Faculty Profiles - EKUNI Daisuke

Papers - EKUNI Daisuke

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Effects of Trehalose on Halitosis: A Randomized Cross-Over Clinical Trial. Reviewed International journal

Hisataka Miyai, Takaaki Tomofuji, Hirofumi Mizuno, Manabu Morita, Momoko Nakahara, Kota Kataoka, Ichiro Sumita, Yurika Uchida, Naoki Toyama, Aya Yokoi, Reiko Yamanaka-Kohno, Noriko Takeuchi, Takayuki Maruyama, Daisuke Ekuni

Healthcare (Basel, Switzerland) 13 ( 6 ) 2025.3

Language：English Publishing type：Research paper (scientific journal)

Background/Objectives: Halitosis is a condition characterized by an unpleasant malodor. Intra-oral halitosis is caused by volatile sulfur compounds (VSCs) and can be associated with oral dryness. Trehalose is one of the materials used to relieve oral dryness. The aim of the present study was to investigate the effect of trehalose on halitosis. Methods: This prospective, double-blinded, placebo-controlled, cross-over study enrolled volunteers from Okayama University Hospital. The participants were randomly divided into two groups, with one group receiving trehalose (a 10% trehalose solution) and the other receiving a placebo (distilled water) in a 1:1 allocation. The primary study outcome was the subjective organoleptic test. The secondary outcomes were the concentrations of the VSCs, which were measured using a portable gas chromatography device, and the oral moisture status, which was measured using an oral moisture meter. The planned sample size was 10 participants based on the previous study. Results: The final intention-to-treat analysis was performed using the data from 9 participants. After applying 10% trehalose as an oral spray, the organoleptic score decreased in a time-dependent manner. However, no significant differences were seen between the trehalose and placebo groups. In terms of secondary outcomes, the oral moisture levels increased immediately after the trehalose spray application, and significant differences in the amount of change from the baseline were seen between the trehalose and placebo groups (p = 0.047). No significant differences were seen in any of the other variables (p > 0.05). Conclusions: We could not identify any positive effects on halitosis from a one-time 10% trehalose application as an oral spray in this prospective, double-blinded, placebo-controlled, cross-over study. However, the trehalose application immediately improved the oral moisture levels and was useful for treating oral dryness.

DOI： 10.3390/healthcare13060619

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Efficacy of Oral Intake of Hydrogen-Rich Jelly Intake on Gingival Inflammation: A Double-Blind, Placebo-Controlled and Exploratory Randomized Clinical Trial. Reviewed International journal

Takayuki Maruyama, Eiji Takayama, Shinichi Tokuno, Manabu Morita, Daisuke Ekuni

Healthcare (Basel, Switzerland) 13 ( 5 ) 2025.3

ナッジ理論の応用による65歳以上の歯科保健行動の変化ランダム化比較試験 Invited Reviewed

角田伊知郎, 丸山貴之, 福原大樹, 横井彩, 外山直樹, 澤田ななみ, 中原桃子, 江國大輔

8020: はち・まる・にい・まる ( 24 ) 86 - 88 2025.3

Association Between Change in Prognostic Nutritional Index During Neoadjuvant Therapy and Dental Occlusal Support in Patients with Esophageal Cancer Under Neoadjuvant Therapy: A Retrospective Longitudinal Pilot Study Reviewed

Reiko Yamanaka-Kohno, Yasuhiro Shirakawa, Mami Inoue-Minakuchi, Aya Yokoi, Kazuhiro Noma, Shunsuke Tanabe, Naoaki Maeda, Toshiyoshi Fujiwara, Manabu Morita, Daisuke Ekuni

nutrients 2024.12

Relationship among cancer treatment, quality of life, and oral function in head and neck cancer survivors: A cross-sectional study. Reviewed International journal

Aya Yokoi, Takayuki Maruyama, Reiko Yamanaka, Noriko Takeuchi, Manabu Morita, Daisuke Ekuni

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 32 ( 12 ) 809 - 809 2024.11

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Treatment for head and neck cancer (HNC), such as surgery and chemoradiotherapy, can reduce oral function and affect quality of life (QoL). However, whether HNC treatment affects QoL via the decline of oral function remains unclear. This study aimed to investigate the relationship among cancer treatment, QoL, and actual oral function in HNC survivors. METHODS: A total of 100 HNC survivors who had completed definitive treatment for HNC at least 6 months prior to enrollment were enrolled in this cross-sectional study. QoL was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 summary score. Oral diadochokinesis (ODK), tongue pressure, moisture level on the mucosal surface, and mouth opening were measured. Information on age, sex, tumor site, tumor stage, history of HNC treatment, height, body weight, and lifestyle were collected from medical records. Structural equation modeling (SEM) was conducted to analyze the indirect/direct associations among HNC treatment, QoL, and oral function. RESULTS: In total, 100 HNC survivors (58 males and 42 females; age range, 30-81 years, median, 67 years) were analyzed. Overall, 63 patients (63.0%) were diagnosed as oral cancer, 66 (66.0%) developed advanced cancer (stage 3/4), and 58 (58.0%) underwent reconstruction surgery in 100 HNC survivors. The SEM results supported the hypothesized structural model (root mean square error of approximation = 0.044, comparative fit index = 0.990, Tucker-Lewis index = 0.986). Surgery with neck dissection and reconstruction for advanced cancer had indirect effects on lower QoL via ODK and mouth opening. CONCLUSION: HNC treatment is indirectly associated with QoL via oral function in HNC survivors.

DOI： 10.1007/s00520-024-09015-y

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Perioperative gum-chewing training prevents a decrease in tongue pressure after esophagectomy in thoracic esophageal cancer patients: a nonrandomized trial Reviewed International journal

Reiko Yamanaka-Kohno, Yasuhiro Shirakawa, Aya Yokoi, Naoaki Maeda, Shunsuke Tanabe, Kazuhiro Noma, Kazuyoshi Shimizu, Toshiharu Mituhashi, Yoshihide Nakamura, Souto Nanba, Yurika Uchida, Takayuki Maruyama, Manabu Morita, Daisuke Ekuni

Scientific Reports 14 ( 1 ) 23886 - 23886 2024.10

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Tongue pressure (TP) decreases significantly after esophagectomy in esophageal cancer patients (ECPs). Meanwhile, 2 weeks of gum-chewing training (GCT) significantly increased TP in healthy university students. We examined whether perioperative GCT would decrease the proportion of patients exhibiting a decline in TP at 2 weeks postoperatively, and prevent postoperative complications, in thoracic ECPs (TECPs). This was a single-center interventional study, and nonrandomized study with a historical control group (HCG). TECPs who underwent first-stage radical esophagectomy were recruited. Thirty-two patients of 40 in the gum-chewing group (GCG) were completed perioperative GCT in 3 times daily. Propensity score matching was performed with covariates related to TP including preoperative age, sex, body mass index, and the repetitive saliva swallowing test result, and yielded a matched cohort of 25 case pairs. Eleven GCG patients [44.0%] exhibited significantly lower TP at 2 weeks postoperatively than before esophagectomy was significantly fewer than that of 19 patients [76.0%] in the HCG. The median number of fever days (> 38 °C) in the 2 weeks after esophagectomy in the GCG was significantly fewer than those in the HCG. Perioperative GCT may prevent postoperative TP decline and postoperative dysphagia-related complications after esophagectomy.

DOI： 10.1038/s41598-024-74090-4

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Other Link： https://www.nature.com/articles/s41598-024-74090-4

Effect of Antimicrobial Photodynamic Therapy on the Tongue Dorsum on Reducing Halitosis and the Duration of the Effect: A Randomized Clinical Trial. Reviewed International journal

Takayuki Maruyama, Daisuke Ekuni, Aya Yokoi, Junichiro Nagasaki, Nanami Sawada, Manabu Morita

Healthcare (Basel, Switzerland) 12 ( 10 ) 2024.5

Language：English Publishing type：Research paper (scientific journal)

Antimicrobial photodynamic therapy (PDT) is a treatment that is gaining popularity in modern clinical medicine. However, little is known about the effect of PDT alone on reducing oral halitosis and the duration of the effect. This trial examined the effect of PDT on the tongue dorsum on reducing oral halitosis and the duration of the effect. This study was approved by the Ethics Committee of Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, and Okayama University Hospital (CRB20-015), and it was registered in the Japan Registry of Clinical Trials (jRCTs061200060). Twenty-two participants were randomly assigned to two groups: an intervention group and control group. PDT was performed in the intervention group using red laser emission and methylene blue gel on the middle and posterior area of the tongue dorsum. The concentration of volatile sulfur compounds, bacterial count on the tongue dorsum, probing pocket depth, bleeding on probing, and simplified oral debris index score were determined before and 1 week after PDT. The Mann-Whitney U test was used to assess the significance of the differences in each parameter between the two groups. We found that the hydrogen sulfide concentration and bacterial count on the tongue dorsum were decreased in the intervention group, but there was no statistically significant difference between the two groups. These results indicated that performing only PDT on the tongue dorsum may not contribute to reducing halitosis.

DOI： 10.3390/healthcare12100980

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周術期ガム咀嚼トレーニングは食道がん術後のフレイルの進行を予防するか Reviewed

横井彩, 江國大輔, 森田学, 山中玲子

8020: はち・まる・にい・まる ( 23 ) 103 - 106 2024.3

Effect of oral health status and oral function on malnutrition in community-dwelling older adult dental patients: A two-year prospective cohort study. Reviewed International journal

Nanami Sawada, Noriko Takeuchi, Daisuke Ekuni, Manabu Morita

Gerodontology 41 ( 3 ) 393 - 399 2023.10

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: To survey oral status in detail and clarify the factors associated with nutritional status as evaluated by the Mini Nutritional Assessment. BACKGROUND: Malnutrition is common in older adults and increases the risk of frailty, sarcopenia, and mortality. However, few longitudinal studies have been performed to investigate the causal effect of oral status on malnutrition in detail, and the information reported in those longitudinal studies has been limited to dentition status and swallowing ability. MATERIALS AND METHODS: The participants in this prospective cohort study were patients who visited the Preventive Dentistry Clinic at Okayama University Hospital from November 2017 to January 2021. The number of teeth, periodontal condition, oral function (oral diadochokinesis, masticatory ability, number of bacteria in tongue coating, occlusal force, oral moisture, tongue pressure, swallowing function), nutritional status, the number of comorbidities, and mental health status were examined. These variables were analysed using structural equation modelling (SEM). RESULTS: The final analysis included 141 participants (40 males and 101 females; mean age, 73.5 ± 6.3 years; follow-up rate: 79.7%). The results of the SEM revealed that oral status (number of teeth present and swallowing function) was positively associated with nutritional status 2 years later. In addition, age was negatively associated with oral status. CONCLUSION: In community-dwelling older adult dental patients (age ≥60 years), oral function at baseline was associated with nutritional status two years later.

DOI： 10.1111/ger.12718

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Nutrients Associated with Sleep Bruxism. Reviewed International journal

Naoki Toyama, Daisuke Ekuni, Daiki Fukuhara, Nanami Sawada, Miho Yamashita, Momoe Komiyama, Takahiko Nagahama, Manabu Morita

Journal of clinical medicine 12 ( 7 ) 2023.3

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The purpose of the present research was to identify nutrients related to sleep bruxism and to establish a hypothesis regarding the relationship between sleep bruxism and nutrients. METHODS: We recruited 143 Japanese university students in 2021 and assigned them to sleep bruxism (n = 58) and non-sleep bruxism groups (n = 85), using an identical single-channel wearable electromyography device. To investigate nutrient intakes, participants answered a food frequency questionnaire based on food groups. We assessed differences in nutrient intakes between the sleep bruxism and non-sleep bruxism groups. RESULTS: Logistic regression modeling showed that sleep bruxism tended to be associated with dietary fiber (odds ratio, 0.91; 95% confidence interval, 0.83-1.00; p = 0.059). In addition, a subgroup analysis selecting students in the top and bottom quartiles of dietary fiber intake showed that students with sleep bruxism had a significantly lower dietary fiber intake (10.4 ± 4.6 g) than those without sleep bruxism (13.4 ± 6.1 g; p = 0.022). CONCLUSION: The present research showed that dietary fiber intake may be related to sleep bruxism. Therefore, we hypothesized that dietary fiber would improve sleep bruxism in young adults.

DOI： 10.3390/jcm12072623

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Association between oral condition and subjective psychological well-being among older adults attending a university hospital dental clinic: A cross-sectional study. Reviewed International journal

Noriko Takeuchi, Nanami Sawada, Daisuke Ekuni, Manabu Morita

PloS one 18 ( 11 ) e0295078 2023

Language：English Publishing type：Research paper (scientific journal)

Positive psychological well-being has a favorable impact on survival rates in both healthy and unhealthy populations. Oral health is also associated with psychological well-being, is multidimensional in nature, and includes physical, psychological, emotional, and social domains that are integral to overall health and well-being. This study aimed to identify the associations between individual and environmental characteristics, oral condition and nutritional status in relation to subjective well-being among older adults using the Wilson and Cleary conceptual model. The participants were older adults (age ≥ 60 years) attending a university hospital. Subjective well-being was assessed using the World Health Organization-5 Well-Being Index, oral condition was assessed based on the number of bacteria in the tongue coating, oral wettability, tongue pressure, occlusal force, oral diadochokinesis, and masticatory ability, and subjective swallowing function was assessed using the Eating Assessment Tool, number of remaining teeth, and number of functional teeth. In addition, factors related to well-being, including social networks, life-space mobility, nutritional status, smoking history, drinking history, and medical history were assessed. In the analysis, structural equation modeling was used to investigate the association between oral condition and subjective well-being. Confirmatory factor analysis revealed oral condition as a latent variable, including tongue pressure, oral diadochokinesis /pa/, /ta/, /ka/, occlusal force, masticatory ability, subjective swallowing function, and number of functional teeth. Structural Equation Modeling revealed that oral condition was positively correlated with nutritional status, and nutritional status was positively correlated with the World Health Organization-5 Well-Being Index. These findings suggest that oral condition may influence subjective well-being via nutritional status or social environmental factors.

DOI： 10.1371/journal.pone.0295078

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Oral function, nutritional status and physical status in Japanese independent older adults. Reviewed International journal

Nanami Sawada, Noriko Takeuchi, Daisuke Ekuni, Manabu Morita

Gerodontology 39 ( 4 ) 359 - 365 2022.12

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: To clarify the associations among oral status, nutritional status and physical status in Japanese independent older adults. BACKGROUND: It is important to focus on factors affecting physical status associated with life dysfunction, long-term care and mortality. However, there are very few reports of the associations among oral status, nutritional status and physical status. MATERIALS AND METHODS: Patients who visited the Preventive Dentistry Clinic at Okayama University Hospital from November 2017 to January 2019 participated in this cross-sectional study. Number of teeth, periodontal condition and oral function were recorded. Bacteria counts in tongue dorsum, oral wettability, tongue pressure, tongue and lip movement function [oral diadochokinesis (ODK)], masticatory ability, bite force and swallowing function were measured. Nutritional status was assessed by the Mini Nutritional Assessment. Physical frailty status and Elderly Status Assessment Set were also evaluated. These variables were analysed by structural equation modelling (SEM). RESULTS: Data from 203 patients were analysed (63 males and 140 females). Patients ranged in age from 60 to 93 years. The final model of the path diagram was completed by SEM. ODK was positively associated with nutritional status, and nutritional status was negatively associated with frailty. Age was associated with ODK, nutritional status and frailty. CONCLUSION: Based on the associations among age, ODK, nutritional status and frailty, maintaining tongue movement function may contribute to good nutritional status and physical status in Japanese independent older adults.

DOI： 10.1111/ger.12593

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The Impact of Oral Health Behaviors, Health Belief Model, and Absolute Risk Aversion on the Willingness of Japanese University Students to Undergo Regular Dental Check-Ups: A Cross-Sectional Study. Reviewed International journal

Ichiro Sumita, Naoki Toyama, Daisuke Ekuni, Takayuki Maruyama, Aya Yokoi, Daiki Fukuhara, Yoko Uchida-Fukuhara, Momoko Nakahara, Manabu Morita

International journal of environmental research and public health 19 ( 21 ) 2022.10

Language：English Publishing type：Research paper (scientific journal)

Oral health behaviors, risk aversion, and the health belief model are associated with health behaviors. However, there have been few studies that investigated the association between these factors and the willingness to undergo regular dental check-ups. The purpose of this cross-sectional study was to investigate the associations between the willingness of Japanese university students to undergo regular dental check-ups and oral health behaviors, the health belief model, and absolute risk aversion. An analysis was conducted with the cooperation of questionnaire respondents (n = 748) who underwent dental check-ups at Okayama University. The students answered questionnaires on oral health behaviors, the health belief model, absolute risk aversion, and willingness to undergo regular dental check-ups. The logistic regression analysis showed significant positive associations (p < 0.05) between oral health behaviors (use of the inter-dental brush and the dental floss) and the health belief model with the willingness to undergo regular dental check-ups. However, there was no significant association with absolute risk aversion (p > 0.05). These results suggest that willingness to undergo regular dental check-ups was associated with oral health behaviors and the health belief model, but not with absolute risk aversion.

DOI： 10.3390/ijerph192113920

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Trends in Self-Rated Oral Health and Its Associations with Oral Health Status and Oral Health Behaviors in Japanese University Students: A Cross-Sectional Study from 2011 to 2019. Reviewed International journal

Momoko Nakahara, Naoki Toyama, Daisuke Ekuni, Noriko Takeuchi, Takayuki Maruyama, Aya Yokoi, Daiki Fukuhara, Nanami Sawada, Yukiho Nakashima, Manabu Morita

International journal of environmental research and public health 19 ( 20 ) 2022.10

Language：English Publishing type：Research paper (scientific journal)

Self-rated oral health (SROH) is a valid, comprehensive indicator of oral health status. The purpose of this cross-sectional study was to analyze how oral health behaviors and clinical oral status were associated with SROH and how they had changed over the course of nine years in Japanese university students. Data were obtained from 17,996 students who underwent oral examinations and completed self-questionnaires from 2011 to 2019. Oral status was assessed using the decayed and filled teeth scores, bleeding on probing (BOP), probing pocket depth, the Oral Hygiene Index-Simplified (OHI-S), oral health behaviors, and related factors. SROH improved from 2011 to 2019. The logistic regression model showed that university students who were female and had a high daily frequency of tooth brushing, no BOP, no decayed teeth, no filled teeth, and a low OHI-S score and were significantly more likely to report very good, good, or fair SROH. An interaction effect was observed between survey year and regular dental check-ups (year × regular dental check-ups). The improvement trend in SROH might be associated with changes in oral health behaviors and oral health status.

DOI： 10.3390/ijerph192013580

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地域在住高齢者における主観的認知機能低下と口腔機能およびソーシャル・キャピタルとの関連 Reviewed

竹内倫子, 澤田ななみ, 鷲尾憲文, 澤田弘一, 江國大輔, 森田学

老年歯科医学 37 ( 2 ) 64 - 75 2022.9

Relationship between Psychological Stress Determined by Voice Analysis and Periodontal Status: A Cohort Study. Reviewed International journal

Takayuki Maruyama, Daisuke Ekuni, Masakazu Higuchi, Eiji Takayama, Shinichi Tokuno, Manabu Morita

International journal of environmental research and public health 19 ( 15 ) 2022.8

Language：English Publishing type：Research paper (scientific journal)

In modern society, evaluation and management of psychological stress may be important for the prevention of periodontal disease. The purpose of this study was to examine the relationship between psychological stress (vitality and mental activity) evaluated by Mind Monitoring System (MIMOSYS) and periodontal status. Forty students of Okayama University underwent the oral examination and self-reported questionnaire on the first day (baseline) and the 14th day (follow-up). Voice recording was performed every day with the MIMOSYS app during the whole study period. The participants completed the Patient Health Questionnaire (PHQ)-9 and Beck Depression Inventory (BDI) at baseline and at follow-up. Spearman's rank correlation coefficient was used to determine the significance of correlations among variables. The PHQ-9 and BDI scores were negatively correlated with vitality in the morning. Change in vitality in the morning was significantly correlated with changes in periodontal inflammation. Mental activity was significantly correlated with change in mean probing pocket depth. This result shows that measurement of psychological stress using a voice-based tool to assess mental health may contribute to the early detection of periodontal disease.

DOI： 10.3390/ijerph19159489

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Association between serum miRNAs and gingival gene expression in an obese rat model. Reviewed International journal

Takayuki Maruyama, Terumasa Kobayashi, Yoshio Sugiura, Toshiki Yoneda, Daisuke Ekuni, Manabu Morita

Journal of periodontal research 57 ( 3 ) 502 - 509 2022.6

Maternal Gut Microbiome Decelerates Fetal Endochondral Bone Formation by Inducing Inflammatory Reaction. Reviewed International journal

Yoko Uchida-Fukuhara, Takako Hattori, Shanqi Fu, Sei Kondo, Miho Kuwahara, Daiki Fukuhara, Md Monirul Islam, Kota Kataoka, Daisuke Ekuni, Satoshi Kubota, Manabu Morita, Mika Iikegame, Hirohiko Okamura

Microorganisms 10 ( 5 ) 2022.5

New Method of Avoiding Underestimation of Caries Incidence and Its Association with Possible Risk Factors in Japanese University Students: A Prospective Cohort Study. Reviewed International journal

Daisuke Ekuni, Naoki Toyama, Yoshiaki Iwasaki, Manabu Morita

International journal of environmental research and public health 19 ( 4 ) 2022.2

Oral Factors as Predictors of Frailty in Community-Dwelling Older People: A Prospective Cohort Study. Reviewed International journal

Noriko Takeuchi, Nanami Sawada, Daisuke Ekuni, Manabu Morita

International journal of environmental research and public health 19 ( 3 ) 2022.1

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Papers - EKUNI Daisuke