Effect of Modified Widman Flap Surgery on Maximum Molar Bite Force: A Clinical Trial
Abstract
Objectives: The purpose of the present study was to evaluate the effect of modified Widman flap (MWF) surgery (as a periodontal treatment procedure) on maximum bite force (MBF; as an indicator of patient function).
Materials and Methods: In this clinical trial, 24 patients were examined for their MBF before and at one, four and eight weeks after their MWF surgery. These recordings along with the patients’ demographics were analyzed using repeated measures ANOVA at a significance level of 0.05.
Results: Males had a significantly higher MBF than female patients. Repeated measures ANOVA revealed a significant difference in MBF among the four time points (P<0.001) in each gender group. The MBFs recorded at baseline, and at four and eight weeks were not significantly different (P=0.148). Also, MBF showed a slight increase in male patients while it decreased in females over time.
Conclusions: The MWF surgery does not eventually decrease patients’ MBF, which is a relief for patients. This procedure is therefore advised in order to save the maximum number of teeth as it remains the most significant factor determining MBF. However, this surgery has more favorable results in male patients. At four weeks after surgery, the patients will regain their baseline bite force.
- Marquezin MC, Kobayashi FY, Montes AB, Gaviao MB, Castelo PM. Assessment of masticatory performance, bite force, orthodontic treatment needand orofacial dysfunction in children and adolescents. Arch Oral Biol. 2013 Mar;58(3):286-92.
- Fontijn-Tekamp FA, Slagter AP, Van Der Bilt A, Van THMA, Witter DJ, Kalk W, et al. Biting and chewing in overdentures, full dentures, and natural dentitions. J Dent Res. 2000 Jul;79(7): 1519-24.
- Fontijn-Tekamp FA, van der Bilt A, Abbink JH, Bosman F. Swallowing threshold and masticatory performance in dentate adults. Physiol Behav. 2004 Dec;83(3):431-6.
- Jain V, Mathur VP, Abhishek K, Kothari M. Effect of occlusal splint therapy on maximum bite force in individuals with moderate to severe attrition of teeth. J Prosthodont Res. 2012 Oct; 56(4):287-92.
- Takeuchi N, Ekuni D, Yamamoto T, Morita M. Relationship between the prognosis of periodontitis and occlusal force during the maintenance phase--a cohort study. J Periodontal Res. 2010 Oct;45(5):612-7.
- Pereira LJ, Gazolla CM, Magalhaes IB, Dominguete MH, Vilela GR, Castelo PM, et al. Influence of periodontal treatment on objective measurement of masticatory performance. J Oral Sci. 2012;54(2):151-7.
- Pereira LJ, Gazolla CM, Magalhaes IB, Ramos-Jorge ML, Marques LS, Gameiro GH, et al. Treatment of chronic periodontitis and its impact on mastication. J Periodontol. 2011 Feb; 82(2):243-50.
- Takeuchi N, Yamamoto T. Correlation between periodontal status and biting force in patients with chronic periodontitis during the maintenance phase of therapy. J Clin Periodontol. 2008 Mar;35(3):215-20.
- Alkan A, Keskiner I, Arici S, Sato S. The effect of periodontitis on biting abilities. J Periodontol. 2006 Aug;77(8):1442-5.
- Kleinfelder JW, Ludwigt K. Maximal bite force in patients with reduced periodontal tissue support with and without splinting. J Periodontol. 2002 Oct;73(10):1184-7.
- Morita M, Nishi K, Kimura T, Fukushima M, Watanabe T, Yamashita F, et al. Correlation between periodontal status and biting ability in Chinese adult population. J Oral Rehabil. 2003 Mar;30(3):260-4.
- Laurell L, Lundgren D. Periodontal ligament areas and occlusal forces in dentitions restored with cross-arch unilateral posterior two-unit cantilever bridges. J Clin Periodontol. 1986 Jan; 13(1):33-8.
- Svensson KG, Trulsson M. Impaired force control during food holding and biting in subjects with tooth- or implant-supported fixed prostheses. J Clin Periodontol. 2011 Dec;38(12): 1137-46.
- Williams WN, Low SB, Cooper WR, Cornell CE. The effect of periodontal bone loss on bite force discrimination. J Periodontol. 1987 Apr;58 (4):236-9.
- Johansson AS, Svensson KG, Trulsson M. Impaired masticatory behavior in subjects with reduced periodontal tissue support. J Periodontol. 2006 Sep;77(9):1491-7.
- Alkan A, Keskiner I, Arici S, Sato S. The effect of periodontal surgery on bite force, occlusal contact area and bite pressure. J Am Dent Assoc. 2006 Jul;137(7):978-83.
- Canakci CF, Canakci V. Pain experienced by patients undergoing different periodontal therapies. J Am Dent Assoc. 2007 Dec;138(12): 1563-73.
- Kyriazis T, Gkrizioti S, Mikrogeorgis G, Tsalikis L, Sakellari D, Lyroudia K, et al. Crestal bone resorption after the application of two periodontal surgical techniques: a randomized, controlled clinical trial. J Clin Periodontol. 2012 Oct;39(10):971-8.
- Trulsson M. Force encoding by human periodontal mechanoreceptors during mastication. Arch Oral Biol. 2007 Apr;52(4):357-60.
- van Steenberghe D, van den Bergh A, de Vries JH, Schoo WH. The influence of advanced periodontitis on the psychophysical threshold level of periodontal mechanoreceptors in man. J Periodontal Res. 1981 Mar;16(2):199-204.
- Tortopidis D, Lyons MF, Baxendale RH, Gilmour WH. The variability of bite force measurement between sessions, in different positions within the dental arch. J Oral Rehabil. 1998 Sep;25 (9):681-6.
- Manns A, Miralles R, Palazzi C. EMG, bite force, and elongation of the masseter muscle under isometric voluntary contractions and variations ofvertical dimension. J Prosthet Dent. 1979 Dec;42(6): 674-82.
- Regalo SC, Santos CM, Vitti M, Regalo CA, de Vasconcelos PB, Mestriner W Jr, et al. Evaluation of molar and incisor bite force in indigenous compared with white population in Brazil. Arch Oral Biol. 2008 Mar;53(3):282-6.
- Kogawa EM, Calderon PS, Lauris JR, Araujo CR, Conti PC. Evaluation of maximal bite force in temporomandibular disorders patients. J Oral Rehabil. 2006 Aug;33(8):559-65.
- Takei H, Carranza FA. The flap technique for pocket therapy. In: Newman MG, Takei H, CarranzaFA, Klokkevold PR, editors. Carranza's clinical periodontology. 12th ed., Missouri, Saunders Elsevier, 2015:593.
- Okada T, Ikebe K, Inomata C, Takeshita H, Uota M, Mihara Y, et al. Association of periodontal status with occlusal force and food acceptability in 70-year-old adults: from SONIC Study. J Oral Rehabil. 2014 Dec;41(12):912-9.
- Scudine KG, Pedroni-Pereira A, Araujo DS, Prado DG, Rossi AC, Castelo PM. Assessment of the differences in masticatory behavior between male and female adolescents. Physiol Behav. 2016 Sep;163: 115-22.
| Files | ||
| Issue | Vol 13, No 5 (2016) | |
| Section | Original Article | |
| Keywords | ||
| Bite Force Chronic Periodontitis Periodontal Diseases Oral Surgical Procedures | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
