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

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.

Background: Temporomandibular joint (TMJ) arthrocentesis is a minimally invasive procedure for internal derangements and degenerative conditions. Although generally safe, rare but serious complications can occur, requiring clinical vigilance.

Case:   A 37-year-old male with bilateral TMJ osteoarthritis presented with severe pain (VAS 8/10), restricted opening (34 mm), and MRI-confirmed bilateral anterior disc displacement without reduction and effusion. After unsuccessful conservative therapy, he underwent three single-needle arthrocentesis sessions with intra-articular hyaluronic acid. Post-treatment, he developed a pulsatile preauricular swelling and tinnitus. Imaging identified an arteriovenous fistula between the superficial temporal artery and external jugular vein. Endovascular repair was unfeasible, so surgical ligation, discectomy, and arthroplasty with amniotic membrane interposition were performed, achieving full recovery and improved mouth opening (45 mm at 6 months).

Conclusion: This rare vascular complication highlights the need for early recognition of atypical postoperative signs. Prompt imaging and a multidisciplinary approach ensure safe management and favorable outcomes.

Aim: This investigation aims to retrospectively investigate the success rate of posterior partial crowns made with a nanoceramic resin-based material.

Materials and methods: A total of 98 patients, mean age 41±8.9 years, who received single partial crown restorations made with Cerasmart® were enrolled. The average follow-up was 7.7±0.4 years. The outcome was evaluated with the modified US Public Health Service [USPHS] criteria. Patients were divided into bruxers and non-bruxers according to the presence of self-reported bruxism and clinical examination.

Results: A significant difference in the number of crowns that needed to be replaced during the follow-up span was identified between the group of bruxers and non-bruxers (p < .05). The logistic regression analysis showed that the presence of bruxism was the only variable contributing to the significantly higher failure rate.

Conclusion: The study suggests that prior to any prosthodontic restoration, an assessment of bruxism should always be performed, as it could contribute to a higher failure rate.

Objective: To compare nonsteroidal anti-inflammatory drug (NSAID) therapy alone with NSAID plus home exercise in temporomandibular joint (TMJ) osteoarthritis and arthralgia.

Methods: Sixty patients received Tenoxicam 20 mg/day alone (Group 1) or with home exercise (Group 2). Outcomes were mandibular range of motion (RoM), pain (VAS), and TMD-related quality of life (TMD-QoL).

Results: Group 2 showed greater MMO increase (+3.9 mm, p < .005) than Group 1 (+0.7 mm, p > .05). VAS decreased similarly in both groups (p < .005; between-group p > .05). TMD-QoL improved more in Group 2 (p < .05).

Conclusion: NSAID plus exercise yields superior functional and QoL benefits versus NSAID alone, with comparable pain relief.

Background: Idiopathic condylar resorption (ICR) is a rare temporomandibular joint disease characterized by progressive condylar degeneration with an unknown etiology. A comprehensive quantitative analysis of the morphological differences in the condyle between ICR patients and normal individuals is crucial, yet limited by small sample sizes in existing literature.

Methods: This systematic review and meta-analysis were conducted following PRISMA guidelines. A random-effects model was employed to synthesize the mean differences in key condylar measurements between ICR patients and normal controls.

Results: The analysis revealed that ICR patients had significantly smaller condylar dimensions compared to normal individuals. The meta-analysis quantified the following reductions: Condylar height: -3.71 mm. Condylar width: -3.38 mm. Condylar length: -1.19 mm. Axial angle: -13.70°    .

Conclusion: This study provides synthesized quantitative data on condylar morphology in ICR, however, the conclusions should be interpreted with caution due to the presence of heterogeneity and potential biases in the included studies.

Background: A four-dimensional impact framework has been recommended for evaluating oral conditions.

Objectives: This study examined the reliability and validity of the four-dimensional structure for the Oral Health Impact Profile for Temporomandibular Disorders (OHIP-TMD).

Methods: 902 TMD patients were grouped into non-painful intra-articular, pain-related, and combined TMDs for comparisons. Participants completed socio-demographic surveys, DC/TMD Axis II tools, and OHIP-TMD.

Results: All dimensions showed good reliability (α: Di1 = 0.814, Di2 = 0.736, Di3 = 0.755, Di4 = 0.935). Di3 (orofacial appearance) and Di1 (oral function) were notably more impacted than Di2 (orofacial pain) and Di4 (psychosocial impact) across subgroups. Moderate-to-strong correlations were identified between Di1-jaw functional limitation, Di2-current/worst pain, Di3-anxiety, and Di4-depression/anxiety (rs = 0.51-0.70). The strongest dimension-domain correlations included Di1-functional limitation, Di2-physical pain, Di3-psychological discomfort, and Di4-psychological disability(rs = 0.88-0.97).

Conclusions: The four-dimensional impact framework for the OHIP-TMD demonstrates good reliability and validity, offering valuable insights into how TMDs affect the well-being and daily functioning of patients.

Objective: Among subjects undergoing polysomnography (PSG), some subjects complain of unrefreshing sleep (URS) after in-laboratory PSG (lab-PSG). The purpose of this study was to clarify whether there are differences in the backgrounds of such subjects and their polysomnographic findings.

Methods: We asked subjects undergoing lab-PSG for the diagnosis of sleep-related breathing disorders whether they had URS immediately after lab-PSG (PSG-URS) and compared their backgrounds and polysomnographic findings.

Results: We conducted an analysis of 151 subjects undergoing lab-PSG. Multivariate analysis demonstrated that the presence of smoking up to six hours before PSG, total sleep time (TST), sleep efficiency (SE), sleep latency (SL), and wake time after sleep onset (WASO) were independent determinants of PSG-URS after adjusting for some factors.

Conclusion: Smoking up to 6 hours before PSG and short TST, small SE, long SL, and long WASO in PSG were significantly associated with the presence of PSG-URS.