A new masticatory performance scale to integrate food biting, comminution and mixing ability in removable partial denture wearers

Abstract

Background:The existing masticatory performance (MP) tests cannot comprehensively evaluate objective masticatory function. Objectives:We aimed to examine the construct validity and responsiveness and determine the clinically minimum important difference (MID) and related factors of a newly developed MP scale to integrate food biting, comminution and mixing ability in patients with removable partial dentures (RPDs).Methods: Masticatory performance tests using gummy jelly, peanuts and colourchangeable gum were performed before and 3 months after RPD treatment in 248 partially dentate patients. A 10-point ordinal subscale was created for each MP test based on the distributions of MP values, and the three subscales were integrated into a single scale (iMP scale). We analysed the correlations between MP values and iMP scores and determined the effect size for RPD treatments and the MID on the basis of patient perception of chewing ability.Results: iMP scores exhibited moderate correlations with the three MP values (|ρ| = 0.73-0.79, p < .001) and with the change scores (|ρ| =0.61-0.64, p < .001). The mean iMP score significantly increased after RPD treatment (p < .001), and the effect size was 0.35. Of the 248 patients, 55 (22%) reported a slight improvement in chewing ability with a mean iMP score change of 2.1 points. Sex and the number of missing teeth were significantly associated with iMP scores (p < .05). Conclusions:The iMP scale comprehensively evaluated objective masticatory function, including food biting, comminution and mixing ability in RPD wearers, and an increase of two points on the iMP scale was considered to be the MID in RPD treatments.

Influence of masticatory side switch frequency on chewing mixing ability and sensory perception in adults with healthy dentitions: A randomized crossover trial

“…Given that fragmenting food depends more on the bite force and dental status, whereas mixing food to form a bolus depends more on tongue and jaw movements, these aspects should be considered complementary and equally essential [35].…”

El odontólogo, custodio de la función masticatoria.

“…También se lleva a cabo con diferentes alimentos artificiales como cubos de cera de dos colores o goma de mascar de dos colores, aunque en realidad en este caso lo que se evalúa es la capacidad de una persona de mezclar los alimentos. 13,22 Entre los alimentos artificiales más comúnmente utilizados se encuentran los cubos 23 o tabletas de silicona por condensación, 16 además del uso de formas diversas en jalea. 24 Al evaluar la capacidad de fractura se considera más conveniente utilizar alimentos naturales, ya que los pacientes conocen esos alimentos, los han consumido y tienen un sabor y textura conocida; sin embargo, la desventaja es que es más complicado estandarizar el alimento prueba y cualquier modificación en la dureza, tamaño o hasta la forma puede alterar los resultados.…”

“…Los alimentos prueba artificiales sí se pueden estandarizar, por lo que se considera conveniente emplearlos, además de que no son tóxicos y se le indica al paciente que no los degluta. La evaluación de esta capacidad de fractura se ha utilizado, entre otras situaciones, para evaluar qué tan afectada está la función masticatoria con la pérdida de los dientes posteriores o extensamente en el campo de las prótesis donde se determina la mejora de la función masticatoria después del uso de implantes o prótesis 22,25,26 y menos en otras áreas como la ortodoncia para determinar la disminución de la capacidad de fractura en pacientes con maloclusiones 27 o si un tratamiento de ortodoncia mejora el desempeño masticatorio. 28 Estos métodos se emplean en proyectos de investigación adecuadamente estructurados, pero la pregunta es, ¿realmente como odontólogos nos preocupamos por mantener y/o restaurar la función masticatoria del paciente?…”

Reference value of masticatory performance by measuring the amount of glucose extraction from chewing gummy jelly

“…The sieve method has long been used to measure MP; however, this method has significant limitations, in that the operation is complicated, and the analysis is lengthy. Therefore, many methods using impression material [1], color-changing gum [2,3], paraffin wax [4], fuchsin beads [5], and gummy jelly [2,3,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] have been reported. Of these, measuring the amount of glucose extraction (AGE) from chewing gummy jelly was the most advantageous.…”

“…Assessment of MP by measuring AGE from chewing gummy jelly is performed in healthy dentate adults [6,7,12,16,21], elderly adults [13,14,17,21], removable partial denture patients [2,3,10], re-movable complete denture patients [9,15,19], implant denture patients [10,11], mandibulectomy patients [20], and other groups. In addition, it has also been reported that AGE tends to decrease due to tooth loss [8,14], and increases after treatment [2,11,15] and with growth [18].…”