ABSTRACT
Introducción: el reemplazo de dientes perdidos aspira a mejorar la función masticatoria. Aunque hay diferentes opciones para ello, la conveniencia de la prótesis parcial removible (PPR) es su bajo costo. Objetivo: comparar el desempeño masticatorio (DM) después de 20 ciclos masticatorios y al umbral de la deglución (UD) en adultos de 50 a 70 años con dientes posteriores perdidos (DPP), con/sin PPR; y los ciclos hasta la deglución. Material y métodos: estudio transversal en 35 adultos con dientes anteriores y PPR bien ajustadas y utilizadas para comer. El lado de prueba fue el lado con más DPP. El DM se evaluó después de 20 ciclos y al UD utilizando un alimento prueba artificial (Optosil Comfort®) con/sin la PPR en orden aleatorizado. Las partículas se tamizaron para determinar el tamaño medio de partícula (TMP) como medida del DM. Los ciclos se contaron visualmente. Estadística descriptiva y comparaciones con SPSS-v23. Resultados: hubo diferencias significativas (p ≤ 0.05) al masticar con/sin PPR. El TMP fue más pequeño (mejor DM) con la PPR después de 20 ciclos y al UD (3.9 vs 4.4 mm y 3.2 vs 4.2 mm). Los ciclos para llegar al UD disminuyeron con la PPR (40 vs 47). Conclusión: a pesar de una mejora limitada de la función masticatoria, las PPR ayudan a preparar los alimentos en partículas más pequeñas antes de deglutirlas. La mejoría en DM con PPR es de 24% al UD, realizando menos ciclos antes de deglutir sus alimentos (AU)
Introduction: replacement of missing teeth should improve masticatory function. Although there are different options removable partial dentures (RPD) are used due to their lower cost. Objective: to compare masticatory performance (MP) after 20 chewing-cycles and swallowing-threshold (ST) in 50-70 year-old adults with missing posterior teeth (MPT) with and without their cast-metal RPD; chewing cycles until swallowing were also compared. Material and methods: 35 adults participated in this cross-sectional study. Subjects with anterior teeth and welladjusted RPDs, used for eating were included. The side with more MPT was selected as the test side. MP was evaluated after 20 cycles and ST using an artificial test-food (Optosil Comfort®) with/without the RPD (subject-own-control) (randomized order). Chewed particles were sieved to determine medium-particle-size (MPS) as a measure of MP. Chewing cycles were visually counted. Descriptive statistics and comparisons were run with SPSS v23. Results: there were significant differences (p ≤ 0.05) for all parameters when chewing with/without the RPD. MPS was smaller (better MP) with the RPD (3.9 vs 4.4 mm and 3.2 vs 4.2 mm) after 20 cycles and ST respectively. Cycles required to reach ST were less when chewing with the denture (40 vs 47). Conclusion: despite a limited improvement of masticatory function RPDs help patients prepare their food into smaller particles before swallowing. Improvement in MP with RPDs for patients with MPT is 24% at ST and they perform fewer chewing cycles before swallowing food (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Data Interpretation, Statistical , Tooth Loss/rehabilitation , Mastication/physiologyABSTRACT
Objetivo: desarrollar y aplicar un manual para evaluar los procesos de deglución y rendimiento masticatorio, dirigido a estudiantes y profesionales de odontología. Método: se realizó un estudio con enfoque cuali-cuantitativo, a partir de dos técnicas de recolección de información: documental para reunir información de los procedimientos y observacional para la aplicación del manual. Los métodos seleccionados fueron el rendimiento masticatorio (Albert T) y de deglución (Técnica Payne); el diseño se esbozó según la metodología para mejorar la calidad de los procesos y una guía técnica de elaboración de manuales de procedimientos en salud. Así, el manual cuenta con introducción, antecedentes históricos, alcance y objetivo, flujograma, descripción de procedimientos de evaluación de la deglución, del rendimiento masticatorio y bibliografía. Este fue aplicado en 27 pacientes de la clínica de ortodoncia, a quienes se les diagnosticó deglución atípica, y se midió el rendimiento masticatorio para conocer la mediana de tamaño de partícula (MTP) de cada individuo. Resultados: el manual se realizó basándose en dos procedimientos, uno con el diagnóstico de deglución y otro con rendimiento masticatorio. Este último fue aplicado por dos estudiantes investigadores a una muestra de 27 pacientes, cuyo resultado fue una mediana de tamaño total de partícula de MTP = 5.35 mm2. Hubo una diferencia estadísticamente significativa entre sexos (MTP en hombres: 6,0 mm2 y mujeres 5.1 mm2) siendo las mujeres quienes presentaron mejor desempeño masticatorio. Conclusión: al aplicar el manual, los estudiantes evaluaron el rendimiento masticatorio y la deglución, con lo cual lograron resultados medibles, aplicables y reproducibles.
Objective: To apply a manual to evaluate swallowing and chewing performance aimed at dental students and professionals. Method: A study was carried out with a qualitative-quantitative approach developing two information gathering techniques: documentary to gather information on procedures and observational in the application of the manual. The methods of chewing performance (Albert T) and swallowing (Payne Technique) were selected; the design was outlined according to the methodology to improve the quality of the processes and a technical guide for the elaboration of manuals of health procedures; in the development phase, the thematic units were created and the manual was prepared with: cover, back cover, authors, introduction, historical background, scope and objective, flow chart, description of swallowing evaluation procedures, chewing performance and bibliography; this was applied to 27 patients from the orthodontic clinic, who were diagnosed with atypical swallowing, and the masticatory performance was measured to determine the median particle size (MTP) of each individual evaluated. Results: The manual was made based on two procedures, one with swallowing diagnosis and the other with masticatory performance, which was applied by two student researchers to a sample of 27 patients, yielding a median total particle size of MTP = 5.35 mm2. There was a statistically significant difference between the sexes (MTP in men: 6.0 mm2 and women 5.1 mm2), with women presenting the best masticatory performance Conclusion: when applying the manual, the students evaluated the chewing performance and swallowing, achieving measurable, applicable and reproducible.
Subject(s)
Humans , Deglutition/physiology , Mastication/physiology , Reference Standards , Students, Dental , Methodology as a Subject , Malocclusion , MasticationABSTRACT
Abstract: This cross-sectional observational study with 24 patients evaluated differences in bite force (BF) and masticatory performance (MP) between conventional complete denture (CCD) and implant mandibular overdenture (IMO) users and the correlation between these variables. The BF test was performed bilaterally with an occlusal force device. During the MP test, patients were asked to chew Optocal particles for 40 cycles. The Shapiro Wilk test was employed to verify the normality of the data, the student t test to identify differences between groups, and Pearson's correlation to investigate interrelationships between variables. A multiple linear regression was subsequently performed via the stepwise method. P values ≤0.05 were considered statistically significant. Unlike IMO users, CCD users presented a significant difference (25.6%) in BF between the dominant and non-dominant chewing side (p=0.04). IMO users presented significantly higher BF (p=0.01) without presenting a dominant side (p=0.38), and also performed significantly better for the following MP parameters: MPX50 values decreased by 27.25% in IMO users (p=0.01), MPB decreased by 48.38% (p=0.01), and ME 5.6 decreased by 53.25% (p=0.02), while ME2.8 increased by 151.57% (p=0.01). The BF and MPX50 in the IMO wearers group were negatively correlated (-0.57; p=0.05); this correlation coefficient was the only parameter included in the multivariate regression model. IMO users have higher BF and better masticatory performance than CCD users, especially in terms of chewed particles size reduction. MP is correlated with a higher BF in IMO users through better particle trituration.
Resumo Este estudo observacional transversal com 24 participantes teve como objetivo avaliar as diferenças na força de mordida (FM) e na PM (performance mastigatória) entre usuários de prótese total convencional (PTC) e de overdenture mandibular (OM) e a correlação entre essas variáveis. O teste de FM foi realizado bilateralmente com um dispositivo de força oclusal. Durante o teste de PM, os pacientes foram solicitados a mastigar uma porção padronizada de Optocal por 40 ciclos mastigatórios. O teste de Shapiro Wilk foi empregado para verificar a normalidade dos dados, o teste T de Student para identificar diferenças entre os grupos e os coeficientes de correlação de Pearson para investigar inter-relações entre variáveis. Uma regressão linear múltipla foi realizada pelo método stepwise. Valores de p≤0,05 foram considerados estatisticamente significantes. Diferentemente dos usuários de OM, os usuários de PTC apresentaram uma diferença significativa (34%) na FM entre o lado dominante e o não dominante (p=0,04). Os usuários de OM apresentaram FM significativamente maior (p=0,01) sem apresentar um lado dominante (p=0,38) e obtiveram PM significativamente melhor nos seguintes parâmetros: os valores de PMX50 diminuíram 27,25% (p=0,01), PMB diminuiu em 48,38% (p=0,01), e EM 5.6 diminuiu 53,25% (p=0,02), enquanto EM2.8 aumentou 151,57% (p=0,01). A FM e PMX50 no grupo de usuários da IMO foram negativamente correlacionados (-0,57;p=0,05); esse coeficiente de correlação foi o único parâmetro incluído no modelo de regressão multivariada. Os usuários da OM possuem maior FM e melhor performance mastigatória do que os usuários de PTC, observados principalmente na redução do tamanho das partículas mastigadas. A PM está correlacionada com um maior FM nos usuários da OM através de uma melhor trituração de partículas.
Subject(s)
Humans , Bite Force , Denture, Overlay , Cross-Sectional Studies , Denture, Complete , MandibleABSTRACT
To obtain denture retention, support, and stability in Class III edentulous cases with flat alveolar ridges and extensive flabby tissue is very difficult. The patient was a 72-year-old male who wore ill-fitting 20 year old dentures made by non-medical institutions. There was flabby tissue on the maxillary anterior ridge. The patient showed Angle Class III skeletal relationship with severe protruded mandible. First, temporary dentures were fabricated to restore the masticatory function, and final dentures were made through non- pressure impression technique and careful the arrangement of the posterior resin teeth. Improvement of the retention and stability of the denture during the occlusal force application is reported.
Subject(s)
Aged , Humans , Male , Bite Force , Denture Retention , Denture, Complete , Dentures , Malocclusion , Malocclusion, Angle Class III , Mandible , ToothABSTRACT
ABSTRACT Objective: To investigate the masticatory and swallowing performances in patients with malocclusions before and after orthodontic treatment, comparing them to an age- and gender-matched control group with normal occlusion. Methods: Twenty-three patients with malocclusions requiring orthodontic treatment were included in this prospective study. One month after appliance removal, seventeen patients completed a follow-up examination and the data were compared with those of a control group with thirty subjects with normal occlusion. Masticatory performance was determined by the median particle size for the Optocal Plus® test food after 15 chewing strokes, and three variables related to swallowing were assessed: a) time and b) number of strokes needed to prepare the test-food for swallowing, and c) median particle size of the crushed particles at the moment of swallowing. Results: At the baseline examination, the malocclusion group had a significantly lower masticatory performance and did not reach the particle size reduction at the moment of swallowing, when compared with the control group. After treatment, the masticatory performance significantly improved in the malocclusion group and the particle size reduction at swallowing reached the same level as in the control group. Conclusions: The present results showed that the correction of malocclusions with fixed appliances can objectively provide positive effects in both mastication and deglutition processes, reinforcing that besides aesthetic reasons, there are also functional indications for orthodontic treatment.
RESUMO Objetivo: investigar as performances mastigatória e de deglutição em pacientes com má oclusão, antes e após o tratamento ortodôntico, comparando-os com um grupo controle com oclusão normal, equiparado por idade e sexo. Métodos: vinte e três pacientes com má oclusão requerendo tratamento ortodôntico foram incluídos neste estudo prospectivo. Um mês após a remoção dos aparelhos, dezessete pacientes completaram os exames de acompanhamento, e seus dados foram comparados com aqueles de um grupo controle com trinta indivíduos com oclusão normal. A performance mastigatória foi determinada pelo tamanho mediano das partículas do alimento teste Optocal Plus® após 15 ciclos mastigatórios, e três variáveis relacionadas à deglutição foram avaliadas: a) tempo e b) número de ciclos necessários para preparar o alimento teste para deglutição, e c) tamanho mediano das partículas trituradas no momento da deglutição. Resultados: no exame inicial, o grupo com má oclusão apresentou uma menor performance mastigatória e não atingiu a redução do tamanho das partículas no momento da deglutição, quando comparado com o grupo controle. Após o tratamento, a performance mastigatória aumentou significativamente no grupo com má oclusão, e a redução do tamanho das partículas no momento da deglutição atingiu o mesmo nível do grupo controle. Conclusões: os resultados demonstraram que a correção das más oclusões com aparelhos fixos pode, objetivamente, proporcionar efeitos positivos nos processos de mastigação e deglutição, reforçando que, além de razões estéticas, existem também indicações funcionais para o tratamento ortodôntico.
Subject(s)
Humans , Male , Female , Young Adult , Orthodontics, Corrective , Deglutition/physiology , Malocclusion/therapy , Mastication/physiology , Prospective Studies , Longitudinal Studies , Treatment OutcomeABSTRACT
Se realizó un estudio para medir y comparar el rendimiento masticatorio empleando el Test de Manly en 2 grupos de 18 individuos cada uno. El primer grupo estaba conformado por pacientes desdentados totales tratados en la Universidad Mayor en el año 2012 con prótesis totales removibles, y el segundo grupo, por pacientes con dentadura natural completa. Además, al grupo de pacientes rehabilitados con prótesis totales se le aplicó la encuesta GOHAI para conocer el nivel de satisfacción con el uso de sus prótesis. Los resultados muestran que el rendimiento masticatorio es muy superior en los individuos dentados naturales con respecto a los portadores de prótesis totales, y esta diferencia es estadísticamente significativa. Los pacientes portadores de prótesis totales señalan un bajo nivel de satisfacción con el uso de sus dentaduras completas, en especial durante la función masticatoria.
This study was conducted in order to measure and compare the masticatory performance using the Manly Test in 2 groups of 18 people. The first group was formed by edentulous patients treated in the Universidad Mayor of Santiago, Chile, in 2012 with removable dentures, and the second group consisted of patients with complete natural dentition. In addition, the GOHAI questionnaire was also applied to determinate the level of satisfaction of the group of patients rehabilitated with complete dentures. The results showed that masticatory performance is much higher in individuals with complete natural dentition than in patients rehabilitated with complete dentures, with the difference being statistically significant. Patients with dentures indicated a low level of satisfaction with the use of their complete dentures, especially during masticatory function.
Subject(s)
Humans , Male , Adult , Jaw, Edentulous , Jaw, Edentulous/therapy , Mastication/physiology , Surveys and Questionnaires , Patient SatisfactionABSTRACT
PURPOSE: To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers. MATERIALS AND METHODS: Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner's Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%. RESULTS: Profile, behavior of drinking and time taken to drink were significantly improved (P<.001) in subjects after wearing obturator. Masticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (P<.001) high inter group difference in maximum occlusal force existed. Correlation between masticatory performance and maximum occlusal force was not significant (P=.124). CONCLUSION: Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition.
Subject(s)
Bite Force , Deglutition , Dental Restoration Wear , Dentition , Dentures , Drinking , Mastication , Prostheses and Implants , Social SciencesABSTRACT
Aim: The purpose of the present study was to evaluate the possible association between the oral stereognostic ability and masticatory efficiency at the time of denture insertion and after 6 months in complete denture wearers. Methods: Sixty edentulous patients were selected. The study was conducted in two parts. First, on the day of denture fit-in oral stereognostic ability test was conducted,followed by masticatory efficiency was carried out. The patients were recalled for check up after 6months and the same test was performed again. Data were tabulated and analyzed statistically by paired t-test and Pearsons correlation coefficient. Results: There was weak correlation between oral stereognosis and masticatory efficiency. Many opinions have been presented in the literature in the past regarding oral stereognosis. The issue whether oral stereognosis also helps inpatients adaptation towards complete denture prosthesis is still ambiguous. No consensus has been reached. This study is further an attempt to understand the basic physiology of oral stereognosis and whether there is any possible relation between oral stereognosis and masticatory efficiency.Conclusions: Within the limitation of this study, it can be concluded that oral stereognostic ability improves with time, which might be due to adaptation to the denture. As adaptation towardsdenture improves masticatory efficiency improves as well. This study showed that there might bea weak association between oral stereognosis and masticatory efficiency.
Subject(s)
Humans , Middle Aged , Denture, Complete , Mastication/physiology , Mouth/physiology , Stereognosis/physiology , Mouth Rehabilitation , Mouth, Edentulous/rehabilitation , Time FactorsABSTRACT
Desde comienzos del siglo pasado han sido utilizados una amplia variedad de métodos para evaluar el rendimiento masticatorio. Existen tests que usan alimentos naturales como material de prueba, otros utilizan alimentos artificiales; además se han propuesto distintos sistemas de procesamiento del material triturado, como el tamizado fraccional, espectrofotométrico, de aire comprimido, observación de área, concentración de azúcar, fotométrico y escaneo óptico. En este trabajo se describen y discuten algunos métodos de trascendencia en la historia de la evaluación del rendimiento masticatorio.
Masticatory performance has been assessed with varying methods throughout last century. Some of them use natural food as a test material and some others use artificial components instead of food. There have also been proposed various systems of processing the crushed material, such as fractional sieving, spectrophotometric analysis, compressed air, area observation, sugar concentration, photometric and optical scanning. This paper describes and discusses some relevant methods in the history of the evaluation of masticatory performance.
Subject(s)
Humans , Mastication/physiologyABSTRACT
STATEMENT OF PROBLEM: The improvement in oral function and comfort from the dental implant appears to depend on the particular type of implant support used with the denture. The number and positioning of implants have an influence on the force transfer and subsequent stress distribution around implants. Nevertheless, a quantitative comparison has not been made between the types of implant prosthesis used with different materials compared to conventional complete denture. PURPOSE: The objective of this study is to assess the masticatory performance, bite force and impact of two different type of implant supported prostheses on oral health-related quality of life compared to conventional complete denture with GOHAI, validated oral-specific health status measures, the sieving method, and the Prescale Dental System. MATERIAL AND METHODS: From the years 1999 to 2006, a total of 30 completely edentulous patients in a single arch were selected from the Yonsei University Dental Hospital, Department of Prosthodontics and Implant Clinic in Seoul, S. Korea. Patients were divided into 3 groups of 10 each. Group HR was restored with fixed-detachable hybrid prostheses with resin teeth. Group FP had fixed dentures with porcelain teeth while Group CD had a complete denture. The masticatory performance was compared between 3 groups. RESULTS: The results showed a significant improvement in oral health-related quality of life with dental implants compared to a conventional denture in GOHAI comparison. Overall, implant prostheses showed a higher masticatory performance (S50) and maximum bite force compared with conventional dentures (P .05). CONCLUSION: Within the limitation of this study, the numbers of implant and material of implant prostheses does not appear to impact patient satisfaction, masticatory performance or bite force.
Subject(s)
Humans , Bite Force , Chimera , Dental Implants , Dental Porcelain , Denture, Complete , Dentures , Korea , Patient Satisfaction , Prostheses and Implants , Prosthodontics , Quality of Life , ToothABSTRACT
El propósito del estudio fue evaluar el rendimiento masticatorio a través del estado oclusal. Fueron evaluados 100 sujetos. El rendimiento masticatorio fue evaluado a través del grado de trituración de pastillas de silicona y análisis de tamizado. El estado oclusal fue medido a través de la contabilización de pares oclusales anteriores y posteriores, y convertidos a unidades oclusales, asignando un valor agregado a cada tipo de par oclusal. Los resultados fueron evaluados a través de las pruebas de Kruskal Wallis, U-Mann Whitney, Spearman, y regresión múltiple stepwise. Se encontrón diferencias estadísticamente significativas entre los grupos de pares y unidades oclusales con respecto al rendimiento masticatorio (p<.001). El rendimiento masticatorio presentó una correlación muy fuerte con los pares oclusales (+.930) y unidades oclusales (+.919); considerable con los pares oclusales posteriores (+.877), pares molares (+.835) pares premolares (+.796); moderada con los pares anteriores (+.757) y la edad (-.679). Bajo las condiciones de este trabajo, aquellos sujetos con menor número de pares y unidades oclusales presentaron menor rendimiento masticatorio. La valorización de los pares como unidades oclusales ofrece una mejor descripción del potencial masticatorio de los dientes según el rendimiento obtenido
The aim of this study was to assess masticatory performance through occlusal state. One hundred subjects with general health were evaluated. The masticatory performance was evaluated through the degree of crushing of pills of silicone and sieving test. The oclusal state was measured through the accounting of occlusal anterior and posterior pairs, and turned to occlusal units, assigning an aggregate value to each type of occlusal pair. The results were evaluated through the tests of Kruskal Wallis, U-Mann Whitney, Spearman, and stepwise multiple regression. There were statistically significant differences between the groups of occlusal pairs and units with respect to the masticatory performance (p<.001). The masticatory performance presented very hard correlation with the occlusal pairs (+.930) and occlusal units (+.919); considerable with the posterior occlusal pairs (+.877), molar pairs (+.835) and premolar pairs (+.796); and moderate with the anterior pairs (+.757) and with the age (- 679). Under the conditions of this work, those subjects with less number of occlusal pairs and units presented less masticatory performance. The valuation of the occlusal pairs as occlusal units offers one better description of the masticatory potential of the teeth according to the masticatory performance obtained