Effect of continuous sweet gustatory stimulation on salivary flow rate over time.

OBJECTIVE: This study aimed to determine changes in saliva secretion and subjective taste intensity during a sustained period with continuous gustatory stimulation. DESIGN: Twenty-two healthy adults participated in this study. The selected taste solutions were aspartame, sucralose, and acesulfame potassium, which are nonnutritive sweeteners. The concentrations of sucralose1 and acesulfame potassium were set to show the same sweetness intensity as aspartame. Sucralose2 was twice the concentration of sucralose1. The solution was continuously fed into the oral cavity at a flow rate of 0.04 mL / min through a neck-worn precise infusion system. The salivary flow rate (g/min) after 10 min of intraoral water supply from the device was used as the baseline. Salivary flow rate, subjective taste intensity evaluated by the visual analog scale (VAS), and salivary flow rate relative to the baseline were recorded at 10, 30, 60, and 120 min after the start of the test. RESULTS: In the aspartame, sucralose1, and sucralose2 groups, the salivary flow rate increased significantly from 10 min to 120 min after the start of the test when compared to the rate at baseline (p < 0.05). The relative salivary flow rate increased and the VAS value decreased significantly over time and were affected by the time factor (p < 0.001, p = 0.013, respectively) but not by the sweetener-group factor and the interaction effects. CONCLUSIONS: Continuous gustatory stimulation may maintain increased salivary production for a sustained period.

Does Multifunctional Acrylate's Addition to Methacrylate Improve Its Flexural Properties and Bond Ability to CAD/CAM PMMA Block?

This study investigated the effects of a multifunctional acrylate copolymer-Trimethylolpropane Triacrylate (TMPTA) and Di-pentaerythritol Polyacrylate (A-DPH)-on the mechanical properties of chemically polymerized acrylic resin and its bond strength to a CAD/CAM polymethyl methacrylate (PMMA) disk. The methyl methacrylate (MMA) samples were doped with one of the following comonomers: TMPTA, A-DPH, or Trimethylolpropane Trimethacrylate (TMPTMA). The doping ratio ranged from 10 wt% to 50 wt% in 10 wt% increments. The flexural strength (FS) and modulus (FM) of PMMA with and without comonomer doping, as well as the shear bond strength (SBS) between the comonomer-doped PMMA and CAD/CAM PMMA disk, were evaluated. The highest FS (93.2 ± 4.2 MPa) was obtained when doped with 20 wt% of TMPTA. For TMPTMA, the FS decreased with the increase in the doping ratio. For SBS, TMPTA showed almost constant values (ranging from 7.0 to 8.2 MPa) regardless of the doping amount, and A-DPH peaked at 10 wt% doping (8.7 ± 2.2 MPa). TMPTMA showed two peaks at 10 wt% (7.2 ± 2.6 MPa) and 40 wt% (6.5 ± 2.3 MPa). Regarding the failure mode, TMPTMA showed mostly adhesive failure between the CAD/CAM PMMA disk and acrylic resin while TMPTA and A-DPH showed an increased rate of cohesive or mixed failures. Acrylate's addition as a comonomer to PMMA provided improved mechanical properties and bond strength to the CAD/CAM PMMA disk.

Craniomaxillofacial Fibrous Dysplasia Improved Cosmetic and Occlusal Problem by Comprehensive Treatment: A Case Report and Review of Current Treatments.

Fibrous dysplasia (FD) is a fibrous lesion of immature bone, with an incidence of 10-20% in the head and neck region. Most cases are monostotic, but when a lesion occurs on the maxillofacial region and spreads to the surrounding bone, it is classified as polyostotic, despite its localized occurrence. In some cases, surgical intervention is required to improve the cosmetic or functional disturbance of a FD in the maxillofacial region, but it is necessary to confirm symmetry of the maxillofacial region in real time, and a surgical support system is required to compensate. Furthermore, prosthetic intervention is considered when postoperative acquired defects occur or further cosmetic or occlusal function improvement is needed. A comprehensive approach by an oral surgeon and a maxillofacial prosthodontist is necessary for the successful treatment and rehabilitation of such patients. In this article, we describe the case of a craniomaxillofacial FD patient with facial asymmetry and denture incompatibility with improved quality of life measures by integrating surgical treatment using a navigation system and postoperative prosthetic rehabilitation. We also discuss recent diagnostic methods and treatment strategies for craniomaxillofacial FD in the literature.

Efficacy of soft palatal augmentation prosthesis for oral functional rehabilitation in patients with dysarthria and dysphagia: a protocol for a randomised controlled trial.

INTRODUCTION: Palatal augmentation prosthesis (PAP) is used in patients with articulation and swallowing disorders caused by postoperative loss of tongue tissue due to tongue cancer, cerebrovascular disease sequelae and age-related hypofunction. We have previously reported a newly designed soft PAP fabricated using an thermoplastic material that is particularly appropriate for early intervention. However, the effect of soft PAP on oral function improvement remains to be elucidated. The aim of this study is to investigate whether soft PAP can improve dysarthria and dysphagia occurring as cerebrovascular disease sequelae. METHODS AND ANALYSIS: This prospective, randomised, controlled trial will compare the immediate and training effects of rehabilitation using soft PAP with those of rehabilitation without using it. Primary outcomes are the single-word intelligibility test score and pharyngeal transit time (PTT). Secondary outcomes are tongue function (evaluated based on maximum tongue pressure, repetitions of tongue pressure and endurance of tongue pressure), articulation function (evaluated based on speech intelligibility, oral diadochokinesis, Voice-Related Quality of Life (V-RQOL)) and swallowing function (evaluated using Eating Assessment Tool-10). The study results will help determine the efficacy of Soft PAP in improving functional outcomes of word intelligibility and PTT. We hypothesised that early rehabilitation using Soft PAP would more effectively improve articulation and swallowing function compared with conventional rehabilitation without using soft PAP. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Okayama University Certified Review Board. The study findings will be published in an open access, peer-reviewed journal and presented at relevant conferences and research meetings. TRIAL REGISTRATION NUMBER: jRCTs062200054.

Lack of occlusal support did not impact amyloid ß deposition in APP knock-in mice.

PURPOSE: The lack of occlusal support is an epidemiological risk factor linked to Alzheimer's disease. This study sought to assess the relationship between amyloid ß (Aß) deposition and the lack of occlusal support in amyloid precursor protein (APP) knock-in mice. METHODS: Sixteen experimental animals were divided into two groups. The upper molars were extracted in the extraction group (group E), and a sham operation was performed in the control group (group C). The Morris water maze test was performed 4 months after the tooth extraction. Aß immunohistochemical staining and Nissl staining of the hippocampus were performed. Hippocampal plasma corticosterone and Aß protein levels were measured. RESULTS: In the maze task, the escape latency was significantly longer in group E than in group C. In the probe trials, the time elapsed in the target quadrant was significantly shorter in group E than in group C. The number of hippocampal neurons decreased in group E. There was no significant difference in the plasma corticosterone levels between the two groups, indicating that there was no effect of chronic stress on the behavioral results. Hippocampal Aß40 and Aß42 protein levels and Aß deposition areas by immunohistochemical staining were not significantly different between the two groups. CONCLUSION: Aß deposition was not increased in the hippocampus of molarless APP knock-in mice. As such, it appears that cognitive impairment due to a lack of occlusal support was not related to Aß deposition.

Newly designed flat surface artificial tongue system for speech improvement in glossectomy patients: A preliminary study.

PURPOSE: To design an efficient tongue prosthesis with reproducibility and to objectively evaluate improvement in speech function. METHODS: A silicon anatomical artificial tongue (AT) and a flat surface artificial tongue system (FTS) were used in our study. Twenty healthy participants (10 males and 10 females, 26.3 ± 1.8 years) were fitted with a tongue movement suppression appliance (TSA) that fit the dental arch to simulate the glossectomy condition. TSA, TSA + FTS, and TSA + AT simulated the state of glossectomy patients without artificial tongue, with normal artificial tongue, and newly designed artificial tongue, respectively. Three speech intelligibility tests were performed for each of the following conditions: pronouncing 100 Japanese monosyllables, 40 Japanese words, and reading a short story. One-way ANOVA, Wilcoxon signed-rank test, and Tukey-Kramer post-hoc test were used for statistical analyses. RESULTS: Significant differences were observed for 100 Japanese monosyllables and 40 Japanese words between the TSA + FTS, TSA, and TSA + AT conditions (p < 0.05). Regarding the speech intelligibility test for reading a short story, the TSA + FTS condition resulted in a significantly higher speech intelligibility than the TSA and TSA + AT conditions (p < 0.05). CONCLUSION: A flat surface artificial tongue system contributed to the improvement in speech function. This structure can be easily used in cases where conventional artificial tongue are applicable, regardless of variation in the oral condition; thus, making it a widely applicable treatment option for glossectomy patients.

Effect of masseter muscle activity during wakefulness and sleep on tooth wear.

PURPOSE: To investigate the effect of masseter muscle activity during wakefulness and sleep on tooth wear. METHODS: Sixteen participants with no or mild tooth wear (NMTW group) and sixteen participants with moderate-to-severe tooth wear (MSTW group) were enrolled. The severity of tooth wear was evaluated using the occlusal and incisal indices of the tooth wear index. Surface electromyography was performed to record the electrical activity of the left masseter muscle during wakefulness and sleep. Electromyographic activity was detected using an electromyographic threshold of 5% and 20% of maximal voluntary clenching (MVC). The total duration of electromyographic activity and bruxism episodes were calculated. RESULTS: The mean ages of the NMTW and MSTW groups were 71.75 ± 7.61 years and 71.69 ± 7.49 years, respectively. The mean cumulative duration of electromyographic activity during wakefulness using a threshold of >5% MVC was 6.44 ± 4.52 min/h and 13.62 ± 10.08 min/h for the NMTW and MSTW groups, respectively (p=0.048). The mean total durations of electromyographic activity during wakefulness and sleep using a threshold of >20% MVC were 1.08 ± 1.70 min/h and 1.05 ± 3.02 min/h, respectively, in the NMTW group and 4.78 ± 6.37 min/h and 1.61 ± 1.79 min/h, respectively, in the MSTW group (p=0.048 and p=0.003, respectively). CONCLUSION: These results suggest that masseter electromyographic activity during wakefulness and sleep may be related to the severity of tooth wear.

Effects of food particle loss on the evaluation of masticatory ability using image analysis.

PURPOSE: To examine how particle loss affects the evaluation of masticatory ability using the image analysis method. METHODS: The subjects were divided into two groups:Y-group (healthy young adults: 10 male, 10 female; mean age 27.6 ± 1.9 years), and D-group (denture wearing older adults: 13 male, 9 female; mean age, 75.1 ± 5.3 years). Raw carrots, peanuts, and a combined test food from 5 daily food materials (mixed foods) were selected as test foods. Images of the boluses were captured and processed after the subjects freely masticated the test foods until the point of swallowing or completed half strokes of total chewing cycles. The median particle size (X50) was calculated from the data for each particle. We compared X50 calculated from all particles obtained from the masticatory bolus (as X50N) with the X50 of only selectively larger particles (as X50R). RESULTS: Significant correlations were observed between X50N and X50R (p < 0.01) determined in almost all masticatory conditions. In particular, for particle sizes of 2 mm or more, the correlation coefficient between X50N and X50R was notably strong (r > 0.75). CONCLUSION: The method of analyzing only larger particles makes it possible to evaluate masticatory ability without losing the characteristics of the original particle size distribution of the entire bolus. This finding can be applied for the evaluation of masticatory ability, especially among older adults who have difficulty retrieving the total amount of test food due to decreased activities of daily living.

Detection of muscle fatigue caused by repeated posterior tongue lift movement from neck surface EMG: a pilot study.

BACKGROUND: Fatigue is an important factor for muscle strengthening in rehabilitation medicine. Frequency analysis has been regarded as the gold standard for muscle fatigue assessment in surface electromyography (EMG). However, there are no experiments quantifying fatigue with grouped discharge (GD), which is one of the historical phenomena observed in patients having fatigue, by using high sampling rate recording of EMG. OBJECTIVE: To investigate the effect of fatigue, which is induced by repeated posterior tongue lift movement (TLM), on the occurrence of GD peaks, thus, to provide possible basis as a parameter for future fatigue evaluation. METHODS: Nineteen healthy adults (9 men and 10 women) participated in this study. The muscle fatigue protocol consisted of repetitive posterior TLM and maximum voluntary contractions (MVC). Bilateral N-EMG (Neck surface EMG for measuring the muscle activity of the posterior tongue) was recorded. RESULTS: Subjective tongue fatigue at the end of the protocol was significantly higher than at beginning throughout the muscle fatigue protocol (p < .01). The frequency of occurrence of GD peaks was 0.9 ± 1.2 (per second) at the baseline in 33 of 38 subject sides, and significantly increased depending on fatigue progression (p < .01). CONCLUSION: It was shown that fatigue due to repetitive posterior tongue lifting resulted in significant increase in the frequency of occurrence of GD peaks. Especially, the nature of GD, showing very few occurrences at non-fatigue condition, might work as an advantageous property for its use in future absolute evaluation of fatigue phenomena.

Coordination of surface electromyography activity in the posterior tongue region during mastication of differently textured foods.

BACKGROUND: Masticatory movement occurs complicatedly and bilaterally. Although the tongue plays an important role in mastication, bilateral tongue function during mastication has not been clarified yet. OBJECTIVE: To investigate the effect of food properties on posterior tongue activity and coordination of muscles bilaterally by electromyography (EMG). METHODS: Twenty healthy adults (10 males and 10 females; mean age 28 years; range: 22-33 years) participated in this study. Three test foods, gummy jelly (hard food), sponge cake (soft food requiring crushing), and mashed potatoes (soft food not requiring crushing), were used. Bilateral masseter N-EMG (surface electromyography for measuring the muscle activity of posterior tongue) and submental EMG were carried out while the participants chewed three test foods. The participants were instructed to masticate three test foods only on the right side and only on the left side unilaterally. RESULTS: In the case of gummy jelly, N-EMG activity on the mastication side was significantly larger than that on the non-mastication side (P < .01). Regarding temporal relationship between the masseter and N-EMG activity, in the case of gummy jelly, the percentage of cases where the N-EMG peak was observed during masseter muscle EMG bursts was significantly higher than those for sponge cake and mashed potatoes (P < .01). CONCLUSION: N-EMG activity on the mastication side was significantly larger than that on the non-mastication side in the mastication of hard foods. Tongue showed activity pattern changes and coordinated with the masseter muscle depending on food texture.

Phosphate group adsorption capacity of inorganic elements affects bond strength between CAD/CAM composite block and luting agent.

This study aimed to investigate whether inorganic elements of polymer-infiltrated ceramic (PIC) and microfilled resin (MFR) for CAD/CAM would affect initial bond strength to luting agent. Inorganic elements of PIC and MFR were different with shape and ingredient observed by SEM, STEM and EDS. Microtensile bond strengths (µTBS) value of PIC was increased by 10-methacryloyloxydecyl dihydrogen phosphate (MDP) and acetic acid (AA)- or MDP-activated silane treatment, and further increased by succeeding heat treatment (HT). The µTBS of MFR was increased by MDP and MDP-activated silane, but decreased by AA-activated silane without HT. The HT improved the µTBS of MFR with AA-activated silane, but conversely for MDP-activated silane. Only in MFR, phosphoric acid (PA) application before each surface treatment dramatically decreased the µTBS of AA-activated silane. FTIR peaks in MFR shifted according to phosphate group's peak. MFR would possess high phosphate group adsorption capacity, with MDP effectively improving its bonding capability.

Flexural properties, bond ability, and crystallographic phase of highly translucent multi-layered zirconia.

This study investigated the mechanical properties, bond ability, and crystallographic forms of different sites in a highly translucent, multi-layered zirconia disk. Flexural properties, bond ability to resin cement, and phase composition were investigated at three sites of a highly translucent, multi-layered zirconia disk: incisal, middle, and cervical. Flexural strength (FS) and flexural modulus (FM) were measured with static three-point flexural test. Shear bond strength (SB) to resin cement was measured after 24 h storage (37°C). Phase composition under mechanical stress was analyzed using X-ray diffraction. Without air abrasion, FS at the incisal site yielded the lowest value and was significantly lower than the middle and cervical sites. Air abrasion lowered the FS of each site. FM at the incisal site without air abrasion showed the significantly lowest value, and air abrasion increased its FM value. At the middle and cervical sites, their FM values were higher than the incisal site but were not significantly affected by air abrasion. SB value did not show significant differences among the sites. After sintering, cubic zirconia was detected at each site. Rhombohedral phase transformation occurred after mirror polishing. In highly translucent, multi-layered zirconia which was mainly composed of cubic zirconia, rhombohedral phase transformation occurred under mechanical stress and resulted in weakened mechanical properties.

CCN3 (NOV) Drives Degradative Changes in Aging Articular Cartilage.

Aging is a major risk factor of osteoarthritis, which is characterized by the degeneration of articular cartilage. CCN3, a member of the CCN family, is expressed in cartilage and has various physiological functions during chondrocyte development, differentiation, and regeneration. Here, we examine the role of CCN3 in cartilage maintenance. During aging, the expression of Ccn3 mRNA in mouse primary chondrocytes from knee cartilage increased and showed a positive correlation with p21 and p53 mRNA. Increased accumulation of CCN3 protein was confirmed. To analyze the effects of CCN3 in vitro, either primary cultured human articular chondrocytes or rat chondrosarcoma cell line (RCS) were used. Artificial senescence induced by H2O2 caused a dose-dependent increase in Ccn3 gene and CCN3 protein expression, along with enhanced expression of p21 and p53 mRNA and proteins, as well as SA-ß gal activity. Overexpression of CCN3 also enhanced p21 promoter activity via p53. Accordingly, the addition of recombinant CCN3 protein to the culture increased the expression of p21 and p53 mRNAs. We have produced cartilage-specific CCN3-overexpressing transgenic mice, and found degradative changes in knee joints within two months. Inflammatory gene expression was found even in the rib chondrocytes of three-month-old transgenic mice. Similar results were observed in human knee articular chondrocytes from patients at both mRNA and protein levels. These results indicate that CCN3 is a new senescence marker of chondrocytes, and the overexpression of CCN3 in cartilage may in part promote chondrocyte senescence, leading to the degeneration of articular cartilage through the induction of p53 and p21.

Effects of stage II transport and food bolus sampling methods on the properties of food particles.

During mastication, some portion of the food bolus is gradually transported to the oropharynx before deglutition, which is known as stage II transport (STII). Although the importance of STII in mastication and deglutition has been widely acknowledged, food particle properties that are transported into the oropharynx by STII have not yet been fully specified. To reveal the food particle properties that are transported into the oropharynx by STII and to assess the usefulness of new food bolus sampling methods for the evaluation of masticatory efficiency. Twenty-two healthy volunteers participated in this study. Four different bolus sampling conditions were adopted: (a) the whole food particles were expectorated when the subject was aware of the first deglutition, (b) the last bolus to be swallowed at the end of unrestrained food intake was expectorated (aftermost bolus sample), (3) the whole food particles were expectorated when the subject felt ready to swallow after swallow-inhibited mastication (swallow-inhibited sample), (4) the particles were regurgitated from the oropharynx after the first STII (stage II-transported sample). Food particles were analysed using the homogeneity index and particle size index. There was no significant difference between food particles in the aftermost bolus sample and swallow-inhibited sample. The particles in the stage II-transported sample showed significantly more homogeneous and smaller sizes than other sampling conditions (P < .05). The food particles transferred to the oropharynx in the stage II-transported sample were smaller than those broken down by natural mastication.

Differences in comminution progress during mastication in healthy dentate and denture-wearing elderly people.

PURPOSE: This study aimed to investigate the effect of removable denture prostheses on the comminution progress in elderly people. METHODS: Twenty-two denture wearers of Eichner's classification B and C (75.1±5.3 years old) and 20 young fully dentate subjects (27.6±1.9 years old) participated in the masticatory examination, which used a combined test food from 5 daily food materials. Full masticatory cycles lasting until subjects needed to swallow and the half number of the cycles were adopted as masticatory conditions. Digital images of food particles under wet conditions were obtained for each bolus, and particles were analyzed by calculating the homogeneity and particle size indices. RESULTS: The characteristic properties of the food particles were observed using a homogeneity index in the elderly denture group for half masticatory strokes. Their homogeneity index was significantly higher than that of the young dentate group. By contrast, no significant difference was observed in the indices for particles immediately before swallowing between two groups. CONCLUSIONS: The comminuted particle size before swallowing in healthy denture wearers was not significantly different from that in the natural dentate group. The comminution of the first-half process in denture wearers was typical and could be one possible focus for meal property specifications in future studies.

Characteristics of Grouped Discharge Waveforms Observed in Long-term Masseter Muscle Electromyographic Recording: A Preliminary Study.

We investigated the characteristics of grouped discharge (GD) waveforms obtained from long-term masseter electromyogram (EMG) recording in 6 female temporomandibular disorder (TMD) patients with myofascial pain and 6 healthy females. The EMG measurement was performed from the morning of the experiment day until the subject woke up the next day. We observed a significantly larger number of GD waveforms in the TMD group compared to the control group (p=0.002). Our results indicate that the existence of GD waveforms in masseter EMGs might be a predictor of future TMD with myofascial pain.

Effect of food properties and chewing condition on the electromyographic activity of the posterior tongue.

BACKGROUND: Retraction of the posterior tongue facilitates bolus formation, food transfer and Stage II transport in chewing and swallowing. Surface electromyography of the neck region (N-EMG) enabled the evaluation of muscle function at the posterior tongue. Although previous studies showed that food hardness increased masticatory muscles EMG activity and volitional chewing altered swallowing, the effect of food properties and chewing condition on N-EMG activity has not yet been elucidated. OBJECTIVE: To investigate the effect of food properties and chewing conditions on N-EMG. METHODS: Twelve healthy adults (six men and six women, mean age 28.1 ± 2.7) participated in this study. Three test foods were used: a cookie (solid food), crushed cookies adjusted using agar and water (semisolid food) and crushed cookies adjusted using thickening agent and water (soft food). Masseter and submental muscle EMG and N-EMG activity were recorded while chewing the three test foods. Participants were instructed to masticate the three test foods in three chewing conditions: (a) chewing freely, (b) chewing test foods with the same number of chewing cycles as when chewing solid food and (c) chewing with a maximum effort. RESULTS: Total N-EMG activity when chewing solid food was higher than that in the other two test foods regardless of the chewing condition. In soft food and semisolid food, the total N-EMG activity was increased by increasing the number of chewing cycles. CONCLUSION: The total N-EMG activity was increased while chewing hard food, which indicates the positive effect of chewing hard food on rehabilitation at the posterior tongue.

Effects of the loss and reconstruction of molar occlusal support on memory retrieval and hippocampal neuron density in rats.

PURPOSE: Animal experiments have shown that the loss of occlusal support causes impairments in spatial cognition. Many reports have focused on the memory encoding process, and only few studies have investigated the effect on memory retrieval. This study aimed to examine the effects of both the loss and reconstruction of occlusal support on the memory retrieval process and on the number of hippocampal pyramidal cells. METHODS: The experimental animals were divided into a molarless group, in which molars were extracted, a denture-wearing molarless group with experimental dentures inserted after molar extraction, and a control group. Radial maze trials were performed for 20 consecutive days (acquisition phase). The rats were tested on long-term memory retention following the acquisition phase in eight trials every five days, and in an additional trial 20 days later (probe phase). RESULTS: The denture-wearing molarless group showed higher levels of spatial learning and memory than the molarless group. There were no significant differences in memory retrieval during the probe phase between the denture-wearing molarless and the control group. The molarless group showed significantly worse spatial learning and memory and had fewer neurons in the hippocampus than the control group. CONCLUSIONS: Our results suggest that the loss of occlusal support decreases the number of pyramidal cells in the hippocampus and impairs memory decoding and retrieval. However, this effect is suppressed by the reconstruction of occlusal support.

Short-Term Crossover Study on the Effect of Orthogonalized Deep-Grooved Posterior Artificial Teeth on the Masticatory Efficiency of Complete Denture Wearers.

BACKGROUND: Mastication has been regarded to play an important role in achieving quality daily life for the elderly. On the occlusal surface of posterior artificial teeth, parallel grooves of 1 mm depth and 1 mm width with an inter-groove distance of 2 mm have been found to significantly improve masticatory efficiency on a mechanical simulator. MATERIALS AND METHODS: In the present study, the effect of the grooved design on masticatory efficiency in edentulous subjects using a short-term crossover trial was evaluated. Six edentulous participants, 1 male and 5 females, were assigned into two groups. One received duplicated complete dentures with grooved molars first, and the other received duplicated complete dentures with conventional molars first. The design of the teeth was crossover after evaluating masticatory efficiency. Raw carrot, raw lettuce and mixed foodstuffs were used to evaluate masticatory efficiency. Subjects were instructed to masticate 20 strokes and arbitrary strokes until they felt like swallowing. RESULTS: The number of masticatory strokes taken was significantly smaller using the grooved design (p<.05). Masticatory efficiency analysis revealed that the grooved design achieved significantly higher masticatory efficiency at 20 masticatory strokes for raw carrot and mixed foodstuffs (p<.05). CONCLUSION: Results show that compared with conventional lingualized occlusion, the grooved design accomplishes higher masticatory efficiency in vivo. Considering the distinction of this design that it can be applied to any existing denture occlusion, the design might help improve the dietary life of the elderly.