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 recruited 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

Modifications of oral hygiene and dietary habits in the patients in treatment with invisalign system

AIM: to evaluate the habits of hygiene of the mouth and appliance, and the changes in the diet in patients treated with INVISALIGN System, to optimize and personalize the indications during treatment. MATERIALS AND METHODS: a 22 question informative questionnarie has been elaborated. 25 patients between 15 and 62 years of age anonymously completed the questionnaires. The data have been entered in an Excel database file and graphically showed through histograms and pies. RESULTS: all the patients who have answered the questions carry out the daily oral hygiene by toothbrushing (¾ manual, ¼ electric toothbrush) and they replace it, not with a regular timing, but when “it’s consumed”. More than a half of the patients are prompt to the dental hygienist visits.The appliance is generally cleaned 2 times a day. The diet changes are very intersting: a tendency to reduction of the potential coloring (tea, coffee, colored drinks) or decayed (sweet, candies, sugar drinks) food and the number of snacks has been observed.The patients concentrate the food assumption during the principal meals. CONCLUSIONS: the INVISALIGN patients pay more attention at the health of the mouth and the hygiene of the appliance, with a highrespect of the visits with the dental hygienist and in attempting to optimize the relations between oral hygiene and food assumption

Esperienza di team building: costruzione di una squadra efficace in un Corso di laurea in Igiene Dentale

Obiettivi: far conoscere in modo più profondo, aumentare la fiducia nei propri colleghi, migliorare il livello di collaborazione, stimolare la creatività, favorire la comunicazione tra studenti e tutor e studenti e studenti di un Corso di Laurea in Igiene Dentale. Materiali e metodi: realizzazione di una giornata di Team Building in un setting outdoor. Risultati: 32 studenti, tutor e Coordinatore didattico nel Parco del Castello di Pavia si sono messi in gioco parlando di sé, partecipando a team game e fasi di debriefing. Conclusioni: l’esperienza formativa ha permesso di trasformare un gruppo di studenti e tutor in una squadra

The Knowledge of Pediatric Sleep Medicine among Orthodontists in Italy

AIM This study aimed to evaluate knowledge and attitude regarding obstructive sleep apnea (OSA) in children among orthodontists. MATERIALS AND METHODS An anonymous questionnaire was prepared using Google Forms and sent to dentists in Italy via private social platforms. The first part of the questionnaire contained basic demographic data questions, and the second part included items about pediatric OSA. A total of 125 responses were recorded over one month. For this study, we considered only the questionnaires compiled by orthodontists, selected using answer “yes” at the question 5 “have you achieved your orthodontic residency?”. RESULTS AND CONCLUSIONS 40 orthodontists from different regions of North, Center and South Italy, 26 male and 14 female, with a mean age of 48 compiled the questionnaire. The findings reveal the desire for more training about pediatric OSA. About half of the orthodontists surveyed feel that their knowledge is poor and does not enable them to manage young patients with OSA. Gaps are observed in the recognition of some relevant risk factors and conditions associated with OSA and in the awareness of some benefits of orthodontic treatments. Moreover, collaboration in a multidisciplinary team to proper manage OSA is still weak and not recognized by all the physicians. This study shows lack of knowledge about pediatric OSA and its management among orthodontists, revealing the need to update the dentistry curriculum and to organize educational interventions

Diagnosis of temporomandibular disorders according to RDC/TMD Axis I findings. A multicenter Italian study

The aim of the present study was to evaluate the prevalence of the different Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I types of temporomandibular disorders (TMD) in a population of subjects seeking for TMD treatment at 2 University Departments in Italy and to compare it with data from similar studies in the literature, in order to assess the usefulness of the RDC/TMD classification system as a tool for epidemiological data gathering and multicenter and cross-cultural comparison. METHODS: A total of 210 consecutive patients seeking for TMD treatment at the Section of Prosthetic Dentistry, Department of Neuroscience, University of Pisa, Italy, and 109 consecutive patients seeking treatment at the Section of Prosthetic Dentistry and Temporo-mandibular Disorders, University of Pavia, Italy, were assessed using RDC/TMD. RESULTS: Only 181 of the patients referring to the University of Pisa and 104 of those referring to the University of Pavia satisfied the criteria for inclusion. Findings from the 2 study populations were very similar. Mean age of the patients was 40 years, with a female:male ratio of 3.5:1 (222 females, 77.9%; 63 males, 22.1%). The prevalence of RDC/TMD Axis I diagnoses was 50.2% (143/285) for Group I disorders (muscle disorders), 38.6% (110/285) for Group II disorders (disc displacement), and 50.2% (143/285) for Group III disorders (arthralgia, osteoarthritis, osteoarthrosis). CONCLUSION: Results from the present investigation have confirmed the usefulness of the RDC/TMD classification system for research purposes and for data gathering in cross-cultural and multicenter comparisons

Diagnosis of temporomandibular disorders according to RDC/TMD Axis I findings. A multicenter Italian study

The aim of the present study was to evaluate the prevalence of the different Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I types of temporomandibular disorders (TMD) in a population of subjects seeking for TMD treatment at 2 University Departments in Italy and to compare it with data from similar studies in the literature, in order to assess the usefulness of the RDC/TMD classification system as a tool for epidemiological data gathering and multicenter and cross-cultural comparison. METHODS: A total of 210 consecutive patients seeking for TMD treatment at the Section of Prosthetic Dentistry, Department of Neuroscience, University of Pisa, Italy, and 109 consecutive patients seeking treatment at the Section of Prosthetic Dentistry and Temporo-mandibular Disorders, University of Pavia, Italy, were assessed using RDC/TMD. RESULTS: Only 181 of the patients referring to the University of Pisa and 104 of those referring to the University of Pavia satisfied the criteria for inclusion. Findings from the 2 study populations were very similar. Mean age of the patients was 40 years, with a female:male ratio of 3.5:1 (222 females, 77.9%; 63 males, 22.1%). The prevalence of RDC/TMD Axis I diagnoses was 50.2% (143/285) for Group I disorders (muscle disorders), 38.6% (110/285) for Group II disorders (disc displacement), and 50.2% (143/285) for Group III disorders (arthralgia, osteoarthritis, osteoarthrosis). CONCLUSION: Results from the present investigation have confirmed the usefulness of the RDC/TMD classification system for research purposes and for data gathering in cross-cultural and multicenter comparisons

The Interaction of Craniofacial Morphology and Body Mass Index in Obstructive Sleep Apnea

Abstract: Aim: This study sets out to explore the relationship between craniofacial morphology and obstructive sleep apnea (OSA) severity, assessing the relative contribution of obesity, calculated using BMI. Methods: A sample of 30 adult patients (20 males; 10 females), mean age = 54(±76) years, with a polysomnography-confirmed diagnosis of OSA, i.e., with an apnea-hypopnea index (AHI) of over 5 events/h, was recruited and underwent cephalometric evaluation. Sleep parameters, namely AHI, AHI supine, oxygen desaturation index (ODI), and mean oxygen saturation [Mean SaO2%], were assessed. Correlation analysis between 13 cephalometric features and AHI was performed using a Pearson test. The sample was split into three groups based on AHI score (mild = 10 < AHI < 15; moderate = 15 < AHI < 30; severe = AHI > 30), and ANOVA was performed to compare the means of cephalometric features. In addition, the sample was split into two groups according to BMI (normal weight = BMI < 25; overweight = BMI > 25). Correlation analysis between cephalometric features and AHI was performed for each group using a Pearson test. Results: The average polysomnographic val- ues were AHI = 29.08(±16); AHI supine = 43.45(±21); ODI = 23.98(±21); mean SaO2(%) = 93.12(±2). Posterior facial height (PFH) was significantly lower in the severe OSA group than in patients with moderate OSA (p = 0.05). In the normal-weight group, negative correlations of the PFH and SNA angle with AHI (r = −0.36; r = −0.25, respectively), and positive correlations of the FMA angle and MP-H distance with AHI (r = 0.29; r = 0.20, respectively), were found. In the overweight group, negative correlations of AO-BO distance, SPAS (upper posterior airway space) and PAS (posterior airway space) with AHI (r = −0.30; r = −0.28; r = −0.24, respectively), and positive correlations of AFH (anterior facial height) and the FMA angle with AHI (r = 0.32; r = 0.25, respectively), emerged. Conclusions: PFH seems to be related to the aggravation of OSA. In normal-weight subjects, hard tissue-related factors have a greater impact on OSA severity, whereas in overweight subjects, the impact of fat tissue is greater