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

Objective: To investigate whether the distance between the two retromolar trigones (RMTs) with the distance between the two posterior plicas (PPs) affects obstructive sleep apnea syndrome (OSAS) and to determine a physical examination method that can be used in the selection of patients to be referred to polysomnography (PSG).

Methods: The study included 86 OSAS patients and 29 healthy controls. RMTs and PPs were measured using a caliper-like device. The values obtained from these measurements were evaluated in both groups.

Results: The PPs were narrower, and the RMTs-PPs, RMTs-PPs/RMTs, and RMTs/PPs values were greater in the OSAS group (p < .05) compared to the control group. The cut-off values were 0.612 for RMTs-PPs/RMTs and 2.589 for RMTs/PPs. The specificity of these values for OSAS was 97%, and sensitivity was 57% and 58%, respectively.

Conclusion: The presented method may play a role in preventing unnecessary PSG among patients with suspected OSAS.

Objective: To assess the validity and reliability of the Turkish version of the Mandibular Function Impairment Questionnaire (MFIQ-TR).

Methods: Included in this study were 248 patients diagnosed with temporomandibular disorder (TMD) according to Diagnostic Criteria for TMD Axis I protocol. Construct-related validity was evaluated through internal and external construct validity; convergent and divergent validities were evaluated by the average variance extracted (AVE), composite reliability (CR), and bivariate correlations between factors. Reliability was assessed by internal consistency and test-retest reliability.

Results: All items of the MFIQ-TR had content validity and factor loadings above 0.5. The model statistics indicated a good fit. The convergent validity was very good (AVE > 0.5 and CR > 0.7), and the discriminant validity was satisfied. Internal consistency and test-retest reliability of the MFIQ-TR were excellent.

Conclusion: The MFIQ-TR is a valid and reliable instrument for evaluating the impairment of mandibular function in Turkish patients with TMD.

Objective: To investigate the reasons for poor adaptation to mandibular advancement splint (MAS) treatment.Methods: The study consisted of 44 patients with obstructive sleep apnea who had unsuccessful MAS treatment. Data were collected on age, body mass index, gender, general and mental diseases, continuous positive airway pressure (CPAP) tryout, usage of occlusal splint, dental overjet, temporomandibular disorders, shortened dental arch, sleep apnea severity, and Apnea-Hypopnea Index. Sixty patients who underwent successful MAS treatment were controls.Results: Patients with missing molars failed significantly more often in MAS therapy than the controls (p = 0.020). Patients with CPAP tryout prior to MAS treatment had a tendency to fail MAS treatment. MAS treatment was more likely to be successful in patients with prior occlusal splint experience (p = 0.050).Conclusion: The study could not identify a single reason for MAS failure.

Objective: To evaluate the long-term effectiveness, compliance, and side effects of tongue stabilizing devices (TSDs).

Methods: Thirty-nine patients were followed up after 12 and 30 months. The subjective effectiveness was assessed using the Epworth Sleepiness Scale (ESS), the Functional Outcomes Sleep Questionnaire (FOSQ-10), the Chalder Fatigue Scale (CFQ), and a sleep-related quality of life questionnaire (QoL). Compliance and side effects were assessed.

Results: At 12-months, 35.9% of patients confirmed continuing the therapy, compared to only 15.4% of patients at 30 months. At 30 months, a significant average improvement of ESS (2.0 ± 2.8) was observed compared to baseline levels in six patients. Six patients demonstrated an average increase in blood pressure. The most frequently reported side effects were mouth dryness and excessive salivation. The 3D analysis revealed small tooth movements.

Conclusion: The TSD therapy demonstrated a good long-term subjective effectiveness against OSA but had a relatively low treatment acceptance rate.

Objective: To investigate the link between malocclusions and temporomandibular disorders (TMD) with a focus on iatrogenic malocclusion. Other etiologies of TMD (oral parafunctions) were also assessed.

Methods: The prevalence of malocclusions was correlated in two groups: patients with TMD (case group) and patients without TMD (control group). Malocclusions involving dental care were specified. Parafunctions in the case group were assessed.

Results: A statistically significant association between TMD and overbite >4 mm, interferences in laterotrusion, and absence of Angle Class I was shown. A potential deleterious effect of iatrogenic malocclusions was highlighted.

Conclusion: The multifactorial etiology of TMD was confirmed because an association between TMD and three malocclusions was found, and all case patients had parafunction(s). Current recommendations advising first a reversible treatment, TMD care should start with a behavioral re-education to remove parafunctions. However, it is essential to avoid creating iatrogenic malocclusion during dental care.

Objective: To study the signs and symptoms of temporomandibular disorders (TMDs) and incisal relationships related to sleep bruxism and parafunctional habits among children.

Methods: The study consisted of 106 children (53 with and 53 without bruxism) between the ages of 7 and 10. A general questionnaire and Diagnostic Criteria for Temporomandibular Disorders Axis I examination form were used for each child.

Results: There were significant differences between children according to pain, headache, midline deviation, opening pattern, temporomandibular joint noise, overjet, overbite, corrected deviation, and pain disorders (p < 0.05). According to the logistic regression, the higher scores of "mouth breathing" and "horizontal incisal overjet" were independent risk factors for TMDs. The lack of "bruxism" and "sleeping with open mouth" were protective factors for TMDs.

Conclusion: Children with bruxism showed signs and symptoms of TMDs and divergence in incisal relationships.

Objective: To investigate biomechanics, muscle performance, and disability of the craniocervical region in temporomandibular disorder (TMD) patients and compare them with controls.

Methods: Craniocervical posture was evaluated using lateral photography and radiography. Range of motion, muscle performance, disability, and TMD severity were assessed using an inclinometer, Functional Strength Testing of Cervical Spine, Neck Disability Index, and Fonseca Anamnestic Index, respectively.

Results: Compared to the control group, the TMD group demonstrated higher cervical flexion angle (p=0.005) and neck disability (p<0.001) as well as lower cervical extension (p=0.040), right cervical rotation (p=0.005), left cervical rotation (p<0.001), and tragus-C7-horizontal (p=0.048) angles, and reduced muscle performances (p≤0.001). Most patients had higher than normal craniocervical angle (p<0.001). Muscle performance in each cervical motion (p<0.005) and disability (p<0.001) were associated with TMD severity in the TMD group.

Conclusion: Biomechanics, muscle performance, and disability of craniocervical region were altered in the TMD group.

Objective: To determine postural changes in relation to mandibular position in maximum intercuspation and at rest in adult patients of both sexes.

Methods: : A descriptive observational clinical study was carried out in 76 patients. Using an analyzer and the Meersseman test, the necessary dermal points for postural analysis were located.

Results: : The authors found significant differences in the posture adopted by the patient between maximum intercuspation and mandibular rest in the frontal, sagittal, and dorsal planes. Foot support in the right foot went from cavus to normal in 6% of the sample, and from flat to normal in 2.5% of the sample in the jaw rest position.

Conclusion: Postural changes were observed in various segments, with clinical and statistical significance at cervical level in the frontal plane, in the biscapular variable in the dorsal plane, and at the level of the lower limbs in the bipopliteal and bimalleolar variables.

Objective: To determine the efficacy of injectable botulinum toxin (BTA) in the management of pain associated with nocturnal bruxism.

Methods: The study subjects consisted of 40 male and female volunteers who complained of chronic pain in the masseter muscles bilaterally due to bruxism. Twenty units of BTA were injected bilaterally into the masseter muscles. Clinical parameters of pain at rest and chewing were assessed at baseline, 2, 4, 8, 12, 16, 18, and 24 weeks using the visual pain scale (VPS).

Results: The study included 24 females and 16 males aged 21 to 52 years (mean 33.9 ± 31.0). The mean VPS score on the first day was 5.75 (SD 1.9), significantly decreasing after two weeks to 0.44 (SD 0.727). The mean difference of VPS from 8 weeks up to 24 weeks gradually increase from 0.69 at 8 weeks to 2.00 at 24 weeks.

Conclusion: This study provides evidence that BTA could reduce the pain of nocturnal bruxism in affected patients.

Objectives: The associations of Temporomandibular disorder (TMD) pain with somatic symptoms, mental ill-being/distress, and well-being were explored, along with the mental correlates of TMD (TS) and somatic symptom (SS) burden in older adolescents-young adults.

Methods: TMD/somatic symptoms were appraised with the five quintessential symptoms (5Ts) of the DC/TMD/Somatic Symptom Scale-8, whereas mental distress/well-being was assessed with the Depression, Anxiety, Stress Scales-21/Scales of Psychological Well-being-18. Data were examined using Chi-square/non-parametric tests and multivariate analyses (α = .05).

Results: Among the 366 participants, 51.4%, 28.1%, 6.8%, and 13.7% had no TMD (NT), TMD pain (TP), TMD dysfunction (TD), and combined TMD (CT) respectively. Though mental distress varied substantially (CT, TP>NT, TD), no significant differences in well-being were discerned. SS burden, but not TS burden, was moderately correlated to distress.

Conclusions: The prospect of TMD pain was increased by being female, depressed, and anxious but reduced by "positive relations with others" and "self-acceptance".