Quantitative Analysis of the Variability of Unilateral Chewing Movements in Young Adults (Physiology)

ABSTRACT: Kinesiography can be used as a diagnostic tool in a dental clinic context. In the current study, a kinesiograph was used to detect and record the three-dimensional motion of the mandibular mid-incisor point during unilateral chewing as a function of time. The aim of the study was to quantity the within-subject short-term reproducibility of the kinesiographic recordings in normal, healthy subjects. Ten seconds of unilateral (right and left) gum chewing were recorded in 20 control subjects using computerized kinesiography. Each subject performed 18 chewing sequences (three repetitions x three sessions x two sides). Chewing cycle duration, volume, standardized depth and width, and the number of reversed cycles were calculated. Intraclass correlation coefficients (two-way random effects analysis of variance with interactions) and paired t-tests were used to compare sessions. For each subject and side, chewing variability was expressed as the coefficient of variation (percentage ratio of standard deviation to mean) of each variable. Mean left and right side mastications were computed over all sessions and subjects. For all the analyzed variables, larger variations between subjects (analysis of variance, p0.001) than between sessions were found, with intraclass correlation coefficients ranging between 0.432 (left side cycle duration) and 0.989 (right side standardized width). No systematic errors between the three measurement sessions were found for cycle volume and shape (paired t, p0.05). The highest between subjects/between sessions variance ratios (up to 223.28) were found for cycle duration and shape. In all subjects, chewing cycle volume was very variable, with mean coefficients of variation up to 47% (left side in females). Cycle duration and standardized depth and width were more reproducible, with mean coefficients of variation up to 10% (duration), 14% (standardized width), and 18% (standardized depth). The spatial characteristics of gum chewing cycles had a large within-subject variability. The temporal and size-standardized (shape) characteristics were more consistent within subject. The results should allow selection of a set of relatively more consistent variables for the definition of normality and the comparison of patients. Mastication is a complex, acquired ability that influences the global quality of life: a good chewing efficiency is directly related to a correct healthful nutritional regimen. (1-3) Modifications in the masticatory movements can point to alterations in several structures: the masticatory muscles, the temporomandibular joints, the teeth and parodontium, the nervous afferent and efferent pathways. (4-10) Direct in-vivo observations of chewing movements are therefore mandatory for a better understanding of the normal function and dysfunction of the stomatognathic apparatus. (1,5,6-9-22) Current technology allows the non-invasive detection and recording of human movements in a three-dimensional space. (1,9,10,12,16,18,19,22-29) In particular, computerized kinesiographs and optoelectronic systems appear to be the most used for the analysis of mandibular motion. (15,18,19,26-29) Optoelectronic digitizers allow tracking