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

Objective: The maxillary canines have long been considered critical for dental function and aesthetics, with traditional practice prioritizing their preservation and alignment. However, this view often stems from outdated teachings rather than evidence-based principles, since there is no scientific support for the concept of canine-protected occlusion. Therefore, this commentary paper provides justification for extraction of severely impacted maxillary canines with first premolar substitution.

Results: In cases of severely impacted maxillary canines, orthodontic alignment may be associated with higher morbidity, unpredictable outcomes, prolonged treatment times, and increased patient burden. As an alternative, extracting the impacted canines and substituting the first premolars offers a viable, efficient solution that can achieve functional and aesthetic outcomes with fewer complications.

Conclusion: This paper challenges traditional perspectives on the management of impacted canines, advocating for an evidence-based approach that prioritizes patient-centered care.

Objective: This cross-sectional study evaluated associations between sleep disorders, pain, bruxism, and chronotypes in patients with trigeminal neuralgia (TN) or post-herpetic neuralgia (PHN) in orofacial area.

Methods: Ninety-four subjects (25 TN, 14 PHN, 55 controls) were evaluated for pain, sleep, chronotype, anxiety, depression, oral behaviors, and lifestyle by validated instruments. Bruxism was assessed by self-report. Between-group comparisons and associations using correlation and regression analysis were made.

Results: TN patients had more sleep disorders and depressive symptoms and poorer lifestyles. Morningness was more common in PHN. Pain and anxiety were correlated with lower sleep quality and oral risk behaviors, mainly in TN. Worse lifestyle in both groups was correlated to anxiety and depression, and morningness was correlated to better lifestyle in TN. No association was observed of sleep or awake bruxism with lifestyle, anxiety, or depression.

Conclusion: TN patients are more vulnerable to sleep disorders and psychosocial impacts of pain.

Objective: To evaluate the prevalence of serum vitamin D and B12, calcium, phosphorus, magnesium levels, and rheumatoid factor (RF) status in patients with bilateral temporomandibular joint osteoarthritis (TMJ-OA) and their correlations with clinical and radiological findings.

Methods: The clinical and radiologic findings and serum vitamin and mineral levels of 90 patients diagnosed with bilateral TMJ-OA were recorded. Descriptive statistics and the Spearman's Rho correlation test were performed.

Results: Low serum vitamin D and B12 levels were detected in 82 (91.1%) and 74 (82.2%) patients. Calcium and phosphorus levels were seen at low rates. RF status was recorded as unfavorable in all patients. Correlations were found between age and the serum vitamin and mineral levels, except phosphorus. Low serum vitamin D levels correlated with pain complaints at rest and painless MIO. Serum B12 levels correlated with condylar erosion. Serum magnesium levels correlated with painful MIO and condylar osteophyte.

Conclusion: Patients with bilateral TMJ-OA showed a high prevalence of low serum vitamin D and B12 levels.

Objective: Bruxism is repetitive masticatory muscle activity occurring during sleep or wakefulness. Once considered purely harmful, it is now recognized as having both risk (e.g., tooth wear, TMD) and protective roles (e.g., against sleep apnea, reflux). This study evaluated Finnish dental students' understanding of modern bruxism concepts and management.

Methods: A 17-question survey was sent to all Finnish dental students (n = 1000), with 220 responses analyzed using SPSS (version 28) via chi-square and Spearman correlation tests.

Results: Knowledge improved with study progression (p < .001), and students with formal bruxism education answered more accurately (p < .001). However, misconceptions about occlusion as a cause increased with study progression (p = .009) and instruction hours (p = .018).

Conclusion: While Finnish dental students demonstrate growing bruxism knowledge, outdated beliefs persist. Universities should update curricula with evidence-based content and promote critical evaluation of bruxism-related information.

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: 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: To investigate several postural parameters and upper cervical functions in patients with temporomandibular disorders (TMD).

Methods: Patients diagnosed with different subtypes of TMD and healthy individuals without complaints of TMD were evaluated for pain, functional limitation, and anxiety by validated instruments. For evaluating upper cervical functions and postural parameters, cervical joint range of motion, cervical performance test, tragus wall distance, hamstring flexibility measurement, and measurement of the sacrum angle were recorded.

Results: Pain and jaw functional limitation scores were statistically higher in all groups with TMD. Patients with internal derangement and myofascial pain were significantly linked to a severe limiting of functions, higher anxiety, and depression scores. Postural parameters and cervical functions were similar between groups.

Conclusion: Although postural parameters and cervical functions remained unaffected, parameters such as pain, anxiety, and functional limitation that may affect the quality of life were related to unfavorable values in the TMD groups.

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: Perform a clinimetric analysis of the visual analogue scale (VAS) and active pain-free mouth opening (PFMO) in patients with muscular temporomandibular disorder (mTMD).

Methods:  Reliability (intraclass correlation coefficient=ICC), construct validity, responsiveness (area under the curve=AUC), minimal detectable change (MDC), and minimal clinically important difference (MCID) values were calculated.

Results: The VAS-24hr (ICC=0.59), VAS-7day (ICC= 0.54), and PFMO (ICC=0.86) exhibited acceptable reliability. Both the VAS (AUC=0.96) and PFMO (AUC=0.87) exhibited a high level of responsiveness. The MCID was 15.5mm (VAS-24 and VAS-7day) and 3.5mm (PFMO) in the improved group; and 27.5mm (VAS-24), 21mm (VAS-7day), and 6.6mm (PFMO) in the much-improved group. The MDC was 9.6mm (VAS-24), 9.5mm (VAS-7day), and 6.1mm (PFMO). All outcomes demonstrated strong construct validity (Pearson's r; p<0.001) .

Conclusions: All three outcome measures demonstrated acceptable clinimetric properties in patients with mTMD at the 3-month follow-up. The MCID lies outside measurement error in all outcomes in the much-improved group.      .

Objective: To evaluate the prevalence of temporomandibular disorders (TMD) and their association with sociodemographic and psychosocial factors among 33- to 35-year-old Finnish adults in the Northern Finland Birth Cohort 1986 (NFBC1986).

Methods: The sample included 1788 NFBC1986 subjects that have been clinically examined in 2018-19. TMD symptoms were inquired, and clinical TMD examinations were performed based on the Diagnostic Criteria of TMD (DC/TMD). Sociodemographic factors and depression/anxiety symptoms based on Hopkins Symptoms Checklist-25 (HSCL-25) and Generalized Anxiety Disorder-7 (GAD-7) were inquired using questionnaire.

Results: The prevalence of at least one of TMD symptoms was 30.4%. Women had higher prevalence of TMD symptoms and diagnoses compared to men. Female sex, anxiety/depression symptoms and socioeconomic group associated significantly with TMD pain symptoms and pain-related diagnoses.

Conclusion: The most frequent TMD diagnosis was myalgia and 26.4% had at least one TMD diagnosis. Anxiety/depression symptoms were associated with TMD symptoms and pain-related diagnoses.