OBJECTIVE: This study aimed to describe the frequency of oral behaviors and generalized anxiety among university students and assess their association using the Oral Behavior Checklist-21 (OBC-21) and Generalized Anxiety...OBJECTIVE: This study aimed to describe the frequency of oral behaviors and generalized anxiety among university students and assess their association using the Oral Behavior Checklist-21 (OBC-21) and Generalized Anxiety Disorder-7 (GAD-7). METHODS: An online questionnaire was sent to students at the University of Trieste, Italy. Mann-Whitney U compared OBC-21 scores by sex; Spearman Correlation and linear regression (adjusted for age and sex) assessed the association between OBC-21 and GAD-7 scores. Fisher's exact test examined categorical relationships. RESULTS: A total of 1,687 students completed the questionnaire (response rate 9.5%; 73% females). Mean OBC-21 and GAD-7 scores were 23.9 ± 8.3 and 9.5 ± 5.2, respectively. Higher OBC-21 scores were associated with younger age ( = 0.004) and females sex ( < 0.001). Oral behaviors and anxiety were moderately correlated ( = 0.42, < 0.001), confirmed by regression. Categorized scores also showed a significant association ( < 0.001, Cramér's V = 0.308). CONCLUSION: Oral behaviors are significantly associated with generalized anxiety in university students, underscoring the importance of integrating mental health assessment into oral health care.
BACKGROUND: Undiagnosed obstructive sleep apnoea (OSA) presents risks in oral and maxillofacial surgery (OMFS), yet tools such as STOP-Bang often underperform in non-obese patients with craniofacial anomalies. This study...BACKGROUND: Undiagnosed obstructive sleep apnoea (OSA) presents risks in oral and maxillofacial surgery (OMFS), yet tools such as STOP-Bang often underperform in non-obese patients with craniofacial anomalies. This study aimed to develop and preliminarily assess the Jain's Obstructive Sleep Apnoea Questionnaire (JOSAQ), a craniofacial-focused screening tool tailored for OMFS practice. METHODS: JOSAQ, a two-stage, 20-item instrument combining patient-reported symptoms and clinician-assessed craniofacial features, underwent Delphi consensus and vignette-based comparison with STOP-Bang. Fifteen experts participated in the Delphi process, and 20 clinicians rated 25 standardized clinical vignettes. RESULTS: Content validity was high (S-CVI = 0.89). JOSAQ identified more high-risk cases than STOP-Bang (62% vs 44%, < .01) with higher Inter-rater reliability (κ = 0.72 vs 0.64), and better clarity scores. Completion times were similar. CONCLUSION: JOSAQ enhances screening sensitivity and inter-rater reliability without increasing assessment time, particulary benefiting non-obese patients with craniofacial anomalies. Multicentre validation against polysomnography is recommended.
OBJECTIVE: This study investigated the correlation between oral behaviors measured by the Oral Behaviors Checklist (OBC) and the frequency of awake bruxism (AB), assessed by Ecological Momentary Assessment (EMA). METHODS...OBJECTIVE: This study investigated the correlation between oral behaviors measured by the Oral Behaviors Checklist (OBC) and the frequency of awake bruxism (AB), assessed by Ecological Momentary Assessment (EMA). METHODS: Seventy-five individuals with AB completed the OBC and responded to ten daily mobile prompts that assessed real-time jaw muscle behavior for a week. RESULTS: Non-functional OBC scores correlated positively with overall AB ( = 0.384, < .001) and individual AB-behavior frequencies measured by EMA, except for a negative correlation with teeth contact ( = -0.289, = .012). CONCLUSION: Functional OBC scores were not associated with AB frequencies. The OBC may serve as a preliminary screening instrument in identifying AB-related behaviors.
OBJECTIVE: To assess soft-tissue variables from CBCT images obtained for dental treatment purposes as potential predictors of OSA severity in adults. METHODS: This retrospective study included 140 snoring patients catego...OBJECTIVE: To assess soft-tissue variables from CBCT images obtained for dental treatment purposes as potential predictors of OSA severity in adults. METHODS: This retrospective study included 140 snoring patients categorized by the apnea-hypopnea index (AHI) into primary snoring, mild, moderate, and severe OSA ( =35 per group). Three-dimensional upper airway parameters were measured and compared from CBCT scans. A hierarchical regression model assessed their association with the AHI after adjusting for demographics. RESULTS: Multiple CBCT-derived soft-tissue parameters differed significantly among OSA severity groups and correlated with the AHI. However, after demographic adjustment in the hierarchical regression model, only palatal length (PL) and minimal cross-sectional area (mCSA) emerged as statistically significant independent predictors ( < 0.05). CONCLUSION: CBCT revealed significant differences in pharyngeal soft-tissue anatomy among OSA severity groups. Palatal length and mCSA were identified as valuable predictors for OSA screening based on AHI.
OBJECTIVES: To investigate the longitudinal impact of orofacial pain symptoms on cardiovascular diseases (CVDs) risk. METHODS: Data from 692,980 Korean individuals were analyzed and categorized by the presence or absence...OBJECTIVES: To investigate the longitudinal impact of orofacial pain symptoms on cardiovascular diseases (CVDs) risk. METHODS: Data from 692,980 Korean individuals were analyzed and categorized by the presence or absence of orofacial pain symptoms. Multivariate Cox proportional hazard regression analyses were conducted to calculate hazard ratios (HRs) of orofacial pain for the incidence of major adverse cardiovascular events (MACE). RESULTS: A total of 47,824 (7.41%) participants reported orofacial pain symptoms, which were associated with increased MACE risks. However, some cases may have referred to cardiac pain rather than primary orofacial pain. CONCLUSIONS: Orofacial pain may independently increase the long-term risk of CVD.
PURPOSE: To evaluate the effects of continuous positive airway pressure (CPAP) therapy on cognitive impairments associated with obstructive sleep apnea (OSA). METHODS: We systematically searched PubMed, Web of Science, E...PURPOSE: To evaluate the effects of continuous positive airway pressure (CPAP) therapy on cognitive impairments associated with obstructive sleep apnea (OSA). METHODS: We systematically searched PubMed, Web of Science, EMBASE, and Cochrane Library for literature from their inception to June 26, 2025. Eligible randomized controlled trials (RCTs) included adults with OSA treated with CPAP, assessing daytime sleepiness, cognitive performance, mood, fatigue, and adherence. RESULTS: 17 RCTs involving 2,372 participants were included. CPAP therapy significantly improved daytime sleepiness (weighted mean difference [WMD] = -2.15; 95% confidence intervals [CI]: -2.96, -1.33), processing speed (WMD = 0.25; 95% CI: 0.07, 0.43), visual search (standardized mean difference [SMD] = -0.30; 95% CI: -0.58, -0.01), and anxiety (WMD = -0.81; 95% CI: -1.45, -0.17). With an average nightly usage of 4.99 hours (95% CI: 4.69, 5.30). CONCLUSIONS: CPAP therapy significantly improved daytime sleepiness, processing speed, visual search, and anxiety in patients with OSA.
OBJECTIVE: The aim of this study was to compare the clinical success and efficacy of single-needle double-cannula (SNDC) and double-needle (DN) arthrocentesis in patients with temporomandibular joint (TMJ) disc displacem...OBJECTIVE: The aim of this study was to compare the clinical success and efficacy of single-needle double-cannula (SNDC) and double-needle (DN) arthrocentesis in patients with temporomandibular joint (TMJ) disc displacement without reduction (DDwoR). MATERIALS AND METHODS: This pilot study included 28 patients with DDwoR who did not receive prior treatment. Data including age, sex, pain duration, maximum mouth opening (MMO), and pain perception were recorded. We performed arthrocentesis once for each indicated joint. Data were collected before arthrocentesis (baseline) and at one week and one, three, and six months after the procedure. RESULTS: Thirteen patients underwent SNDC arthrocentesis, and 15 underwent DN arthrocentesis. The mean MMO was significantly greater in the SNDC group (38.38±3.88) than in the DN group (34.33±5.92) at six months ( = 0.040). The mean VAS pain scores were significantly higher in the SNDC group (5.90±1.85) than in the DN group (3.53±2.23) at one week ( = 0.011). CONCLUSION: Both techniques improved MMO and pain; SNDC may provide greater long-term MMO improvement, while DN may offer superior early pain relief.
BACKGROUND: Temporomandibular joint (TMJ) arthrocentesis is a minimally invasive procedure for internal derangements and degenerative conditions. Although generally safe, rare but serious complications can occur, requiri...BACKGROUND: Temporomandibular joint (TMJ) arthrocentesis is a minimally invasive procedure for internal derangements and degenerative conditions. Although generally safe, rare but serious complications can occur, requiring clinical vigilance. CASE: A 37-year-old male with bilateral TMJ osteoarthritis presented with severe pain (VAS 8/10), restricted opening (34 mm), and MRI-confirmed bilateral anterior disc displacement without reduction and effusion. After unsuccessful conservative therapy, he underwent three single-needle arthrocentesis sessions with intra-articular hyaluronic acid. Post-treatment, he developed a pulsatile preauricular swelling and tinnitus. Imaging identified an arteriovenous fistula between the superficial temporal artery and external jugular vein. Endovascular repair was unfeasible, so surgical ligation, discectomy, and arthroplasty with amniotic membrane interposition were performed, achieving full recovery and improved mouth opening (45 mm at 6 months). CONCLUSION: This rare vascular complication highlights the need for early recognition of atypical postoperative signs. Prompt imaging and a multidisciplinary approach ensure safe management and favorable outcomes.
OBJECTIVE: To investigate the prevalence of radiological findings of condyles and their association with temporomandibular disorders (TMD) and missing teeth in the Northern Finland Birth Cohort 1966 study population. MET...OBJECTIVE: To investigate the prevalence of radiological findings of condyles and their association with temporomandibular disorders (TMD) and missing teeth in the Northern Finland Birth Cohort 1966 study population. METHODS: Altogether 1915 subjects volunteered clinical and radiological examination and answered questionnaires. Condylar changes were evaluated using dental panoramic tomograms (DPT). Association of condylar changes with TMD diagnosis, missing teeth and rheumatic diseases was analysed using Pearson's chi-square test and Fisher's exact test. Odds ratio (OR) and 95% confident intervals (CI) were estimated using a binary logistic regression model. RESULTS: Most common condylar change was flattening (32.8%). Associations were found between unilaterally flattened condyle and myalgia and arthralgia. No statistically significant associations were found between condylar changes and missing teeth or missing molars. Erosive and deform changes in condyles were associated with juvenile idiopathic arthritis and rheumatoid arthritis. CONCLUSION: Condylar changes in DPTs were not associated with TMD diagnosis or missing teeth among 46-year-old study population. Erosive and deform changes of condyle were shown in patients with rheumatic disease.
AIM: This investigation aims to retrospectively investigate the success rate of posterior partial crowns made with a nanoceramic resin-based material. MATERIALS AND METHODS: A total of 98 patients, mean age 41±8.9 years,...AIM: This investigation aims to retrospectively investigate the success rate of posterior partial crowns made with a nanoceramic resin-based material. MATERIALS AND METHODS: A total of 98 patients, mean age 41±8.9 years, who received single partial crown restorations made with Cerasmart® were enrolled. The average follow-up was 7.7±0.4 years. The outcome was evaluated with the modified US Public Health Service [USPHS] criteria. Patients were divided into bruxers and non-bruxers according to the presence of self-reported bruxism and clinical examination. RESULTS: A significant difference in the number of crowns that needed to be replaced during the follow-up span was identified between the group of bruxers and non-bruxers ( < .05). The logistic regression analysis showed that the presence of bruxism was the only variable contributing to the significantly higher failure rate. CONCLUSION: The study suggests that prior to any prosthodontic restoration, an assessment of bruxism should always be performed, as it could contribute to a higher failure rate.
OBJECTIVE: To compare nonsteroidal anti-inflammatory drug (NSAID) therapy alone with NSAID plus home exercise in temporomandibular joint (TMJ) osteoarthritis and arthralgia. METHODS: Sixty patients received Tenoxicam 20 ...OBJECTIVE: To compare nonsteroidal anti-inflammatory drug (NSAID) therapy alone with NSAID plus home exercise in temporomandibular joint (TMJ) osteoarthritis and arthralgia. METHODS: Sixty patients received Tenoxicam 20 mg/day alone (Group 1) or with home exercise (Group 2). Outcomes were mandibular range of motion (RoM), pain (VAS), and TMD-related quality of life (TMD-QoL). RESULTS: Group 2 showed greater MMO increase (+3.9 mm, < .005) than Group 1 (+0.7 mm, > .05). VAS decreased similarly in both groups ( < .005; between-group > .05). TMD-QoL improved more in Group 2 ( < .05). CONCLUSION: NSAID plus exercise yields superior functional and QoL benefits versus NSAID alone, with comparable pain relief.
BACKGROUND: Idiopathic condylar resorption (ICR) is a rare temporomandibular joint disease characterized by progressive condylar degeneration with an unknown etiology. A comprehensive quantitative analysis of the morphol...BACKGROUND: Idiopathic condylar resorption (ICR) is a rare temporomandibular joint disease characterized by progressive condylar degeneration with an unknown etiology. A comprehensive quantitative analysis of the morphological differences in the condyle between ICR patients and normal individuals is crucial, yet limited by small sample sizes in existing literature. METHODS: This systematic review and meta-analysis were conducted following PRISMA guidelines. A random-effects model was employed to synthesize the mean differences in key condylar measurements between ICR patients and normal controls. RESULTS: The analysis revealed that ICR patients had significantly smaller condylar dimensions compared to normal individuals. The meta-analysis quantified the following reductions: Condylar height: -3.71 mm. Condylar width: -3.38 mm. Condylar length: -1.19 mm. Axial angle: -13.70° . CONCLUSION: This study provides synthesized quantitative data on condylar morphology in ICR, however, the conclusions should be interpreted with caution due to the presence of heterogeneity and potential biases in the included studies.
BACKGROUND: A four-dimensional impact framework has been recommended for evaluating oral conditions. OBJECTIVES: This study examined the reliability and validity of the four-dimensional structure for the Oral Health Impa...BACKGROUND: A four-dimensional impact framework has been recommended for evaluating oral conditions. OBJECTIVES: This study examined the reliability and validity of the four-dimensional structure for the Oral Health Impact Profile for Temporomandibular Disorders (OHIP-TMD). METHODS: 902 TMD patients were grouped into non-painful intra-articular, pain-related, and combined TMDs for comparisons. Participants completed socio-demographic surveys, DC/TMD Axis II tools, and OHIP-TMD. RESULTS: All dimensions showed good reliability (α: Di1 = 0.814, Di2 = 0.736, Di3 = 0.755, Di4 = 0.935). Di3 (orofacial appearance) and Di1 (oral function) were notably more impacted than Di2 (orofacial pain) and Di4 (psychosocial impact) across subgroups. Moderate-to-strong correlations were identified between Di1-jaw functional limitation, Di2-current/worst pain, Di3-anxiety, and Di4-depression/anxiety (rs = 0.51-0.70). The strongest dimension-domain correlations included Di1-functional limitation, Di2-physical pain, Di3-psychological discomfort, and Di4-psychological disability(rs = 0.88-0.97). CONCLUSIONS: The four-dimensional impact framework for the OHIP-TMD demonstrates good reliability and validity, offering valuable insights into how TMDs affect the well-being and daily functioning of patients.
OBJECTIVE: Among subjects undergoing polysomnography (PSG), some subjects complain of unrefreshing sleep (URS) after in-laboratory PSG (lab-PSG). The purpose of this study was to clarify whether there are differences in...OBJECTIVE: Among subjects undergoing polysomnography (PSG), some subjects complain of unrefreshing sleep (URS) after in-laboratory PSG (lab-PSG). The purpose of this study was to clarify whether there are differences in the backgrounds of such subjects and their polysomnographic findings. METHODS: We asked subjects undergoing lab-PSG for the diagnosis of sleep-related breathing disorders whether they had URS immediately after lab-PSG (PSG-URS) and compared their backgrounds and polysomnographic findings. RESULTS: We conducted an analysis of 151 subjects undergoing lab-PSG. Multivariate analysis demonstrated that the presence of smoking up to six hours before PSG, total sleep time (TST), sleep efficiency (SE), sleep latency (SL), and wake time after sleep onset (WASO) were independent determinants of PSG-URS after adjusting for some factors. CONCLUSION: Smoking up to 6 hours before PSG and short TST, small SE, long SL, and long WASO in PSG were significantly associated with the presence of PSG-URS.
AIM: To assess sleep medicine and obstructive sleep apnea knowledge and management confidence among Greek dentists. METHODS: Postgraduate dental students at the Aristotle University of Thessaloniki completed the Assessme...AIM: To assess sleep medicine and obstructive sleep apnea knowledge and management confidence among Greek dentists. METHODS: Postgraduate dental students at the Aristotle University of Thessaloniki completed the Assessment of Sleep Knowledge in Medical Education (ASKME) and the knowledge and attitudes towards obstructive sleep apnea (OSA) questionnaires (OSAKA) via an online survey from May to December 2022. RESULTS: The response rate was 77.1%, yielding 168 respondents (mean age 30.5 years; 50% female). Master's candidates accounted for 83% (n=140) and PhD candidates for 17% (n=28). The mean ASKME score was 13.9 ± 5.2, with 79.2% answering fewer than 60% of items correctly. The mean OSAKA knowledge score was 10.9 ± 4.2; half scored below 60%. Although all recognized OSA's clinical importance, 70.8% reported low confidence in managing it. CONCLUSION: Greek postgraduate dental students exhibit limited sleep medicine knowledge and low OSA management confidence. Incorporating structured sleep medicine education into dental training is essential.
OBJECTIVE: The aim of this study was to investigate the impact of rapid maxillary expansion (RME) on sleep bruxism (SB) and respiratory indexes in pediatric patients. METHODS: Twenty-four subjects needing orthodontic tre...OBJECTIVE: The aim of this study was to investigate the impact of rapid maxillary expansion (RME) on sleep bruxism (SB) and respiratory indexes in pediatric patients. METHODS: Twenty-four subjects needing orthodontic treatment and with suspicion of obstructive sleep apnea (OSA) were recruited. Before orthodontics, a clinical and anamnestic evaluation as well as a polygraphic recording was performed. The subjects underwent rapid palatal expansion and, after 6 months, the evaluations were repeated for the participants with an apnea-hypopnea index (AHI) > 1. RESULTS: Mean AHI was 2.3±1.4 and 2.2±1.2 at T0 and T1, respectively, while sleep bruxism events (SBEs) values were 15.1± 17 and 23.1±14.5. No significant differences between pre and post treatment values could be detected. CONCLUSIONS: At the study population level, no statistically significant differences in the main (i.e., AHI and SBEs) and secondary outcomes with RME treatment were described. Specific phenotypes might be identified with future studies.
BACKGROUND: Alternobaric facial palsy (AFP) is a rare peripheral facial nerve palsy resulting from transient neurapraxia when sudden ambient-pressure changes disrupt middle-ear equilibrium. Common precipitants include sc...BACKGROUND: Alternobaric facial palsy (AFP) is a rare peripheral facial nerve palsy resulting from transient neurapraxia when sudden ambient-pressure changes disrupt middle-ear equilibrium. Common precipitants include scuba diving, air travel, and altitude. AFP triggered by routine activities is exceedingly uncommon. CASE REPORT: A healthy 27 year old man developed acute right facial paresis after a prolonged yawn, while in the car. He reported ear fullness, cheek and tongue numbness, and inability to close the right eye, without other neurological sympthoms. Examination revealed a right peripheral facial palsy (House - Brackmann Grade IV), positive Bell's sign, and otherwise normal findings. CT and MRI of the brain and temporal bones showed no lesions. Other causes were ruled-out. Given the abrupt onset, absence of structural pathology, exclusion of other etiologies, AFP was diagnosed. MANAGEMENT AND OUTCOME: Prednisone (50 mg, tapered over 3 weeks), eye care, and close follow-up led to full recovery within three weeks. No recurrence occurred at 3, 6, or 12 months. CONCLUSIONS: This case highlights an atypical AFP trigger - a simple yawn - and underscores the importance of considering alternobaric mechanisms in acute peripheral facial palsy, even in everyday settings.
OBJECTIVE: To investigate the prevalence of temporomandibular disorder (TMD) and its association with stress, bruxism, and pain hypervigilance among military personnel in the Amazon region, Brazil. MATERIAL AND METHODS:...OBJECTIVE: To investigate the prevalence of temporomandibular disorder (TMD) and its association with stress, bruxism, and pain hypervigilance among military personnel in the Amazon region, Brazil. MATERIAL AND METHODS: A cross-sectional study was conducted with 352 active-duty military personnel without health issues. Participants completed the Perceived Stress Scale, Pain Vigilance Awareness Questionnaire, questions on awake and sleep bruxism, and the Diagnostic Criteria for Temporomandibular Disorder (DC/TMD). Logistic regression models were applied, retaining variables with ≤ .05. Model fit was tested using the Akaike Information Criterion. RESULTS: TMD symptoms were reported by 53.7% of participants, and 48.0% experienced pain. Significant associations were observed between TMD and longer service duration, awake and sleep bruxism, and higher stress. Women reported more headaches, while men more often experienced jaw-locking. CONCLUSION: TMD was highly prevalent and linked to stress, bruxism, and service duration, highlighting the need for interventions to mitigate physical and psychological consequences in military populations.
OBJECTIVE: To develop and evaluate an Arabic version of the OBC-21 questionnaire for use among Levantine Arabic-speaking populations. METHODS: A structured translation and cultural adaptation process was performed for th...OBJECTIVE: To develop and evaluate an Arabic version of the OBC-21 questionnaire for use among Levantine Arabic-speaking populations. METHODS: A structured translation and cultural adaptation process was performed for the OBC-21, followed by assessment of translational sufficiency and content validity. Reliability was tested with internal consistency, and test-retest reliability was evaluated. RESULTS: All 117 participants completed the survey twice, two weeks apart. The test-retest reliability of the OBC sum scores was excellent, with an ICC of 0.84 (95% CI = [0.77; 0.88]), and the reliability of OBC grades was very good, with a Cohen's Kappa of 0.81. Internal consistency was also very good, with a Cronbach's alpha of 0.8 (95% CI = [0.75; 0.8]). CONCLUSION: The Arabic version of the OBC-21 seems to be a reliable tool for assessing oral behaviors. Future studies need to establish the construct validity of the tool in the clinical settings.