Can sleeping habits be associated with sleep bruxism, temporomandibular disorders and dental caries among children?

BACKGROUND: Sleeping problems are common in the pediatric population. Their potential relationship with oral manifestations is in the scope of researchers' interest. OBJECTIVES: The aim of the present study was to evaluate the possible associations between sleeping habits and sleep bruxism, temporomandibular disorders (TMD) and dental caries among children by using Children's Sleep Habits Questionnaire (CSHQ). MATERIAL AND METHODS: A cross-sectional study was carried out at the Faculty of Dentistry of Istanbul Aydin University, Turkey, with a representative sample of 100 children aged 6-13 years. The CSHQ was completed by their parents. In addition, an intraoral examination was carried out in a clinical setting and sleep bruxism was recorded. The temporomandibular joints (TMJ) were examined and TMD were rated according to the Helkimo anamnestic and clinical dysfunction index. Data was analyzed with Fisher's exact test and the χ2 test. RESULTS: Among sleeping habits, bedtime resistance was found to be significantly associated with sleep bruxism and TMD symptoms in children. Sleep behavior problems were also found to be related to TMD. Untreated dental caries was significantly associated with sleep fragmentation. CONCLUSIONS: Sleep bruxism, TMD and untreated dental caries might have a negative impact on children's sleeping habits and characteristics. Pediatricians and pedodontists should collaborate to identify the causes and clinical features of sleeping habits and disorders in order to avoid adverse effects on the child's stomatognathic system.

Cone beam computed tomography analysis results in patients with obstructive sleep apnoea syndrome.

INTRODUCTION: The present study aimed to investigate the contribution of cone-beam computed tomography (CBCT) to the diagnosis of obstructive sleep apnoea syndrome (OSAS). METHODS: The present study investigate the relationships among body mass index (BMI), upper airway, septum deviation, nasal cavity width, airway, and the hard and soft palate width using CBCT images of 64 patients obtained in Usak University Faculty of Dentistry. The study included 31 (8 female and 23 male; mean age: 52.52 ± 10.01 years) and 33 patients (12 female and 21 male; mean age: 47.39 ± 10.27 years) with and without OSAS, respectively. Between-group comparisons of non-normally and normally distributed variables were performed using the Mann-Whitney U test and Student's t-test, respectively. Spearman's correlation analysis was used to determine the relationship between quantitative data. Statistical significance was evaluated at P < .01 and P < .05. RESULTS: There were significant differences between groups in the BMI, nasal septum position, hard and soft palate width, maxillary skeletal width, and palatal alveolar angle (P < .01). In addition it was also found that BMI was higher, the nasopharyngeal airway was longer, and the soft palate was longer and wider in males. (P = .001; P < .01). CONCLUSION: This study concluded that patients with OSAS had marked narrowing of the upper airway, nasal cavity and maxillary width, shortening and enlargement of the soft palate, and marked increase in BMI. However, to gather sufficiently reliable data for routine use in orthodontic analyses, there is a need for greater number of samples to improve the database.

Effects of saliva and nasal secretion on some physical properties off our different resin materials

Objective: Aim of this study was to evaluate possible effects of saliva and nasal secretion on some physical properties,such as sorption, solubility, surface hardness and colour change on four different resin-based materials overa certain time period.Materials and Methods: A total of 128 disc-shaped specimens with a diameter of 50mm and thickness of 0.5mm were tested to evaluate sorption and solubility (ISO-1567). The specimens were stored in different solutions prior to testing. Surface hardness measurements were performed by using a Vickers hardness testing machine. A total of 20 cylinder shaped test specimens with a diameter of 13 mm and thickness of 1 mm were prepared to evaluate colour change (ÄE).Analysis of variance was used to determine significant differences among groups. Paired t and Tukey Post-Hoc tests were performed to investigate significant differences among subgroups at all time intervals (p<0.05).Results: It was found that while the percentage absorption value at T7(7 days) of the auto-polymerizing (A) groups storaged in artificial saliva + nasal secretion were the highest (0.057±0.119), the percentage absorption value atT15(15 days) of the D groups storaged in artificial nasal secretion were the lowest (0.013±0.09). Besides, it was found that the percentage solubility value at T30(30 days) of visible ligth-cusing resin (VLC) groups storaged inartificial nasal secretion were the highest (0.016±0.003), and the percentage solubility value at T1(1 day) of the Dgroups storaged in distilled water were the lowest (0.01±0.02). While (..) (AU)

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Effects of saliva and nasal secretion on some physical properties of four different resin materials.

OBJECTIVE: Aim of this study was to evaluate possible effects of saliva and nasal secretion on some physical properties, such as sorption, solubility, surface hardness and colour change on four different resin-based materials over a certain time period. METHODS: A total of 128 disc-shaped specimens with a diameter of 50 mm and thickness of 0.5 mm were tested to evaluate sorption and solubility (ISO-1567). The specimens were stored in different solutions prior to testing. Surface hardness measurements were performed by using a Vickers hardness testing machine. A total of 20 cylinder-shaped test specimens with a diameter of 13 mm and thickness of 1 mm were prepared to evaluate colour change (ΔE). Analysis of variance was used to determine significant differences among groups. Paired t and Tukey Post-Hoc tests were performed to investigate significant differences among subgroups at all time intervals (p<0.05). RESULTS: It was found that while the percentage absorption value at T7 (7 days) of the A groups stored in artificial saliva+nasal secretion were the highest (0.057±0.119), the percentage absorption value at T15 (15 days) of the D groups stored in artificial nasal secretion were the lowest (0.013±0.09). Besides, it was found that the percentage solubility value at T30 (30 days) of VLC groups stored in artificial nasal secretion were the highest (0.016±0.003), and the percentage solubility value at T1(1 day) of the D groups stored in distilled water were the lowest (0.01±0.02). While the highest hardness value was of T0 (Dry) in group H (36.19±1.35), the lowest hardness value was of T0 in group D (9.83±2.48). When ΔE values analysed for each group, VLC group showed the highest values (23.78±5.05) (p<0.05), group D showed the lowest values (9.06±2.82) in time (between the T0 and T30). CONCLUSION: The new polyamide resin was observed to show better physical properties when compared with other materials.

Comparative effects of two different artificial body fluids on Candida albicans adhesion to soft lining materials.

This study investigated the C. albicans adhesion to cold- and heat-polymerized soft lining materials that were initially incubated in two different artificial body fluids, namely saliva and nasal secretion, and examined the surface roughness the materials (cold and heat polymerized soft liner) tested in vitro. Cold (Visco Gel) and heat-polymerized (Molloplast B) soft liner specimens (N=32, n=8 per group) (10x10x1.5 mm) were randomly produced to express the relationship between surface roughness and contamination, and influence of body fluids, and incubated in 1.5 ml contaminated solutions for 2 h. After fixation, all of materials were evaluated under optical microscope (x400) and SEM. Surface roughness measurements were examined with profilometre for each material. Data were analyzed using two-way ANOVA, Tukey's HSD and Dunnett T3 tests (alpha=0.05). Material type (p<0.05) and contamination media (p<0.05) showed a significant influence on the C. albicans adherence. The surface roughness of cold polymerized soft liner (Visco Gel) was significantly higher than heat-polymerized soft liner (Molloplast B) (p<0.05).

Candida albicans adherence on silicone elastomers: effect of polymerisation duration and exposure to simulated saliva and nasal secretion.

OBJECTIVES: The surfaces of maxillo-facial prostheses made of silicone elastomers exposed to soft tissues may interact with saliva and nasal secretion. These body fluids may lead to colonisation of microorganisms on their surfaces leading to their degradation or infection. This study investigated Candida albicans adhesion onto commercial maxillo-facial silicone elastomers based on different polymerisation processes. METHODS: Room-temperature polymerised maxillo-facial silicone elastomers (N=48) (10 mm x 10 mm x 2 mm) processed at different durations [VerSilTal VST-30 (20 min), VST-50 (12h overnight), VST-50F (6h)] were studied. C. albicans was chosen as a model organism for this study. The specimens were randomly divided into two subgroups and incubated in either 1.5 ml simulated saliva or nasal secretion containing C. albicans (ATCC 60193, set to 0.5 OD, 540 nm in advance) for 2h. Candida assays and adherence assays were made by inoculating C. albicans into Mueller Hinton Broth, Fluka added 500 mmol sucrose overnight. After fixation, specimens were stained by using sterilised Methylene Blue stain (Merck) and evaluated under optical microscope and SEM. For each material, on each specimen 15 different areas (mm(2)) were counted. Data were analysed using one-way ANOVA, paired sample t-test and Tukey's HSD (alpha=0.05). RESULTS: Material type (p<0.05) and exposure media (p<0.05) showed a significant influence on the C. albicans adherence. VST-30 material showed the most C. albicans adherence in both saliva and nasal secretion (mean rank: 99.84 and 53.47, respectively) (p<0.05) and VST-50 had the least colonisation in both media (10.35 and 5.57, respectively). Microscopic evaluation showed clusters of blastospore cells of C. albicans being more spread out on VST-30 whereas cells were more localised on VST-50 and VST-50F. SIGNIFICANCE: Among the tested materials, 12h room-temperature polymerised silicone elastomer resulted in less C. albicans adherence in both artificial saliva and nasal secretion.

The effect of a mandibular advancement splint on electromyographic activity of the submental and masseter muscles in patients with obstructive sleep apnea.

PURPOSE: The effectiveness of an appliance for the treatment of obstructive sleep apnea (OSA) shows inordinate interindividual differences. Also, its therapeutic effects still remain unresolved. This study examined and compared the effects of a mandibular advancement splint (MAS) on the masseter and submental muscles of patients with mild and moderate OSA. MATERIALS AND METHODS: Twenty OSA patients (10 mild and 10 moderate) who refused or did not tolerate nasal continuous positive airway pressure were randomly selected among individuals whose apnea-hypopnea indices (AHIs) were determined at the sleep laboratory of the Department of Chest Diseases, Ege University, before the study. Two polysomnography (PSG) sessions were performed and evaluated: the first without an MAS for the first half of the night to determine baseline muscle activity and the second with an MAS for the other half of the night to follow the condition of muscle activity. Electromyograms (EMGs) of the sum of the submental musculature and masseter muscle were measured with PSGs. The highest EMG amplitudes of the muscles and their AHIs were recorded before and after use of the appliance. Data were analyzed statistically using a t test. RESULTS: After insertion of the MAS device, EMG amplitudes increased significantly in the submental (P < .05) and masseter muscles (P < .05) of both mild and moderate OSA patients. However, the increase in muscle activity in the mild OSA group was significantly different from the moderate OSA group (P < .05). Accordingly, the mean EMG amplitude during moderate apnea episodes was lower than mild both with and without the appliance. After insertion of the MAS, the mean AHI in both mild and moderate OSA patients decreased significantly from baseline recordings (P < .05). Patients reported a favorable sleeping pattern and no dislodgement of the appliance during sleep. CONCLUSION: The MAS activated the masseter and submental muscles during sleep and prevented the upper airway from collapsing. The prosthetic appliance was useful in the treatment of both mild and moderate OSA syndrome.

Computed tomography-based planning and three-dimensional modeling for craniofacial implant placement: a technical note.

Facial defects can result from trauma, treatment of neoplasms, or congenital malformations, and their restoration is still a challenge for both surgeon and prosthodontists. Craniofacial implants can provide many benefits for prosthetic rehabilitation of facial defects; however, accurate placement of extraoral implants is vital for clinical success. Three-dimensional modeling is a novel technique that not only helps the surgeon to evaluate potential bone sites and adjacent structures, but also facilitates planning of the extraoral implant treatment by the prosthodontist. This technical report describes the use of three-dimensional modeling and planning for craniofacial implant placement.

Management of obstructive sleep apnea with a mandibular and tongue advancement splint (MTAS) in a completely edentulous patient. A clinical report.

Treatment of obstructive sleep apnea (OSA) in dentate patients using a mandibular advancement splint (MAS) from mandibular repositioners has been documented in detail. Nevertheless, studies about completely edentulous patients with OSA are sparse. This clinical report describes a clinical and laboratory method for producing a functional splint combining an MAS and a tongue-retaining device with an individualized tongue tip housing and discusses the rationale for using such a device.

Management of obstructive sleep apnea in an edentulous patient with a combination of mandibular advancement splint and tongue-retaining device: a clinical report.

BACKGROUND: Treatment of obstructive sleep apnea (OSA) in dentate patients by using mandibular advancement splint (MAS), had been documented in detail. Nevertheless, studies about completely edentulous patients with OSA are sparse. REPORT: This clinical report describes a clinical and laboratory method for producing a new functional splint combining a MAS and a tongue-retaining device with a custom-made tongue-tip housing and discusses the rationale for using such a device.

Treatment of a patient with cleft lip and palate using an internal distraction device.

A 24-year-old man with a bilateral cleft lip and palate was treated by a multidisciplinary team composed of an orthodontist, plastic surgeon, and prosthodontist with assistance from an engineer. Before treatment, clinical photographs, dental casts, lateral and posteroanterior cephalograms, periapical and panoramic radiographs, and three-dimensional computed tomography (3D CT) images were obtained. He presented with a narrow and retrognathic maxilla with a 23-mm anterior open bite. Following maxillary expansion with rapid palatal expansion, a Le Fort I maxillary osteotomy was performed, and an internal distractor was placed. After a 5-day latency period, internal maxillary distraction was performed at a rate of 1 mm/day achieved by two activations per day. Cephalometric analysis showed a 7-mm maxillary advancement. Mandibular bilateral sagittal split osteotomy was also performed to close the open bite following maxillary distraction and a 3-month stabilization period. Finally, the treatment was completed with prosthetic rehabilitation. The changes in speech production were evaluated using an automatic speech recognition system.

Management of lateral mandibular discontinuity by maxillary guidance.

Balance and symmetry of mandibular function is disturbed by loss of continuity of the mandible, which leads to altered mandibular movements and deviation of the residual fragment, as a consequence of which problems with chewing, swallowing, speech, and aesthetics develop. Methods such as maxillary fixation, and use of mandibular and palatal guidance have been used to reduce or eliminate the mandibular deviation. The aim of this study was to achieve a normal maxillomandibular relation in a patient with mandibular discontinuity. An acceptable maxillomandibular relation was obtained within 3 months with a maxillary guidance ramp prosthesis.

Heightened telescopic copings in cleft palate rehabilitation: a case report.

OBJECTIVE: To increase retention of overdentures in cleft palate patients by means of heightened telescopic copings with a newly designed attachment. In this study, a "precision attachment" is described to develop the stability and retention of telescopic overdentures. CASE: A cleft palate patient was treated with a newly designed overdenture. Intraoral examination revealed poor tooth structure and retention. Therefore, a new semiprecision attachment was designed in order to increase retention and stabilization. CONCLUSION: The patient's tolerance was increased with the new overdenture.

The use of prefabricated titanium tissue abutments for the construction of a maxillary subperiosteal implant.

This article presents a bimodal procedure for a patient with an implant-supported fixed partial denture (FP2 class of Misch) where endosteal implants (EOIs) and a subperiosteal implant (SPI) were indicated in different sections of the same arch. In edentulous patients, heterogeneous bone volume and density may be encountered in different regions of the same arch. When the available bone is favorable, the use of EOIs is simpler and less time consuming. An SPI is indicated when the available bone is severely resorbed, as in the type I division C, type II divisions C and D, and type III divisions C and D. The main advantage of the described combined technique is that it offers an alternative to invasive surgeries such as iliac crest bone grafts or various surgical augmentation procedures. The second advantage is the very brief healing period after insertion of the SPI before prosthetic loading. Planning, design, laboratory construction, surgical application, and prosthetic rehabilitation for bimodal implant treatment are described. Prefabricated titanium tissue abutments are used in the fabrication of the posts of the anterior titanium SPI. Titanium tissue abutments are placed in the waxup stage of the SPI before the casting of the titanium SPI. Posterior fixtures are EOIs. An anterior SPI with 4 posts and 4 posterior EOIs provides a combination of support for the screw-retained fixed maxillary denture of Misch's FP2.