Awareness and Sources of Knowledge about Obstructive Sleep Apnea: A Cross Sectional Survey Study

Obstructive sleep apnea (OSA) is a multifactorial sleep breathing disorder, seriously impacting quality of life and involving approximately 1 billion of the world’s population. It is characterized by episodes of total cessation of breathing or decreases in airflow during sleep. Available data suggest that most cases of OSA remain undiagnosed even in developed countries. This is due to a lack of widespread knowledge about this pathology and the medical morbidities and mortality it brings about, among both laypeople and physicians. Moreover, despite receiving indications about the need to undergo specific evaluations for OSA signs and symptoms, sometimes patients do not pay sufficient attention to the problem. This is probably due to a lack of correct information on these issues. The present investigation analyzed the level of knowledge about OSA pathology and the sources through which a group of OSA patients gained information on their condition. A survey of 92 patients diagnosed with OSA (mean age 60.55 ± 10.10) and referred to the Unit of Orthodontics and Dental Sleep Medicine of the University of Bologna was conducted by means of a questionnaire investigating sociodemographic characteristics, the level of general knowledge on OSA pathology and its possible medical consequences. Despite about two third (67.38%) of the population demonstrating extensive knowledge, remarkably, a group of subjects (20.65%) had poor awareness of the OSA condition. A statistically significant correlation emerged between the level of knowledge about OSA and the level of education (p = 0.002). A great effort should be made to improve the quality of information and the communication modalities for OSA to enable a fully appropriate awareness of the condition among patients

Effect of orthopedic and functional orthodontic treatment in children with obstructive sleep apnea: A systematic review and meta-analysis

Orthodontic treatment is suggested in growing individuals to correct transverse maxillary deficiency and mandibular retrusion. Since, as a secondary effect, these orthodontic procedures may improve pediatric obstructive sleep apnea (OSA), this systematic review assessed their effects on apnea-hypopnea index (AHI) and oxygen saturation (SaO2). Twenty-five (25) manuscripts were included for qualitative synthesis, 19 were selected for quantitative synthesis. Five interventions were analyzed: rapid maxillary expansion (RME, 15 studies), mandibular advancement (MAA, five studies), myofunctional therapy (MT, four studies), and RME combined with MAA (one study). RME produced a significant AHI reduction and minimum SaO2 increase immediately after active treatment, at six and 12 months from baseline. A significant AHI reduction was also observed six and 12 months after the beginning of MAA treatment. MT showed positive effects, with different protocols. In this systematic review and meta-analysis of data from mainly uncontrolled studies, interceptive orthodontic treatments showed overall favorable effects on respiratory outcomes in pediatric OSA. However, due to the low to very low level of the body evidence, this treatment cannot be suggested as elective for OSA treatment. An orthodontic indication is needed to support this therapy and a careful monitoring is required to ensure positive improvement in OSA parameters

Onychophagia and post-orthodontic isolated gingival recession: diagnosis and treatment

This clinical report describes the diagnosis and the management of isolated-type recession defects of complex etiology in 2 healthy postorthodontic patients. The lesions were confined to 1 mandibular incisor and were associated with an abnormal buccolingual inclination of the affected tooth despite a lingual retainer made with a round stainless steel twisted wire. After careful questioning, it was determined that the recession defects were indirect effects of habitual onychophagia. The concomitant fingernail-biting habit and the lingual bonded retainer led to the indirect development of bone dehiscence and, consequently, gingival recession

Inclusione dei canini mascellari permanenti e riassorbimento radicolare degli incisivi: prevenzione e aspetti medico-legali

Objectives. To discuss the risk of incisor root resorption in the presence of ectopic eruption of the permanent maxillary canines. Discussion. Early detection of an anomalously positioned maxillary canine is essential. To this end, patients should undergo a comprehensive clinical and radiographic assessment starting at the age 8 years. Results and conclusions. Eruption of the ectopic permanent canines can be facilitated with early extraction of the primary maxillary canines (and possibly the primary first molars). This approach can prevent impaction (which requires more complicated, prolonged, and biologically expensive treatment) and limit the risk of root resorption involving the adjacent teeth (an event that causes irreversible damage and may give rise to medicolegal litigation)

A new transalveolar sinus lift procedure for single implant placement: The ebanist technique. A technical description and case series

6noNowadays, there are many techniques to compensate bone atrophies of the posterior maxilla in order to obtain an implant-supported rehabilitation. OBJECTIVE: This case series describes the Ebanist technique: a sinus lift procedure to be used in case of extremely resorbed bone crests (≤3 mm) allowing simultaneous implant placement. METHODS: With a dedicated cylindrical trephine bur, it is possible to harvest a cylinder of bone from a fresh mineralized frozen homologous bone block graft and to simultaneously create a trapdoor on the recipient site. The trapdoor cortical bone is detached from the sinus membrane and removed. Dental implant is placed into the graft before the grafting procedure since the cylindrical block, once inserted in the recipient area, is not able to oppose sufficient resistance to the torque needed for implant placement. RESULTS: Second-stage surgery and following prosthetic rehabilitation were performed after 5 months. In all cases, implant stability was manually checked and no pathological symptoms or signs were recovered at any follow-up visit. CONCLUSION: This technique can be considered a valid procedure for implant therapy on atrophic posterior upper maxillae, when the residual bone crest is extremely resorbed.openopenRizzo, Rosario; Checchi, Vittorio; Marsili, Federico; Zani, Antonio; Incerti-Parenti, Serena; Checchi, LuigiRizzo, Rosario; Checchi, Vittorio; Marsili, Federico; Zani, Antonio; Incerti Parenti, Serena; Checchi, Luig

Different doses of low\u2013level laser irradiation modulate the in vitro response of osteoblast-like cells

The in vitro response of osteoblast-like cells to different doses of low\u2013level laser irradiation is described

Association between the inclination of the lateral incisors and the position of the erupting canines on panoramic radiographs

Objective. To analyze correlations between the inclination of the permanent maxillary lateral incisors and the intraosseous position of the erupting permanent maxillary canines on panoramic radiographs. Material and methods. The inclination of the lateral incisor to the midline, the mesiodistal position of the crown of the canine, and the inclination of the canine to the midline and to the long axis of the adjacent incisor were measured on panoramic radiographs of 1013 subjects aged 8\u201311 years. Results. The distal inclination of the lateral incisor crown increased until 10 years, after which no significant changes occurred. The canine erupted with increasing mesial inclination of the crown until 9 years, after which it began to progressively right itself. As a result, inclination of the canine to the adjacent incisor increased between 8 and 9 years and decreased between 10 and 11 years. Until the children reached 9 years of age, the more mesial the crown of the unerupted canine, the greater the decrease in the distal inclination of the lateral incisor crown. Conclusions. The inclination of the crown of the lateral incisor varies during eruption of the canine, increasing distally until 10 years as a physiological stage in the mixed dentition. The inclination of the lateral incisor is also associated with the mesiodistal position of the canine crown. The mesial intraosseous location of the canine crown results in righting of the lateral incisor

Passive archwires for intermaxillary fixation in surgical cases: a clinical report

In intraoperative intermaxillary fixation (IMF), bonding a minimally adapted, rectangular, stainless steel, preformed archwire directly to the teeth with a light-cured composite resin can offer many benefits to clinicians and patients. The procedure is easier and less time-consuming than conventional bracket placement, the risk of occlusal interference is reduced and the patient's comfort is increased. With the use of composite resin, the wire fits buccal tooth surfaces accurately, thus creating a completely passive anchor unit. Crimpable hooks can be easily adjusted along the archwire, thus establishing different directions of postoperative elastic traction. Furthermore, this technique eliminates soft tissue injuries and tooth root damage, which are risks associated with the use of miniscrews for IMF. In this clinical report, we describe the case of a 50-year-old man, who required a passive anchor unit to assist IMF before undergoing maxillomandibular advancement to treat severe obstructive sleep apnea syndrome

Double vs Single Primary Teeth Extraction Approach as Prevention of Permanent Maxillary Canines Ectopic Eruption

PURPOSE: To compare the effects of extraction of primary maxillary canines and first molars (double extraction approach) vs primary maxillary canines extraction (single extraction approach) in cases of ectopic permanent maxillary canines (PMCs). METHODS: Palatally or centrally displaced PMCs were randomly assigned as follows: single extraction (Group 1=29 patients, 52 canines); double extraction (Group 2=30 patients, 56 canines). PMCs inclination to the midline and to the long axis of the lateral incisor, mesiodistal position of the PMCs crown, and first premolars angulation to the midline were measured on panoramic radiographs at T0 and after 18 months (T1), on average. Between-group statistical comparison was carried out on T0-T1 changes for all the radiographic variables. Eruption/noneruption of the PMCs was also assessed. RESULTS: Group 2 exhibited improvements in PMCs intrabony position among all the examined variables (P<.001), obtaining a greater parallelism between the roots of the PMCs and the adjacent lateral incisors (P<.001). An improved position of the first premolars due to a reduced angulation (P<.001) was also observed. Clinical success rates showed no statistically significant difference. CONCLUSIONS: The double extraction approach proved to be a more effective procedure vs the single extraction approach in improving permanent maxillary canines' intraosseous position