{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T03:53:32Z","timestamp":1776743612252,"version":"3.51.2"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,12,30]],"date-time":"2017-12-30T00:00:00Z","timestamp":1514592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005774","name":"Universitat de Barcelona","doi-asserted-by":"publisher","award":["ACESB2014\/04"],"award-info":[{"award-number":["ACESB2014\/04"]}],"id":[{"id":"10.13039\/501100005774","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005774","name":"Universitat de Barcelona","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005774","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Oral Rehabilitation"],"published-print":{"date-parts":[[2018,3]]},"abstract":"Summary<\/jats:title>Amyotrophic lateral sclerosis (ALS<\/jats:styled-content>) with bulbar dysfunction affects the motor neurons responsible for controlling the muscles in the jaw, face, soft palate, pharynx, larynx and tongue. This cross\u2010sectional study aimed to determine the functional limitation of the jaw in patients with ALS<\/jats:styled-content> and bulbar dysfunction who had upper motor neuron (UMN<\/jats:styled-content>), lower motor neuron (LMN<\/jats:styled-content>) or balanced involvement. One hundred and fifty\u2010three patients with ALS<\/jats:styled-content> and 23 controls were included. All participants answered using the 8\u2010item Jaw Functional Limitation Scale (JFLS<\/jats:styled-content>\u20108). Patients with ALS<\/jats:styled-content> were grouped by neurologic examination as follows: non\u2010bulbar ALS<\/jats:styled-content>, bulbar UMN<\/jats:styled-content>\u2010predominant ALS<\/jats:styled-content>; bulbar LMN<\/jats:styled-content>\u2010predominant ALS<\/jats:styled-content>; and bulbar balanced (UMN<\/jats:styled-content>\u00a0+\u00a0LMN<\/jats:styled-content>) ALS<\/jats:styled-content>. Jaw limitation between the different groups was compared using the Kruskal\u2010Wallis test. Patients with non\u2010bulbar ALS<\/jats:styled-content> had similar mandibular limitations to healthy participants. Only patients with balanced UMN<\/jats:styled-content> and LMN<\/jats:styled-content> bulbar manifestations reported greater difficulties in chewing soft food or in jaw mobility compared to the non\u2010bulbar ALS<\/jats:styled-content> group. Patients with bulbar involvement also had greater difficulties in chewing tough food or chicken and in swallowing and talking compared to the non\u2010bulbar group, regardless of whether UMN<\/jats:styled-content> or LMN<\/jats:styled-content> predominant. No significant differences were found between the groups in smiling and yawning difficulties. Bulbar involvement in patients with ALS<\/jats:styled-content> is associated with functional limitation of the masticatory system. However, balanced bulbar UMN<\/jats:styled-content> and LMN<\/jats:styled-content> involvement is associated with the worst impairments in chewing soft food and in opening the jaw widely.<\/jats:p>","DOI":"10.1111\/joor.12597","type":"journal-article","created":{"date-parts":[[2017,12,14]],"date-time":"2017-12-14T19:16:40Z","timestamp":1513279000000},"page":"204-210","source":"Crossref","is-referenced-by-count":14,"title":["Functional limitation of the masticatory system in patients with bulbar involvement in amyotrophic lateral sclerosis"],"prefix":"10.1111","volume":"45","author":[{"given":"N.","family":"Riera\u2010Punet","sequence":"first","affiliation":[{"name":"Department of Prosthodontics School of Dentistry Faculty of Medicine and Health Sciences University of Barcelona L'Hospitalet de llobregat Barcelona 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