APPLICATION OF OBJECTIVE AND SUBJECTIVE EVALUATION METHODS FOR MASTICATORY FUNCTION IN PATIENTS WITH MANDIBULAR OVERDENTURES
Authors: Bratus-Hrynkiv R.R. , Kordiiak A.Yu. 
Published: September 2020

Appropriate chewing function is an important indicator of oral health, and masticatory efficiency assessment is one of the most objective methods of prosthetic treatment quality control.

In the globe dental practice, static and dynamic chewing tests are still considered to be the main methods of masticatory function assessment. Thus, there is an extension of functionally-oriented clinical investigations base, which actualizes the importance of this work.

The aim of the work was to evaluate the masticatory function of patients that use mandibular overdentures by studying the results of physiological masticatory test and self-assessment indicators of dental health associated with the use of dentures.

Materials and methods. The clinical trials were carried out in two stages. At the first stage upon informed consent an examination of 20 student volunteers aged 18-22 years (control group -I) and 36 patients -17 women, 19 men (aged 57-76 years) with complete mandibular removable dentures (comparison group -II) was proceeded. Patients of the group I underwent physiological masticatory test with agar-agar samples formed according to UMSA method, patients of group II- masticatory test procedure and interview survey. The second stage was performed by the group III–42 persons –23 women, 19 men (aged 56-89 years) at 1, 6 and 12 months after mandibular dental arch restoration with complete removable overdentures, fixed by spherical attachments. Chewing efficiency was determined using masticatory physiological test and problem-oriented questionnaires. Video registration by Nikon Digital Camera D3200 was used to determine chewing time, number of movements and peculiarities of the mastication process.

All patients of groups II and III in personal interview survey answered 6 questions about indicators of oral health connected with the use of dentures. Questions were formed according to European Oral Health Indicators (2005). Statistical data analysis was performed by standard statistics variation methods with Statistica 6.0 Program use.

Results and discussion. All the parameters of physiological masticatory test: duration of chewing, group I 25,3±2,8 sec. group II 67,3±3,7 sec., group III 60.5±3.5 sec, number of chewing movements in group I was 58.3±4,8, in group II − 82.3±6.3, in group III − 68.8±3,4, samples mass loss: group I − ≤0,13(4,3%), group II − ≤0,21(7,0%), group III − ≤0,18(5,9%). Diminution Index obtained: group I − 1.85±0.5, group II – 3.33±0.7, group III – 2.48±0.5). Masticatory efficiency level in patients of the group III prevailed over group II by the respective parameters. Masticatory test video registration data analysis showed that the patients of group I diminished test samples with bilateral chewing pattern, as the majority of group II patients, while patients in group II employed combined— uni- and bilateral chewing pattern.

According to the average values of the expression of all oral health-related questionnaire indicators: chewing difficulties - 2.67 ± 1.35 vs 0.50 ± 0.20*; excessive bite closure efforts - 1.19 ± 0.65 vs 0.57 ± 0.30*; limited food consumption 2.83 ± 1.35 vs 0.59 ± 0.30*; oral lesions 2.39 ± 1.20 vs 0.56 ± 0.30*; difficulty non-chewing movements 2.14 ± 1.05 vs 0.51 ± 0.30*; uncertainty about reaching treatment goals 2.06 ± 1.10 vs 0.66 ± 0.30*. A statistically significant (p <0.05) difference in favor of group III was clearly demonstrated.

Conclusions

The results of physiological masticatory test and patients interview survey indicated favorable adaptation process to mandibular overdentures with reestablished masticatory function restoration during 12 months of use.

Masticatory efficiency and oral health indicators, connected with dental prostheses usage proved the appropriate quality level of prosthetic treatment in mandibular single remaining teeth-attended patients, using dentures fixed by spherical attachments.