62 Chapter 4 Masticatory performance The MAT measures how well a subject can mix a two-coloured wax tablet by chewing on it. The tablet has a diameter of 20 mm and consists of two 3 mm layers of red and blue wax. The test-wax is a soft material (Plasticine modelling wax, non-toxic DIN EN-71) that forms a compact bolus during chewing and was offered at room temperature (20˚C). After chewing, the wax is flattened between foils to a thickness of 2.0 mm to avoid shadows. Then, the test-wax is illuminated by a scanner lamp and photographed on both sides using a high-quality scanner (Epson V750). The images of the wax were analysed and processed using a commercially available program for image analysis (Adobe Photoshop CS3). Intermediate colour intensities appear, and the spreads of the intensities for red and blue decrease. A lower mixing ability index (MAI) score implies a bettermixed tablet and, hence, better masticatory performance [22, 23]. Oral Health Impact Profile for EDENTulous people The OHIP-EDENT is based on the original 49 items of OHIP and adapted for edentulous patients. The internal consistency of the OHIP-EDENT has a Cronbach’s alpha of .86-.97 [29-31]. The test-retest reliability has an intraclass correlation (ICC) of .57-.76 [29, 31]. The aim of the OHIP-EDENT is to detect OHRQoL changes, as influenced by the clinical aspects of edentulism and its treatment. The in total 19 items are defined to measure seven domains: (1) functional limitation (3 items), (2) pain (4 items), (3) psychological discomfort (2 items), (4) physical disability (3 items), (5) psychological disability (2 items), (6) social disability (3 items), and (7) handicap (2 items). Each item is scored on a Likert scale from 1 (‘Never’) to 5 (‘Very often’). The outcomes of the OHIP-EDENT can have a range from 19 to 95. A score of 19 means that dental problems do not affect daily life at all, whereas a score of 95 means that dental problems affect daily life very often. Obturator Function Scale The OFS assesses patients’ satisfaction and the quality of their obturator prosthesis [7]. The total scale of the questionnaire has an excellent internal consistency, and the eating and speech sub-scales have a Cronbach’s alpha of .86, .82, and .87, respectively [7]. This questionnaire consists of 15 items in total and three subcategories: (a) eating problems (3 items), (b) speech problems (5 items), and (c) other problems (7 items). Each item is scored on a Likert scale from 1 (‘Not at all a problem’) to 5 (‘Always a problem’).
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