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Comparison of Masticatory Function of Symptomatic Patients and Control Subjects
Abstract
Mastication (chewing) is a frequently ignored aspect of occlusal function. Cosmetic factors have traditionally outweighed function because appearance is what patients are most aware of, and often request smile improvements. Although damaged teeth are routinely restored with crowns or replaced with implants, much less emphasis is placed upon evaluating a patient's functional improvements from any rendered occlusal therapy. The complexity of masticatory system has been confounding, defeating most efforts to sort out what is good mastication from poor mastication. Most chewing performance evaluations measured particle size changes from chewing, which are somewhat interesting but do not provide clinically relevant assessments of chewing muscular performance or chewing motion mechanics. Whereas the implementation of the biometrically derived normal average chewing pattern (ACP) and the normal average chewing cycle (ACC) establishes a clinically applicable baseline for evaluating masticatory function. The ACP reveals the average shape, timing, variability, and smoothness of an individual's chewing movements, while the ACC reveals the muscular hierarchy, any muscular variability, the presence within the chewing stroke of problematic occlusal contacts that induce muscular silent periods (SP), and the masseter and temporalis muscles' timing during the bolus crush. These measurements can then categorize chewing as Type I (normal movements with normal muscle activity), Type II (normal movements with dysfunctional or adapted muscle activity), and Type III (abnormal movements and dysfunctional or adapted muscle activity). Rarely is a Type IV mastication encountered (abnormal movements with normal muscle function), but it can also be observed. Therefore, the Specific Aims of this chapter are to describe the ACP and the ACC in detail, to illustrate examples of healthy Type I patients, well-adapted Type II patients, and compromised Type III patients, and to illustrate that measured mastication improvements can be an excellent outcome parameter following dental therapeutic interventions.
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