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

Background: Chondromyxoid fibroma (CMF) is a rare cartilaginous tumor, accounting for < 1% of benign bone tumors. We report a case of temporomandibular joint (TMJ)-CMF, involving the pterygopalatine space and skull base and discuss its epidemiology, clinical characteristics, and management.

Case presentation: A 56-year-old woman presented with facial asymmetry and progressive mouth opening restriction due to a mass expanding upwardly to the auriculotemporal region. Using digital techniques to determine the lesion's boundary and reconstruct the normal glenoid fossa, the temporalis myofascial flap was transplanted between the titanium mesh and condyle to reconstruct the disc after tumor resection.

Conclusion: This case highlights the importance of identifying patients with TMJ-CMF.

Objective: It was aimed to investigate the role of tonsil ultrasonography(USG) in the diagnosis of pediatric OSAS.

Methods: Before tonsillectomy (±adenoidectomy) for OSAS, all patients tonsil USG and polysomnography (PSG) tests were performed. Tonsil volume was measured preoperatively with the Brodsky tonsil grading scale and by postoperative water displacement test.

Results: In total, 47 patients were included in the study. We observed a positive correlation between tonsil volumes measured by preoperative USG and water displacement test postoperatively. There was a statistically significant correlation between tonsil sizes measured by tonsil USG, PSG AHI and questionnaire scores(p < .05).

Conclusion: Preoperative tonsil USG may be helpful test in children with suspected OSAS.

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 investigate the effect of a home exercise program on pain and quality of life (QoL) in TMD.

Methods: Twenty patients were included in the study. The Group A received both a home exercise program and a physiotherapy program, while only a physiotherapy program was given to the Group B. Pain was measured using the Visual Analogue Scale (VAS) and QoL using the Short-Form 36 (SF-36).

Results: Pain decreased in both groups (p < 0.05). Among the SF-36 domains, bodily pain, vitality and social functioning scores improved in the Group A, while only the bodily pain parameter improved in the Group B (p < 0.05). On between-group comparison, the positive effect on pain and quality of life was greater in the Group A (p < 0.05).

Conclusion: The addition of a home exercise program to the conventional physiotherapy program provided greater improvement in pain and QoL in patients with TMD.

Objective: The tympanic plate typically joins the articular tubercle in the medial glenoid wall. It is aimed to report a peculiar anatomic variant of the latter.

Methods: The computed tomography scans of two adult male cases were documented for the anatomical details of the temporomandibular joint.

Results: The absence of the tubal processes of the tympanic plates was found bilaterally. The medial glenoid walls were penetrated by posterior or tubal sphenoidal plates extending posteriorly from the sphenoidal spines, 6.6 mm/12.2 mm on the right/left sides in the first case, and 9.8/8.4 mm on the right/left sides in the second case. These plates formed the lateral tubal walls and modified the tubal sulci on the sphenopetrosal fissures into musculotubal pseudo-canals. On the sides of the tubal sphenoidal plates formed in the medial wall of the glenoid fossa additional fissures, an anterolateral sphenotemporal one and a postero-medial sphenotympanic one.

Conclusion: As far as the authors know, the tubal plate of the sphenoid bone was not observed previously to participate in the glenoid fossa's medial wall. It could be regarded as a rare anatomic variation.

Objective: To assess the frequency of awake bruxism (AB) behaviors in a group of undergraduate dentistry students and correlate it with the status of anxiety and depression.

Materials and methods: The frequency of five oral behaviors (i.e., relaxed jaw muscle, teeth contact, mandible bracing, teeth clenching, teeth grinding) was evaluated using a smartphone-based ecological momentary assessment (EMA) approach. The anxiety and depression status was investigated with the four-item patient health questionnaire for anxiety and depression (PHQ-4). ANOVA with Tukey post-hoc test was used to assess the difference in frequency of AB behaviors among the four PHQ-4 groups.

Results: Among the four groups, there was a statistically significant difference in the frequency of relaxed jaw muscle, teeth contact, mandible bracing, and teeth clenching, but not for teeth grinding.

Conclusion: Based on this cross-sectional study's findings, psyche seems to have a determinant impact on AB behaviors, which is significantly higher in individuals with anxiety and depression traits.

Objective: This study aimed to assess the effects of aligners on masseter muscle activity by using an electromyographic device in the home environment.

Methods: The study was performed on healthy patients who required orthodontic treatment. Three different 24 h-EMG recording sessions were performed in different conditions: without aligners, with passive aligners, and with active aligners. The non-functional MMA work index (nfMMA-WI) and the non-functional MMA time index (nfMMA-TI) for both awake and sleep hours were assessed. ANOVA test was used to compare the average activity during the three recording conditions.

Results: On average, a total recording time of 204.7 ± 7.9 hours were provided for each patient. For most patients, ANOVA test showed an absence of significant differences between the recording sessions.

Conclusions: The impact of our results is not negligible: clinicians can find remarkable support to the hypothesis that the use of aligners affects the MMA only in a minority of subjects.

Objective: This study aimed to evaluate the relationship between the presence of calcium deposits (CDs) around the dens axis and patients' age, gender, and systemic diseases.

Methods: This retrospective study was carried out by examining CBCT. Basic descriptive statistical analyses and normality tests were performed on all variables. The assumption of normality was checked using the Shapiro-Wilk method. The statistical significance level was accepted as a p-value less than 0.05.

Results: CDs were observed in a total of 99 (21.9%) individuals. The incidence of CDs statistically significantly increased with age (p < .01),while it didn't statistically significantly differ between genders (p = .47). 13% were systemically healthy, while 55% had hypertension. The incidence of CDs was statistically significantly higher in individuals with hypertension.

Conclusions: In the presence of CDs, the patient should be referred to a medical doctor to confirm the diagnosis of CDS and prevent possible complications.

Objective: To assess the association between self-reported symptoms of pediatric OSA and clinical signs in MB children.

Methods: Seventy-three MB children aged 7-14 years answered an interview questionnaire on OSA symptoms in childhood, focusing on chewing, nasal, and sleep disturbances. MB children were checked for changes on the craniofacial, occlusion, TMJ, upper airway, and body posture by a multi-disciplinary team, consisting of medical residents, dental, and psychology postgraduate students. Multiple logistic regression analysis verified the association between clinical signs and self-reported symptoms.

Results: Reported symptoms of chewing disturbance as TMD noise, muscle pain, and morning headache were significantly associated with the presence of lip incompetence and Class II malocclusion. Sleep disturbances as snoring, waking up at night, daytime sleepiness, and sleeping with the mouth open were significantly associated with the presence of hypertrophic tonsils and obstructive Mallampati score.

Conclusion: Symptoms of pediatric OSA were found in mouth-breathing children, which should be carefully investigated in order to prevent OSA in the future.

Objectives: Anabolic androgenic steroids (AAS) are derivatives of testosterone, used to treat gonadal disturbances, performance enhancement, and aesthetic purposes. AAS abuse can lead to side effects, including androgenic, cardiovascular, and liver disturbances, effects on libido, gynecomastia, and behavioral effects. There is a hypothesis that some joint tissues may be targets for sex hormones, and the use of AAS without medical follow-up may exacerbate temporomandibular joint problems in patients seeking performance and aesthetics.

Methods: In this study, a cross-sectional survey was conducted on AAS abusers who voluntarily presented themselves for clinical evaluation. Patients were subdivided by sex and age group, and the length of AAS use and symptoms such as headache, tinnitus, and temporomandibular joint pain were evaluated.

Results: It was observed that drug usage is related to symptoms.

Conclusion: The results suggest that AAS use without medical follow-up may exacerbate temporomandibular joint problems, especially in patients with low estrogen levels.