Dental Approach for Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is characterized by intermittent upper airway obstruction during sleep. It causes sleep fragmentation from brief arousal and affects social life by excessive daytime sleepiness. Moreover, OSA is considered a risk factor for cardiovascular complications and type 2 diabetes as associated features. The gold standard treatment for OSA is continuous positive airway pressure during sleep. However, if this treatment is frustrating to the patient or the apnea and hypopnea index is low or mild, alternative treatments for OSA must be found. One possible treatment is an oral appliance (OA) to improve the upper airway configuration. Dental clinicians have attempted to improve this respiratory condition caused by OSA by using OA, and at Tokushima University Hospital, OA therapy has been in use since 1993. Nishigawa et al. introduced a method to fabricate an OA and to investigate the effects of this therapy. In the present article, the method of OA fabrication was modified, and its effects were evaluated. Dental clinicians should have some knowledge about the mechanics of sleep and the management of sleep conditions so that they can cooperate closely with medical physicians. Thus, collaboration between the medical and dental fields can help patients attain healthy sleep

Supplementation of protein-free diet with whey protein hydrolysates prevents skeletal muscle mass loss in rats

AbstractMuscle mass loss is induced by aging, several catabolic diseases, and malnutrition. It is well known that ingestion of whey protein and its hydrolysates (WPH) is effective in stimulating muscle protein synthesis. However, these studies focused on the acute up-regulation of muscle protein synthesis, and few studies have investigated the effect of whey protein and WPH on muscle mass during chronic malnutrition. The aim of the present study was to investigate the effect of 7 days supplementation of whey protein and WPH on muscle reduction in Wistar rats fed a protein-free (PF) diet. Wistar rats were fed either a standard diet (containing 20% protein) or a PF diet during the experimental period. Those fed a PF diet received a dietary supplement containing an amino acid mixture, whey protein, or WPH for 7 days. The weight of the extensor digitorum longus decreased in rats fed a PF diet supplemented with the amino acid mixture or the whey protein. However, this decrease was partially but significantly suppressed in the group fed the WPH supplement. Additionally, administration of WPH induced a postprandial increase in plasma essential amino acids, branched-chain amino acids, and leucine concentration compared with animals fed the amino acid mixture or the whey protein. These results suggest that 7 days supplementation of the diet with WPH suppressed muscle weight loss in rats fed a PF diet

Dose-response relationship between sports activity and musculoskeletal pain in adolescents.

Physical activity has multiple health benefits but may also increase the risk of developing musculoskeletal pain (MSP). However, the relationship between physical activity and MSP has not been well characterized. This study examined the dose-response relationship between sports activity and MSP among adolescents. Two school-based serial surveys were conducted 1 year apart in adolescents aged 12 to 18 years in Unnan, Japan. Self-administered questionnaires were completed by 2403 students. Associations between time spent in organized sports activity and MSP were analyzed cross-sectionally (n = 2403) and longitudinally (n = 374, students free of pain and in seventh or 10th grade at baseline) with repeated-measures Poisson regression and restricted cubic splines, with adjustment for potential confounders. The prevalence of overall pain, defined as having pain recently at least several times a week in at least one part of the body, was 27.4%. In the cross-sectional analysis, sports activity was significantly associated with pain prevalence. Each additional 1 h/wk of sports activity was associated with a 3% higher probability of having pain (prevalence ratio = 1.03, 95% confidence interval = 1.02-1.04). Similar trends were found across causes (traumatic and nontraumatic pain) and anatomic locations (upper limbs, lower back, and lower limbs). In longitudinal analysis, the risk ratio for developing pain at 1-year follow-up per 1 h/wk increase in baseline sports activity was 1.03 (95% confidence interval = 1.02-1.05). Spline models indicated a linear association (P < 0.001) but not a nonlinear association (P ≥ 0.45). The more the adolescents played sports, the more likely they were to have and develop pain.This study was supported by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan. MK is supported by a JSPS Postdoctoral Fellowship for Research Abroad. FI is supported by the Medical Research Council Epidemiology Unit (MC_UU_12015/1; MC_UU_12015/5).This is the final version of the article. It first appeared from Wolters Kluwer via http://dx.doi.org/10.1097/j.pain.000000000000052

Frontal/Lateral Mandibular Translations-masticatory Movement Relationship

Objective: This study aimed to clarify whether crown restorations with adjusted occlusal surfaces that were formed using frontal/lateral mandibular translations, functioned without interference during mastication. Materials and Methods: In 10 adult volunteers who had healthy normal dentition, frontal and lateral border movement was measured during unilateral mastication and free mastication, using an ultrasound digital mandibular measuring system (ARCUS digma2). Additionally, precise impressions of the upper and lower dental arch were taken, and dental casts were made. These casts were measured using a CAD/CAM scanning system (ARCTICA). For the fabrication of crown restorations, the functionally generated path technique (FGP technique) was used on the monitor for the lower first and second molar. The movement of the opposite teeth on the occlusal surface during frontal and lateral border movement, during unilateral mastication, and during free mastication was considered the functional occlusal surface. The data of the functional occlusal surface generated by frontal/lateral mandibular translations and that of each of the masticatory functional occlusal surfaces were superimposed using three-dimensional data evaluation software (GOM). The difference between these surfaces was evaluated to determine the interference area, maximum interference difference, and average interference difference. Results: Interference was present for all functional occlusal surfaces created by mastication as well as those determined by frontal/lateral mandibular translations. The average interference values, in order of free masticatory movement, habitual masticatory side, and non-habitual masticatory side, were as follows. Interference area: 167.5±20.8 mm2, 121.9±28.5 mm2, 144.6±28.0 mm2; maximum interference distance: 345.0±43.1 μm, 189.0±39.9 μm, 309.0 ± 46.8 μm; average interference distance: 130.0±15.7 μm, 64.0±10.6 μm, 130.0±21.9 μm. Statistically significant differences were found for the maximum interference distance and average interference distance (both p<0.05). Conclusions: The functional occlusal surfaces for each form of mastication demonstrated interference with the functional surface of frontal/lateral mandibular translations. Thus, crown restorations of which the occlusal surfaces were adjusted and formed by frontal/lateral mandibular translations may interfere with mastication

Educational effects using a robot patient simulation system for development of clinical attitude

Introduction: The aim of this study was to assess the effectiveness of improving the attitude of dental students toward the use of a full-body patient simulation system (SIMROID) compared to the traditional mannequin (CLINSIM) for dental clinical education. Materials and methods: The participants were 10 male undergraduate dental students who had finished clinical training in the university hospital 1 year before this study started. They performed a crown preparation on an upper premolar tooth using SIMROID and CLINSIM as the practical clinical trials. The elapsed time for preparation was recorded. The taper of the abutment teeth was measured using a 3-dimensional shape-measuring device after this trial. In addition, a self-reported questionnaire was collected that included physical pain, treatment safety, and maintaining a clean area for each simulator. Qualitative data analysis of a free format report about SIMROID was performed using text-mining analysis. This trial was performed twice at 1-month intervals. Results: The students considered physical pain, treatment safety, and a clean area for SIMROID significantly better than that for CLINSIM (P < 0.01). The elapsed time of preparation in the second practical clinical trial was significantly lower than in the first for SIMROID and CLINSIM (P < 0.01). However, there were no significant differences between the abutment tapers for both systems. For the text-mining analysis, most of the students wrote that SIMROID was similar to real patients. Conclusion: The use of SIMROID was proven to be effective in improving the attitude of students toward patients, thereby giving importance to considerations for actual patients during dental treatment