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

Objective: Obstructive sleep apnea (OSA) is a sleep disorder accompanied by intermittent hypoxia. Neuromuscular transmission (NT) is known to be disturbed under chronic hypoxia. In this descriptive study, it has been aimed to test NT under intermittent hypoxia in OSA. Methods: Thirty-nine newly diagnosed OSA patients without any comorbidities or conditions that alter NT were included in the study. Jitter analysis was performed using a concentric needle electrode. Results: The mean jitter value of 39 OSA patients was 25.9 ± 3.7 μs. When compared to the mean reference jitter values, patients in the present study had significantly higher jitter (p < 0.001). Seven (17.9%) patients met the electrophysiological criteria for NT failure. Conclusion: The authors propose that intermittent hypoxia can be the trigger for NT failure in OSA. The interaction between increased oxidative stress and disturbed mitochondrial functions may also contribute.

Objective: To evaluate reliable and validated temporomandibular disorder (TMD) diagnostic instruments for use as diagnostic tools in epidemiological surveys.Methods: Two independent reviewers performed searches in the Medline/PubMed, Cochrane Library, and Web of Science databases to identify validation studies of diagnostic and screening instruments for TMD published up to March 2021.Results: Sixteen studies were included for the systematic review. Different TMD instruments were evaluated, such as FAI, RDC/TMD, DC/TMD, Helkimo Index, and AAOP Questionnaire. The instruments differed according to the number of items. Some questionnaires appear to be effective for the initial screening of TMD patients and can be incorporated in clinical practice and epidemiological studies since they are easy and fast to apply.Conclusion: To provide an accurate TMD diagnosis, it is important to use instruments that involve a clinical examination. Authors suggest the development of a new validated diagnostic tool for use in epidemiological surveys.

Objective: This study investigated the associations between temporomandibular disorder (TMD) symptoms, psychological distress, and well-being.

Methods: A total of 372 university students were recruited and stratified into no TMD, TMD pain, TMJ sounds, and combined TMD groups. Psychological distress and well-being were assessed with the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Scales of Psychological Well-being-18 (SPWB-18), respectively. Data were appraised with Kruskal-Wallis/Mann-Whitney U tests and logistic regression analysis (α = 0.05).

Results: Significant differences in anxiety, stress, and autonomy scores were observed among the four groups, and psychological distress was mostly negatively correlated to psychological well-being. Multivariate analyses revealed that anxiety was associated with TMD pain, TMJ sounds, and combined TMD, while autonomy was related to TMJ sounds.

Conclusion: Participants with TMD symptoms generally experienced more psychological distress and lower autonomy. Anxiety appeared to increase the likelihood of TMD pain and/or TMJ sounds.

Objective: To investigate myoelectric signals of dystonic activities in oromandibular dystonia (OMD) subjects using surface electromyography (EMG).

Methods: Twelve OMD subjects were included in this study. Resting myoelectric activities of the superficial masseter, anterior temporalis, and anterior belly of the digastric muscle on both sides were monitored, and dystonic muscle contractions were recorded using surface EMG. Myoelectric signal amplitude, the type of muscle contraction, and contraction rate for phasic activities were evaluated.

Results: Surface EMG revealed that eight subjects had dystonic muscle activities in the phasic contraction pattern, three subjects had a tonic contraction pattern, and one subject had a mixed pattern. Synchronous contraction of dystonic muscles was frequently observed. Many of the monitored muscles showed high resting amplitudes.

Conclusion: Surface EMG detects abnormal muscle activities related to oromandibular dystonia. Surface EMG can serve as an objective method for diagnosing oromandibular dystonia.

Background: Osteochondromas of the mandibular condyle show facial asymmetry and malocclusion. Because condylar osteochondromas are generally resected in a preauricular approach with risks of facial nerve injury and visible scar, the authors report endoscopically assisted intraoral resection of osteochondroma of the mandibular condyle with a piezoelectric surgical device.Case presentation: A 38-year-old woman presented with malocclusion and facial asymmetry caused by deviation of the chin to the left. Computed tomography showed a hyperdense, well-circumscribed mass arising from the medial aspect of the right mandibular condyle with resorption of the skull base. The patient underwent an endoscopically-assisted intraoral condylectomy with a piezoelectric surgical device. The postoperative course was uneventful without trismus, malocclusion, or facial asymmetry, and there was no recurrence 4 years after surgery.Conclusion:Endoscopically assisted intraoral resection of osteochondroma of the mandibular condyle with a piezoelectric surgical device is a minimally invasive and safe surgery.

Objective: To describe the role of body posture and skeletal class in the symmetrical activity of chewing muscles.

Methods: Descriptive study with association. Skeletal class measured by the Steiner method. Postural analysis through APECS mobile application for forward head posture and shoulder discrepancy, and surface electromyography with Biopac® device.

Results: The skeletal class, forward head posture, and shoulder discrepancy presented statistical association with the symmetrical electromyographic response of digastric muscles and masseter muscles during swallowing.

Discussion: This study exhibited a positive relationship between digastric muscle symmetry and skeletal class during swallowing. The compensation of the hyoid system explains these results, showing that skeletal Class III has better electromyographic balance. In contrast, masseter muscle symmetry during swallowing presented a negative relationship with skeletal class. The stabilization role that this muscle plays during swallowing explains these findings, caused by the different lengths and direction of this muscle in skeletal Class III.

Objective: : Systematic reviews (SRs) are an increasingly important format in the scientific literature. Commentaries on improvements to the SR format have focused on methodological quality, but a greater concern is a frequent lack of critical analysis. A structured critical analysis (SCA) was described as a solution to this deficiency.

Methods: : Recommendations and conclusions of a recent SR were analyzed with a SCA to address common problems previously reported with the SR format.

Results: : Errors in the component studies and their interpretation by the SR that led to erroneous recommendations were presented. The 5-part SCA provided comprehensive analysis that corrected the SR, which had accepted the component study conclusions verbatim.

Conclusion: : The SCA is a logical approach to provide critical thinking in SRs to ensure appropriate conclusions. This is especially important, as many SRs report contradictory evidence. Also, the reader can use the SCA format to better understand existing literature.

Objective: To compile the screening tools used to study temporomandibular disorders (TMD), classify and analyze their potential application in the field of physiotherapy.Methods: All gathered data included randomized clinical trials on humans over 18 years of age pulled from three databases up to November 2019.Results: Nineteen articles were retained, in which the subjects included 1095 women and 385 men. The 32 valuation systems reported were classified as follows: direct, requiring observation and/or palpation in situ by a clinician, which can be subdivided into protocols and instrumental systems; and indirect, requiring neither observation nor palpation by a clinician, which can be subdivided into questionnaires and scales.Conclusion: In order to evaluate TMD, the best choice is to combine direct and indirect assessment methodologies. The valuation of pressure pain threshold with an algometer and Fonseca's Anamnestic Index in combination with Anamnestic Questionnaire CMD, respectively, seems to provide the best results.

Objectives: This study established the diagnostic accuracy of the Fonseca Anamnestic Index (FAI) in relation to the Diagnostic Criteria for TMD (DC/TMD) standard.Methods: A total of 866 TMD patients and 57 TMD-free controls were instructed to answer the FAI and DC/TMD Symptom Questionnaire (SQ). Participants were subsequently categorized into no (NT), pain-related (PT), and/or intra-articular (IT) TMDs using the DC/TMD protocolized examination/algorithms. Receiver operating characteristics (ROC) curves, best cut-off points, and accuracy measures were determined.Results:The FAI demonstrated high accuracy for detecting all TMDs, PT, and IT (AUC = 0.96-0.98). The best cut-off points were 22.50 for all TMDs/IT and 27.50 for PT. Sensitivity of the FAI was high (94.23-98.21%), but specificity was moderate (87.72%) for all diagnostic categories.Discussion:The diagnostic accuracy of the FAI for identifying pain-related and intra-articular TMDs was high. FAI scores ≥25 points should be used to screen for TMDs.