Effects of surgical mandibular advancement on the upper airways of adult class II patients: A systematic review with meta‐analysis

Greek DailyNews shared this article with you from Inoreader Effects of surgical mandibular advancement on the upper airways of adult class II patients: A systematic review with meta‐analysis Via Journal of Oral Rehabilitation Abstract Aim To systematically review the effects of surgical mandibular advancement (SMA) regarding changes of the upper airways in adult patients with skeletal Class II malocclusion. Materials and Methods Five electronic databases were searched up to April 2020. Human studies focusing on the morphology and dimension of the upper airways after SMA were included. 'Quality assessment for Before‐After (Pre‐Post) Studies' was used to assess the risk of bias of the individual studies. Standard mean differences (SMD) with 95% confidence intervals (CI) were calculated for random effect model meta‐analysis. The certainty of evidence was assessed using the GRADE tool. Results Twenty cohort studies of only treated patients without control group were eligible for qualitative synthesis, of which 17 were used for quantitative synthesis. Very low certainty of evidence indicated that SMA resulted in significant increase of the volume and of the smallest cross‐sectional area (SMC) of the nasopharynx (volume SMD: 1.43, CI: 0.62, 2.24, P = .001, I 2 = 87.8%; SMC SMD: 1.53, CI: 0.59, 2.47, P = .001, I 2 = 90.5%) and oropharynx (volume SMD: 1.36, CI: 0.37,2.35, P = .007, I 2 = 92.1%; SMC SMD: 1.21, CI: 0.11,2.32, P = .032, I 2 = 93.1%). Significant augmentation of the distances between the posterior pharynx wall and the uvala (SMD: 0.73, CI: 0.46,0.98, P < .001, I 2 = 72.7%), the posterior border of the tongue (SMD: 0.52, CI: 0.21,0.84, P = .001; I 2: 60.5%), the gonion (SMD: 1.24, CI: 0.56,1.91, P < .001; I 2 = 88.8%) and the epiglottis (SMD: 0.40, CI: 0.06,0.74, P = .033; I 2 = 84.8%) were observed. Conclusions Weak evidence suggests enlargement of the upper airways of adult Class II subjects following SMA, with major increases in the oropharynx. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sterile water; a novel and promising human experimental craniofacial muscle pain model

Greek DailyNews shared this article with you from Inoreader Sterile water; a novel and promising human experimental craniofacial muscle pain model Via Journal of Oral Rehabilitation Abstract Background The aim of this study was to investigate if intramuscular injection of sterile water can be used as a human experimental pain model that resembles clinical craniofacial muscle pain, and to analyze if the effects differ between sexes. Methods This randomized, double‐blind, placebo‐controlled cross‐over study included 30 healthy age‐matched women and men (23.6±2.4 years). At three sessions, with at least one week of wash‐out in between, 0.2mL of either sterile water (test‐substance), hypertonic saline (58.5mg/mL; active‐control) or isotonic saline (0.9mg/mL; passive‐control) were randomly injected into the right masseter muscle. Pain intensity (VAS) was continuously assessed during 5min whereafter pain duration (s) and pain area (au) were calculated pressure pain thresholds (PPT;kPa) were recorded every 5‐min during 30min. Results Sterile water evoked pain of similar intensity (74.5±49.9) as hypertonic saline (74.0±50.5), whereas isotonic saline evoked low‐intensity pain (11.4±23.4). The pain induced by sterile water and hypertonic saline had higher intensity (P<0.001), longer duration (P<0.001) and larger pain area (P<0.001) than isotonic saline. There were no significant differences in any pain variable between sterile water and hypertonic saline. The PPT did not change significantly after any substance, except for in women 5 min after sterile water injection (P<0.002). Pain duration was longer in the men for all substances (P<0.006), while the pain area was larger in women after injection of hypertonic saline (P<0.003). Conclusion These results indicate that pain evoked by sterile water resembles clinical muscle pain and may offer a novel and simpler alternative to hypertonic saline injections. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oral health‐related quality of life and associated factors in patients with burning mouth syndrome

Greek DailyNews shared this article with you from Inoreader Oral health‐related quality of life and associated factors in patients with burning mouth syndrome Via Journal of Oral Rehabilitation Abstract Objective The purpose of this study was to assess oral health‐related quality of life (OHRQoL) in patients with burning mouth syndrome (BMS) and to identify clinical factors associated with OHRQoL. Methods Fifty‐seven patients with BMS (56.4 ± 10.7 years) participated in the study. Patients underwent oral examination, laboratory tests, psychological evaluation, measurement of salivary flow rates and evaluation of clinical characteristics using a BMS questionnaire. The OHRQoL of patients was assessed using the Oral Health Impact Profile‐14 (OHIP‐14). Results The OHIP‐14 score for patients with BMS was 38.6 ± 12.8. Patients had higher scores for the psychological discomfort and physical pain dimensions of the OHIP‐14. The intensity of taste disturbance or xerostomia symptoms (β = 0.464, P < .001), worry about symptoms (β = 0.307, P = .020), and results of psychological evaluation (β = 0.311, P = .026) were significantly associated with OHIP‐14 score. Multiple linear regression showed that the intensity of taste disturbance or xerostomia symptoms was significantly associated with decreased OHRQoL (β = 0.637, P = .026). Conclusions This study suggests that severity of taste disturbance or xerostomia is an important factor that influences OHRQoL in patients with BMS. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Changes in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders

Greek DailyNews shared this article with you from Inoreader Changes in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders Via Journal of Oral Rehabilitation Abstract Background Menstrual cycle may contribute to experimental pain measures in healthy women and women with chronic pain. Objectives The present study aimed to investigate variation in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders (TMD) and to explore the effect of TMD pain and psychosocial variables on the pulp response. Methods This longitudinal study involved 47 regularly menstruating women aged 20‐45, 24 healthy and 23 with diagnosed painful TMD. The electric and cold stimuli were performed by electric pulp tester and refrigerant spray, respectively, on mandibular lateral incisors, in five menstrual phases (menstrual, follicular, periovulatory, luteal and premenstrual). Research Diagnostic Criteria for TMD were used to assess TMD, chronic pain, depression and somatisation. Regression analysis was performed to investigate the effect of the predictor variables on the pulp sensitivity. Results Significant phase‐related differences were observed for pain intensity to cold stimuli. Higher pain sensitivity was reported in menstrual in comparison with luteal phase (P = .019) among healthy women, and in menstrual in comparison with follicular (P = .033), periovulatory (P = .003) and luteal (P = .007) phases in TMD women. No significant differences were recorded for electric stimuli. Regression analysis identified depression as the determinant of cold and electric response in menstrual phase, regardless of age and presence of TMD. Conclusion Menstrual phase in healthy and TMD women with regular menstrual cycle is characterised with higher pulp sensitivity to cold stimuli. Depressive symptoms independently influence pulp response in this phase. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of oral myofunctional therapy in middle‐aged to elderly patients with obstructive sleep apnoea treated with continuous positive airway pressure

Greek DailyNews shared this article with you from Inoreader Efficacy of oral myofunctional therapy in middle‐aged to elderly patients with obstructive sleep apnoea treated with continuous positive airway pressure Via Journal of Oral Rehabilitation Apnoea‐hypopnea index values were significantly reduced after 6 months of MFT. Tongue pressures were significantly increased after 6 months of MFT. Half of the patients with moderate OSA successfully withdrew from CPAP. Abstract Background Oral myofunctional therapy (MFT) is an effective treatment for mild‐to‐moderate obstructive sleep apnoea (OSA) in middle‐aged patients. However, few reports have described its use in elderly patients with moderate and severe OSA. Moreover, no studies have examined the relationship between changes in tongue pressure with MFT and the severity of OSA. Objective We conducted an interventional study using MFT to evaluate the effect of MFT on middle‐to‐senior‐aged patients with moderate or severe OSA and compared changes in apnoea‐hypopnea index (AHI) and tongue pressure. Methods Thirty‐two OSA patients (≥45 years) treated with continuous positive airway pressure (CPAP) were included. MFT was performed in parallel with CPAP. Three days after CPAP discontinuation, polysomnographies were performed and tongue pressures were measured before and after MFT. Results Patients were 69.3 ± 1.5 years old. After 6 months of MFT, AHI decreased significantly from 34.7 to 29.0/h (P = .03), while tongue pressure significantly increased from 35.9 to 45.6 kPa (P < .01). Seven patients (22%), including 6 of the 12 patients with moderate OSA (50%), experienced successful CPAP discontinuation. Conclusions MFT can be a useful intervention even among middle‐aged to elderly patients with OSA. Increased tongue pressure may have contributed to the AHI improvement. Clinical trials: Trial registration at www.umin.ac.jp UMIN000027547. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Functional properties of single motor units in the human medial pterygoid muscle: Thresholds

Greek DailyNews shared this article with you from Inoreader Functional properties of single motor units in the human medial pterygoid muscle: Thresholds Via Journal of Oral Rehabilitation Abstract Background Little is known regarding the functional properties of single motor units (SMUs) in the medial pterygoid muscle (MPt) during jaw movements. Objectives The aims are (a) to report the thresholds of onset of MPt SMUs during 4 goal‐directed jaw movement tasks, and (b) to determine whether the threshold of onset of SMU activation varies with the velocity of jaw movement and the location within the muscle. Methods Intra‐muscular electrodes were inserted in the right MPt of 18 participants performing ipsilateral (right), contralateral, protrusive and opening‐closing jaw movements recorded at 2 velocities. Task phases were as follows: BEFORE, OUT, HOLDING, RETURN and AFTER. SMU onset thresholds were determined from the displacement (mm) of the lower mid‐incisor point. Electrode location within 4 arbitrary muscle divisions was determined with computer tomography. Statistical tests: Spearman's correlations, Kruskal‐Wallis tests; significance accepted at P < .05. Results A significant inverse relation occurred between velocity and threshold for the RETURN of the ipsilateral movement (n = 62 SMU thresholds), while a significant positive relation occurred for the OUT of the contralateral movement (n = 208); there were no significant associations for the protrusive (n = 131) and opening‐closing (n = 58) tasks. Significant threshold differences occurred across the 4 muscle divisions only during the OUT of the contralateral and protrusive movements. Some evidence was provided for gender differences in MPt SMU properties. Conclusions The absence of a significant inverse relation between velocity and SMU threshold for most recorded movements suggests the MPt acts as a stabilizer of the jaw in horizontal and opening‐closing jaw movements. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The prevalence of awake bruxism and sleep bruxism in the adolescent population

Greek DailyNews shared this article with you from Inoreader The prevalence of awake bruxism and sleep bruxism in the Dutch adolescent population Via Journal of Oral Rehabilitation Abstract Objectives This study aimed to assess the prevalence of awake bruxism and sleep bruxism in the Dutch adolescent population. Materials and Methods As part of a large epidemiologic survey on oral health of the general Dutch adolescent population in 2017, a total of 920 subjects were asked about their bruxism behaviour during daytime and during sleep. The collected data were subjected to stratified analysis by two age groups (for 17 and 23 years, respectively), gender and socio‐economic status. Results A prevalence of 4.1% and 4.2% was found for awake bruxism and of 7.6% and 13.2% for sleep bruxism. Women reported awake bruxism more often than men in the 17‐year‐old age group (5.0% and 3.2%, respectively), while in the 23‐year‐old age group it was the other way around (4.0% and 4.4%, respectively). Regarding sleep bruxism, women reported higher percentages than men in both age groups (7.8% versus 7.5% and 14.9% versus 11.5%, respectively). Concerning socio‐economic status (SES), awake bruxism was more often found in high SES groups (4.6% versus 3.7% and 4.9% versus 4.0% in both age groups, respectively) as well as for sleep bruxism in the 23‐year‐old group (16.5% versus 8.6%). In the 17‐year‐old group, sleep bruxism was more often reported in the low SES group (9.7% versus 5.3%). Conclusions Sleep bruxism is a common condition in the Dutch adolescent population, while awake bruxism is rarer. Clinical relevance Dental caregivers can use this information when negative healthcare outcomes are present amongst adolescents. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Physical, psychological and socio‐demographic predictors related to patients’ self‐belief of their temporomandibular disorders’ aetiology

Greek DailyNews shared this article with you from Inoreader Physical, psychological and socio‐demographic predictors related to patients' self‐belief of their temporomandibular disorders' aetiology Via Journal of Oral Rehabilitation Abstract Background The aetiology of temporomandibular disorders (TMDs) has been widely discussed in literature, but little is known about patients' self‐belief of their TMD aetiology. Objective For six categories of self‐believed aetiology of the TMD complaint (viz., occlusal factors, physical trauma, emotional stress, deep pain input, parafunctions and unknown), associations with physical, psychological and socio‐demographic predictors were assessed. Methods In this retrospective study, medical records of 328 TMD patients who had visited a clinic for Orofacial Pain and Dental Sleep Medicine were analysed. Results The most frequently reported self‐believed TMD aetiology was 'unknown' (42.3%). The category 'occlusal factors' was associated with pain worsening with emotion. 'Physical trauma' as self‐believed aetiology was associated with TMD dysfunction score. 'Emotional stress' was associated with awake bruxism and age 18‐49 years. 'Deep pain input' was associated with TMD dysfunction score, sleep bruxism, and arthritis or joint pain. 'Parafunctions' were associated with sleep bruxism. 'Unknown' was associated with TMD symptoms severity and work disability. Conclusion For each category of self‐believed aetiology of the TMD complaint, different associations with physical, psychological and socio‐demographic predictors were identified. This may suggest that individual phenotypes play a role in the patient's belief in the cause of the TMD complaint. Determination of phenotypic risk factors associated with aetiological self‐belief might help clinicians to provide better treatment, including counselling, to their patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pain complications of oral implants: Is that an issue?

Greek DailyNews shared this article with you from Inoreader Pain complications of oral implants: Is that an issue? Via Journal of Oral Rehabilitation Abstract The use of oral implants as a form of replacing missing teeth in partial or total edentulous patients is considered the gold standard in oral rehabilitation. Although considered a history of success in contemporary dentistry, surgical complications may occur, as excessive bleeding, damage to the adjacent teeth and mandibular fractures. Persistent pain and abnormal somatosensory responses after the surgery ordinary healing time are also potential problems and may lead to the development of a condition named posttraumatic trigeminal neuropathic pain (PTNP). Though relatively rare, PTNP has a profound impact on patient's quality of life. Appropriated previous image techniques, effective anaesthetic procedures and caution during the surgical procedure and implant installation are recommended for the prevention of this condition. In case of the PTNP, different management modalities, including antidepressant and membrane stabilizer medications, as well as peripheral strategies, as the use of topical medication and the botulin toxin are presented and discussed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tongue muscle strength affects posterior pharyngeal wall advancement during swallowing: A cross‐sectional study of outpatients with dysphagia

Greek DailyNews shared this article with you from Inoreader Tongue muscle strength affects posterior pharyngeal wall advancement during swallowing: A cross‐sectional study of outpatients with dysphagia Via Journal of Oral Rehabilitation Abstract Background Tongue muscle strength is important for swallowing but decreases with age, in association with reduced skeletal muscle mass. However, the relationships between pharyngeal dynamics and both skeletal muscle mass and tongue muscle strength are unknown. Objective To investigate the effect of reductions in tongue muscle strength on pharyngeal movement during swallowing in patients with dysphagia. Methods Subjects were selected from male outpatients ≥65 years old who were examined for the main complaint of dysphagia. Patients with history of neurodegenerative disease affecting tongue movement, cerebrovascular disease or oral cancer were excluded. As a result, 82 men (mean age, 80.6 ± 6.8 years) participated. Skeletal muscle mass index (SMI) as physical parameters and maximum tongue pressure (MTP) as tongue muscles strength were measured. Status and dynamics of the pharyngeal organs, including change in posterior pharyngeal wall advancement (PPWA) when swallowing 3.0 mL of moderately thick liquid, were measured by analysing videofluoroscopic images. Simple bivariate correlation and multiple regression analysis were used to statistically analyse correlations between parameters. Results MTP showed a significant positive correlation with SMI (r = .43, P < .01). PPWA showed a significant negative correlation with MTP (r = −0.30, P < .01), but no association with SMI. Conclusions While tongue muscle strength is affected by skeletal muscle mass, posterior pharyngeal wall advancement is not readily affected by decreases in skeletal muscle mass. Posterior pharyngeal wall advancement may increase to compensate for swallowing function among individuals with reduced tongue muscle strength. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of posterior tongue mobility using lingual‐palatal suction: Progress towards a functional definition of ankyloglossia

Greek DailyNews shared this article with you from Inoreader Assessment of posterior tongue mobility using lingual‐palatal suction: Progress towards a functional definition of ankyloglossia Via Journal of Oral Rehabilitation Abstract Background A functional definition of ankyloglossia has been based on assessment of tongue mobility using the tongue range of motion ratio (TRMR) with the tongue tip extended towards the incisive papilla (TIP). Whereas this measurement has been helpful in assessing for variations in the mobility of the anterior one‐third of the tongue (tongue tip and apex), it may be insufficient to adequately assess the mobility of the posterior two‐thirds body of the tongue. A commonly used modification is to assess TRMR while the tongue is held in suction against the roof of the mouth in lingual‐palatal suction (LPS). Objective This study aims to explore the utility and normative values of TRMR‐LPS as an adjunct to functional assessment of tongue mobility using TRMR‐TIP. Study Design Cross‐sectional cohort study of 611 subjects (ages: 3‐83 years) from the general population. Methods Measurements of tongue mobility using TRMR were performed with TIP and LPS functional movements. Objective TRMR measurements were compared with subjective self‐assessment of resting tongue position, ease or difficulty elevating the tongue tip to the palate, and ease or difficulty elevating the tongue body to the palate. Results There was a statistically significant association between the objective measures of TRMR‐TIP and TRMR‐LPS and subjective reports of tongue mobility. LPS measurements were much more highly correlated with differences in elevating the posterior body of the tongue as compared to TIP measurements (R2 0.31 vs 0.05, P < .0001). Conclusions This study validates the TRMR‐LPS as a useful functional metric for assessment of posterior tongue mobility. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.