横井 美有希

Objectives: Malnutrition can influence perioperative complications and long-term survival in patients with gastrointestinal (GI) cancers. Oral functional decline is associated with decreased food intake, and a reduced number of remaining teeth contributes to malnutrition. However, the impact of preoperative oral conditions on perioperative nutritional status remains unclear. This study investigated the relationship between the number of remaining teeth and the prognostic nutritional index (PNI) in patients undergoing surgery for gastrointestinal malignancies. Methods: In total, 178 patients who underwent gastrointestinal surgery with perioperative oral management at our hospital between January and December 2022 were retrospectively analyzed. Data, including age, sex, tumor site, number of remaining teeth, blood test results, skeletal muscle index, and body mass index (BMI), were extracted from electronic medical records. The PNI and CRP-albumin ratio (CAR) were calculated. Correlations between the number of remaining teeth and nutritional indicators were examined. Results: The number of remaining teeth showed a significant correlation with the PNI in the upper gastrointestinal group (r = 0.336, p = 0.015) and with BMI in the hepatobiliary-pancreatic group (r = -0.519, p = 0.001), after adjusting for age using partial correlation analysis. No significant correlations were observed in the lower GI group. Conclusions: Among patients with upper GI cancer, a lower number of remaining teeth was associated with a lower PNI, influencing postoperative outcomes. Impaired oral function may affect the prognosis of patients with upper GI tumors, emphasizing the need for careful, comprehensive nutritional and oral management as part of perioperative support.

BACKGROUND: Denture treatment for unilateral distal extension defects can cause organic and functional asymmetry in the oral cavity, which may be influenced by physical laterality and the preferred chewing side (PCS). However, existing classification systems for dental defects overlook left-right defect distribution, and individual laterality is rarely considered in treatment planning. OBJECTIVE: This study investigated the relationship between dental defect location and laterality. METHODS: This was a cross-sectional study of 176 right-handed elderly participants divided into five groups by denture type: control (n = 87), right distal extension (n = 9), left distal extension (n = 13), bilateral distal extension (n = 43), and complete denture (n = 24). Primary outcomes included masticatory efficiency, bite force, oral health-related quality of life (OHRQoL), and PCS assessed through interviews. RESULTS: The right distal extension group demonstrated significantly reduced masticatory efficiency, bite force and OHRQoL compared to the control group, indicating diminished oral function and quality of life. The left distal extension group showed significant left-right differences in function, with reduced performance on the distal extension defect side. The right side was the PCS in all groups, with no significant differences in distribution observed between the control and denture groups. CONCLUSION: In elderly individuals with unilateral distal extension dentures, right-handed individuals demonstrate different masticatory functions based on whether the defect is on the right or left side. Additionally, when occlusal support is bilaterally maintained through prosthodontic treatment, including dentures, the impact of structural asymmetry on the PCS is limited.

ABSTRACT Objective We aimed to examine the effects of oral care in patients with terminal cancer approaching death. Background Patients with terminal‐stage cancer often experience symptoms like oral dryness and candidiasis. Previous studies showed that without professional dental care, oral hygiene significantly worsens within 3 weeks before death. Therefore, oral management is essential for patients with terminal cancer. However, the specific effects of oral hygiene in these patients remain unclear. Material and Methods Twenty patients were admitted to two palliative care units at our institution between June 2022 and May 2023 and received oral care multiple times before death. Oral hygiene was assessed using the Oral Health Assessment Tool (OHAT), and oral dryness was evaluated with an oral moisture checker. The Face Rating Scale (FRS) was assessed before and after professional oral care. Results During the week of death, the number of people who were able to speak and follow instructions decreased, while the number who used sedatives and oxygen increased. There was no significant difference in the degree of oral dryness before oral care between the time of hospitalisation and the week of death. However, oral dryness improved significantly after oral care at admission (before: 21.0 ± 8.3, after: 26.7 ± 3.2) and the week of death (before: 16.8 ± 8.4, after: 25.8 ± 3.7). There was no difference in the time taken for oral care or FRS scores at admission and the week of death. Conclusion Continuous oral care in patients with terminal cancer can prevent worsening oral hygiene and maintain moisture.