Chewing Gum Test Research Articles

Effectiveness of salivary-gland and oral-mucosa massage in alleviating xerostomia in patients with schizophrenia

ObjectiveTo investigate the effectiveness of salivary-gland and oral-mucosa massage in alleviating xerostomia, which is an adverse effect of antipsychotics, in patients with schizophrenia and to investigate factors associated with its efficacy and clarify its indications. MethodsIn this randomized controlled trial, 47 patients with chronic schizophrenia were randomly divided into the intervention and control groups. The intervention group underwent salivary-gland and oral-mucosa massage and was followed up from baseline to week 8. The control group was assessed at baseline and after 8 weeks. ResultsOverall, 30 patients completed the study (15 in the intervention group and 15 in the control group). In the intervention group, the salivary flow rate stimulated by the chewing gum test significantly increased after 8 weeks. Furthermore, the use of first-generation antipsychotic (FGA) equivalents was significantly higher in patients whose salivary flow rate was unchanged after salivary gland oral-mucosal massage than in patients who showed improvement. Compared with the patients who used SGA alone, those who used second-generation antipsychotics (SGAs) and FGAs had less recognition of the tendency for salivary secretion to increase, and most of them used levomepromazine, an FGA with high muscarinic receptor affinity. ConclusionsSalivary-gland and oral-mucosa massage may promote salivation in patients with chronic schizophrenia. FGA intake inhibited the effects of the massage, and levomepromazine may have influenced this inhibition. Understanding the interactions between levomepromazine and salivary-gland and oral-mucosa massage can improve treatment strategies and patient care in chronic schizophrenia.

Very old age impacts masticatory performance: a study among sexagenarians to centenarians

ObjectiveThis cross-sectional pilot study evaluated the impact of age on masticatory performance among individuals aged 65 to 106 years, as part of the Heidelberg Dental Centenarian Study (HD-100Z) conducted in South-Western Germany.Materials and methodsA total of 31 centenarians were recruited, alongside 31 individuals each from the age groups 75–99 and 65–74, matched based on sex, prosthetic status, and number of teeth. Masticatory performance was assessed using a two-colored chewing gum test and digital image processing. Multiple linear regression analysis was performed to assess the effect of age, sex, number of teeth, type of prosthesis on the masticatory performance.ResultsMasticatory performance, as measured by the standard deviation of hue in the chewing gum test, decreased significantly in centenarians compared to individuals aged 75–99 years (-0.112, p = 0.037) and those aged 65–74 years (-0.274, p < 0.001). The effects of sex, number of teeth, and type of prosthesis on masticatory performance were not significant associations (p ≥ 0.135).ConclusionThe findings suggest that age may have a significant influence on masticatory performance in the studied age groups, challenging previous notions that aging itself has little impact on masticatory ability. The inclusion of centenarians in the study highlights the need for further investigation into masticatory function in age groups reaching up to 100 years or more.Clinical relevanceThis study contributes to the understanding of how ageing affects oral function, which may guide dental treatment approaches for older individuals, and set the stage for more in-depth investigations in this field in the future.

Effect of Dental Characteristics of Stroke Patients on the Masticatory System*

Aim: The aim of this study was to assess the interplay between central facial paralysis and dental characteristics for impaired mastication in sub-acute or chronic-stage stroke patients. Method: 20 stroke patients and 27 healthy individuals were included in the study. Oral health, oral hygiene, masticatory efficiency, central facial paralysis, and forward head posture of the participants were assessed by OHIP-14 questionnaire, a self-prepared questionnaire, a two-colored chewing gum test, labial commissure, and craniocervical angle measurements. Stroke characteristics and dental characteristics were also assessed. Results: The sociodemographic and physical characteristics of both groups were similar (p&amp;gt;.05). The dental characteristics of the stroke patients were significantly poor compared to healthy individuals (p&amp;lt;.05). Masticatory efficiency of the stroke patients was nearly half that of the healthy individuals (p&amp;lt;.05). The forward head posture and facial paralysis values of both groups were similar (p&amp;gt;.05). Conclusion: Our study showed that central facial paralysis gradually loses its effect on impaired mastication in stroke patients and gives its place to dental characteristics. Masticatory muscle activation and increasing postural adaptations like forward head posture may not be preferred by stroke patients. The preferred mastication side might be used to assess the severity or existence of central facial paralysis in stroke patients.

Subjective and Objective Assessment of Chewing Performance in Older Adults with Different Dental Occlusion

Objectives: Satisfactory masticatory function is a significant indicator of improved oral health-related quality of life in older adults, either with or without artificial teeth. The purpose of this study was to examine masticatory performance of older adults with different prosthodontic reconstructions and occlusion, as well as to compare subjective and objective assessment of chewing performance. Material and Methods: This study included 100 participants aged 65 and more. The chewing function questionnaire (CFQ) with answers on the Likert scale 0–4 (0 = no difficulties; 4 = maximum difficulties) was used as an indicator of subjective masticatory assessment. The two-color chewing gum test was used as objective assessment of masticatory function (mixing ability), based on the Z-score values. Dental occlusion was assessed using functional teeth units (FTU). Results: The results obtained using the CFQ and the clinical mixing ability test are in compliance with each other (r = 0.742). A decrease in the number of natural teeth, especially posterior teeth, progressively reduced chewing ability and increased difficulties in mastication. Participants with less FTUs, or with FTUs that are a part of removable denture, had greater reduction in masticatory function compared to those with FTUs composed of natural teeth or fixed partial dentures. Conclusion: This study revealed a strong positive correlation between the subjective masticatory assessment in older adults using the validated questionnaire and the objective clinical test of the mixing ability of two chewing gums. Our data on influence of the number and the type of FTU on masticatory performance will be valuable when planning prosthodontic therapy.

Assessment of masticatory function in the differential diagnosis of Stage IV periodontitis: A pilot diagnostic accuracy study.

After diagnosis of periodontitis is made, detection of Stage IV cases is critical for appropriate management that may call for interdisciplinary care. This study aims to identify and assess the accuracy of a simple screening approach for practice and surveillance of Stage IV periodontitis. Masticatory function assessments by both validated self-reported masticatory dysfunction questionnaire and dual-color chewing gum mixing ability test (index test) were conducted in 214 consecutive patients, followed by a full-mouth periodontal examination. Periodontal diagnosis was based on the 2017 World Workshop classification of periodontal diseases (reference standard). Multivariate logistic regression and area under the receiver operating characteristic curve (AUROC) analyses were performed. Overall, the individual patient-reported masticatory dysfunction questions showed low to moderate accuracy for predicting Stage IV periodontitis. The objective measures of masticatory function by calculating the variance of hue from the chewing gum test performed better with an AUROC of 0.840. A diagnostic approach based on age, self-report of altered food type intake, and chewing gum test results exhibited excellent performance for predicting Stage IV periodontitis (sensitivity: 89.7%; specificity:76.3%; AUROC:0.912). Once the presence of periodontitis has been established, a simple diagnostic approach that does not require specialized workforce, complex, or lengthy assessment allows identification of patients with Stage IV periodontitis. This is important as these patients require specific case work up and interdisciplinary care pathways. Additional studies are required to validate the findings in multiple populations.

Screening for a Decreased Masticatory Function by a Color-changeable Chewing Gum Test in Patients with Metabolic Disease.

Objective This study aimed to reveal the screening performance of a color-changeable chewing gum test for a decreased masticatory function in the assessment of oral hypofunction in patients with metabolic diseases. Methods We analyzed 1,000 patients with metabolic diseases, including diabetes, dyslipidemia, hypertension, and hyperuricemia. A decreased masticatory function was diagnosed by a gummy jelly test. Patients were asked to chew a test gum, which changed from green to red by thorough mastication, 60 times for 1 minute. The color change was visually evaluated using the color scale, from 1 (green-dominant) to 10 points (red-dominant), and was colorimetrically quantified as delta E in the L*a*b* color space. The screening performance for a decreased masticatory function was evaluated with the receiver operating characteristic (ROC) curve. Results Seventy-seven patients (7.7%) were diagnosed with a decreased masticatory function. The mean color scale and delta E of the gum test were 6.7±1.8 points and 42.9±6.7 units, respectively. The area under the ROC curve was 0.822 (95% confidence interval, 0.768-0.872) for the color scale and 0.838 (0.781-0.890) for delta E (p=0.41). The optimal cut-off point of the color scale was 5.5 (5.0-6.5) points, whereas that of delta E was 37.7 (35.5-38.8) units. The optimal cut-off points were not significantly different between the subgroups divided by clinical characteristics. Conclusions A color-changeable chewing gum test using the color scale as well as delta E would be a useful tool for screening patients with metabolic diseases for a decreased masticatory function in the assessment of oral hypofunction.

Obturator Prosthesis Rehabilitation after Maxillectomy: Functional and Aesthetical Analysis in 25 Patients.

The number of patients undergoing a surgical resection of the maxilla for oncological reasons is constantly increasing, the most common complication of which remains the communication between oral and nasal cavities. On the basis of data arising from the literature regarding the treatment options of maxillary oncological post-surgical defects, obturator prosthesis remains the most used worldwide. We studied 25 patients (with at least 1-year follow up) rehabilitated by obturator prosthesis after maxillary resection leading to oro-nasal communication, providing data on the objective/subjective evaluation of such rehabilitation and mastication performance measured by a two-color chewing gum test. The type of defect was classified according to the classification system proposed by Aramany. Among the patients in our study, 72% rated a higher score for either stability and retention than for aesthetic appearance, as confirmed by the Kapur score rated by clinicians. The two-color chewing gum test shows similar results as only one patient had insufficient chewing function. Interestingly, we found no correlation between the masticatory function and residual denture, confirming that the maxillary obturator remains a predictable solution in such patients regardless of the anatomical alterations following surgery.

A novel method for assessing oral mixing ability based on the spatial clusters quantified by variogram.

The two-colour chewing test (TCCT) has been widely used for assessing oral mixing ability, a critical component of masticatory performance. Most studies focused on quantifying the evenness of colour distribution. It remained unknown if the variation of colour clustering was a valid index of oral mixing ability. The study aims to investigate the oral mixing ability based on the spatial clusters quantified by variogram. Fifty older people (15 male/35 female, age: 66.0±7.8years) were assessed for the TCCT and the colour-changeable chewing gum test (CCGT). For the CCGT, we quantified the degree of colour change (ΔE). For the TCCT, the highest peak in colour histogram (HP), the standard deviation of colour values (SDC) and the range of variogram from colour spatial distribution (VARG) were quantified. The participants were grouped according to the contacts of posterior teeth, as assessed by Eichner Index (EI). Highest peak, SDC and VARG showed statistically significant differences between the EI groups (two-tailed independent t test P<.05). Higher VARG (ie a lower degree of clustering) was significantly negatively correlated with ΔE (r=-.36,one-tailed P<.01). The binary logistic regression revealed that among the spatial indices (HP, SDC and VARG), only VARG achieved statistical significance in prediction to the EI group. Eliminating other indices was insignificant to the model performance. Our results show that the averaged cluster sizes, quantified by variogram, are a valid index for quantifying the TCCT. Compared with other spatial indices, it had the best predictability to the condition of posterior contact.

Orofacial Functions and Chewing Effiency in Elderly Patients with Parkinson’s Disease Rehabilitated with Removable Prostheses

Background: Parkinson’s Disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease. It is one of the movement disorders that can affect oro-facial conditions. It is more common in the elderly, having an average age of onset of around 60 years. Objective: The aim was to study orofacial functions in patients suffering from PD with partial or total edentulism, wearing removable prostheses. Methods: Forty-eight (48) elders, rehabilitated with removable dentures, were included: 24 patients suffering from Parkinson's disease constitute the Study Group (SG), and 24 subjects not suffering from Parkinson's disease or neurological degenerative diseases represent the Control Group (CG). In SG, the severity of Parkinson's disease was assessed according to the Unified Parkinson's Disease Rating objective motor scale III, and oro-facial dysfunctions were evaluated using Nordic Orofacial Test-Screening (NOT-S). The duration of the use of dental prostheses expressed in years has been reported. In both the groups, the subjective chewing index for the analysis of masticatory ability and the two-color chewing gum test for the analysis of masticatory efficiency were conducted . Results: There was a statistically significant difference between the SG and CG compared to the NOT-S (P = 0.001). Analyzing the study group, a statistically significant correlation was found between the masticatory efficiency and prosthetic years of use (rs = 0.436; P &lt;0.05); instead, no statistically significant correlation was found between the masticatory efficiency and the severity of Parkinson's disease. Conclusion: In our study, we did not find differences between SG and CG in terms of the degree of masticatory efficiency; therefore, only a correlation between the duration of use of dental prostheses and the degree of masticatory efficiency was found.

Chewing Gum Test for the Diagnosis of Giant Cell Arteritis (Horton's Disease) - ChewingHort

Chewing Gum Test for the Diagnosis of Giant Cell Arteritis (Horton's Disease) - ChewingHort

Masticatory efficiency of implant‐supported removable partial dental prostheses in patients with free fibula flap reconstructed mandibles: A split‐mouth, observational study

The aim of this split-mouth study was to evaluate the masticatory efficiency in patients with segmentally reconstructed mandibles using free fibula flaps, with and without stabilizing osteosynthesis material in-situ during implant placement for rehabilitation with implant-supported removable partial dental prostheses (ISRPDPs). Ten participants (n=10; ♀=2, ♂=8; mean age=38.1years) consented to participate in this study. The participants' normal side (Side N) of the mandible served as the control side, for comparing the masticatory efficiency of the segmentally reconstructed and rehabilitated side (Side R). Masticatory efficiency was evaluated using the two-colored chewing gum test, measured as subjective assessment (SA) and electronically evaluated variance of hue (VOH). Data were checked for normal distribution and statistically analyzed with the level of significance set to p<0.05. Thirty-four tissue-level implants were placed in reconstructed mandibles of 10 participants. There was no significant difference observed in the masticatory efficiencies between Side N and Side R, in both subjective and electronic assessments. No implant loss was observed after a post-rehabilitated mean follow-up period of 42.7months, revealing an implant survival rate of 100%. In patients with surgically reconstructed mandibles, a normal masticatory function can be successfully achieved with a rehabilitation of the reconstructed side with implant-supported removable partial dental prostheses. Implant-supported prostheses should be actively advocated in patients with reconstructive surgeries to restore their masticatory function, extend their food choices, and improve their overall oral health-related quality of life.

Masticatory efficiency in patients with partially dentate dentitions

ObjectivesTo assess associations amongst masticatory performance, dental functional status, and perceived chewing problems with common soft and hard foods. Materials and methods387 adult participants with reduced natural dentitions were included and underwent an oral examination, completed a written structured questionnaire and performed a two-color chewing gum test for masticatory efficiency. A multivariate regression model was used to analyze associations between masticatory efficiency and a number of dental conditions, with age, gender and perceived chewing difficulties as background variables. Likelihood ratios were calculated to analyze the relationship between masticatory efficiency and dental conditions within a validated hierarchical dental functional classification system expressed by (1) number of teeth in upper and lower jaw, (2) completeness of anterior regions, (3) number of premolar occluding pairs, and (4) number of molar occluding pairs. ResultsThe regression model showed a significant positive association between unmixed ratio and self-reported problems with chewing (p = .004), and age (p < 0.001), and negative associations with having a sufficient premolar region (p < 0.001). In the hierarchical dental functional classification system, the likelihoods of having a high unmixed ratio and chewing problems with hard foods were highest for the predictor ‘less than 10 teeth in each jaw’ (LRs 4.01, respectively 13.06). ConclusionsIn partially dentates people, perceived chewing difficulties were associated with lower objective masticatory efficiency. Having fewer than 10 teeth in each jaw and having an impaired premolar region were best predictors for low masticatory efficiency. Clinical significanceThis study shows that having fewer than 10 teeth in each jaw and having an impaired premolar region are associated with low masticatory efficiency and chewing problems. Preservation of at least 10 teeth in each jaw and 3 to 4 premolars is important for preventing chewing difficulties.

Acute effect of created muscle fatigue in cervical region on temporomandibular joint in healthy women

The aim of study was to investigate acute effects of neck muscles fatigue, on masticator muscle pain threshold, endurance and maximum pain-free mouth opening. 14 healty women aged between 20-25 years (Mean±SD: 21.7±1.18) were included in the study. Initially, lack of teeth and bruxism status and demographic information of cases were recorded. Before fatigue protocole, masticator muscle pain threshold, maximum pain-free mouth opening and fatigue level of masticator muscles by 5 minutes chewing gum test were evaluated. After that, participants performed fatigue protocole consisting of head flexion and extension at prone position until take 10 points from Modify Borg Scale. And all the tests were re-performed after fatigue protocole. After fatigue protocol, pain threshold of masseter muscles, right temporomandibular joint and left temporalis muscle, maximum pain-free mouth opening and chewing endurance were reduced (p 0.05). In our study, we identified that neck fatigue negatively affects some parameteres of masticator muscle immediately. Fatigue of the neck muscles are thought to predispose temporomandibular joint dysfunction.

FRI0435 Salivary Epidermal Growth Factor (EGF) in SjÖGren's Syndrome: Association between Salivary EGF Levels and the Severity of Intraoral Manifestations

BackgroundXerostomia accompanied in patients with Sjögren's syndrome (SS) relates to reduced salivary flow rate as a result of salivary gland dysfunction. Dry mouth causes various intraoral manifestations such as refractory...

Non‐invasive objective evaluation of radiotherapy‐induced dry mouth

Dry mouth is a common complaint in patients undergoing radiotherapy. Here, we employed the oral moisture meter Mucus III to evaluate dry mouth in head and neck tumor patients before and after they underwent radiotherapy. We recruited 17 newly diagnosed patients with pharyngeal squamous cell carcinoma or unknown primary squamous cell carcinoma, who received head and neck radiation therapy at Tokyo University Hospital in 2008-2010. The primary sites were the epipharynx (n = 1), oropharynx (n = 6), or hypopharynx (n = 5); it was unknown in five cases. Salivary function was assessed by a dry mouth questionnaire, resting saliva test, chewing gum test, and Mucus III, before (n = 17), immediately after radiotherapy (n = 10), and at 3 (n = 9) and 12 months after radiotherapy (n = 11). The questionnaire, resting saliva test, and chewing gum test at 3 and 12 months after radiotherapy indicated a significantly decreased resting and stimulated whole saliva flow rate than prior radiotherapy (P < 0.05 and P < 0.001). In contrast, Mucus III results showed significant worsening of xerostomia at 12 months after radiotherapy (P < 0.05). Mucus III has been proven to be an objective diagnostic tool for patients with serious dry mouth, such as in patients with Sjogren's syndrome. However, we did not find a perfect correlation between Mucus III and other objective (resting saliva and chewing gum) and subjective (questionnaire) measures of dry mouth. To precisely diagnose radiotherapy-induced dry mouth, further improvement to the method is needed.

Novel software for quantitative evaluation and graphical representation of masticatory efficiency

Blending of chewing gums of different colours is used in the clinical setting, as a simple and reliable means for the assessment of chewing efficiency. However, the available software is difficult to use in an everyday clinical setting, and there is no possibility of automated classification of the patient's chewing ability in a graph, to facilitate visualisation of the results and to evaluate potential chewing difficulties. The aims of this study were to test the validity of ViewGum - a novel image analysis software for the evaluation of boli derived from a two-colour mixing ability test - and to establish a baseline graph for the representation of the masticatory efficiency in a healthy population. Image analysis demonstrated significant hue variation decrease as the number of chewing cycles increased, indicating a higher degree of colour mixture. Standard deviation of hue (SDHue) was significantly different between all chewing cycles. Regression of the log-transformed values of the medians of SDHue on the number of chewing cycles showed a high statistically significant correlation (r² = 0.94, P < 0.01). ViewGum eliminates drawbacks of previous two-colour chewing gum test methods by the simplicity of its application. The newly developed ViewGum software provides speed, ease of use and immediate extraction of clinically useful conclusions to the already established method of chewing efficiency evaluation and is a valid adjunct for the evaluation of masticatory efficiency with two-colour chewing gum.

A study of the effects of saliva stimulation by nizatidine on dry mouth symptoms of primary biliary cirrhosis

To elucidate the effect of saliva stimulation by nizatidine on oral symptoms of primary biliary cirrhosis (PBC) by administering it to PBC cases. From among 73 cases that had been definitively diagnosed as PBC at our hospital by February 2010, we selected 27 cases of PBC, 4 males and 23 females, as subjects. We obtained subjects' consent after giving them a full explanation of the administration of nizatidine. Nizatidine 150 mg was administered internally twice daily, after morning and evening meals. To observe changes in the quantity of saliva secreted, chewing gum tests were carried out four times: before the initial dose, and after 6 mo, 12 mo and 24 mo of administration. For subjective dry mouth symptoms, a visual analog scale (VAS) method was used to assess their feelings of oral dryness and eating difficulty, five times: before the initial dose, and after 1, 6, 12 and 24 mo of administration in 8 cases. The nutritional condition and the hepatic functional reserve were compared between before and after the nizatidine treatment. The result of a chewing gum test on the subjects before the administration of nizatidine showed that 50% produced less than 10 mL of saliva, i.e., the standard under which cases are considered to have hyposalivation. The results of these tests showed that the quantity of saliva secreted was 10.5 ± 6.8 mL before administration of nizatidine, 10.9 ± 6.0 mL after 6 mo, 10.6 ± 4.9 mL after 12 mo, and 11.8 ± 6.8 mL after 24 mo administration. Thus, there was a slowly increasing trend in the quantity of saliva in the whole group. The percentage of subjects with saliva production above 10 mL was 45.8% after 6 mo administration of nizatidine, that is, only a slight change from before its administration, but it was 64.3% after 12 mo, that is, a significant increase. The saliva secretion by subject patients was examined before the beginning of administration of nizatidine, 12 mo later, and 24 mo later, and Fisher's combined probability test was used to examine the results for increases in saliva secretion. The analysis yielded P values of 0.51 and 0.53 for 12 mo later and 24 mo later, respectively. Thus, although there was no statistically significant increase, it was confirmed that saliva secretion tended to increase. A VAS method was employed to study the intensities of subjective symptoms of oral dryness and eating difficulty. Almost every case indicated some improvement of subjective oral dryness on the VAS early in the administration, i.e., one month after. We also studied the effects of the administration of nizatidine on nutritional condition, hepatic functional reserve, and long-term prognosis of PBC. No significant improvements in cholinesterase (ChE) level, albumin (Alb) level, or Child-Pugh score were found during the period of observation from the beginning to the end of administration of nizatidine, nor in comparison with the non-administration group. A comparative analysis between before administration and 24 mo later yielded P values of 0.41 for Alb, 0.56 for ChE, and 0.59 for the Child-Pugh scores. It was confirmed that administering nizatidine to cases of PBC with dry mouth increased the secretion of saliva and improved the symptoms.

A two-colored chewing gum test for assessing masticatory performance: a preliminary study

This study was conducted to compare subjective and objective assessment methods of a two-colored chewing gum test and to find out whether these methods are capable of discriminating masticatory performances between sexes. 31 adults, 16 males and 15 females participated in this study. Each subject chewed five samples of two-colored chewing gum sticks for 5, 10, 20, 30 and 50 chewing strokes, respectively. The subjective color-mixing and shape indices for the gum bolus (SCMI-B, SSI-B) and the subjective color-mixing index and objective color-mixing ratio for the gum wafer (SCMI-W, OCMR-W) were evaluated by two independent examiners and, on a different day, re-evaluated by one of the examiners. The SCMI-B and SCMI-W assessments had inter- and intra-examiner reliable agreement at 20 or more chewing strokes. The OCMR-W measurement demonstrated high accuracy and low reproducibility between and within the examiners. There were significant gender differences in the distribution of SCMI-W scores (P = 0.044) and in the mean OCMI-W (P = 0.007). The SCMI-B and SCMI-W assessments and the OCMR-W measurement were reliable and valid at the 20 and 30 chewing strokes in this two-colored chewing gum test. The subjective color-mixing index (SCMI-W) and objective color-mixing ratio (OCMR-W) for the chewing gum wafer are capable of discriminating masticatory performance between sexes in this two-colored chewing gum test and that the OCMR-W measurement is discriminating better than the SCMI-W assessment.

A two‐colour chewing gum test for masticatory efficiency: development of different assessment methods

The aim of this study was to investigate different assessment methods of a two-colour chewing gum test for masticatory efficiency to determine its validity for research and clinical purposes. Twenty adult volunteers, eleven women and nine men (mean age of 27.5 years), participated in this study. All participants perceived their masticatory efficiency as normal. The task was to chew five samples of a two-colour chewing gum for 5, 10, 20, 30 and 50 cycles respectively. Maximum bite force was measured. All samples were assessed twice by two independent operators both, as 'bolus' and after flattening to 1 mm thick 'wafers'. The latter were scanned and the unmixed pixels counted using Adobe Photoshop Elements to calculate the ratio of unmixed colour to the total surface. Digital image processing confirmed a significant correlation between colour mixing and chewing duration (P < 0.001). Subjective assessment proved less accurate with fair to substantial intra-examiner agreement for 'bolus' (0.20 < kappa < 0.63) and substantial to almost perfect agreement for 'wafer' (0.60 < kappa < 0.88). Inter-examiner agreement was consistently moderate or substantial only for specimen chewed 20 cycles or longer. No significant correlation was found between the colour mixture and the maximum bite force. Digital image processing of the two-colour chewing gum test specimen provides reliable quantitative data for chewing efficiency. Visual assessments were less reliable but might still be useful in screening for chewing deficiencies in a clinical setting. In this context, the test should be performed with a flattened specimen chewed, probably for 20 cycles.

シェーグレン症候群の診断における唾液分泌量測定法としてのガムテストの検討

シェーグレン症候群の診断における唾液分泌量測定法としてのガムテストの検討