cycle in both experiments. The EMG of the masseter muscle expressed as percentage of the maximum EMG during maximal clenching showed significantly higher values in the bulbar group than in the other groups. This was not found for the temporalis muscle. It was suggested that bulbar patients use a strategy of limited effort to produce a bolus that can be swallowed. The ocular patients and the patients in remission showed no subclinical impairments in muscle function during chewing.

Adult↗

PubMed2001

Chewing efficiency of pre-orthognathic surgery patients: selection and breakage of food particles.

Comminution of food is the composite result of selection and breakage. Selection is characterised by the chance that a food particle will at least be damaged by the teeth during chewing. For any size, this chance equals the ratio between the weight of damaged or broken particles and that of all initial particles. The breakage process refers to fracturing of selected particles. The aim was to examine whether a reduced chewing performance of pre-orthognathic surgery patients is due to an impairment of selection, breakage or both. Eight cubes of 8.0 mm of the silicone-rubber Optosil " were used as a test food to determine chewing efficiency for 12 patients (skeletal Angle Class II and dental Angle Class II, subdivision 1) and 12 controls (class I molar relation). Selection and breakage were determined in one-chew experiments using various particle sizes. Chewing efficiency was significantly lower for the patients than for the controls. The selection chance was significantly smaller for the patients, in particular for smaller (< or = 4.8 mm) particles. The degree of breakage was lower for the patients, in particular for medium-sized particles of 4.8 mm. These findings suggest that the reduced chewing performance of pre-orthognathic surgery patients is due to an impairment of both selection and breakage.

Adult↗

PubMed2001

Tumour embolization of the Vx2 rabbit head and neck cancer model with Dextran hydrogel and Holmium-poly(L-lactic acid) microspheres: a radionuclide and histological pilot study.

INTRODUCTION: Intra-arterial embolization of unresectable malignant tumours with biodegradable microspheres is an effective way of selective anti-tumour therapy. Promising candidates are Dextran hydrogel (Dex) microspheres for chemo-embolization and Holmium-166 poly(L-lactic acid) (166HoPLA) microspheres for radio-embolization. This study was performed to investigate the distribution of intra-arterially injected microspheres both in vivo and histologically in order to establish an optimal size of particles for embolization of head and neck tumours. MATERIAL: Twenty rabbits with Vx2 auricular tumours were embolized via the caudal auricular artery with 4 different batches of microspheres: Radioactive (166)HoPLA microspheres sieved between 20 and 50 microm and Dextran hydrogel microspheres sieved between 20 and 100 microm (Dex20), 30 and 100 microm (Dex30) or 50 and 100 microm (Dex50). Dex20 and Dex50 microspheres were labelled with 99mTechnetium in six cases. METHODS: The average particle size of the microspheres was determined. The proportion of microspheres entrapped in the tumour was measured with a gamma camera. The distribution of microspheres around the primary tumour and spill of particles over into lungs or other organs was analysed from histological sections. RESULTS: The mean particle diameter varied from 19 to 66 microm: (166)HoPLA 19+/-11 microm, Dex20 40+/-19 microm, Dex30 50+/-19 microm, Dex50 66+/-21 microm. The 19 microm(166)HoPLA particles proved inadequate for embolization as 51% spilled over into the lungs, whereas over 95% of the 40-66 microm Dex microspheres were retained within the primary tumour area. Particle density in lung tissues proved significantly lower for the Dex50 group. Stray emboli to the brain occurred in two rabbits. CONCLUSION: The results of this investigation show that both Dextran hydrogel and holmium-166 poly(L-lactic acid) microspheres are potential candidates for embolization of head and neck cancer. In future studies, arterio-arteriolar anastomoses which might confound treatment should be identified and occluded. Particles with a number weighted mean diameter of at least 40 microm and a volume weighted mean size up to 70 microm should be used.

Analysis of Variance↗

PubMed2000

What's in a smile?: Quantification of the vertical smile of patients with myasthenia gravis.

Many patients with myasthenia gravis who experience bulbar symptoms show a vertical smile, which may have a considerable, and often underestimated, impact on social life. Peri-oral muscle function can be quantified by calculating lip-length and snout indices, which indicate the degree to which a person is capable of smiling and of pursing the lips, respectively. In the present study patients with bulbar myasthenia gravis were compared to patients with ocular myasthenia gravis, patients now in remission (but previously suffering from bulbar myasthenia gravis), and healthy subjects. The lip-length and snout indices of patients with bulbar myasthenia gravis were significantly lower than those of the other groups. The facial impairments were no longer detectable in patients with bulbar myasthenia gravis in remission and no subclinical impairments in lip-length and snout indices were found in the ocular myasthenia gravis group. These findings were consistent with the patients' reports of impairment of smiling and other oral functions. The patients suffering from a vertical smile or other oral impairments were well aware of their condition, most probably because of the social consequences of being unable to smile. The indices could be of importance in the longitudinal evaluation of therapy in individual patients and in pharmacotherapeutical research. We found a low correlation between the lip-length and snout indices, which reflects the capricious pattern of involvement of separate muscles in myasthenia gravis. Therefore both indices deserve special attention if they are used for monitoring myasthenic symptoms.

Adult↗

PubMed2000

Maximal bite force and surface EMG in patients with myasthenia gravis.

Masticatory muscle strength was quantified in patients with bulbar myasthenia gravis and compared with that of patients with ocular myasthenia gravis, patients in clinical remission (whether or not pharmacological) who previously suffered from bulbar myasthenia gravis, and healthy subjects. Maximal bite force and maximal activity of the masseter and temporalis muscles and of the submental muscle complex were measured. Bite force was decreased in the patients with bulbar myasthenia gravis, but was normal in the patients in the clinical remission group and in the ocular group. These findings were consistent with the results of electromyographic data. Although subjective reports of masticatory muscle weakness provide valuable information, quantitative measurements provide more information about the degree of muscle weakness of individual muscles. This is especially important for longitudinal evaluation of therapy in individual patients and for pharmacotherapeutic research.

Adult↗

PubMed2000

Mechanisms underlying the effects of remote noxious stimulation and mental activities on exteroceptive jaw reflexes in man.

Successive inhibitory, excitatory, inhibitory and excitatory reflexes (the Q, R, S and T waves of the post-stimulus electromyographic complex (PSEC)), evoked by applying non-painful taps to an incisor tooth, were recorded from the jaw-closing muscles of 15 subjects. The effects on these reflexes of the subjects undertaking mental exercises (MEx) in the form of arithmetic calculations were compared with those of remote noxious stimulation (RNS; application of 3 degrees C to a hand). This was done to investigate whether the previously established effects of RNS were likely to be related to a change in the subject's mental state and/or to direct nociceptive mechanisms. Both MEx and RNS caused increases in EMG activity around the Q-R and S-T transitions of the PSEC, which resulted principally from shortenings of the inhibitory Q and S waves. Reducing the intensity of the tap stimuli, which mimicked condition-induced disinhibition, caused shortenings of the inhibitory waves at latencies similar to the shortenings induced by MEx or RNS. The magnitude of the RNS-induced effect on the ST segment of the PSEC was greater (P<0.01) than that on the QR segment. By contrast, MEx induced similar effects on both segments. Regression analyses were performed for the relationship between condition-induced changes in amplitude of the excitatory waves and their control amplitudes. These analyses were performed to reveal any condition-induced inhibition or facilitation of the tap-induced influences on the motoneurons. Overall, the evidence suggested that: (1) mental exercise induced a similar degree of inhibition of the two tap-induced inhibitory jaw reflexes and a facilitation of the excitatory ones, and (2) remote noxious stimulation induced an inhibition of the second tap-induced inhibitory reflex which was greater than that of the first one, and an inhibition of the first excitatory reflex. Thus, although factors related to altered mental activity could play a role in the modulation of jaw reflexes by RNS, the differences between the effects of MEx and RNS suggest that alternative or complementary mechanisms are also likely to be involved.

Adult↗

PubMed2000

Tongue force in patients with myasthenia gravis.

OBJECTIVES: The aim was to study tongue force in patients with bulbar myasthenia gravis and compare it with that of patients with ocular myasthenia gravis, patients in clinical remission who previously suffered from bulbar myasthenia gravis, and healthy subjects. MATERIAL AND METHODS: Tongue force was measured with a tongue force transducer in cranial and lateral directions, which coincide with the directions in which the tongue exerts force during swallowing, speech, and mastication. RESULTS: Tongue force in lateral direction was significantly decreased in patients with bulbar myasthenia gravis. In addition, our findings suggest an incomplete recovery of lateral tongue force in the patients of the remission group. CONCLUSION: Our tongue force measurements may be useful for longitudinal evaluation of therapy in individual patients and also in studies of therapy efficacy in matched groups of patients if the influence of factors such as age, dental state, and sex is taken into account.

Adult↗

PubMed2000

Evaluation of the VX2 rabbit auricle carcinoma as a model for head and neck cancer in humans.

INTRODUCTION: This study investigates whether the VX2 carcinoma cell line, transplanted into the rabbit auricle, can be used as a head and neck cancer model. The biologic behaviour of this model is evaluated, comparing tumour transplantation with either tissue pieces or cell suspensions. MATERIAL: Thirty-six adult NZW rabbits received s.c. injections of VX2-suspensions (Group S) and 11 rabbits received solid VX2-pieces (Group P) into both auricles. METHODS: In Group S, 16 rabbits were sacrificed at various days before (S1) and 15 after (S2) the 28th day following transplantation. In the other five rabbits transplantation failed. Animals from Group P were sacrificed every 2 weeks after the 28th day. At autopsy the size of the primary tumours and of lymph node, lung and other metastases were assessed. If transplantation failed, the maximal tumour size and the time at which regression took place were recorded. Exponential trend lines were used to create growth curves of metastases. Differences between groups were evaluated with the chi2 test, correlations between parameters with Kendall's tau. RESULTS: The tumour take-rate in Groups S and P was 78% and 59% respectively. The maximal size and time at which regression occurred was significantly different, amounting to 83 +/- 7 mm2 at 10.4 +/- 1.6 days (Group S) and 243 +/- 30 mm2 at 20.9 +/- 2.0 days (Group P), respectively. Development of lymph node metastases was not different. In Groups P and S2, over 90% of the necks contained lymph node metastases. There was a higher incidence of lung metastases in Group S2 when compared to Group P (47% vs. 14%) but it was not statistically significant. A significant correlation (p<0.05) between weight loss and the size of lung metastases was found. CONCLUSION: Transplantation of the VX2-tumour with cell suspensions produces a useful head and neck cancer model for locoregional disease in which anti-tumour regimens against both the primary and lymph node metastases can be tested. Transplantation with tumour pieces is not advised as the take-rate is low and spontaneous remissions occur at a late stage.

Animals↗