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THE INFLUENCE OF OCCLUSAL ON CHEWING PERFORMANGE

JAMES R. LAMBRECHT,

CONTACT

AREA

D.D.S.,M.S.D.+

Staten Island, N. Y.

wo CONFLICTING SCHOOLS of thought exist concerning the relative merits of anatomic and nonanatomic types of posterior teeth for complete dentures. In an attempt to resolve this controversy, determinations of chewing performance have been used as a method of evaluation, but the findings have been either inconsistent or inconclusive. Paulson and Clausen cited by Seppae,l Christiansen, and Ono3 studied the mechanical breakdown of food in the oral cavity. Hara,4 Gelman and Schultz6 discussed digestion of certain selected foods in relation to masticatory performance. Dahlberg’ and Farrell8 inferred that the chewing pattern is habitual rather than controlled by particle size. Yurkstas and Manly9 evaluated test foods to determine those which were representative of the various groups and also consistent in regard to performance. Manly and Braley lo studied the factors which influenced masticatory effectiveness, while Manly and Vintonrl evaluated factors that affected chewing performance of a large group of subjects wearing complete dentures. Thompson,12 Schultz,6 Payne, 13*14Trapozzano and Lazzari,16 and others16J7 evaluated occlusal tooth patterns used in complete dentures. Other factors may have a far greater effect on chewing performance than the type of posterior teeth used in the denture. Some of these are : (1) the potential contact area of the food table, (2) the orientation and height of the occlusal plane, and (3) the physiologic and psychologic ability of the patient to control the bolus of food.

T

PURPOSE OF THIS

INVESTIGATION

Many factors influence the results of chewing performance. However, determinations are of value when they are performed so that only the factor which is to be evaluated is varied. This study was designed to determine the effect of a controlled reduction in the size of the potential contact area of opposing posterior teeth on chewing effectiveness. Multiple tests were performed prior to and following reduction of the buccolingual width of the posterior teeth, and a comparison of the results obtained from the performance determinations was made. Findings were
Presented at the United States Public Health Service Regional Clinical Society Boston, Mass. *Public Health Service Hospital, Dental Department, United States Department Education, and Welfare, Staten Island, N. Y. 444 Meeting in

of Health,

The masticated material was treated as follows to determine the particle s’ize distribution : (1) A small amount of detergent was added. Quantitative measurements were secured from each of the drawings. (2) The mass was poured into a cylindrical nest of calibrated United States Standard screens. (4) The fractions of peanuts . during which time all adjustments were made. The sample was divided into 3 units of 3 Gm. The first unit was placed in the mouth.-A 9 Gm. the cylinder was allowed to drain. METHODS AND MATERIALS Complete dentures were constructed for five patients.ve hundred cubic centimeters of water was poured over the material to wash the finer particles down through the screens. All patients had previous experience with dentures and had Class I ridge relationships. three of whom were men. Individual trays were used for final impression procedures. (3) Fi. and Gothic arch (needle point) tracings were developed. 10. sample of peanuts was used for each test. The casts were mounted by means of interocclusal records degree porcelain posterior on House semiadjustable articulators.pe’r ‘3” INFLUENCE OF OCCLUSAL CONTACT AREA ON CHEWING 445 compared with those of previous studies designed to evaluate the relative chewing performance of anatomic and nonanatomic posterior teeth. Thirty-three teeth were used on all dentures. Peanuts..18 The potential contact area was arbitrarily defined as any area in which the maxillary and the mandibular teeth were within 1 mm. The second and third 3 Gm. and SO.-A whole raw carrot was diced into pieces approximately one-quarter of an inch square. and expectorated into a beaker. and the resulting films were scanned with the use of a microdensitometer. units of peanuts were subjected to mastication and collected in a similar manner as the initial unit. in centric occlusion). chewed for 20 masticatory strokes. All determinations were made in duplicate to assure accuracy. Each unit of 3 Gm. making a total of 9 Gm. The diced pieces were weighed out into 3 units of 3 Gm. Semiradiopaque rubber-base interocclusal records were made of opposing posterior teeth when they were in their maximum intercuspal relation (i. Room temperature water was used to rinse the remaining particles of peanuts from remote parts of the oral cavity and then was collected in the beaker.-The potential contact area of opposing posterior teeth on both the right and left sides was determined by a technique developed by Kydd. Occlusal corrections were made after processing. and the entire mass was stirred gently to break up clumps.e. gauges 4.~~l~:.-The test foods used for determination of performance were whole jumbo peanuts and diced raw carrots. Chew&g Performance Determinations. Roentgenograms were made of these interocclusal records. each. of contact when the jaws were fully closed in centric occlusion. The patients wore the dentures from 4 to 6 weeks. as the maximum functional distance. and the content of each screen was collected on filter paper. Occlusal Contact Area Deternzin&ion. They expressed complete satisfaction with the dentures prior to the testing phase. with the consideration of 1 mm. The dentures were constructed following a conventional technique. each. The information obtained was plotted on graph paper. was masticated 20 times and collected in a manner similar to that used for the peanuts. Carrots.

9% loss in performance .4 49.40 8.10 8.35 6.6 6.8 9 9 6.25 4.65 64.85 8.TABLE SUBTECT PEANUTS CARROTS I.2 41.4 8.2 45.3 24.70 4.) WEIGHT THROUGH 4 GAUGE SCREEN 70 THROUGH 4 GAUGE SCREEN TRIAL y0 THROUGH 10 GAUGE SCREEN TOTAL WEIGHT WEIGHT RECOVERED (GM.7 12. TYPICAL EVALUATION OF CHEWING PERFORMANCE C = I TOTAL WEIGHT RECOVERED (GM.9 56.4 31.) WEIGHT THROUGH 10 GAUGE SCREEN Full Occlusal Surfaces First trial Second trial 2.) (GM.1.50 .6 12.75 2.1 1.60 4.20 2.25 6.3% loss in performance 51.4 21.4 46.10 3.25 6.70 36.45 4. Second trial Reduced Occlusal Surfaces Third trial Fourth trial ii 3.35 6.5 9.8% loss in performance II.4 73.10 8 8.05 4.60 37.6y0 loss in performance rK E E Reduced Occlusal Surfaces Third trial Fourth trial 9” 7.60 19.55 TABLE D CARROTS TRIAL TOTAL WEIGHT (GM.30 2.10 6.30 7.2 6.40 1. TYPICAL SUBJECT PEANUTS I EVALUATION OF CHEWING PERFORMANCE 6.5 75.30 6. 8.35 2.8 50.05 54.) Full Occlusal Surfaces First trial .

Then. A wide variation in loss in performance was also noted between subjects.6 17.8 18. Reduction of Occlusal Contact Area. (7) Percentage calculations were made for each fraction on the basis of the total amount of test food recovered. At this time. COMPARISON OF CHEWING PERFORMANCE AND KEDUCTI~N OF FOOD TABLE SIZE PATIEKT I I-- LOSS IN CHEWING PEANUTS PERFORMANCE (76. the loss of masticatory performance ranged from 6.4 18.9 per cent with an average loss of 13 per cent.1* 12. and the patients were given several days to become reacquainted with the modified dentures. The reduction in contact area was remarkably consistent for all dentures and varied from a minimum of 14. determinations of the potential contact areas and the clinical testing procedures were carried out as previou.& fraction was weighed (discounting the weight of the filter paper). A loss in performance was noted in every test following reduction of the potential contact area.3 12.9 6.6 21.3 per cent. the patient having the greatest occlusal reduction demonstrated the greatest loss in masticatory performance with peanuts.-Approximately 1 mm.8 9. TABLE III.jly described.8 to 21. the dentures were remounted on the articulator. The remaining three subjects demonstrated wide variation from one food to the other (Table III). However.1 to 12.8 per cent with an average loss of 9.3 7. No proportional change could be shown between the percentage of reduction in potential contact area and the percentage of loss in chewing performance. Typical findings are shown in Tables I and II.4 *One-half .) I l CARROTS REDUCTION IN SIZE OF FOODTABLE (o/o) A B 10. (6) Ea. When peanuts were used as the test food.6 per cent. of tooth structure was ground from the lingual surfaces of all maxillary artificial posterior teeth and a like amount from the buccal surfaces of all mandibular posterior teeth. 14. corrections were made to re-establish balanced occlusion. the loss of masticatory performance ranged from 6. and the patient having the smallest reduction exhibited the smallest loss with carrots.3 unit of peanuts recovered intact.4 per cent to a maximum of 20. The loss in performance for each of the test foods for two subjects was very similar.3 9.7 20. FINDINGS Five patients were evaluated to determine the effect of a reduction in the potential contact area on chewing performance.Volume 1s Nunlber 3 INFLUENCE OF OCCLUSAL CONTACT AREA ON CHEWING 447 were thoroughly air dried.8 14.9 6. When carrots were used. (5) The fractions of carrots were transferred to a second and finally a third filter paper to absorb excess moisture from the surface.

the total weight of the peanuts passing through the 10 gauge screen or carrots passing through the 4 gauge screen was divided by the total weight recovered. After the reduction in the width of the teeth. the loss in effectiveness due to the reduction in potential contact area was comparatively accurate. This variation was most pronounced with peanuts because they could be so finely ground that recovery and accurate weighing of the fine fractions were impossible. In addition. . could be more readily collected and weighed.448 DISCUSSION LAMBRECHT J. Consequently. therefore. they do not vary proportionally (Table III). However. and. the loss in performance expressed in per cent was less than the percentage reduction in the effective size of the food table. This variation could be caused by the influence of factors such as: (1) the ability of the patient to position and maintain the bolus on the food table. 1965 A rather large discrepancy was noted between the weight of the test food prior to mastication and the weight of food debris recovered. The surface moisture was eliminated by thoroughly blotting each fraction of food with filter paper. The necessity of using two test foods for determinations of performance9 was made apparent by the variations noted in Table III. Chewing performance varied directly with potential contact area. while these two factors vary directly. In order to establish a percentage of performance. Generally speaking. Pros. The food. the percentage expression was not an accurate value. controlled by the neuromuscular mechanism. complicated the weighing procedures with carrots. there were increased numbers of large pieces. rather than particle size. a linear reduction in performance does not occur. This was expected because of the inherent nature of the function. a certain amount of fluid actually was absorbed by the bolus. The fluid which was absorbed could not be controlled. (2) the variation in the amount of force exerted on the bolus. However. The musculature. With one exception. a greater weight was recovered after chewing than was used initially. This variation may have occurred because the patients had greater difficulty maintaining the fibrous bolus of carrots on the narrowed food table. Marked variation was noted from one patient to another. The results from each of these paired tests were averaged and the loss in performance was determined (Table III). Inasmuch as a loss in performance occurred. both prior to and following reduction of the size of the artificial teeth. May-June. not all of the material was recovered. Two tests were carried out for each food. the loss in performance was greater for carrots than when peanuts were used as the test food. the discrepancy was consistent from one test to another. The determinations of performance were designed to test functional effectiveness following a reduction in the size of the food table. (3) the technical excellence of the dentures. Den. Therefore. As stated previously. Moisture. The cornminuted bolus of carrots accumulated surface moisture both intraorally and during collection. has the function of positioning and maintaining the food bolus on the food table during mastication. a somewhat greater weight of peanuts was consistently reclaimed. which was less thoroughly masticated. and (4) the relative condition of the supporting tissues. In one test.

and Flat acrylic resm . Peanuts 20 degree b. The difference would be due solely to the variation in potential contact area. or (3) selecting molds of posterior teeth which have buccal or occlusal modifications. 33 degree much more at x no. Only slightly more at swallowing threshold a.1s pointed out variations in superiority of one mold of posterior teeth over another ranging from 3 to 33 per cent based on performance tests. F’ayner3 3.. the value of a study comparing occlusal forms with various buccolingual widths is questionable. ty. Inasmuch as a moderate reduction in the size of the potential contact area is capable of producing a 10 to 15 per cent loss in effectiveness. or drew no definite conclusions. Carrots Hall (1 subject) 20 degree (1 subject) No conclusion should be drawn 20 degree No clear-cut difference 26 to 33c/. Trapozzanor5 and Lazzari 2 20 degree. the potential contact area is at least as important as the mold of the posterior teeth in affecting chewing performance.OF I SUBJECTS OF PREVIOUS STUDIESOF CHEWINGPERFORMANCE MOLDFOUND MOST EFFICIENT DETERMINATIONS DEGREE OF SUPERIORITY INVESTIGATOR I MOLDSCOMPARED 1. They cannot be expected to perform as efficiently as a 20 or 30 degree mold. Potential contact area was not considered as a factor affecting performance in six previous studies 6. of cases). Schultz6 2.Y3%lr:r ‘3” INFLUENCE OF OCCLUSAL CONTACT AREA ON CHEWING 449 In view of the magnitude of the losses in performance noted in this study. Many molds of posterior teeth (French’s or Hardy’s) are manufactured with a reduced potential contact area. and DeVan 5. The studies which demonstrated percentage superiority of a given mold may have unknowingly expressed little more than a variation in potential contact area. and Geometric Porcelain 33 degree No definite conclusions (insufficient no. French. which is relatively worthless. of strokes b. (2) using molds with varying buccolingual widths. Trapozzano’6 6. Myerson-Sears. The other three studies employed either visual evaluation. a 20 degree mold of posterior teeth set in a relatively end-to-end relationship would be more effective than a 20 degree mold set with an exaggerated horizontal overlap. Tru Kusp. 20 degree. The variation in contact area need not be accomplished through selective grinding of the tooth surfaces. a. This is of particular importance when the mean variation attributed to the change in molds has been stated as being somewhere between 10 and 20 per cent. Hall.. TABLE IV. It may be affectled by : ( 1) increasing or decreasing the amount of horizontal overlap when arranging posterior teeth. Three of these studieseJ5.$s 10 Visual evaluation of debris Sieve analy:sis 3 to 28%1 4. Visual evaluation of debris Sic. In like manner.A COMPOSITE NO.13-17(Table IV). Bascom” 8 6 20 degree and Hall 33 degree. PayneI 2 1 5 Porcelain and acrylic resin 33 degree and flat plane 33 degree.

and Manly. Practitioner & D.: The Crushing Power and Masticating Area of the Teeth as the Foundations of Oral Hygienics. E. D. P. and Vinton. 12:4. 1946. 1957.: Dte Bedeutung des Kauaktes fur die Verdauung. No sound conclusions can be drawn in this area due to the vast number of uncontrollable variables. Res. and D. Yurkstas. Manly. V. 9 : 53-69. M. 1965 Evaluations of the performance of various posterior tooth molds have been either conflicting or inconclusive. S. DEN. 5 8: 9. 5. S.. Gelman. they did not vary proportionally. J. R.: Masticatory Efficiency of Complete Dentures. D. D. G. 45:318-319. 1962. DEN. K. : A Comparative Study of Posterior Occlusion.: The Masticatory Habits. DEN. Brit.: Value of Different Test Foods in Estimating Masticatory Ability. Cosmos 63:1278-1283. PROS. J. and Lazzari. 1937.: Masticatory Performance and Efficiency. J.: A Survey of the Chewing Ability of Denture Wearers. B. z: 4. DEN. 3:45-53.: Partial Dentures and the Restoration of Masticatory Efficiency. While these two factors varied directly. The great variation in the physiologic and psychologic capabilities of the individual tempers the technical aspects of the problem. J. Thompson. PROS. Den. PROS. Arch. Kydd. PROS. Trapozzano. 1950. Dahlberg. 1:38-48.. J. 17. R. C. Ztschr. Pros. S. Shokugo 2-3 : 129-144. J. A. 1:322- 14.. M. J. I. 1933. 15.: Comfort and Chewing Efficiency in Dentures. F.A. S. W. 1924. Cosmos 24:207-219. Res. 11.: The Chewing Power of Teeth. Physiol. J. May-June. S. Skand. 2:661-666. Res. E. Y.53-459. A..: An Experimental Study of the Testing of Occlusal Patterns on the Same Denture Bases. Paynesz6 IIIilStudy of Posterior Occlusion on Duplicate Dentures. : Testing of Occlusal Patterns on the Same Denture Base. 10. . PROS. J. 2&O-457.450 SUMMARY AND CONCLUSION LAMBRECHT J. 1952.1930. Christiansen. J. J. V. Payne. : Zur Kenntnis der Bedeutung des kauens fur Resorption.‘H. J. Seppae. R. J. 1959. R. ‘L. N. DEN. Bascoy%F W. D. 29 ~448-462. V. Physiol.A. D.D. 13: 1220-1232. D. 1952.: Masticatory Efficiency as Related to Cusp Form in Denture Prosthesis. Stomatol. J. Appl. L. 1951. This loss in performance emphasizes the fact that the potential contact area must be considered when evaluating the relative effectiveness of posterior tooth molds. and Braley. SERVICE Contact Areas in Human Dentition. 1950. 13. 30:314-321. Manly.: Quantifying Progress 2 :228-292. 18. Farrell. DEN. J. 57 : 159-242.: Relationship Between Mastication and Digestion and Absorption. Hara. Ono.. B. S. Record 7:375-379. D. 1951. 25:67-72. R. Trapozzano. 16. REFERENCES 1. and Bingham. U.. Schultz. W. This study has indicated that a reduction in the size of the potential contact area of artificial posterior teeth causes a loss in chewing effectiveness. 1929. 12. PROS. 1921. STATEN PUBLIC HEALTH ISLAND 4.