The development of a simple objective test of mastication suitable for older people,using chewing gums

Aims: To develop and assess a simple test for evaluating the mastication of visco‐elastic foods and prosthodontic success subsequent to treatment of older people. Method: The weight lost from chewing gum during mastication tests and the saliva secreted is weighed. The percentage of the original gum weight that is chewed out in a defined number of strokes is termed the Masticatory Effectiveness (ME) Material: Five edentate and three dentate volunteers were selected to provide a range of dental states and age. Four commercially available chewing gums of different origins and perceived hardness were tested, one without sweetener acted as a control for salivary stimulation. Intervention: Pre‐weighed samples of each gum were chewed, each for defined numbers of strokes. The saliva secreted was collected and weighed. The chewed gum was desiccated and the total weight loss of sweeteners chewed out provided an objective measure of chewing performance. Results: Weight loss showed large differences between gums, between subjects and the number of strokes. ME was significantly correlated with salivary secretion rates for two subjects. The interaction between subject and gum was statistically significant, established by an ANOVA model, the value of which is shown for multivariate studies. Differential success between gums of different thickness may provide evaluation of denture stability. Conclusions: Measuring the weight lost from gums during chewing provides a simple test of masticatory effectiveness of visco‐elastic foods. This has particular value both in functional assessment of older people and in physiological research.     

The influence of experimental manipulations on chewing speed during in vivo laboratory research in tufted capuchins (Cebus apella)

Even though in vivo studies of mastication in living primates are often used to test functional and adaptive hypotheses explaining primate masticatory behavior, we currently have little data addressing how experimental procedures performed in the laboratory influence mastication. The obvious logistical issue in assessing how animal manipulation impacts feeding physiology reflects the difficulty in quantifying mechanical parameters without handling the animal. In this study, we measured chewing cycle duration as a mechanical variable that can be collected remotely to: 1) assess how experimental manipulations affect chewing speed in Cebus apella, 2) compare captive chewing cycle durations to that of wild conspecifics, and 3) document sources of variation (beyond experimental manipulation) impacting captive chewing cycle durations. We find that experimental manipulations do increase chewing cycle durations in C. apella by as much as 152 milliseconds (ms) on average. These slower chewing speeds are mainly an effect of anesthesia (and/or restraint), rather than electrode implantation or more invasive surgical procedures. Comparison of captive and wild C. apella suggest there is no novel effect of captivity on chewing speed, although this cannot unequivocally demonstrate that masticatory mechanics are similar in captive and wild individuals. Furthermore, we document significant differences in cycle durations due to inter-individual variation and food type, although duration did not always significantly correlate with mechanical properties of foods. We advocate that the significant reduction in chewing speed be considered as an appropriate qualification when applying the results of laboratory-based feeding studies to adaptive explanations of primate feeding behaviors.     

Impaired orofacial motor functions on chronic temporomandibular disorders

Because temporomandibular disorders (TMDs) rehabilitation continues to be a challenge, a more comprehensive picture of the orofacial functions in patients with chronic pain is required. This study assessed the orofacial functions, including surface electromyography (EMG) of dynamic rhythmic activities, in patients with moderate-severe signs and symptoms of chronic TMD. It was hypothesized that orofacial motor control differs between patients with moderate-severe chronic TMD and healthy subjects. Seventy-six subjects (46 with TMD and 30 control) answered questionnaires of severity of TMD and chewing difficulties. Orofacial functions and EMG during chewing were assessed.Standardized EMG indices were obtained by quantitative analysis of the differential EMG signals of the paired masseter and temporal muscles, and used to describe muscular action during chewing.TMD patients showed significant greater difficulty in chewing; worse orofacial scores; longer time for free mastication; a less accurate recruitment of the muscles on the working and balancing sides, reduced symmetrical mastication index (SMI) and increased standardized activity during EMG test than healthy subjects. SMI, TMD severity and orofacial myofunctional scores were correlated (P < 0.01). Impaired orofacial functions and increased activity of the muscles of balancing sides during unilateral chewing characterized the altered orofacial motor control in patients with moderate-severe chronic TMD. Implications for rehabilitation are discussed.     

Influence of age and dental status on chewing behaviour studied by EMG recordings during consumption of various food samples

Objective: To evaluate the effects of age and dental status on chewing performance in humans. Design: Electromyography recordings (EMG) were made during chewing of six foods (rice, beef, cheese, crispy bread, apple, and peanuts) to compare the masticatory patterns of four subject groups with different ages and dental status. Subjects: Nineteen elders (mean age 67.2 years) classified into three categories according to their number of opposing post‐canine teeth pairs (i.e. functional units) and a control group of 10 young adults (mean age 26.5 years) with a high number of functional units. Main outcome measures: Number of chewing cycles, chewing time, total muscle activity and muscle activity per chew, burst and inter‐burst durations, maximum and mean voltages from EMG recordings. Results: Time‐related EMG parameters increased from young subjects to elderly subjects with high, middle and low dental status. Parameters related to EMG voltages per chew decreased in the same order among the different groups of subjects. These tendencies were observed for all the studied products. Subjects with weak muscle contraction may compensate for their poor chewing performance by lengthening both chewing cycle and sequence duration. Additional alterations in the chewing patterns were observed when age effect was associated with a dental status degradation in terms of number of functional units. Conclusion: Impairment in mastication for the elderly is due to both ageing and decreasing number of functional pairs of post‐canine teeth.     

Textural evaluation of rice cake by chewing and swallowing measurements on human subjects

The difficulty in masticating and swallowing rice cake was quantified. Healthy subjects ate pieces of rice cake (9 g and 3 g) and a modified product (9 g). We used electromyography to measure the activity of the jaw-closing and -opening muscles during chewing, as well as the suprahyoid muscle activity, laryngeal movement, and sound during swallowing. The smaller the rice cake, the shorter the mastication time, the fewer the number of chews, and the less the jaw-closing muscle activity. A modified rice cake product (9 g) was consumed with less mastication effort than the standard rice cake (9 g) and with the same effort as the standard (3 g). Both the sample amount and texture influenced mastication, although neither factor caused a significant difference in swallowing characteristics. These observations suggest that swallowing was induced when the bolus properties became suitable for swallowing, as healthy subjects could adjust their mastication technique according to the food amount and texture.     

The influence of mandibular implant-retained overdentures in masticatory efficiency

doi: 10.1111/j.1741‐2358.2011.00539.x The influence of mandibular implant‐retained overdentures in masticatory efficiency Objective: To evaluate the masticatory efficiency of patients rehabilitated with conventional dentures (CDs) or implant‐retained mandibular overdentures. Background: Despite the evident benefits of implants on mastication as assessed by subjective patient‐based outcomes, the extent of implant overdenture treatment effect on food comminution is not well established. Materials and methods: A randomised clinical trial was carried out with 29 completely edentulous patients divided into two groups. The first group was rehabilitated with a mandibular overdenture retained by two splinted implants with bar‐clip system, while the second group was rehabilitated with a mandibular CD. Both groups also were rehabilitated with maxillary CDs. Masticatory efficiency and patient satisfaction were assessed 3 months after denture insertion. Masticatory efficiency was evaluated through the colorimetric method with the beads as the artificial test‐food. Comparisons for masticatory efficiency and patient satisfaction were performed using Student’s t‐test (α = 0.05). Results: No significant statistical difference was found for masticatory efficiency (p = 0.198). Patient overall satisfaction was significantly higher for the mandibular overdenture (p < 0.001). In addition, mandibular overdenture patients were significantly more satisfied with chewing experience (p < 0.05) and retention of the lower denture (p < 0.005). Conclusion: The results of this study suggest that mandibular overdenture significantly improves chewing experience, although limited effect on masticatory efficiency has been observed.     

The masticatory handicap of wearing removable dentures in elderly men

Objective: This study aimed at describing the masticatory handicap of wearing removable dentures measured by some masticatory tests and the intake of hard and soft foods. Materials and methods: The subjects were participants in a comprehensive health examination of 67–68‐year‐old men living in Malmö, Sweden. Four hundred eighty‐three men took part in a clinical oral examination which recorded the number of teeth and removable dentures. One hundred and one had complete dentures in both jaws and 131 had removable partial dentures in different combinations. Masticatory tests used almonds to record the number of stokes to the first swallow, and two‐coloured chewing gums for recording bolus kneading and shaping. A nutritionist paid a home visit to assess dietary habits including the consumption of hard and soft foods. The data could be split into groups of different tooth and denture situations which were large enough to enable statistical analysis to be carried out. The results of a regression analysis of the group with different numbers of natural teeth (NT) and no removable dentures could be used as a reference for correlation with the masticatory capacity of removable denture wearers. Results: Number of strokes to the first swallow revealed no masticatory limitations of wearing removable dentures, while chewing gum colour‐mixing and shaping revealed more differentiated impairments equivalent to the function of five to 16 teeth in a remaining natural dentition. Hard food intake for the removable denture groups was comparable to 17–19 NT. Soft food intake was not influenced by denture wearing. In a ranking of oral conditions, those with more than 24 NT had the highest test values for all tests, and those with complete sets of dentures the lowest except for the number of strokes to the first swallow of an almond. Conclusion: Removable denture wearing can be regarded as a handicap when measured with objective masticatory tests using chewing gum and the intake of hard foods. The number of chewing strokes to the first swallow of an almond and the intake of soft foods is not affected by the wearing of removable dentures.     

Mandibular biomechanics and temporomandibular joint function in primates.

There is disagreement as to whether the mandibular condyles are stress-bearing or stress-free during mastication. In support of alternative models, analogies have been drawn with Class III levers, links, and couple systems. Physiological data are reviewed which indicate that maximum masticatory forces are generated when maxillary and mandibular teeth are in contact, and that this phase lasts for over 100 msec during many chewing strokes. During this period, the mandible can be modeled as a beam with multiple supports. Equations of simple beam theory suggest that large condylar reaction forces are present during mastication. With unilateral molar biting in man, the total condylar reaction force may be over 75% of the bite force. Analysis of a frontal projection demonstrates that up to 80% of the total condylar reaction force is borne by the contralateral (balancing side) condyle during unilateral molar biting. A comparison of human, chimpanzee (P. troglodytes), spider monkey (A. belzebuth), and macaque (Macaca sp.) morphology indicates that the frugivorous chimpanzee and spider monkey have a relatively lower condylar reaction force than the omnivorous macaque or man during molar biting. The percentage reaction force during incisal biting is lower in man than in the other primates, and lower in the frugivorous primates than in the macaque.     

Mandibular kinematics and masticatory muscles EMG in patients with short lasting TMD of mild-moderate severity

Mandibular kinematic and standardized surface electromyography (sEMG) characteristics of masticatory muscles of subjects with short lasting TMD of mild-moderate severity were examined.Volunteers were submitted to clinical examination and questionnaire of severity. Ten subjects with TMD (age 27.3 years, SD 7.8) and 10 control subjects without TMD, matched by age, were selected.Mandibular movements were recorded during free maximum mouth opening and closing (O–C) and unilateral, left and right, gum chewing. sEMG of the masseter and temporal muscles was performed during maximum teeth clenching either on cotton rolls or in intercuspal position, and during gum chewing. sEMG indices were obtained. Subjects with TMD, relative to control subjects, had lower relative mandibular rotation at the end of mouth opening, larger mean number of intersection between interincisal O–C paths during mastication and smaller asymmetry between working and balancing side, with participation beyond the expected of the contralateral muscles (P < 0.05, t-test). Overall, TMD subjects showed similarities with the control subjects in several kinematic parameters and the EMG indices of the static test, although some changes in the mastication were observed.     

Strain in the galago facial skull

Little experimental work has been directed at understanding the distribution of stresses along the facial skull during routine masticatory behaviors. Such information is important for understanding the functional significance of the mammalian circumorbital region. In this study, bone strain was recorded along the dorsal interorbit, postorbital bar, and mandibular corpus in Otolemur garnettii and O. crassicaudatus (greater galagos) during molar chewing and biting. We determined principal-strain magnitudes and directions, compared peak shear-strain magnitudes between various regions of the face, and compared galago strain patterns with similar experimental data for anthropoids. This suite of analyses were used to test the facial torsion model (Greaves [1985] J Zool (Lond) 207:125-136; [1991] Zool J Linn Soc 101:121-129; [1995] Functional morphology in vertebrate paleontology. Cambridge: Cambridge University Press, p 99-115). A comparison of galago circumorbital and mandibular peak strains during powerful mastication indicates that circumorbital strains are very low in magnitude. This demonstrates that, as in anthropoids, the strepsirhine circumorbital region is highly overbuilt for countering routine masticatory loads. The fact that circumorbital peak-strain magnitudes are uniformly low in both primate suborders undermines any model that emphasizes the importance of masticatory stresses as a determinant of circumorbital form, function, and evolution. Preliminary data also suggest that the difference between mandibular and circumorbital strains is greater in larger-bodied primates. This pattern is interpreted to mean that sufficient cortical bone must exist in the circumorbital region to prevent structural failure due to nonmasticatory traumatic forces. During unilateral mastication, the direction of epsilon(1) at the galago dorsal interorbit indicates the presence of facial torsion combined with bending in the frontal plane. Postorbital bar principal-strain directions during mastication are oriented, on average, very close to 45 degrees relative to the skull's long axis, much as predicted by the facial torsion model. When chewing shifts from one side of the face to the other, there is a characteristic reversal or flip-flop in principal-strain directions for both the interorbit and postorbital bar. Although anthropoids also exhibit an interorbital reversal pattern, peak-strain directions for this clade are opposite those for galagos. The presence of such variation may be due to suborder differences in relative balancing-side jaw-muscle force recruitment. Most importantly, although the strain-direction data for the galago circumorbital region offer support for the occurrence of facial torsion, the low magnitude of these strains suggests that this loading pattern may not be an important determinant of circumorbital morphology.     

Design and Evaluation of the Release Characteristics of Caffeine-Loaded Microcapsules in a Medicated Chewing Gum Formulation

The aim of this study was to microencapsulate caffeine by the emulsion technique, trying to control its release from a medicated chewing gum. Three formulations were prepared using alginate, alginate-starch, and alginate-starch with chitosan coating as the wall materials. These microcapsules were characterized with regard to the morphology studied by using an optical microscope and scanning electron microscopy (SEM), particle size, and encapsulation efficiency. The microcapsules were then incorporated into the chewing gums. The chewing gums were characterized by thermal behavior (by differential scanning calorimetry [DSC]), texture profile analysis [TPA], and sensory evaluation. Furthermore, the release of caffeine from the chewing gum was studied in vitro using the masticatory simulator and in vivo by a chew-out study. The microcapsules revealed a spherical form and high encapsulation efficiency, representing the success of the technique. The outcomes indicated that it is possible to encapsulate caffeine with the techniques employed and the microcapsules prolonged the release of caffeine throughout mastication. The chewing gum containing alginate-starch with chitosan-coated microcapsules showed the great potential of the microcapsule in controlling the release of the caffeine from the chewing gum, thereby delaying its bitterness.     

Effects of alcohol and coca on foot temperature responses of highland Peruvians during a localized cold exposure

Two groups of highland Quechua Indian males were tested under conditions of local foot exposure to cold air (0°C). Foot temperatures were monitored throughout the hour cold test and for 16 minutes recovery at room temperature (24°C). In the first group (age range 14–20 years), 29 subjects were tested while chewing coca leaves and while under control conditions. The second group (age range 20–50 years) of 25 subjects was tested while consuming 1.1 gm of ethyl alcohol per kilogram of body weight and again under control conditions. Both drugs (coca and alcohol) are habitually consumed by members of the native population. The mastication of coca leaves had no effect on foot skin temperatures. Alcohol consumption, however, elevated foot temperatures to between 4 and 6°C higher than control values at the end of 60 minutes of cold exposure. It is suggested that alcohol consumption gives the Indian a slight thermal advantage and increases levels of comfort during natural cold exposure.     

THE EFFECT OF MASTICATORY PATTERNS AS MEASURED BY TIME-INTENSITY AND ELECTROMYOGRAPHY ON THE PERCEPTION OF BOVINE MUSCLE TENDERNESS

The relationship between perception of tenderness and chewing activity was explored using the Time-Intensity measurement of perception and electromyographic measurements of masseter muscle movement. Semitendinosus muscles from eight treatments of forage fed beef were evaluated by nine individuals. The Time-Intensity parameters of Area Under the Curve and Decrease Area were the most useful for treatment separation based on tenderness. Information was obtained from the electromyogram regarding the number of chews, time to chew and mastication rate. However, more work with EMG measurements is required to accurately study the effect of masticatory patterns on tenderness perception.     

Coca chewing in prehistoric coastal Peru: dental evidence

In this study, we describe the dental health of four prehistoric human populations from the southern coast of Peru, an area in which independent archaeological evidence suggests that the practice of coca-leaf chewing was relatively common. A repeated pattern of cervical-root caries accompanying root exposure was found on the buccal surfaces of the posterior dentition, coinciding with the typical placement of coca quids during mastication. To further examine the association between caries patterning and coca chewing, caries site characteristics of molar teeth were utilized as indicators for estimating the likelihood of coca chewing for adults within each of the study samples. Likelihood estimates were then compared with results of a test for coca use derived from hair samples from the same individuals. The hair and dental studies exhibited an 85.7% agreement. Thus, we have demonstrated the validity of a hard-tissue technique for identifying the presence of habitual coca-leaf chewing in ancient human remains, which is useful in archaeological contexts where hair is not preserved. These data can be used to explore the distribution of coca chewing in prehistoric times. Simultaneously, we document the dental health associated with this traditional Andean cultural practice.     

Preweaning feeding mechanisms in the rabbit.

Muscle contraction patterns and mandibular movements of infant rabbits during suckling and chewing were compared. Oral muscle activity was recorded by fine-wire electromyography, while jaw movements and milk bottle pressure were registered. Suckling and mastication have a comparable cycle duration and share a common pattern of oral muscle activity which consists of a succession of a jaw closer burst, during which the jaw closes and undergoes a power stroke (in mastication), a suprahyoid burst with a stationary or slightly opening jaw and a digastric burst with fast jaw opening (the power stroke of suckling). Compared to suckling, mastication shows decreased jaw opener activity, increased jaw closer activity, development of jaw closing activity in the lateral pterygoid, and increased asymmetry in the masseter by development of a new differentiated motor pattern on the working side. The study shows that the suckling motor pattern enables the infant rabbits to change to chewing with just a few modifications.     

Time analysis of hard and soft bolus processing

Objective: Clinical observations and mathematical models show that dental implants are influenced by the magnitude of loading. Therefore, the knowledge of mandible movement during mastication is important to assess occlusal and masticatory force vectors. The purpose of this study was to detect the path of movement of the lower jaw and to distinguish stages of mastication, duration of bolus processing and peak amplitude of mastication. Method: Motion analysis was used to record three-dimensional mandible movements. Individualized sensors were rigidly attached to the mandible of 51 study participants. At the beginning of the measurement, all subjects were asked to move the mandible in extreme positions (maximal opening and maximal lateral movements). Then, each subject masticated a bite of hard and soft food. Duration of bolus mastication and peak amplitude of mastication movement in mesio-distal, cranio-caudal and vestibulo-oral axes related to peak amplitude of marginal movements were evaluated for each subject. The chewing record of each subject was divided into three phases (chopping, grinding and swallowing), and the duration of mastication and number of closing movements were evaluated. Results: The findings of this pilot study suggest that masticatory movements vary in individuals. Bolus character influences the process duration, but not the frequency of closing movements. Neither gender nor age had any influence on either the time or frequency of bolus processing. Conclusion: Relationships to directions and magnitudes of acting chewing force should be more precisely examined since transversally acted forces during grinding are important factors in tooth/implant overloading.     

Masticatory function in patients with xerostomia

The effects of reduced salivary output in patients suffering from xerostomia on masticatory function has not been previously studied. This study compares masticatory performance and kinematic activity of patients suffering from xerostomia with age-, sex-, and number of occluding pairs-matched healthy controls. Masticatory function was evaluated by assessment of chewing motion and muscle activity during chewing an artificial food (CutterSil®), chewing gum and swallowing a bolus of almond. Chewing motion was recorded with the Optotrak® computer system. Bilateral muscle activity of both masseter and anterior temporalis was recorded using surface electrodes. Results of this study revealed significant differences between patients and controls in their ability to process food and masticatory muscle activity. The majority of patients could not break down the artificial food, others had a larger median particle size than the controls. A significant difference was also observed in the number of chewing cycles required to swallow almonds, the patients required more than twice as many chews as the controls, P<0.001. The right masseter muscle displayed significantly less activity for the patient than the controls. These findings suggest that patients with xerostomia exhibit reduced ability to process food. The observed decline in masticatory performance is probably due to reduced activity of the muscles of mastication.     

Why fuse the mandibular symphysis? A comparative analysis

Fused symphyses, which evolved independently in several mammalian taxa, including anthropoids, are stiffer and stronger than unfused symphyses. This paper tests the hypothesis that orientations of tooth movements during occlusion are the primary basis for variations in symphyseal fusion. Mammals whose teeth have primarily dorsally oriented occlusal trajectories and/or rotate their mandibles during occlusion will not benefit from symphyseal fusion because it prevents independent mandibular movements and because unfused symphyses transfer dorsally oriented forces with equal efficiency; mammals with predominantly transverse power strokes are predicted to benefit from symphyseal fusion or greatly restricted mediolateral movement at the symphysis in order to increase force transfer efficiency across the symphysis in the transverse plane. These hypotheses are tested with comparative data on symphyseal and occlusal morphology in several mammals, and with kinematic and EMG analyses of mastication in opossums (Didelphis virginiana) and goats (Capra hircus) that are compared with published data on chewing in primates. Among mammals, symphyseal fusion or a morphology that greatly restricts movement correlates significantly with occlusal orientation: species with more transversely oriented occlusal planes tend to have fused symphyses. The ratio of working- to balancing-side adductor muscle force in goats and opossums is close to 1:1, as in macaques, but goats and opossums have mandibles that rotate independently during occlusion, and have predominantly vertically oriented tooth movements during the power stroke. Symphyseal fusion is therefore most likely an adaptation for increasing the efficiency of transfer of transversely oriented occlusal forces in mammals whose mandibles do not rotate independently during the power stroke.     

Microbial Reduction of 1,2-Diketones to Optically Active α-Hydroxyketones

We have attempted to develop an intraoral method which can measure the textural changes in foodstuffs during chewing by using electromyography (EMG). Forty-three foodstuffs with variable textural attributes were used.

Total chewing energy for these foodstuffs during chewing varied from 3 to 108 for the masseter muscle and 13 to 154 for the digastric muscle, respectively. Large differences in total chewing energy could be observed by EMG among the foodstuffs. The chewing energy for many foodstuffs revealed distinct differences throughout the chewing process. Foodstuffs could be categorized into six groups according to the changing patterns of chewing energy. EMG data and the number of strokes were influenced by masticatory index and salivary flow rate.     

A novel computational method to determine subject-specific bite force and occlusal loading during mastication

The evaluation of three-dimensional occlusal loading during biting and chewing may assist in development of new dental materials, in designing effective and long-lasting restorations such as crowns and bridges, and for evaluating functional performance of prosthodontic components such as dental and/or maxillofacial implants. At present, little is known about the dynamic force and pressure distributions at the occlusal surface during mastication, as these quantities cannot be measured directly. The aim of this study was to evaluate subject-specific occlusal loading forces during mastication using accurate jaw motion measurements. Motion data was obtained from experiments in which an individual performed maximal effort dynamic chewing cycles on a rubber sample with known mechanical properties. A finite element model simulation of one recorded chewing cycle was then performed to evaluate the deformation of the rubber. This was achieved by imposing the measured jaw motions on a three-dimensional geometric surface model of the subject’s dental impressions. Based on the rubber’s deformation and its material behaviour, the simulation was used to compute the resulting stresses within the rubber as well as the contact pressures and forces on the occlusal surfaces. An advantage of this novel modelling approach is that dynamic occlusal pressure maps and biting forces may be predicted with high accuracy and resolution at each time step throughout the chewing cycle. Depending on the motion capture technique and the speed of simulation, the methodology may be automated in such a way that it can be performed chair-side. The present study demonstrates a novel modelling methodology for evaluating dynamic occlusal loading during biting or chewing.