The role of progressive oral implant rehabilitation in mastication, cognition and oral health-related quality of life outcomes—A pilot to define the protocol

Daniel Tan*, Sheryl Foster, Mayuresh S. Korgaonkar, Vincent Oxenham, Terry Whittle, Iven Klineberg

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background: The implications of oral rehabilitation after tooth loss require further investigation. Objectives: To conduct a pilot study to investigate: (a) changes in masticatory performance with progressive oral implant rehabilitation (POR); (b) association between POR and neurocognitive function using functional magnetic resonance imaging (fMRI); and (c) oral health-related quality of life (OHQoL) outcomes. Methods: Four completely edentulous patients (mean age: 73 ± 1.4 years) participated. Each received new complete removable dental prostheses (RDPs) transitioned to mandibular two implant-retained RDPs (IR-RDP). Assessments were performed at 4 time points for neurocognitive skills, fMRI with functional tasks (jaw clenching, working memory and sustained attention, inhibition), masticatory performance with colour-changing gum and OHQoL. Assessments were performed with new complete RDPs (T0 as baseline data) and IR-RDPs at 1 week (T1), 6 weeks (T2) and 12 months (T3) post-insertion. Data analyses were based on intra-patient and inter-patient results. Results: Masticatory performance and QoL improved with an IR-RDP at each time point. FMRI jaw clenching sensory and motor cortical activity decreased at T1, with motor cortical activity increasing to T0 levels at T2. For cognitive fMRI activation tasks, cortical activity decreased from T0 to T1 across all regions of interests (ROI) and increased at T2 throughout the cognitive brain regions. Neurocognitive skills declined at T1, followed by improvement to or beyond T0 levels at T2. Conclusion: Improvements in masticatory performance and OHQoL occurred from complete RDPs to IR-RDP. Prosthetic adaptation was associated with neurocognitive changes to pre-insertion activity levels or greater after 6 weeks. These pilot data suggest both behavioural and neural associations between POR and cognition; however, larger study numbers are required.

    Original languageEnglish
    Pages (from-to)1368-1381
    Number of pages14
    JournalJournal of Oral Rehabilitation
    Volume47
    Issue number11
    Early online date5 Sep 2020
    DOIs
    Publication statusPublished - Nov 2020

    Keywords

    • cognition
    • dental implants
    • fMRI
    • mastication
    • oral rehabilitation
    • quality of life

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