Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: A randomized, placebo-controlled trial on temporomandibular side-effects.

PURPOSE: To assess the differences in the frequency of clinical signs of temporomandibular disorder (TMD) pain and mandibular function impairment between mandibular advancement device (MAD) and nasal continuous positive airway pressure (nCPAP) therapies in obstructive sleep apnea (OSA) patients at baseline and after 6 month of treatment. METHODS: This study concerns a secondary analysis of a randomized placebo-controlled trial in which different treatment effects of an objectively titrated MAD were compared with those of nCPAP and an intra-oral placebo appliance in a parallel design. Sixty-four mild to severe OSA patients (52.0 ± 9.6 years) were randomly assigned to these three groups. All patients underwent a shortened functional examination of their masticatory system at baseline and after 6 months to establish the presence of clinical signs of TMD pain. Mandibular function impairment was assessed with a questionnaire. RESULTS: Clinical signs of TMD pain were only rarely present at baseline and therapy evaluation. No significant differences were found between the three groups in the (low) frequency of clinical signs of TMD pain at both time points (p = .401-.176). In addition, the (low) scores of mandibular function impairment did not differ between the three groups either, neither at baseline (p = .744) nor after 6 months (p = .359). CONCLUSIONS: A low frequency of clinical signs of TMD pain in mild to severe OSA patients was found after 6 months, regardless of treatment with MAD or nCPAP. In addition, no difference in mandibular function impairment was observed between the different treatment modalities.

Microwave-assisted functionalization of the Aurivillius phase Bi2SrTa2O9: diol grafting and amine insertion vs. alcohol grafting.

Microwave-assisted functionalization of the layered Aurivillius phase Bi2SrTa2O9 by alcohols is thoroughly investigated. The grafting of linear aliphatic and bulky alcohols is studied as a function of the starting material, underlining the importance of the prefunctionalization of the layered perovskite, for instance by butylamine. In addition, the functionalization by α,ω-alkanediols is explored. α,ω-alkanediols bearing long alkyl chains (n C > 3) adopt an unprecedented pillaring arrangement, whereas 1,3-propanediol and ethyleneglycol adopt a bilayer arrangement, only one out of the two hydroxyl groups being coordinated. Finally, the reactivities of alcohols and amines towards insertion are compared: the preferential reactivity of the two functional groups appears to be strongly dependent of the reaction conditions, and especially of the water content. This study is further extended to the case of amino-alcohol insertion. In this case, the amine group is preferentially bound, but it is possible to control the grafting of the alcohol moiety, thus going from a bilayer arrangement to a pillaring one. This work is of particular importance to be able to functionalize easily and rapidly layered oxides with elaborated molecules, bearing several different potentially reactive groups.

Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: a randomized, placebo-controlled trial on psychological distress.

OBJECTIVES: The aim of this randomized placebo-controlled trail was to compare the effects of an objectively titrated mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) and an intraoral placebo device on symptoms of psychological distress in OSA patients. MATERIALS AND METHODS: In a parallel design, 64 mild/moderate OSA patients (52.0 ± 9.6 years) were randomly assigned to an objectively titrated MAD, nCPAP, or an intraoral placebo appliance. All patients filled out the Symptom Checklist-90-Revised twice: one before treatment and one after 6 months of treatment. The Symptom Checklist-90-Revised is a multidimensional symptom inventory designed to measure symptomatic psychological distress over the past week. Linear mixed model analyses were performed to study differences between the therapy groups for the different dimensions of the Symptom Checklist-90-Revised over time. RESULTS: The MAD group showed significant improvements over time in the dimensions "somatization," "insufficiency of thinking and acting," "agoraphobia," "anxiety," "sleeping problems," and "global severity index" (F = 4.14-16.73, P = 0.048-0.000). These improvements in symptoms of psychological distress were, however, not significantly different from those observed in the nCPAP and placebo groups (P = 0.374-0.953). CONCLUSION: There is no significant difference between MAD, nCPAP, and an intraoral placebo appliance in their beneficial effects on symptoms of psychological distress. CLINICAL RELEVANCE: The improvement in psychological distress symptoms in mild/moderate OSA patients under MAD or nCPAP treatment may be explained by a placebo effect.

Microcosm evaluation of autochthonous bioaugmentation to combat marine oil spills.

Oil spills can be disastrous to any ecosystem. Bioremediation through bioaugmentation (addition of oil-degrading bacteria) and biostimulation (addition of nutrients N&P) options can be a promising strategy for combating oil spills following first response actions. However, bioaugmentation is one of the most controversial issues of bioremediation since nutrient addition alone has a greater effect on oil biodegradation than the addition of microbial products that are highly dependent on environmental conditions. There is increasing evidence that the best way to overcome the above barriers is to use microorganisms from the polluted area, an approach proposed as autochthonous bioaugmentation (ABA) and defined as the bioaugmentation technology that uses exclusively microorganisms indigenous to the sites (soil, sand, and water) to be decontaminated. In this study, we examined the effectiveness of an ABA strategy for the successful remediation of polluted marine environments. A consortium was enriched from seawater samples taken from Elefsina Gulf near the Hellenic Petroleum Refinery, a site exposed to chronic crude oil pollution. Pre-adapted consortium was tested alone or in combination with inorganic nutrients in the presence (or not) of biosurfactants (rhamnolipids) in 30-day experiments. Treatment with fertilizers in the presence of biosurfactants exhibited the highest alkane and PAH degradation and showed highest growth over a period of almost 15 days. Considering the above, the use of biostimulation additives in combination with naturally pre-adapted hydrocarbon degrading consortia has proved to be a very effective treatment and it is a promising strategy in the future especially when combined with lipophilic fertilizers instead of inorganic nutrients. Such an approach becomes more pertinent when the oil spill approaches near the shoreline and immediate hydrocarbon degradation is needed.

Effects of occlusal stabilization splints on obstructive sleep apnea: a randomized controlled trial.

AIMS: To assess the influence of occlusal stabilization splints on sleep-related respiratory variables in obstructive sleep apnea (OSA) patients. METHODS: Ten OSA patients (47.3 ± 11.7 years of age) received a stabilization splint in the maxilla. All patients underwent three polysomnographic recordings with their splint in situ, and three recordings without their splint in situ, using a randomized crossover design. RESULTS: Repeated-measures ANOVAs did not yield statistically significant differences in the Apnea-Hypopnea Index (AHI) or in the Epworth Sleepiness Scale (ESS), neither between the three nights without the stabilization splint (AHI: F = 2.757, P = .090; ESS: F = 0.153, P = .860) nor between the nights with the splint in situ (AHI: F = 0.815, P = .458; ESS: F = 0.231, P = .796). However, independent ANOVAs revealed that the mean AHI of the three nights with the stabilization splint in situ (17.4 ± 7.0 events/hour) was significantly higher than that of the nights without the splint in situ (15.9 ± 6.4 events/hour) (F = 7.203, P = .025). The mean increase in AHI with the splint in situ was 1.4 ± 1.7 (95% confidence interval = -1.9-4.7). No difference in ESS was found when both conditions were compared (F = 1.000, P = .343). CONCLUSION: The use of an occlusal stabilization splint is associated with a risk of aggravation of OSA; however, the effect size was small, which reduces the clinical relevance of the study.

Enhanced bioremediation of crude oil utilizing lipophilic fertilizers combined with biosurfactants and molasses.

Many research studies have demonstrated the feasibility and efficacy of fertilization with nitrogen and phosphorus to combat oil spills in marine environments. Rapid dilution of water-soluble nutrients can be overcome by oleophilic formulations that retain optimal nutrient concentrations at the oil-water interface where biodegradation occurs. Previous work has demonstrated that biodegradation processes are enhanced by the addition of lipophilic fertilizers of natural origin (uric acid and lecithin). In this work, we examined the effectiveness of these nutrients in combination with biosurfactants (rhamnolipids) and molasses (source of C and vitamins) to enhance the biodegradation by naturally occurring microorganisms. It was found that the use of biosurfactants resulted in an increased removal of petroleum hydrocarbons (96% removal of C19-C34 n-alkanes within a period of 18 days) as well as in a reduction of the lag phase (almost 80% removal was achieved within the first week of biosurfactant application).

ArF-193 excimer laser and Emdogain in the treatment of experimental periodontitis: an experimental study in rabbits.

OBJECTIVE: We aimed to investigate how the progress made on laser technology during the last ten years could overcome this obstacle and allow the use of lasers in periodontology, together with the application of a number of products permitting the regeneration of periodontal tissues. BACKGROUND DATA: The use of lasers in dentistry remains controversial, in spite of their increasing application in medical practice. The main reason for this discrepancy is the frequent report of damage to surrounding tissues and the dental pulp, due to the energy transfer, from the site of laser impact. METHODS: Experimental periodontitis was initiated in fifteen rabbits. Animals were divided into five equal groups. In the control group, no therapy was applied. The remaining four groups were treated with curettage or ArF 193 excimer laser, under conditions of strict control of frequency, fluency, and application, without or with the application of a periodontal healing product (Emdogain). Laser was applied by the use of a new, articulated arm for beam delivery. Pocket depth and microscopic analysis were performed three weeks after treatment. RESULTS: Our results show that all treatment groups decreased pocket depth significantly. ArF193 excimer laser does not produce any histological damage to the dental pulp, and facilitates periodontal regeneration. This result is highly facilitated by the application of Emdogain). CONCLUSIONS: The use of UV lasers, under a tight control of its energy, may be a valuable tool for the treatment of periodontal diseases, especially combined with the use of healing products. Further study is need to confirm these results.