The regulation of masticatory function and food bolus formation

Blood flow in denture-supporting maxillary mucosa in response to simulated mastication by loading

PURPOSE

The purpose of this study was to determine the effect of number of chewing strokes on change in blood flow in denture-supporting maxillary mucosa.

METHODS

Subjects consisted of 11 healthy dentate men. Mastication was simulated by intermittent loading (10 N, 1/0.75 Hz) on a lateral area of the hard palate using a 2-cm(2) test plate. Loading duration was set at 1, 4, 8 or 12 min (80, 320, 640 or 960 chewing strokes). A non-contact laser Doppler blood flow meter was used to determine change in blood flow and time taken for recovery to 110% of the pre-loading value. Mean blood flow at pre-loading and at each duration of intermittent loading were compared using a repeated measures ANOVA (α=0.05) and the Dunnett test. Recovery times for each loading duration were compared using a one-way ANOVA (α=0.05) and the Bonferroni-test.

RESULTS

Three subjects showed no increase in mean blood flow with loading. Eight subjects consistently showed an increase in mean blood flow during intermittent loading relative to at pre-loading. Duration of loading yielded no significant difference in mean blood flow. Significant differences were observed in recovery time between at after 8 min loading and at after the other 3 loading (1, 4, and 12 min loading) durations.

CONCLUSION

Number of simulated chewing strokes showed no influence on mean blood flow during intermittent loading in denture-supporting mucosa. It did, however, affect recovery time taken for blood flow to return to its pre-loading level.

Role of the artificial tooth arch during swallowing in edentates

PURPOSE

This study aimed to clarify the role of the artificial tooth arch (ATA) during swallowing in edentates.

METHODS

The tongue pressures, activities of the masseter and suprahyoid muscles, and laryngeal and mandibular movements when swallowing saliva, water, pudding, and corned beef were measured simultaneously using experimental dentures with and without an ATA. We analysed the maximum magnitudes of muscle activities and tongue pressures (MAmax and TPmax, respectively), the times from reaching MAmax and TPmax to laryngeal movement (TLM-MAmax and TLM-TPmax, respectively), and the vertical mandibular position.

RESULTS

The MAmax of the masseter muscle and TPmax were significantly greater with the ATA than without the ATA (p<0.05). However, MAmax of the suprahyoid muscles was not significantly different in the conditions with and without the ATA. TLM-TPmax was significantly longer without the ATA than with the ATA (p<0.05) but the TLM-MAmax of the suprahyoid and masseter muscles were not significantly different with and without the ATA. The MAmax of both suprahyoid and masseter muscles and the TPmax were significantly greater, and TLM-TPmax was significantly longer when swallowing corned beef than other materials (p<0.05). The intermaxillar distance and the range of measured mandibular position at the time of swallowing were shorter and wider in the absence of the ATA than with it.

CONCLUSION

The present study shows that during swallowing the ATA supports the function of the tongue to perform skillful movements for the smooth passage of food to the oropharynx and the elevation of the larynx by maintaining the mandible position constant near the intercuspal position.

Assessment scale of the oral motor performance of children and adolescents with neurological damages

Among the conditions that classify individuals as special needs patients are those resulting from neurological sequelae, particularly cerebral palsy (CP), which is a disorder of high prevalence. Innumerable alterations can be found in individuals with CP but the inability to control striated muscles, due to damages suffered by the central nervous system, should be emphasized. Changes in tonus, speed and strength of oral muscles, reduction of mandibular mobility amplitude and difficulty to passively seal the lips are characteristics observed in such individuals. Categorization of the individual's mastication pattern is important in order to establish diagnosis and treatment protocols and prognosis. The aim of this study was to develop an Oral Motor Assessment Scale (OMAS) and evaluate its performance in terms of construct validity and reliability in a cohort of 53 children and individuals with CP. Two dentists examined the same patients on two different occasions. Good interexaminer (kappa > 0.85) and intra-examiner (kappa > 0.90) agreement was obtained for the majority of the OMAS items. This study shows that the OMAS is an accurate and valid method of assessment of oral motor skills in children and adolescents with neurological damages.

Effects of simulated functional loading conditions on dentin, composite, and laminate structures

Use of composite restorations continues to increase, tempered by more potential problems when placed in posterior dentition. Thus, it is essential to understand how these materials function under stress-bearing clinical conditions. Because mastication is difficult to replicate in the laboratory, cyclic loading is frequently used within in vitro evaluations but often employs traditional fatigue testing, which typically does not simulate occlusal loading because higher stresses and loading frequencies are used, so failure mechanisms may be different. This investigation utilized relevant parameters (specimen size, loading frequency) to assess the effects of cyclic loading on flexural mechanical properties and fracture morphology of (coronal) dentin, composite, and dentin-adhesive-composite "laminate" structures. Incremental monitoring of flexural modulus on individual beams over 60,000 loading cycles revealed a gradual increase across materials; post hoc comparisons indicated statistical significance only for 1 versus 60k cycles. Paired specimens were tested (one exposed to 60k loading cycles, one to static loading only), and comparisons of flexural modulus and strength showed statistically significantly higher values for cyclically loaded specimens across materials, with no observable differences in fracture morphology. Localized reorganization of dentin collagen and polymer chains could have increased flexural modulus and strength during cyclic loading, which may have implications toward the life and failure mechanisms of clinical restorations and underlying tooth structure.

Masticatory muscle activity during deliberately performed oral tasks

The aim of this study was to investigate masticatory muscle activity during deliberately performed functional and non-functional oral tasks. Electromyographic (EMG) surface activity was recorded unilaterally from the masseter, anterior temporalis and suprahyoid muscles in 11 subjects (5 men, 6 women; age = 34.6 +/- 10.8 years), who were accurately instructed to perform 30 different oral tasks under computer guidance using task markers. Data were analyzed by descriptive statistics, repeated measurements analysis of variance (ANOVA) and hierarchical cluster analysis. The maximum EMG amplitude of the masseter and anterior temporalis muscles was more often found during hard chewing tasks than during maximum clenching tasks. The relative contribution of masseter and anterior temporalis changed across the tasks examined (F 5.2; p < or = 0.001). The masseter muscle was significantly (p < or = 0.05) more active than the anterior temporalis muscle during tasks involving incisal biting, jaw protrusion, laterotrusion and jaw cupping, the difference being statistically significant (p < or = 0.05). The anterior temporalis muscle was significantly (p < or = 0.01) more active than the masseter muscle during tasks performed in intercuspal position, during tooth grinding, and during hard chewing on the working side. Based upon the relative contribution of the masseter, anterior temporalis, and suprahyoid muscles, the investigated oral tasks could be grouped into six separate clusters. The findings provided further insight into muscle- and task-specific EMG patterns during functional and non-functional oral behaviors.

Association between food mixing ability and electromyographic activity of jaw-closing muscles during chewing of a wax cube

The purpose of this study was to clarify association between food mixing ability and activity of jaw-closing muscles during chewing of a wax cube. Twenty subjects with complete dentitions (mean age 24.1 years) were directed to chew a two-coloured paraffin wax cube for 10 strokes on preferred chewing side. Surface electromyograms (EMG) were recorded from the right and left masseter and anterior temporalis muscles during chewing of the wax cube. Maximum voltage, duration and muscle work for burst of each chewing cycle were measured on integrated EMG in each muscle. Food mixing ability was estimated as mixing ability index determined from the colour mixture and shape of the chewed wax cube. Some EMG parameters of all muscles except for masseter muscle on non-chewing side showed significant positive correlations with the mixing ability index (r = 0.45-0.56, P < 0.05). However, most of the EMG parameters correlated with one another. As a result, only muscle work of masseter muscle on the chewing side was identified as a significant predictor accounting for 28% interindividual variation in the mixing ability index (P < 0.01). These results suggest that activity of jaw-closing muscles during chewing the wax cube seems to be weakly related to food mixing ability.

Electromyographic activity of the mandible muscles at the beginning and end of masticatory cycles in patients with complete dentures

The aim of this study was to assess the electrical activity of the masseter and anterior temporal muscles in subjects with severe bone resorption at two different times: (a) the initial period, with the complete dentures they had worn for over 10 years, and (b) the final period, 5 months after having new dentures put into place. Twelve asymptomatic subjects were asked to respond to the questionnaire, according to the research diagnostic criteria for temporomandibular disorders, before denture rehabilitation and 5 months after the new dentures were put in place. The electrical activity of the muscles was recorded during mastication in the initial and final period, using artificial food (Optocal). The operator monitored the 35 chewing cycles that were repeated to grind the artificial food. After wearing the new dentures for 5 months, the right anterior temporal muscle showed a statistical difference before and after denture rehabilitation at the beginning and end of mastication. Muscular capacity and ability reduced the electrical activity in the masseter muscles after rehabilitation.

Validation of video versus electromyography for chewing evaluation of the elderly wearing a complete denture

Chewing efficiency may affect nutritional status in the elderly. Many elderly patients are complete denture wearers, and often present cognitive problems. Those two factors make evaluation of mastication difficult with experimental methods. Analysis of video recording may be a simple way to routinely assess chewing parameters. This study aimed at validating several parameters of video evaluation versus electromyography (EMG), which is considered the 'gold standard'. The design was a prospective randomized study, carried out at the Faculty of Dentistry, University of Auvergne, Clermont-Ferrand, France. Twelve complete denture wearers chewed four model foods differing in hardness. Sessions were videotaped and EMG recordings were registered. Mastication time, number of masticatory cycles and cleaning time were recorded simultaneously by video and EMG. Two investigators independently analyzed the videos twice, in random order. Evaluation of criterion validity: a positive video/EMG correlation was found for the parameters 'chewing time' (0.89, Pearson) and 'number of masticatory cycles' (0.94, Spearman), whereas no statistical difference was found between these two EMG and video variables (t-test). Inter and intra-rater reliability gave a positive intraclass coefficient (ICC) for duration of mastication (0.86-0.98), number of masticatory cycles (0.90-0.97) and cleaning time (0.90-0.98). Discriminatory ability was studied using anova (P = 0.01): variation was significant in masticatory duration (F = 10), number of masticatory cycles (F = 10) and cleaning time (F = 4). Video may be a useful assessment tool in prosthetic rehabilitation and can be applied to help choose the type of food (solid, semi-liquid or liquid) to administer to dependent persons, particularly those suffering from dementia.

Mastication of model products in complete denture wearers

OBJECTIVE

The aim of this study was to define the characteristics of muscular activity in complete denture wearers and in dentate subjects during mastication of model foods differing in hardness but similar in terms of rheologically properties.

MATERIAL AND METHODS

The foodstuffs used in this study were laboratory-developed gumdrops demonstrating viscoelastic properties. The test foods cover a range of four hardness levels. The group of complete denture wearers included 15 subjects, while the control group included 9 subjects with normal dentition. Electromyograph (EMG) recordings were taken from the masseter and temporal muscles during mastication of the test foods. The results were evaluated by one-way and two-way ANOVA followed by means comparisons using a Student-Newman-Keuls post hoc test (alpha=0.05).

RESULTS

Preparing the same food bolus for swallowing required a greater number of masticatory cycles and a longer duration of mastication for complete denture wearers than for dentate subjects. In addition, complete denture wearers failed to increase EMG activity per cycle in response to hardness of the food.

CONCLUSION

Denture wearers experienced difficulties during mastication, as indicated by a decreased masticatory rate and the observed failure to increase EMG activity per cycle in response to increased food hardness. The increases in number of cycle and masticatory duration appear to be a response to this impaired masticatory function.

Effects of adding fluids to solid foods on muscle activity and number of chewing cycles

The production of a sufficient amount of saliva is indispensable for good chewing. In the present study, we examined the hypothesis that adding fluid to a food will facilitate the chewing process, especially for dry foods. The effect might be larger for subjects with relatively low salivary flow rates. Furthermore, adding fluids that contain mucins or alpha-amylase may have a larger facilitating effect on mastication than the addition of water alone. Twenty subjects chewed on melba toast, breakfast cake, carrot, peanut, and Gouda cheese. In addition, they chewed on these foods after different volumes of water, artificial saliva containing mucins, or a solution of alpha-amylase had been added. Muscle activity and number of chewing strokes until swallowing were measured. The salivary flow rates of the subjects were also determined. Adding fluid to the food significantly reduced the number of chewing cycles and total muscular work (i.e. the integrated surface electromyograpy of masseter and temporalis muscles measured bilaterally, summed for all chewing cycles) until swallowing for all foods, except carrot. The largest effects were observed for melba and cake, which are dry products requiring sufficient saliva to form a coherent bolus safe for swallowing. More facilitation of the chewing process was observed after adding fluid to breakfast cake for subjects with relatively low salivary flow rates. The type of fluid had no significant effect on the chewing process.