Journal of
Oral Rehabilitation
Journal of Oral Rehabilitation 2014 41; 624--629
Maximum bite force following unilateral implant-supported prosthetic treatment: within-subject comparison to opposite dentate side M. K. AL-OMIRI*, M. G. SGHAIREEN†, M. M. ALHIJAWI‡, I. A. ALZOUBI§, C . D . L Y N C H ¶ & E . L Y N C H * * *Faculty of Dentistry, University of Jordan, Amman, Jordan, †Faculty of
Dentistry,
‡
Department of Prosthetic Dentistry, Aljouf University, Sakaka, KSA, Department of Dentistry, Ministry of Health, Amman, Jordan, §
Faculty of Dentistry, Aljouf University, Sakaka, KSA, ¶School of Dentistry, College of Biomedical and Life Sciences, Cardiff University,
Cardiff, and **Warwick Dentistry, Warwick Medical School, University of Warwick, Coventry, UK
Bite force is a significant component of chewing and masticatory function. The literature lacks studies that compare bite force values of implant-supported fixed bridges to natural dentition within same subjects. The objective of the study was to assess maximum occlusal bite force (MBF) among patients with an implantsupported fixed prosthesis and compare it to their opposite dentate side and also to determine the effect of gender, age and Body Mass Index (BMI) on maximum occlusal bite force. Forty patients (20 males and 20 females, mean age = 427 96 years) with an implant-supported fixed prosthetic rehabilitation on one side and dentate on the other side were recruited into this study. Participants’ MBF were measured bilaterally at the first molar region using a digital hydraulic occlusal force gauge (GM10). The measurements were repeated three times (with 45 s intervals between times) for each SUMMARY
Introduction Bite force is a significant component of chewing and masticatory function. Measurement of bite force helps in the assessment of masticatory muscles function and allows researchers to compare muscle activity between subjects under different experimental conditions. Several devices were used to directly measure bite force including the bite fork (1–3), strain gauge transducers (4–6), foil transducers (7, 8), pressurised rub© 2014 John Wiley & Sons Ltd
side, and the highest value of the bite force (MBF) was recorded for each side. The mean MBF was 5779 N at the implant-supported prosthesis side and 5951 N at the dentate side. The average MBF was higher at the dentulous side (P < 005). Maximum occlusal bite force was higher in males and participants with higher weight and height. However, BMI was not significantly related to MBF values. Maximum occlusal bite force values at the dentate side were slightly (3%) but significantly higher than MBF at implant-supported prosthesis side. Males, taller patients and patients with higher weights had higher MBF values. Body mass index was not significantly related to MBF values. KEYWORDS: bite force, bite gauge, bite force recording devices, implant-supported prosthesis Accepted for publication 23 March 2014
ber tube (9), gnatho-dynamometer (10), pressure sensitive sheets (11, 12), force sensing resistors (13) and portable hydraulic pressure gauges (14, 15). Bite force has been reported to be different among different populations (15–17). Urban people were found to have lower bite force to those living in rural environments (16). For example, a population of Eskimos were able to produce a mean bite force of about 1500 N (16), while the bite force among Western people was about 600–750 N (17). doi: 10.1111/joor.12174
MAXIMUM BITE FORCE IN IMPLANT-SUPPORTED PROSTHESIS The wide range of maximum bite force values reported in different studies can be attributed to individual or technique-related factors. Technique-related factors include location of measuring device on dentition, interocclusal spacing and head posture at the time of measurement (15). On the other hand, individual-related factors include physical characteristics or craniofacial morphology. Shiau and Wang (18) concluded that the bite force increased with age, height and weight. Also, Abu Alhaija et al. (15) reported a statistically significant positive correlation between body mass index (BMI) and bite force. Nevertheless, Braun et al. (9) reported a low correlation between bite force and body variables. Furthermore, gender differences were also highlighted in the literature, and bite force values were reported to be significantly higher in males than in females (2, 15, 19–22). In addition, many researchers investigated the relationship between bite force and craniofacial morphology, and bite force values were reported to be higher in long-faced adults than in short-faced adults (7, 15, 23, 24). Among the potential factors that can affect the values of maximum bite force is individuals’ dental status. It was found that fully dentate individuals had the highest maximum bite force values when compared to individuals with complete dentures, removable partial dentures or fixed partial dentures (25). Moreover, Fontijn-Tekamp et al. (26) found that individuals with implant-supported overdentures had significantly higher maximum bite force values than individuals with root-retained overdentures or complete dentures. Nevertheless, fully dentate individuals had the highest maximum bite force values (26). The literature lacks studies that compare bite force values of implant-supported fixed bridges to natural dentition within same and different subjects. This provoked the conduction of this study which aimed to assess maximum occlusal bite force (MBF) among patients with fitted implant-supported fixed prosthesis and compare it to their opposite dentulous side. Also, the study aimed to determine the relationship between maximum occlusal bite force and gender, age and BMI.
Materials and methods The study was ethically approved by the research committee (35/1434) for the human studies at Aljouf © 2014 John Wiley & Sons Ltd
University, Saudi Arabia. Each participant was provided with a full explanation of the study, and a written confirmed consent was obtained from each participant before being recruited into the study. One hundred and thirty-five patients who attended the prosthodontic clinics, Aljouf University, Saudi Arabia, were screened. Inclusion criteria were the following: participants should have unilateral Kennedy class II modification 0 edentulous area with missing second premolar, first molar and second molar. The edentulous area should be replaced by a fixed prosthesis that replaced the above missing teeth and supported by two implants at the sites of the missing second premolar and second molar, and opposed by natural teeth. The implant-supported prosthesis should be successful and fitted for no
Oral Rehabilitation
Journal of Oral Rehabilitation 2014 41; 624--629
Maximum bite force following unilateral implant-supported prosthetic treatment: within-subject comparison to opposite dentate side M. K. AL-OMIRI*, M. G. SGHAIREEN†, M. M. ALHIJAWI‡, I. A. ALZOUBI§, C . D . L Y N C H ¶ & E . L Y N C H * * *Faculty of Dentistry, University of Jordan, Amman, Jordan, †Faculty of
Dentistry,
‡
Department of Prosthetic Dentistry, Aljouf University, Sakaka, KSA, Department of Dentistry, Ministry of Health, Amman, Jordan, §
Faculty of Dentistry, Aljouf University, Sakaka, KSA, ¶School of Dentistry, College of Biomedical and Life Sciences, Cardiff University,
Cardiff, and **Warwick Dentistry, Warwick Medical School, University of Warwick, Coventry, UK
Bite force is a significant component of chewing and masticatory function. The literature lacks studies that compare bite force values of implant-supported fixed bridges to natural dentition within same subjects. The objective of the study was to assess maximum occlusal bite force (MBF) among patients with an implantsupported fixed prosthesis and compare it to their opposite dentate side and also to determine the effect of gender, age and Body Mass Index (BMI) on maximum occlusal bite force. Forty patients (20 males and 20 females, mean age = 427 96 years) with an implant-supported fixed prosthetic rehabilitation on one side and dentate on the other side were recruited into this study. Participants’ MBF were measured bilaterally at the first molar region using a digital hydraulic occlusal force gauge (GM10). The measurements were repeated three times (with 45 s intervals between times) for each SUMMARY
Introduction Bite force is a significant component of chewing and masticatory function. Measurement of bite force helps in the assessment of masticatory muscles function and allows researchers to compare muscle activity between subjects under different experimental conditions. Several devices were used to directly measure bite force including the bite fork (1–3), strain gauge transducers (4–6), foil transducers (7, 8), pressurised rub© 2014 John Wiley & Sons Ltd
side, and the highest value of the bite force (MBF) was recorded for each side. The mean MBF was 5779 N at the implant-supported prosthesis side and 5951 N at the dentate side. The average MBF was higher at the dentulous side (P < 005). Maximum occlusal bite force was higher in males and participants with higher weight and height. However, BMI was not significantly related to MBF values. Maximum occlusal bite force values at the dentate side were slightly (3%) but significantly higher than MBF at implant-supported prosthesis side. Males, taller patients and patients with higher weights had higher MBF values. Body mass index was not significantly related to MBF values. KEYWORDS: bite force, bite gauge, bite force recording devices, implant-supported prosthesis Accepted for publication 23 March 2014
ber tube (9), gnatho-dynamometer (10), pressure sensitive sheets (11, 12), force sensing resistors (13) and portable hydraulic pressure gauges (14, 15). Bite force has been reported to be different among different populations (15–17). Urban people were found to have lower bite force to those living in rural environments (16). For example, a population of Eskimos were able to produce a mean bite force of about 1500 N (16), while the bite force among Western people was about 600–750 N (17). doi: 10.1111/joor.12174
MAXIMUM BITE FORCE IN IMPLANT-SUPPORTED PROSTHESIS The wide range of maximum bite force values reported in different studies can be attributed to individual or technique-related factors. Technique-related factors include location of measuring device on dentition, interocclusal spacing and head posture at the time of measurement (15). On the other hand, individual-related factors include physical characteristics or craniofacial morphology. Shiau and Wang (18) concluded that the bite force increased with age, height and weight. Also, Abu Alhaija et al. (15) reported a statistically significant positive correlation between body mass index (BMI) and bite force. Nevertheless, Braun et al. (9) reported a low correlation between bite force and body variables. Furthermore, gender differences were also highlighted in the literature, and bite force values were reported to be significantly higher in males than in females (2, 15, 19–22). In addition, many researchers investigated the relationship between bite force and craniofacial morphology, and bite force values were reported to be higher in long-faced adults than in short-faced adults (7, 15, 23, 24). Among the potential factors that can affect the values of maximum bite force is individuals’ dental status. It was found that fully dentate individuals had the highest maximum bite force values when compared to individuals with complete dentures, removable partial dentures or fixed partial dentures (25). Moreover, Fontijn-Tekamp et al. (26) found that individuals with implant-supported overdentures had significantly higher maximum bite force values than individuals with root-retained overdentures or complete dentures. Nevertheless, fully dentate individuals had the highest maximum bite force values (26). The literature lacks studies that compare bite force values of implant-supported fixed bridges to natural dentition within same and different subjects. This provoked the conduction of this study which aimed to assess maximum occlusal bite force (MBF) among patients with fitted implant-supported fixed prosthesis and compare it to their opposite dentulous side. Also, the study aimed to determine the relationship between maximum occlusal bite force and gender, age and BMI.
Materials and methods The study was ethically approved by the research committee (35/1434) for the human studies at Aljouf © 2014 John Wiley & Sons Ltd
University, Saudi Arabia. Each participant was provided with a full explanation of the study, and a written confirmed consent was obtained from each participant before being recruited into the study. One hundred and thirty-five patients who attended the prosthodontic clinics, Aljouf University, Saudi Arabia, were screened. Inclusion criteria were the following: participants should have unilateral Kennedy class II modification 0 edentulous area with missing second premolar, first molar and second molar. The edentulous area should be replaced by a fixed prosthesis that replaced the above missing teeth and supported by two implants at the sites of the missing second premolar and second molar, and opposed by natural teeth. The implant-supported prosthesis should be successful and fitted for no
