The Impact of Orthodontic Treatment on Masticatory Performance: A Literature Review

The aim of this narrative review was to evaluate the possible association between orthodontic therapy and improved masticatory function. A search strategy was conducted using the PubMed database for up to January 2020 using the keywords "mastication" and "orthodontics". Only human studies investigating mastication in orthodontics settings were selected. The search strategy resulted in 1,011 articles, out of which 57 were included in the final analysis. Investigations have generally agreed that masticatory and chewing functions improved post-orthodontic and orthognathic treatments. Studies also showed improvement in the quality of life of patients' post-orthodontic treatment. The articles examined reinforced that besides esthetic reasons, orthodontic therapy does improve the masticatory and chewing functions of individuals, ultimately enhancing their health-related quality of life.

Hemodynamic Changes in the Masseter and Superior Orbicularis Oris Muscles before and after Exercise Load: A Comparison between Young Adult Women and Middle-Aged to Old Adult Women

Background

The vascularity index (VI) is useful for measuring the hemodynamics on ultrasound imaging. However, there are no reports concerning the application of the VI to facial muscles.

Objective

The aim of this study was (1) to establish a method of measuring the hemodynamics in facial muscles in a constant way and (2) to evaluate the hemodynamic changes in the masseter and superior orbicularis oris muscles (SOOMs) before and after exercise load in two subject groups of females of different ages.

Methods

(1) The VI in the SOOM was calculated, and the test-retest reliability was assessed in seven healthy adults. (2) The VIs in the left-side masseter and SOOM were calculated in 3 sessions: before exercise loading (T0), immediately after loading (T1), and 5 minutes after T1 (T2) for the young adult group (YAG, n = 20; age range, 20–35 years) and the middle-aged to old group (MOG, n = 20; age range, 50–70 years). Tasks were gum chewing for the masseter muscle and lip sealing for the SOOM. The differences in the mean peak flows between two sessions were examined.

Results

(1) Significant differences were not noted for the repeatedly measured average volumes of blood flow with good test-retest agreement (intraclass correlation coefficient = 0.81). (2) In both muscles of the YAG, there were a significant increase in T1 compared with T0 and a significant decrease in T2 compared with T1 (all p < 0.05). In both muscles of the MOG, no significant differences were noted in either comparison.

Conclusions

A method of measuring the hemodynamics in facial muscles was developed and showed good reliability. Changes in the blood flow after exercise load in these muscles may vary with age in women.

Population affinity and variation of sexual dimorphism in three-dimensional facial forms: comparisons between Turkish and Japanese populations

Examining the extent to which sex differences in three-dimensional (3D) facial soft tissue configurations are similar across diverse populations could suggest the source of the indirect evolutionary benefits of facial sexual dimorphism traits. To explore this idea, we selected two geographically distinct populations. Three-dimensional model faces were derived from 272 Turkish and Japanese men and women; their facial morphologies were evaluated using landmark and surface-based analyses. We found four common facial features related to sexual dimorphism. Both Turkish and Japanese females had a shorter lower face height, a flatter forehead, greater sagittal cheek protrusion in the infraorbital region but less prominence of the cheek in the parotid-masseteric region, and an antero-posteriorly smaller nose when compared with their male counterparts. The results indicated the possible phylogenetic contribution of the masticatory organ function and morphogenesis on sexual dimorphism of the human face in addition to previously reported biological and psychological characteristics, including sexual maturity, reproductive potential, mating success, general health, immune response, age, and personality.

Extraction treatment of a class II division 2 malocclusion with mandibular posterior discrepancy and changes in stomatognathic function

This case report describes the successful extraction treatment of a Class II division 2 malocclusion with mandibular posterior discrepancy and a congenitally missing maxillary lateral incisor on the left side. The posterior space in the mandibular arch was small, and the mandibular second molars were impacted, with distal tipping. The discrepancies in the maxillary and mandibular arches were resolved by extraction of the maxillary lateral incisor on the right side and the mandibular second premolars on both sides. The mesial movement of the mandibular first molars occurred appropriately, with the second molars moving into an upright position. A lip bumper was used with a preadjusted edgewise appliance in the maxillary dentition to reinforce molar anchorage and labial movement of the retroclined incisors. Despite the extraction treatment, a deep bite could be corrected without aggravation as a result of the lip bumper and utility arch in the mandibular dentition. Thus, an Angle Class I molar relationship and an ideal overbite were achieved. The occlusal contact area and masticatory muscle activities during maximum clenching increased after treatment. The maximum closing velocity and the maximum gape during chewing increased, and the chewing pattern changed from the chopping to grinding type. The findings in the present case suggest that the correction of a deep bite might be effective for improving stomatognathic function.

Improvements in smoothness of chewing cycles in adults with mandibular prognathism after surgery: a longitudinal study

Although adults with mandibular prognathism are known to show impaired smoothness of masticatory jaw movements, it remains uncertain whether/how the surgical-orthodontic treatment is effective to improve masticatory jaw movements. The aims of this study were (i) to verify whether the surgical-orthodontic treatment of patients with mandibular prognathism improve smoothness of the chewing jaw movements post-operatively and, if so, (ii) to examine whether the improved parameters show similar quantities as those of the control subjects. The chewing jaw movements for 13 patients with mandibular prognathism were recorded at pre- and post-treatment stages. The patient group was divided into two groups: Class III(closed) showed full occlusal contact at the habitual intercuspal position, whereas Class III(open) showed inability of occlusal contact between the upper and lower anterior teeth. The control group (CG) consisted of 52 subjects having acceptably good occlusion. The normalised jerk cost (NJC), movement duration and peak velocity in jaw closing were compared. For both Class III(open) and Class III(closed) groups, statistical comparisons revealed that the NJC and movement duration were decreased after the treatment, whereas the peak velocity was increased (all P < 0·01). For the Class III(open), these quantities at the post-treatment stage did not show any significant differences compared with those for the CG. It is concluded that the smoothness of chewing jaw movements for patient with mandibular prognathism were improved after treatment, and for the patients with anterior open bite at pre-treatment, the post-operatively achieved smoothness of jaw-closing movements did not differ from those of the CG.

Influence of malocclusion on the development of masticatory function and mandibular growth

OBJECTIVE

To verify the hypothesis that appropriate acquisition of masticatory function and normal growth of the mandible are modified by malocclusion.

MATERIALS AND METHODS

Eighteen Jcl:ICR mice were divided into two groups. In one group we shifted the mandible laterally using an occlusal guidance appliance, creating a posterior crossbite at 5 weeks of age. The other group served as control. After 10 weeks, three-dimensional jaw movements and muscle activities were recorded simultaneously during mastication. Microcomputed tomography scans were obtained in vivo to evaluate morphometric changes in the mandible.

RESULTS

(1) The jaw movement pattern in the sagittal plane showed significantly less anteroposterior excursion in the malocclusion group during the late-closing phase (power phase). (2) Electromyography showed significantly less masseter activity in the malocclusion group. (3) The condylar width and mandibular bone mineral density (BMD) were significantly reduced in the malocclusion mice compared to the normal mice.

CONCLUSIONS

These findings suggest that optimization of the chewing pattern and acquisition of appropriate masticatory function is impeded by malocclusion. Altered mechanical loading to the mandible may cause significant reduction of condylar width and mandibular BMD.

The impact of malocclusion on adolescents' dissatisfaction with dental appearance and oral functions

OBJECTIVE

To investigate the impact of malocclusion on adolescents' dissatisfaction with dental appearance and oral functions and to identify components of malocclusion that may contribute to these outcomes.

MATERIALS AND METHODS

The sample comprised 704 secondary school adolescents aged 12 to 13 years from Balneário Camboriú, Brazil. A trained and calibrated orthodontist examined the severity of malocclusion using the Dental Aesthetic Index (DAI). A pretested questionnaire was used to assess reported dental appearance, self-perception of speech, and self-perception of masticatory function using a 5-point scale of oral health status. The outcomes of the present study were dissatisfaction with dental appearance and dissatisfaction with oral functions. Simple and multivariate logistic regression analysis was performed to explore the association between DAI and outcomes and to quantify the effect of DAI components on dissatisfaction with dental appearance.

RESULTS

Each DAI unit increase led to a significant increase of 5% in the likelihood of dissatisfaction with dental appearance (OR: 1.05; 95% CI 1.01-1.08). DAI components that exerted influence on dissatisfaction with dental appearance were: missing teeth (P  =  .010), largest maxillary anterior irregularity ≥3 mm (P  =  .013), and largest mandibular anterior irregularity ≥2 mm (P  =  .008). There was no association between severity of malocclusion and dissatisfaction with oral functions.

CONCLUSIONS

Severity of malocclusion interfered with satisfaction of dental appearance in this population. Missing teeth and anterior irregularity were identified as factors influencing this outcome.

Measurement of jerk-cost using a triaxial piezoelectric accelerometer for the evaluation of jaw movement smoothness

Jerk-cost as a measure of jaw movement smoothness has been used to evaluate the masticatory function of patients with tooth loss and malocclusion. Jerk-cost measuring systems have thus far been unable to determine the jerk-cost of each chewing phase over time. The purposes of this study were (i) to develop a new method for measuring momentary jerk-cost of the jaw movement using a small triaxial piezoelectric accelerometer and (ii) to test the hypothesis that the lowest smoothness is seen during jaw-opening phase. The accelerometer was attached to the skin of the mentum of each subject. Vertical jaw displacement, acceleration, the jerk, and the time differential of jerk-cost during gum chewing were analysed as a function of time in five normal dentate subjects (n = 5). The system revealed intra-class correlation coefficients of intra-examiner, inter-examiner, and test-retest consistency of substantially high values (0.80-0.88). In all subjects, the highest jerk-cost was observed in the opening phase of each chewing cycle when the gum was parting from the teeth; the lowest jerk-cost was observed in the intercuspal phase throughout the chewing cycle, thus confirming the hypothesis. Significant differences were observed between the opening, closing, and intercuspal chewing phases (N = 5, P = 0.007). The smoothness measurement system used in this study evaluated the momentary smoothness of each chewing phase in the masticatory cycle. The system may serve as a diagnostic tool to evaluate the smoothness of the jaw movement in general dental practice.

Masticatory performance and chewing cycle kinematics-are they related?

OBJECTIVE

To compare chewing cycle kinematics of subjects with better and poorer masticatory performance.

MATERIALS AND METHODS

A cross-sectional study compared masticatory performance, based on the breakdown of the artificial test food Cuttersil, in 30 subjects with Class I occlusion. Individuals with median particle sizes greater and lesser than the median value for the entire sample were categorized as poorer (15) and better (15) performers, respectively. While chewing Cuttersil, three-dimensional jaw movements of subjects were tracked with an optoelectric computer system. Multilevel linear modeling was used to evaluate differences in estimated cycle shape, cycle duration, and maximum excursions, as well as within-subject variation between the two groups.

RESULTS

Poorer performers had a significantly longer opening duration (0.274 +/- 0.225 sec vs 0.325 +/- 0.270 sec) than better performers. Poorer and better performers also showed significant differences in cycle shape, including a less horizontal path of closure and more posterior jaw movement in the poorer performers. In addition, poorer performers exhibited significantly more cycle-to-cycle (within-subject) variability in chewing cycle duration, excursive movements, and lateral velocity than did better performers.

CONCLUSIONS

Poorer performers lacked consistency in their chewing cycles, and their cycle shape differs from that of better performers.