Combination Therapies with an Oral Appliance in the Management of Obstructive Sleep Apnea.

Combination therapy (CT) with a mandibular advancement device (MAD) and positive airway pressure (PAP) has been advocated for patients for whom neither MAD nor PAP alone provides an efficacious and tolerated therapy. This article reviews the small and limited, but growing body of evidence in support of CT and highlights details in its implementation. In most studies, CT was found to be preferred by many, but not all PAP-intolerant patients.

Differences in temporal profile of brain responses by pleasantness of somatosensory stimulation in autistic individuals.

. Autistic individuals may show either or responsiveness to touch compared to non-autistic individuals. These behavioural responses depend on perceptual and evaluative mechanisms, which unfold sequentially and thus can be distinguished by exploring the timing of neural responses.

Tactile motion lacks momentum.

The displacement of the final position of a moving object in the direction of the observed motion path, i.e. an overestimation, is known as representational momentum.

Initially intact neural responses to pain in autism are diminished during sustained pain.

Pain assessments typically depend on self-report of the pain experience. Yet, in individuals with autism spectrum disorders, this can be an unreliable due to communication difficulties. Importantly, observations of behavioral hypo- and hyperresponsivity to pain suggest altered pain sensitivity in autism spectrum disorder.

Auto-adjusting mandibular repositioning device for in-home use.

Obstructive Sleep Apnea (OSA) is a form of respiratory dysfunction that affects 20% of adults in the world. Among the first-line treatments that are used to mitigate the effects of OSA are continuous positive airway pressure (CPAP) and mandibular repositioning devices (MRD). Although CPAP provides a more efficacious therapy than MRDs, recent studies suggest that both are comparable in overall effectiveness due to greater patient preference and adherence to MRD therapy.

Circulating Omentin-1 and Chronic Painful Temporomandibular Disorders.

Aims: To investigate the relationship between omentin-1 levels and painful temporomandibular disorders (TMD).

Methods: In a case-control design, chronic painful TMD cases (n = 90) and TMD-free controls (n = 54) were selected from participants in the multisite OPPERA study (Orofacial Pain: Prospective Evaluation and Risk Assessment). Painful TMD case status was determined by examination using established Research Diagnostic Criteria for TMD (RDC/TMD).

Patient response to sleep apnea screening in a dental practice.

Objective: This study investigated patient response to a recommendation for physician evaluation following screening for obstructive sleep apnea (OSA) in a dental practice.

Methods: In a community-based dental practice in Raleigh, North Carolina, 119 patients were recruited by nonprobability purposive sampling and administered both a validated subjective (STOP questionnaire) and objective (pulse oximeter) screening instrument for OSA. Patients who screened high-risk for OSA on either instrument were recommended to consult their physician within three months.

Tooth loss and obstructive sleep apnea signs and symptoms in the US population.

Purpose: The aim of this study is to investigate the relationship between tooth loss and signs and symptoms of obstructive sleep apnea (OSA) in a representative sample of the general US population.

Methods: Data were from 7305 men and women aged ≥25 years participating in the 2005-2008 National Health and Nutrition Examination Survey. Tooth loss, occlusal contacts, and denture use were determined by dental examination.

Sleep medicine content in dental hygiene education.

According to the National Research Council, 70 million Americans chronically suffer from approximately 60 medically recognized sleep disorders. With most clinicians unaware of these disorders, many individuals remain undiagnosed. To effectively address this issue, health care professionals must work collaboratively to educate, identify, and treat patients with sleep disorders.

Periodontitis and Sleep Disordered Breathing in the Hispanic Community Health Study/Study of Latinos.

Study Objectives: To investigate the association between sleep disordered breathing (SDB) and severe chronic periodontitis.

Design: Cross-sectional data analysis from the Hispanic Community Health Study/Study of Latinos.

Setting: Community-based setting with probability sampling from four urban US communities.

Electromyographic evaluation of masticatory muscles in dentate patients versus conventional and implant-supported fixed and removable denture wearers- a preliminary report comparing model foods.

Purpose: To evaluate differences in masticatory muscle function during chewing of model foods designed to differ in fracture strength between dentate subjects (n = 5, ages 59 to 68 years) versus patients treated with a maxillary conventional complete denture opposing natural dentition or one of the following types of mandibular complete dentures: conventional, implant-supported overdenture, implant-supported fixed denture (n = 20, ages 45 to 83 years). The authors hypothesized that denture wearers would differ in duration of chewing, frequency of chewing, and masticatory muscle activity while preparing a bolus for swallowing.

Materials And Methods: Surface electromyography was recorded bilaterally from the masseter, anterior temporalis, and anterior digastric.

Nonverbal patient with autism spectrum disorder and obstructive sleep apnea: use of desensitization to acclimatize to a dental appliance.

Patients with autism spectrum disorders (ASDs) may have difficulty tolerating conventional dental treatment due to aberrant sensory responsiveness. The purpose of this report was to describe the successful treatment of obstructive sleep apnea (OSA) in a nonverbal 20-year-old male patient with ASD using a dental appliance. A series of appointments prepared the patient for the required treatment procedures and desensitized him for use of the final appliance.

Tactile experience does not ameliorate age-related reductions in sensory function.

Unlabelled: BACKGROUND/STUDY CONTEXT: Sensory function degrades with age, with well-established reductions in tactile spatial acuity, vibrotactile sensitivity, and thermosensation, to name but three aspects of perception. Such age-related losses might be partially stemmed by ongoing experience with tasks requiring high levels of manual dexterity or analogous tactile expertise; individuals who are highly expert in skills that have a fundamental tactile component can show improved tactile function as compared with nonexperts.

Methods: Eighty individuals (17 males, 63 females) in the 18-58 age range were assessed on their tactile experience, as measured by self-assessment on a variety of tasks and competencies, each of which required a high level of skill with the hands.

Effect of hydration on the tactile and thermal sensitivity of the lip.

The vermilion lip is a body site particularly susceptible to water loss. Therefore, the role of hydration in tactile perception at the lip was investigated. A series of measures of tactile performance and response were obtained from 22 female subjects, namely: (1) the subjective assessment of lip feel, (2) tactile sensitivity, (3) spatial acuity, (4) thermal sensitivity, and (5) the subjective assessment of thermal stimulation.

Obstructive sleep apnea in association with periodontitis: a case-control study.

Purpose: Periodontitis is associated with several cardio-metabolic disorders that are co-morbid with sleep-disordered breathing. A relationship between periodontitis and obstructive sleep apnea (OSA) is plausible, but has received little attention. This study investigated the strength of association between periodontitis and risk for OSA.

Sleep medicine care under one roof: a proposed model for integrating dentistry and medicine.

Integrating oral appliance therapy into the delivery of care for sleeprelated breathing disorders has been a challenge for dental and medical professionals alike. We review the difficulties that have been faced and propose a multidisciplinary care delivery model that integrates dental sleep medicine and sleep medicine under the same roof with educational and research components. The model promises to offer distinct advantages to improved patient care, continuity of treatment, and the central coordination of clinical and insurance-related benefits.

Sleep apnea symptoms and risk of temporomandibular disorder: OPPERA cohort.

The authors tested the hypothesis that obstructive sleep apnea (OSA) signs/symptoms are associated with the occurrence of temporomandibular disorder (TMD), using the OPPERA prospective cohort study of adults aged 18 to 44 years at enrollment (n = 2,604) and the OPPERA case-control study of chronic TMD (n = 1,716). In both the OPPERA cohort and case-control studies, TMD was examiner determined according to established research diagnostic criteria. People were considered to have high likelihood of OSA if they reported a history of sleep apnea or ≥ 2 hallmarks of OSA: loud snoring, daytime sleepiness, witnessed apnea, and hypertension.

Food oral processing: conversion of food structure to textural perception.

Food oral processing includes all muscle activities, jaw movements, and tongue movements that contribute to preparing food for swallowing. Simultaneously, during the transformation of food structure to a bolus, a cognitive representation of food texture is formed. These physiological signals detected during oral processing are highly complex and dynamic in nature because food structure changes continuously due to mechanical and biochemical breakdown coupled with the lubricating action of saliva.

Reliability and reproducibility of novel methodology for assessment of pressure pain sensitivity in pelvis.

Unlabelled: Vestibulodynia, the most common type of chronic vulvovaginal pain, impairs the psychological, physical health of nearly 10% of women at some point in their lifetime. The aim of this investigation was to establish reliable standardized methodologies for assessment of pain sensitivity in vulvar mucosa and pelvic musculature. We enrolled 34 women with vestibulodynia and 21 pain-free controls.

Effects of lip revision surgery on long-term orosensory function in patients with cleft lip/palate.

OBJECTIVE : To determine whether secondary lip revision surgery impacts sensitivity of the upper lip. DESIGN : A three-group, parallel, prospective, nonrandomized clinical trial. SETTING : University of North Carolina School of Dentistry.

Perception of fluids with diverse rheology applied to the underarm versus forearm skin.

Little is known about the tactile-perceptual structure of fluids. Therefore, ten fluids with diverse, characterized rheologies were rated by 16 females, on 27 sensory attributes (e.g.

Touching and feeling: differences in pleasant touch processing between glabrous and hairy skin in humans.

Previous functional magnetic resonance imaging studies in two rare patients, together with microneurography and psychophysical observations in healthy subjects, have demonstrated a system of mechanosensitive C-fiber tactile (CT) afferents sensitive to slowly moving stimuli. They project to the posterior insular cortex and signal pleasant aspects of touch. Importantly, CTs have not been found in the glabrous skin of the hand, yet it is commonly observed that glabrous skin touch is also perceived as pleasant.

Non-invasive therapy for altered facial sensation following orthognathic surgery: an exploratory randomized clinical trial of intranasal vitamin B12 spray.

Aim: The aim of the study was to obtain pilot data on the putative effects of intranasal spray Vitamin B12 in lessening the impairment from orthognathic surgery on large and small diameter nerve fiber functions.

Methods: Thirty-five subjects scheduled for a mandibular osteotomy were enrolled in an open-label two-group parallel stratified-block randomized clinical trial: Intranasal Vitamin B12 Spray (B12), with weekly doses self-administered two weeks before until 6 months after surgery, or no intranasal spray. All subjects received sensory retraining exercises.

Perceptual and neural response to affective tactile texture stimulation in adults with autism spectrum disorders.

Autism spectrum disorders (ASD) are associated with differences in sensory sensitivity and affective response to sensory stimuli, the neural basis of which is still largely unknown. We used psychophysics and functional magnetic resonance imaging (fMRI) to investigate responses to somatosensory stimulation with three textured surfaces that spanned a range of roughness and pleasantness in a sample of adults with ASD and a control group. While psychophysical ratings of roughness and pleasantness were largely similar across the two groups, the ASD group gave pleasant and unpleasant textures more extreme average ratings than did controls.

Tactile and thermal detection thresholds of the scalp skin.

The tactile and thermal sensitivity of diverse regions of the human body have been documented extensively, with one exception being the scalp. Additionally, sensory changes may accompany the hair loss from the scalp in androgen-related alopecia (ARA), but formal quantitative sensory testing (QST) has not been reported in respect of this. Therefore, light touch detection thresholds were obtained at nine scalp sites and one forehead site, using Semmes-Weinstein filaments (Von Frey hairs), and for warming and cooling from skin baseline temperature, using 28 and 256 mm(2) thermodes.