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Review

Investigating Masticatory Cycle Parameters and Functional Wear Characteristics in Older Removable Complete Denture Wearers: A Targeted Literature Review

by
Savvas Kamalakidis
1,*,
Athanasios Stratos
1,
Dimitrios Tortopidis
1,
Norina Consuela Forna
2 and
Vassiliki Anastassiadou
1
1
Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
2
Faculty of Dentistry, Gr. T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania
*
Author to whom correspondence should be addressed.
Oral 2025, 5(2), 34; https://doi.org/10.3390/oral5020034
Submission received: 29 March 2025 / Revised: 7 May 2025 / Accepted: 9 May 2025 / Published: 14 May 2025
(This article belongs to the Special Issue Editorial Board Members' Collection Series: Oral Health Management for Special Care Patients)
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Abstract

Background: Mandibular movement is inherently complex, involving both lateral and vertical components. In older adults, this complexity is compounded by diminished neuromuscular coordination and reduced proprioceptive feedback, often impairing effective mastication. Objectives: This study aimed to review dental literature on the influence of masticatory parameters in the formation of wear facets on acrylic resin denture teeth. Methods: A targeted literature review was conducted, analyzing peer-reviewed studies from 1991 to 2024 through PubMed and Scopus. The review focused on masticatory parameters, age-related neuromuscular adaptations, chewing patterns, and preferred-side denture tooth wear, affecting older adults using complete removable dentures. Results: Mandibular movement characteristics—particularly velocity, duration, and cycle frequency—were found to significantly influence denture tooth wear, often resulting in reduced bite force and masticatory efficiency. Contemporary denture materials demonstrated improved wear resistance, aiding in the regulation of chewing frequency and velocity. These factors are increasingly important as age-related changes impact the stomatognathic system. Notably, wear facets were most prominent on the maxillary first molars, regardless of the occlusal scheme. Conclusions: This review provided a comprehensive overview of existing research, analyzed current evidence, and offered insights into the role of masticatory function and wear characteristics in older complete denture wearers.

1. Introduction

Understanding the oral physiology of mastication holds substantial clinical importance, with edentulism significantly affecting the lives of older adults worldwide, leading to considerable functional, psychological, and social burdens [1,2]. Tooth loss and the ongoing resorption of alveolar bone remain common issues among older individuals who require prosthodontic rehabilitation, mainly through removable complete dentures [3]. Despite advances in prosthodontics, patient-specific challenges persist, primarily due to a decreased chewing efficiency, reduced bite force, instability, a loss of retention, and the discomfort often associated with removable prostheses [4]. These problems hinder nutritional intake, negatively influence oral health-related quality of life, and underscore the everyday difficulties faced by older denture wearers. Understanding the challenges older individuals encounter and developing practical solutions through recognizing the oral physiology of neuromuscular control is crucial [5,6,7].
Located in the brainstem, the Central Pattern Generator (CPG) can receive input from the cortex and peripheral receptors, allowing for dynamic changes based on food consistency, texture, and occlusal contacts. While the absence of periodontal ligaments in complete denture wearers eliminates a key sensory feedback loop, the neuromuscular system modulates chewing actions based on muscle and mucosal feedback [7]. Mastication depends on complex interactions among occlusion, neuromuscular coordination, and sensory feedback systems. Moreover, the chewing process shows significant differences in the sensory inputs that offer feedback on how food is transformed in the mouth. This oral processing function largely depends on peripheral feedback and finely tunes the basic masticatory pattern, resulting in a precise physiological activity that adapts perfectly to oral events and the properties of the food or food bolus being processed [8]. In older adults with removable complete or partial dentures, age-related physiological changes, such as the marked resorption of alveolar bone, muscle atrophy that, if left untreated, can lead to sarcopenia, reduced salivary production, and diminished tactile sensitivity, exacerbate these mastication challenges [9,10,11]. Moreover, the continuous resorption of alveolar bone significantly impacts denture stability and retention since periodontal and muscle spindle afferents are one of the three significant inputs to the CPG, making mastication increasingly complicated over time [12,13].
The wear of artificial denture teeth, which depends on an individual’s specific mandibular motion patterns, decreases their occlusal efficiency, necessitating regular recall visits or replacements. An in vivo study in healthy dentate individuals concluded that the movement path of the mandible could be classified into seven specific patterns with a combination of vertical and lateral components and with no established gender-related differences in the frequency of each pattern [14]. Additionally, the exact location of the wear on denture teeth, under in vivo conditions, is highly variable, with a strong patient effect. Clinical studies have shown that more wear could be expected in maxillary denture teeth compared to mandibular teeth, first molars compared to premolars, and supporting cusps compared to non-supporting ones. This wear results from lingualized occlusal schemes and the molar teeth being closer to the mandibular hinge axis [15,16].
Many authors agree that two typical chewing patterns exist: one is vertical with minimal sliding components, and the other is horizontal with distinct teeth sliding. Natural teeth provide precise sensory feedback with constant and continuous masticatory forces through periodontal mechanoreceptors, which are lost after tooth extraction [17,18]. Since the denture base acts as a single unit, users of removable complete dentures must compensate for their chewing process by relying on less accurate signals from pressure receptors on the oral mucosa and muscle proprioceptors in the lingual and buccal phase of bolus formation [19,20]. These adaptations are often prolonged and less effective in older patients due to declines in sensory and motor functions associated with aging [21,22,23]. The differences in chewing patterns between natural teeth and denture teeth are depicted in Table 1.
Dental implants have given patients the advantage of implant-supported prostheses. Implant-assisted removable prostheses, when compared to conventional dentures, offer enhanced retention, masticatory efficiency, and, ultimately, patient satisfaction. However, their widespread use among older populations remains limited due to clinical, economic, and anatomical factors [24,25]. In vivo studies concluded that full arch implant-supported removable prostheses generated anterior biting forces with increased variability in the hold and split phase compared to natural dentitions [26,27]. Consequently, conventional complete dentures remain the primary prosthetic option for most edentulous individuals, even though food hardness and preferred chewing side still play a pivotal role in masticatory performance. A rigid diet impacts masticatory function, increasing nearly all physiological masticatory parameters, muscle coordination, and changes on the masticatory side [28,29].
In today’s demanding clinical practice set-up, it is crucial to thoroughly review the existing literature on masticatory parameters, functional adaptation, chewing patterns, occlusal morphology, denture tooth wear, and the impacts of aging in old and very old removable complete denture wearers [30,31,32,33,34,35,36]. Such insights can guide clinicians and are crucial for improving the edentulous population’s oral function, nutritional status, and overall quality of life and for further research and innovation [37,38,39,40,41,42,43,44,45,46,47,48]. The purpose of the present study was to review the dental literature regarding the influence of patients’ masticatory parameters on the generation of wear facets on acrylic resin denture teeth.

2. Methodology

This current targeted literature review examined peer-reviewed studies concerning masticatory parameters, neuromuscular adaptations, chewing movement characteristics, preferred side denture tooth wear, and age-related physiological changes in older adults using removable complete dentures. The articles were chosen for their relevance to removable prosthodontics and gerodontology. Studies published in English were identified using targeted keywords from two scientific databases, PubMed and Scopus, without date restrictions.
The inclusion criteria were randomized and non-randomized clinical studies, cohort studies and case–control studies on complete denture wearers in both arches who were 65 years of age and older. The exclusion criteria were review articles, systematic reviews and meta-analyses, case reports, case series, animal studies, in vitro studies, studies with removable complete dentures in one arch, studies using soft liners or denture adhesives, studies with 14 or fewer participants, studies with a follow-up period or denture clearance of fewer than 3 months, studies in which the participants were institutionalized, hospitalized or residing in nursing homes, studies in which the participants had cognitive impairment or TMJ disorders, studies with denture teeth made of ceramic, milled or printed acrylic resin material, and studies published in languages other than English (Table 2). Two reviewers (S.K., A.S.) independently extracted data from each article, and any disagreement was resolved through discussion with a third reviewer (D.T.).

3. Results

Initially, 262 papers were identified through PubMed, Scopus, and manual searches. After removing duplicates, screening titles and abstracts, and applying the inclusion/exclusion criteria, 16 papers were selected for data extraction. The publication years ranged from 1991 to 2024.

3.1. Masticatory Cycle Parameters

Goiato et al. [2] reported a significant increase in masticatory efficiency with a recorded decrease in particle size and the number of masticatory cycles needed to chew with new removable complete dentures compared to the patients’ existing ones. When patients are satisfied with their previous complete dentures, a newly constructed prosthesis will have no statistically significant different effect on the mandibular path patterns, which are representative of healthy dentate individuals, as stated by Kuramochi and Shiga [15]. In the same study, the opening distance and masticatory width increased, and the mastication cycle time was shortened after the placement of the new prosthesis. Regarding temporalis and masseter EMG activity, Veyrune et al. [9] concluded that these muscles failed to increase their activity per mastication cycle when denture wearers were provided with hard food. The increase in the number of cycles and masticatory duration points to an adaptation response to the impaired masticatory function of complete denture wearers. Additionally, a study by Ochiai et al. [24] examined the possible correlation between facial form and chewing side preference in a group of conventional and implant-assisted mandibular overdentures. It concluded that masticatory performance on the preferred side was dependent on facial form and was slightly reduced in the dolichocephalic group of patients compared to the mesocephalic and brachycephalic groups. Also, classification by skeletal class demonstrated a higher degree of masticatory function for Class I patients compared to Class III, followed by Class II. Furthermore, in another study [45] that investigated the association between skeletal class and masticatory function, the authors concluded that even the use of implant-supported overdentures did not significantly improve the homogenization of food in Class II individuals. In the same study, brachycephalic individuals demonstrated a better homogenization of the food bolus compared to the other facial form participants. A cross-sectional study by Gonçalves et al. [46] evaluated the occlusal and masticatory cycle times, movement angle, maximum velocity, total area, and chewing cycle amplitudes. The amplitude of mandibular movement and spatial components in the opening and closing phases of the masticatory cycles was reduced in older participants compared to young adults. The only difference between dentate individuals and complete denture wearers was the longer duration of the closing phase in complete denture wearers. Similarly, Spiltz et al. [48] evaluated the vertical and horizontal components of the mandible and the opening and closing velocity between conventional complete dentures and implant-supported overdenture wearers who used their prostheses for 13 years. They reported that only the maximum closing velocity was statistically significantly higher for the implant-supported group, with the other factors not being statistically significant due to neuromuscular adaptation. In the same study, masseter and temporalis muscle EMG was significantly higher for the implant-supported overdentures. Finally, Mishellany-Dutour et al. [40] reported that the reduction in food particle size at the time of swallowing was significantly poorer for denture wearers than for their aged dentate counterparts, despite an increase in chewing strokes, sequence duration, and masseter muscle EMG activity. The information of all studies related to masticatory cycle parameters is summarized in Table 3.

3.2. Functional Wear Characteristics of Denture Teeth

The wear of artificial denture teeth significantly impacts oral function as it progresses, particularly affecting the pivotal occlusal surfaces of premolar and molar teeth. This occlusal wear is present, irrespective of the acrylic material, as has been demonstrated in clinical studies [16,27,36,37,42,43,44]. Lindquist et al. [16] outlined that the most extensive wear occurs mainly in the molars, emphasizing that occlusal schemes and subjective factors, such as the abrasiveness of one’s diet and habits like teeth grinding, significantly shape the wear patterns. The average tooth wear recorded at 12 months was 90 μm, with statistically significant more wear observed in the maxillary denture teeth. Ogle and Davis [27], in a 3-year-longitudinal clinical study on the same group of patients, recorded significant differences based on the location of the tooth in the arch but no significant differences based on gender and the acrylic tooth material. The average tooth wear recorded was 214 μm after 36 months, with no statistically significant differences regarding the wear on preferred and nonpreferred chewing sides. Additionally, three clinical studies [36,42,43] investigating denture teeth material wear for a span of up to 2 years concluded that wear is tooth- and patient-dependent, with maxillary first molars being more severely affected and women tending to show less wear compared to men, with a decreasing wear rate in relation to age. It should be noted that in the prospective clinical study by Schmid-Schwap et al. [36], the authors applied a canine guidance occlusal scheme to the complete dentures they provided. In a recent clinical study, Wang et al. [37] investigated the wear on complete denture teeth with a bilateral balanced versus lingualized occlusal set-up. They reported that denture teeth wear down irrespective of the occlusal scheme within a year and that lingualized occlusion recorded higher wear and lower bite force compared to the bilateral balance occlusal scheme due to the transition from point contact to plane contact. Finally, Abdulhameed et al. [44] reported mean wear values between 37 and 63 μm after 1 year of clinical use based on the denture tooth material, with no significant differences regarding monoplane and anatomical tooth types. The high deviations in teeth wear rates were attributed to the different material types of denture teeth used in the study, with newer materials being more resistant to wear. The information on all studies related to the functional wear characteristics of denture teeth is summarized in Table 4. A typical example of clinical wear in denture teeth made from Double Cross-Linked (DCL) resin demonstrating a higher wear resistance and compressive strength compared to PMMA is illustrated in Figure 1, Figure 2 and Figure 3.

4. Discussion

This targeted literature review outlines the fundamental concepts and key challenges older individuals face using complete removable dentures regarding their masticatory functions. The current findings suggest that these patients experience significant reductions in masticatory efficiency due to multiple factors such as diminished bite forces, the wear of denture teeth, prolonged neuromuscular adaptation, and age-related physiological changes. A common belief among clinicians in various studies stresses the need for optimal occlusal stability with sufficient contacts and muscular function to support adequate mastication, improving nutritional health and overall oral health-related quality of life [3,5,20]. Functional imaging studies using techniques like fMRI have further connected the mastication processes to brain function, revealing insights into neuromuscular coordination and adaptation to prostheses, particularly in older populations. Moreover, the impact of unilateral chewing patterns on overall masticatory efficiency and oral health outcomes has been extensively documented, suggesting that balanced occlusal schemes and denture base stability and support are crucial for long-term successful oral rehabilitation [38]. Additional research has reinforced these findings, indicating that older patients experience distinct neuromuscular and physiological adaptations that significantly affect chewing efficacy and denture performance over time [39,40].
Mandibular movement pathways in denture wearers initially show significant deviations from standard chewing patterns, often marked by limited lateral movements to maintain the prosthesis’s stability. Additionally, persons possess a preferred chewing side when starting the mastication process [24,28,39]. Nissan et al. [28] concluded that in partially edentulous patients, their preferred chewing side was not significantly affected by the location of the edentulous area and that no gender-specific distribution could be established, with 78.3% of the participants opting for the right side because of other symmetrical sidedness functions. Devlin et al. [39], in a small group of eight complete denture wearers, reported that all patients chewed more comfortably on their preferred chewing side, with higher EMG activity and fatigue in the masseter muscle on the non-preferred chewing side. According to Karlsson and Jemt [12], patients exhibited changes in their mandibular movements, specifically a higher mandibular velocity and a greater displacement after implant rehabilitation. However, they concluded that the CPG driving output over the years is constant, supported by the relatively consistent temporal timing.
Clinical wear simulations have provided valuable data about artificial teeth materials’ durability and degradation under functional loads, reinforcing the need for best practices in occlusal design and outcome maintenance through recall schedules. The importance of understanding the complexity of neuromuscular oral movements and their implications for effective prosthodontic treatment planning has also been highlighted. Furthermore, comprehensive assessments of oral physiology related to mastication have emphasized the necessity for multidisciplinary approaches that integrate dental, neurological, and nutritional considerations to optimize prosthetic outcomes [11]. The wear of artificial denture teeth, particularly in posterior regions, due to the pivot point of the occlusion and its close proximity to the center of condylar rotation has become a primary clinical concern that increasingly impacts oral function [27], highlighting the critical need for regular recall visits to maintain chewing efficiency and patient satisfaction. Moreover, variations in combinations of axial movements in chewing patterns, especially those involving lateral grinding movements, have been identified as significant contributors to accelerated denture wear, underscoring the importance of tailored clinical management strategies for these patients [17].
Wang et al. [37], in a 12-month randomized clinical trial, reported on the wear locations of artificial teeth under different occlusal schemes and found that wear was more pronounced in the lingualized occlusion scheme compared to the bilateral balanced occlusion. This difference was attributed to the larger occlusal contact area associated with the lingualized occlusal design.
In some instances of severely absorbed alveolar ridges, the use of a zero-degree denture teeth set-up in a monoplane posterior occlusal arrangement has been proposed [49]. This occlusal scheme is believed to enhance denture stability during mastication, as posterior teeth without a sufficient cuspal height will not create deflective contacts. In contrast, studies have indicated that monoplane occlusal schemes require patients to exert more effort when breaking down food, leading to decreased satisfaction rates [50]. With this type of occlusal scheme, patients are more likely to function as choppers rather than shearing or grinding their food effectively.
Denture teeth made from different materials exhibit varying rates of functional wear over time. Tooth wear is more pronounced in older acrylic resin teeth compared to newer double cross-linked and highly cross-linked resin teeth. However, the overall wear pattern tends to remain consistent across materials [44].
Additionally, studies have shown that duplicating a patient’s existing dentures can benefit older individuals with poor neuromuscular coordination and severe bone resorption. A key advantage of denture duplication protocols is that the new dentures preserve the favorable contours of the original prostheses, supporting the individual’s neuromuscular dynamics and personalized masticatory patterns, thereby helping to shorten the initial adaptation period [51].
Aging complicates these functional challenges, underscoring the importance of age-appropriate prosthodontic solutions. Physiological changes related to aging, such as muscle atrophy, reduced sensory feedback, and decreased saliva production, significantly exacerbate the difficulties associated with denture use, necessitating targeted interventions tailored for older patients [3,4,35,40]. The comminution of food bolus relies on an individual’s chewing rate, which is dictated by the CPG and is not age-dependent. The only major adaptation needed is increased masticatory cycles, with the frequency remaining constant through normal aging [20]. Aging is a significant factor that exacerbates the functional limitations older adults face when using removable dentures. Physiological changes due to aging, such as muscle weakness, reduced sensory perception, and lower salivary flow, intensify the challenges of denture usage [1,32,34,35,40]. Locker [1] reported that for edentulous individuals aged 65 years and above, dissatisfaction with their ability to chew increased significantly after a 7-year follow-up period. A study conducted by Sekundo et al. [32] with the participation of old and extremely old individuals, namely 65 to 106 years of age, highlighted a decrease in masticatory performance with age. Finally, a study by Min et al. [34] that focused on masticatory performance and oral diadochokinesis reported decreased tongue pressure and saliva secretion. All the above data regarding older individuals with partial or complete edentulism point to specific mastication processes that remain constant throughout life, with small adaptations needed as age-related changes and denture teeth wear occur.

4.1. Limitations

This targeted literature review has several inherent limitations. Differences in the methodology used among the studies, including study designs, assessment techniques, and participant profiles, hinder the application of the findings to the general population. Furthermore, the inclusion of cross-sectional studies restricts our ability to draw meaningful conclusions about long-term adaptations and the outcomes of removable prosthodontic rehabilitation. Additionally, subjective assessments introduce variability, influenced by psychological and perceptual factors that are challenging to quantify accurately and consistently.

4.2. Future Implications

Future studies should address the identified limitations by utilizing rigorous longitudinal research that clarifies long-term prosthesis usage, neuromuscular adjustments, and changes in chewing function over extended periods. Implementing standardized clinical assessment protocols for masticatory function and denture performance will greatly enhance the comparability and relevance of results across diverse patient groups. Furthermore, investigating advanced denture materials and minimally invasive implant-supported prosthetics offers substantial potential for improving functional outcomes and satisfaction in older denture users. Additionally, structured neuromuscular rehabilitation programs aimed at enhancing sensory–motor integration in older patients could significantly improve prosthodontic results.

5. Conclusions

This targeted literature review highlights the complex challenges older individuals face when using complete removable dentures, including decreased chewing efficiency, notable difficulties with neuromuscular adaptation, the ongoing wear of denture teeth, and added physiological changes due to aging. Successful prosthodontic management requires careful denture occlusal design, consistent prosthetic recall, and maintenance due to the established continuous wear of denture teeth and decreased neuromuscular control. The authors identified a possible mastication pattern since the most prominent denture teeth wear facets were located on the maxillary first molars, stressing the importance of neuromuscular adaptation and balanced occlusal designs. Future clinical and research initiatives should advance toward tailored, evidence-based prosthodontic treatments that enhance chewing ability, nutritional health, and the overall quality of life for older removable complete denture wearers.

Author Contributions

Conceptualization, S.K. and V.A.; methodology, S.K., A.S. and D.T.; validation, D.T., N.C.F. and V.A.; formal analysis, S.K.; investigation, S.K. and D.T.; resources, S.K. and A.S.; data curation, S.K.; writing—original draft preparation, S.K.; writing—review and editing, V.A.; supervision, V.A.; project administration, S.K. and V.A. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Locker, D. Changes in chewing ability with ageing: A 7-year study of older adults. J. Oral Rehabil. 2002, 29, 1021–1029. [Google Scholar] [CrossRef]
  2. Goiato, M.C.; Garcia, A.R.; dos Santos, D.M.; Zuim, P.R. Analysis of masticatory cycle efficiency in complete denture wearers. J. Prosthodont. 2010, 19, 10–13. [Google Scholar] [CrossRef] [PubMed]
  3. Müller, F.; Hernandez, M.; Grütter, L.; Aracil-Kessler, L.; Weingart, D.; Schimmel, M. Masseter muscle thickness, chewing efficiency and bite force in edentulous patients with fixed and removable implant-supported prostheses: A cross-sectional multicenter study. Clin. Oral Implants Res. 2013, 23, 144–150. [Google Scholar] [CrossRef] [PubMed]
  4. Kim, S.; Doh, R.-M.; Yoo, L.; Jeong, S.-A.; Jung, B.-Y. Assessment of age-related changes on masticatory function in a population with normal dentition. Int. J. Environ. Res. Public Health 2021, 18, 6899. [Google Scholar] [CrossRef] [PubMed]
  5. Peyron, M.-A.; Blanc, O.; Lund, J.P.; Woda, A. Influence of age on adaptability of human mastication. J. Neurophysiol. 2004, 92, 773–779. [Google Scholar] [CrossRef]
  6. Mioche, L.; Bourdiol, P.; Peyron, M.-A. Influence of age on mastication: Effects on eating behavior. Nutr. Res. Rev. 2004, 17, 43–54. [Google Scholar] [CrossRef]
  7. Yamashita, S.; Hatch, J.P.; Rugh, J.D. Does chewing performance depend upon a specific masticatory pattern? J. Oral Rehabil. 1999, 26, 547–553. [Google Scholar] [CrossRef]
  8. Van der Bilt, A. Assessment of mastication with implications for oral rehabilitation: A review. J. Oral Rehabil. 2011, 38, 754–780. [Google Scholar] [CrossRef]
  9. Veyrune, J.L.; Lassauzay, C.; Nicolas, E.; Peyron, M.A.; Woda, A. Mastication of model products in complete denture wearers. Arch. Oral Biol. 2007, 52, 1180–1185. [Google Scholar] [CrossRef]
  10. Tanigawa, Y.; Kasahara, T.; Yamashita, S. Location of main occluding areas and masticatory ability in patients with implant-supported prostheses. Aust. Dent. J. 2012, 57, 171–177. [Google Scholar] [CrossRef]
  11. Bourdiol, P.; Hennequin, M.; Peyron, M.A.; Woda, A. Masticatory adaptation to occlusal changes. Front. Physiol. 2020, 11, 263. [Google Scholar] [CrossRef] [PubMed]
  12. Karlsson, S.; Jemt, T. Adaptive changes of masticatory movement characteristics after rehabilitation with osseointegrated fixed prostheses in the edentulous jaw: A 10-year follow-up study. Int. J. Oral Maxillofac. Implants 1991, 6, 259–263. [Google Scholar]
  13. Lund, J.P.; Kolta, A. Generation of the central masticatory pattern and its modification by sensory feedback. Dysphagia 2006, 21, 167–174. [Google Scholar] [CrossRef]
  14. Kobayashi, Y.; Shiga, H.; Arakawa, I.; Yokoyama, M.; Nakajima, K. Masticatory path pattern during mastication of chewing gum with regard to gender difference. J. Prosthodont. Res. 2009, 53, 11–14. [Google Scholar] [CrossRef] [PubMed]
  15. Kuramochi, A.; Shiga, H. Effect of denture treatment on masticatory movement in patients with complete dentures. J. Prosthodont. Res. 2019, 63, 245–249. [Google Scholar] [CrossRef]
  16. Lindquist, T.J.; Ogle, R.E.; Davis, E.L. Twelve-month results of a clinical wear study of three artificial tooth materials. J. Prosthet. Dent. 1995, 74, 156–161. [Google Scholar] [CrossRef]
  17. Kim, S.K.; Kim, K.N.; Chang, I.T.; Heo, S.J. A study of the effects of chewing patterns on occlusal wear. J. Oral Rehabil. 2001, 28, 1048–1055. [Google Scholar] [CrossRef]
  18. Lima, V.P.; Machado, J.B.; Zhang, Y.; Loomans, B.A.C.; Moraes, R. Laboratory methods to simulate the mechanical degradation of resin composite restorations. Dent. Mater. 2022, 38, 214–229. [Google Scholar] [CrossRef] [PubMed]
  19. Heath, M.R. The oral management of food: The bases of oral success and for understanding the sensations that drive us to eat. Food Qual. Prefer. 2002, 13, 453–461. [Google Scholar] [CrossRef]
  20. Ikebe, K.; Morii, K.; Matsuda, K.I.; Nokubi, T. Discrepancy between satisfaction with mastication, food acceptability, and masticatory performance in older adults. Int. J. Prosthodont. 2007, 20, 161–167. [Google Scholar]
  21. Bourdiol, P.; Mioche, L. Correlations between functional and occlusal tooth-surface areas and food texture during natural chewing sequences in humans. Arch. Oral Biol. 2000, 45, 691–699. [Google Scholar] [CrossRef] [PubMed]
  22. Avivi-Arber, L.; Sessle, B.J. Jaw sensorimotor control in healthy adults and effects of aging. J. Oral Rehabil. 2018, 45, 50–80. [Google Scholar] [CrossRef] [PubMed]
  23. Foster, K.D.; Woda, A.; Peyron, M.A. Effect of texture of plastic and elastic model foods on the parameters of mastication. J. Neurophysiol. 2006, 95, 3469–3479. [Google Scholar] [CrossRef]
  24. Ochiai, K.T.; Hojo, S.; Nakamura, C.; Ikeda, H.; Garrett, N.R. Impact of facial form on the relationship between conventional or implant-assisted mandibular dentures and masticatory function. J. Prosthet. Dent. 2011, 105, 256–265. [Google Scholar] [CrossRef] [PubMed]
  25. Trulsson, M.; Johansson, R.S. Orofacial mechanoreceptors in humans: Encoding characteristics and responses during natural orofacial behaviors. Behav. Brain. Res. 2002, 135, 27–33. [Google Scholar] [CrossRef]
  26. Trulsson, M.; Gunne, H.S.J. Food-holding and -biting behavior in human subjects lacking periodontal receptors. J. Dent. Res. 1998, 77, 574–582. [Google Scholar] [CrossRef]
  27. Ogle, R.E.; Davis, E.L. Clinical wear study of three commercially available artificial tooth materials: Thirty-six month results. J. Prosthet. Dent. 1998, 79, 145–151. [Google Scholar] [CrossRef]
  28. Nissan, J.; Berman, O.; Gross, O.; Haim, B.; Chaushu, G. The influence of partial implant-supported restorations on chewing side preference. J. Oral Rehabil. 2011, 38, 165–169. [Google Scholar] [CrossRef]
  29. Tonni, I.; Ricciardi, G.; Piancino, M.G.; Stretti, C.; Constantinides, F.; Paganelli, C. The influence of food hardness on the physiological parameters of mastication: A systematic review. Arch. Oral Biol. 2020, 104903. [Google Scholar] [CrossRef]
  30. De Souza Silva, N.C.; de Oliveira, P.H.B.; Gama, L.T.; Magno, M.B.; Maranon-Vasquez, G.A.; Maia, L.C.; Garcia, R.C.M.R. Does occlusal morphology of artificial teeth improve chewing of removable denture wearers? A systematic review and meta-analysis. J. Prosthodont. 2025, 34, 120–138. [Google Scholar] [CrossRef]
  31. Quintero, A.; Ichesco, E.; Myers, C.; Schutt, R.; Gerstner, G.E. Brain activity and human unilateral chewing: An fMRI study. J. Dent. Res. 2013, 92, 136–142. [Google Scholar] [CrossRef] [PubMed]
  32. Sekundo, C.; Frese, C.; Alich, N.; Langowski, E.; Awounvo, S.; Wolff, D.; Zenthοfer, A. Very old age impacts masticatory performance: A study among sexagenarians to centenarians. Clin. Oral Investig. 2024, 28, 349. [Google Scholar] [CrossRef]
  33. Müller, F.; Duvernay, E.; Loup, A.; Vazquez, L.; Herrmann, F.R.; Schimmel, M. Implant-supported mandibular overdentures in very old adults: A randomized controlled trial. J. Dent. Res. 2013, 92, 154S–160S. [Google Scholar] [CrossRef] [PubMed]
  34. Min, S.-Y.; Pang, N.-S.; Kim, Y.-R.; Jeong, S.-A.; Jung, B.-Y. Factors associated with age-related changes in oral diadochokinesis and masticatory function in healthy old adults. BMC Oral Health 2024, 24, 462. [Google Scholar] [CrossRef] [PubMed]
  35. Ramos, V.F.; Silva, A.F.; Picinato-Pirola, M. Masticatory function in elderly compared to young adults. CoDAS 2022, 34, e20200364. [Google Scholar] [CrossRef]
  36. Schmid-Schwap, M.; Rousson, V.; Vornwagner, K.; Heintze, S.D. Wear of two artificial tooth materials in vivo: A 12-month pilot study. J. Prosthet. Dent. 2009, 102, 104–114. [Google Scholar] [CrossRef]
  37. Wang, Z.; Su, Y.; Wang, J.; Xing, W. Occlusal parameters and wear of artificial teeth in complete dentures with lingualized versus bilateral balanced occlusion: A randomized clinical trial. BMC Oral Health 2024, 24, 1405. [Google Scholar] [CrossRef]
  38. Yeung, A.W.K.; Leung, W.K. Functional neuroplasticity of adults with partial or complete denture rehabilitation with or without implants: Evidence from fMRI studies. Nutrients 2023, 15, 1577. [Google Scholar] [CrossRef]
  39. Devlin, H.; Wastell, D.G.; Duxbury, A.J.; Grant, A.A. Chewing side preference and muscle quality in complete denture-wearing subjects. J. Dent. 1987, 15, 23–25. [Google Scholar] [CrossRef]
  40. Mishellany-Dutour, A.; Renaud, J.; Peyron, M.-A.; Rimek, F.; Woda, A. Is the goal of mastication reached in young dentates, aged dentates and aged denture wearers? Br. J. Nutr. 2008, 99, 121–128. [Google Scholar] [CrossRef]
  41. Meng, M.; Zhang, Q.; Witter, D.W.; Bronkhorst, E.M.; Creugers, N.H.J.; Ma, C.; Zhang, S. Occlusal tooth wear in patients of a dental school’s prosthodontic department in Xi’an, China. Int. J. Prosthodont. 2014, 27, 54–60. [Google Scholar] [CrossRef] [PubMed]
  42. Heintze, S.D.; Zellweger, G.; Sbicego, S.; Rousson, V.; Munoz-Viveros, C.; Stober, T. Wear of two denture teeth materials in vivo-2-year results. Dent. Mater. 2013, 29, e191–e204. [Google Scholar] [CrossRef]
  43. Heintze, S.D.; Rousson, V.; Stober, T. Patient- and therapy-related factor on the wear of denture teeth—Results of a clinical trial. Dent. Mater. 2015, 31, 302–307. [Google Scholar] [CrossRef]
  44. Abdulhameed, N.; Volschow, B.; Abedi, T.; Bifaretti, N.; Slipak, I.; Manibo, A.; Hussein, H. Clinical wear of different types of denture teeth after one year in service: A clinical study. J. Prosthet. Dent. 2023. [Google Scholar] [CrossRef]
  45. Da Rosa Possebon, A.P.; Marcello-Machado, R.M.; Bielemann, A.M.; Schuster, A.J.; de Rezende Pinto, L.; Faot, F. Masticatory function of conventional complete denture wearers changing to 2-implant retained mandibular overdentures: Clinical factor influences after 1 year of function. J. Prosthodont. Res. 2018, 23, 479–484. [Google Scholar] [CrossRef]
  46. Gonçalves, T.M.S.V.; Vilanova, L.S.R.; Gonçalves, L.M.; Rodrigues Garcia, R.C.M. Effect of complete and partial removable dentures on chewing movements. J. Oral Rehabil. 2014, 41, 177–183. [Google Scholar] [CrossRef] [PubMed]
  47. Karlsson, S.; Persson, M.; Carlsson, G.E. Mandibular movement and velocity in relation to state of dentition and age. J. Oral Rehabil. 1991, 18, 1–8. [Google Scholar] [CrossRef]
  48. Spitzl, C.; Proeschel, P.; Wichmann, M.; Heckmann, S. Long-term neuromuscular status in overdenture and complete denture patients with severe mandibular atrophy. Int. J. Oral Maxillofac. Implants 2012, 27, 155–161. [Google Scholar] [PubMed]
  49. Abduo, J. Occlusal schemes for complete dentures: A systematic review. Int. J. Prosthodont. 2013, 26, 26–33. [Google Scholar] [CrossRef]
  50. Rossy Borges, M.H.; Bandeira Miranda, L.F.; Dini, C.; Marañón-Vásquez, G.A.; Magno, M.B.; Maia, L.C.; Barao, V.A.R. Clinical performance of and patient satisfaction with conventional complete dentures with different occlusal schemes: A systematic review of systematic reviews. J. Prosthet. Dent. 2023, 130, 341–350. [Google Scholar] [CrossRef]
  51. Kamalakidis, S.N.; Anastassiadou, V.; Sofou, A.; Pissiotis, A.L. Comparative study of acceptance and adaptation to new complete dentures, using two construction protocols. J. Prosthodont. 2016, 25, 536–543. [Google Scholar] [CrossRef] [PubMed]
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Figure 1. (a) Maxillary complete denture; (b) Mandibular complete denture. No occlusal wear facets after 1 year of clinical use (SR Vivodent DCL Denture Teeth, Ivoclar Vivadent).
Figure 1. (a) Maxillary complete denture; (b) Mandibular complete denture. No occlusal wear facets after 1 year of clinical use (SR Vivodent DCL Denture Teeth, Ivoclar Vivadent).
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Figure 2. (a) Maxillary complete denture; (b) Mandibular complete denture. Severe occlusal wear facets after 7 years of clinical use. Facets are more prominent on premolars and on the first molar on the right side (preferred chewing side).
Figure 2. (a) Maxillary complete denture; (b) Mandibular complete denture. Severe occlusal wear facets after 7 years of clinical use. Facets are more prominent on premolars and on the first molar on the right side (preferred chewing side).
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Figure 3. (a) Maxillary complete denture; (b) Mandibular complete denture. Complete loss of occlusal morphology after 14 years of clinical use.
Figure 3. (a) Maxillary complete denture; (b) Mandibular complete denture. Complete loss of occlusal morphology after 14 years of clinical use.
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Table 1. Differences in chewing patterns between natural teeth and denture teeth.
Table 1. Differences in chewing patterns between natural teeth and denture teeth.
Natural TeethDenture Teeth
Teeth are retained in periodontal ligament and move independently.Teeth are retained in the denture base which moves as a single unit.
A higher power stroke of mastication involves cusp interdigitation accompanied by coordinated lingual and buccal activity in response to moment-to-moment bite forces.The power stroke of mastication is reduced, involving cusp interdigitation and both lingual and buccal activity, which follow the precise contours of the denture only during the act of chewing.
Higher chewing velocity with regular rhythmic chewing cycles.Reduced chewing velocity with irregular slower chewing rhythm.
Higher masticatory efficiency.Lower masticatory efficiency.
Ample lateral excursions present while the occurrence of bilateral balanced occlusion remains rare.Limited lateral excursions present while bilateral balanced occlusion is employed to enhance denture base stability during functional movements.
Rich proprioception and tactile sensitivity.Diminished sensory input with decreased tactile acuity.
Table 2. Inclusion and exclusion criteria for selected studies.
Table 2. Inclusion and exclusion criteria for selected studies.
CriteriaDetails
InclusionRandomized and non-randomized clinical studies, cohort studies, and case-control studies. Participants wearing complete dentures in both arches.
Participants aged 65 years or older.
ExclusionReview articles, systematic reviews, and meta-analyses.
Case reports and case series.
Animal studies and in vitro studies.
Studies including dentures in only one arch. Studies using soft liners or denture adhesives.
Studies with 14 or fewer participants.
Studies with a follow-up period or denture clearance of fewer than 3 months.
Studies with institutionalized, hospitalized, or nursing home residents.
Studies involving participants with cognitive impairments or TMJ disorders.
Studies using denture teeth made of ceramic, milled, or printed acrylic resin materials. Studies published in languages other than English.
Table 3. Studies related to masticatory cycle parameters.
Table 3. Studies related to masticatory cycle parameters.
Authors/YearStudy type/DurationNumber of ParticipantsMain Result
Karlsson et al.
1991
[47]		Cross-sectional65The duration of all phases of the masticatory cycle was longer for complete denture wearers, but the mean velocity was lower.
Veyrune et al.
2007
[9]		Clinical trial/12 months24Decrease in masticatory rate and increase in number of mastication cycles and duration for complete denture wearers.
Mishellany-Dutour et al.
2008
[40]		Cross-sectional42Increase in chewing strokes and poorer particle size reduction for complete denture wearers.
Goiato et al.
2010
[2]		Clinical trial/12 months14The duration of the masticatory cycle was reduced, and masticatory efficiency was improved for complete denture wearers.
Ochiai et al.
2011
[24]		Randomized Control Trial/6 months69Mean masticatory performance was slightly less in dolichocephalic compared to mesocephalic and brachyfacial forms of complete denture wearers.
Spitzl et al.
2012
[48]		Cross-sectional22Mandibular closing velocity was significantly higher for implant-supported overdenture wearers compared to conventional complete dentures.
Gonçalves et al.
2014
[46]		Cross-sectional29Complete denture wearers use a slower chewing sequence with fewer vertical and horizontal mandibular excursion components than removable partial denture wearers.
da Rosa Possebon et al.
2018
[45]		Clinical trial/12 months40Skeletal Class II individuals with complete dentures and implant-supported overdentures have an 89% lower chance of good food bolus homogenization.
Kuramochi & Shiga
2019
[15]		Clinical trial/3 months68Great improvement of all masticatory movements with the use of a newly constructed complete denture.
Table 4. Studies related to functional wear characteristics of denture teeth.
Table 4. Studies related to functional wear characteristics of denture teeth.
Authors/YearStudy Type/DurationNumber of ParticipantsMain Result
Linquist et al.
1995
[16]		Randomized Clinical Trial/12 months67Average denture teeth wear was 90 μm (maxillary 108 μm–mandibular 80 μm, p = 0.001)
Olge and Davis
1998
[27]		Randomized Clinical Trial/36 months67Average denture teeth wear was 214 μm with 202 μm for first premolars, 224 μm for second premolars, 225 μm for first molars, 243 μm for maxillary arch, and 181 μm for mandibular arch
Schmid-Schwap et al.
2009
[36]		Prospective Clinical Study/12 months28Mean vertical loss 49–221 μm with canine-guidance occlusal scheme and higher for posterior maxillary teeth
Heintze et al.
2013
[42]		Prospective Clinical Study/24 months89Log wear increase recorded with the highest on the maxillary first molars
Heintze et al.
2015
[42]		Prospective Clinical Study/24 months89Trend for women to exhibit less wear compared to men and a trend of decreasing wear with increasing age
Abdulhameed et al.
2023
[44]		Randomized Clinical Trial/12 months14Mean wear recorded between 37 and 62.7 μm based on the denture tooth material
Wang et al.
2024
[37]		Randomized Clinical Trial/12 months30Mean wear recorded between 75.7 μm for bilateral balanced occlusion and 121.75 μm for lingualized occlusion
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Kamalakidis, S.; Stratos, A.; Tortopidis, D.; Forna, N.C.; Anastassiadou, V. Investigating Masticatory Cycle Parameters and Functional Wear Characteristics in Older Removable Complete Denture Wearers: A Targeted Literature Review. Oral 2025, 5, 34. https://doi.org/10.3390/oral5020034

AMA Style

Kamalakidis S, Stratos A, Tortopidis D, Forna NC, Anastassiadou V. Investigating Masticatory Cycle Parameters and Functional Wear Characteristics in Older Removable Complete Denture Wearers: A Targeted Literature Review. Oral. 2025; 5(2):34. https://doi.org/10.3390/oral5020034

Chicago/Turabian Style

Kamalakidis, Savvas, Athanasios Stratos, Dimitrios Tortopidis, Norina Consuela Forna, and Vassiliki Anastassiadou. 2025. "Investigating Masticatory Cycle Parameters and Functional Wear Characteristics in Older Removable Complete Denture Wearers: A Targeted Literature Review" Oral 5, no. 2: 34. https://doi.org/10.3390/oral5020034

APA Style

Kamalakidis, S., Stratos, A., Tortopidis, D., Forna, N. C., & Anastassiadou, V. (2025). Investigating Masticatory Cycle Parameters and Functional Wear Characteristics in Older Removable Complete Denture Wearers: A Targeted Literature Review. Oral, 5(2), 34. https://doi.org/10.3390/oral5020034

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