archives of oral biology 52 (2007) 1180–1185

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Mastication of model products in complete denture wearers

J.L. Veyrune a,b, C. Lassauzay a,b, E. Nicolas a,b,*, M.A. Peyron c, A. Woda a,b
a
Univ Clermont 1, UFR Odontologie EA3847, Clermont-Ferrand F-63000, France
b
CHU Clermont-Ferrand, Service d’Odontologie, Clermont-Ferrand F-63000, France
c
INRA, French National Institute for Agricultural Research, Saint-Genés-Champanelle F-63122, France

article info abstract

Article history: Objective: The aim of this study was to define the characteristics of muscular activity in
Accepted 27 April 2007 complete denture wearers and in dentate subjects during mastication of model foods
differing in hardness but similar in terms of rheologically properties.
Keywords: Material and methods: The foodstuffs used in this study were laboratory-developed gum-
Complete denture drops demonstrating viscoelastic properties. The test foods cover a range of four hardness
EMG levels. The group of complete denture wearers included 15 subjects, while the control group
Test food included 9 subjects with normal dentition. Electromyograph (EMG) recordings were taken
Mastication from the masseter and temporal muscles during mastication of the test foods. The results
were evaluated by one-way and two-way ANOVA followed by means comparisons using a
Student–Newman–Keuls post hoc test (a = 0.05).
Results: Preparing the same food bolus for swallowing required a greater number of mas-
ticatory cycles and a longer duration of mastication for complete denture wearers than for
dentate subjects. In addition, complete denture wearers failed to increase EMG activity per
cycle in response to hardness of the food.
Conclusion: Denture wearers experienced difficulties during mastication, as indicated by a
decreased masticatory rate and the observed failure to increase EMG activity per cycle in
response to increased food hardness. The increases in number of cycle and masticatory
duration appear to be a response to this impaired masticatory function.
# 2007 Elsevier Ltd. All rights reserved.

1. Introduction properties of foodstuffs, giving contrasting results. Veyrune

The main role of mastication is to transform foodstuffs into a
bolus that is fit for swallowing.1 Teeth and the neuromuscular
apparatus are directly involved in the crushing of foodstuffs
and consequently loss of teeth can be expected to lead to less
efficient mastication.2 Removable dentures only partially
restore functional mastication, especially when they are used
to replace a large number of teeth.3 Hence, masticatory
efficiency in complete denture wearers is less than half that of
dentate subjects.4–7 Several studies have explored the ability
of complete denture wearers to adapt to the rheological
and Mioche8 pointed to the lack of adaptation to an increased
hardness of meat, whereas Chauncey et al.9 described a
positive variation to the hardness of certain natural foods.
This discrepancy could be explained by the rheological
properties and texture of the test foods. The lack of adaptation
of mastication to an increased hardness of food observed in
Veyrune and Mioche’s study could result from the texture of
the meat samples, which may have overstretched the
masticatory capacity of complete denture wearers.10 Other
authors have used natural foods set on a graded scale to vary
food hardness. Hardness is not, however, a simple physical

* Corresponding author at: EA3847, Université d’Auvergne, Faculté de Chirurgie Dentaire, 11 Bd Charles de Gaulle, 63000 Clermont-Ferrand,
France. Tel.: +33 4 73 17 73 82; fax: +33 4 73 17 73 88.
E-mail address: emmanuel.nicolas@u-clermont1.fr (E. Nicolas).
0003–9969/$ – see front matter # 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.archoralbio.2007.04.016
 archives of oral biology 52 (2007) 1180–1185
variable. It interferes with many different rheological proper-
ties, such as elasticity, plasticity, toughness, viscosity or
brittleness.11–18 Viscoelastic model products with progres-
sively increasing hardness are a very useful tool, as demon-
strated by Peyron et al. and Lassauzay et al.10,16,17 The
rheological properties of these products remain reliable
whatever the hardness of the food samples, in contrast with
natural foods, such as meat, which vary significantly with
cooking conditions.
The aim of this work was to study complete denture
wearers’ adaptation to increased hardness by monitoring
masticatory patterns using electromyographic (EMG) activity.
Number of cycles, duration of the sequence of mastication,
masticatory rate and electrical activity produced per cycle and
per sequence were used as muscular variables to describe how
subjects adapt mastication to their dentition7,8 or to the
texture of the test food.17
2. Material and methods
The foodstuffs used in this study were laboratory-developed
gumdrops demonstrating viscoelastic but non-sticky proper-
ties.16,17 Range of hardness and reproducibility of properties
were controlled rheologically. Four food samples of identical
size and shape were produced (a cylinder of 1 cm height and
2 cm diameter). The food samples covered a range of
progressively increasing hardness levels (H1, H2, H3 and H4).
The variability (mean  S.D.) of the total muscular activity,
taken as the principal criterion and inferred from a previous
study, 19 was used to calculate the number of subjects
necessary for the study. It was calculated with a = 5% and
b = 5%. For a control group of 9 (5 males and 4 females,
64  5.63 years old), 15 complete denture wearers were needed
(8 males and 7 females, 68.7  7.34 years old).
Complete denture wearers were recruited from the
Clermont-Ferrand City Hospital Department of Dentistry for
inclusion in the study over a 12-month period. Subjects had to
state that they usually ate comfortably with their dentures.
The ridge resorption level was not considered. The prostheses
were more or less old models (average age of 3 years,
minimum: 1 year, maximum: 10 years). Subjects were
excluded from the study if they presented with salivation
problems, degenerative disease, diabetes, an allergy to one of
the ingredients in the test food or articular disease liable to
cause discomfort during mastication.
All subjects included in the control group presented a
normal dentition with at least 26 permanent teeth. Control
subjects were excluded from the study if they presented with
more than two missing teeth (excluding third molars), were
undergoing dental treatment, had a removable denture or
implant or displayed any one of the above exclusion criteria
given for complete denture wearers.
EMG recordings were taken from the masseter and
temporal muscles during mastication of the test foods.
Mastication recordings were taken from each subject in two
sessions scheduled 1 week apart on the same day and at the
same time. The first session acted as training for the subjects,
enabling them to familiarise themselves with the experi-
mental setting.17 During this first session, the experimenter
1181
informed the subjects of the protocol, explained the study
procedure and asked the subject to sign an informed consent
form. Bipolar surface electrodes were attached to the skin over
the right and left masseter muscles and anterior head of the
temporal muscles. A ground electrode was strapped around
the wrist. The signals were filtered between 0 and 1000 Hz
bandwidth and amplified 50-fold using a 511 model amplifier
(Grass Instruments, USA). Signals were then digitised using a
CED 1401 analogue-to-digital converter (Cambridge Electric
Design1). Sampling frequency was 1000 Hz. Data capture and
data management were performed using the Spike 21 soft-
ware package (Cambridge Electric Design1).
Once the electrodes were attached, the subjects sat
comfortably with their feet fully isolated from the floor by a
plastic footrest. As the gumdrops were coloured according to
their hardness, all subjects were asked to close their eyes while
the experimenter placed the food sample on the tongue so as to
prevent them from recognizing the food sample. The subjects
then had to close their mouth and teeth without contracting
their muscles, keeping the food sample between tongue and
palate. When prompted by the experimenter, the subjects
began masticating as naturally as possible. Each subject had to
decide which side they preferred and this side was used
throughout the experiment. Data acquisition continued until
the test food was completely swallowed. Subjects were allowed
to talk, drink and relax between recordings. Subjects were given
each of the four gumdrops three times in random order at each
recording session. Only the EMG data acquired during the
second session were included in the study for analysis.
The different steps of EMG analysis are described by Peyron
et al. and Lassauzay et al.16,17 Briefly, a programmed
calculation of variables was preceded by setting some
predetermined variables on the wave-rectified and integrated
signals. For example, the beginning and end of each chewing
burst were defined as an EMG signal reaching a level 10% above
or below the mean area relative to the baseline at 0 mV. Then,
a laboratory-developed script in Spike 2 language (Cambridge
Electric Design1) was used to extract the following variables:
number of cycles and total muscular activity (mV s). The sum
of the EMG activities produced by all four muscles during the
sequence, average muscular activity (mV s), was obtained by
dividing total muscular activity by number of cycles, duration
of mastication (s) and masticatory rate (cycles/s).
Statistical analysis was performed using the SPSS111.5
software package. After checking for equality of variance and
normal distribution curves, the results were evaluated by one-
way and two-way ANOVA followed by means comparisons
using a Student–Newman–Keuls post hoc test (a = 0.05).
3. Results
3.1. Masticatory adaptation in dentate subjects
In the dentate subjects, muscular activity was adapted to the
hardness of the test food. Food sample hardness had a
significant influence on number of cycles (F = 5, p < 0.01),
duration of mastication (F = 4, p < 0.01), total muscular activity
(F = 13, p < 0.001) and average muscular activity per cycle
(F = 6, p < 0.001). These variables increased significantly with
1182 archives of oral biology 52 (2007) 1180–1185

Table 1 – Mean values and standard deviation (S.D.) for the masticatory parameters corresponding to the four test food
hardnesses for the control group
Test food hardness Dentate group

Number of Duration of Total muscular Average muscular Masticating

cycles mastication (s) activity (mV s) activity (mV s) rate (Hz)

H1 27.96 (11.46) 21.82 (10.40) 18.34 (9.66) 0.67 (0.24) 1.33 (0.21)
H2 30.15 (13.88) 22.77 (10.87) 19.53 (7.99) 0.68 (0.20) 1.35 (0.24)
H3 38.52 (14.12) 29.47 (12.57) 31.85 (12.83) 0.85 (0.25) 1.34 (0.23)
H4 39.66 (15.81) 30.93 (13.75) 34.77 (16.35) 0.89 (0.26) 1.31 (0.19)

Mean values were calculated from 9 subjects and 3 replicates (n = 27) for all the variables.
The values represent mean (S.D.).

Table 2 – Mean values and standard deviation (S.D.) for the masticatory parameters corresponding to the four test food
hardnesses for the complete denture wearer group
Test food hardness Complete denture wearer group

Number of Duration of Total muscular Average muscular Masticating

cycles mastication (s) activity (mV s) activity (mV s) rate (Hz)

H1 35.97 (13.66) 30.00 (11.27) 27.99 (16.62) 0.82 (0.45) 1.21 (0.24)
H2 42.37 (15.37) 35.00 (12.69) 33.55 (20.98) 0.82 (0.46) 1.23 (0.22)
H3 53.94 (19.24) 42.61 (14.39) 51.44 (33.01) 1.02 (0.58) 1.27 (0.2)
H4 57.16 (20.79) 43.71 (14.01) 54.20 (33.17) 1.02 (0.56) 1.30 (0.2)

Mean values were calculated from 15 subjects and 3 replicates (n = 45) for all the variables.
The values represent mean (S.D.).

product hardness, leading to the identification of two clear
groups (H1–H2 and H3–H4). The mean values observed for the
different variables are given in Table 1. Masticatory rate
remained constant regardless of hardness level (since no
statistical difference was shown). We also noted a significant
inter-subject variation of masticatory rate (F = 74, p < 0.001).
Table 2. Average muscular activity per cycle and masticating
rate increased slightly with hardness, but no statistically
significant differences could be shown. There was also a
significant inter-subject variation (F = 25, p < 0.001).
3.3. Comparison of the two groups

3.2. Mastication variation in complete denture wearers
Number of cycles (F = 14, p < 0.001), duration of mastication
(F = 11, p < 0.001) and total muscular activity (F = 10, p < 0.001)
increased significantly with test food hardness, leading to the
identification of two clear groups (H1–H2 and H3–H4). The
mean values observed for the different variables are given in
The complete denture wearers undertook more masticatory
cycles with all the products. Dentate subjects performed an
average of 34 (S.D. 14.63) cycles whereas the average for
complete denture wearers was 47 (S.D. 19) (Fig. 1). Similarly,
duration of mastication was longer for complete denture
wearers (F = 46, p < 0.001). Duration of mastication and
number of masticatory cycles increased with hardness more

Fig. 1 – Examples of recordings obtained during mastication of the hardest test food: differences in masseter muscle activity
between a dentate subject (top) and a complete denture wearer (bottom). Note that during the last 10 s before deglutition,
the complete denture wearer showed less active mastication.
 archives of oral biology 52 (2007) 1180–1185
in denture wearers than in dentate subjects (Tables 1 and 2)
but this difference was significant only for the number of
cycles ( p < 0.05).
Masticatory rate was lower (F = 9, p < 0.01) in complete
denture wearers (Fig. 1) than in controls, at 1.253 cycles/s (S.D.
0.22) for complete denture wearers versus 1.333 cycles/s (S.D.
0.21) for dentate subjects. In both groups (dentate and denture
wearers), masticatory rate remained constant for all food
samples.
4. Discussion
Electrical activity recordings obtained from the masticatory
muscles provided a good indicator for studying patterns in a
masticatory sequence or in strategy used to masticate
different types of food. The most relevant muscular activity
indicators for studying the variation of mastication to
increased food hardness appeared to be number of masticat-
ing cycles and total EMG activity.8
Four limits of this study must be emphasised. Firstly,
comparing the absolute values of EMG recording between
complete denture wearers and dentate subjects may lead to
uncontrolled bias. Therefore, comparison of EMG activity per
cycle between the two groups was not performed. Secondly,
studying the EMG parameters did not give any indication
about the crushing of food, and masticatory efficiency needs to
be known before an overall understanding of the mastication
process could be achieved. Thirdly, the results only apply for
the rheological property (viscoelastic) characterising the
model food used in this study and other results may have
been reached with a plastic food model, for example ref. 18.
Fourthly, it is known that the jaw-closing muscles contribute
to the stability of complete dentures. Increased duration of
EMG burst during the occlusal phase20,21 and inter-burst
activities22 have been described during chewing of complete
denture wearers. However, because of our method of analysis,
only the bursting phase was analysed, whereas the inter-burst
and low level activities observed during the occlusal phase22
were not considered. Artificial foods, such as silicones present
sufficiently similar reproducible properties to be used in
masticatory efficiency tests23 as well as during EMG recordings
during chewing24. However, a full masticatory sequence
cannot be tracked since the products cannot be swallowed.
Natural foodstuffs present inconsistent rheological properties,
making it difficult to set reproducible and controllable
variables. In a previous study using meat as test food, some
meat textures and hardness overstretched the masticatory
capacity of complete denture wearers.8 Therefore, viscoelastic
model products with progressively increasing hardness con-
stitute a very useful tool, as demonstrated by Peyron et al. and
Lassauzay et al.16,17,19 Their rheological properties are con-
trollable, and they are able to be swallowed. Compression tests
applied to the test foods identified four different levels of
hardness. The hardness range obtained in this study appeared
to remain within the masticatory capacity of complete
denture wearers. In contrast to a report using meat as a test
food,8 none of the subjects in our study felt obliged to spit the
food sample out due to the fact that they were unable to break
it down sufficiently for swallowing. Thus, these test foods can
1183
be used to investigate levels of variation in complete denture
wearers. Moreover, duration of sequence did not exceed 1 min,
so remained within the limits described by Alajbeg et al. and
did not induce fatigue.25
In the same way as dentate subjects, complete denture
wearers are able to adapt their mastication to hardness of food
substance by increasing the number of cycles and duration of
masticatory sequence. This led to an increase in the number of
chewing cycles, duration of mastication sequence and EMG
activity per sequence, confirming preliminary data obtained
with natural foods26,27 or non-edible products28 Using model
foods, this study confirms that these adaptive changes are due
to hardness and not due to differences in the rheological
properties between foods. It has recently been emphasised
that comparing the hardness between natural foods may be
greatly misleading because natural foods are characterised
not only by hardness but also by complex rheological
properties. For example, change in food hardness led to a
change in the EMG parameters but change in rheological
characteristics from elastic to a plastic product modified the
cinematic parameters of mastication.18
Total muscular activity, duration of mastication and
number of masticatory cycles increased with hardness both
in denture wearer subjects and in their dentate counterparts,
but the number of masticatory cycles increased more with
hardness in denture wearers than in dentate subjects. This
increased number of cycle between dentate subjects and
complete denture wearers may correspond to an adaptation to
the limit of masticatory strength of the edentulous subjects. In
addition, the possibility that the average muscle activity per
cycle recorded in the edentulous group was overestimated
must be considered. In edentulous subjects, the lip, cheek and
tongue muscles may play an important role in stabilising the
dentures. The observed increase in global muscular activity
(temporalis and masseter) may have been caused by
unwanted recordings from muscles innervated by the facial
nerve. The same increase was, however, observed in the
temporal muscle, which is located relatively far from the
muscles involved in denture stabilisation. The jaw-closing
muscles also contribute to the stabilisation of the denture,29,30
and it may be hypothesised that this applies more specifically
to the masseter and the temporalis muscles controlateral to
the bolus side. However, this was not confirmed by EMG
recordings which showed similar or even more activities in the
ipsilateral side.7 A recent study has shown a time-dependent
change in amplitude of muscle activity following the place-
ment of a new full denture.31 The EMG activities derived from
the elevator muscles were initially similar in the two sides,
whereas after 3 months EMG activity was higher in the
ipsilateral side, as is the case in dentate subjects.16,8
Again, a corresponding increase in the occlusal phase
duration could account for a possible overestimation of total
EMG activity developed for comminution of food.21,22,30
Although somewhat speculative, it is also possible that
limitation of the muscle activity was due to the somewhat
atrophic state of the masticatory muscles of edentulous
subjects that has been demonstrated32 by computed tomo-
graphy. Following this hypothesis, inside a given muscle, the
active fraction of motor units may be greater in complete
denture wearers, and the muscles of denture wearers may
1184 archives of oral biology 52 (2007) 1180–1185
work nearer to the maximal bite force during mastication.
Therefore, this greater number of active motor units and total
EMG activity may not be necessarily associated with the
intensity of bite force.33,34 It has recently been shown that
edentulous subjects have to use higher potentials of muscle
activity (% of maximal voluntary contraction) than age-
matched dentate subjects.25
Previous studies have shown that complete denture
wearers presented both lower masticatory efficiency and
lower bite force than dentate subjects.35,6 Our results showed
that complete denture wearers masticated longer, with more
cycles than dentate subjects. However, the results obtained
with granulometry of the food boluses made by denture
wearers36,37 indicated that the increased chewing activity does
not lead to a better comminution of food bolus. Therefore, the
increased number of cycles does not prevent a decrease in
performance in complete denture wearers.
It was suggested that cycle frequency is a good criterion for
evaluating masticatory health.38 In this study, masticatory
rate was lower in complete denture wearers than in dentate
subjects. This could be explained by the fact that, during
mastication, the dentures are separated from their foundation
due to forces exerted unilaterally on the occlusal surfaces. As
each cycle is completed, the occlusion reposits the denture
bases on the foundations, regenerating the salivary film
required for the adhesion of the dentures.
The lower masticatory rate observed in complete denture
wearers is not due to a longer occlusion phase. Several
studies26,39,40 have dealt with the movement patterns of the
mandible during mastication, comparing dentate and edentu-
lous groups. The duration of the opening and closing phases
was longer in denture wearer group, whereas the occlusion
phase was never longer. The shortened vertical displacement
and the slowed velocity of the opening and closing phases
probably corresponded to the same denture stabilisation need.
Moreover, the effect of dental state on the movement and the
velocity of the mandible appeared to weaken with advancing
age. These differences between chewing performed with
natural or artificial dentitions were less visible with the elderly
subjects (mean age 80 years) studied by Karlsson et al.40 Finally,
the closing phase appears to be the critical kinematic parameter
differentiating denture wearers from dentate subjects.26,40,39
This may be linked to the proposal of Neill et al., who
suggested that the decreased applied load seen in denture
wearers is to some extent compensated by an increase of the
loading time during the closing phase 41. Similarly, the cycle
duration decrease observed in edentates after rehabilitation
with implants could be attributed to the stabilisation of the
occlusion provided by the fixed mandible denture42.
It is also possible that the destabilising forces produced by
the texture of the bolus and which mobilise the denture base
can cause pain through mucosal damage. Thus, complete
denture wearers may adopt a ‘safer’ mastication cycle with a
dual aim of stabilising their dentures and avoiding pain43 It
has been recently pointed out that a decreased masticatory
rate could be a good predictor of an impaired mastication.44
Indeed, the food boluses produced by edentulous subjects are
not as well prepared as they are in normal dentate subjects.44
In conclusion, denture wearers showed a greater increase
in duration of mastication with hardness than dentate
subjects. In addition, complete denture wearers failed to
increase EMG activity per cycle in response to hardness of the
food. This, together with the general increase in number of
cycles and masticatory duration and a decreased masticatory
rate indicates that denture wearers experience difficulties
during mastication. Further investigations should be carried
out in order to adapt diet texture for complete denture
wearers.
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