![]() Digital scanning was proposed here, food particles are scanned and particle size, area, or weight are assessed using digital software (Eberhard et al., 2012 Eberhard, Schneider, Eiffler, Kappel, & Giannakopoulos, 2015 Mowlana, Heath, van der Bilt, & van der Glas, 1994). Many years later, alternatives to the sieve method were introduced for assessing particle size distribution. They used test foods, such as peanuts and carrots, and later, silicone-based materials were introduced. Dahlberg and Manley were among the first to introduce the sieve method (Dahlberg, 1942 Manly & Braley, 1950). Test food is masticated, and then, food particles are separated using sieves with varying aperture sizes the smaller the particles size, the better the masticatory performance. Masticatory performance is defined as ability to comminute or mix test food (van der Bilt, 2011) The most common method for assessing masticatory performance is a comminution method using a sieve. Clinical trials with sufficient sample size, to infer trueness and precision, are needed for evaluating diagnostic values of available methods for assessing masticatory performance.Ī primary goal of dental treatment is to restore dental and oral function, including ability to masticate food. All available assessment methods with variable level of evidence require lab-intensive equipment, such as sieves or digital image software. In a clinical setting or as a diagnostic method, there are no gold standard methods for assessing MP with a strong level of evidence for all measurement properties. No adverse events associated with any assessment methods were reported. Different measurement properties were identified, in decreasing order construct validity ( n = 30), reliability ( n = 22), measurement error ( n = 9), criterion validity ( n = 6), and responsiveness ( n = 4). Forty-six out of 9,908 articles were appraised, and the assessment methods were categorized as comminution ( n = 21), mixing ability ( n = 23), or other methods ( n = 2). The level of evidence was synthesized across studies with an overall conclusion, that is, unknown, conflicting, limited, moderate, or strong evidence. Studies that described the use of identical assessment method received an individual score, and the pooled sum score resulted in an overall evidence synthesis. All studies were quality assessed separately, initially, and subsequently for each method. The level of evidence was rated by using data synthesis for each MP assessment method, where the rating was a product of methodological quality and measurement properties quality. The qualities of the measurement properties were evaluated using predefined criteria. Four other investigators independently appraised any measurement properties of the assessment method according to the consensus-based standards for the selection of health measurement instruments checklist. Eligible papers that satisfied predefined inclusion and exclusion criteria were appraised independently by two investigators. Bibliographic databases were searched, including MEDLINE, Embase, Web of Science Core Collection, Cochrane, and Cinahl databases. A secondary objective was to identify any reported adverse events associated with the methods to assess MP. The objectives of this study is to identify methods for objectively assessing masticatory performance (MP) and to evaluate their measurement properties.
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