Bite force in Bengalee Children

ASSESSMENT OF BITE FORCE IN BENGALEE CHILDREN OF KOLKATA AND ITS CORRELATION WITH DIFFERENT

VARIABLES

PRESENTED BY: ROSHNI MAURYAUNDER THE GUIDANCE OF: PROFESSOR

DR. SHABNAM ZAHIR DEPT. OF PEDODONTICS &

PREVENTIVE DENTISTRY GURU NANAK INSTITUE OF

DENTAL SCIENCE & RESEARCH KOLKATA-114

CONTENTS INTRODUCTION OVERVIEW OF BITE FORCE AND INFLUENTIAL FACTORS AIM OF STUDY OBJECTIVES OF STUDY MATERIAL AND METHODS RESULTS DISCUSSION CONCLUSION

INTRODUCTION

Bite force is one indicator of the functional state of the masticatory system that results from the action of jaw muscles modified by the craniomandibular biomechanics.

Adequate bite force gives stimulus and proper function for the normal development of the maxilla and mandible. This in turn helps in proper mastication, digestion, nutrition and general growth and development of a child.

Determination of individual bite force level has been widely used in dentistry to understand the mechanics of mastication for evaluation of the therapeutic effects of prosthetic devices, to determine effect on Orofacial growth and development, to provide reference values for studies on the biomechanics of prosthetic devices. In addition, bite force has been considered important in the diagnosis of the disturbances of stomatognathic system

BITE FORCE AND INFLUENTIAL FACTORS

Different investigators have found a wide range of maximum bite force values. The great variation in bite force values depends on many factors related to the anatomical and physiologic characteristics of the subjects. Facial structure, general muscular force and gender differences are only a few factors that may influence bite force values.

Other factors, such as state of dentition, instrumentation design and transducer position related to dental arch, malocclusions, signs and symptoms of temporomandibular disorders; size, composition and mechanical advantage of jaw-closing muscles, may influence the values found for bite force.

• References: Koca et al :Force and Influential Factors on Bite Force Measurements: A Literature Review European Journal of Dentistry : April 2010 - Vol.4

Justification and relevance of the research work

After conducting a critical review of the available relevant literature it became apparent that there was an obvious lack of studies evaluating bite force in Bengalee children of Kolkata. A lack of research on different variables influencing bite force in these children has also been noted.

AIM OF THE STUDY

The aim of the present study was to determine maximum voluntary molar bite force

(MVBF) in Bengalee children of Kolkata of mixed and

permanent dentition and correlation of the bite force

with different variables.

OBJECTIVES OF THE STUDY• The present study would provide key references

value for bite force measurement in Bengalee children of Kolkata with respect to different variables considered in the study, thereby providing a near accurate data for evaluation of stomatognathic system, jaw muscle function and activity.

• This in turn will help in the preventive and corrective treatment of dentofacial complications occurring due to interference of orofacial growth and development due to change in bite force in different clinical context.

STUDY

AREA

MATERIALS AND METHODS

MATERIALS AND METHODS

STUDY POPULATION:6-14 years old children were included in the present study.

STUDY PERIOD:The study was performed during the period from January 2013 to March 2014.

SAMPLE SIZE:A total of 421 children (210 male and 211 female) were included for the present study as study sample.

SAMPLE DESIGN

• In the present study , 421 Bengalee children between 6-14 years of age were selected for the assessment of bite force and its correlation with different variables.

• Distribution of study sample based on age, sex, dentition stage and dental status is depicted in Table 1.

Age Dentition stage

Case(caries affected)

Control(caries free)

Total

Male

Female

Male

Female

6-8 years

Early mixed

dentition stage

35

36

35

35

141

9-11 years

Late mixed dentition stage

35

35

35

35

140

12-14 years

Permanent

dentition stage

35

35

35

35

140

Table1. Distribution of the study sample by age, sex, dentition stage and dental status.

Inclusion criteria:• Children between age group 6-14 years.

• Children having Bengali as mother tongue.

• Children’s family should have resided in West Bengal since two prior generations.

• Children without any history of previous orthodontic treatment of any kind.

• Children who are cooperative and agree to participate in the study.

Exclusion criteria:• Medically, physically, mentally

compromised children.

• Children having any signs or symptoms of TMJ dysfunction.

• Children having any neurologic disorder.

• Children with any pathology or developmental defect of oro-facial region.

• Absence of permanent molars in specific age group.

STUDY ARMAMENTARIUM • Portable height scale.• Weighing machine• Adequate light source• Sterilised mouth mirror• Sterilized sharp, sickle shaped explorer, tweezers• Gloves , mouth mask , drape• Divider• Scale graduated in millimeter• Articulating paper• Fine lead pencil• Unsupported chair.• Latex finger cot• Consent form• Data collection proforma • Bite force meter (gnathodynamometer)

Study sample selected

General examination

Extraoral examination

Intraoral examination

OP, VOR, MPTC, MMO,

dmft/DMFT &

dmfs/DMFS recorded

Ht. and wt. measured;

BMI calculated, Diet diaryrecorded

Children with facial swelling, dental abscess excluded

Bite force recorded

Stastically analysis of data

schematic Study design

Study design

BMI was then calculated by a

known formula BMI=

Weight /Height.

Study sample

selected

Examination conducted & data

recorded

Lt: MMO measured (cm) Rt: MPTC recorded (pairs)

Bite force measured with the bite plate covered with latex cot

Bite force value displayed

ANALYSIS OF DATA Statistical Analysis was performed with help of Epi Info (TM)

3.5.3. Descriptive statistical analysis was performed to calculate the means with corresponding standard deviations (s.d).

Also One Way Analysis of variance (ANOVA) followed by Tukey’s Test was performed with the help of Critical Difference (CD) or Least Significant Difference (LSD) at 5% and 1% level of significance to compare the mean values.

Pearson Correlation Co-efficient for quantitative data and Spearman Correlation Co-efficient for qualitative data were calculated to find the correlation and t-test was used to find the significance level of the correlations.

Chi-square test was performed to find the associations. p≤0.05 was taken to be statistically significant.

Results and Observations

Distribution of the study sample by age, sex and dentition stage

Distribution of the study sample by dental status

2222222

Variables Case(n=71)

Control(n=70)

ANOVA F-Value with p-value

/ Chi-square( )/ t-test

CD5 CD1

Male(n=35)

Female(n=36)

Male(n=35)

Female(n=35)

Body Height (in cm) Mean ±s.d

122.32±7.37 121.22±7.41 125.53±5.31 121.10±8.97 F3,136 = 1.44p=0.531

11.87 17.60

Body Weight (in kg)Mean ±s.d

24.10 ±4.38 23.98 ±4.28 26.25 ±3.90 22.60±4.52 F3,136 = 2.84p=0.032*

9.18 12.74

BMI (inkg/m2) Mean ±s.d

15.95 ±2.26 16.31 ±2.28 16.66 ±2.21 15.27 ±1.35 F3,136 = 1.98p=0.621

5.97 7.75

Under Weight (<18.5) 31 (86.6%) 33(91.66 %) 8(22.85.%) 10(28.57%) = 2.83p=0.525

Normal (18.5-25) 4(11.4%) 2(5.55 %) 24(68.57%) 25(71.42%)Over Weight (25-30) 0(0.0%) 1(2.77 %) 3(8.57%) 0(0.0%)Obese (>30) 0(0.0%) 0(0.0%) 0(0.0%) 0(0.0%) Occlusal PatternClass-I (1) 29(82.9%) 26(72.22 %) 22(62.85%) 19 (54.28%) =2.98

p=0.913

Class-II (2) 5(14.3%) 9(25 %) 13(37.14 %) 14(40%)Class-III (3) 1(2.9%) 1(2.77 %) 0(0.0%) 2(5.71%)Vertical Occlusal relationshipNormal Bite (1) 27(77.1%) 27 (74.3%) 31(88.57%) 21(60 %) =2.18

p=0.314

Deep Bite (2) 6(17.1%) 7(20%) 4(11.42%) 12(34.28%)Open Bite (3) 2(5.7%) 2(5.7%) 0(0.0%) 2(5.71%)Maxillary Posterior Teeth in contact (pairs)0-2 9(25.7%) 10 (27.7%) 10(.28.6%) 14 (40%) =11.79

p=0.0014*

3-4 12(34.3%) 10(27.7%) 13(37.14%) 18(51.42%)5-6 14(40.0%) 16 (44.4%) 12(34.28%) 3(8.57%)

Food ConsistencyHard-1 17 (48.6%) 21(33.58.%) 25(71.42%) 24(68.57%) =12.74

p=0.031*

Soft-2 18(51.4%) 15 (41.66%) 10(28.57%) 9(25.71%) =11.29p=0.0013*

Table 2: Comparison of Variables for the age group 6-8 years


Control(n=70)

ANOVA F-Value with p-value

/ Chi-square( )/ t-test

CD5 CD1

Male(n=35)

Female(n=36)

Male(n=35)

Female(n=35)

Caries Prevalence (dmft; DMFT)

2.78±1.45 3.80 ±2.78 t68=2.04

p=0.043*

Low 12(34.28%) 13(36.11%) =13.12p=0.036*

Medium 17(48.57%) 21(58.33%)

High 6(17.14%) 2(5.55%)

Caries Severity (dmfs; DMFS) 9.97±8.30 11.08±9.58 - - t68=8.04

p=0.039*

Low 12(34.28%) 11(30.55%) =15.74p=0.039*

Medium 20(57.14%) 17(47.22%

High 3(8.57%) 8(22.22%)

Maximum Voluntary Bite Force on right side in kg [MVBF (R)]

7.91±2.91 7.90±1.51 8.24±2.31 8.21±2.14 F3,136 =

8.77p=0.024*

3.27 7.58

Maximum Voluntary Bite Force on left side in kg[MVBF (L)]

7.60±2.24 7.52 ±1.40 8.00±2.25 7.90±1.99 F3,136 = 7.64

p=0.037*

2.77 10.07

Mean MVBFin kg

7.75±1.97 7.71±1.44 8.12±2.18 8.05±203 F3,136 = 6.88

p=0.041*

4.78 9.35

Mouth Opening in cm 3.98±0.43 3.86 ±0.39 4.30 ±0.39 4.22 ±0.48 F3,136 = 2.92

p=0.58

1.43 2.79

Table 2: Comparison of Variables for the age group 6-8 years (cont.)

* - Significant


Control(n=70)

ANOVA F-Value with

p-value/ Chi-

square( )/ t-test

CD5 CD1

Male(n=35)

Female(n=35)

Male(n=35)

Female(n=35)


135.67±4.00 136.16±4.35 136.37±4.30 139.08±5.14 F3,136 = 1.45p=0.346

11.02 17.54


31.18 ±3.47 33.01 ±5.15 31.74 ±3.70 35.70±6.10 F3,136 = 2.45p=0.027*

9.01 12.84

BMI (in kg/m2) Mean ±s.d

16.89±1.14 17.94 ±2.41 17.01±1.09 18.41±2.70 F3,136 = 1.87p=0.521

5.08 8.98

Under Weight (<18.5)

32 (91.4%) 26(74.3%) 13 (37.14%) 10(28.57%) = 3.23p=0.254

Normal (18.5-25)

3(8.6%) 8(22.9%) 22 (62.85%) 25(71.42%)

Over Weight (25-30)

0(0.0%) 1 (2.9%) 0(0.0%) 0(0.0%)

Obese (>30) 0(0.0%) 0(0.0%) 0(0.0%) 0(0.0%)Occlusal PatternClass-I (1) 26(74.3%) 29(82.9%) 22 (62.85%) 22(62.85%) =2.98

p=0.517

Class-II (2) 7(20%) 6(17.1%) 13(37.14%) 12(34.28%)Class-III (3) 2(5.7%) 0(0.0%) 0(0.0%) 1(2.85%)Vertical Occlusal relationshipNormal Bite (1) 26(74.3%) 29(82.9%) 22(62.85%) 31(88.57%) =2.68

p=0.316

Deep Bite (2) 8(22.9%) 4 (11.4%) 13 (37.14%) 3(8.6%)Open Bite (3) 1(2.9%) 2(5.7%) 0(0.0%) 1(2.85%)Maxillary Posterior Teeth in contact (pairs)0-2 11(31.4%) 15(42.9 %) 15(42.85%) 17(48.57%) =11.79

p=0.0023*

3-4 24 (68.6%) 20(57.1%) 20(57.14 %) 18 (51.42%)5-6 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%)Food ConsistencyHard-1 24(68.6%) 19(54.3%) 29 (82.85%) 25 (71.42%) =10.74

p=0.027*

Soft-2 11(31.4%) 16 (45.7%) 6(17.14%) 10(28.57%) =11.29p=0.018*

Table 3: Comparison of Variables for the age group 9-11 yearsVariables Case

(n=70)Control(n=70)

ANOVA F-Value with

p-value/ Chi-

square( )/ t-test

CD5 CD1

Male(n=35)

Female(n=35)

Male(n=35)

Female(n=35)

Caries Prevalence (DMFT)

3.13±1.18 3.38±2.05 t68=6.04

p=0.041*

Low 22(62.85%) 20(55.55%) =13.29p=0.036*

Medium 14(40%) 13(36.11%)

High 1(2.85%) 2(5.33%)

Caries Severity (DMFS)

7.89±4.30 8.89. ±6.58 - - t68=7.04

p=0.042

Low 12(34.28%) 19(54.3%) =13.12p=0.056*

Medium 12(34.28%) 16(45.7%)

High 11(31.42%) 0(0.0%)


10.83±3.07 10.79±2.43 14.53±4.14 12.04±3.07 F3,136 = 12.10

p=0.023*

3.31 7.85


10.79±3.09 10.48±2.49 13.84±4.22 11.48±2.98 F3,136 = 11.74

p=0.033*

2.37 10.07

Mean MVBF in kg

10.81±3.09 10.63±2.46 14.19±4.17 11.76±3.01 F3,136 = 10.88

p=0.041*

4.08 9.15

Mouth Opening in cm

4.68 ±0.42 4.64 ±0.32 4.55 ±0.56 4.52 ±0.45 F3,136 = 3.92

p=0.426

1.30 1.29


Control(n=70)

ANOVA F-Value with

p-value/ Chi-square(

)/ t-test

CD5 CD1

Male(n=35)

Female(n=35)

Male(n=35)

Female(n=35)


151.96±7.17 150.57±5.51 153.02±5.31 152.50±5.06 F3,136 = 1.27p=0.463

11.32 17.68


42.85 ±8.99 46.29 ±9.42 45.65 ±7.92 53.56±13.95 F3,136 = 2.74p=0.019*

9.87 12.34

BMI (in kg/m2) Mean ±s.d

18.45 ±3.05 20.43 ±3.92 19.43 ±2.80 23.04 ±5.94 F3,136 = 1.88p=0.525

5.47 8.75

Under Weight (<18.5)

24(68.6%) 10(29.4%) 17(48.57%) 13(37.14%) = 2.23p=0.225

Normal (18.5-25)

8(22.9%) 18(52.9%) 17(48.57%) 16(45.71%)

Over Weight (25-30)

3(8.6%) 6(17.6%) 1(2..85%) 5(14.28%)

Obese (>30) 0(0.0%) 0(0.0%) 0(0.0%) 1(2.85%)Occlusal PatternClass-I (1) 27(77.1%) 31(88.6%) 24(68.57%) 21(60%) =1.98

p=0.317

Class-II (2) 6(17.1%) 4(11.4%) 11(31.42%) 13(37.14%)Class-III (3) 2(5.7%) 0(0.0%) 0(0.0%) 1(2.85%)Vertical Occlusal relationshipNormal Bite (1)

9(25.7%) 27(77.1%) 24(34.28%) 30(85.71%) =2.08p=0.219

Deep Bite (2) 20(57.1%) 7(20%) 11(31.42%) 4(11.42%)Open Bite (3) 6(17.1%) 1(2.9%) 0(0.0%) 1(2.85%)Maxillary Posterior Teeth in contact (pairs)0-2 9(25.7%) 12(34.3%) 12(34.28.3%) 16(45.71%) =13.79

p=0.0013*

3-4 20(57.1%) 22(62.9%) 18(51.42%) 13(37.14%)5-6 6(17.1%) 1(2.9%) 5(14.28%) 6(17.14%)

Food ConsistencyHard-1 22(62.9%) 18(51.4%) 21(60%) 28(80%) =8.74

p=0.037*

Soft-2 13(37.1%) 17(48.6%) 14(40%) 7(20%) =9.29 p=0.028*

Table 4: Comparison of Variables for the age group years 12-14 years


Control(n=70)

ANOVA F-Value with

p-value/ Chi-

square( )/ t-test

CD5 CD1

Male(n=35)

Female(n=35)

Male(n=35)

Female(n=35)


2..56 ±4.18 3.13±5.18 t68=1.04

p=0.039*

Low 17(48.57%) 20(55.55%) =14.12p=0.046*

Medium 12(34.28%) 14(38.85%)

High 6(17.14%) 2(5.55%)


5.97 ±3.30 6.08 ±5.58 - - t68=8.54

p=0.029*

Low 23(65.7%) 14(38.83%) =16.14p=0.021*

Medium 12(34.3%) 16(44.44%)

High 0(0.0%) 5(13.88%)


15.57±3.55 14.83±3.28 24.41±5.45 17.78±6.18 F3,136 = 8.87

p=0.027*

3.37 7.88


15.60±3.16 14.04 ±3.47 22.60±4.81 16.14±5.18 F3,136 = 7.74

p=0.034*

2.87 10.27

Mean MVBF in kg

15.59±3.12 14.43 ±3.33 23.50±5.07 16.96±5.66 F3,136 = 6.88

p=0.041*

4.48 9.75

Mouth Opening in cm

4.66 ±0.49 4.78 ±0.40 4.98 ±0.29 4.53 ±0.73 F3,136 = 1.92

p=0.483

1.33 2.29

FIG.3: Mean MVBF of male and female of Case and Control of three age and dentition group.

FIG.4: BMI of different age group with different categories expressed as percentile: Under Weight (<18.5); Normal (18.5-25); Over Weight (25-30) and Obese (>30).

FIG.5: MMO of the study sample of three age groups

FIG.6: dmft/DMFT for Case male child of three age groups

FIG.7: dmft/DMFT for Case female child of three age groups

FIG.8: dmfs/DMFS for Case male child of three age groups

FIG.9: dmfs/DMFS for Case female child of three age groups


Control(n=70)

Male(n=35)

Female(n=36)

Male(n=35)

Female(n=35)

Body Height (in cm)

r=0.37p= 0.48

r=0.22 p=0.41

r=0.29p=0.46

r=0.27p=0.53

Body Weight (in kg)

r=0.61p= 0.0123*

r=0.64p= 0.0245*

r=0. 67p= 0.0333*

r=0.65 p= 0.0312*

BMI (in kg/m2)

r=0.51p= 0.502

r=0.59p= 0.431

r=0.28p= 0.564

r=0.21p= 0.623

Occlusal Pattern r=0.37p= 0.541

r= 0.21p= 0.413

r=0.30p= 0.334

r=0.25p= 0.377

Vertical Occlusal relationship

r=0.23p= 0.23

r=0.30p= 0.28

r=0.35p= 0.31

r=0.33p= 0.32

Maxillary Posterior Teeth in contact (pairs)

r=0.64p= 0.011*

r=0.74p= 0.023*

r=0.80p= 0.035*

r=0.79p= 0.028*

Food Consistency r=0.72p= 0.023*

r=0.83p= 0.037*

r=0.79p= 0.028*

r=0.78p= 0.025*

Caries Prevalence (dmft/ DMFT)

r= - 0.60p= 0.012*

r= - 0.64p= 0.018*

Caries Severity (dmfs/DMFS)

r= - 0.84 p= 0.033*

r = - 0.88 p= 0.038*

Table 5: Correlation of Variables with MVBF for the age group 6-8 years


Control(n=70)

Male(n=35)

Female(n=35)

Male(n=35)

Female(n=35)

Body Height (in cm)

r=0.29p= 0.442

r=0.24 p=0.423

r=0.29 p=0.442

r=0.25p=0.426

Body Weight (in kg)

r=0.69p= 0.011*

r=0.65p= 0.033*

r=0.65p= 0.033*

r=0.67p= 0.037*

BMI (in kg/m2)

r=0.51p= 0.323

r=0.49p= 0.331

r=0.28p= 0.427

r=0.21p= 0.405


r= 0.21p= 0.405

r=0.30p= 0.313

r=0.25p= 0.379


r=0.22p= 0.234

r=0.11p= 0.180

r=0.47p= 0.315

r=0.33p= 0.473

Maxillary Posterior Teeth in

contact (pairs)

r=0.82p= 0.021*

r=0.71p= 0.033*

r=0.89p= 0.011*

r=0.69p= 0.034*


r=0.85p= 0.030*

r=0.81p= 0.021*

r=0.83p= 0.022*

Caries Prevalence (dmft/DMFT)

r= - 0.65p= 0.036*

r= - 0.71p= 0.029*

Caries Severity (dmfs/DMFS)

r= - 0.85p= 0.023*

r= - 0.83p= 0.021*



Control(n=70)

Male(n=35)

Female(n=35)

Male(n=35)

Female(n=35)

Body Height (in cm)

r=0.27p= 0.443

r=0.22p=0.427

r=0.29p=0.461

r=0.24p=0.431

Body Weight (in kg)

r=0.61p= 0.018*

r=0.64p= 0.023*

r=0.77p= 0.041*

r=0.73p= 0.039*

BMI (in kg/m2)

r=0.51p= 0.324

r=0.49p= 0.337

r=0.28p= 0.429

r=0.21p= 0.451


r= 0.21p= 0.418

r=0.30p= 0.337

r=0.25p= 0.373


r=0.25p= 0.236

r=0.31p= 0.281

r=0.37p= 0.318

r=0.33p= 0.289

Maxillary Posterior Teeth in contact (pairs)

r=0.84p= 0.045*

r=0.74p= 0.033*

r=0.87p= 0.041*

r=0.79p= 0.035*


r=0.83p= 0.043*

r=0.81p= 0.042*

r=0.86p= 0.046*


r= - 0.66p= 0.016*

r= - 0.73p= 0.024*


r= - 0.80p= 0.034*

r= - 0.86p= 0.039*


Correlation between MVBF and BMI for male (left) and female (right) of 6-8 years

Correlation between MVBF and MPTC for male (left) and female (right) of study sample of 9-11 years

Correlation between MVBF and dmfs/DMFS for male (left) and female (right) of Case of 12-14 years

DISCUSSION• The mean of bite force in male (both in control and case) was

found to be greater than that of female .The results were shown to be statistically significant (p > 0.05). Importantly, this finding supports the findings of other studies (Owais et al. 2012 ;Sathyanaryana and Permkumar;2012. )

• The findings of this study reaffirm that an increase in bite force is recognised alongside an increase in age (Pearson correlation coefficient of r = 0.590, p < 0.01), which also correlates to progression from early primary dentition through early mixed dentition to late mixed dentition. This finding is in agreement with several previously conducted studies that have shown a positive correlation of age with bite force (Kiliardis et al, 1993; Braun et al, 1996; Kamegai et al, 2005; Usui et al, 2007; Owais et al, 2012).

• The correlation between body mass index(BMI) and maximum bite force in the current study was found to statistically non-significant at the 0.05 level. This finding is in agreement with the findings of Mountain (2008) who reported a similar correlation in a sample of children that proved to be non-significant.

• Oral status variable DMFT & DMFS showed significant negative correlations with MVBF. (supported by study of Su et al, 2009)

• DMFS showed higher significant negative correlation compared to DMFT suggesting that the severity of tooth decay may be more important than the number of teeth exhibiting decay.( as supported by study of Su et al ,2009).

• Severely decayed and missing teeth are detrimental to mastication .People will choose soft food if they cannot chew effectively as found in the present study.

• ANOVA showed that there was no significant difference in mean of mouth opening of male and female of case and of control and also as per the CD no significant difference was found between the means among male and female of each age group and also between different age groups. Pearson Correlation Co-efficient signified weak and non-significant correlation between MMO and MVBF for male and female in case and control group for each age and between different age groups. This finding is in agreement with study of Su et al (2009).

• When comparing different occlusal patterns and vertical occlusal relationships no difference was found in the bite force attributable to any of these conditions. The children selected in the present study were mature enough, had fully developed motor control ability to control their masticatory muscles.

• Although class I and II children among the study sample of

each age group had higher average bite forces on both sides and a higher maximum bite force than class III children, the differences were not statistically significant(see tables in result and observation section). This indicates that there might not be a strong relationship between different occlusal patterns and bite force. These results are similar to the conclusions drawn by Ahlgren (1996), Ahlgren et al (1973) and Kiliaridis et al (1993).

• To study the number of maxillary posterior teeth in contact, the number of tooth contacts was divided into three groups for measurement. Although there were no significant differences in the bite force on the left and right sides or in the maximum bite force in these three groups, a higher number of maxillary posterior teeth in contact were associated with a stronger bite force. This finding is similar to the results of a study by Ingervall and Minder (1997) of children aged 7−16 years.

CONCLUSION• Considering the sample size and methodology used in the present study the

following conclusions can be drawn:• Age and gender was an important determinant factor of maximum bite force

in the present sample of children. It value increased from 6 to 14 years; moreover males in each groups demonstrated higher bite force compared to corresponding females of that age group.

• The maximum voluntary bite force in children was influenced by a number of

key factors including body variables. A positive correlation existed between both body height (nonsignificant) and weight (significant) and the bite force exerted by the child.

• BMI had no direct effect on bite force and correlation was not stastically

significant. • Oral status variable such as the number of maxillary posterior teeth in

contact showed significant positive correlations with bite force in comparison to other variables such as occlusal pattern, vertical occlusal relationship and maximum mouth opening.

• This study confirmed the presence of a significant negative impact of poor dental status (i.e. caries experience) on a child’s maximum bite force.

• The study confirmed that children with preferred hard

type and texture of food demonstrated high bite force in comparison to children on soft diet.

• It must be highlighted that further research on larger population is required in this field in order to broaden knowledge about children’s bite force and the various different influencing key factors as well as improving it.

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Bite force in Bengalee Children

Healthcare

Transcript of Bite force in Bengalee Children