Predicting maximum occlusal force and tongue pressure using decision tree analysis in patients diagnosed with head and neck tumors

Ziyi Bai; Xuewei Han; Yuka Sumita; Mariko Hattori; Kosuke Maki; Marwa Ahmed Aboelez; Noriyuki Wakabayashi

doi:10.1016/j.prosdent.2024.03.025

Predicting maximum occlusal force and tongue pressure using decision tree analysis in patients diagnosed with head and neck tumors

J Prosthet Dent. 2024 Apr 24:S0022-3913(24)00217-8. doi: 10.1016/j.prosdent.2024.03.025. Online ahead of print.

Authors

Ziyi Bai¹, Xuewei Han¹, Yuka Sumita², Mariko Hattori³, Kosuke Maki⁴, Marwa Ahmed Aboelez⁵, Noriyuki Wakabayashi⁶

Affiliations

¹ Graduate student, Department of Advanced Prosthodontics, Tokyo Medical and Dental University, Tokyo, Japan.
² Professor, Department of Partial and Complete Denture, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan. Electronic address: sumita@tky.ndu.ac.jp.
³ Junior Associate Professor, Department of Advanced Prosthodontics, Tokyo Medical and Dental University, Tokyo, Japan.
⁴ Resident, Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Japan.
⁵ Lecturer, Department of Prosthodontics, Mansoura University, Mansoura, Egypt.
⁶ Professor, Department of Advanced Prosthodontics, Tokyo Medical and Dental University, Tokyo, Japan.

PMID: 38664182
DOI: 10.1016/j.prosdent.2024.03.025

Abstract

Statement of problem: Preserving and restoring oral functions, especially mastication and swallowing, is important to the quality of life of patients being treated for head and neck tumors. Studies that help predict maximum occlusal force and tongue pressure during prosthetic treatment, necessary for providing comprehensive, appropriate treatment and encouraging patient adherence and confidence are lacking.

Purpose: The purpose of this clinical study was to develop a decision tree model for predicting maximum occlusal force and tongue pressure in patients diagnosed with head and neck tumors that could help both experienced and less experienced prosthodontists and oral surgeons optimize the treatment plan and support patient compliance and their quality of life.

Material and methods: A total of 80 patients who had been treated for head and neck tumors were enrolled in the study. Their maximum occlusal force was measured using a pressure-sensitive film and tongue pressure using a tongue pressure measurement device. Data, including basic characteristics, were transferred to a comma separated values file, which was then imported into a statistical software package to produce a decision tree. The classification and regression tree method was used to construct a predictive model.

Results: The number of occlusal contacts associated with not wearing a prosthesis, flap reconstruction, radiotherapy, chemotherapy, the number of teeth present, age, tumor stage, and tumor type were found to be associated with maximum occlusal force, with a prediction accuracy of 96.3%, area under the receiver operating characteristic curve of 0.99, sensitivity of 97%, and specificity of 94%. The number of occlusal contacts associated with wearing and not wearing a prosthesis, tumor stage, age, radiotherapy, and surgery type were found to be associated with tongue pressure, with a prediction accuracy of 96.3%, area under the receiver operating characteristic curve of 0.97, sensitivity of 97%, and specificity of 93%.

Conclusions: The decision tree model can be an effective tool for the prediction of maximum occlusal force and tongue pressure in patients diagnosed with head and neck tumors, helping both experienced and less experienced prosthodontists and oral surgeons to provide early, appropriate, and necessary treatment before starting prosthetic treatment and helping patients with treatment compliance and communication with medical staff.