32 However, these associations were only observed in 11–12 year-old children. This finding is consistent with several psychological theories suggesting that health-related quality of life decreases by gender with increasing age, 33 as a consequence of menarche and an imbalance in the hormonal status, 34 the presence of stressful life events 35 and variations in specific coping mechanisms. 36 Surprisingly, the association between functional aspects of QoL and values

of X50 was negative. Perhaps the subjectivity of the functional domain perception was an influence factor. Moreover, despite of the advantages of the Optocal plus 20 as a chewable Ixazomib cell line test material, its artificial nature could have a role in the test sensitivity. Mastication is a complex process characterized by the comminution and breakdown of food into smaller particles to facilitate digestion, which provides a larger surface area for enzymatic action, resulting in food breakdown Afatinib mouse and gastric emptying.7 According to Gibbs et al.37 and English et al.,38 three factors may influence MP:

the number and area of occlusal contacts, occlusal forces (maximum bite force) and the amount of lateral excursion during mastication. In the present study, a smaller number of occlusal contacts, i.e., a greater number of missing teeth was associated with higher values of X50, which represents the test food median particle size after chewing. This result indicates that patients with fewer teeth broke the chewable test material into larger particles, resulting in a worse MP, which was also observed by de Morais Tureli et al. 12 However, this correlation was only observed among 11–12 year-old children, agreeing with the individual differences in MP observed

by Toro et al. 7 In this respect, these authors noted that ageing in children is accompanied by dental maturation and an increase in body size. In addition, the results of the multiple linear regression showed a negative association between the X50 values and FL domain scores, indicating that 11–12-year-old children who broke the test material into smaller sizes, i.e., those who had a better MP, rated their functional ability as less efficient in terms of their oral status. These findings contradict previous evidence that showed that a worse objective masticatory Bumetanide function yielded a less favourable OHRQoL, which was observed in an elderly population. 14 In contrast, although not significant, the association between the “b” index and the CPQ scores was positive. Moreover, despite a lack of significance, X50 values and the “b” index were negatively correlated. Broadness depends on the number of chewing cycles 39; therefore, these results suggest that, despite the decrease in median particle size, 11–12 year-old children need more chewing cycles to comminute food into particles that are smaller than the median size.