Cranio-The Journal of Craniomandibular & Sleep Practice最新文献

Objective: Dental professionals are highly vulnerable to work-related musculoskeletal disorders (WMSD). As females, who are more prone to WMSD, represent a growing proportion of the dental workforce, this study explored sex differences in WMSD-pain prevalence among dental students, and differentiated it between preclinical and clinical students.

Methods: A multi-center cross-sectional study was conducted among dental students at three U.S. dental schools. An anonymous survey assessed prevalence of WMSD pain over the last 12 months and 7 days using the Nordic Musculoskeletal questionnaire. Sex and academic stage differences were analyzed with independent t-tests and chi-square, adjusted for demographics and occupational habits (working hours, self-reported ergonomics, loupes, sport engagement) with ANCOVA.

Results: Among 175 students (26.6±3.6 years, 66.9% females), 93.7% and 57.7% reported WMSD-pain in the past 12 months and 7 days, respectively. Females scored higher than males in pain intensity (p=.025), WMSD-pain prevalence in the past 7 days (p=.006), and number of painful body sites in the past 12 months (p=.006) and 7 days (p<.001). Clinical students had higher WMSD-pain prevalence (p<.001) and number of painful body sites (p<.001) in the past 7 days than preclinical students. Differences remained significant only among females.

Conclusion: A high prevalence of WMSD-pain was evident in dental students, with significant sex and academic stage differences.

Objective: To analyse the relationship between bruxism and musculoskeletal parameters of the cervical and mandibular regions in children and adolescents.

Methods: A comparative cross-sectional study was performed with subjects from 6 to 16 years. Subjects were divided into bruxism (any type) and control groups. Descriptive data, jaw opening, upper cervical spine mobility, myofascial trigger points (MTPs) and muscular tension of the jaw and neck muscles, the activation pattern of neck flexors and activation of Deep Neck Flexors (DNF) were registered and compared between groups.

Results: 121 subjects participated in the study. Children and adolescents reporting bruxism showed a significant reduction in the contraction of DNF (p = .034) and the activation ratio (p = .035) compared to controls. Besides, MTPs of both masseters were significantly more frequent in subjects reporting bruxism (p = .001-0.002). No differences were found in other measurements.

Conclusion: Bruxism is related to a weaker contraction of DNF, a lower activation ratio, and a higher number of MTPs in masseters.

Objective: Evaluate the relationship between OSAS and floppy eyelid syndrome [FES], along with possible confounding factors such as gender, age, and BMI.

Methods: This was a multicenter, cross-sectional prospective study. Patients referred to the sleep clinic suspected of OSAS were included in the study. Polysomnography, ophthalmological examination, and standard sleep questionnaires were applied for all patients.

Results: A total of 617 patients, 68.4% of whom were men, with a mean age of 50.66 [±12.43] years were included. While FES was 70.2% in the group with OSAS for ≥5/h, OSAS was detected in 93.6% of the individuals with FES. In addition, a positive correlation was found between AHI and FES. Age and the male gender were independent risk factors for FES.

Conclusion: A direct relationship was found between FES and the severity of AHI and OSAS. However, there was no evidence that OSAS is an independent risk factor for FES.

Objective: To present a list of key points for good Temporomandibular Disorders (TMDs) clinical practice on behalf of the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) group of the International Association for Dental, Oral and Craniofacial Research (IADR).

Methods: An open working group discussion was held at the IADR General Session in New Orleans (March 2024), where members of the INfORM group finalized the proposal of a list of 10 key points.

Results: The key points covered knowledge on the etiology, diagnosis, and treatment. They represent a summary of the current standard of care for management of TMD patients. They are in line with the current need to assist general dental practitioners advance their understanding and prevent inappropriate treatment.

Conclusions: The key points can be viewed as a guiding template for other national and international associations to prepare guidelines and recommendations on management of TMDs adapted to the different cultural, social, educational, and healthcare requirements.

Objective: Mean apnea-hypopnea duration (AHD) is the mean duration of apnea-hypopneas experienced during sleep and was found as an indicator of blood oxygenation. The aim of this study was to compare and define the differences in clinical, demographic and polysomnographic characteristics of obstructive sleep apnea (OSA) patients in long and short AHD groups and investigate the relationship between apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and sleepiness.

Methods: The cross-sectional analysis included 511 OSA patients who were >18 years and followed up between June 2019 and December 2019 in the Sleep Center of university hospital. The consecutive polysomnography reports and patient data were recorded retrospectively.

Results: Polysomnographic evaluation of different AHD groups showed obvious differences. Although there were no statistically significant differences in the overall AHI values. The Epworth measurements, ODI, time that saturation is below 90%, and N1 and N2 sleep were higher in the long AHD group. On the contrary, sleep efficiency, total sleep time, N3 and REM sleep, average oxygen saturation (AOS), and lowest oxygen saturation (LOS) were lower in the long AHD group.

Conclusions: The findings of this study showed that the AHD is a useful indicator of blood oxygenation and, therefore, tissue oxygenation, independent of the AHI. OSA patients with longer AHD have more vascular complications such as diabetes and hypertension. We suggest that the severity of OSA should be monitored with AHD for preventing potential complications of OSA.

Objective: This systematic review determined whether occlusal appliance use influences the sleep of individuals with sleep bruxism.

Material and methods: Six databases and the gray literature were searched to identify randomized and non-randomized clinical trials comparing slow wave sleep and sleep quality of sleep bruxers before and after occlusal appliance use. The Risk of Bias was assessed using Cochrane tools and Meta-analyses were performed to compare data. The Certainty of the evidence was evaluated by Grading of Recommendations Assessment, Development, and Evaluation approach.

Results: Two randomized and eight non-randomized studies were included. Meta-analyses indicated that soft and hard appliances influenced the slow-wave sleep and sleep quality of sleep bruxers, as determined by polysomnography (Z = 5.58; p < .001), the Pittsburgh Sleep Quality Index (Z = 3.45; p < .001), and the Sleep Assessment Questionnaire (Z = 48.1; p < .001).

Conclusion: Occlusal appliance use significantly impacts slow-wave sleep and sleep quality in sleep bruxism individuals, regardless of appliance design or material.

Objective: To examine the relationship between non-physiological awake oral behaviors (NPAOB) and awake bruxism (AB) and symptoms of depression, distress, anxiety and somatization in adolescents.

Methods: A total of 100 adolescents aged 12-15 from Medellín, Colombia participated, with 79 completing the assessments after excluding those with known health conditions. The frequency of NPAOB and AB was evaluated using the oral behavior checklist (OBC). Symptoms of depression, anxiety, distress, and somatization were assessed with standardized instruments (PHQ-A, GAD-7, PSS-C and PHQ-15).

Results: Symptoms of depression did not represent a significant predictor of NPAOB, but it is of AB. The occurrence of anxiety symptoms led to a twofold increase in the likelihood of having NPAOB (OR>2; p<0.05), while anxiety, distress and somatization was associated with a more than three times higher probability of NPAOB and AB (OR>2;p<0.05).

Conclusion: Distress, anxiety, depression and somatization significantly influences NPAOB and AB in adolescents.

Objective: To explore the relationship between parenting styles and children's personality traits and parental-reported sleep bruxism (SB).

Methods: A total of 301 parents/caregivers of Brazilian children participated in this cross-sectional study and answered an online questionnaire addressing sociodemographic characteristics, sleep-related behaviors and parent-reported SB. The Brazilian versions of the Parenting Styles and Dimensions Questionnaire and the Eysenck Personality Questionnaire-Junior assessed children's parenting styles and personality traits. Descriptive analysis and multinomial logistic regression were used.

Results: Boys (OR=2.07; 95% CI=1.09-3.91) whose snoring (OR=2.98; 95% CI=1.55-5.73) were associated with mild parent-reported SB. Boys (OR=2.61; 95% CI=1.20-5.70) and high levels of neuroticism (OR=2.27; 95% CI=1.06-4.860) were associated with moderate/severe parent-reported SB. Authoritarian parenting attitudes decreased the likelihood of moderate/severe parent-reported SB (OR=0.37; 95% CI=0.16-0.86).

Conclusions: Parents/caregivers who exhibited more authoritarian attitudes reported a lower prevalence of moderate/severe children SB. Neuroticism trait and snoring influenced the severity of parent-reported SB.