Assessment of Bite Force in Bengalee Children of Kolkata and its correlation with different variables.

2. ASSESSMENT OF BITE FORCE IN BENGALEE CHILDREN OF
KOLKATA AND ITS CORRELATION WITH DIFFERENT VARIABLES
PRESENTED BY: ROSHNI MAURYA
UNDER THE GUIDANCE OF: PROFESSOR DR. SHABNAM ZAHIR
DEPT. OF PEDODONTICS & PREVENTIVE DENTISTRY
GURU NANAK INSTITUE OF DENTAL SCIENCE & RESEARCH
KOLKATA-114

3. CONTENTS
 INTRODUCTION
 OVERVIEW OF BITE FORCE AND INFLUENTIAL
FACTORS
 AIM OF STUDY
 OBJECTIVES OF STUDY
 MATERIALAND METHODS
 RESULTS
 DISCUSSION
 CONCLUSION

4. INTRODUCTION
Bite force is one indicator of the functional state of the
masticatory system that results from the action of jaw
muscles modified by the craniomandibular biomechanics.
Adequate bite force gives stimulus and proper function
for the normal development of the maxilla and mandible.
This in turn helps in proper mastication, digestion,
nutrition and general growth and development of a child.

5. Determination of individual bite force level has been
widely used in dentistry to understand the mechanics of
mastication for evaluation of the therapeutic effects of
prosthetic devices, to determine effect on Orofacial
growth and development, to provide reference values for
studies on the biomechanics of prosthetic devices. In
addition, bite force has been considered important in the
diagnosis of the disturbances of stomatognathic system

6. BITE FORCE AND INFLUENTIAL
FACTORS
Different investigators have found a wide range of maximum bite force values. The great
variation in bite force values depends on many factors related to the anatomical and
physiologic characteristics of the subjects. Facial structure, general muscular force and
gender differences are only a few factors that may influence bite force values.
Other factors, such as state of dentition, instrumentation design and transducer position
related to dental arch, malocclusions, signs and symptoms of temporomandibular
disorders; size, composition and mechanical advantage of jaw-closing muscles, may
influence the values found for bite force.
• References: Koca et al :Force and Influential Factors on Bite Force Measurements: A
Literature Review European Journal of Dentistry : April 2010 - Vol.4

7. Justification and relevance of the
research work
After conducting a critical review of the available relevant literature it became
apparent that there was an obvious lack of studies evaluating bite force in Bengalee
children of Kolkata. A lack of research on different variables influencing bite force in
these children has also been noted.

8. AIM OF THE STUDY
The aim of the present study was
to determine maximum voluntary
molar bite force (MVBF) in
Bengalee children of Kolkata of
mixed and permanent dentition
and correlation of the bite force
with different variables.

9. OBJECTIVES OF THE STUDY
• The present study would provide key references value for
bite force measurement in Bengalee children of Kolkata
with respect to different variables considered in the study,
thereby providing a near accurate data for evaluation of
stomatognathic system, jaw muscle function and activity.
• This in turn will help in the preventive and corrective
treatment of dentofacial complications occurring due to
interference of orofacial growth and development due to
change in bite force in different clinical context.

10. STUDY
AREA
MATERIALS AND METHODS

11. MATERIALS AND METHODS
STUDY POPULATION:
6-14 years old children were included in the present study.
STUDY PERIOD:
The study was performed during the period from January
2013 to March 2014.
SAMPLE SIZE:
A total of 421 children (210 male and 211 female) were
included for the present study as study sample.

12. SAMPLE DESIGN
• In the present study , 421 Bengalee children between
6-14 years of age were selected for the assessment
of bite force and its correlation with different
variables.
• Distribution of study sample based on age, sex,
dentition stage and dental status is depicted in Table
1.

13. Age Dentition
stage
Case
(caries affected)
Control
(caries free)
Total
Male Female Male Female
6-8 years Early mixed
dentition stage 35 36 35 35 141
9-11 years Late mixed
dentition stage
35 35 35 35 140
12-14 years Permanent
dentition stage
35 35 35 35 140
Table1. Distribution of the study sample by age, sex, dentition stage and dental status.

14. Inclusion criteria:
• Children between age group 6-14
years.
• Children having Bengali as mother
tongue.
• Children’s family should have
resided in West Bengal since two
prior generations.
• Children without any history of
previous orthodontic treatment of
any kind.
• Children who are cooperative and
agree to participate in the study.
Exclusion criteria:
• Medically, physically, mentally
compromised children.
• Children having any signs or
symptoms of TMJ dysfunction.
• Children having any neurologic
disorder.
• Children with any pathology or
developmental defect of oro-
facial region.
• Absence of permanent molars in
specific age group.

15. STUDY ARMAMENTARIUM
• Portable height scale.
• Weighing machine
• Adequate light source
• Sterilised mouth mirror
• Sterilized sharp, sickle shaped explorer, tweezers
• Gloves , mouth mask , drape
• Divider
• Scale graduated in millimeter
• Articulating paper
• Fine lead pencil
• Unsupported chair.
• Latex finger cot
• Consent form
• Data collection proforma
• Bite force meter (gnathodynamometer)

16. /

17. Study sample selected
General
examination
Extraoral
examination
Intraoral
examination
OP, VOR,
MPTC,
MMO,
dmft/DMFT
&
dmfs/DMFS
recorded
Ht. and wt.
measured;
BMI
calculated,
Diet diary
recorded
Children with facial swelling, dental
abscess excluded
Bite force recorded
Stastically analysis of data
schematic Study design

18. Study design
BMI was then
calculated by a known
formula BMI=
Weight /Height.
Study sample
selected

19. Examination
conducted & data
recorded
Lt: MMO measured
(cm)
Rt: MPTC recorded
(pairs)

20. Bite force measured with the bite plate
covered with latex cot
Bite force value displayed

21. ANALYSIS OF DATA
 Statistical Analysis was performed with help of Epi Info (TM) 3.5.3.
Descriptive statistical analysis was performed to calculate the means with
corresponding standard deviations (s.d).
 Also One Way Analysis of variance (ANOVA) followed by Tukey’s Test was
performed with the help of Critical Difference (CD) or Least Significant
Difference (LSD) at 5% and 1% level of significance to compare the mean
values.
 Pearson Correlation Co-efficient for quantitative data and Spearman
Correlation Co-efficient for qualitative data were calculated to find the
correlation and t-test was used to find the significance level of the
correlations.
 Chi-square test was performed to find the associations. p≤0.05 was taken to
be statistically significant.

22. Results and Observations
Distribution of the study sample
by age, sex and dentition stage
Distribution of the study sample
by dental status

23. 2
2
2
2
2
2
2

Variables Case
(n=71)
Control
(n=70)
ANOVA F-Value with
p-value
/ Chi-square( )
/ t-test
CD5 CD1
Male
(n=35)
Female
(n=36)
Male
(n=35)
Female
(n=35)
Body Height (in cm)
Mean ±s.d
122.32±7.37 121.22±7.41 125.53±5.31 121.10±8.97 F3,136 = 1.44
p=0.531
11.87 17.60
Body Weight (in kg)
Mean ±s.d
24.10 ±4.38 23.98 ±4.28 26.25 ±3.90 22.60±4.52 F3,136 = 2.84
p=0.032*
9.18 12.74
BMI (in
kg/m2)
Mean ±s.d
15.95 ±2.26 16.31 ±2.28 16.66 ±2.21 15.27 ±1.35 F3,136 = 1.98
p=0.621
5.97 7.75
Under Weight (<18.5) 31 (86.6%) 33(91.66 %) 8(22.85.%) 10(28.57%) = 2.83
p=0.525
Normal (18.5-25) 4(11.4%) 2(5.55 %) 24(68.57%) 25(71.42%)
Over Weight (25-30) 0(0.0%) 1(2.77 %) 3(8.57%) 0(0.0%)
Obese (>30) 0(0.0%) 0(0.0%) 0(0.0%) 0(0.0%)
Occlusal Pattern
Class-I (1) 29(82.9%) 26(72.22 %) 22(62.85%) 19 (54.28%) =2.98
p=0.913Class-II (2) 5(14.3%) 9(25 %) 13(37.14 %) 14(40%)
Class-III (3) 1(2.9%) 1(2.77 %) 0(0.0%) 2(5.71%)
Vertical Occlusal relationship
Normal Bite (1) 27(77.1%) 27 (74.3%) 31(88.57%) 21(60 %) =2.18
p=0.314Deep Bite (2) 6(17.1%) 7(20%) 4(11.42%) 12(34.28%)
Open Bite (3) 2(5.7%) 2(5.7%) 0(0.0%) 2(5.71%)
Maxillary Posterior Teeth in contact (pairs)
0-2 9(25.7%) 10 (27.7%) 10(.28.6%) 14 (40%) =11.79
p=0.0014*3-4 12(34.3%) 10(27.7%) 13(37.14%) 18(51.42%)
5-6 14(40.0%) 16 (44.4%) 12(34.28%) 3(8.57%)
Food Consistency
Hard-1 17 (48.6%) 21(33.58.%) 25(71.42%) 24(68.57%) =12.74
p=0.031*
Soft-2 18(51.4%) 15 (41.66%) 10(28.57%) 9(25.71%) =11.29
p=0.0013*
Table 2: Comparison of Variables for the age group 6-8 years

24. Variables Case
(n=71)
Control
(n=70)
ANOVA F-Value with
p-value
/ Chi-square( )
/ t-test
CD5 CD1
Male
(n=35)
Female
(n=36)
Male
(n=35)
Female
(n=35)
Caries Prevalence (dmft;
DMFT)
2.78±1.45 3.80 ±2.78 t68=2.04
p=0.043*
Low 12(34.28%) 13(36.11%) =13.12
p=0.036*Medium 17(48.57%) 21(58.33%)
High 6(17.14%) 2(5.55%)
Caries Severity (dmfs; DMFS) 9.97±8.30 11.08±9.58 - - t68=8.04
p=0.039*
Low 12(34.28%) 11(30.55%) =15.74
p=0.039*Medium 20(57.14%) 17(47.22%
High 3(8.57%) 8(22.22%)
Maximum Voluntary Bite
Force on right side in kg
[MVBF (R)]
7.91±2.91 7.90±1.51 8.24±2.31 8.21±2.14 F3,136 =
8.77
p=0.024*
3.27 7.58
Maximum Voluntary Bite
Force on left side in kg
[MVBF (L)]
7.60±2.24 7.52 ±1.40 8.00±2.25 7.90±1.99 F3,136 = 7.64
p=0.037*
2.77 10.07
Mean MVBF
in kg
7.75±1.97 7.71±1.44 8.12±2.18 8.05±203 F3,136 = 6.88
p=0.041*
4.78 9.35
Mouth Opening in cm 3.98±0.43 3.86 ±0.39 4.30 ±0.39 4.22 ±0.48 F3,136 = 2.92
p=0.58
1.43 2.79
Table 2: Comparison of Variables for the age group 6-8 years (cont.)
* - Significant

25. Variables Case
(n=70)
Control
(n=70)
ANOVA F-
Value with
p-value
/ Chi-square(
)
/ t-test
CD5 CD1
Male
(n=35)
Female
(n=35)
Male
(n=35)
Female
(n=35)
Body Height (in
cm)
Mean ±s.d
135.67±4.00 136.16±4.35 136.37±4.30 139.08±5.14 F3,136 = 1.45
p=0.346
11.02 17.54
Body Weight
(in kg)
Mean ±s.d
31.18 ±3.47 33.01 ±5.15 31.74 ±3.70 35.70±6.10 F3,136 = 2.45
p=0.027*
9.01 12.84
BMI (in kg/m2)
Mean ±s.d
16.89±1.14 17.94 ±2.41 17.01±1.09 18.41±2.70 F3,136 = 1.87
p=0.521
5.08 8.98
Under Weight
(<18.5)
32 (91.4%) 26(74.3%) 13 (37.14%) 10(28.57%) = 3.23
p=0.254
Normal (18.5-
25)
3(8.6%) 8(22.9%) 22 (62.85%) 25(71.42%)
Over Weight
(25-30)
0(0.0%) 1 (2.9%) 0(0.0%) 0(0.0%)
Obese (>30) 0(0.0%) 0(0.0%) 0(0.0%) 0(0.0%)
Occlusal Pattern
Class-I (1) 26(74.3%) 29(82.9%) 22 (62.85%) 22(62.85%) =2.98
p=0.517Class-II (2) 7(20%) 6(17.1%) 13(37.14%) 12(34.28%)
Class-III (3) 2(5.7%) 0(0.0%) 0(0.0%) 1(2.85%)
Vertical Occlusal relationship
Normal Bite (1)26(74.3%) 29(82.9%) 22(62.85%) 31(88.57%) =2.68
p=0.316Deep Bite (2) 8(22.9%) 4 (11.4%) 13 (37.14%) 3(8.6%)
Open Bite (3) 1(2.9%) 2(5.7%) 0(0.0%) 1(2.85%)
Maxillary Posterior Teeth in contact (pairs)
0-2 11(31.4%) 15(42.9 %) 15(42.85%) 17(48.57%) =11.79
p=0.0023*3-4 24 (68.6%) 20(57.1%) 20(57.14 %) 18 (51.42%)
5-6 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%)
Food Consistency
Hard-1 24(68.6%) 19(54.3%) 29 (82.85%) 25 (71.42%) =10.74
p=0.027*
Soft-2 11(31.4%) 16 (45.7%) 6(17.14%) 10(28.57%) =11.29
p=0.018*
Table 3: Comparison of Variables for the age group 9-11 years
Variables Case
(n=70)
Control
(n=70)
ANOVA F-
Value with
p-value
/ Chi-
square( )
/ t-test
CD5 CD1
Male
(n=35)
Female
(n=35)
Male
(n=35)
Female
(n=35)
Caries
Prevalence
(DMFT)
3.13±1.18 3.38±2.05 t68=6.04
p=0.041*
Low 22(62.85%) 20(55.55%) =13.29
p=0.036*Medium 14(40%) 13(36.11%)
High 1(2.85%) 2(5.33%)
Caries Severity
(DMFS)
7.89±4.30 8.89. ±6.58 - - t68=7.04
p=0.042
Low 12(34.28%) 19(54.3%) =13.12
p=0.056*Medium 12(34.28%) 16(45.7%)
High 11(31.42%) 0(0.0%)
Maximum
Voluntary Bite
Force on right
side in kg
[MVBF (R)]
10.83±3.07 10.79±2.43 14.53±4.14 12.04±3.07 F3,136 =
12.10
p=0.023*
3.31 7.85
Maximum
Voluntary Bite
Force on left
side in kg
[MVBF (L)]
10.79±3.09 10.48±2.49 13.84±4.22 11.48±2.98 F3,136 =
11.74
p=0.033*
2.37 10.07
Mean MVBF
in kg
10.81±3.09 10.63±2.46 14.19±4.17 11.76±3.01 F3,136 =
10.88
p=0.041*
4.08 9.15
Mouth Opening
in cm
4.68 ±0.42 4.64 ±0.32 4.55 ±0.56 4.52 ±0.45 F3,136 = 3.92
p=0.426
1.30 1.29

26. Variables Case
(n=70)
Control
(n=70)
ANOVA F-
Value with
p-value
/ Chi-square(
)
/ t-test
CD5 CD1
Male
(n=35)
Female
(n=35)
Male
(n=35)
Female
(n=35)
Body Height
(in cm)
Mean ±s.d
151.96±7.17 150.57±5.51 153.02±5.31 152.50±5.06 F3,136 = 1.27
p=0.463
11.32 17.68
Body Weight
(in kg)
Mean ±s.d
42.85 ±8.99 46.29 ±9.42 45.65 ±7.92 53.56±13.95 F3,136 = 2.74
p=0.019*
9.87 12.34
BMI (in kg/m2)
Mean ±s.d
18.45 ±3.05 20.43 ±3.92 19.43 ±2.80 23.04 ±5.94 F3,136 = 1.88
p=0.525
5.47 8.75
Under Weight
(<18.5)
24(68.6%) 10(29.4%) 17(48.57%) 13(37.14%) = 2.23
p=0.225
Normal (18.5-
25)
8(22.9%) 18(52.9%) 17(48.57%) 16(45.71%)
Over Weight
(25-30)
3(8.6%) 6(17.6%) 1(2..85%) 5(14.28%)
Obese (>30) 0(0.0%) 0(0.0%) 0(0.0%) 1(2.85%)
Occlusal Pattern
Class-I (1) 27(77.1%) 31(88.6%) 24(68.57%) 21(60%) =1.98
p=0.317Class-II (2) 6(17.1%) 4(11.4%) 11(31.42%) 13(37.14%)
Class-III (3) 2(5.7%) 0(0.0%) 0(0.0%) 1(2.85%)
Vertical Occlusal relationship
Normal Bite
(1)
9(25.7%) 27(77.1%) 24(34.28%) 30(85.71%) =2.08
p=0.219
Deep Bite (2) 20(57.1%) 7(20%) 11(31.42%) 4(11.42%)
Open Bite (3) 6(17.1%) 1(2.9%) 0(0.0%) 1(2.85%)
Maxillary Posterior Teeth in contact (pairs)
0-2 9(25.7%) 12(34.3%) 12(34.28.3%) 16(45.71%) =13.79
p=0.0013*3-4 20(57.1%) 22(62.9%) 18(51.42%) 13(37.14%)
5-6 6(17.1%) 1(2.9%) 5(14.28%) 6(17.14%)
Food Consistency
Hard-1 22(62.9%) 18(51.4%) 21(60%) 28(80%) =8.74
p=0.037*
Soft-2 13(37.1%) 17(48.6%) 14(40%) 7(20%) =9.29
p=0.028*
Table 4: Comparison of Variables for the age group years 12-14 years
Variables Case
(n=70)
Control
(n=70)
ANOVA F-
Value with
p-value
/ Chi-
square( )
/ t-test
CD5 CD1
Male
(n=35)
Female
(n=35)
Male
(n=35)
Female
(n=35)
Caries
Prevalence
(DMFT)
2..56 ±4.18 3.13±5.18 t68=1.04
p=0.039*
Low 17(48.57%) 20(55.55%) =14.12
p=0.046*Medium 12(34.28%) 14(38.85%)
High 6(17.14%) 2(5.55%)
Caries Severity
(DMFS)
5.97 ±3.30 6.08 ±5.58 - - t68=8.54
p=0.029*
Low 23(65.7%) 14(38.83%) =16.14
p=0.021*Medium 12(34.3%) 16(44.44%)
High 0(0.0%) 5(13.88%)
Maximum
Voluntary Bite
Force on right
side in kg [MVBF
(R)]
15.57±3.55 14.83±3.28 24.41±5.45 17.78±6.18 F3,136 = 8.87
p=0.027*
3.37 7.88
Maximum
Voluntary Bite
Force on left
side in kg
[MVBF (L)]
15.60±3.16 14.04 ±3.47 22.60±4.81 16.14±5.18 F3,136 = 7.74
p=0.034*
2.87 10.27
Mean MVBF
in kg
15.59±3.12 14.43 ±3.33 23.50±5.07 16.96±5.66 F3,136 = 6.88
p=0.041*
4.48 9.75
Mouth Opening
in cm
4.66 ±0.49 4.78 ±0.40 4.98 ±0.29 4.53 ±0.73 F3,136 = 1.92
p=0.483
1.33 2.29

27. FIG.3: Mean MVBF of male and female of Case and
Control of three age and dentition group.

28. FIG.4: BMI of different age group with different
categories expressed as percentile: Under Weight
(<18.5); Normal (18.5-25); Over Weight (25-30)
and Obese (>30).
FIG.5: MMO of the study sample of three
age groups

29. FIG.6: dmft/DMFT for Case male child of
three age groups
FIG.7: dmft/DMFT for Case female child of
three age groups

30. FIG.8: dmfs/DMFS for Case male child
of three age groups
FIG.9: dmfs/DMFS for Case female child
of three age groups

31. Variables Case
(n=70)
Control
(n=70)
Male
(n=35)
Female
(n=36)
Male
(n=35)
Female
(n=35)
Body Height (in cm) r=0.37
p= 0.48
r=0.22
p=0.41
r=0.29
p=0.46
r=0.27
p=0.53
Body Weight (in kg) r=0.61
p= 0.0123*
r=0.64
p= 0.0245*
r=0. 67
p= 0.0333*
r=0.65
p= 0.0312*
BMI (in kg/m2) r=0.51
p= 0.502
r=0.59
p= 0.431
r=0.28
p= 0.564
r=0.21
p= 0.623
Occlusal Pattern r=0.37
p= 0.541
r= 0.21
p= 0.413
r=0.30
p= 0.334
r=0.25
p= 0.377
Vertical Occlusal
relationship
r=0.23
p= 0.23
r=0.30
p= 0.28
r=0.35
p= 0.31
r=0.33
p= 0.32
Maxillary Posterior Teeth
in contact (pairs)
r=0.64
p= 0.011*
r=0.74
p= 0.023*
r=0.80
p= 0.035*
r=0.79
p= 0.028*
Food Consistency r=0.72
p= 0.023*
r=0.83
p= 0.037*
r=0.79
p= 0.028*
r=0.78
p= 0.025*
Caries Prevalence (dmft/
DMFT)
r= - 0.60
p= 0.012*
r= - 0.64
p= 0.018*
Caries Severity
(dmfs/DMFS)
r= - 0.84
p= 0.033*
r = - 0.88
p= 0.038*
Table 5: Correlation of Variables with MVBF for the age group 6-8
years

32. Variables Case
(n=70)
Control
(n=70)
Male
(n=35)
Female
(n=35)
Male
(n=35)
Female
(n=35)
Body Height (in
cm)
r=0.29
p= 0.442
r=0.24
p=0.423
r=0.29
p=0.442
r=0.25
p=0.426
Body Weight (in
kg)
r=0.69
p= 0.011*
r=0.65
p= 0.033*
r=0.65
p= 0.033*
r=0.67
p= 0.037*
BMI (in kg/m2) r=0.51
p= 0.323
r=0.49
p= 0.331
r=0.28
p= 0.427
r=0.21
p= 0.405
Occlusal Pattern r=0.27
p= 0.424
r= 0.21
p= 0.405
r=0.30
p= 0.313
r=0.25
p= 0.379
Vertical Occlusal
relationship
r=0.22
p= 0.234
r=0.11
p= 0.180
r=0.47
p= 0.315
r=0.33
p= 0.473
Maxillary
Posterior Teeth
in contact (pairs)
r=0.82
p= 0.021*
r=0.71
p= 0.033*
r=0.89
p= 0.011*
r=0.69
p= 0.034*
Food Consistency r=0.84
p= 0.024*
r=0.85
p= 0.030*
r=0.81
p= 0.021*
r=0.83
p= 0.022*
Caries Prevalence
(dmft/DMFT)
r= - 0.65
p= 0.036*
r= - 0.71
p= 0.029*
Caries Severity
(dmfs/DMFS)
r= - 0.85
p= 0.023*
r= - 0.83
p= 0.021*
Table 6: Correlation of Variables with MVBF for the age
group 9-11 years
Variables Case
(n=70)
Control
(n=70)
Male
(n=35)
Female
(n=35)
Male
(n=35)
Female
(n=35)
Body Height (in
cm)
r=0.27
p= 0.443
r=0.22
p=0.427
r=0.29
p=0.461
r=0.24
p=0.431
Body Weight (in
kg)
r=0.61
p= 0.018*
r=0.64
p= 0.023*
r=0.77
p= 0.041*
r=0.73
p= 0.039*
BMI (in kg/m2) r=0.51
p= 0.324
r=0.49
p= 0.337
r=0.28
p= 0.429
r=0.21
p= 0.451
Occlusal Pattern r=0.27
p= 0.441
r= 0.21
p= 0.418
r=0.30
p= 0.337
r=0.25
p= 0.373
Vertical Occlusal
relationship
r=0.25
p= 0.236
r=0.31
p= 0.281
r=0.37
p= 0.318
r=0.33
p= 0.289
Maxillary
Posterior Teeth
in contact (pairs)
r=0.84
p= 0.045*
r=0.74
p= 0.033*
r=0.87
p= 0.041*
r=0.79
p= 0.035*
Food Consistency r=0.74
p= 0.022*
r=0.83
p= 0.043*
r=0.81
p= 0.042*
r=0.86
p= 0.046*
Caries
Prevalence
(DMFT)
r= - 0.66
p= 0.016*
r= - 0.73
p= 0.024*
Caries Severity
(DMFS)
r= - 0.80
p= 0.034*
r= - 0.86
p= 0.039*
Table 7: Correlation of Variables with MVBF for the age
group 12-14 years

33. Correlation between MVBF
and BMI for male (left) and
female (right) of 6-8 years
Correlation between
MVBF and MPTC for male
(left) and female (right) of
study sample of 9-11 years
Correlation between
MVBF and dmfs/DMFS for
male (left) and female
(right) of Case of 12-14
years

34. DISCUSSION
• The mean of bite force in male (both in control and case) was found to be
greater than that of female .The results were shown to be statistically
significant (p > 0.05). Importantly, this finding supports the findings of
other studies (Owais et al. 2012 ;Sathyanaryana and Permkumar;2012. )
• The findings of this study reaffirm that an increase in bite force is
recognised alongside an increase in age (Pearson correlation coefficient of
r = 0.590, p < 0.01), which also correlates to progression from early
primary dentition through early mixed dentition to late mixed dentition.
This finding is in agreement with several previously conducted studies that
have shown a positive correlation of age with bite force (Kiliardis et al,
1993; Braun et al, 1996; Kamegai et al, 2005; Usui et al, 2007; Owais et
al, 2012).

35. • The correlation between body mass index(BMI) and maximum bite
force in the current study was found to statistically non-significant at
the 0.05 level. This finding is in agreement with the findings of
Mountain (2008) who reported a similar correlation in a sample of
children that proved to be non-significant.
• Oral status variable DMFT & DMFS showed significant negative
correlations with MVBF. (supported by study of Su et al, 2009)
• DMFS showed higher significant negative correlation compared to
DMFT suggesting that the severity of tooth decay may be more
important than the number of teeth exhibiting decay.( as supported by
study of Su et al ,2009).

36. • Severely decayed and missing teeth are detrimental to mastication
.People will choose soft food if they cannot chew effectively as
found in the present study.
• ANOVA showed that there was no significant difference in mean
of mouth opening of male and female of case and of control and
also as per the CD no significant difference was found between the
means among male and female of each age group and also
between different age groups. Pearson Correlation Co-efficient
signified weak and non-significant correlation between MMO and
MVBF for male and female in case and control group for each age
and between different age groups. This finding is in agreement
with study of Su et al (2009).

37. • When comparing different occlusal patterns and vertical occlusal
relationships no difference was found in the bite force attributable to any of
these conditions. The children selected in the present study were mature
enough, had fully developed motor control ability to control their
masticatory muscles.
• Although class I and II children among the study sample of each age
group had higher average bite forces on both sides and a higher maximum
bite force than class III children, the differences were not statistically
significant(see tables in result and observation section). This indicates
that there might not be a strong relationship between different occlusal
patterns and bite force. These results are similar to the conclusions drawn
by Ahlgren (1996), Ahlgren et al (1973) and Kiliaridis et al (1993).

38. • To study the number of maxillary posterior teeth in contact, the
number of tooth contacts was divided into three groups for
measurement. Although there were no significant differences in
the bite force on the left and right sides or in the maximum bite
force in these three groups, a higher number of maxillary posterior
teeth in contact were associated with a stronger bite force. This
finding is similar to the results of a study by Ingervall and Minder
(1997) of children aged 7−16 years.

39. CONCLUSION
• Considering the sample size and methodology used in the present study the following
conclusions can be drawn:
• Age and gender was an important determinant factor of maximum bite force in the present
sample of children. It value increased from 6 to 14 years; moreover males in each groups
demonstrated higher bite force compared to corresponding females of that age group.
• The maximum voluntary bite force in children was influenced by a number of key factors
including body variables. A positive correlation existed between both body height
(nonsignificant) and weight (significant) and the bite force exerted by the child.
• BMI had no direct effect on bite force and correlation was not stastically significant.
• Oral status variable such as the number of maxillary posterior teeth in contact showed
significant positive correlations with bite force in comparison to other variables such as
occlusal pattern, vertical occlusal relationship and maximum mouth opening.

40. • This study confirmed the presence of a significant negative impact
of poor dental status (i.e. caries experience) on a child’s maximum
bite force.
• The study confirmed that children with preferred hard type and
texture of food demonstrated high bite force in comparison to
children on soft diet.
• It must be highlighted that further research on larger population is
required in this field in order to broaden knowledge about
children’s bite force and the various different influencing key
factors as well as improving it.

41. Thank
you!