Interactions between sleep disorders and oral diseases.

Dental sleep medicine is a rapidly growing field that is in close and direct interaction with sleep medicine and comprises many aspects of human health. As a result, dentists who encounter sleep health and sleep disorders may work with clinicians from many other disciplines and specialties. The main sleep and oral health issues that are covered in this review are obstructive sleep apnea, chronic mouth breathing, sleep-related gastroesophageal reflux, and sleep bruxism. In addition, edentulism and its impact on sleep disorders are discussed. Improving sleep quality and sleep characteristics, oral health, and oral function involves both pathophysiology and disease management. The multiple interactions between oral health and sleep underscore the need for an interdisciplinary clinical team to manage oral health-related sleep disorders that are commonly seen in dental practice.

Blood supply to the platysma muscle flap: an anatomic study with clinical correlation.

PURPOSE: This study evaluated the blood supply of the superiorly based and posteriorly based platysma muscle myocutaneous flap. MATERIALS AND METHODS: Four fresh cadaver specimens were injected with Microfil (Flow Technologies, Inc, Carver, ME) red stain in the common carotid artery and blue stain in the brachiocephalic vein. To clarify the blood supply to the platysma muscle, the blood vessels were first identified on lateral and posteroanterior radiographs of the specimens. Subsequently, anatomic dissection of the arteries and veins associated with the platysma muscle and overlying skin was performed. RESULTS: The submental artery was the primary vessel to the platysma muscle. The superior thyroid artery, occipital artery, and posterior auricular artery were identified as secondary vessels. The external jugular vein provided the primary venous drainage, followed by the submental vein. CONCLUSIONS: The superiorly based design has a reliable arterial blood supply (facial and submental arteries) and poor venous drainage. The posteriorly based design has a reliable venous drainage (external jugular vein), but the arterial blood supply is almost random (occipital artery).

Quality of life in obstructive sleep apnea: a systematic review of the literature.

OBJECTIVE: To review the literature on obstructive sleep apnea (OSA) and health-related quality of life (HRQOL). BACKGROUND: OSA affects nearly one in four men and one in ten women aged 30-60 years in the United States. Health consequences of OSA can include neuropsychiatric and cardiovascular sequela that disrupt professional, family, and social life and negatively impact HRQOL. METHODS: We conducted a comprehensive review of the literature on HRQOL and OSA, with special attention paid to instruments developed specifically for OSA. RESULTS: Generic instruments used to study HRQOL and OSA include: Medical Outcomes Study Short Form-36, Nottingham Health Profile, Sickness Impact Profile, Functional Limitations Profile, EuroQol, and Munich Life Quality Dimension List. Specific instruments include: Calgary Sleep Apnea Quality of Life Instrument, Functional Outcomes of Sleep Questionnaire, OSA Patient Oriented Severity Index, the OSA-18, and Cohen's pediatric OSA surgery quality of life questionnaire. CONCLUSIONS: OSA patients have impaired HRQOL when compared with healthy age- and gender-matched controls. Treatment with continuous positive airway pressure appears to improve HRQOL. Other treatment modalities have not been rigorously studied. In addition, more data are needed from preference-based measures that allow conversion to utility scores, which can be used to calculate quality-adjusted life years and cost-effectiveness ratios.