Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019 Jan;41(1):216-224.
doi: 10.1002/hed.25445. Epub 2018 Dec 15.

Masticatory function and related factors after oral oncological treatment: A 5-year prospective study

Reilly J de Groot  1 , Jan-Willem Wetzels  1   2 , Matthias A W Merkx  2 , Antoine J W P Rosenberg  1 , Anton F J de Haan  3 , Andries van der Bilt  1 , Jan H Abbink  1 , Caroline M Speksnijder  1   2   4   5
Affiliations
Multicenter Study

Masticatory function and related factors after oral oncological treatment: A 5-year prospective study

Reilly J de Groot et al. Head Neck. 2019 Jan.

Abstract

Background: Chewing ability is often compromised in patients with oral cancer. The aim of this study was to identify which factors affect masticatory performance in these patients.

Methods: Patients with primary oral cancer were assessed for up to 5 years after primary treatment. Healthy controls were assessed once. A mixed-model analysis was performed, with masticatory performance as outcome measure.

Results: A total of 123 patients were included in the study. Factors positively associated with masticatory performance were number of occlusal units (OU), having functional dentures, and maximum mouth opening (MMO). The impact of tumor location and maximum bite force (MBF) differed per assessment moment. Masticatory performance declined for up to 1 year but recovered at 5 years after treatment.

Conclusion: Masticatory performance in patients treated for oral cancer is affected by MBF, MMO, number of OU, and dental status. These should be the focus of posttreatment therapy.

Keywords: bite force; head and neck neoplasms; mastication; mixed model analysis; prospective cohort.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart showing the number of subjects (n) at each assessment stage and the average time since the primary oncological treatment. TFM, Tongue/Floor of the Mouth
Figure 2
Figure 2
Visual presentation of the significant variables and their coefficients of the estimated mixing ability index (MAI) formula. Variables without an interaction with time are presented left of the y‐axis. Impact on the intercept (MAI = 23.9) is shown. The variables without interaction with the assessment moment are shown separately. The continuous variables (MMO, OU, MBF) are presented as the impact for the mean values of those variables. The mean number of occlusal units was 2.9 and the mean MMO was 52 mm. Mean MBF differs per assessment moment and is 326 N before intervention, 145 N directly after intervention, 193 N at 6 months, 194 N at 1 year, and 283 N at 5 years. Factors with positive outcomes increase the mixing ability outcome, reflecting a deterioration of masticatory performance; for convenience, the y‐axis has been inverted. *Reference category in mixed model, equals 0. D, Dentate; ED, edentulous; FD, full denture; FDI, full denture on implants; max: maxilla; Mand, mandible; MBF, maximum bite force; MAI, mixing ability index; MMO, maximum mouth opening; OU, occlusal units; TFM, tongue and floor of the mouth
Figure 3
Figure 3
Estimates of mixing ability index (MAI) and SE rendered using a mixed‐model analysis. The y‐axis inverted for more values entered into the model was that of the mean patient in the cohort, calculated using a least‐squares method. The outcome presented is divided by the location of the primary tumor over a 5‐year follow up. Differences between groups are presented in the table under the figure. MAI ranges from 0 to 30, where 0 represents the best and 30 the worst possible outcome; thus for convenience, the y‐axis has been inverted. *A significant difference (P < .05) between that and the next assessment; † A significant difference (P < .05) between 2 groups at the same assessment time point, calculated using a restricted maximum likelihood approach. Only the assessment at 5 years after treatment of the maxillary tumor group was not significantly different from the control group (P = .27). Max, Maxilla; Mand, Mandible; TFM, Tongue/Floor of the Mouth
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Moroi HH, Okimoto K, Terada Y. The effect of an oral prosthesis on the quality of life for head and neck cancer patients. J Oral Rehabil. 1999;26:265‐273. - PubMed
    1. Burlage FR, Coppes RP, Meertens H, Stokman MA, Vissink A. Parotid and submandibular/sublingual salivary flow during high dose radiotherapy. Radiother Oncol. 2001;61(3):271‐274. - PubMed
    1. Specht L. Oral complications in the head and neck radiation patient. Support Care Cancer. 2002;10(1):36‐39. - PubMed
    1. Korfage A, Schoen PJ, Raghoebar GM, et al. Five‐year follow up of oral functioning and quality of life in patients with oral cancer with implant‐retained mandibular overdentures. Head Neck. 2011;33:831‐839. - PubMed
    1. Wells M, Swartzman S, Lang H, et al. Predictors of quality of life in head and neck cancer survivors up to 5 years after end of treatment: a cross‐sectional survey. Support Care Cancer. 2016;24(6):2463‐2472. - PubMed

Publication types

  NODES
twitter 2