Prosthodont Res Pract 4 :9 -15, 2005

Original Research

Reproducibility and Accuracy in Measuring Masticatory

Performance Using Test Gummy Jelly
Ikebe Kazunori, DDS, PhD, Morii Kentaro, DDS, PhD, Matsuda Ken-ichi, DDS,
Hazeyama Tomohiro, DDS and Nokubi Takashi, DDS, PhD

Division of Oromaxillofacial Regeneration,

Osaka University Graduate School of Dentistry
(Chief：Prof. Nokubi Takashi)

Clinical significance
A reliable assessment of masticatory performance would be a valuable contribution to the practice of evidence-
based dentistry. A method of measuring masticatory performance using the glucose concentration from test
gummy jelly simplified the procedure, reduced the time involved, and provided accurate and reproducible
feedback for assessing masticatory ability.

ABSTRACT
：To establish a simpler and more accurate method of measuring masticatory ability in routine
dental practice compared to current methods.
：To find the most suitable conditions for assessing masticatory performance
using the test gummy jelly,variable factors were investigated,such as temperature and length of rinse
time in water,temperature of distilled water,and dissolution time of glucose. The accuracy of this test
was confirmed by correlating the surface area of the jelly and the glucose concentration. A student s
t-test or ANOVA was used for statistical analysis at the 5% level of significance. The Bonferroni
method was used for multiple comparisons.
：The glucose concentration decreased gradually (p＜0.05) as the rinsing time increased but
tended to remain unchanged at 30seconds or more. As the temperature of the distilled water for
dissolving the glucose or the dissolution time increased,the glucose concentration constantly increased
(p＜0.05). A linear regression analysis showed that the concentration of glucose had a significantly
high correlation to the surface area (mm ) of the comminuted jelly (r＝0.993, p＜0.01).
：The concentration of glucose dissolved from the comminuted particles of the test gummy
jelly indicated high reproducibility and accuracy when the rinsing time, temperature of the distilled
water, and dissolution time of the glucose were strictly prescribed.

Key words
masticatory performance, test gummy jelly, glucose, reproducibility, accuracy
Corresponding author：Ikebe Kazunori
1-8, Yamadaoka, Suita, Osaka 565-0871, Japan
Tel：＋81-6-6879-2956, Fax：＋81-6-6879-2957
E-mail：ikebe＠dent.osaka-u.ac.jp
Received on February 1, 2005/Accepted on March 10, 2005

9
 10 Prosthodont Res Pract VOL.4 NO.1（2005)
INTRODUCTION
The primary purpose of prosthodontic treat-
ment is not only to restore dental and periodontal
structures, but also to achieve acceptable mas-
ticatory function . Accordingly,establishment
of an objective evaluation of masticatory ability
is indispensable for pre-and post-prosthetic treat-
ment.
The aim of mastication is to comminute food
and to increase the surface area of the food to
promote proper digestion and absorption ofnutri-
ents. There are several objective measures of
masticatory function,such as masticatory perfor-
mance, masticatory efficiency, swallowing
threshold and occlusal force . The most com-
mon technique for qualifying chewed food has
been to measure particle size distribution with a
series of mesh sieves . A sieve method using
peanuts was developed in 1950 and has been
used until recently . Both real foods,including
peanuts or carrots , and artificial materials,
such as gelatin or silicone ,have been used
to measure masticatory performance. Finding a
universally accepted test food or material has
been difficult and is still unresolved. Therefore,
new methods are being introduced to simplify the
procedure, reduce the time involved in testing,
and provide more relevant measures for assess-
ing masticatory function .
Yamamoto developed an assessment of mas-
ticatory performance using the test gummy
jelly test method of evaluating the surface area
of the comminuted jelly from the dissolved gela-
tin concentration. This method offers consider-
able advantages such as speed, accuracy and
hygiene, compared to the sieve method of analy-
sis. However,to measure the gelatin concentra-
tion,a specific laboratory setting with a spectro-
photometer and more than 40minutes drying
time is necessary. Therefore, it is difficult to
obtain results in the usual clinical environment.
The purpose of this study was to establish a
simpler and more accurate method of measuring
masticatory ability in routine dental practice
compared to conventional methods.
MATERIALS AND METHODS
Reproducibility of M easurements
Masticatory performance was evaluated by
measuring the increase in the surface area (mm )
of the expectorated pieces of comminuted jelly
(Fig.1). Subjects were instructed to chew one
block of the jelly (10×10×20mm) at their own
pace on their preferred chewing side (left, right
or both) and to expectorate the bolus of the
comminuted jelly as thoroughly as possible onto
a sheet of gauze (Fig.2). The collected parti-
cles of the comminuted jelly were rinsed with
running water to remove the saliva. Then the
particles were soaked in 15ml of distilled water
and stirred. The supernatant fluid of the solu-
tion was sampled, and the concentration of dis-
solved glucose from the jelly was measured with
a blood glucose meter (Glutest, Sanwa Kagaku
Kenkyusho, Nagoya, Japan) intended for home
use by diabetic patients (Fig.3).
To find the most suitable condition for asses-
sing masticatory performance using test gummy
jelly, variable factors were investigated, such as
Subject chews one block of gummy jelly
Comminuted jelly is rinsed with running water
Distilled water with the comminuted jelly is stirred
Supernatant is sampled, and
concentration of glucose (mg/dl) measured
Increase of surface area (mm ) is calculated
Fig. Procedure for measuring masticatory perfor-
mance using the test gummy jelly
 M easuring Masticatory Performance Using Test Gummy Jelly 11

Fig. Chewing one block of the test gummy jelly

1）One block of the jelly is chewed using 30 strokes
2）Particles of the jelly are collected
3）Particles are rinsed in running water
4）Original and comminuted test gummy jelly

Fig. Measuring glucose concentrations with blood glucose meter

1）Particles of the comminuted test gummy jelly were soaked in distilled water and stirred
2）The measuring tip is inserted into the blood glucose meter（Glutest ）
3）The supernatant fluid is touched with the tip
4）The meter displays the concentration of glucose（mg/dl）
 12 Prosthodont Res Pract VOL.4 NO.1（2005)
Fig. The test gummy jelly is divided into equal portions
the temperature and length of rinsing time, tem-
perature of the distilled water, and dissolution
time of the glucose.
The preliminary conditions were defined as
follows：the temperature of the water used to
rinse the particles of jelly was 18℃；the rinsing
time was 30seconds；the temperature of the
distilled water for dissolution was 35℃；and the
dissolution time was 20seconds. One of these
variable factors was changed during each test,
and then the concentration of glucose was mea-
sured and compared for each condition.
Five jellies were used for each condition,and
the glucose concentration was measured once for
each sample. The statistical analysis was per-
formed using a student s t-test or ANOVA at the
5% level of significance. The Bonferroni
method was used for multiple comparisons. The
data analyses were done using the SPSS 12.0for
Windows（SPSS Inc., Chicago, USA).
Accuracy of the Examination
The accuracy of this test was confirmed by
correlating the surface area of the jelly and the
glucose concentration.
The original form of the test gummy jelly
（20×20×10mm；surface area：1,600mm ) was
divided to make surface areas totaling 2,000,
2,400, 3,200, 4,000, and 4,800mm (Fig.4), and
then the glucose concentrations dissolved from
the divided jellies were measured. A linear
regression analysis of the total surface area of
the divided jelly (mm ) and the glucose concen-
tration (mg/dl) was subsequently conducted.
The glucose concentrations were measured from
five jellies for each surface area. The increase
in the surface area, which indicated masticatory
performance, was calculated by subtracting the
original surface area (1,600mm ) from the total
surface area of the divided jelly.
RESULTS
The glucose concentration was not signifi-
cantly different between the 18℃ and the 40℃
rinse water conditions (Fig.5). However,as the
rinsing time increased,the glucose concentration
decreased gradually and tended to remain un-
changed at 30sec. or more (Fig.6). After a
rinsing time of 20sec., the glucose concentration
was significantly higher than after rinsing times
of 30, 40or 60seconds. On the other hand,there
was no significant difference in the glucose con-
centration after rinsing times of 30, 40 and 60
 M easuring Masticatory Performance Using Test Gummy Jelly
Fig. Influence of rinse water temperature on concen-
tration of glucose
Rinsing time for the comminuted jelly was 30
seconds；dissolution temperature was 35℃；
dissolution time was 20 seconds
Fig. Influence of rinsing time on glucose concen-
tration
seconds.
As the temperature of the distilled water
used to dissolve the glucose increased, the glu-
cose concentration increased constantly (Fig.7).
There were significant differences in the glucose
concentration between a dissolution temperature
of 35℃ and of 30 or 40℃. The glucose concen-
tration exceeded the measurable range when
distilled water of 50℃ was used. As the dissolu-
tion time lengthened, the glucose concentration
13
Fig. Influence of temperature of distilled water
for dissolution on glucose concentration
Fig. Influence of dissolution time on glucose
concentration
increased constantly (Fig.8). The standard
deviation for the glucose concentration after
dissolution of 10seconds was larger than for
longer periods.
The linear regression analysis showed that
the concentration of glucose had a significantly
high correlation with the surface area (mm ) of
the comminuted jelly (r＝0.993,p＜0.001,Fig.9).
DISCUSSION
It is recognized that a reliable assessment of
 14 Prosthodont Res Pract VOL.4 NO.1（2005)
Fig. Relationship between increase in surface area
（mm ) of test gummy jelly and glucose concen-
tration
masticatory performance may be a valuable con-
tribution to the practice of evidence-based den-
tistry . Objective evaluations of masticatory
performance have usually involved subjects
chewing sample food, and then the particle size
distribution of comminuted food was measured
with a series of mesh sieves. However, most of
these measurement methods are complicated,and
therefore, assessment is difficult during routine
chair-side work. In addition, reproducibility of
these sieving methods to determine particle
breakdown is poor and prone to experimental
error due to the complicated procedures . cose concentration unstable or too low to mea-
We have been utilizing test gummy jellies as
food for assessment of masticatory performance
since 1993 . Evaluation using the jelly is based
on the calculation of the surface area increased
by chewing, which was obtained by measuring
the concentration of the glucose dissolved from
the jelly. Previously, absorptiometry was used
to assess the quantity of gelatin extracted from
the jelly. However, the absorbance meter was
large and expensive, and the total measurement
time took more than one hour,which is too long
for clinical use. To solve these problems, a
relatively cheaper and smaller commercially
available blood glucose meter was selected for
this study.
The test gummy jelly to be examined after
comminution was rinsed to remove the saliva,
including glucose,which adhered during mastica-
tion. The temperatures of the running water
tested were 18℃, which was cool enough to pre-
vent the dissolution of the glucose, and 40℃,
which was higher than the maximum room tem-
perature of the clinic. It was found that the
temperature of the running water did not signifi-
cantly affect the concentration of the dissolved
glucose, indicating that the surface area of the
jelly had not changed up to 40℃. As the rinsing
time increased, the glucose concentration de-
creased gradually and finally stabilized,suggest-
ing that the saliva was thoroughly removed in 30
seconds. In other words,the glucose that adher-
ed during mastication might remain if the rinsing
time was less than 30seconds, in which case the
surface area might be overestimated. There-
fore, the jelly should be rinsed for more than 30
seconds to obtain an accurate value.
The concentration of glucose dissolved from
the jelly depended on both the temperature of the
distilled water and the dissolution time. A disso-
lution time of less than 20seconds or a dissolu-
tion temperature lower than 30℃ made the glu-
sure using a blood glucose meter,probably due to
technical error. Therefore, in order to obtain
accurate and reproducible data, the temperature
and the dissolution time should be watched care-
fully.
Yamamoto already reported that the con-
centration of gelatin dissolved from the test
gummy jelly correlated closely to the number of
masticatory cycles. With respect to accuracy,
the regression analysis showed that the glucose
concentration and the surface area of the jelly,
which involved the physiological significance of
mastication,had a strong linear correlation,sug-
gesting this assessment could precisely calculate
the masticatory performance.
 M easuring Masticatory Performance Using Test Gummy Jelly
CONCLUSIONS
1. The concentration of glucose dissolved
from comminuted particles of the test gummy
jelly indicated high reproducibility when the rins-
ing time, temperature of the distilled water, and
dissolution time of the glucose were strictly pre-
scribed.
2. The increase in the surface area of the
comminuted test gummy jelly particles was accu-
rately calculated from the glucose concentration
dissolved from the jelly.
Acknowledgments：The authors greatly appreciated
the grammatical correction of the manuscript by Joanne
M adsen, M .A. This research was partially supported by
a Grant of Health and Labour Science Research,Compre-
hensive Research on Ageing and Health, Tokyo, Japan
（H 15-longevity-002).
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