APPLICATION OF OBJECTIVE AND SUBJECTIVE EVALUATION METHODS FOR MASTICATORY FUNCTION IN PATIENTS WITH MANDIBULAR OVERDENTURES
Appropriate chewing function is an important indicator of oral health, and masticatory efficiency assessment is one of the most objective methods of prosthetic treatment quality control.
In the globe dental practice, static and dynamic chewing tests are still considered to be the main methods of masticatory function assessment. Thus, there is an extension of functionally-oriented clinical investigations base, which actualizes the importance of this work.
The aim of the work was to evaluate the masticatory function of patients that use mandibular overdentures by studying the results of physiological masticatory test and self-assessment indicators of dental health associated with the use of dentures.
Materials and methods. The clinical trials were carried out in two stages. At the first stage upon informed consent an examination of 20 student volunteers aged 18-22 years (control group -I) and 36 patients -17 women, 19 men (aged 57-76 years) with complete mandibular removable dentures (comparison group -II) was proceeded. Patients of the group I underwent physiological masticatory test with agar-agar samples formed according to UMSA method, patients of group II- masticatory test procedure and interview survey. The second stage was performed by the group III–42 persons –23 women, 19 men (aged 56-89 years) at 1, 6 and 12 months after mandibular dental arch restoration with complete removable overdentures, fixed by spherical attachments. Chewing efficiency was determined using masticatory physiological test and problem-oriented questionnaires. Video registration by Nikon Digital Camera D3200 was used to determine chewing time, number of movements and peculiarities of the mastication process.
All patients of groups II and III in personal interview survey answered 6 questions about indicators of oral health connected with the use of dentures. Questions were formed according to European Oral Health Indicators (2005). Statistical data analysis was performed by standard statistics variation methods with Statistica 6.0 Program use.
Results and discussion. All the parameters of physiological masticatory test: duration of chewing, group I 25,3±2,8 sec. group II 67,3±3,7 sec., group III 60.5±3.5 sec, number of chewing movements in group I was 58.3±4,8, in group II − 82.3±6.3, in group III − 68.8±3,4, samples mass loss: group I − ≤0,13(4,3%), group II − ≤0,21(7,0%), group III − ≤0,18(5,9%). Diminution Index obtained: group I − 1.85±0.5, group II – 3.33±0.7, group III – 2.48±0.5). Masticatory efficiency level in patients of the group III prevailed over group II by the respective parameters. Masticatory test video registration data analysis showed that the patients of group I diminished test samples with bilateral chewing pattern, as the majority of group II patients, while patients in group II employed combined— uni- and bilateral chewing pattern.
According to the average values of the expression of all oral health-related questionnaire indicators: chewing difficulties - 2.67 ± 1.35 vs 0.50 ± 0.20*; excessive bite closure efforts - 1.19 ± 0.65 vs 0.57 ± 0.30*; limited food consumption 2.83 ± 1.35 vs 0.59 ± 0.30*; oral lesions 2.39 ± 1.20 vs 0.56 ± 0.30*; difficulty non-chewing movements 2.14 ± 1.05 vs 0.51 ± 0.30*; uncertainty about reaching treatment goals 2.06 ± 1.10 vs 0.66 ± 0.30*. A statistically significant (p <0.05) difference in favor of group III was clearly demonstrated.
- The results of physiological masticatory test and patients interview survey indicated favorable adaptation process to mandibular overdentures with reestablished masticatory function restoration during 12 months of use.
- Masticatory efficiency and oral health indicators, connected with dental prostheses usage proved the appropriate quality level of prosthetic treatment in mandibular single remaining teeth-attended patients, using dentures fixed by spherical attachments.
2. Sierpinska T, Golebiewska M, Kuc J, Lapuc M. The influence of the occlusal vertical dimension on masticatory muscle activities and hyoid bone position in complete denture wearers. Adv Med Sci. 2009;54(1):104–8.
3. Van der Bilt A. Assessment of mastication with implications for oral rehabilitation: A review. Journal of Oral Rehabilitation. 2011:754–80.
4. Van der Bilt A, Engelen L, Pereira L, Van der Glas H, Abbink J. Oral physiology and mastication. Physiol Behav. 2006;89(1):22–7.
5. Akan E, Gungor M, Yilmaz G, Artunc C BS. Stress analysis of fiber-reinforced maxillary dentures under different loadings. J Reinf Plast Compos. 2010;29(19):2961–74.
6. Alkan A, Keskiner I, Arici S SS. The effect of periodontal surgery on bite force, occlusal contact area and bite pressure. J Am Dent Assoc. 2006;137(7):978–83.
7. Kasperski J, Zmudzki J CG. Denture foundation tissues loading criteria in evaluation of dentures wearing characteristics. J Achiev Mater Manuf Eng. 2010;43(1):324–32.
8. Lü Y Lou H, Rong Q, Dong JX. Stress area of the mandibular alveolar mucosa under complete denture with linear occlusion at lateral excursion. Chin Med J (Engl). 2010;123(7):917–21.
9. Polyzois G, Partalis C, Lagouvardos P PH. Effect of adaptation time on the occlusal force at denture dislodgement with or without denture adhesive. J Prosthet Dent. 2014;111(3):216–21.
10. Alzoubi EE, Hariri R ANJ. Oral Health Related Quality of Life Impact in Dentistry. J Dent Heal Oral Disord Ther. 2017;6(6):183–8.
11. Batisse C, Bonnet G, Eschevins C, Hennequin M NE. The influence of oral health on patients’ food perception: a systematic review. Journal of Oral Rehabilitation. 2017. p. 966–1003.
12. Koyano K, Tsukiyama Y KR. Rehabilitation of occlusion—science or art? J Oral Rehabil. 2012;39:513–521.
13. Yamaga E, Sato Y MS. A structural equation model relating oral condition, denture quality, chewing ability, satisfaction, and oral health-related quality of life in complete denture wearers. J Dent. 2013;41(8):710–4.
14. Ikebe K, Matsuda K, Murai S, Maeda Y NT. Validation of the eichner index in relation to occlusal force and masticatory performance. Int J Prosthodont. 2010;23(6):521–4.
15. Matsuda K, Ikebe K, Ogawa T, Kagawa R MY. Increase of salivary flow rate along with improved occlusal force after the replacement of complete dentures. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2009;108(2):211–5.
16. Nakatsuka Y, Yamashita S, Nimura H, Mizoue S, Tsuchiya S HK. Location of main occluding areas and masticatory ability in patients with reduced occlusal support. Aust Dent J. 2010;55(1):45–50.
17. Tumrasvin W, Fueki K, Yanagawa M, Asakawa A, Yoshimura M OT. Masticatory function after unilateral distal extension removable partial denture treatment: intra-individual comparison with opposite dentulous side. J Med Dent Sci. 2005;52(1):35–41.
18. Zaporozhchenko IV. Porivnjal'na harakterystyka suchasnyh metodiv vyznachennja zhuval'noi' efektyvnosti. Visnyk VDNZ Ukrai'ny «Ukrai'ns'ka medychna stomatologichna akademija». 2018;18(2):326–31. (Ukrainian).
19. Tokarevych YV, Naumovych JuJa. Sovremennыe metodyky ocenky funkcyy zhevanyja. Sovremennaja stomatologyja. 2009;3(4):14–9. (Russian).
20. Armellini D, Fraunhofer J. Modern methods of estimation of chewing function. J Prosthet Dent. 2004;92:531–5.
21. Takayama Y, Sasaki H, Goto M, Mizuno K, Saito M YА. Morphological factors of mandibular edentulous alveolar ridges influencing the movement of dentures calculated using finite element analysis. J Prosthodont Res. 2011;55(2):98–103.
22. Wakabayashi N, Suzuki T. Patient-specific finite element analysis of viscoelastic masticatory mucosa. J Dent Biomech. 2013;4(1):1–7.
23. Korol' DM, Korol' MD, Skubij IV, Kindij DD. TJeD. Zhuval'na efektyvnist' jak kryterij ocinky funkcional'nogo stanu zuboshhelepnoi' systemy. Ukrai'ns'kyj stomatologichnyj al'manah. 2016;3(1):59–62. (Ukrainian).
24. Skubij IV, Korol' DM, Kindij DD. Sposib funkcional'nogo vyznachennja zhuval'noi' efektyvnosti u pacijentiv molodogo viku (eksperymental'na model'). Visnyk problem biologii' i medycyn. 2015;2(119):217–21. (Ukrainian).
25. Korol DM, Kalashnikov DV, Kindiy DD, Toncheva KD ZV. Masticatory test procedure based on the use of man-made test patterns. World Med Biol. 2018;1(63):36–9.
26. Vasileva T, Mitin N, GrishinM. Modern assessment methods of the effectiveness of chewing phases in orthopedic treatment (literature review). J New Med Technol. 2015;9(4):1–10.
27. Who. Oral Health Surveys - Basic Methofd. World Heal Organ. 2013;
28. Bourgeois DM, Llodra JC, Nordblad A, Pitts NB. Report of the EGOHID I Project Selecting a coherent set of indicators for monitoring and evaluating oral health in Europe: Criteria, methods and results from the EGOHID I project. Community Dent Health. 2008;25(1):4–10.
This work is licensed under a Creative Commons Attribution 4.0 International License.