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

Objective: To evaluate the effect of conservative therapeutic interventions in adult patients with temporomandibular disorders (TMD) and associated otologic symptoms.

Methods: An electronic search across six databases and grey literature was conducted. Studies were assessed for risk of bias, a random-effects meta-analysis, and the certainty of the evidence was evaluated using the GRADE tool.

Results: Eighteen studies were included in the final synthesis. Otologic symptoms significantly decreased following intervention compared to baseline [OR = 0.09; 95% CI = 0.04 - 0.23, I² = 56%], reflecting an approximately 11-fold reduction in symptom likelihood of otologic symptoms after conservative treatment. Of the studies, eight had a low risk of bias, five had moderate, and four had high risk, with evidence certainty rated as very low.

Conclusion: Conservative therapeutic interventions for TMD appear to reduce otologic symptoms. However, the certainty of the current evidence is limited, warranting further research to establish more definitive conclusions..

Objective: To investigate the effect of parathormone and thyroid hormones, along with their associated biochemical factors in individuals with and without symptoms indicative of temporomandibular disorder (TMDs) admitted to the internal medicine department.

Methods: The study involved 416 participants with symptoms indicative of TMDs and 415 controls. Serum concentrations of anti-thyroid peroxidase antibody (Anti-TPO Ab), free triiodothyronine, free thyroxine, thyroid-stimulating hormone, parathyroid hormone, calcium, sodium, potassium, magnesium, phosphorus, vitamin D, vitamin B12, folate, creatine kinase, haemoglobin, ferritin, C-reactive protein and sedimentation rate were analysed.

Results: The serum level of anti-TPO Ab was found to be elevated in participants with symptoms indicative of TMDs in comparison to controls (p < .001). However, no significant differences were observed in the other parameters assessed between the two groups (p > .05).

Conclusion: Serum concentrations of parathormone and thyroid hormones associated biochemical factors are not affected in participants with symptoms indicative of TMDs except Anti-TPO Ab.

Objective: The study aimed to determine the associations between several important and potentially modifiable health variables and TMD signs and symptoms.

Methods: A total of 209 adult dental patients from two clinics completed surveys on demographics, self-reported awake and sleep bruxism, TMD signs and symptoms, stress, depression, chronic pain, and sleep quality. Correlations and regression analyses were used to identify associations between these health variables and TMD symptoms.

Results: Awake bruxism was significantly associated with chronic pain intensity, jaw pain, clenching pain, and headaches. Stress and depression correlated with chronic pain intensity and clenching pain. No correlation was found between BMI and TMD symptoms. In multivariate analysis, both awake and sleep bruxism were associated with TMD symptoms, while sleep quality was related to pain on chewing and depression was associated with chronic pain intensity.

Conclusions: Identifying these associations can guide clinicians in assessing, educating and managing TMD-related issues by addressing bruxism, sleep quality, and depressive symptoms.

Objective: To investigate if there are dose-response relationships between self-reported waking-state oral behaviours, including awake bruxism, and three indicators of psychological distress (depression, anxiety, stress).

Methods: The study sample consisted of 1,886 patients with function-dependent TMD pain. Relationships between six non-functional and six functional waking-state oral behaviours, scored on a 5-point ordinal scale, and the psychological factors were investigated using ordinal logistic regression.

Results: Mean age was 42.4 (±15.3) years, 78.7% being female. The odds of reporting the higher categories of non-functional oral behaviours depended on the severity of depression, anxiety, and stress. Most OR coefficients followed a quadratic dose-response distribution, the others increased linearly as the severity of the psychological scales increased. Almost no such associations were found with normal jaw function behaviours.

Conclusion: Within the limitations of this study, it may be concluded that non-functional waking-state oral behaviours, including awake bruxism, and psychological distress have a dose-response relationship, with higher levels of distress being associated with higher reports of oral behaviours.

Objective: This study aimed to examine the dimensional characteristics of the condylar head in 3D models of dry human mandibles using two different measurement methods.

Methods: A total of 46 condylar heads from 29 dry human mandibles were scanned using a 3D scanner. Two perpendicular reference planes were used to identify the most medial, lateral, anterior, and posterior points. Measurements in the mediolateral and anteroposterior dimensions were taken using the direct measurement method, and the proposed method using the two reference planes. Paired t-tests were performed to compare the results.

Results: Significant differences were observed, particularly in anteroposterior dimensions, which were smaller when using the proposed method (p < .001).

Conclusion: Measurements of the condylar head should be taken from the outermost points. Given the nature of bone remodeling, relying solely on a single cut from CBCT images for dimensional evaluation may result in missing potentially significant changes.

Objective: To compare the efficacy of tonsillectomy and expansion sphincter pharyngoplasty (ESP) in the surgical treatment of obstructive sleep apnea (OSA).

Methods: OSA patients with Friedman grade III-IV tonsil hypertrophy diagnosed with polysomnography were separated into two groups according to the surgery performed, as the classic tonsillectomy group (Group 1) and the ESP group (Group 2). The primary endpoint of the study was to determine the Apnea-Hypopnea Index (AHI) value.

Results: Group 1 comprised 24 patients with median preoperative AHI of 19.7 and postoperative AHI of median 11.8 (p = .0001). Group 2 comprised 29 patients with median preoperative AHI of 25.1 and postoperative AHI of median 16.3 (p = .0001). Nine (37.5%) of the 24 patients in Group 1 accepted as cure (79.1%). Eight (27.5%) of the 29 patients in Group 2 accepted as cure (72.4%).

Conclusion: There was no superiority of ESP over tonsillectomy in patients with lateral pharyngeal obstruction.

Objective: We assessed association between periodontitis and sleep patterns.

Methods: Our study included 7289 participants based on a large-scale study in NHANES. Periodontitis was defined through an oral examination. We used logistic regression to explore association between sleep status and risk of periodontitis. Further, stratified analysis was conducted. We performed a Mendelian randomization (MR) analysis using publicly available genetic data from corresponding studies.

Results: Odds Ratio (OR) of periodontitis was 1.25 (1.07-1.46) in individuals with < 7 hours/per night. Stratification analysis showed individuals under 45 years old (OR: 1.28, 95% CI: 1.07-1.54), women (1.28(1.07-1.54)), education levels below high school (1.45(1.03-2.05)) and higher family income (-1.28(1.06-1.56)) were more likely to deteriorate to periodontitis if sleep time less than 7 hours. IVW-MR showed periodontitis risk was not associated with genetically increased levels of sleep time (0.22 (0.02-3.05)) or insomnia (0.83(0.55-1.24)).

Conclusion: There was no indication that sleep status was associated with periodontitis.

Purpose: To evaluate the effects of continuous positive airway pressure (CPAP) therapy on cognitive impairments associated with obstructive sleep apnea (OSA).

Methods: We systematically searched PubMed, Web of Science, EMBASE, and Cochrane Library for literature from their inception to June 26, 2025. Eligible randomized controlled trials (RCTs) included adults with OSA treated with CPAP, assessing daytime sleepiness, cognitive performance, mood, fatigue, and adherence.

Results: 17 RCTs involving 2,372 participants were included. CPAP therapy significantly improved daytime sleepiness (weighted mean difference [WMD] = -2.15; 95% confidence intervals [CI]: -2.96, -1.33), processing speed (WMD = 0.25; 95% CI: 0.07, 0.43), visual search (standardized mean difference [SMD] = -0.30; 95% CI: -0.58, -0.01), and anxiety (WMD = -0.81; 95% CI: -1.45, -0.17). With an average nightly usage of 4.99 hours (95% CI: 4.69, 5.30).

Conclusions: CPAP therapy significantly improved daytime sleepiness, processing speed, visual search, and anxiety in patients with OSA.

Objective: The aim of this study was to compare the clinical success and efficacy of single-needle double-cannula (SNDC) and double-needle (DN) arthrocentesis in patients with temporomandibular joint (TMJ) disc displacement without reduction (DDwoR).

Materials and methods: This pilot study included 28 patients with DDwoR who did not receive prior treatment. Data including age, sex, pain duration, maximum mouth opening (MMO), and pain perception were recorded. We performed arthrocentesis once for each indicated joint. Data were collected before arthrocentesis (baseline) and at one week and one, three, and six months after the procedure.

Results: Thirteen patients underwent SNDC arthrocentesis, and 15 underwent DN arthrocentesis. The mean MMO was significantly greater in the SNDC group (38.38±3.88) than in the DN group (34.33±5.92) at six months (p = 0.040). The mean VAS pain scores were significantly higher in the SNDC group (5.90±1.85) than in the DN group (3.53±2.23) at one week (p = 0.011).

Conclusion: Both techniques improved MMO and pain; SNDC may provide greater long-term MMO improvement, while DN may offer superior early pain relief.