Preferred Chewing Side Research Articles

Mandible Position and Chewing Preference Side Do Not Alter Plantar Support in Children Aged 4-11 Years.

Mandible positioning can cause global postural adaptations. Physiotherapists and dentists try to relate the mandible position and chewing side to plantar support; however, this indication is uncertain. To check the existence of a relationship between mandible position, preferred chewing side, age, and plantar support in children. This is a cross-sectional study with 93 children, aged between 4 and 11 years. Photogrammetry was used to confirm the mandibular positions (centralized, to the right, and to the left), and baropodometry was used to measure plantar support. The mandibular displacement distance to the right and left was evaluated, and the plantar support in the three mandibular positions was compared as a function of age (4-7 and 8-11 years) and preferred chewing side. There was greater mandibular displacement in left laterality [13 (9-19) cm] compared to right laterality [7 (3.50-12.00) cm] (p < 0.01). Mandibular position did not alter mean pressure, maximum pressure, or plantar support surface (p > 0.05). With the mandible centralized, higher mean pressure, maximum pressure, and surface area were observed in the left foot (p < 0.01). Older children showed greater mandibular displacement to the left (p < 0.01). No differences were observed for the variables of plantar support as a function of age (p > 0.05) and chewing side (p > 0.05). There was a moderate to strong correlation between age, body mass, height, and plantar surface area (0.63 < r < 0.83; p < 0.05) and between mean and maximum pressures of plantar support (0.58 < r < 0.89; p < 0.05). Mandibular position, age, and preferred chewing side do not influence plantar support in children. Bittar KCB, Zamboti CL, Macedo CSG. Mandible Position and Chewing Preference Side Do Not Alter Plantar Support in Children Aged 4-11 Years. Int J Clin Pediatr Dent 2024;17(6):658-664.

Mandibular overdenture with a single implant in the canine region (c-SIMO): a feasibility study

ObjectivesThe aim of this multi-center pilot study was to assess the viability and feasibility of a novel treatment concept – the canine-positioned single implant mandibular overdenture (c-SIMO), with the single implant placed on the patient's preferred chewing side instead of the midline.Materials and methodsParticipants received a single implant in the canine region of their preferred chewing side, based on an Asymmetry Index observed during mastication. The pre-existing mandibular denture was transformed into a c-SIMO on a spherical attachment. The primary outcome was oral health-related quality of life (OHRQoL), measured with GOHAI and OHIP-EDENT. Secondary outcomes included denture satisfaction index (DSI), chewing efficiency (CE), maximum bite force (MBF), implant survival and success, and prosthetic maintenance. Data analysis included descriptive statistics and bivariate comparison tests.ResultsFifteen participants received the c-SIMO treatment (mean age: 69.9 ± 7.0). Implant success and survival rates were 100% at 1 year. Patient-reported outcome measures improved significantly compared to pre-treatment values (OHIP-EDENT: p = 0.001; DSI: p = 0.001; GOHAI: p = 0.002). Masticatory outcomes also improved significantly (CE: p = 0.001; overall MBF: p = 0.005). Post-implant, MBF was significantly higher in the ipsilateral side compared to the contralateral side at 2 weeks (p = 0.019) and 3 months (p = 0.015), but no longer at T3 (p = 0.730). Common prosthodontic events included denture base adjustments (n = 17) and matrix activation (n = 9).ConclusionsThis pilot study concludes that c-SIMO is a promising treatment option, and a potential alternative to the single midline implant overdenture.Clinical relevanceThe novel treatment concept of a canine-positioned single implant mandibular overdenture could be a viable treatment alternative to the midline positioning.

Three tests to determine a preferred chewing side in partially edentulous patients: A pilot study

Determining the preferred chewing side may be an important factor in prosthetic treatment planning, especially where additional support for a removable dental prosthesis can be provided by implants. The purpose of this clinical study was to investigate the validity and reproducibility of 3 different tests to determine the preferred chewing side. A total of 82 partial denture wearers, with an average age of 70 years, were enrolled in this study. The first test (CG) evaluated the left or right position of a piece of chewing gum after spontaneous mouth opening during mastication. A second test (ASI) videotaped 30 seconds of mastication and analyzed the distribution of masticatory cycles by means of an asymmetry index. For the third test (VAS), participants were asked to mark their subjective perception of their preferred chewing side on a visual analog scale representing the right and left sides. All the tests were performed and repeated in a randomized sequence. The reproducibility of the tests was first evaluated. The mean values of the ASI and VAS tests were calculated, and the results were compared with the second series of the CG test. The Pearson correlation test was used to associate ASI and VAS, and the Cohen kappa agreement was used for the inter-reliability of CG (α=.01). The results indicated fair to almost perfect reproducibility for the 3 tests. Kappa values were.37 (P<.01) for the CG,.47 (P<.01) for the ASI and.91 (P<.01) for the VAS. Correlation coefficients resulted in rho=.86 (P<.01) for the ASI and rho=.97 (P<.01) for the VAS. The correlation between ASI and VAS was excellent, with rho=.85 (P<.010). CG and ASI (test kappa=.36, P<.010) and CG and VAS (test kappa=.39, P<.010) showed fair agreement. ASI and VAS seem more reliable than CG to determine a patient's preferred chewing side and might be helpful within the context of prosthetic treatment planning, where additional support may improve denture function.

Association between chewing side preference and MRI characteristics in patients with anterior disc displacement of the temporomandibular joint

ObjectiveTo compare the magnetic resonance imaging (MRI) characteristics in the anterior disc displacement (ADD) patients with and without chewing side preference (CSP). MethodsThe MRI characteristics of the bilateral temporomandibular joint (TMJ) in 111 patients with ADD were retrospectively analysed. Based on the presence of CSP, all subjects were divided into the non-CSP group (NC group, N = 40) and CSP group (C group, N = 71). Based on the preferred chewing side in the C group, the patients were divided into ipsilateral and contralateral sides. The morphology, length, disc-condyle angle, and coordinate position of the disc and condyle of the bilateral TMJ were compared. ResultsMRI examination showed a significant difference between ipsilateral and contralateral joint displacement in patients with CSP (P<0.05). In CSP patients, the disc length of the same side in the ipsilateral side was significantly shorter than the contralateral side (P<0.05). A significant difference in the Y-axis coordinates of the ipsilateral and contralateral discs was also found in patients with CSP (P<0.05). The disc displacement grade, morphology of the articular disc, ipsilateral disc length, and ipsilateral disc-condyle Y-axis distance were positively correlated with CSP (P<0.05). ConclusionCSP is related to the shape of the articular disc and disc-condyle position in patients with ADD. CSP may aggravate the development of ADD.

Comparative evaluation of hemispheric and masticatory laterality in complete dentures with two occlusal schemes - A prospective cohort study.

The lateralization can influence the choice of occlusion scheme, patient comfort and success of the prosthesis. The existence of favored masticatory side in complete denture patients and its influence with various occlusal schemes is less analyzed in the literature. The study objective was to compare the masticatory and hemispheric laterality in complete denture subjects rehabilitated with 2 different occlusal schemes at different time intervals. The cohort study recruited 26 patients in each group of balanced and non-balanced occlusion with definitive criteria. Conventional procedures were followed in denture fabrication. The hemispheric and masticatory laterality for all participants were established at 0,1,3- and 6-month intervals. The laterality was categorized as preferred chewing side (CPCS), predominant preferred chewing side (PPCS) and observed preferred chewing side (OPCS). The data on chewing side preference was analyzed by chi square test. (α=0.05). Right side preference was predominant in 86.1% of non-balanced and 60.1% of balanced occlusion participants. The side preference among the 2 laterality and across time interval decreased in masticatory laterality of balanced occlusion participants (P<.05) when compared to non-balanced occlusion. (P>.05). The balanced occlusion dentures had lesser masticatory side preference when compared to non-balanced occlusion complete denture.

Does Orthodontic Treatment Change the Preferred Chewing Side of Patients with Malocclusion?

Whether orthodontic treatment can change the preferred chewing side (PCS) is unknown. This study examined (1) if the PCS changes after orthodontic treatment and (2) which factors contribute to this change. Two hundred fifty patients who visited the orthodontic clinic at Tokyo Medical and Dental University Hospital between 2017 and 2020 were included in the study. Mandibular kinesiograph (MKG) was taken at pre- and post-treatment, and PCS was determined. Patients who showed a change in PCS to the opposite side and those who showed no change in PCS at post-treatment were pooled into the PCS-changed and PCS-unchanged groups, respectively. The demographic, clinical, and cephalometric parameters were compared between the groups. Significant factors associated with changes in were of age &lt; 20 years at the beginning of orthodontic treatment (odds ratio (OR), 2.00), maximum lateral mandibular movement to PCS ≥ 10.0 mm at pre-treatment (OR, 6.51), and change in occlusal canting of ≥1.0° (OR, 2.72). The predicted probability of change in PCS was 13.2%, 36.0%, and 67.5% for no factor, one factor, and two factors associated with PCS change, respectively. Orthodontic treatment may change PCS due to patient age, maximum lateral mandibular movement to PCS, and change in occlusal canting.

Chewing side preference and laterality in patients treated with unilateral posterior implant-supported fixed partial prostheses.

It is not clear to what extent chewing is improved by unilateral oral rehabilitation with implant-supported fixed partial prostheses (ISFPPs). This study aimed to investigate whether patients treated with unilateral ISFPPs in the maxilla use their prostheses during mastication to the same extent as they used their contralateral natural teeth. A further aim was to investigate whether there is a correlation between preferred chewing side and laterality. Chewing side preference was assessed in 15 participants treated with unilateral ISFPPs in the maxilla. The first, second, third, fifth and tenth chewing cycles were assessed, and the test was repeated 10 times. All participants also answered a questionnaire about their chewing side preference. Most of the participants presented bilateral chewing, but two (13%) chewed only on the ISFPP. There was no statistically significant association between the objectively assessed chewing side and dental status (natural teeth or ISFPPs) during any of the recorded chewing cycles (p > .1). There were statistically significant correlations between both the subjectively reported usually preferred chewing side and the subjective chewing side preference during the test and the objectively assessed chewing side for the first three chewing cycles (p < .01). No correlation was found between handedness and the objectively assessed chewing side. In the present study, most participants chewed bilaterally, and chewing was performed both on the ISFPP and on the natural teeth. No correlation was found between the preferred chewing side, objectively or subjectively determined and laterality.

Biomechanical properties of masticatory balance in cases with RPDs-The influence of preferred and nonpreferred chewing side: A pilot study.

ObjectivesRemovable partial dentures (RPDs) are inserted with the aim to restore masticatory function. There is however inconsistent evidence supporting the alleged improvements, posterior occlusal contacts being one of the decisive factors. We hypothesized that the distribution of abutment teeth in RPDs influences masticatory performance and functional parameters. To evaluate the masticatory performance and functional parameters in patients with a RPD using a single mathematical parameter (tilting index [TI]) for both jaws that predicts biomechanical behavior on the basis of the distribution of abutment teeth.Materials and MethodsMasticatory performance was measured in patients wearing long‐time adapted RPDs using the standardized test food optocal, yielding the mean particle size (X 50). Mastication on the preferred and nonpreferred chewing sides was analyzed. Total muscle work (TMW) was calculated using bipolar electromyographic recordings of the masseter and anterior temporalis muscle. Functional parameters were subjected to multiple linear regression analysis including X 50 as a dependent variable and functional units (FU), the number of teeth, bite forces, and sagittal and frontal components of TI (TI α and TI β) as independent variables.ResultsWhen the preferred chewing side was tested, none of the investigated parameters correlated significantly with X 50. In contrast, chewing on the nonpreferred side was correlated significantly with performance for most variables (p < .05). This means that increased dental support improved chewing performance with RPDs under these conditions.ConclusionsIn well‐adapted RPDs, the distribution of abutment teeth as expressed by the tilting index seems to be of subordinate importance for masticatory performance.

A comparative study of condyle position in temporomandibular disorder patients with chewing side preference using cone-beam computed tomography.

Chewing side preference (CSP) could cause structural and morphological changes of temporomandibular joint (TMJ) and has been suggested as one aetiology of temporomandibular disorders (TMDs), but the condylar position in TMD patients with CSP is unknown. To compare the condylar position in the TMD patients with and without CSP. Ninety TMD patients with unilateral symptom (69 with CSP and 21 without CSP) and 20 asymptomatic participants received cone-beam computed tomography. The condylar position was determined based on the measurements of sagittal joint spaces. Intergroup and intra-group comparisons of the condylar position were performed. The condyles in asymptomatic participants located nearly randomly in anterior, centric and posterior positions. Patients without CSP had significantly more posterior condyles than asymptomatic participants (57.1% vs 30.0%, p<0.05). In patients with CSP, 50.7% of the condyles on the preferred chewing side and 42.0% on the unpreferred side located posteriorly, reaching no significant level compared with the asymptomatic participants and patients without CSP (p>0.05). The symptomatic joints and asymptomatic joints in patients with CSP and without CSP showed no significant differences in condylar position. While patients without CSP had significantly more posterior condyles in symptomatic joints than asymptomatic participants (p<0.05), patients with CSP showed a trend towards more posterior condyles in symptomatic joints compared with the asymptomatic participants (53.6% vs 30.0%, p=0.054). Condylar position is not a strong indicator to differentiate CSP-related TMDs from non-CSP-related TMDs. Posterior condyle could not be viewed as one indicator of TMD.

Facial asymmetry and chewing sides in twins

Objective To resolve how the preferred chewing side (PCS) affects facial asymmetry in twins, whether there are differences between monozygotic (MZ) and dizygotic (DZ) twins, and whether the twins with PCS have more asymmetric faces compared to symmetrically chewing twins. Material and methods The study included 106 Lithuanian twin pairs of the same sex, 59 MZ and 47 DZ pairs. The data were analysed from facial 3D images and manually added landmarks. 3D images were analysed by Rapidform2006 software and statistical analyses were done by using the R software environment version 4.1.0. Results The contralateral effect of PCS and larger chin side was dominant among right and non-right side chewing twins. Being female increased the whole face symmetry. Conclusion The volume of the chin becomes larger on the side opposite to the twins’ habitual chewing side. As the results are quite similar in both twin types, functional factors are more prominent than heredity.

A cross sectional study of preferred chewing side and masticatory function in community dwelling elderly

A cross sectional study of preferred chewing side and masticatory function in community dwelling elderly

Non-carious cervical lesions and risk factors: A case-control study.

To evaluate whether the presence of non-carious cervical lesions (NCCLs) was related to the considered risk factors and to show the corresponding odds ratio in a predictive model. The sample was 280 dentistry students. In an initial clinical examination, 140 cases were selected that presented one or more teeth with non-carious cervical wear. For each case, a similar sex and age control without any tooth with non-carious cervical lesions was selected. An occlusal examination and periodontal probing were performed in all cases and controls by skilled dentists. All the subjects answered a questionnaire referring to factors of brushing, bruxism, preferred chewing side, consumption of extrinsic acids and the presence of intrinsic acids. Data were analysed by means of univariate and multivariate logistic regression. Of all the study variables, only the protrusion interferences, interferences on the non-working side, the brushing force, CPITN value and the consumption of salads increase the risk of NCCLs in the univariate regression. The best predictive model was formed by the combination of CPITN variables >1, the consumption of acidic salads, self-reported bruxism, brushing force and attrition. However, it only correctly classifies 68.75% of subjects. This study supports the multifactorial aetiology of NCCLs, the combination of several factors being necessary to explain their presence. The risk factors that make up the predictive model are not sufficient to explain the appearance of NCCLs. Dentists should take into account all these risk factors in prevention, diagnosis and treatment.

Relations of laterality and chewing sidedness in twins.

To study, whether there are associations between chewing side preference and other lateralities, whether there is a genetic origin for preferred chewing side (PCS), relations to sex, birth order and orthodontic treatment. The study included 113 twin pairs, 57 pairs monozygotic, 47 pairs same sex dizygotic and 9 pairs of opposite sex. The lateralities of preferred chewing side, footedness and eyedness were assessed by functional tests and handedness was checked by asking. Right-handed, -footed and -eyed as separated groups, and true-right sided (combined), were evenly distributed by preferred chewing side. By contrast, left-handed, -footed, -eyed and non-right sided used more left or both sides when chewing. Birth order affected preferred chewing side among monozygotic: the first-born twin was more likely to have the preferred chewing side on the non-right, whereas second-born twins used right side. Gender, zygosity and orthodontic treatment were not statistically significant factors. Examination of chewing sidedness could have been done in several different ways to provide a definite result. Sample size of opposite sex twins was very small. Preferred chewing side generally seemed to follow the side where other lateralities occur; however, monozygotic twins seemed to be more receptive to it. True-right sided were more evenly distributed than non-right sided by the preferred chewing side.

Predilection of chewing side preferences and clinical assessment of its impact on temporomandibular joint

Statement of the Problem: Normal mastication in humans generally favors one side and then the other, but most people chew more on a particular side, which means they have a preferred chewing side (PCS). The relationship between the use of one habitual chewing side and the peripheral factors involved in temporomandibular disorders (TMDs) is not understood yet. Aims and Objectives: The objective of the study is to explore the effect of chewing side preference on temporomandibular joint (TMJ) in adult population. Methods: One hundred and seventy healthy dentate subjects (148 female and 22 male) were selected and clinically examined for this cross-sectional study. Chewing side preference test and TMJ clinical examination were conducted. Subjects were classified into unilateral and bilateral chewers, signs and symptoms of TMDs were recorded. Results: Statistical analysis was performed to evaluate the difference between the subjects regarding preferable chewing side, distribution of subjects with respect to signs and symptoms of TMDs, and frequency of symptoms in habitual chewers using Chi-square test, at 5% significance level. The results showed that among all the subjects, 80% preferred unilateral chewing side and there was a significant correlation with asymmetric factors of TMJ with masticatory side. Conclusion: Within the limitations of the study, it may be concluded that the presence of a PCS affects the morphology and parameters of TMJ. This signifies that it is not only sufficient enough to maintain anatomic health but also dynamic and functional factors should be considered to avoid TMDs.

Immediate effects of temporary bite-raising with light-cured orthodontic band cement on the electromyographic response of masticatory muscles.

Objective:To assess the immediate effects of temporary bite-raising using light-cured orthodontic band cement on the superficial masseter and anterior temporalis electromyography (EMG) activity in healthy adults.Materials and Methods:Surface EMG signals were recorded bilaterally from the superficial masseter and anterior temporalis muscles of 30 volunteers with a normal occlusion, before and after having temporary bite-raising. The bite-raising was done by adding light-cured orthodontic band cement (3x5x2 mm WxLxH) on the lingual cusps of both upper first molars. The measurements were recorded (i) at rest, (ii) while clenching in centric occluding position and (iii) while chewing on an artificial test food. The EMG activity at rest and during clenching, the maximum voltage, and the duration of the identified EMG signal burst while chewing the artificial test food before and after temporary bite-raising were statistically compared using the paired t-test or the Wilcoxon signed-rank test based on the normality of the variables. The significance level was set at 5%.Results:After temporary bite-raising, we found no significant change in integral EMG activity at rest position for the superficial masseter (mean difference (MD)=7.5 μVs) and for the anterior temporalis muscle (MD=36.8 μVs); however, the integral EMG activity during clenching was significantly reduced for the superficial masseter (MD=201.2 μVs) and for the anterior temporalis muscle (MD=151.8 μVs). During mastication, the maximum voltage of the identified burst was significantly reduced on the preferred chewing side of the superficial masseter and anterior temporalis muscles (MD=127.9 and 47.7 μV, respectively), while no significant change was found for the duration of the identified burst (MD=-34.1 and 3.4 ms, respectively) after temporary bite-raising.Conclusion:The results point to an altered neuromuscular behavior during clenching and chewing immediately after temporary bite-raising with light-cured orthodontic band cement. This information is relevant for orthodontists to inform their patients what will happen to their masticatory muscle activity when this bite-raising method is used.

Unilateral Chewing as a Risk Factor for Hearing Loss: Association between Chewing Habits and Hearing Acuity.

Hearing loss is a common disease in older adults. In order to lower the prevalence of hearing loss, it is important to identify its risk factors. Although some studies have found a relationship between dental status and hearing acuity, few studies have investigated the relationship between unilateral chewing and hearing acuity. This study aimed to assess the effects of unilateral chewing on hearing acuity, with a focus on the risk of hearing loss. Eighty-one participants (aged 51-87 years) were included in the present study. Their chewing habits were determined by visual inspection. The participants were divided into two groups: the Unilateral Chewing Group (UCG; n = 43) and the Bilateral Chewing Group (BCG; n = 38). The preferred chewing side was identified for the UCG. Hearing acuity was determined using pure tone audiometry in a noise-free chamber, conducted at frequencies of 500, 1,000, 2,000, and 4,000 Hz. Hearing loss was defined as a lower hearing threshold greater than 50 dB in either ear at any frequency. Mean hearing thresholds at frequencies of 2,000 and 4,000 Hz were significantly higher, by 5.12 and 15.75 dB, respectively, for the UCG compared to the BCG (P < 0.05). The UCG had a 3.78-fold higher likelihood of suffering from hearing loss (95% confidence interval [CI]: 1.81-7.88). The results suggest that bilateral chewing could be beneficial for preventing hearing loss. This study may provide evidence to support clinical interventions aimed at reducing the risk of hearing loss in patients with unilateral chewing habits.

Development of a computerized method for masticatory pattern assessment

Objective: To develop a computerized method to assess the mandibular lateral deviation pattern during mastication. Method: 44 videos of masticatory processes were analysed using the algorithm developed. The individuals were instructed to perform a specific pattern of mastication: only on the left or the right side (group 1), alternating five bites on one side and two on the opposite side (group 2), alternating 3 bites on each side (group 3). The computerized method identified, frame by frame, the lateral displacement of the chin and determined the amplitude and the percentage of mandibular lateral deviation to each side. Results: The groups 1 and 2 showed significantly higher number of cycles on the side of chewing compared to the opposite side and there was no difference between two sides in group 3. The amplitude of cycles showed similar results. In groups 1 and 2, the method identified the preferred chewing side, however, the percentage of the identified cycles in the chewing side was significantly lower than the percentage of cycles required (p &lt;0.001). Conclusion: The proposed computerized method was effective in identifying the bilateral masticatory pattern and recognizing the existence of preference to use one of the sides during the masticatory cycles.

Periodontal tactile sensation and occlusal loading condition of autotransplanted teeth: A retrospective pilot study

PurposeThe objectives of this retrospective pilot study were: (1) to examine the occlusal properties (periodontal tactile sensation, occlusal force support ability, dynamic tooth mobility, occlusal force, contact area, preferred chewing side and main occluding area) of autotransplanted teeth with no clinical complications after transplantation (postoperative periods from 1 to 7 years). MethodsThree groups were formed from 20 subjects (23 teeth in each group): autotransplanted teeth (ATP group), teeth contralateral to the recipient site (control group A), and teeth contralateral to the donor site (control group B). ResultsThe tactile detection threshold of the ATP group was higher than both the control groups, and the individual occlusal force was significantly lower than control group A. The occlusal force ratio and the occlusal contact area ratio were significantly lower in the ATP group than in both control groups, while the mobility was similar in all groups. Eight out of 20 subjects chose the autotransplanted teeth side as the preferred chewing side. Especially when the recipient site was the first molar, the ATP of these subjects were included in the main occluding area. The pocket depth of the three groups was within the normal range. ConclusionsThese results demonstrate that teeth autotransplantation can achieve a mastication efficiency and periodontal condition similar to normal teeth; however, without proper healing, the periodontal sensation of autotransplanted teeth may be inferior to that of normal teeth (<250).

Correlation between temporomandibular disorders and the preferred chewing side as evaluated by the deep temperature of the masseter muscle

Correlation between temporomandibular disorders and the preferred chewing side as evaluated by the deep temperature of the masseter muscle

Chewing side preference - Impact on facial symmetry, dentition and temporomandibular joint and its correlation with handedness

Introduction: Habitual unilateral chewing develops subconsciously and serves as an example for lateral preference. This study aims to assess the possible impact of chewing side preference to facial asymmetry, temporomandibular joint (TMJ) and oral hygiene and existence of any link between the preferred chewing side (PCS) and handedness. Materials and Methods: A 2-month cross-sectional (observational) study was performed on 76 healthy dentate subjects [24 males (31.6%) and 52 females (68.4%)] with a mean age of 20.8 ± 1.5 years who participated in this study according to the selection criteria. Results: A total of 75 subjects out of 76 (98.6%) were observed to have a PCS. Out of them, 38 chewed on their right and 37 on the left side. Of the 74 right-handed subjects, 48.6% chewed on the right, 50% on the left and 1.4% chewed equally on both the sides. Conclusion: Chewing side preference has a detrimental effect on the TMJ of the corresponding side and is also related to lateral facial asymmetry, which suggests that examination and recording of chewing side preference merit consideration in routine dental examination and treatment planning.