Selection in mixtures of food particles during oral processing in man

Objectives Two processes underlie food comminution during chewing: (1) selection, i.e. every particle has a chance of being placed between the teeth and being subjected to (2) breakage. Selection decreases with particle number by saturation of breakage sites, and it depends on competition between smaller and larger particles for breakage sites. Theoretical models were tested which describe competition between various sizes X. In the one-way model, small particles cannot compete with larger ones because of their smaller height. In the two-way model, small particles may compete when piled between antagonistic teeth. Design Five subjects participated in one-chew experiments on cubes made of Optosil®. The critical particle number (nc(X)) at which saturation starts, and the number of breakage sites (nb(X)) were determined by varying particle numbers (nX) for single-sized cubes of 1.7-6.8 mm. Using nc(X) and nb(X), the models predicted relationships between number of selected particles (ns(X)) and nX in one-chew experiments using simple mixtures with only two sizes. A fixed number (mean 6 or 26) of larger cubes (X = 6.8 or 3.4 mm) was mixed with various numbers (16–1024) of smaller cubes (X = 4.8, 2.4 or 1.7 mm), thus varying the factors X, nX, and possible particle piling (for X <4 mm). Results The one-way model was largely followed with small numbers of smaller particles and the two-way model with large numbers. Conclusions The two-way model applies to chewing a food which yields a loose aggregation of different-sized particles following an initial phase, whereas other circumstances may be favourable for the one-way model. As conditions of a food bolus can be approached by embedding hard Optosil particles in a soft medium, the models will, apart from dentistry, be of interest for controlling flavour release in food engineering

Consensus on the terminologies and methodologies for masticatory assessment

A large number of methodological procedures and experimental conditions are reported to describe the masticatory process. However, similar terms are sometimes employed to describe different methodologies. Standardisation of terms is essential to allow comparisons among different studies. This article was aimed to provide a consensus concerning the terms, definitions and technical methods generally reported when evaluating masticatory function objectively and subjectively. The consensus is based on the results from discussions and consultations among world-leading researchers in the related research areas. Advantages, limitations and relevance of each method are also discussed. The present consensus provides a revised framework of standardised terms to improve the consistent use of masticatory terminology and facilitate further investigations on masticatory function analysis. In addition, this article also outlines various methods used to evaluate the masticatory process and their advantages and disadvantages in order to help researchers to design their experiments

Towards an optimal therapy strategy for myogenous TMD, physiotherapy compared with occlusal splint therapy in an RCT with therapy-and-patient-specific treatment durations

Appendix. Threshold of signs and symptoms. Post-hoc power analysis on measures of effectiveness. Two-way ANOVA statistical analysis for pain intensity. Rules for progressing and ending splint therapy. Rules for progressing and ending physiotherapy. A stepped-care model including two possible therapies. (PDF 86 kb

The index 'Treatment Duration Control' for enabling randomized controlled trials with variation in duration of treatment of chronic pain patients

BACKGROUND: Treatment duration varies with the type of therapy and a patient’s recovery speed. Including such a variation in randomized controlled trials (RCTs) enables comparison of the actual therapeutic potential of different therapies in clinical care. An index, Treatment Duration Control (TDC) of outcome scores was developed to help decide when to end treatment and also to determine treatment outcome by a blinded assessor. In contrast to traditional Routine Outcome Monitoring which considers raw score changes, TDC uses relative change. METHODS: Our theory shows that if a patient with the largest baseline scores in a sample requires a relative decrease by treatment factor T to reach a zone of low score values (functional status), any patient with smaller baselines will attain functional status with T. Furthermore, the end score values are proportional to the baseline. These characteristics concur with findings from the literature that a patient’s assessment of ‘much improved’ following treatment (related to attaining functional status) is associated with a particular relative decrease in pain intensity yielding a final pain intensity that is proportional to the baseline. Regarding the TDC-procedure: those patient’s scores that were related to pronounced signs and symptoms, were selected for adaptive testing (reference scores). A Contrast-value was determined for each reference score between its reference level and a subsequent level, and averaging all Contrast-values yielded TDC. A cut-off point related to factor T for attaining functional status, was the TDC-criterion to end a patient’s treatment as being successful. The use of TDC has been illustrated in RCT data from 118 chronic pain patients with myogenous Temporomandibular Disorders, and the TDC-criterion was validated. RESULTS: The TDC-criterion of successful/unsuccessful treatment approximated the cut-off separating two patient subgroups in a bimodal post-treatment distribution of TDC-values. Pain intensity decreased to residual levels and Health-Related Quality of Life (HRQoL) increased to normal levels, following successful treatment according to TDC. The post-treatment TDC-values were independent from the baseline values of pain intensity or HRQoL, and thus independent from the patient’s baseline severity of myogenous Temporomandibular Disorders. CONCLUSIONS: TDC enables RCTs that have a variable therapy- and patient-specific duration