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

Objective: This study aimed to describe the frequency of oral behaviors and generalized anxiety among university students and assess their association using the Oral Behavior Checklist-21 (OBC-21) and Generalized Anxiety Disorder-7 (GAD-7).

Methods: An online questionnaire was sent to students at the University of Trieste, Italy. Mann-Whitney U compared OBC-21 scores by sex; Spearman Correlation and linear regression (adjusted for age and sex) assessed the association between OBC-21 and GAD-7 scores. Fisher's exact test examined categorical relationships.

Results: A total of 1,687 students completed the questionnaire (response rate 9.5%; 73% females). Mean OBC-21 and GAD-7 scores were 23.9 ± 8.3 and 9.5 ± 5.2, respectively. Higher OBC-21 scores were associated with younger age (p = 0.004) and females sex (p < 0.001). Oral behaviors and anxiety were moderately correlated (r = 0.42, p < 0.001), confirmed by regression. Categorized scores also showed a significant association (p < 0.001, Cramér's V = 0.308).

Conclusion: Oral behaviors are significantly associated with generalized anxiety in university students, underscoring the importance of integrating mental health assessment into oral health care.

Background: Undiagnosed obstructive sleep apnoea (OSA) presents risks in oral and maxillofacial surgery (OMFS), yet tools such as STOP-Bang often underperform in non-obese patients with craniofacial anomalies. This study aimed to develop and preliminarily assess the Jain's Obstructive Sleep Apnoea Questionnaire (JOSAQ), a craniofacial-focused screening tool tailored for OMFS practice.

Methods: JOSAQ, a two-stage, 20-item instrument combining patient-reported symptoms and clinician-assessed craniofacial features, underwent Delphi consensus and vignette-based comparison with STOP-Bang. Fifteen experts participated in the Delphi process, and 20 clinicians rated 25 standardized clinical vignettes.

Results: Content validity was high (S-CVI = 0.89). JOSAQ identified more high-risk cases than STOP-Bang (62% vs 44%, p < .01) with higher Inter-rater reliability (κ = 0.72 vs 0.64), and better clarity scores. Completion times were similar.

Conclusion: JOSAQ enhances screening sensitivity and inter-rater reliability without increasing assessment time, particulary benefiting non-obese patients with craniofacial anomalies. Multicentre validation against polysomnography is recommended.

Objective: This study investigated the correlation between oral behaviors measured by the Oral Behaviors Checklist (OBC) and the frequency of awake bruxism (AB), assessed by Ecological Momentary Assessment (EMA).

Methods: Seventy-five individuals with AB completed the OBC and responded to ten daily mobile prompts that assessed real-time jaw muscle behavior for a week.

Results: Non-functional OBC scores correlated positively with overall AB (r = 0.384, p < .001) and individual AB-behavior frequencies measured by EMA, except for a negative correlation with teeth contact (r = -0.289, p = .012).

Conclusion: Functional OBC scores were not associated with AB frequencies. The OBC may serve as a preliminary screening instrument in identifying AB-related behaviors.

Objective: To assess soft-tissue variables from CBCT images obtained for dental treatment purposes as potential predictors of OSA severity in adults.

Methods: This retrospective study included 140 snoring patients categorized by the apnea-hypopnea index (AHI) into primary snoring, mild, moderate, and severe OSA (n =35 per group). Three-dimensional upper airway parameters were measured and compared from CBCT scans. A hierarchical regression model assessed their association with the AHI after adjusting for demographics.

Results: Multiple CBCT-derived soft-tissue parameters differed significantly among OSA severity groups and correlated with the AHI. However, after demographic adjustment in the hierarchical regression model, only palatal length (PL) and minimal cross-sectional area (mCSA) emerged as statistically significant independent predictors (p < 0.05).

Conclusion: CBCT revealed significant differences in pharyngeal soft-tissue anatomy among OSA severity groups. Palatal length and mCSA were identified as valuable predictors for OSA screening based on AHI.

Objectives: To investigate the longitudinal impact of orofacial pain symptoms on cardiovascular diseases (CVDs) risk.

Methods: Data from 692,980 Korean individuals were analyzed and categorized by the presence or absence of orofacial pain symptoms. Multivariate Cox proportional hazard regression analyses were conducted to calculate hazard ratios (HRs) of orofacial pain for the incidence of major adverse cardiovascular events (MACE).

Results: A total of 47,824 (7.41%) participants reported orofacial pain symptoms, which were associated with increased MACE risks. However, some cases may have referred to cardiac pain rather than primary orofacial pain.

Conclusions: Orofacial pain may independently increase the long-term risk of CVD.

Objective: We examined the relationships between the structural connectome and temporomandibular disorders (TMDs).

Methods: Bidirectional Mendelian randomization analyses were conducted using Genome-wide association studies data on the structural connectome and TMDs.

Results: Positive associations with TMD risk were found for white matter structural connectivity from the left hemisphere limbic network to putamen, left hemisphere salience_ventral attention network to caudate, right hemisphere visual network to thalamus, and right hemisphere salience_ventral attention network to right hemisphere control network, while negative associations were observed for connectivity from the left hemisphere control and somatomotor networks to pallidum, left hemisphere somatomotor network to right hemisphere dorsal attention network, and right hemisphere somatomotor network to hippocampus (p< 0.05). In TMD patients, connectivity from the Left-hemisphere visual network to putamen was reduced, whereas connectivity from the Left-hemisphere limbic network to left-hemisphere control network was increased (p< 0.05).

Conclusion: Our findings provide insights into the TMD pathogenesis.

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.

Objective: The aim of this study was to investigate the effects of exercise and mandibular advancement device (MAD) on severity of Obstructive sleep apnea syndrome (OSAS) with mandibular retrognathia.

Methods: Patients were randomly allocated into either exercise group or MAD group. All patients underwent blood tests, polysomnography studies and questionnaires studies at enrollment and at the 12-week's follow-up.

Results: Our study showed MAD was superior to exercise in improving polysomnographic outcomes and Snore Scale (SS) score. No significant difference was observed between the two treatments in terms of Epworth Sleepiness Scale (ESS) score. Moreover, in the exercise group, improvements were also observed in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C).

Conclusion: MAD was more effective than exercise in improving sleep efficiency. Exercise can improve daytime sleepiness and lipid metabolism, independent of the effects on BMI.Trial registration ChiCTR2000034188.

Objective: The objective of this study was to investigate whether trigeminal somatosensory function and mechanosensitivity differ between groups with craniofacial neuropathic pain (CNP), non-neuropathic craniofacial pain (NNP), and healthy controls (HC).

Methods: Thirty-three participants were categorized into these groups, matched for age and sex. The study evaluated pain intensity, the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), and various trigeminal somatosensory tests, including vibration, pressure pain, thermal detection, cold pain, and neurodynamic tests of the trigeminal nerve.

Results: Cold pain thresholds differed significantly among the three groups CNP, NNP, and HC (p = .047). No difference was found in vibration detection, pressure pain threshold, and thermal detection. Trigeminal nerve mechanosensitivity was significantly different among the three groups (p = .03), particularly between groups CNP and HC (p = .01).

Conclusion: Differences in aspects of trigeminal somatosensory function, including cold pain and trigeminal mechanosensitivity, exist between subjects with chronic craniofacial pain and HC. This implies that a clinical classification system for neuromusculoskeletal rehabilitation could be valuable in evaluating patients.

Objective: We reviewed the efficacy of dextrose prolotherapy versus placebo and other active interventions, like autologous blood injection (ABI) and botulinum toxin (BTX), in improving the outcomes of temporomandibular joint (TMJ) hypermobility.

Methods: We searched PubMed, the Cochrane CENTRAL library, Embase, Scopus, and Web of Science databases to identify randomized controlled trials (RCTs) . Maximal mouth opening (MMO), pain, and frequency of dislocations were analyzed.

Results: Eight RCTs were included. In comparison with placebo, dextrose prolotherapy was associated with significantly reduced pain and MMO. Comparison of dextrose with ABI revealed no significant difference in MMO. Qualitative analysis showed no significant difference in outcomes in patients who received dextrose prolotherapy and BTX.

Conclusions: Low-quality evidence suggests that dextrose prolotherapy may reduce MMO and improve pain scores compared to placebo in patients with TMJ hypermobility. Low-quality evidence also suggests that there may be minimal difference in outcomes between dextrose vs ABI and BTX.