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

Objective: To evaluate the knowledge of Italian physiotherapists regarding temporomandibular disorders (TMD) management and to investigate the use of evidence-based strategies.

Methods: A survey was distributed to 412 Italian physiotherapists collecting data on demographics, education, TMD knowledge, assessment, and treatment strategies.

Results: Most respondents (73.3%) reported no formal TMD training during their bachelor, and more than half (51.0%) treated no TMD patients in an average month. 67.2% provided a TMDs definition according to literature, and 92.0% recognized the primary structural pain generators. 21.8% were familiar with the DC/TMD diagnostic criteria, while misconceptions persisted regarding occlusion (26.7% endorsing a causal role) and posture (28.6%). 81.1% used education , and 88.3% adopted a multimodal strategy consistent with guidelines.

Conclusions: Italian physiotherapists showed good general TMDs knowledge and frequent use of guideline-consistent treatment. However, limited undergraduate exposure, variable postgraduate education, and persisting misconceptions highlight the need for more standardized and evidence-based training in this context.

Objective: To evaluate whether phenotypic classification according to the PALM framework (pharyngeal collapsibility, arousal threshold, loop gain, and muscle responsiveness) can predict postoperative outcomes in patients with obstructive sleep apnea (OSA) undergoing maxillomandibular advancement (MMA). Secondary objectives were to explore its usefulness in preoperative planning and to assess the influence of body mass index (BMI) on surgical response.

Methods: A retrospective study was conducted on 59 patients with OSAS who underwent MMA between 2017 and 2023. Patients were classified using a modified PALM system based on preoperative AHI and therapeutic CPAP pressure requirements. Postoperative outcomes were assessed by polysonnography, and regression analyses examined the relationship between percentage changes in AHI and BMI.

Results: PALM 1 patients showed a significantly greater reduction in AHI compared with PALM 2 patients and higher rate of surgical success.No significant correlation was found between changes in AHI and BMI.

Conclusion: PALM phenotyping demonstrated predictive value for MMA outcomes, supporting a more personalized approach to OSA management.

Objective: To compare asymmetry in occlusal contact area, number of occlusal contact points, and number of occluding tooth pairs between healthy individuals and patients with temporomandibular disorders (TMDs) categorized by the DC/TMD.

Methods: A cross-sectional analytical study was conducted on 49 participants aged 18-45 years, divided into five groups: healthy, muscle pain, joint pain, combined muscle and joint pain, and joint disorder. Occlusal contacts at maximum intercuspation were recorded using an intraoral scanner. STL files were analyzed to quantify occlusal contact area, contact points, and occluding tooth pairs. Clinical and psychosocial variables were assessed using standardized questionnaires.

Results: Intra-examiner reliability was high (ICC = 0.90). No significant between-group differences were found in demographic characteristics or occlusal asymmetry measures (p ≥ .05).

Conclusion: No statistically significant differences in occlusal asymmetry were found among TMD subgroups or healthy individuals. Current evidence does not support the use of intraoral scanning of occlusal contacts for diagnosing or differentiating TMDs.

Objective: To evaluate the position and orientation of the mandibular proximal segment and the volume of condylar and coronoid processes in class II and III patients submitted to bimaxillary orthognathic surgery, using cone beam computed tomography scans.

Methods: Class II and III patients who underwent bimaxillary orthognathic surgery were evaluated by fusing their preoperative virtual planning and postoperative outcomes. The CBCT scans were import into Dolphin Imaging Software and the images were superimposed. The superimposition of the planned and postoperative CBCT images was performed with the voxel-based method. Results: Differences were found in condylar resorption between class II and III.

Conclusion: The displacement of the mandibular proximal segment after orthognathic surgery was negligible and supported by the condyle and coronoid process, which demonstrated with a clinically non-relevant resorption and postoperative stability.

Objective: This systematic review determined whether occlusal appliance use influences the sleep of individuals with sleep bruxism.

Material and methods: Six databases and the gray literature were searched to identify randomized and non-randomized clinical trials comparing slow wave sleep and sleep quality of sleep bruxers before and after occlusal appliance use. The Risk of Bias was assessed using Cochrane tools and Meta-analyses were performed to compare data. The Certainty of the evidence was evaluated by Grading of Recommendations Assessment, Development, and Evaluation approach.

Results: Two randomized and eight non-randomized studies were included. Meta-analyses indicated that soft and hard appliances influenced the slow-wave sleep and sleep quality of sleep bruxers, as determined by polysomnography (Z = 5.58; p < .001), the Pittsburgh Sleep Quality Index (Z = 3.45; p < .001), and the Sleep Assessment Questionnaire (Z = 48.1; p < .001).

Conclusion: Occlusal appliance use significantly impacts slow-wave sleep and sleep quality in sleep bruxism individuals, regardless of appliance design or material.

Objective: To explore the relationship between parenting styles and children's personality traits and parental-reported sleep bruxism (SB).

Methods: A total of 301 parents/caregivers of Brazilian children participated in this cross-sectional study and answered an online questionnaire addressing sociodemographic characteristics, sleep-related behaviors and parent-reported SB. The Brazilian versions of the Parenting Styles and Dimensions Questionnaire and the Eysenck Personality Questionnaire-Junior assessed children's parenting styles and personality traits. Descriptive analysis and multinomial logistic regression were used.

Results: Boys (OR=2.07; 95% CI=1.09-3.91) whose snoring (OR=2.98; 95% CI=1.55-5.73) were associated with mild parent-reported SB. Boys (OR=2.61; 95% CI=1.20-5.70) and high levels of neuroticism (OR=2.27; 95% CI=1.06-4.860) were associated with moderate/severe parent-reported SB. Authoritarian parenting attitudes decreased the likelihood of moderate/severe parent-reported SB (OR=0.37; 95% CI=0.16-0.86).

Conclusions: Parents/caregivers who exhibited more authoritarian attitudes reported a lower prevalence of moderate/severe children SB. Neuroticism trait and snoring influenced the severity of parent-reported SB.

Objective: Dental professionals are highly vulnerable to work-related musculoskeletal disorders (WMSD). As females, who are more prone to WMSD, represent a growing proportion of the dental workforce, this study explored sex differences in WMSD-pain prevalence among dental students, and differentiated it between preclinical and clinical students.

Methods: A multi-center cross-sectional study was conducted among dental students at three U.S. dental schools. An anonymous survey assessed prevalence of WMSD pain over the last 12 months and 7 days using the Nordic Musculoskeletal questionnaire. Sex and academic stage differences were analyzed with independent t-tests and chi-square, adjusted for demographics and occupational habits (working hours, self-reported ergonomics, loupes, sport engagement) with ANCOVA.

Results: Among 175 students (26.6±3.6 years, 66.9% females), 93.7% and 57.7% reported WMSD-pain in the past 12 months and 7 days, respectively. Females scored higher than males in pain intensity (p=.025), WMSD-pain prevalence in the past 7 days (p=.006), and number of painful body sites in the past 12 months (p=.006) and 7 days (p<.001). Clinical students had higher WMSD-pain prevalence (p<.001) and number of painful body sites (p<.001) in the past 7 days than preclinical students. Differences remained significant only among females.

Conclusion: A high prevalence of WMSD-pain was evident in dental students, with significant sex and academic stage differences.

Objective: To analyse the relationship between bruxism and musculoskeletal parameters of the cervical and mandibular regions in children and adolescents.

Methods: A comparative cross-sectional study was performed with subjects from 6 to 16 years. Subjects were divided into bruxism (any type) and control groups. Descriptive data, jaw opening, upper cervical spine mobility, myofascial trigger points (MTPs) and muscular tension of the jaw and neck muscles, the activation pattern of neck flexors and activation of Deep Neck Flexors (DNF) were registered and compared between groups.

Results: 121 subjects participated in the study. Children and adolescents reporting bruxism showed a significant reduction in the contraction of DNF (p = .034) and the activation ratio (p = .035) compared to controls. Besides, MTPs of both masseters were significantly more frequent in subjects reporting bruxism (p = .001-0.002). No differences were found in other measurements.

Conclusion: Bruxism is related to a weaker contraction of DNF, a lower activation ratio, and a higher number of MTPs in masseters.

Objective: To investigate the relationship between sleep bruxism(SB) and gastroesophageal reflux disease (GERD) with the use of validated questionnaires in a general population convenience sample.

Methods: SB behaviour was evaluated in accordance with the Subject-Based Assessment strategy recommended in the Standardized Tool for the Assessment of Bruxism (STAB). .To evaluate GERD-related symptoms, the GERD-Q questionnaire was adopted. To study the correlation between current SB and GERD, Spearman test was performed. Mann-Whitney-U test was adopted to compare GERD-related symptoms in two distinct group comparisons based on the presence of current SB and a history of SB, respectively.

Results: A significant but weak positive correlation between current SB and GERD was found (r = .112; p = .044). No significant differences in GERD-related symptoms between groups emerged.

Conclusions: This investigation showed a positive but weak correlation between current SB and GERD-related symptoms. Larger scale studies in representative samples are needed to further explore this correlation.