It has been suggested that the provision of dental implants can improve the oral function of subjects with severely resorbed mandibles, possibly restoring function to the level experienced by satisfied wearers of conventional complete dentures. Nevertheless, a quantitative comparison has never been made and can be drawn from the literature only with difficulty, since studies differ greatly in methodology. To make such a comparison, we measured bite force and chewing efficiency by using identical methods in subjects with overdentures, complete full dentures, and natural dentitions. Our results indicated that bite forces achieved with overdentures on dental implants were between those achieved with artificial and natural dentitions. Chewing efficiency was significantly greater than that of subjects with full dentures (low mandible), but was still lower than that of subjects with full dentures (high mandible) and overdentures on bare roots. Differences in the height of the mandible revealed significant differences in chewing efficiency between the two full-denture groups. Furthermore, subjects with a shortened dental arch exerted bite forces similar to those of subjects with a complete-natural dentition, but their chewing efficiency was limited due to the reduced occlusal area. For all groups combined, a significant correlation was found between maximum bite force and chewing efficiency. Nearly half of the variation in chewing efficiency was explained by bite force alone.

An experimental artificial test food with low fracture strength (Optocal) was compared with Optosil with respect to the comminution during mastication by complete denture wearers and subjects with natural dentitions. The comminution of both test foods revealed large differences between the denture wearers and the dentate subjects. These differences were larger with Optosil than with Optocal. The differences in comminution between Optocal and Optosil were larger in the denture wearers than in the dentate subjects. The differences in comminution between the denture wearers and the dentate subjects as well as the differences in comminution between Optocal and Optosil within each group were largely established in less than 20 chewing strokes. The results indicate that differences in selection contributed substantially to the differences in comminution. Since Optocal appeared to be much easier to chew than Optosil, it may be preferred to Optosil for measuring masticatory performance in complete denture wearers.

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Sensitivity or pain of the mucoperiosteum covering the mandibular edentulous ridge is often thought to limit bite forces in complete-denture wearers. Therefore, bite forces with mandibular implant-retained overdentures may depend on the degree of implant support. This study analyzed the effects of different degrees of support for the mandibular denture on bite forces measured four years after denture treatment as part of a randomized controlled clinical trial. All subjects had received new maxillary dentures and (1) mainly implant-borne overdentures on a transmandibular implant (TMI), (2) mucosa-borne overdentures on two cylindric permucosal IMZ implants, or (3) new conventional dentures in the mandible. Fifty-three women and 15 men (mean age, 59.1 yrs; range, 41 to 77) participated in this trial. Both unilateral and bilateral bite forces were recorded at different positions with a miniature strain gauge transducer and a mechanical bite fork, respectively. The subjects were asked to bite at three force levels. Results indicated that women had significantly lower maximum bite forces than men. Persons with mandibular implant-retained overdentures had significantly higher unilateral and bilateral maximum bite forces than complete-denture wearers. However, bite forces did not differ between the mainly implant-borne (TMI) and mucosa-implant-borne (IMZ) implant systems. Therefore, it appears that differences in support for the mandibular overdenture by dental implants are not reflected in bite force capabilities.

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