Chewing Capacity Research Articles

Hardness Analysis of Foods in a Diet Based on the Mediterranean Diet and Adapted to Chilean Gastronomy.

The human diet is a factor for disease prevention and the extension of life expectancy. Loss of teeth can adversely affect chewing capacity, which can lead patients to modify their diet and subsequently result in a poor dietary intake. This work is conducted within the framework of an ongoing research project in the Dentistry School of Universidad de la Frontera aimed at designing a diet for patients with complete removable dental prostheses (CRDP). This study aimed to evaluate the hardness of foods in a diet designed for patients using CRDP, using texture profile analysis (TPA). TPA was used to measure the hardness of 43 foods, categorized into seven groups, dairy, animal protein, fruits, vegetables, cereals and grains, high-lipid foods, and vegetable protein, to understand their impact on masticatory performance in CRDP wearers. TPA consists of two compression cycles where the food sample is compressed until it reaches a pre-established deformation. The first force peak achieved in the first cycle is used as a measure of sample hardness. Significant differences in hardness were identified within each food group, indicating a wide spectrum of textural properties that could influence chewing behavior. These findings suggest that assessing food hardness can help tailor dietary recommendations to improve masticatory efficiency in patients with dental prostheses.

Magnum of magnet: Rehabilitation of surgical defect post rhinocerebral mucormycosis with hybrid prosthesis

Midfacial defects are defined as ones limited to the middle one-third of the face in the horizontal axis which communes with intraoral maxillary defects. They affect patient’s phonation, chewing capacity, quality of life, and social and community behavior. Surgical reconstruction alone is inadequate to rehabilitate these large midfacial defects, thereby necessitating use of a maxillofacial prosthesis to restore form, function, esthetics and comfort. The present case report presents the prosthetic restoration of a surgical defect secondary to treatment of rhinocerebral mucormycosis with an extraoral (exenteration) and intraoral (Armany Class IV) defect connected with magnetic attachment.

Unveiling the Influence of the Curve of Spee on Bite Force and Chewing Ability: A Comparative Study.

To investigate the impact of the curve of Spee (CS) accentuation on bite force, chewing ability, and additionally, other factors that influence chewing ability and bite force such as restorations, caries, gender, habits, and TMJ problems. 231 participants (118 male and 113 female, mean age = ±27.96 years) were recruited for this cross-section study. Participants completed a data collection sheet in which age, gender, Angle's classification of malocclusion, overjet, overbite, TMJ problems, habits, restorations, and caries experience were recorded. Two examiners made a lower impression, chewing ability test and measured the bite force for each participant. Measurement of the CS was obtained digitally from the poured dental cast, and the categorization was as follows: flat (<1 mm), normal (1-2 mm), or deep (>2 mm). The mean maximum bite force (MBF) was 468.722 N for participants with flat CS, 389.822 N for normal CS, 647.08 N for deep CS, and 384.667 N for reverse CS. The average MBF was higher for participants with deep CS (p < 0.05). MBF force was higher in males. However, BMI was not significantly related to MBF values. Participants with normal and flat CS have comparable chewing capacity (p > 0.05). Also, a significant difference in bite force and chewing ability was found between the three categories of CS (p < 0.05). Bite force variations across various CS types were linked to gender and habits. Chewing ability showed no differences concerning gender, habits, TMJ problems, caries, or restorations, emphasizing CS's significant impact on bite force while showcasing the unchanged nature of chewing ability amidst diverse factors.

Exploration of chewing: The functional masticating angles of planas FMAPs

The most important aspect in the exploration of mastication is the possibility that the patient can easily move the mandible to both sides. The chewing capacity must be the same on both sides. Although this laterality movement is not functional in itself, it is nevertheless the one that best imitates the masticatory functional situation. The key element of the study of mastication is the examination of the functional masticatory angles of Planas (FMAPs). We compared the results of this examination in 15 patients with the results of electromyographic recording of the activity of the masseter and anterior temporal muscles during food chewing in order to assess the reliability of FMAPs in the exploration of chewing function. We found that the electromyographic activity of the above-named muscles is higher on the side of the smallest FMAP or on the side usually used by the patient for chewing, thus confirming the reliability of Planas FMAPs.

P-50949547-212 - Implant-supported occlusal platform.

<h3>Purpose</h3> The purpose of this work is to design Oclusal Platforms with the aim of avoiding complications derived from over-implanted prostheses. They are prone to create certain issues in nearby areas, gingival stomatitis, mucositis, etc. To prevent those, some complex hygienic measures are required. This results in complex practices for the patient, often of advanced age. Therefore, it finally results in frequent visits to the specialists (from dentists to maxillofacial surgeons, etc.). <h3>Method</h3> The method of this work is based on usual procedures to perform implant supported prosthesis. They are all adapted to our platforms and short crowns where applicable. In this way it is possible to control the occlusion which provides the function and better oral and maxillofacial aesthetics. The target group of this research has been patients with advanced age or additional related difficulties. <h3>Results</h3> Making of implant-supported prostheses is a conventional process simply adapting the platforms to the specific characteristics of each patient. Generally speaking, this could be from a toothless patient to a partially toothless patient in one of both jaws. The platform is then placed so that the chewing capacity is recovered in first place. Secondly, it would be added together with the platform a sketch of incisors and canines or the pieces deemed necessary without reaching the imlpanted gingival area. <h3>Conclusions</h3> The occlusal deviced proposed is simple and applicable in a way that the patient recovers the functional capacity for chewing, swallowing and speaking, without forgetting the aesthetic aspects.

Prosthetic management of acquired dentate maxillectomy defects: A clinical case series

Abstract Acquired maxillectomy defects produce hypernasal speech, food, and liquid regurgitation into the nasal cavity, impaired deglutition and mastication, and cosmetic deformity. Furthermore, patients with acquired maxillary defects face psychosocial stigma, which has a negative impact on their quality of life. Prosthetic rehabilitation of such defects is required for stomatognathic system restoration and oroantral communication obturation. This case series discusses the fabrication of surgical, interim, and definitive obturator prostheses to restore the acquired dentate maxillectomy defects of three cancer patients. All patients had their treatment in the prosthodontics department of the RUHS College of Dental Sciences. The surgical obturator prosthesis was made before surgery, whereas the interim and definitive obturators were made one month and six months after surgery, respectively. The surgical obturator formed a shield between the surgical pack and the oral cavity. After the surgical obturator and packing were removed, an interim obturator was inserted for three to six months to allow the surgical site to heal. After the surgical site had healed, the fabrication of the definitive obturator began. Prosthetic rehabilitation with obturator prostheses sealed the acquired tissue defects of the palate and restored swallowing, speaking, chewing capacity, and cosmetic value, as well as significantly improved the quality of life of these patients.

Cognitive deterioration in association with teeth loss in elderly population: A study from Eastern India

Background: With the global increase in cognitive impairment and dementia, the need to investigate into the possible ways that can be used to prevent or delay such occurrence has been growing. Maintenance of dental care and oral hygiene has been promoted as one such aspect. Aims and Objectives: To study the association between cognitive impairment in patients without registered diagnosis of dementia with tooth loss and chewing ability. Materials and Methods: It was a cross-sectional hospital-based study where consenting elderly persons attending Dental outpatient department over 1½ years were included. Data obtained on socio-demographic details, number of tooth loss, number of remaining teeth, subjective chewing ability, cognitive assessment as per mini-mental state examination (MMSE), and Clock Drawing Test were analyzed statistically to check correlational association. Results: In this study 96 eligible elderly persons of mean age of 68.30±6.28 years showed increased cognitive impairment among females (P=0.003), increased age (P=0.009), rural background (P=0.033) and low income groups (P=0.001). Positive correlation was found between chewing capacity (P=0.348), number of remaining teeth (r=0.418) with MMSE scores. Conclusion: Our study population showed positive correlation between impaired cognition and the number of extracted tooth and chewing capacity. With further study on wider and representative population, we hope to project the role of maintaining good oral hygiene and dental care as a possible preventive strategy among many others to combat the increased burden of cognitive impairment.

Association of Oral Health and Mini Nutritional Assessment in Older Adults: A Systematic Review with Meta-analyses.

To evaluate whether poor oral health is associated with a higher risk of malnutrition based on the Mini Nutritional Assessment (MNA) or MNA-SF (short form) in older adults. For this meta-analysis, cohort and cross-sectional studies with adults 65 years and older, reporting oral health outcomes (i.e. edentulism, number of teeth) and either the MNA or MNA-SF were selected. Four electronic databases were searched (Medline via PubMed, Web of Science, Cochrane Library and EMBASE) through June 2020. Risk of bias was assessed with the checklist by the Agency for Healthcare Research and Quality scale. A total of 928 abstracts were reviewed with 33 studies, comprising 27,559 participants, aged ≥65 being ultimately included. Meta-analyses showed that the lack of daily oral hygiene (teeth or denture cleaning), chewing problems and being partially/fully edentulous, put older adults at higher risk of malnutrition (p<0.05). After adjustment for socio-demographic variables, the included studies reported lack of autonomy for oral care, poor/moderate oral health, no access to the dentist and being edentulous with either no dentures or only one denture were risk factors significantly associated with a higher risk of malnutrition (p<0.05). These findings may imply that once elders become dependent on others for assistance with oral care, have decreased access to oral healthcare, and lack efficient chewing capacity, there is increased risk of malnourishment. Limitations of the study include heterogeneity of oral health variables and the observational nature of the studies. Further studies are needed to validate our findings.

Quality of Life in Patients Rehabilitated with Implant-Supported Prostheses – A Systematic Review

Abstract Oral health-related quality of life can be defined as the perception of the impact that oral health has on the quality of life. The quality of life is characterized by a person’s perception of his/her social status and the activities he/she carries out in daily life, in relation to his/her standards, objectives, concerns and expectations, as well as the system of values and cultural conditions within he/she lives in. Objective: The objective of this study was to systematically review the dental literature to identify and classify relevant articles on the quality of life associated with the oral health of patients rehabilitated with implant-supported prostheses. Materials and methods: A systematic search of the literature on PubMed was performed for articles published between 2000 and 2021. The main method used was the electronic search using keywords such as: “quality of life”, “dental implant”. The articles found were subject to inclusion and exclusion criteria. Results: Following a systematic search, a total of 249 publications were identified, of which only 9 met the inclusion criteria. Discussions: A small number of studies were found to meet the inclusion criteria and to present high levels of evidence. Therefore, more research in the field is recommended, as current research on quality of life in patients rehabilitated with implant-supported prostheses is still in the development phase. Conclusions: The quality of oral health could have an impact on patients’ daily lives and dental satisfaction (satisfaction with dental appearance, pain perception levels, oral comfort, functional performance and chewing capacity). Patients’ satisfaction with their dentition has a definite impact on the quality of daily life and perceptions of oral health.

'Periodontal health and disease in an older population: A 10-year longitudinal study'.

To investigate alveolar bone loss (ABL), which is an indicator of periodontitis, and to identify risk factors for ABL in an older population between 2008 and 2018. This longitudinal study used data from a questionnaire survey and a clinical examination administered on two occasions ten years apart to 273 individuals who were 65years and 75years in 2008. The mean number of teeth decreased significantly over the ten-year study period, while the proportion of individuals with calculus and moderate ABL visible on radiographs increased. For both ages, the number of teeth decreased by a mean of 2 teeth. The proportions of participants reporting poor general health, daily medication, xerostomia, living singly, visiting dental care irregularly and being in need of extra support in their homes all increased over the observation period. Despite an increased progression of moderate alveolar bone loss, a fairly good dentition and chewing capacity was retained in this older population. However, the individual's age and fragility are important indicators that need to be considered when planning oral health care and the availability of dental care.

Evaluation of Satisfaction of Adolescents Treated by Dental Students

Objective: To evaluate the satisfaction of adolescents undergoing dental treatment between 2016 and 2018 at the Dental School of the Federal University of Minas Gerais (FAO UFMG). Material and Methods: A descriptive cross-sectional study using the Oral Health Services Satisfaction Assessment Questionnaire (QASSaB). The structured questionnaire has eleven questions divided among the dimensions: dentist / patient relationship, relationship with other professionals, effectiveness, accessibility/availability, technical-scientific quality, cleanliness and physical environment, acceptability, effectiveness/resolution, each with five response options. Descriptive data analysis was performed using absolute and relative frequencies. Results: A total of 145 adolescents participated in this study, 60 males and 85 females; 74.85% of adolescents rated dental treatment received as excellent, 76.7% reported having no symptoms after treatment, 46.2% considered it easy/very easy to get treatment, 65.6% reported that waiting time was short/very short, 90% considered dental equipment modern/very modern, 98% regarded the cleanliness of the waiting room and bathrooms as being excellent, 83.4% reported that they always received an explanation about the treatment, and 51.57% were totally satisfied with the appearance of the treated teeth and their chewing capacity. Conclusion: It was possible to observe that the adolescents, users of FAO UFMG, were satisfied with the service in the studied dimensions: human relations, effectiveness, accessibility/availability, technical-scientific quality, physical environment/cleanliness, acceptability and resolvability/effectiveness.

Validação de planejamento digital de restabelecimento de dimensão vertical através de dispositivos interoclusais em pacientes com desgaste dental severo

Restoring the vertical dimension is one of the most challenging procedures in dentistry. Patients who have suffered severe wear of the dental elements must have their occlusal condition restored to normal through oral rehabilitation and interocclusal devices. The objective of this work is to validate the rehabilitation planning through the construction of an interocclusal device cemented over tooth remnants, produced within the digital flow for patients with severe loss of vertical dimension of occlusion. Dental scanning of the upper and lower maxillary arches was performed. Afterwards, the muscle deprogramming with Leaf Gauge strips was produced with the purpose of obtaining the relation of dimension and taking the digital vertical dimension. In a planning software, the teeth were added in volume until the new occlusion was reestablished. An interocclusal device was obtained through a 3D printer and it was cemented in the mouth to validate the vertical increase strategy. In conclusion, virtual planning is an excellent tool to produce devices, bringing a predictable functional and aesthetic result, improving chewing capacity, speech, as well as reducing the patient’s pain complaint.

Case report: post-maxillary (mouth) cancer: oro-facial and dental rehabilitation using zygomatic implants to support a bar-retained obturator

This case report details the orofacial dental rehabilitation of a 46-year-old man, who had lost significant maxillary bone following a T4N2 oral squamous cell carcinoma. The cancer was treated with surgery and adjuvant chemoradiotherapy. Rehabilitation was based on the placement of four oncology zygomatic implants, which were splinted by a ring-shaped milled titanium bar. This formed the support for a removable obturator, which was retained by precision attachments. The treatment resulted in a large reported improvement in the patient’s quality of life, chewing capacity, speech and appearance. The treatment also allows for long-term mouth cancer surveillance in a young man of this age, as the resection site can be easily visualised on removal of the obturator.

TEMPOROMANDIBULAR JOINT ANKYLOSIS: CASE REPORT

Ankylosis is a temporomandibular joint (TMJ) pathology characterized by bone and/or fibrous union between the condyle and the glenoid fossa, restricting joint movements. The etiology of ankylosis may be related to infectious processes, local traumatology, radiotherapy, and TMJ tumors. Among the consequences are the limitation of mouth opening, limited chewing capacity, difficulty in phonation, and oral hygiene. The objective of this research was to report a clinical case of unilateral bone ankylosis of TMJ in a male patient with a history of firearm projectile aggression, which presented 3 mm of interincisal distance and was submitted to a right-sided gap arthroplasty and bilateral coronoidectomy. Satisfactory results were achieved by removing the bone ankylotic block appropriately, with excellent intraoperative joint movement, as well as for early therapeutic monitoring. The patient is being followed up in an outpatient clinic with no signs of relapse and with good oral opening.

Oral health and cognitive status in the Concord Health and Ageing in Men Project: A cross-sectional study in community-dwelling older Australian men.

Several studies have examined the relationship between cognition and oral health in older populations. To further understand this relationship, we examined the associations between cognitive function, chewing capacity and the number of teeth present in community-dwelling older males in Australia. Data were obtained from cross-sectional analysis of fourth wave of the Concord Health and Ageing in Men Project (CHAMP). Participants were 369 community-dwelling males aged 78years or over. Cognitive function was measured utilising the Mini-Mental State Examination (MMSE). Chewing capacity was determined on ability to chew food items of different textures, and oral health data were collected. Ordinal regression was used to analyse associations between MMSE (four categories) and chewing capacity and number of natural teeth present. Overall, 67.5% of participants reported that they could chew all 11 listed food items. Participants with fewer than 20 teeth were statistically significantly more likely to have cognitive impairment (unadjusted odds ratio (OR) 1.87; 95% confidence interval (CI) 1.25-2.79, adjusted OR 1.62; 95% CI 1.07-2.43). Participants with limited chewing capacity were also more likely to have cognitive impairment (unadjusted OR 1.91; 95% CI 1.25-2.94, adjusted OR 1.61; 95% CI 1.03-2.49). This study suggests either that older men with fewer than 20 natural teeth and those with limited chewing capacity are more likely to have an associated cognitive impairment or that those with cognitive impairment are more likely to have fewer teeth and limited chewing capacity. Further longitudinal studies should clarify these relationships.

Associations between oral health and depressive symptoms: Findings from the Concord Health and Ageing in Men Project.

To investigate whether poorer oral health, tooth loss and lower usage of dental services are associated with depressive symptoms in older Australian men. Cross-sectional study of data collected from participants of the Concord Health and Ageing in Men Project. Depressive symptoms were evaluated by the Geriatric Depression Scale. Chewing capacity was estimated by ability to chew 11 food items. The prevalence of depressive symptoms was 17.5%. Self-evaluated oral health, chewing capacity and the number of natural and decayed teeth were associated with depressive symptoms. After adjusting for multiple confounders, chewing capacity (PR 1.93; 95% CI 1.34-2.79) and decayed teeth (PR 1.68; 95% CI 1.03-2.75) maintained a significant association with depressive symptoms. The direction of causality between oral health and depression is unclear; however, oral health may contribute to depression in older Australian men and depressive symptoms may limit chewing capacity and be aggravated by untreated dental decay.

Impairments in Food Oral Processing in Patients Treated for Tongue Cancer.

Patients surgically treated for oral cancer are affected by several underestimated deglutition disorders risk factors. This study aims to characterize the level of these food oral processing (FOP) impairments in a group of patients treated by surgery for tongue cancer. Twenty-seven consecutive patients surgically treated for tongue cancer were evaluated concerning their chewing capacity (Mastication-test), and responded to questions concerning their capacity to bite, chew and manipulate food with their tongue, and their quality of life. According to the Mastication-test, 16 patients suffered total FOP incapacities (TI group), characterized by high tumor stage, invasive carcinological surgery and necessity of reconstructive surgery; 12 patients were partially or not impaired (PI/NI-group). Tongue movement score and number of dental units were lower in the TI group than in the PI/NI-group. Subjective FOP criteria were clearly impaired in the TI group and correlated with a poor oral health-related quality of life. One year after surgery, there is a decrease in BMI for TI group patients while the PI group patients had a significant increase in BMI. All patients surgically treated for oral cancer suffered FOP impairments, but not with the same severity. Totally impaired subjects are at higher risk from long-term malnutrition. Functional evaluation of FOP should form part of the post-operative follow-up for all patients suffering from tongue cancer, using a quick combined evaluation of chewing efficiency, oral health quality of life and nutritional status.

Chewing capacity and ideal cardiovascular health in adulthood: A cross-sectional analysis of a population-based cohort study

To study the association between chewing capacity-a prerequisite for eating- and the level of cardiovascular health (CVH). This is a cross-sectional analysis conducted on 5430 study participants from the Paris Prospective Study 3 that were subjected to an oral examination by trained dentists at study recruitment between 2008 and 2012. Chewing capacity was determined by the number of functional tooth units (FTUs), and ≥ 5FTUs defined adequate chewing capacity. Subjects were categorized into poor, intermediate, or ideal CVH for the 4 behavioural (smoking status, body mass index, physical activity, diet) and the 3 biological (total cholesterol, fasting glycemia, and blood pressure) factors according to the American Heart Association Life's Simple 7. Multinomial logistic regression was used to explore the association between the number of FTUs (exposure) and ideal or intermediate vs. poor CVH (main outcome). 10.31% of the study participants had an ideal CVH and 7% presented an impaired chewing capacity (<5 FTUs). Subjects with at least 5 FTUs (OR=2.37; 95% CI: 1.37-4.12) were more likely to have an ideal global CVH, after adjustment for age, sex, marital status, education, deprivation, depressive status, and dental plaque. This association existed for the behavioural but not the biological CVH, with the strongest association being observed with the diet metric. This is the first study suggesting that adults with a preserved chewing capacity have an increased likelihood to be at an ideal behavioural CVH.

Improvement in Food Intolerance Resulting from Roux-En-Y Gastric Bypass after Speech Therapy Intervention in Chewing.

Food intolerance is expected during the postoperative period following gastric bypass and may be associated with inadequate chewing. To evaluate chewing before and after speech therapy intervention in subjects undergoing Roux-en-Y gastric bypass who present with food intolerance. This was a randomized controlled trial, approved by the Brazilian Ethics and Research Committee under n. 438,600. The study population was allocated into two groups: the study group (SG), who received speech therapy intervention, and the control group (CG), who did not receive any intervention, in six visits at 7, 15, 30, 60, and 90days (v7, v15, v30, v60, and v90) after the initial visit (v0). During v0 and v90, a chewing evaluation was performed according to the MBGR protocol adapted. The significance level adopted was 5%. A total of 30 females (88%) and 4 males (12%) were analyzed. The SG had 18 subjects, and the CG had 16, with mean ages of 50.17 ± 12.28years and 45.69 ± 9.78years, respectively. The postoperative time ranged from 4 to19months. In the SG, a marked improvement in the number of episodes of food intolerance was observed (p < 0.001), an improvement in the intake of cereals and meats (p = 0.004 and p < 0.001, respectively), and an improvement in chewing capacity and swallowing (p = 0.002 and p = 0.011, respectively). Speech therapy intervention in chewing led to a marked improvement of food acceptance and food intolerance resulting from Roux-en-Y gastric bypass.

Comparing the Shear Bond Strength with Acrylic Teeth, Hardness, Surface Roughness and Cost-benefit of three Different Denture Base Materials

One of the major problem affecting the denture function is the detachment of the artificial teeth from denture as a result to the higher chewing capacity that will rise the risk of artificial teeth displacement. Displacement of the teeth may precede by changing in the material properties affecting the denture function that is why surface roughness and hardness considered as a predictor for the material behaviors and performance. Replacing a denture may cause a burden to the patients, hence, the material and fabrication coasts of dentures should be considered as one of the major factors affecting the selection of the denture base material, as in some cases a base material with impressive propertied limitedly used because of its expenses.[1] In this study, shear bond strength with acrylic teeth, hardness, surface roughness and the net benefits, associated with alternatives for achieving defined treatment objective, were evaluated by comparing some properties of three different denture base materials with the cost of each one in Iraq. A total of (90) specimens of polycarbonate, injectable acrylic and conventional heat cured acrylic were fabricated according to manufacturer’s instructions and divided into (3) groups, (30) specimens for each testing group i.e. the shear bond strength with acrylic teeth, shore D hardness and surface roughness (10 specimens for each testing material). the total cost of each specimens group was collected and calculated to evaluate the overall cost benefit of each material. Highly significant differences (P≤ 0.01) between all the (3) experimental materials were noticed after analyzing each test's results with descriptive statistical analysis, one-way ANOVA and post-hoc LSD, except for the shore D hardness whereas a non-significant differences(P&gt; 0.05) between heat cured and injectable acrylic was found. The heat cured acrylic has the highest mean value of the shear bond strength with acrylic teeth (516.1 N) followed by the injectable acrylic with (329.9 N) mean value while the lowest mean value was for the Polycarbonate (180.1 N). Furthermore, the injectable acrylic has the highest mean value in shore D hardness (91.96), followed by the heat cured acrylic (91.5), then Polycarbonate (82.94). As for surface roughness, the Polycarbonate has the highest mean value (0.31703) followed by the injectable acrylic (0.2129), then the heat cured acrylic (0.10367). Finally, Polycarbonate has the highest mean value of the specimens’ cost in Iraq (10.022 US dollar /specimens), followed by the injectable acrylic (8.695 US dollar /specimens) then the heat cured acrylic (3.243 US dollar /specimens). All thermoplastic materials included in this study (Injectable acrylic and Polycarbonate) exhibited higher cost with lower properties in comparison with heat cured acrylic material for the selected tests.