@article {16361,
	title = {A novel colourimetric technique to assess chewing function using two-coloured specimens: Validation and application.},
	journal = {J Dent},
	volume = {43},
	year = {2015},
	month = {2015 Aug},
	pages = {955-64},
	abstract = {OBJECTIVES: Chewing efficiency may be evaluated using cohesive specimen, especially in elderly or dysphagic patients. The aim of this study was to evaluate three two-coloured chewing gums for a colour-mixing ability test and to validate a new purpose built software (ViewGum{\textcopyright}).

METHODS: Dentate participants (dentate-group) and edentulous patients with mandibular two-implant overdentures (IOD-group) were recruited. First, the dentate-group chewed three different types of two-coloured gum (gum1-gum3) for 5, 10, 20, 30 and 50 chewing cycles. Subsequently the number of chewing cycles with the highest intra- and inter-rater agreement was determined visually by applying a scale (SA) and opto-electronically (ViewGum{\textcopyright}, Bland-Altman analysis). The ViewGum{\textcopyright} software determines semi-automatically the variance of hue (VOH); inadequate mixing presents with larger VOH than complete mixing. Secondly, the dentate-group and the IOD-group were compared.

RESULTS: The dentate-group comprised 20 participants (10 female, 30.3{\textpm}6.7 years); the IOD-group 15 participants (10 female, 74.6{\textpm}8.3 years). Intra-rater and inter-rater agreement (SA) was very high at 20 chewing cycles (95.00-98.75\%). Gums 1-3 showed different colour-mixing characteristics as a function of chewing cycles, gum1 showed a logarithmic association; gum2 and gum3 demonstrated more linear behaviours. However, the number of chewing cycles could be predicted in all specimens from VOH (all p<0.0001, mixed linear regression models). Both analyses proved discriminative to the dental state.

CONCLUSION: ViewGum{\textcopyright} proved to be a reliable and discriminative tool to opto-electronically assess chewing efficiency, given an elastic specimen is chewed for 20 cycles and could be recommended for the evaluation of chewing efficiency in a clinical and research setting.

CLINICAL SIGNIFICANCE: Chewing is a complex function of the oro-facial structures and the central nervous system. The application of the proposed assessments of the chewing function in geriatrics or special care dentistry could help visualising oro-functional or dental comorbidities in dysphagic patients or those suffering from protein-energy malnutrition.},
	keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Colorimetry, Female, Humans, Male, Mastication, Young Adult},
	issn = {1879-176X},
	doi = {10.1016/j.jdent.2015.06.003},
	author = {Schimmel, Martin and Christou, Panagiotis and Miyazaki, Hideo and Halazonetis, Demetrios and Herrmann, Fran{\c c}ois R and M{\"u}ller, Frauke}
}
