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

Objective: To evaluate the effect of low-level laser therapy (LLLT) on pain intensity (PI) and chewing performance (CP) in systemic lupus erythematosus (SLE) patients with myogenic temporomandibular disorder (TMD).

Methods: Ninety-one patients were randomly allocated to three groups: Group L (intervention), Group P (placebo), and Group C (control). Outcomes were PI (assessed with visual analog scale (VAS)) and CP (assessed with the geometric mean diameter (GMD) of crushed test food). Measurements were performed at T0 (before the LLLT), T1 (immediately after the LLLT), and T2 (1-month follow-up). Data were analyzed using Generalized Linear Models, Kruskal-Wallis, and Friedman tests.

Results: For T1 and T2, Group L demonstrated the lowest values for both GMD (6283.7 ± 257.2 µm; 6382.7 ± 303.7 µm) and VAS (5;6) (p < 0.001).

Conclusion: LLLT was an effective therapeutic approach in reducing pain and improving CP for one month in SLE patients with myogenic TMD.

Objective: This review proposes a neurobiological model for temporomandibular disorders (TMD) associated with stress and anxiety.

Methods: An electronic search was performed in the PubMed, Embase, and Web of Science databases. Articles published up to 2020 were selected. The search terms were the following: temporomandibular disorders, anxiety, stress, neurobiology of stress and anxiety, and orofacial pain.

Results: In total, there were 100 studies, which presented a total of 10 different analyses. The results were described, demonstrating the type of analysis that was performed on each item analyzed for a better understanding of the context.

Conclusion: The conclusion is that the interactions between the masticatory system, temporomandibular joints (TMJs), and stomatognathic apparatus with "stress neuromatrix," "pain neuromatrix," "limbic system," and "neuroimmunoendocrine system" would produce the range of changes observed in neural connectivity and the diversity of symptoms presented in TMD.

Objective: To compare the comfort and anxiety levels of patients undergoing two different temporomandibular joint (TMJ) arthrocentesis techniques.

Methods: Fifty female patients were randomly assigned into two groups of 25 based on the treatment modality: Group 1, single-puncture Type-1 arthrocentesis (SPA); Group 2, conventional double-puncture arthrocentesis (DPA). Preoperative and postoperative anxiety was scored with the State-Trait Anxiety Inventory-S (STAI-S) questionnaire. Blood pressure and heart rate were assessed preoperatively during the application of local anesthesia and at needle insertion into the joint cavity, the 5th and 10th minute of the procedure, and end of the procedure.

Results: STAI-S scores were lower postoperative than preoperative in both groups. Heart rate and mean arterial pressure were highest during anesthesia and needle insertion (p < 0.005). Changes in heart rate, mean arterial pressure, and STAI-S scores were statistically similar between the groups.

Conclusion: DPA and SPA were tolerated similarly by the patients.

Objective: To evaluate the effects of low doses of botulinum toxin type A (BoNT-A) to control pain in patients with sleep bruxism (SB), awake bruxism (AB), and temporomandibular disorder (TMD) during 180 days.

Methods: Overall sample of thirty-five patients with chronic pain related to TMD, SB, and AB received a single dose of 20 U of BoNT-A in masseter and temporalis muscles. The pain was assessed with a visual analog scale (VAS) before and after 15, 30, 60, 90, and 180 days of the application.

Results: The three clinical conditions experienced decrease in pain after 15 days of treatment (p < 0.0001); the maximum pain relief persisted for up to 90 days after BoNT-A application in patients with SB and AB and 15 days for patients with TMD.

Conclusion: A low dose of BoNT-A may be effective for controlling chronic pain related to SB and AB, but TMD pain reduction was short-lived.

To compare craniofacial and cervical morphology between skeletal Classes II and III applying Geometric Morphometric Methods (GMM). Twenty-six cervical and craniofacial landmarks of 40 Class II and 39 Class III individuals were digitalized on lateral cephalograms. Procrustes ANOVA, generalized Procrustes, principal component analyses, and thin-plate spline function were applied to assess the pattern of shape variation of craniofacial structure and the cervical spine in relation to skeletal classes. Compared with Class III, Class II individuals presented a maxillary protrusion, mandibular retrusion, shorter mandibular corpus, posterior mandibular ramus rotation, anterior cranial base rotation, and a smaller centroid size. Furthermore, a forward and smaller cervical spine were observed. With GMM, the shape and size differences between skeletal classes can be analyzed visually and numerically.

Objective: Rhinoplasty can reduce nasal airways' resistance. This study evaluates the effects of rhinoplasty on sleep quality, daytime drowsiness, and obstructive sleep apnea (OSA).

Methods: In this prospective cohort study, 80 rhinoplasty candidates were examined before and six months after rhinoplasty to evaluate symptom changes. STOP-BANG, Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) questionnaires, and nocturnal polysomnography were used, respectively, to screen for OSA, assess sleep quality, assess daytime drowsiness, and confirm results.

Results: Seventeen men (21.2%) and 63 women (78.8%) were studied. PSQI results showed an increase only in post-operative sleep disturbance items (p = 0.04). STOP-BANG showed an increase in apnea (p = 0.06) and a decrease in snoring (p = 0.06), which were both insignificant. The polysomnography tests confirmed the results of the questionnaires.

Conclusion: Contrary to popular belief, rhinoplasty does not increase snoring, sleep disorders, or apnea.

Objective: To evaluate the prevalence/severity of somatic and temporomandibular disorder (TMD) symptoms in Southeast Asian youths and determine their associations with psychological distress.

Methods: Demographic information, Patient Health Questionnaire-15 (PHQ-15), Fonseca Anamnestic Index (FAI), and Depression, Anxiety, Stress Scale-21 (DASS-21) responses were gathered electronically and analyzed using non-parametric statistical and logistic regression analysis (p < 0.05).

Results: Of 400 youths (mean age 18.7 ± 1.7 years; 52.3% females), 65.0%/47.0% reported somatic/TMD symptoms, and 10.5% had TMDs. Significant differences in psychological distress were observed among the varying severity of somatic/TMD symptoms. Correlations between PHQ-15/FAI and DASS-21 scores were weak to moderately strong (r_s = 0.30-0.61). Stepwise logistic regression indicated that female gender, TMD symptoms, and stress were risk factors for somatic symptoms, while somatic symptoms and stress were probable factors for TMDs.

Conclusion: Somatic and TMD symptoms are common in Southeast Asian youths and may be a manifestation of psychological distress.

Objective: The study aims to evaluate the stresses and the deformations generated at the periodontal level by two mandibular advancement devices (MADs) using finite element analysis.

Methods: A three-dimensional digital model of the skull of a 29-year-old patient was created using a CBCT. The 3D models of two MADs (Somnodent Flex^TM and Somnodent Avant^TM) were reconstructed from scanning prototypes based on the patient's anatomy. The overall geometry was imported into software for the finite element study. A force of 11.18 N representing an advancement of 9.5 mm was applied to the devices. A finite element analysis wfas subsequently performed.

Results: Somnodent Flex^TM generates a peak of 3.27 kPa on periodontal ligaments and 287 kPa on teeth. For Somnodent Avant^TM the maximum stress is 4.53 kPa on periodontal ligaments and 467 kPa on teeth.

Conclusion: Different activation mechanisms of the devices generate stresses of different entities.

Objective: To investigate the relationship between T102C (rs6313) polymorphism in the 5-hydroxytryptamine receptor-2A (5HTR2A) gene and temporomandibular disorder (TMD) and anxiety.

Methods: This observational case-control study included 80 patients and 70 healthy controls. TMD was diagnosed using the criteria for TMD (DC/TMD). Anxiety was assessed with the Beck anxiety scale. A genotyping study of HTRR2A T102C (rs6313) gene polymorphism was performed from genomic DNA isolated from blood.

Results: The TMD group had higher anxiety scores than the control group (p < .05). The TMD group was similar to the control group regarding genotype and allele frequencies. However, the polymorphic CC genotype was more common in those with high anxiety (p < .05).

Conclusion: There was no clear evidence of an association between TMD and the T102C polymorphism in HTR2A and TMD. However, anxiety is closely related to the T102C polymorphism in HTR2A.

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.