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.

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.

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).

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.

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.

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.

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.

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.

Sensory retraining: a cognitive behavioral therapy for altered sensation.

Sensory retraining teaches the patient to ignore or blot out postinjury unpleasant orofacial sensations to optimally tune into and decipher the weakened and damaged signals from the tissues. Sensory retraining is a simple, inexpensive, noninvasive exercise program, which initiated shortly after injury, can lessen the objectionable impression of orofacial altered sensations. Sensory retraining exercises are most effective on decreasing the perceived burden associated with hypoesthetic orofacial altered sensations.

The development and validation of sensory and emotional scales of touch perception.

No comprehensive language exists that describes the experience of touch. Three experiments were conducted to take steps toward establishing a touch lexicon. In Experiment I, 49 participants rated how well 262 adjectives described sensory, emotional and evaluative aspects of touch.

Sensory retraining after orthognathic surgery: effect on patient report of altered sensations.

Introduction: The purpose of this analysis was to determine whether, over a 2-year period after bilateral sagittal split osteotomy, patients who received facial sensory-retraining exercises with standard opening exercises in the first 6 months after surgery were as likely to report an alteration in facial sensation as those who received standard opening exercises only.

Methods: 186 subjects were enrolled in a multi-center, double-blind, stratified-block, randomized clinical trial with 2 parallel groups. Patient reports of altered sensations were obtained before surgery, and 1, 3, 6, 12, and 24 months after surgery.

Quantitative assessment of pleasant touch.

The hedonic attributes of tactile stimulation are important to one's quality of life, yet they have rarely been studied scientifically. The earliest experimental investigations suggested soft and smooth materials as pleasant, those that were stiff, rough, or coarse as unpleasant. More recent studies conducted by the authors and described herein obtained ratings of pleasantness of different textured materials stroked across the skin of multiple body sites at controlled velocities and forces of application.

Sensory and affective judgments of skin during inter- and intrapersonal touch.

Here we report two experiments that investigated the tactile perception of one's own skin (intrapersonal touch) versus the skin of other individuals (interpersonal touch). In the first experiment, thirteen female participants rated, along four perceptual attributes, the skin of their own palm and volar forearm, then that of several of the other participants. Ratings were made using visual analogue scales for perceived smoothness, softness, stickiness, and pleasantness.

The effect of oral drying and astringent liquids on the perception of mouth wetness.

A feeling of mouth dryness occurs from actual drying of the oral surfaces or from sampling astringent substances such as polyphenols (e.g., tannins in brewed tea and wine), which bind proline-rich proteins in saliva to reduce its lubricity.

Functional outcomes of cleft lip surgery. Part IV: Between- and within-participant variables affecting lip vermilion sensory thresholds.

Objective: Compare neurosensory assessments for participants with and without a cleft lip; identify between- and within-participant variables affecting sensory thresholds on the vermilion of participants with cleft lip.

Design: A parallel group, nonrandomized clinical trial.

Subjects: There were 56 participants with cleft lip and 37 noncleft participants.

Functional outcomes of cleft lip surgery. Part I: Study design and surgeon ratings of lip disability and need for lip revision.

Objective: Children with a cleft of the upper lip exhibit obvious facial disfigurement. Many require multiple lip surgeries for an optimal esthetic result. However, because the decision for lip revision is based on subjective clinical criteria, clinicians may disagree on whether these surgeries should be performed.

Human cortical representation of oral temperature.

The temperature of foods and fluids is a major factor that determines their pleasantness and acceptability. Studies of nonhuman primates have shown that many neurons in cortical taste areas receive and process not only chemosensory inputs, but oral thermosensory (temperature) inputs as well. We investigated whether changes in oral temperature activate these areas in humans, or middle or posterior insular cortex, the areas most frequently identified for the encoding of temperature information from the human hand.

Sensory retraining after orthognathic surgery: effect on patients' perception of altered sensation.

Purpose: The primary research hypothesis was that the magnitude and duration of the perceived burden from altered sensation reported by patients after bilateral sagittal split osteotomy and trauma to the third division of the trigeminal nerve are decreased when facial sensory retraining exercises are performed in conjunction with standard opening exercises as compared with standard opening exercises alone.

Subjects And Methods: A total of 186 subjects were enrolled in a multicenter, double-blind, 2 parallel group-stratified block randomized clinical trial. Oral and facial pain, unusual sensations, numbness, and loss of sensitivity were scored from "no problem" to "serious problem" before surgery and 1 month, 3 months, and 6 months after surgery.

Relationship between patients' perceptions of postsurgical sequelae and altered sensations after bilateral sagittal split osteotomy.

Purpose: Following orthognathic surgery, patients use qualitatively different words to describe altered sensation on their face. These words indicate normal, hypoesthetic, paresthetic, or dysesthetic sensations and so reflect the intrusiveness of the altered sensation. The objective of this study was to examine the relationship between the intrusiveness of the altered sensation and the extent to which it and the associated impairment in facial function were perceived to be a problem in the lives of the patients.