1.Evaluation of Bite Force in Teeth Restored with Zirconia and Porcelain-Fused-to-Metal Crowns
Batbold E ; Munkhjargal G ; Javkhlan P ; Batsukh Sh
Mongolian Journal of Health Sciences 2025;88(4):216-220
Background:
Mastication is a biomechanical process that involves the jaws and teeth working together to effectively
break down food through the contraction of masticatory muscles. The efficiency of this process is influenced by factors
such as bite force, the integrity of the dental arch, and individual characteristics, including age, gender, and body weight.
Previous research has investigated the bite force of natural teeth, comparing the differences between removable and fixed
denture teeth. For instance, Gibbs et al. estimated the bite force of Eskimo individuals to be 348 lbs (138 kg), while Al-Zarea et al. reported a bite force of 580.9 N for fixed partial dentures. Additionally, J. Urangua estimated the bite force of first
permanent molars to be 472 N. Although studies have explored the bite force of Mongolian individuals with removable
dentures, there has been no investigation into the bite force of fixed partial dentures, highlighting a significant gap in the
literature that the current study aims to address.
Aim:
This study aims to assess the bite force following the restoration of teeth with Zirconia and Porcelain-Fused-to-Metal crowns.
Materials and Methods:
The study involved 20 individuals aged 18 to 34 years, each of whom had their mandibular
molars restored with Zirconia and Porcelain-Fused-to-Metal (PFM) crowns on one side, while the other side retained
their natural teeth, which had not undergone root canal treatment and exhibited no significant alveolar bone loss. A single-instance design was employed to measure occlusal force using the Occlusal Force Meter GM10. Statistical analysis
was conducted using SPSS 26.0 software, with results considered statistically significant at a probability level of p < 0.05.
Results:
The cohort comprised 20 subjects aged 18 to 34 years, with 65% (13) male and 35% (7) female, yielding a mean
age of 28.2 ± 3.5 years. The mean bite force for teeth covered with crowns was (393.2±0.3 N), compared to (445.5±70
N) for natural teeth. Notably, the bite force of the Zirconia crown (407.0±0.7 N) was higher than that of the Porcelain-Fused-to-Metal (PFM) crown 367.7±0.9N. When analyzed by gender, the bite force of natural teeth in men averaged
484.1±46.2N, while that of crowns was 445.3±43.7N. In women, the bite force of natural teeth averaged 373.7±15.4N,
compared to 296.4±19.6 N for crowns.
Conclusion
1. The bite force of zirconia porcelain crowns was 407.0±76N, while the bite force of metal porcelain crowns was
367.7±97N.
2. When determining the bite force of crowns and natural teeth, the bite force of crowns and natural teeth was
296.4±19.6N, and the bite force of uncoated teeth was 445.5±70N, respectively.
3. When compared by gender, the bite force of uncoated teeth in men was 484.1±46.2N, the bite force of coated teeth
was 445.3±43.7N, and the bite force of uncoated teeth in women was 373.7±15.4N, and the bite force of coated teeth
was 296.4±19.6N, and the bite force was significantly related to gender (p<0.0001).
2.Issue in late diagnosis of gastric cancer
Tulgaa L ; Ganchimeg D ; Chinzorig M ; Erkhembayar E ; Tegshjargal B ; Nasanjargal T ; Dashmaa A ; Bayar D ; Tsegmed S ; Bolor-Erdene T ; Otgonbayar I ; Batbold B
Mongolian Medical Sciences 2019;187(1):42-47
Introduction:
Gastric cancer is still one of the most leading causes of mortality in the world. The highest mortality rate of gastric cancer is estimated in Mongolia. South Korea and Japan, where leading the incidence of gastric cancer, mortality rates are observed in 51th and 31nd rank respectively. In Mongolia, gastric cancer is the second leading site, after liver cancer.
Goal:
We aimed to determine the cause of late diagnosis of gastric cancer and to evaluate supply of upper endoscopy devices and human resource for gastric cancer in the general hospital of provinces and districts.
Materials and Methods:
In this study, 84 patients suffering from gastric cancer (42 patients in III, IV TNM stage; 42 patients in I, II TNM stage)were investigated in National Cancer Center, Mongolia. A survey questionnaire which included age, gender, education, income, risk factors and clinical questions was detected from all patients. And we conducted study of supply of upper endoscopy devices and human resource for gastric cancer in general hospitals of from 21 provinces and general hospitals of 6 districts by questionnaire.
Results:
Seventy three(86.9%) patients were over 50 years old and the highest rates of gastric cancer were in group of 61-70 years (40.5%). From the results, the reason to visiting hospital was significantly different between two groups. 55.1% of patients suffering from early-stage gastric cancer were voluntarily diagnosed by upper endoscopy. In contrary, 55.8% of patients suffering from late-stage gastric cancer have visited the hospital due to worsening symptoms or dysphagia and vomiting. Factors such as age, gender, education, employment status and income had no significant effect on late diagnosis of gastric cancer. In totally 24(89%)general hospitals out of 27 had upper endoscopy devices and 22 (81.5%) hospitals had endoscopist. Although 75% of total general hospitals conduct
annual cancer screening, 64% of them do not perform the endoscopy in annual screening.
Conclusion
In our country, late diagnosis of gastric cancer is related to the attitudes of patients for preventing and screening disease. Therefore, it is important to improve the health education of the population and to develop healthy, right attitudes and practices. And the study revealed that general hospitals have insufficient for upper endoscopy devices and human resource.
3.Measuring serum pepsinogen level for screening early stage of gastric cancer
Dashmaa A ; Chinzorig M ; Erkhembayar E ; Nasanjargal T ; Bayar D ; Ganchimeg D ; Batbold B ; Tulgaa L ; Erkhembulgan P
Mongolian Medical Sciences 2018;186(4):86-92
Gastric cancer is the second leading cause of death worldwide. About half of the incidence of stomach
cancer has been reported in East Asian countries. In Mongolia, gastric cancer is the second most common cancer in males and the third most common in females. The age-standardized mortality rate for gastric cancer was 29.3 per 100,000 in 2016, ranking second after liver cancer. Pepsinogen (PG) is a proenzyme of pepsin, by chief and mucous neck cells in the gastric mucosa. On the basis of the source of secretion, PGs are subdivided into 2 types: PG I and II. PG I is only secreted from the fundic glands in the corpus of the stomach, whereas PG II is secreted from the corpus, as well as the pyloric glands in the antrum and proximal duodenum. PG is excreted mainly into the stomach lumen, but approximately 1% diffuses into the blood stream. Atrophic gastritis and intestinal metaplasia are well-known risk factors for gastric neoplasms including dysplasia. To identify these premalignant gastric conditions, histological biopsy or image-enhanced endoscopy is performed. Gastric cancer is usually preceded by a decades-long precancerous process driven by Helicobacter pylori infection and environmental conditions with well-defined successive lesions. In the advanced stages, they are characterized by glandular atrophy and intestinal metaplasia. These changes involve loss of the original glands and result in decrease of the mass of chief cells of the gastric corpus, where PGI is produced. Loss of chief cells leads to lower PGI levels and PGI/PGII ratio in the peripheral blood. Serum PG levels are therefore a key tool to be used in screening programs. Serum PG measurements could provide a simple and noninvasive method for screening gastric neoplasms.
4.Study on the risk factors of gastric cancer
Tulgaa L ; Ganchimeg D ; Enkhmyagmar D ; Tegshjargal B ; Nasanjargal T ; Ulziisaikhan B ; Dashmaa A ; Bayar D ; Bolor-Erdene T ; Erkhembayar E ; Chinzorig M ; Serjbayar G ; Batbold B
Mongolian Medical Sciences 2020;192(2):37-44
Introduction:
In 2018, a total of 901 new cases of gastric cancer were recorded, of which 64.8% in males and
34.2% in females. The incidence rate of gastric cancer was 28.5 per 100 000 population, which 38.2
for males and 19.2 for females.
Goal:
We aimed to investigate the associations between some risk factors and gastric cancer among the
Mongolian population.
Materials and Methods:
A case-control study was conducted between November 2017 and September 2019. We selected
120 cases from National cancer center of Mongolia who newly diagnosed gastric cancer. And 120
controls were selected by matching by sex, age and the place of residence. Informed consents
were obtained from all subjects. All subjects were personally interviewed with researchers used by a
structured questionnaire consisting of 86 questions. The SPSS 21 (version 16.0, SPSS Inc., Chicago,
IL, USA) software was used for all analyses.
Results:
The mean age was 59.2±11.4 (26-85) years. Habits of having dinner after 6.00 pm (OR 1.42, 95%CI
1.11-1.83, p=0.008), having leftover meals (OR 2.22, 95%CI 1.27-3.86, p=0.008), daily consumption
of tea with salt (OR 1.97, 95%CI 1.18-3.30, p=0.01), smoking on an empty stomach (OR 2.44,
95%CI 1.11-5.37, p=0.033), weekly consumption of ham and smoked meat (OR 1.5, 95%CI 1.17-
2.13, p=0.02), and consumption of fat grease (OR 2.09, 95%CI .03-4.24, p=0.038) were significantly
increased gastric cancer risk. In contrast, habit of eating at regular times (OR 0.43, 95%CI 0.25-0.73,
p=0.002), chewing thoroughly (OR 0.39, 95%CI 0.23-0.67, p=0.001), cooking meat thoroughly until
it’s tender (OR 0.48, 95%CI 0.25-0.97, p=0.047), daily consumption of vegetables (OR 0.45, 95%CI
0.27-0.76, p=0.003), and daily consumption of fruit juice (OR 0.36, 95%CI 0.15-0.85, p=0.026) were
significantly reduced gastric cancer risk. Furthermore, having first-degree relatives diagnosed with
gastric cancer had 2-3 fold higher increased risk of gastric cancer (parents OR 2.88, 95%CI 1.07-
7.78, p=0.038, sibling (OR 3.09, 95%CI 1.09-8.81, p=0.036). Also, previous records of the digestive
disease increased risk of gastric cancer (OR 3.65, 95%CI 2.10-6.35, p<0.0001).
Conclusion
Dietary habits, family history of gastric cancer and previous records of digestive disease were
associated with risk of gastric cancer. Thus, prevention effort could be focused on the population with
a family history of gastric cancer, changing bad dietary habit and screening precancerous disease of
gastric cancer.
5.Association between rs738409 and rs2896019 polymorphisms of PNPLA3 and metabolic dysfunction-associated steatotic liver disease
Dolgion D ; Yumchinsuren Ts ; Yesukhei E ; Baljinnyam T ; Enkhmend Kh ; Otgongerel N ; Gantogtokh D ; Ganchimeg D ; Batbold B ; Davaadorj D ; Khurelbaatar N ; Tulgaa L
Mongolian Medical Sciences 2024;209(3):3-11
Introduction:
The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD)
has increased significantly over the last three decades worldwide, from 17.6% in
1990 to 23.4% in 2019. The development of this disease depends on many risk
factors, including genetics, lifestyle, and environment. The PNPLA3 (patatin-like
phospholipase domain-containing protein 3) gene is the most relevant genetic factor
influencing the risk of metabolic dysfunction-associated steatotic liver disease.
The PNPLA3 rs738409 GG genotype impairs adiponutrin function, accumulating
triglyceride in liver cells and forming small fat droplets within the liver.
Aim:
To determine rs738409 and rs2896019 single nucleotide polymorphisms of the
PNPLA3 gene in metabolic dysfunction-associated steatotic liver disease and their
correlation with some parameters of anthropometric and laboratory tests.
Materials and Methods:
This study was conducted with a case-control design in 2023–2024. There were 150
participants in the study, 50 in the control group without MASLD, and 100 in the case group with MASLD. The PNPLA3 (rs738409, rs2896019) gene’s single nucleotide
polymorphism was identified by the RFLP-PCR technique. All statistical analysis
was performed using SPSS 23 software. Categorical variables were described by
numbers and percentages, and the numerical variables were characterized by the
median (min and max) for the normal distribution, and mean± standard deviation for
the non-normal distribution. The statistical tests utilized were the Chi-square test,
Fisher’s exact test, student t-test, and Mann–Whitney test. Ethical approval for the
survey was obtained from the Medical Ethics Committee under the Ministry of Health
Of Mongolia in January 2023.
Results:
The participants’ average age was 46.73±11.45, with 60% being women (90) and
40% being men (60). Among all patients, the PNPLA3 gene’s single nucleotide
polymorphism rs738409 revealed 44.7% (67) CC, 54.7% (82) GC, and 0.7% (1) GG
(OR-CG+GG genotype- 2.9, p=0.003). In addition, as a result of determining the
PNPLA3 gene rs2896019 single nucleotide polymorphism, the frequency of the TT
genotype was significantly higher in the control group than in the case group (48%,
31%, p = 0.042).
Conclusion
The frequency of CG/GG genotypes rs738409, and rs2896019 of the PNPLA3 gene
is higher in the case group, suggesting that they may be more susceptible to MASLD.
6.Chronic kidney disease and serum NT-proBNP level
Sodgerel B ; Anudari I ; Buyandelger J ; Pilmaa Yo ; Gantogtokh D ; Yesukhei E ; Bilguun E ; Nyam-Erdene N ; Yundendash D ; Munkhbayar S ; Bolormaa Do ; Sarangerel Ga ; Munkhzul D ; Batbold B ; Sodnomtsogt L
Mongolian Medical Sciences 2024;210(4):9-17
Background:
Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular
dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD),
emphasizing the need for its early detection and prognosis.
Objective:
This study aimed to determine the serum NT-proBNP levels in participants with CKD and
establish a cut-off value for predicting heart failure.
Methods:
A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study
received approval from the Ethics Committee of the Institute of Medical Sciences (Approval
No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology
Department of the third state hospital were enrolled based on predefined inclusion and
exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound
test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence
quantitative analyzer. Data were analyzed with SPSS 26.0.
Results:
The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The
mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences
were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension
between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly
between heart failure and non-heart failure groups (p<0.05). Significant differences were
also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05).
NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted
between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value
for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%,
specificity: 55%).
Conclusion
Serum NT-proBNP levels are elevated in CKD patients regardless of heart
failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure
was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).
7.The effect of nutrition risk factors for esophageal and gastric cancer
Enkhmyagmar D ; Tulgaa L ; Nasanjargal T ; Batbold B ; Ganchimeg D ; Tegshjargal B ; Bolor-Erdene T ; Bayar D ; Erkhembayar E ; Chinzorig M ; Dashmaa A ; Tsegmed S
Mongolian Medical Sciences 2019;187(1):80-86
Gastric and esophageal cancer is a significant global health issue. The epidemiology of these tumors has significantly increased over the past several years especially in developing and developed countries. Many dietary exposures have been proposed to protect against or increase risk for esophageal and gastrointestinal (GI) cancers, including poor diets, foods, individual nutrients, methods of food preparation, and habits of consumption. Overweight/obese status is associated with an increased risk for many cancer types such as esophageal, gallbladder, kidney, pancreatic and
gastric cancer. The association between obesity and cancer is strong. Nowadays there is a recognized decrease in incidence and mortality of distal gastric cancer and an increase in incidence and mortality of proximal esophageal cancer. In Mongolia, gastric cancer is the second most common cancer in males and the third most common in females. It is very important to understand how diet and nutrition affect to gastric and esophageal cancers. In this review we will discuss the effect of diet in locally advanced gastro-esophageal cancer. Although we tried to conclude all published articles about gastric and esophageal cancers in Mongolia.
In this survey, is considered dietary risks into 5 groups as following;
• Insufficient nutrition education(don’t know food and nutrients significance and food hygiene, don’t know right consumption of food)
• Bad habits (hot tea and meals, salty tea and food, low consumption of fruits and vegetables, sometimes eating breakfast, most of daily energy of food in the night, high amount of sugar, a drink of caffeine, overweight and etc.)
• Food processing technology (such as overcooking, pickling, preserving, frying, excessive salt in tea fried and etc).
• Chemical contaminants in food products (various inorganic fertilizers, heavy metals and etc.)
• Household economic capacity is influencing
Diet can be used as a tool to evoke the positive/desirable biological responses of an organism aiming to maximize health and protection against diseases (chronic/non-communicable diseasesparticularly cancer) by mostly means of prevention.
8.A new diagnostic biomarker in early detection of Hepatocellular Carcinoma
Batchimeg B ; Baljinnyam T ; Khulan U ; Khaliun M ; Bilguun E ; Munkhtsetseg B ; Terguunbileg B ; Chinzorig M ; Gan-Erdene B ; Bilegtsaikhan Ts ; Erkhembulgan P ; Batbold B ; Munkhbat B ; Munkhtuvshin N ; Munkhbayar S
Mongolian Medical Sciences 2021;197(3):10-16
Background and Aims:
Hepatocellular carcinoma (HCC) is a common cause of cancer related death
in Mongolia. Early diagnosis is the very important management to increase successful treatment
and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC)
tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a
diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic
value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic
biomarker of HCC.
Methods:
We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver
cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP)
levels were measured using commercially available enzyme-linked immunosorbent assay kits. The
diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and
estimated sensitivity and specificity of each biomarker.
Results:
sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and
healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity
was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999
(0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6
ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 %
with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%).
Conclusion
Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC.
Combination of two markers showed greatest diagnostic accuracy.
9.Correlation between FTO gene rs9939609, rs17817449 polymorphisms and, obesity
Yumchinsuren Ts ; Dolgion D ; Yesukhei E ; Baljinnyam T ; Enkhmend Kh ; Ganchimeg D ; Gantogtokh D ; Otgongerel N ; Batbold B ; Shiirevnyamba A ; Tulgaa L
Mongolian Journal of Health Sciences 2025;85(1):136-141
Background:
In 2022, the World Health Organization (WHO) reported that globally, 2.5 billion (43%) of adults aged
18 and older were overweight, with 890 million (16%) of these individuals classified as living with obesity. Some genes
such as the FTO gene are strongly associated with obesity and overweigh. The FTO protein is crucial in regulating food
consumption, appetite, energy equilibrium, and expenditure.
Aim:
The identify single nucleotide polymorphisms rs9939609 and rs17817449 of the FTO gene, which are associated
with obesity, and to study their correlation with antropometric measurements and some laboratory test parameters.
Materials and Methods:
According to the inclusion and exclusion criteria, 50 obese (BMI >30 kg/m²) were included in
the case group, and 50 relatively healthy and normal weight (BMI 18.5-24.9 kg/m²) were enrolled in the control group,
for a total of 100 people matched for age and gender (1:1). We took physical measurements and collected peripheral blood
samples after obtaining informed consent from each participant. Laboratory analyses assessed some parameters of lipid
and glucose metabolism. We used the PCR-RFLP technique on two genotype SNPs. A p-value below 0.05 was considered
a statistically significant result.
Results:
In this study, including 100 people aged 23 to 75, the mean age was 46.81±11.54 years, with 60% being female.
In terms of antropometric measurements, body mass index, waist circumference, and arterial pressure were markedly
elevated in the case group compared to the control group (p<0.001). In laboratory measures, fasting blood glucose,
cholesterol, and mean LDL mean levels were statistically significantly higher in the case group compared to the control
group. On the other hand, HDL cholesterol levels were lower in the case group compared to the control group. The FTO
gene rs9939609 single nucleotide polymorphism was identified in 62% of the total study individuals as TT, 35% as AT,
and 3% as AA genotypes. Also, FTO gene rs17817449 single nucleotide polymorphism was identified in 62% of the total
study individuals as TT, 33% as AT, and 5% as AA genotypes.
Conclusion
The rs9939609 AT/AA genotype of the FTO gene elevates the risk of obesity and is associated with increased body weight, waist circumference, and BMI.