Reliability of a two‐colour chewing gum test to assess masticatory performance in complete denture wearers

Abstract

The aim of this study was to test the reliability of a method to measure the masticatory performance of complete denture wearers employing a colour-mixing ability test and assessment by visual and electronic colourimetric analysis. A sample of 75 subjects was selected from patients who received new conventional complete dentures. Masticatory tests were performed using a two-colour chewing gum that was masticated for 5, 10, 20, 30 and 50 chewing cycles, performed in a random order. The mixing level of the two colours of the chewed gum was assessed visually by two independent raters based on a 5-point ordinal scale. The specimens were flattened into a 1-mm-width wafer, scanned and saved as a two-sided digital image. Each pair of images was submitted to an electronic colourimetric analysis to assess the level of colour mixture, measured by the circular variance of hue (VOH). Overall inter- and intra-rater agreements in visual analysis were 64% and 68%, respectively (almost 99% of scores ranged within ±1 point), whilst overall weighted kappa was >0.80. A proportional increase in the level of mixture occurred with increased number of chewing cycles (P < .001). Similarly, VOH and the visual analysis were highly correlated (r = -.89; P < .001). Bland-Altman plots revealed excellent agreement and extremely low systematic error between duplicated VOH measures. It was concluded that the two-colour chewing gum test is a reliable method to assess the masticatory performance in complete denture wearers using both visual and electronic colourimetric analyses.

The effects of prosthetic status and dementia on the chewing efficiency of seniors in nursing homes

“…18,33,34 In this recent study, mean chewing efficiency determined by the variance of hue was .451 (.251) for participants with natural teeth or fixed dental prosthesis. 18,33,34 In this recent study, mean chewing efficiency determined by the variance of hue was .451 (.251) for participants with natural teeth or fixed dental prosthesis.…”

Systematic review of measurement properties of methods for objectively assessing masticatory performance

“…Construct validity or hypotheses testing was frequently described ( n = 30 studies; Abe et al, ; Felicio et al, ; Goto et al, ; Gunne, ; Halazonetis et al, ; Hama et al, ; Hayakawa et al, ; Huggare, ; Ikebe et al, ; Ikebe et al, ; Khoury‐Ribas et al, ; Mahmood et al, ; Matsui et al, ; Mowlana et al, ; Nokubi et al, ; Ohara et al, ; Prinz, ; Sato et al, ; Schimmel et al, ; Schimmel et al, ; Shiga et al, ; Slagter et al, ; Speksnijder et al, ; Sugiura et al, ; Vaccaro et al, ; van der Bilt et al, ; van der Bilt et al, ; Wada et al, ; Weijenberg et al, ; Woda et al, ), as was the reliability of the method for assessing masticatory performance ( n = 22; Felicio et al, ; Endo et al, ; Escudeiro Santos et al, ; Hama et al, ; Hama et al, ; Huggare, ; Kamiyama et al, ; Kapur, Yurkstas, & Soman, ; Khoury‐Ribas et al, ; Liedberg & Owall, ; Lujan‐Climent et al, ; Mahmood et al, ; Nokubi et al, ; Ohara et al, ; Sanchez‐Ayala et al, ; Sanchez‐Ayala et al, ; Sato et al, ; Schimmel et al, ; Schimmel et al, ; Silva, Nogueira, Rios, Schimmel, & Leles, ; van der Bilt et al, ; Weijenberg et al, ). Less frequently reported was measurement error ( n = 9; Goto et al, ; Halazonetis et al, ; Lujan‐Climent et al, ; Matsui et al, ; Prinz, ; Sanchez‐Ayala et al, ; Schimmel et al, ; Silva et al, ; Sugiura et al, ) and responsiveness ( n ...…”

“…Methods for assessing masticatory performance may be categorized into three main categories; that is, comminution methods ( n = 21; Felicio et al, ; Eberhard et al, ; Eberhard et al, ; Escudeiro Santos et al, ; Fauzza & Lyons, ; Gunne, ; Huggare, ; Ikebe et al, ; Kapur et al, ; Khoury‐Ribas et al, ; Kobayashi et al, ; Lujan‐Climent et al, ; Mahmood et al, ; Mowlana et al, ; Nokubi et al, ; Ohara et al, ; Sanchez‐Ayala et al, ; Sanchez‐Ayala et al, ; Shiga et al, ; Slagter et al, ; Woda et al, ), mixing ability methods ( n = 23; Abe et al, ; Asakawa et al, ; Endo et al, ; Halazonetis et al, ; Hama et al, ; Hama et al, ; Hayakawa et al, ; Ishikawa et al, ; Kamiyama et al, ; Liedberg & Owall, ; Matsui et al, ; Prinz, ; Sato et al, ; Schimmel et al, ; Schimmel et al, ; Silva et al, ; Speksnijder et al, ; Sugiura et al, ; Vaccaro et al, ; van der Bilt et al, ; van der Bilt et al, ; Wada et al, ; Weijenberg et al, ), or other methods ( n = 2; Goto et al, ; Ikebe et al, ).…”

“…Several studies have attempted to establish the reliability of visual color or bolus scales that are used to assess masticatory performance with two‐color gums. One good‐quality study (Silva et al, ) reported that a two‐color gum visual scale enables reliable masticatory performance assessment as per visual and electronic colorimetric analyses [positive rating]. One fair‐quality study (Schimmel et al, ) assessed the same visual scale [positive rating].…”

Changes in masticatory performance of edentulous patients treated with single‐implant mandibular overdentures and conventional complete dentures

“…On the other hand, studies employing mixing ability tests show a different picture. These tests rely less on the crushing and comminution of the test food, but more on the bolus forming and kneading . Therefore, these tests are not highly dependent on the maximum bite force, as the specimens are more deformable and often soft, but rather on the force, coordination and sensitivity of the soft tissues (eg, the tongue, palate and cheeks) that are affected by ageing itself, diminished capability of adaptation to the dentures and poor mandibular denture retention .…”