In the past, fixed prostheses were believed to be more efficient implant-supported devices than removable types for edentulous patients. However, this hypothesis was never properly tested. Therefore, a within-subject crossover clinical trial was designed in which 145 completely edentulous subjects were tested wearing implant-supported mandibular fixed prostheses and long-bar overdentures. Eight subjects received the fixed appliance first and seven the removable type. The patients' perceptions of various characteristics of the implant-supported prostheses were measured after a minimum of two months' adaptation. Mandibular movements and jaw muscle electromyographic activity were recorded while the patients chewed five standard-sized test foods: bread, apple, hard cheese, sausage, and raw carrot. The prostheses were then changed, worn for the same period of adaptation, and the procedures repeated. There were three test sessions per prosthesis, and each included five trials per food. The measurements were repeated three times at one-week intervals. Mastication time was found to be shorter for three foods (bread, cheese, and sausage) when subjects wore the long-bar overdenture. The vertical amplitude of the masticatory strokes was significantly less with the overdenture for all foods except carrot. Cycle duration was significantly longer with the overdenture for sausage and carrot. Contrary to what might be expected, the long-bar overdenture appears to be no less efficient than the fixed prosthesis. Furthermore, these data suggest that patients are capable of adapting their masticatory movements to the characteristics of the two prostheses.

This study was designed to investigate the relationship among jaw movements, physical characteristics of food, and sensory perception of hardness in man. Vertical movements of the mandible were recorded with an infrared tracking device in humans during biting on two test foods, carrot and cheese. Samples of standard length (2 cm) and width (2 cm) were prepared in three different thicknesses (0.5, 1.0, and 1.5 cm). Nine subjects were asked to perform two types of bite with their incisor teeth. In the first, they cut through the food, then stopped and spat out the pieces (bite alone); in the second, biting was followed by mastication and swallowing (bite+chew). The 12 conditions (thickness x3, food x2, and bite x2) were presented in a random order within each block, and blocks were repeated five times (60 trials per subject). Subjects also estimated the hardness of the samples twice for each condition on visual analogue scales (VAS) 100 mm long. The duration, vertical amplitude, and maximum vertical velocity of the mandible during biting were calculated by computer for the three phases of the movements (opening, and fast and slow closing). Multilevel statistical models were used for data analysis. The estimated hardness scores associated with the first bite of thin carrot (59.0 VAS units) was significantly greater than for cheese (16.8 VAS units). The type of bite had no significant effect on these scores, but the estimate of hardness was significantly greater for the thickest sample (+13.3 VAS units). Food type had its strongest effect on the slow-closing phase. In particular, the peak velocity that followed the fracturing of the food sample was much greater for carrot than for cheese (thin, 34.1 mm.s-1 vs. 26.6 mm.s-1), and the difference between foods increased with thickness. The amplitude of opening was significantly greater for the thickest sample than for the other two. There were no significant relationships between VAS scores and the movement parameters. These results suggest that, when humans bite food: (1) changing the thickness of food has a greater effect on movement parameters than changing from soft to hard food, (2) the parameters of biting change little if biting is followed by mastication, (3) hardness perception is dependent on the thickness of food, (4) hardness perception is not different when food is removed from the mouth than when it is chewed and swallowed, and (5) there is no relationship between any of the parameters of movement that change with food type and the perceived hardness of food.