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

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.

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.