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Maintaining Oral Health and Oral Function (MOHOF)

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Maintaining Oral Health and Oral Function (MOHOF) is a new program in which all dental related research has been combined, whereas it was spread over different programs in the past. The program is focussing on biomaterials in dentistry and maintaining oral health in which preclinical and clinical research projects are involved.

Programme Leaders   Mission  

Mission
To provide new tools and strategies to maintain and restore oral health and function during life with an optimal cost and minimal patient morbidity.

Aim

  1. To determine physico-chemical factors involved in salivary protein adsorption, oral lubrication, prevention of biofilm formation to hard and soft oral surfaces, and surfaces of restorative and orthodontic materials.
  2. Clinical evaluation of oral health care products and dental materials applications and further explore the relation between oral health and the human health status in general.
  3. Improvement of the understanding of behavior of indirect restoration materials and dental implants and to explore new strategies to restore function.

Rationale
Maintaining oral health and restoring function is important for the quality of life. Laboratory models of oral ecosystems and manipulation of essential parameters in these systems are studied in vitro and tested in vivo. Existing restorative biomaterials are evaluated clinically with a long-term follow-up and modifications are tested in the laboratory. Therefore this program requires a multidisciplinary research approach in which both clinical scientists and preclinical scientists in microbiology, physics and material science collaborate.

Description of the Programme  

A healthy oral cavity, acceptable aesthetics and a functional dentition contribute to a good quality of life. Oral health facilitates eating, drinking, speech and therefore plays an essential role in healthy ageing. The oral cavity is the main portal of entree of the human body and therewith the first defense line against disease. The balance between oral health and disease involves predominantly chemical and microbial surface phenomena. One area involves the role of saliva in oral homeostasis. With ageing the balance shifts gradually toward a more diseased state. All surfaces in the oral cavity are covered with an adsorbed salivary protein film to provide sufficient lubrication and to allow mastication and speech. Particularly in the elderly, decreased salivary lubrication often needs treatment including artificial saliva’s. Salivary conditioning protein films on oral hard and soft surfaces facilitate microorganisms to adhere and to form oral and dental biofilms. Dental plaque is essential in the etiology of dental and periodontal diseases. Inhibition and manipulation of biofilm formation is an essential strategy to prevent chronic oral infectious diseases to develop. A variety of oral health care products and measures is currently available. However, especially in the elderly and children receiving orthodontic treatment effective control of the oral biofilm needs further improvement. Plaque control is also essential in periodontally compromised patients and patients with dental implants. Supportive preventive and curative measures are necessary to maintain natural teeth and dental implants as their replacement.
Restoration of teeth with indirect restoration materials and replacement of missing teeth with dental implants and their restorations are characterized by a large number of properties which have to be fulfilled for an optimal and long-lasting result. The materials itself have to be biocompatible, stable over time and resemble the appearance of the material which has to be replaced. Next to this, these biomaterials need to be optimally bonded to surrounding soft and/or hard tissues. Evaluation of these biomaterials in dentistry focuses on initial incorporation and long-term function, aesthetics and patient satisfaction, and without biological and technical complications.
Applying biomaterials in fixation of bones and covering of defects after trauma must help in quickening the healing process. In vitro and in vivo evaluations of new materials are carried out to explore properties and possible complications.
The program is characterized by multidisciplinary research including clinicians, microbiologists and material scientists.

Relevance to Healthy Ageing  

Oral disorders are often cumulative, i.e. destruction of oral tissues and loss of function accumulate in time. Therefore, aging is positively associated with reduced oral functions. Oral diseases have great impact on mastication, lubrication, speech, taste and aesthetics. Maintaining or restoring oral health and function have therefore a significant impact on quality of life parameters. Oral diseases, e.g. periodontitis is not only a local chronic inflammatory oral infectious disorder but the disease has systemic effects. Positive associations have been established between oral health and cardiovascular diseases and auto-immune diseases notably diabetes, rheumatoid arthritis and thyroid disorders. Oral diseases can have an impact on the onset and progression of these diseases. Also, treatment of these diseases can be hampered in subjects with oral infections. Reduction of the total inflammatory status including reduction or elimination of chronic oral infections in susceptible individuals can therefore contribute to reduction of medical and economic burden.
Tooth loss still increases with age, and demographic trends indicate that the population of older individuals is increasing in size. As a result, the number of edentulous people and the demand for complete dentures will continue to be high for several decades. Edentulous patients often experience problems with removable complete dentures. Lack of stability and retention of their dentures, together with pain, decreased chewing ability, and speech problems, are common obstructing complaints reported by these patients. Clinical studies revealed that these denture-related complaints seriously affect the patients’ quality of life. For example, masticatory performance in complete denture wearers is less than 20% of masticatory performance in subjects with a natural dentition. As a result many denture wearers face problems when eating food, and particularly when eating hard or tough food. This inconvenience forces patients to change their diets, often resulting in poorer nutrition compared with patients who have their natural teeth. Therefore, it is not uncommon for many denture wearers to report gastrointestinal problems. Implant-retained overdentures improve edentulous patients' nutritional status, general health, and quality of life.

Principal Investigators