Search Results (31)

Obstructive sleep apnea syndrome (OSAS) is a prevalent disorder with significant systemic and oral health consequences. This narrative review synthesizes the current knowledge on the interplay between dental health and sleep apnea, highlighting the expanding role of dentists in the screening, early detection, and management of OSAS. Validated questionnaires, anatomical assessments, and anthropometric measurements have enhanced dentists’ capacity for early screening. However, knowledge and training gaps remain, particularly in low- and middle-income countries. Dentists are uniquely positioned to identify anatomical and oral risk factors, facilitate referrals for diagnosis, and provide therapeutic interventions such as oral appliance therapy. Interdisciplinary collaboration between dental and medical professionals is essential to improve early detection, treatment outcomes, and patient quality of life. Enhancing education, standardizing protocols, and integrating dentists into multidisciplinary care pathways are critical steps for advancing the management of sleep apnea. Full article

The etiology of temporomandibular disorders (TMDs) has been linked to various factors, including functional and psychological factors, which makes it difficult to identify associations between a single etiological factor and the signs and symptoms of TMDs. Objectives: This study aimed to describe the presence of TMD symptoms and their relationship with sleep disturbances and emotional disorders in children and adolescents. Methods: This observational study included Spanish children aged between 8 and 13 years. The measurement instruments consisted of the BRUNI survey for sleep disorders and the Educational-Clinical Questionnaire: Anxiety and Depression (CECAD) survey. A clinical examination was subsequently performed following the DC/TMD guidelines for diagnosing TMDs. Frequencies, means, and standard deviations were applied, along with the prevalence ratio as a measure of association and the chi-square test. The significance level was set at 5%. Results: A total of 128 participants participated in the study with a mean age of 10.89 (±2.15) years. The prevalence of TMDs was 54%, while the most common symptoms were muscle pain at 26%, joint pain at 14%, and a combination of both at 14%. Children who presented muscle pain had a mean anxiety score of 44.87 (±11.85), whereas those without symptoms had a mean score of 36 (±10.78, and 0.03 p-value). The BRUNI index revealed that 78.13% of patients with TMDs had difficulty initiating and maintaining sleep, with a prevalence ratio (PR) of 3.57 (p-value 0.041). Conclusions: The present study reveals that temporomandibular disorders are common in children and adolescents, with 54% presenting at least one clinical sign or symptom. Emotional disturbances and sleep problems were also prevalent, affecting 41% and 56% of participants, respectively. Early interdisciplinary screening is essential to manage the co-occurrence of TMDs, emotional distress, and sleep problems in children. Full article

This review explores the emerging relationship between obstructive sleep apnea (OSA) and periodontal disease (PD), emphasizing shared inflammatory pathways, overlapping risk factors, and potential systemic health implications. Both conditions are characterized by chronic inflammation and oxidative stress, which independently contribute to cardiovascular disease, diabetes, and other systemic disorders. Evidence suggests a bidirectional relationship, with OSA-related hypoxia exacerbating periodontal tissue breakdown and PD-induced inflammation potentially influencing OSA severity. However, the causative nature of the relationship between OSA and PD remains uncertain, largely due to inconsistencies in diagnostic criteria, methodological variability, and study heterogeneity. This review highlights the essential role of systematic reviews (SRs) in synthesizing current evidence, identifying research gaps, and guiding future studies. To maximize their impact, SRs should adhere to rigorous methodological quality standards, improve transparency in data reporting, and address the heterogeneity of included studies. Future research should focus on longitudinal and interventional designs, standardize diagnostic protocols, and investigate biomarkers, oral microbiome profiles, and inflammatory mediators to elucidate the mechanisms linking OSA and PD. Multidisciplinary collaboration between dental and sleep specialists is crucial to advancing evidence-based strategies that improve patient outcomes and address the broader health implications of these often coexisting conditions. Full article

Polysomnography (PSG) is the gold standard for the diagnosis of pediatric obstructive sleep apnea (OSA); however, high costs and limited availability restrict its use for routine screening. This systematic review and meta-analysis investigated the accuracy of overnight oximetry for the diagnosis of pediatric OSA. Studies evaluating overnight oximetry against PSG-derived apnea-hypopnea index (AHI) in subjects aged ≤18 years were considered in the qualitative analysis and evaluated with the QUADAS-2 tool. Only oximetry parameters adopted by at least four studies using the currently accepted diagnostic thresholds for pediatric OSA (AHI of 1, 5 and 10 events/h) were included for quantitative analyses. A bivariate meta-analysis was used to estimate sensitivity and specificity, as well as to construct summary receiver operator characteristic curves. The positive and negative predictive values were calculated. A total of 28 studies (9122 participants) were included in qualitative analyses. Only 3% oxygen desaturation index (ODI3) was eligible for the quantitative analyses (six studies, 1276 participants). As OSA severity increases sensitivity, specificity and the negative predictive value also increase, reaching values of 79%, 84%, and 89% at AHI ≥ 10, respectively. Oximetry displays a good performance as a screening tool for pediatric OSA, especially with moderate-to-severe disease. ODI3 is particularly effective at ruling out OSA in children who test negative. Full article

The widespread implementation of artificial intelligence technologies provides an appealing alternative to traditional search engines for online patient healthcare education. This study assessed ChatGPT-3.5’s capabilities as a source of obstructive sleep apnea (OSA) information, using Google Search as a comparison. Ten frequently searched questions related to OSA were entered into Google Search and ChatGPT-3.5. The responses were assessed by two independent researchers using the Global Quality Score (GQS), Patient Education Materials Assessment Tool (PEMAT), DISCERN instrument, CLEAR tool, and readability scores (Flesch Reading Ease and Flesch–Kincaid Grade Level). ChatGPT-3.5 significantly outperformed Google Search in terms of GQS (5.00 vs. 2.50, p < 0.0001), DISCERN reliability (35.00 vs. 29.50, p = 0.001), and quality (11.50 vs. 7.00, p = 0.02). The CLEAR tool scores indicated that ChatGPT-3.5 provided excellent content (25.00 vs. 15.50, p < 0.001). PEMAT scores showed higher understandability (60–91% vs. 44–80%) and actionability for ChatGPT-3.5 (0–40% vs. 0%). Readability analysis revealed that Google Search responses were easier to read (FRE: 56.05 vs. 22.00; FKGL: 9.00 vs. 14.00, p < 0.0001). ChatGPT-3.5 delivers higher quality and more comprehensive OSA information compared to Google Search, although its responses are less readable. This suggests that while ChatGPT-3.5 can be a valuable tool for patient education, efforts to improve readability are necessary to ensure accessibility and utility for all patients. Healthcare providers should be aware of the strengths and weaknesses of various healthcare information resources and emphasize the importance of critically evaluating online health information, advising patients on its reliability and relevance. Full article

Drug-induced sleep endoscopy (DISE) has been progressively used to determine the individual patient responsiveness to therapy with a mandibular advancement device (MAD) for obstructive sleep apnea (OSA). This retrospective cohort study compared the general and polygraphic characteristics, as well as the sites, degrees, and patterns of upper airway collapse, in patients who responded to advancement with a titratable mandibular advancement (TMA) simulator during DISE—referred to as responders—to those in non-responders. The sample included 335 OSA patients (307 males) with a mean age of 49.98 (SD = 9.88) years, and a mean AHI of 34.14 (SD = 18.61). Once the TMA simulator customized to the patient’s dental arches was inserted and the examination was performed at 0%, 25%, 50%, and 75% of the patient’s range of antero-posterior mandibular excursion, the simulator was removed and the upper airway behavior was studied in the baseline situation. Without TMA simulator non-responders had a higher percentage of oropharyngeal complete latero-lateral and complete concentric velopharyngeal collapse. With TMA simulators, there was a significant difference between responders and non-responders in individual obstructive sites at velopharyngeal, oropharyngeal, and epiglottis levels, while at the tongue level, responders and non-responders showed the same response tendency. If confirmed in future prospective studies, these results suggest that the presence of complete latero-lateral obstruction at the oropharynx level and complete circular obstruction at the velopharynx level could be adverse phenotypes for MAD treatment outcomes in OSA patients and MAD treatment should not be considered in these patients (at least as a single therapy). Full article

Distal occlusion is one of the most common dentoalveolar anomalies and can be the reason for the obstructive sleep apnea (OSA) syndrome development among children. The aim of the study was to investigate the relationship between cephalometric and OSA parameters in the pediatric population. Methods: The cohort study included 39 children with OSA symptoms. Orthodontic examination consisted of a cephalometric analysis of 39 linear and angular variables. Patients underwent a sleep diagnostic study. Statistical analysis was performed using SPSS 19.0.0. Results: Of the general sample, 53.8% were mouth breathers and 46.2% had a mixed type of breathing. Moreover, 30.8% of patients had bruxism. The mean apnea-hypopnea index and oxygen desaturation index were 4.6/h and 3.9/h, respectively. A 1.06 times increase in the SNA index indicated the anterior position of the upper jaw. The MnPLSN° exceeded the norm by 1.3 times, which indicated the posterior position of the lower jaw and vertical type of the growth. An increase in ANSPNSSPT° by 1.1 times indicated an inclination of the upper jaw in the posterior position and a narrowing of the nasal passages. Patients with pediatric OSA had a significantly smaller lower airway space and MPH parameter. Conclusion: Systematic orthodontic monitoring of children with pediatric OSA is important for diagnosis and timely treatment. Full article

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. Full article

Background: OSA is a common problem in children and adolescents. Angle class II malocclusion, a tendency toward the vertical type of growth, causes a decrease in the volume of the oral air space, increasing the risk of OSAS. The aim of this study was to evaluate the relationship between cephalometric and OSA parameters, to develop collaborative approaches between orthodontists and somnologists in the treatment of adolescents with OSA. Methods: We analyzed data from 41 adolescents with OSA. Their mean age was 15.8 ± 1.08 years. Orthodontic and polysomnographic examinations of patients were conducted. Statistical analysis was performed in SPSS 19.0.0. Results: Most often in patients with distal occlusion, a violation of the harmony in the development of the dental system was observed. The sagittal incisive fissure, characteristic of a distal occlusion, was absent due to the palatal inclination of the upper incisors in 25 (60.98%) patients. The SNB was 79.4 ± 3.1°, indicating a distal position of the mandible relative to the anterior cranial base. The SNA exceeded the normal value, which is one of the prerequisites for mandibular retrognathia. The ANB angle was 4.3 ± 1.9°. Tonsillar hypertrophy affected 6 patients, 21 had adenoid hypertrophy, and 3 had both of them. Movements of the masticatory muscles during sleep were recorded in 22.0% of patients. Conclusion: To improve the quality of diagnosis and treatment of OSA, a multidisciplinary approach is needed that will correct the processes of child growth and development. Full article

Orofacial pain is a complex experience made up of different features and involving various aspects of life. It has demonstrated a connection, especially when chronic, with conditions such as anxiety, depression, and sleep disorders, through paths that still have not been completely clarified. A deep understanding of orofacial pain and its impact on an individual’s life is critical for planning accurate diagnostic and therapeutic approaches. This review seeks to provide a comprehensive overview of the components constituting the pain experience, its implications in an individual’s life, the different tools for multidimensional pain assessment, and the specific applications for each tool. A comprehensive review was performed using the PubMed, Scopus, and Web of Science electronic databases. Ninety-five studies, including observational studies, clinical trials, case–control studies, and case reports, were included and analyzed in this review. Orofacial pain assessment exploits several methods, ranging from clinical evaluation to rating scales, questionnaires, and daily diaries. The choice of the correct instrument requires an evaluation of the type of pain experienced, of the patient’s characteristics and abilities to complete particular tasks, and finally, of the assessment tool features. Full article

The aim of this paper is to perform an observational descriptive study of the Obstructive Sleep Apnea Syndrome (OSAS) in a population of children by evaluating the prevalence and role of sex and age variables. The 22-item Pediatric Sleep Questionnaire (PSQ) was administered to parents of children aged 3 to 12 years. The questionnaire is a very simple tool since it allows for the indication of patients with possible OSAS diagnosis through a cut-off of 0.33. The anonymous diagnostic questionnaire, available in digital format, was administered to the population under study by a link or QR code. Only the questionnaires completed in all their parts were recorded and analyzed. Eight hundred and thirty-two questionnaires were collected. One hundred and fifty-four subjects obtained a PSQ score > 0.33 and the prevalence of OSAS was 18.51%. The Chi-square test showed a statistically significant association between the PSQ score > 0.33 and male sex. The higher prevalence of subjects with a value of PSQ > 0.33 (n = 277) are aged 3–4–5 years, followed by the 6–7–8 range in the group with PSQ score > 0.33, p < 0.05. The prevalence of OSAS was 18.51% in children aged 3 to 12 years. The variables male biological sex and the age group 3–8 year were statistically significant for subjects with OSAS diagnosis. This study underlines the use of the 22-item Pediatric Sleep Questionnaire as a first screening tool to identify children at risk of OSAS. Full article

Aim: The aim of this paper is to describe the multidisciplinary management pathway for pediatric patients with suspected obstructive sleep apnea syndrome (OSAS) conducted by the Pediatric and Orthodontic Department of the Dental Clinic of Padua. Materials and methods: All pediatric subjects undergo a comprehensive medical history, including the completion of the Pediatric Sleep Questionnaire (PSQ), and a physical examination. Patients with suspected OSAS are placed on a waiting list for home respiratory polygraphy testing. The respiratory polygraphy examination is conducted over two consecutive nights and interpreted by a neurologist. Additionally, patients diagnosed with OSAS undergo a case study involving intraoral and extraoral photography, as well as radiographic evaluation. Results: Between September 2021 and May 2023, a total of 134 subjects (including 76 males), with an average age of 9.2 years, were identified as diagnostic suspects. Among these, 38 patients (28.3%) tested positive based on respiratory polygraphic results. Depending on the severity and etiopathogenetic characteristics of the disease, the positive cases were referred to various specialists. Conclusion: In the daily clinical practice of dentistry, particularly in orthodontics and pedodontics, the establishment of a defined management pathway for pediatric patients with OSAS is crucial. The collaboration of a multidisciplinary team with a shared objective of achieving accurate diagnosis and implementing targeted treatment in a timely manner is essential. Regular re-evaluation of patients through clinical and instrumental examinations is recommended. Full article

This study aimed to develop an automated pH-cycling system using inexpensive commercial components that can replicate pH fluctuations in the oral cavity and salivary clearance to compare demineralization characteristics with the conventional method. The study found that the newly developed cycle-1 group showed improved demineralization properties, including apparent lesion depth, surface roughness, Vickers hardness, mineral loss, and depth of demineralization, compared to the control group. Additionally, the cycle-2 group, which had a longer cycle interval, showed further improvements in the demineralization properties. This system can replicate the differences in dental damage caused by differences in meals, snacking frequencies, and lifestyle rhythms, making it useful in cariology, preventive dentistry research, and oral care product development. It can be constructed using inexpensive commercial products, significantly reducing research costs and improving reproducibility and fairness between different experimental facilities. The system can replicate lifestyle rhythms, such as meals, sleep, and oral clearance by saliva, making it an in vitro pseudo-oral cavity. Full article

The Internet is a preferred source of health information. This study evaluated the quality, reliability and content of online audio-visual information on the mandibular advancement device (MAD) for the treatment of obstructive sleep apnea (OSA). “Mandibular advancement device” was searched on four online platforms. A total of 63 videos (51% from healthcare professionals, 22% from commercial companies, 21% from laypeople, and 6% from hospitals/universities) were evaluated using metrics, the video information and quality index (VIQI), modified-DISCERN, and the Journal of American Medical Association (JAMA) benchmark criteria and contents. VIQI had significantly lower scores for videos uploaded by laypeople (mean 7.92, 95%CI 5.90–9.95) versus healthcare professionals (12.38, 95%CI 11.28–13.47) and commercial companies (11.21, 95%CI 9.61–12.81). The m-DISCERN scores were significantly lower for laypeople (1.15, 95%CI 0.93–1.40) versus healthcare professionals (2.13, 95%CI 1.73–2.52) and hospitals/universities (3.00, 95%CI 1.70–4.30), as well as for commercial companies (1.43, 95%CI 1.13-1.73) versus hospitals/universities. Contents were significantly less complete for laypeople (1.54, 95%CI 0.60–2.48) versus healthcare professionals (3.25, 95%CI 2.66–3.84). The results of the present study suggest that the quality and completeness of online audio-visual information with respect to the use of MAD for the treatment of OSA are generally poor, and the currently available videos, especially those uploaded by laypeople, may determine misinformation and/or unrealistic treatment expectations. Full article

Background: Stress and everyday problems may impact memory and cognition. Therefore, many people use cognitive enhancers (CEs), sold for prescription, as over-the-counter drugs, or dietary supplements, believing they may help with everyday functioning. Our study was designed to answer whether taking CEs is common among Medical University students and to identify which substances are mainly used. Methods and Results: An anonymous online questionnaire was answered by 479 students of Medical (88%) and Dentistry (12%) Faculties in Poland. Women constituted the majority of respondents (63%). CEs were used by 53% of respondents, with the most frequent being caffeine, ginseng, nicotine, theanine, ginkgo, and lecithin. Some persons used CEs that are available only with a prescription. The most important reasons for the use of CEs were to increase arousal and improve concentration (mentioned by 81% and 73%, respectively). Over 65% of students experienced some undesired/adverse effects after taking CEs, with tachycardia being the most common, followed by sleep disturbances (reported by 51% and 40%, respectively). Conclusions: More than half of the respondents from the Medical and Dentistry Faculties reported using CEs, despite their unproven efficacy and not-well-established safety. This raises significant concern about the knowledge of young persons regarding CEs and should encourage universities to undertake educational actions. Full article