A functional evaluation of fixed and removable bridgework

Removable and fixed prosthetic appliances were constructed for each of twenty subjects in order to replace a missing first molar. (In two cases the second bicuspid was also restored.) Masticatory performance tests with soft and tough foods were made before, immediately after, and one and two weeks following the insertion of the appliance. The degree of pulverization before swallowing and the time and chewing strokes required per mouthful were obtained for each subject at each period.The insertion of either fixed or removable appliances caused a statistically significant increase in masticatory performance with both hard and soft foods. The two appliances were about equivalent in their effect. Masticatory performance was generally higher after appliances were in place for a two-week period, indicating that individuals learned to use both fixed and removable appliances more efficiently within this time. The duration of this learning period has not been determined.Subjects with a diminished masticatory capacity swallowed larger particles of food than did those with a normal or superior masticatory performance. Upon the insertion of fixed and removable appliances, most individuals immediately used fewer strokes to pulverize their food finer at the swallowing point. After two weeks of usage, the patients required seven fewer masticatory strokes and six seconds less time per mouthful and at the same time achieved 16 units greater pulverization than they did previous to the insertion of the partial appliances.