Pilot Study of a New Mandibular Advancement Device

This study was conducted to determine the efficacy of a customized mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA). Eight patients (M = 3; F = 5; mean age = 56.3 ± 9.4) with a diagnosis of OSA confirmed by polysomnography (PSG) were re-cruited on the basis of the following inclusion criteria: apnea-hypopnea index (AHI) > 5, age between 18 and 75 years, body mass index (BMI) < 25, and PSG data available at baseline (T0). All were treated with the new NOA® MAD by OrthoApnea (NOA® ) for at least 3 months; PSG with NOA in situ was performed after 3 months of treatment (T1). The following parameters were calculated at T0 and T1: AHI, supine AHI, oxygen desaturation index (ODI), percentage of recording time spent with oxygen saturation <90% (SpO2 < 90%), and mean oxygen desaturation (MeanSpO2%). Data were submitted for statistical analysis. The baseline values were AHI = 21.33 ± 14.79, supine AHI = 35.64 ± 12.80, ODI = 17.51 ± 13.5, SpO2 < 90% = 7.82 ± 17.08, and MeanSpO2% = 93.45 ± 1.86. Four patients had mild OSA (5 > AHI < 15), one moderate OSA (15 > AHI < 30), and three severe OSA (AHI > 30). After treatment with NOA®, statistically significant improvements in AHI (8.6 ± 4.21) and supine AHI (11.21 ± 7.26) were recorded. OrthoApnea NOA® could be an effective alternative in the treatment of OSA: the device improved the PSG parameters assessed

Prevalence of oral behaviours in general dental patients attending a university clinic in Italy

Background: Oral behaviors represent a diverse array of habits beyond the physiological behaviors of the stomatognathic system. Objective: To describe the prevalence of different oral behaviors, as reported with the Oral Behavior Checklist (OBC-21), in a convenience sample of patients attending an Italian university clinic for routine dental cares. Methods: In this study, charts of adult patients presenting to the dental department of a regional hospital in Trieste, Italy, from January 2018 and January 2019 were reviewed. Patients with complete files were retrieved, and those with orofacial pain complaints were excluded. OBC-21 scores and grades (score of 0 corresponding to no risk, 1-24 to low risk, and higher than 24 to high risk) were analyzed and stratified according to age and sex. Results: Data from a total of 1424 patients were reported. The overall mean OBC score was 13.3 ± 9.9, with 6.7% no-risk grade, 79.6% low-risk grade, and 13.7% high-risk grade. In general, mean OBC scores decreased with increasing age. Females showed a higher frequency of high-risk grade than males. Most frequent prevalent habits included yawning (73.1%), eating between meals (66.9%) and chewing food on one side only (63.3%). Other behaviors were also highly prevalent, including pressing, touching, or holding teeth together other than while eating (52.7%) and awake clenching (47.5%). Conclusion: A low-risk grade of oral behaviors has been found to be frequent in our sample. Future studies are warranted to confirm these findings in larger, representative general populations and to assess if any of these habits are linked to negative effects on the stomatognathic system

Human rights and community work. Complementary theories and practices

Much effort has been placed on developing international understandings of human rights without the corresponding attention to responsibilities. The authors argue that a community development framework may be useful in re-conceiving human rights in a more holistic way, and that social workers and community development workers are well placed to be 'grass roots human rights workers

A reference map of the human binary protein interactome.

Global insights into cellular organization and genome function require comprehensive understanding of the interactome networks that mediate genotype-phenotype relationships(1,2). Here we present a human 'all-by-all' reference interactome map of human binary protein interactions, or 'HuRI'. With approximately 53,000 protein-protein interactions, HuRI has approximately four times as many such interactions as there are high-quality curated interactions from small-scale studies. The integration of HuRI with genome(3), transcriptome(4) and proteome(5) data enables cellular function to be studied within most physiological or pathological cellular contexts. We demonstrate the utility of HuRI in identifying the specific subcellular roles of protein-protein interactions. Inferred tissue-specific networks reveal general principles for the formation of cellular context-specific functions and elucidate potential molecular mechanisms that might underlie tissue-specific phenotypes of Mendelian diseases. HuRI is a systematic proteome-wide reference that links genomic variation to phenotypic outcomes

Gut Bless Your Pain—Roles of the Gut Microbiota, Sleep, and Melatonin in Chronic Orofacial Pain and Depression

Background. Increased attention has been paid to the gut–brain axis recently, but little is known so far regarding how this translates into pain susceptibility. Aim. The aim of this review is to determine whether gastroenterological disorders and sleep disorders (directly or indirectly) contribute to an increased susceptibility to depression and chronic orofacial pain. Method. A search was performed in the U.S. National Library of Medicine (PubMed) database in order to find studies published before 19 December 2021. We used the following terms: gut microbiome, OR sleep quality, OR melatonin, OR GERD, OR IBS, AND: depression OR chronic pain, in different configurations. Only papers in English were selected. Given the large number of papers retrieved in the search, their findings were described and organized narratively. Results. A link exists between sleep disorders and gastroenterological disorders, which, by adversely affecting the psyche and increasing inflammation, disturb the metabolism of tryptophan and cause excessive microglial activation, leading to increased susceptibility to pain sensation and depression. Conclusions. Pain therapists should pay close attention to sleep and gastrointestinal disorders in patients with chronic pain and depression

Correlation Between Parental-Reported Tooth Grinding and Sleep Disorders: Investigation in a Cohort of 741 Consecutive Children

PURPOSE: A possible relationship between sleep bruxism (SB) and several sleep disorders has been suggested in children, which could influence sleep quality and quality of life. This study aims to assess such correlations in a large sample of school children. METHODS: Parents of 741 consecutive children aged between 8 and 12 years filled the Sleep Disturbance Scale for Children (SDSC). It evaluated 45 items grouped in 8 components: duration of night-time sleep, sleep latency, bedtime problems, sleep quality, night awakenings, noc-turnal symptoms, morning symptoms and daytime sleepiness. An item evaluating parental-reported tooth grinding was also included. Correlation analysis was performed between paren-tal-reported tooth grinding and all the other items. RESULTS: A significant correlation between parental-reported tooth grinding and several sleep disorders concerning bedtime problems, night awakenings, nocturnal symptoms, and morning symptoms has been found. In general, correlation strength of significant pairs was low, ranging from .092 (sleep apnea) to .234 (movement while falling asleep). CONCLUSIONS: Parental-reported tooth grinding in children is correlated, even if weakly, with some sleep disorders concerning the sphere of bedtime problems, night awakenings, noc-turnal symptoms, breathing symptoms and morning symptoms. Further studies are needed to confirm these findings, with particular regard to the consistency of correlation outcomes between the parental reports and the sleep laboratory measures

Craniofacial morphology in patients with obstructive sleep apnoea

AIM: The aim of the study is to assess the relationship between cranio-facial morphology and the severity of OSA. METHODS: A sample of 14 adult patients (8 males and 6 females, mean±SD age=58±16.9 years), with a polysomnography confirmed diagnosis of OSA (i.e., AHI over 5 events/h), was recruited from the Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry (Pavia) and underwent a cephalometric evaluation. The cephalometric tracing was performed with Tweed analysis and using the Delta-Dent CE software. Sleep parameters such as AHI, AHI supine, ODI and mean desaturation (%) were assessed. Correlation analysis between cephalometric features and AHI was performed by means of Pearson test. RESULTS: Five of the OSA patients were diagnosed with mild OSA, 3 with moderate OSA, and 6 with severe OSA. Mean AHI was 24,3±19.3/h, mean AHI supine 56,9/h, mean Oxygen Desaturation Index (ODI) 18,95/h, mean desaturation 93,55 %. Cephalometric variables were FMA 19,3±1,4; SNB 78,8±0,8; ANB 1,25±3,4; Occl Plane 12,35 ± 9,1; PFH 50,8±11. Pearson test showed a lack of correlation with any of the assessed cephalometric variables (p>.05). CONCLUSIONS: This investigation showed that apnea severity is not correlated to craniofacial parameters. However, most of the patients in the sample showed a reduced FMA, a tendency to skeletal class III, an anterotation of the occlusal plane. Furthermore, prosthetic rehabilitations of the posterior sectors were found in many patients