Responsiveness of methods to evaluate objective masticatory function in removable partial denture treatments

Abstract

The aim of this study was to examine the responsiveness of chewing tests after removable partial denture (RPD) treatment in this prospective cohort study. Methods: Pre-and post-RPD treatment, objective masticatory function was evaluated in 248 patients via chewing tests involving peanuts, a gummy jelly, and a color-changeable gum. A statistical comparison was performed between the pre-and post-treatment scores, and the standardized response mean (SRM) was determined as the treatment effect size (ES). Results: After RPD treatment, the median particle size in the sieving method using peanuts significantly decreased, and the glucose concentration in the gummy jelly method significantly increased (P < 0.001). The ESs of the sieving and gummy jelly methods were larger (|SRM| = 0.3-0.4) than that of the gum method (|SRM| = 0.1). In the subgroup analysis, the sieving and gummy jelly methods resulted in a broader effective range (|SRM| ≥ 0.3) than the gum method. In patients without pre-treatment dentures, the ES was medium in the sieving method (|SRM| = 0.6) and weak in the gummy jelly and gum methods (|SRM| = 0.3-0.4). The pre-treatment level of masticatory function was significantly correlated with ES (ρ = 0.93, P < 0.001). Conclusions: These results suggest that the sieving and gummy jelly methods are more responsive than the gum method for RPD treatment and that the pretreatment scores affect the responsiveness.

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

“…MP decreases when a tooth is lost. On the other hand, MP is improved by dental prosthetic treatment [2,11,15]. To evaluate treatment, it is necessary to compare the reference value obtained from healthy adults.…”

“…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]. However, the reference value of healthy adults, which is important for the evaluation of MP, has not yet been fully clarified.…”

“…It is clear that MP by measuring AGE decreases when teeth are lost [8,14], and improves with dental treatment [2,11,15]. At present, only the values [6,12] of a small number of healthy adults are referred to when evaluating the data [8,16] obtained in MP studies.…”

El odontólogo, custodio de la función masticatoria.

“…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.…”