Digital method of chewing efficiency analysis in the orthopedic dentistry clinic

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Introduction

It is known that the general somatic status of the body largely affects the functional state of the dental apparatus [1]. The oral cavity is the initial section of the digestive tract and has a direct impact on the quality of human life. The condition and number of teeth in the oral cavity play an important role not only in the functioning of the gastrointestinal tract, but also in the appearance and harmonious structure of the maxillofacial area [2].

The loss of teeth and the lack of timely orthopaedic treatment lead to digestive disorders. The inability to form an adequate food bolus can disrupt the digestive process and cause diseases of the gastrointestinal tract. Moreover, changes in the position of the mandible caused by tooth loss or inadequate dental treatment can lead to temporomandibular joint pathology. These disorders can cause not only physical discomfort but also worsen the overall quality of life, emotional state, and interpersonal communication of patients [3–4].

Timely orthopaedic dental treatment will help to avoid complications. Various subjective and objective methods for assessing the functioning of the dental apparatus exist for the adequate rehabilitation of the patient and to assess the quality of restoration of compensated defects and chewing function [5]. Objective methods for assessing chewing efficiency include static, dynamic, and digital chewing tests [6].

Static methods for determining chewing efficiency are still used during medical examinations for military service, but despite their simplicity, they cannot adequately assess the functional and dynamic aspects of the dentofacial apparatus [7]. The use of various types of dynamic chewing tests is becoming an integral part of modern dental practice, as they allow dentists to assess chewing efficiency and the functional state of the dentofacial system [8].

Today, digital chewing tests are gaining popularity as a new way to assess chewing efficiency. In recent years, the active development of technologies has made new research methods relevant, among which digital dynamic methods can be distinguished. These innovative approaches provide a higher level of accuracy and reliability in the analysis of chewing efficiency. Digital functional diagnostic methods are becoming increasingly widespread and popular, simplifying the process of obtaining results with high reliability. They not only facilitate diagnosis but also help dentists to plan individual treatment more rationally [9].

Thus, the transition from analogue methods to digital technologies in assessing chewing efficiency opens up prospects for improvement in both clinical practice and the general approach to the treatment and rehabilitation of patients with various diseases of the dentofacial system [10].

Materials and Methods

At the Department of Orthodontic Dentistry of RosUnimed, NOI of Dentistry named after A. I. Evdokimov, software called “MastiCad3D” was developed to calculate chewing efficiency at all stages of orthopaedic dental treatment1 and they also developed their own method for determining the chewing efficiency of the dentofacial system2.

As part of the study, we examined the most accessible and common dynamic sieve chewing tests and conducted a comparative analysis based on the literature data. We also formed criteria for evaluating dynamic sieve chewing tests to identify their advantages and difficulties during the process. The analysis carried out allowed us to develop an improved method for determining chewing efficiency.

For the development of the MastiCad3D computer program using a digital sieve chewing test, the study involved 350 volunteers aged 19 to 25 years, who were studying in the fourth and fifth years at RosUnimed NOI Dentistry named after A. I. Evdokimov. The subjects had intact dentitions and healthy periodontal tissues, no general somatic pathology, and no pathology of the temporomandibular joint and the muscle complex of the maxillofacial region.

After the initial clinical examination of 350 volunteers, according to the inclusion and exclusion criteria, as well as based on the results of arthrovibrography and electromyography of the masticatory muscles, 90 volunteers were included in the control group.

All volunteers underwent a digital sieve chewing test according to the developed protocol, and the analysis of the data obtained was carried out using the “MastiCad3D” computer program.

The test protocol consisted of several steps:

1. The subjects were given two cylinders made of A-silicone impression material measuring 12 × 6 mm as a test material for the chewing test (Fig. 1).

 

Fig. 1. Test portion

 

2. The chewing test consisted of two stages: an adaptation test and the main stage of the chewing test, each including 20 chewing movements.
3. The obtained test portion was dried for 2 minutes and distributed on a special photopolymer scan platform printed by laser stereolithography from liquid photopolymer resin (Fig. 2).

 

Fig. 2. Test portion on the developed scan platform

 

4. The test portion on the scan platform was scanned with an intraoral scanner to obtain a 3D image of the test portion (Fig. 3).

 

Fig. 3. Scanned test portion. stl.file

 

5. The resulting 3D image was loaded into the developed program for calculating chewing efficiency, “MastiCad3D” (Fig. 4).

 

Fig. 4. The “MastiCad3D” program window

 

Results and Discussion

As a result of the study conducted on 90 volunteers studying in the fourth and fifth years at RosUnimed NOI Dentistry named after A. I. Evdokimov, a reference value was identified — the “norm” of chewing ability in individuals with intact dentitions and physiological occlusion — 0.033 conventional units/second. This value allows us to assess chewing efficiency using the developed software “MastiCad3D” with a digital sieve chewing test in the clinic of orthopaedic dentistry on patients (Fig. 5).

 

Fig. 5. A selection of indicators of chewing ability for the control group (25 out of 90 examinees)

 

Conclusions

1. The criteria for evaluating dynamic sieve chewing tests that we have developed allowed us to justify an improved digital method for determining chewing efficiency using the software we have developed in the clinic of orthopaedic dentistry.
2. During the study, the “normal” value of chewing ability for a “healthy” person was identified, which allows calculating chewing efficiency in patients at all stages of orthopaedic dental care.
3. The “MastiCad3D” software, using the developed method for determining chewing efficiency, allows for a reliable study of the functioning of the dentofacial apparatus. This is achieved through the acquisition and analysis of a three-dimensional image of the test portion.
4. The use of the developed digital sieve method for determining chewing efficiency is easy to implement in the conditions of a modern clinical appointment due to the availability of materials in each dental orthopaedic office.

 

1 Isaeva M.S., Dubova L.V., Maksimov G.V., Leonovich A.A. Certificate of State Registration of a Computer Program of the Russian Federation No. 2023661578 (2023). Bulletin No. 6.

2 Isaeva M.S., Maksimov G.V., Dubova L.V., Samokhina E.V., Kharchenko D.A. Patent of the Russian Federation No. 2814363 (2024). Bulletin No. 7.

About the authors

L. V. Dubova

Russian University of Medicine

Email: marina.is.ser@mail.ru
ORCID iD: 0000-0003-2651-2699

Head of the Department of Orthopedic Dentistry of the Dental Faculty

Russian Federation, Moscow

M. S. Isaeva

Russian University of Medicine

Author for correspondence.
Email: marina.is.ser@mail.ru
ORCID iD: 0000-0002-0146-8970

Assistant of the Department of Orthopedic Dentistry of the Dental Faculty

Russian Federation, Moscow

E. R. Madzhidova

Russian University of Medicine

Email: marina.is.ser@mail.ru
ORCID iD: 0000-0002-5879-7580

PhD (Medicine), Associate Professor of the Department of Orthopedic Dentistry of the Dental Faculty

Russian Federation, Moscow

D. A. Kharchenko

Russian University of Medicine

Email: marina.is.ser@mail.ru
ORCID iD: 0000-0001-9801-4280

PhD (Medicine), Associate Professor of the Department of Orthopedic Dentistry of the Dental Faculty

Russian Federation, Moscow

References

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