Journal of Oral Rehabilitation 2006 33; 335–340
Influence of food platform width of mandibular removable
partial denture on food mixing ability
M . Y O S H I M U R A * , K . F U E K I * , †, N . G A R R E T T †, ‡ & T . O H Y A M A *
†
Graduate School, Tokyo Medical and Dental University, Tokyo, Japan, The Jane and Jerry Weintraub Center for Reconstructive Biotechnology
and the Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, UCLA School of Dentistry, Los Angeles, CA, USA and
‡
Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CA, USA
SUMMARY The aim of this study was to clarify the
influence of food platform width on food mixing
ability in patients with mandibular removable par-
tial dentures (RPDs). Twelve subjects (six males and
six females, mean age 56Æ8 years) with intact denti-
tion except for unilaterally missing mandibular first
and second molars participated in the study. The
food platforms of their RPDs were made of light
polymerized composite and three platform condi-
tions were evaluated. A food platform (Control
condition) had 7 mm width with a central focus on
the top of the residual ridge. Narrowed platforms
(5 mm) were created by trimming a lingual portion
(Buccally oriented occlusion, Buccal condition) or a
buccal portion (Lingually oriented occlusion, Lin-
gual condition) from the control. Subjects chewed a
standardized wax cube which provided an estimate
of food mixing ability [Mixing Ability Index (MAI)]
for each of the three platforms. A significant effect
Introduction
In designing distal extension removable partial den-
tures (RPDs), it is important to restore masticatory
function as well as to preserve the remaining oral
structure. Some authors recommend reducing the size
of posterior artificial teeth (1–3) and/or shortening the
food platform of RPDs (4), in order to reduce the stress
on the residual ridges and abutment teeth during
mastication.
Food platform area has previously been shown to be
an important factor in masticatory function in dentate
persons (5, 6), but to have a limited effect on mastica-
ª 2006 Blackwell Publishing Ltd
*Removable Prosthodontics,
(P < 0Æ001) on the MAI was found for food platform
type (repeated measures one-way analysis of var-
iance). Tukey multiple comparisons found signifi-
cant differences of MAI between Control condition
(1Æ05
0Æ26) and Buccal condition (0Æ86
0Æ23)
(P ¼ 0Æ032), and between Control and Lingual con-
dition (0Æ54
0Æ37) (P < 0Æ001). Furthermore, MAI
with Lingual condition was significantly smaller
than that with Buccal condition (P < 0Æ001). These
results suggest that reduction in the width of the
food platform may impair masticatory function and
the buccal portion of mandibular food platform of
RPD is more critical for food mixing than the lingual
portion of the platform.
KEYWORDS: removable partial denture, food plat-
form, tooth width, masticatory function, food mix-
ing ability
Accepted for publication 8 August 2005
tory performance in complete denture wearers (7).
Evaluation of a single case (1, 2) indicated that with an
RPD, the reduction in the size of posterior denture teeth
results in decreased pressure transmitted to the residual
ridge during mastication. The decreased tooth size also
appears to result in a corresponding reduction in
masticatory performance. However, the limited nature
of this single case report makes it difficult to draw any
definitive conclusions.
Masticatory function in the previous studies was
primarily evaluated with masticatory performance tests
involving the comminution of a hard bolus, such as
peanuts, carrots, or silicon rubber and measuring the
doi: 10.1111/j.1365-2842.2005.01570.x
336 M . Y O S H I M U R A et al.
fractionated particles (1, 5–12). Bolus shaping and
kneading has also been recognized as playing an
important role in the masticatory process (13), and
studies have begun to evaluate tests for assessing food
mixing ability (14–18), and the relationships to occlusal
form of artificial teeth of distal extension RPDs (19, 20).
Working side contacts with opposing natural dentition
of mandibular distal extension RPDs were found to
affect food mixing ability, while more traditional
masticatory performance measures obtained with single
sieve method were not impacted (19). In addition, a
series of simulation studies on the influence of the
stress caused by the functional loading through the food
platform on denture base and/or abutment teeth (21–
24) led Yanagawa et al. (20) to evaluate the influence of
a shortened food platform on food mixing ability.
Results indicate that food mixing ability decreased
significantly when the food platform was shortened as
little as one and a half molars. These studies suggest
that the occlusal form of artificial teeth such as teeth
contacts and food platform length are related to the
food mixing ability. However, the influence of food
platform width has not been clarified.
The purpose of this study was to test two null
hypotheses: (i) that bucco-lingual width of the food
platform of mandibular distal extension RPD does not
affect food mixing ability, and (ii) the buccal/lingual
location of the reduced food platform does not alter
food mixing ability.
Materials and methods
Subjects
Twelve subjects (six males and six females, mean age
56Æ8 years) with a mandibular unilateral distal edent-
ulous space from the first to third molar (Kennedy Class
II) were recruited from patients seeking treatment at
the Prosthodontic Clinic of Tokyo Medical and Dental
University Hospital. Subjects were required to have at
least 3 months of experience with an RPD and com-
plete dentition with or without fixed prostheses to the
second molar in the opposing arch and in the mandible
contralateral to the edentulous space. Exclusion criteria
were: (i) excessive mobility of abutment teeth; and (ii)
signs and symptoms of temporomandibular disorder,
neurological disorder and salivary dysfunction. All
study-related procedures and tests were approved by
the Ethical Committee at Tokyo Medical and Dental
ª 2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 335–340
University. Each subject received a written and oral
description of the study and informed consent was
obtained prior to enrolment into the study.
Denture design
To be consistent with the methodology of the previous
study (20) on food platform length, a similar unilateral
framework design was employed for experimental
RPDs. The characteristics of the prosthesis included a
back-action clasp with a mesial-occlusal rest on the
second premolar, an embrasure hook on the first
premolar and the canine, an acrylic resin denture base
and a food platform (Fig. 1). The frameworks were cast
in gold-platinum alloy (Degulor M*).
Food platform
A flat food platform was made in light polymerized
composite (Revotec LC†) instead of commercial artifi-
cial teeth, to standardize a food platform and occlusal
relationships with the opposing maxillary natural teeth.
The food platform was made on the denture base
directly in the mouth. The width of the platform used as
a control was 7 mm and centred on the top of the
residual ridge (Control condition; Fig. 1). The width of
Control condition was designed to match the size of the
occlusal table of commercial posterior artificial teeth
(Endura Posterio‡). Two narrow-width platforms were
created (Fig. 1) by trimming 2 mm off the lingual
(buccally oriented occlusion, Buccal condition) or
buccal (lingually oriented occlusion, Lingual condition)
portion of the Control condition. Mesiodistal length of
the food platform was maintained for all three condi-
tions as the length from the distal end of the second
mandibular premolar to the distal end of the opposing
maxillary second molar.
Occlusal contacts were adjusted intraorally so that
the opposing maxillary cusps contacted the mandibular
platform in the intercuspal position, and no contacts
were present during eccentric movements. The reduc-
tion in width for Lingual condition eliminated the
contacts of maxillary buccal cusps with the mandibular
platform. However, the contacts of maxillary lingual
*Dentsply-Sankin Corp., Tokyo, Japan.
†
GC Corp., Tokyo, Japan.
‡
SHOFU Inc., Kyoto, Japan.
 FOOD PLATFORM WIDTH AND MASTICATORY FUNCTION 337

Control condition Lingual condition). Subjects were randomly assigned

Lingual to a test sequence, with the limitation that only two
d
subjects could be assigned a specific sequence.
e
c 7 mm
Food mixing ability
b
a Buccal
Food mixing ability was evaluated by Mixing Ability
Buccal condition
Test (18). Subjects were directed to masticate a two-
coloured (red/green) paraffin wax cube
(12 · 12 · 12 mm, Fig. 3), only on the side of the
mouth with the RPD. The wax cube, which was
5 mm
maintained in an incubator at 37
C until chewing,
has a soft texture. This texture differs considerably from
Lingual condition other test foods, such as peanuts or raw carrot, widely
used for assessment of food comminuting ability (5–12).
Each subject was directed to chew the test food for
5 mm exactly 10 strokes, based on previous studies (26, 27).
All tests were completed at one sitting. Subjects
Food platform completed three adaptation trials, chewing three sam-
ple cubes separately, immediately after delivery of the
Trimmed portion
RPD. Following the adaptation trials, five experimental
Fig. 1. Schema of the experimental removable partial dentures trials were given (one wax cube at a time) for the first
and three types of food platforms used in this study (occlusal denture condition. Each subject repeated the entire
view). (a) A back-action clasp; (b) a mesial-occlusal rest; (c) an process twice more with the remaining two platform
embrasure hook on the first premolar and the canine; (d) acrylic
conditions.
resin denture base; (e) a food platform; Control condition: control
food platform (7 mm); Buccal condition: buccal-oriented food
(a) (b)
platform (5 mm); Lingual condition: lingual-oriented food plat- 12
mm
form (5 mm).

cusps with the mandibular platform were maintained

for each type of food platform (Fig. 2).
A crossover design (25) was employed to balance the
effect of the delivery order on the food mixing ability
before chewing after chewing
test. An orthogonal Latin square, consisting of six
possible combinations of delivery order, was made for Fig. 3. Wax cube used in Mixing Ability Test: (a) before chewing;
three types of food platform (Control, Buccal and (b) after chewing.

Frontal view
Food platform Trimmed portion

Fig. 2. Schematic representations of

occlusal relationships between man-
dibular food platform and maxillary
natural teeth in the intercuspal posi- Lingual Buccal Lingual Buccal Lingual Buccal
tion (frontal view). Control condi-
tion: control food platform (7 mm);
Buccal condition: buccal-oriented
Denture 7 mm 5 mm
food platform (5 mm); Lingual con- 5 mm
base
dition: lingual-oriented food platform
(5 mm). Control condition Buccal condition Lingual condition

ª 2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 335–340

338 M . Y O S H I M U R A et al.
The detailed techniques for analysing the samples have
been reported previously (18). Briefly, monochrome
and colour digital images of both sides of a masticated
wax cube were captured with a colour-CCD camera
under standardized lighting condition. The colour and
the shape of masticated wax cubes were measured
automatically on the captured images using an image
analyzer (Luzex-FS§). On the monochrome image, the
total projection area (AH), the projection area above
50 lm in thickness, the maximum length and the
maximum breadth were measured. On the colour
images, the software uses thresholds for minimum area
(4Æ0 · 10)4 mm2) and colour intensity to define the
total, remaining red and green area, separately. The
remaining area is defined as the mixed colour area, and
a ratio of the mixed colour area to the total area is
calculated (MIX). In addition, the ratio of area greater
than 50 lm in thickness to the total projection area
(TR), the ratio of maximum length to maximum
breadth (LB) and a shape factor describing flatness of
the sample (FF) were obtained. A Mixing Ability Index
(MAI) was obtained by utilizing the variables MIX, TR,
LB, FF and AH in a model previously derived from
discriminant analysis (18). The validity, the reliability
and the responsiveness to dentition categories and
prosthetic treatment of Mixing Ability Test have been
reported (26, 27).
Sample size
Sample size was determined by power analysis (28)
using the MAI as the key variable. Based on previous
studies (19, 26), a change of 0Æ4 in the MAI was
considered to be clinically significant, and the within-
group standard deviation in this study was expected to
be 0Æ3. The effect size was 0Æ77 for three groups. While
11 subjects per group were found to yield a power of
80% at 5% a level, 12 subjects were enrolled to allocate
two subjects for all six test sequences.
Comparison between flat table and commercial artificial teeth
Food mixing ability was additionally evaluated with
new conventional RPDs to clarify the influence of the
difference in form between the flat table and commer-
cial artificial teeth. For the conventional RPDs, the
frameworks from the experimental prosthesis were
§ ¶
Nireco Co., Tokyo, Japan.
ª 2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 335–340
reused. Commercial artificial teeth (Endura Posterio‡)
7 mm in width were used for new dentures. A 12-week
adaptation period after denture insertion was provided
for adaptation prior to testing (12). Mixing Ability Tests
were given using the same protocol as for the experi-
mental RPD, and comparisons of the MAI was made
between the conventional RPD and the experimental
RPD with the Control condition.
Statistical analysis
The primary unit of analysis was the mean MAI
obtained from five tests (one cube each) for each
platform for each subject. The effect of food platform
type (Control, Buccal and Lingual condition) on MAI
was evaluated with a repeated measures one-way
analysis of variance (ANOVA), with Tukey multiple
comparison tests for post hoc multiple pairwise compar-
isons. In addition, the effect of delivery order of the
food platform (first, second and third) on MAI was
evaluated with a repeated measures one-way ANOVA. A
paired t-test was used to compare MAI between the
Control condition and conventional RPD. SPSS 11Æ0 J¶
was used for statistical analyses and P-values <0Æ05
were considered significant.
Results
The mean
standard deviation of the MAI decreased
with narrowing of the food platform width, from
1Æ05
0Æ26 with Control condition to either
0Æ86
0Æ23 with Buccal condition or 0Æ54
0Æ37 with
Lingual condition. ANOVA result indicates a significant
effect of the food platform (Control, Buccal and Lingual
condition) on MAI (F ¼ 26Æ8, P < 0Æ001). Multiple
comparisons of means show that the MAI was greater
with the larger Control condition than both the Buccal
condition (P ¼ 0Æ032) and Lingual condition
(P < 0Æ001). In addition, the location of the reduced
platform was found to affect the MAI, with the buccal-
oriented platform (Buccal condition) having a higher
MAI than the lingual-oriented platform (Lingual con-
dition; P < 0Æ001). No significant effect of the delivery
order of the food platform (first, second and third) was
found (P ¼ 0Æ70: first, 0Æ76
0Æ30; second, 0Æ87
0Æ28;
third, 0Æ81
0Æ47). The mean
standard deviation of
‡
SHOFU Inc., Kyoto, Japan.
SPSS Japan Inc., Tokyo, Japan.
 FOOD PLATFORM WIDTH AND MASTICATORY FUNCTION
MAI with commercial artificial teeth of 0Æ93
0Æ21 was
not different from the MAI with the Control condition
(P ¼ 0Æ13).
As both width and location of the platform were
found to have an effect on the MAI, a multiple linear
regression analysis was made to evaluate the relative
contributions of these factors. Included in the regres-
sion equation as predictors were the width (7/5 mm)
and the position of the platform relative to the buccal-
lingual centre (Control condition ¼ 0 mm, Buccal con-
dition ¼ +1 mm and Lingual condition ¼ )1 mm).
These two factors accounted for 32% (adjusted
R2 ¼ 0Æ32) of the variability in the MAI (P < 0Æ001).
As expected from the previous analyses, both width and
position of the platform accounted for significant
portions of the variability in MAI. However, width
was found to have a greater impact, with a standardized
coefficient of 0Æ47 (P ¼ 0Æ02) compared with 0Æ37
(P ¼ 0Æ012) for position.
Discussion
In this study, masticatory function was evaluated with
the Mixing Ability Test, which was originally developed
to simplify assessment of masticatory function com-
pared with traditional sieving methods (1, 5–12). As the
test food used for Mixing Ability Test has a soft texture
with cohesive properties, the wax cube remains a single
bolus during mastication, and does not fractionate as
many other test foods. By assessing the colour mixture
and the shape of the masticated wax cube, this test
reflects the degree the bolus is mixed together. The
reliability, the validity and the responsiveness in clinical
use of Mixing Ability Test have been established (26,
27). In addition, previous studies indicate the MAI is
sensitive to differences in occlusal form of artificial
teeth of RPD (19, 20), while more traditional mastica-
tory tests of fractionation based on a single sieve were
not responsive (19).
Reducing the food platform width of the experimen-
tal RPD from 7 to 5 mm was found to significantly
reduce mixing ability, with the MAI for the Control
condition being greater than for both reduced platforms
(Buccal and Lingual condition). Additionally, location
of the reduced platform critically impacts mixing ability,
with a more buccal orientation producing a greater MAI
than a more lingual orientation. While both factors
have a critical impact on function, regression analysis
indicates that width of the platform may have greater
ª 2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 33; 335–340
339
effect on function than location. Additional study
including a condition with a reduced (5 mm) platform
centred bucco-lingually is needed to confirm this
relationship.
While the three different platform conditions in this
study were delivered consecutively to each subject, the
order effect was balanced among subjects for all six
possible combinations. As a result, comparisons of the
effect of order of delivery could be evaluated and was
found to have no significant effect on MAI, and
confirms that any learning effects for repeated trials
were controlled between conditions.
There are some limitations for generalizing the results
obtained from this study. First, the subjects were
directed to masticate three wax cubes for training
before actual data collection. Ideally, 12 or more weeks
of function with the prosthesis would be needed for
adaptation to each new denture (12). Thus, long-term
effects of adaptation to the prosthesis may alter the
relationships of the platform width and location with
mixing ability. Second, a flat platform was used in order
to standardize the food platform and occlusal relation-
ships. Although the width of Control condition has
been matched with that of commercial posterior teeth,
there are obviously differences in the form for the flat
platform and conventional denture teeth. Comparisons
of MAI between Control condition and commercial
artificial teeth showed no significant differences, which
indicates the flat platform may provide a reasonable
estimate of function with commercial artificial teeth.
Third, only patients with a mandibular unilateral
partially edentulous condition were included in this
study. Differences in occlusion between natural and
artificial teeth and relationships of residual ridges
indicate the results may not extrapolate to patients
with maxillary dentures. Additional studies would be
needed to determine if the results extend to maxillary
dentures.
This study suggests that, in a clinical situation when
a reduction of functional stress on abutment teeth of
a mandibular RPD and/or residual ridge are needed,
buccal area of the mandibular occlusal table should be
preserved for maintaining food mixing ability as much
as possible. Within limitations of this study, it would
be concluded that the food platform width affects
food mixing ability in patients with unilateral man-
dibular RPD, and the buccal portion of the food
platform is more critical than the lingual portion for
food mixing.
340 M . Y O S H I M U R A et al.
Acknowledgments
The authors thank staffs of the Technical Laboratory in
Dental Hospital of Tokyo Medical and Dental University
for making patients’ metal frameworks and dentures.
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Correspondence: Dr Kenji Fueki, Removable Prosthodontics, Graduate
School, Tokyo Medical and Dental University, 1-5-45 Yushima,
Bunkyo-ku, Tokyo, Japan 113-8549.
E-mail: kunfu.rpro@tmd.ac.jp