Can tooth extraction affect oxygen consumption during exercise?!?
Yes, or so it would seem according to the hypotheses of various authors over the years ..
But what is VO2 max?
It is "the maximum quantity of oxygen consumed per unit of time during essentially aerobic maximum exercise which, under defined conditions, makes it possible to measure the energy cost of an exercise; it is therefore the most investigated parameter in sport physiology!
Returning to the "main topic, c" it must be said that for some time but in particular in recent years, thanks to branches of holistic medicine such as Kinesiology and "Osteopathy, orthodontic and gnathological studies have multiplied and enriched with new data, offering us a more global (holistic in fact) of the human being.
In summary, it seems that the dental extraction of the first upper premolar, not followed by its compliant prosthetic replacement, induces a decrease in performance in the extrapolation of VO2 max, both in GXT on a transporter ergometer (therefore in relation to body weight) and on cycle ergometer (not in relation to body weight) in elite aerobic specialty athletes. In practice it would seem that the "athlete" struggles more by running at the same speed and is able to dispose of the peak of LA (blood lactate) more quickly after -exercise, remembering that the maximum amount of LA produced in a maximal effort is proportional to the active muscle mass and that in running an increase of 1mmol / l is equal to a consumption of 2.8-3ml O2 / kg weight.
But how is all this possible?!?
The hypothesis of the authors is that this tooth is associated with a specific organ, the lung, and with a specific muscle, the thoracic diaphragm, so that its extraction can affect the action of the diaphragm both from a structural and purely energetic point of view. , with all the resulting postural and physiological problems.
Since the "postural aspect, which is also very important," is the theme of this article, let's focus on the second, that is the physiological one: taking for granted the knowledge of diaphragmatic biomechanics, it is clear how its "relative weakness" can lead to a increase in gas exchange, QR (CO2 / O2), lung volumes, as well as a consequent impact on cardiac output, during exercise or not.
If everything was monitored on elite athletes, followed and prepared at the highest level, let alone the repercussions we could have on our middle-aged client in the gym, every day, with all the problems involved.
But let's see what physics applied to physiology tells us about this:
from specialized technicians of the exercise we know that to move 1 meter 1 kg of body mass on flat ground it takes about 0.1mlO2 / kg / m, while in running the consumption doubles to 0.2 mlO2 / kg / m. Again, during walking, the consumption of O2 to overcome gravity at sea level is approximately 1.8 mlO2 / kg / m per kg of body mass per meter of height.
Considering a client (not surprisingly a woman, since after the third decade of life they develop a "5% higher osteopenia than men, especially at the mandibular, maxillary and premaxillary level) monitored before and after an" extraction not followed by prosthetic replacement , what could happen?
This is the question to ask, in my opinion, for the role that concerns us.
Let's assume, first of all, to have a 50-year-old customer, 25% fat mass, 67 kg of weight, who performs an aerobic exercise (running) covering a distance of less than 5 km / h in 30 minutes at 1.5. % slope, and we extrapolate the VO2 in relative value by applying an "equation of the ACSM:
VO2 = (0.2 x 75m / min) + (1.8 x 75m / min) x 1.5% + 3.5
Where the speed is expressed in m / min and the slope is 1.5%.
Solving ... VO2 = 15 + (135 x 1.5%) + 3.5
VO2 = 15 + 20.2 + 3.5 = 38.7 mlO2 / kg / min
Subtracting 1 basal half..38.7-3.5 = 35.2 mlO2 / kg / min
For accuracy we express the value relating to the lean mass for which:
67 x 25% = 16.7 kg of fat mass
67 - 16.7 = 50.3 kg of lean mass
At this point:
35mlO2 / kg / min x 50.3kg = 1760mlO2 / min
1760mlO2 / min x 30 min = 52800 mlO2 / 1000 = 52.8 L02 ventilated during operation
Converting into kcal remembering that: 1LO2 oxidized = 5kcal = 21kj
And that the oxidation of 1 mol of LA (89 g) implies the consumption of 3 moles of O2 (67L)
We'll have:
52.8 x 5 = 264 kcal consumed in this exercise assuming a concentration of hepatic and intramuscular glycogen considered "very good" for the client (15-16 g of glycogen per kg of fresh muscle and 70 g of hepatic glycogen)
and an "incomplete oxidation (52.8L versus 67L) of 1 mole of LA.
Considering the client after the extraction not replaced by a prosthetic synthesis and assuming (according to these studies) an increase in consumption of about 50% as regards the movement on flat ground and of about 10% as regards the movement per meters of height caused by a "relative inability" of the diaphragm we could have that:
0.2mlO2 / kg / m x 50% = 0.2 + 0.1 = 0.3mlO27kg / m
and 1.8mlO2 / kg / m x 10% = 1.98mlO2 / kg / m
whereby: VO2 = (0.3 x 75m / min) + (1.98 x 75m / min) x 1.5% + 3.5
VO2 = 22.5 + (148.5 x 1.5%) + 3.5 ... VO2 = 22.5 + 22.2 + 3.5 = 48.2 mlO2 / kg / min
Subtracting 1 basal half we will have that 48.2 - 3.5 = 44.7mlO2 / kg / min
As before 44.7mlO2 / kg / min x 50.3kg = 2248mlO2 / min
2248mlO2 / min x 30min = 67440mlO2 / 1000 = 67.4 LO2 ventilated during operation
Converting 67.4 x 5 into kcal = 337kcal consumed
With a difference of 337-264 = 73kcal !!
And a complete oxidation of 1mole of LA (67.4L)!
A difference in "passable" kcal if related to the "generic fitness activity performed by our client, but not exactly negligible if expressed in relation to the competitive preparation of an elite athlete who must excel in a specific discipline or who simply has to" do the weight "for a race!
This does not mean that all dental extractions not followed by a prosthetic replacement should lead to situations of this type, but that, according to the authors, it can happen.
This does not mean that an experienced professional must be able to observe, measure, evaluate and direct the client / patient to the appropriate specialist, whether he is an orthodontic dentist or an orthopedist, an optician or a general practitioner, in order to increase our professionalism and safeguard the customer's health.
After all, prevention is better than cure!
Bibliography:
American College of Sports Medicine: "Advanced Metabolic Equation and Calculation Lessons", Glass Steve, Phd, HFI, E.S., R.E.C.P.
I.T.C.S .: "TMJ Lesson in Cranial Osteopathy", Frediani Stefano, M.D., O.d.
"Synopsis", Walther David, D.C., Diplomate I.C.A.K., Systems DC Pueblo, Colorado
"Physiology of" physical exercise ", Cerretelli Paolo M.D., Universo Roma Publishing Company
"A.C.S.M.- I.S.S.A. Research Manual 2005-2006", Massimo Armeni
"A.N. Research Manual 2002 - 200 ...", Massimo Armeni
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