Maximum bite force in reduced periodontal support
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Maximum Bite Force in Reduced Periodontal Support
Introduction to Bite Force and Periodontal Support
Maximum bite force is a critical indicator of the functional state of the masticatory system. It is influenced by various factors, including the number of teeth, occlusal contacts, and periodontal support. Reduced periodontal support, often due to periodontitis, can impact the bite force and overall masticatory efficiency.
Impact of Reduced Periodontal Support on Bite Force
Influence of Periodontal Ligament and Alveolar Bone
The periodontal ligament (PDL) and alveolar bone play crucial roles in the sensory feedback and mechanical support of teeth. Reduced periodontal support, characterized by a decrease in alveolar bone height and PDL area, can lead to increased stress in periodontal structures. This stress is particularly evident in the PDL, where tensile stress increases with bone height reduction, potentially causing mechanical damage. Despite this, the compressive stress in the cortical bone does not significantly increase with reduced bone height, suggesting that the bone itself may not be adversely affected.
Maximal Bite Force in Natural Dentitions
Studies have shown that reduced periodontal tissue support does not necessarily limit the maximal bite force in natural dentitions. In patients with reduced periodontal support, the mean maximal bite force without splinting was found to be comparable to that of periodontally healthy subjects (357 N vs. 378 N, respectively). However, when posterior teeth were splinted, the maximal bite force increased significantly in both groups, indicating that splinting can enhance bite force even in the presence of reduced periodontal support.
Masticatory Behavior and Efficiency
Reduced periodontal support can impair masticatory behavior. Subjects with periodontitis exhibit greater variability in the force used to hold food between their teeth and a more hesitant biting strategy when splitting food. This impaired regulation of masticatory forces is attributed to faulty mechanoreceptive innervation of the PDL, leading to elevated hold forces and defensive biting behavior. Additionally, periodontitis negatively impacts masticatory cycle efficiency and molar bite force, with significant differences observed in the left molar region during the chewing of various foods.
Effect of Splinting and Prosthetic Treatments
Splinting of Posterior Teeth
Splinting posterior teeth can significantly increase maximal bite force in individuals with reduced periodontal support. After splinting, the bite force in test subjects increased from 357 N to 509 N, demonstrating the effectiveness of splinting in enhancing bite force. This suggests that including molar teeth in a posterior splint can compensate for the reduced periodontal support and improve masticatory function.
Implant-Supported Prostheses
Implant-supported prostheses can also improve bite force and masticatory performance. Patients with implant-supported fixed prostheses exhibit higher bite forces compared to their natural dentition, although the difference is slight (577.9 N vs. 595.1 N). This indicates that implant-supported prostheses can effectively restore bite force in patients with compromised periodontal support.
Conclusion
Reduced periodontal support due to conditions like periodontitis can impact bite force and masticatory efficiency. However, interventions such as splinting and implant-supported prostheses can significantly enhance bite force, compensating for the loss of periodontal support. Understanding these dynamics is crucial for developing effective treatment strategies to maintain and improve masticatory function in patients with reduced periodontal support.
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