Impact of the number of teeth with pulp involvement and the number of masticatory units on the masticatory performance of children.

Abstract

Introduction/Rationale: Masticatory performance (MP) refers to the ability of oral structures to adequately grind food and is of great importance in the development of the stomatognathic system. Among the means of evaluation, masticatory function can be measured by assessing masticatory performance (MP), which consists of the individual's ability to grind or crush a sample of particles (test food) after a standardized number of chewing cycles. Thus, the smaller the particle size, the more efficient the breakdown of food molecules, which has direct implications for growth and development, especially in children, since good chewing allows for faster hydrolysis of macronutrients and better molecular diffusion, resulting in better nutrient absorption. Objective: To evaluate the impact of dental caries and its clinical consequences, as well as the presence of restorations and the number of occlusal pairs on the Masticatory Performance (MP) of schoolchildren. Methodology: This is a cross-sectional study, approved by the Ethics and Research Committee of the Federal University of the Jequitinhonha and Mucuri Valleys under protocol number 1.525.953, with a sample of 324 children aged between seven and twelve years enrolled in public schools in the city of Diamantina-MG, Brazil, who presented with their four first permanent molars in occlusion. The sample size was determined using the OpenEpi platform, employing data from the pilot study: median particle size in children without MIH (mean: 2.61, standard deviation: 0.85) and with MIH (mean 2.91, standard deviation 0.88). A sample of 246 participants was needed to carry out the study. However, considering possible losses, 324 children were recruited. The sample was recruited by convenience in six schools in the city. Individuals with systemic or neurological disorders, such as Down syndrome or cerebral palsy, those taking medications that could affect muscle activity, such as antidepressants, muscle relaxants, or sedatives, those using orthodontic appliances, as well as those who did not cooperate with the clinical examination and/or refused to participate in the research were excluded. The oral clinical examination was performed to assess HMI, malocclusion, number of teeth lost due to caries, number of masticatory units, and presence of dental caries. For PM assessment, an artificial test food (Optocal) was used, and the processing method was sieving. From the weight of the particles retained in each sieve, the median size (X50) of the crushed particles for each child was determined. All variables were categorized according to their variation during the follow-up period. The risk of impact of the variables on PM was tested using the Kolmogorov-Smirnov, Mann-Whitney, and Kruskal-Wallis tests, as well as simple and multiple linear regression. The significance level adopted was p≤0.05. Results: The largest median particle size was associated with a greater number of teeth with pulp involvement (p=0.040). The greatest number of masticatory units was associated with a smaller median particle size (p<0.004). Conclusion: Poorer masticatory performance in school-aged children was associated with a greater number of teeth with pulp involvement and a smaller number of masticatory units.