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ABSTRACT INTRODUCTION
It has been suggested that the provision of dental The provision of dental implants to subjects with severely resorbed
implants can improve the oral function of subjects I mandibles significantly improves subjective oral function. Subjects with
with severely resorbed mandibles, possibly dental implants have fewer complaints, feel more satisfied, and rate their
restoring function to the level experienced by chewing comfort and ability more highly (Lindquist and Carlsson, 1985;
satisfied wearers of conventional complete Boerrigter et al., 1995; Geertman et al., 1996a,b; Kapur et al., 1998; Meijer
dentures. Nevertheless, a quantitative comparison et al., 1999). Also, objective oral function improves after treatment with oral
has never been made and can be drawn from the implants, as can be seen from an increased bite force and masticatory
literature only with difficulty, since studies differ function (Lindquist and Carlsson, 1985; Haraldson et al., 1988; Geertman et
greatly in methodology. To make such a al., 1994; Fontijn-Tekamp et al., 1998; Pera et al., 1998). According to
comparison, we measured bite force and chewing Lindquist and Carlsson (1982, 1985) and Haraldson et al. (1988), the
efficiency by using identical methods in subjects improvement in objective function seems to depend on the type of implant
with overdentures, complete full dentures, and support for the mandibular denture. However, more recent studies revealed
natural dentitions. Our results indicated that bite no such differences, either for chewing efficiency (Geertman et al., 1994) or
forces achieved with overdentures on dental for unilateral and bilateral bite force (Fontijn-Tekamp et al., 1998).
implants were between those achieved with It has been suggested that the provision of dental implants to subjects with
artificial and natural dentitions. Chewing severely resorbed mandibles can restore objective oral function to the level
efficiency was significantly greater than that of experienced by satisfied wearers of conventional full dentures (Geertman et
subjects with full dentures (low mandible), but al., 1994). We must emphasize, however, that a comparative quantification of
was still lower than that of subjects with full such improvement has never been made and cannot be drawn from the
dentures (high mandible) and overdentures on literature, since available studies are difficult to compare, because of variations
bare roots. Differences in the height of the in the study design (the age of the population studied, the male-to-female
mandible revealed significant differences in ratio), outcome measures used, clinical setting in which the implant therapy
chewing efficiency between the two full-denture was provided, oral status of subjects included, and the type of implant therapy
groups. Furthermore, subjects with a shortened provided (Locker, 1998). To obtain outcome measures, chewing efficiency
dental arch exerted bite forces similar to those of tests and bite force measurements are performed amongst other tests. In the
subjects with a complete-natural dentition, but chewing efficiency tests, the types of test foods (natural foods, e.g., peanuts,
their chewing efficiency was limited due to the carrots, almonds, gummy bears, and gelatin, or artificial test foods such as
reduced occlusal area. For all groups combined, a Optosil, Optocal, and Cutter Sil) vary, as do the amounts of test foods, the
significant correlation was found between sieving method, and the methods for analysis of the results can be used (van
maximum bite force and chewing efficiency. der Bilt et al., 1993a). For evaluating the bite force, several equipment designs
Nearly half of the variation in chewing efficiency can be used (see Fontijn-Tekamp et al., 1998).
was explained by bite force alone. In view of the above, the aim of the current study was to compare,
quantitatively, the oral function of three groups of subjects with (a)
KEY WORDS: chewing efficiency, bite force, overdentures, (b) full dentures, and (c) natural dentitions. Furthermore, we
dental implants, (over)dentures, dentate. investigated correlations between maximum bite forces and chewing efficiency.
In addition, we inclusded a group of younger subjects with a complete-natural
dentition to provide information about more optimal oral function.