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PubMedDate not supplied

Management of the airway.

Management of the airway for sufferers of SDB is the newest field in dentistry and is growing at a very rapid rate. An understanding of sleep medicine and physiology as well as the techniques for clinically managing the patients is necessary and complex. Dentists interested in managing these patients properly should consider membership in the SDDS and should pursue continuing education through their auspices. This field offers dentists opportunities to participate in a tremendously rewarding area of medicine, but requires due diligence to participate responsibly in that field.

Female↗
PubMed1998

The long-term effect of occlusal therapy on self-administered treatment outcomes of TMD.

Because of a lack of substantial scientific data, the efficacy of occlusal therapy for the management of temporomandibular disorders (TMD) is still controversial. Of a total of 1405 consecutive TMD patients examined over the last 10 years, 369 (26.3%) were determined to have completed treatment at least 1 year before the present survey. A sample questionnaire was mailed to each patient in this sample population. The questionnaire failed to reach 46 patients; of the 323 patients who received the questionnaire, 260 (80.5%) responded. The mean duration of time between their last visit and this survey was 3.7 years. The questionnaire elicited information on treatment outcomes, present treatment needs, and current signs and symptoms. Participants were divided into two treatment groups: (a) those who underwent some occlusal therapies (Phase II) following successful reversible therapies (Phase I) (20 men and 114 women); and (b) those who underwent reversible therapy only (33 men and 93 women). Participants were further differentially diagnosed into five diagnostic subgroups of TMD, based on the clinical examination at the initial visit, tomography, and, for some patients, magnetic resonance imaging. The subgroups included myalgia, arthralgia, anterior disc displacement with an without reduction, and osteoarthritis/osteoarthrosis. Only 12.3% of the total population surveyed reported lack of improvement to an acceptable level and further need for treatment. The remaining patients reported satisfactory results in the reduction of TMD symptomatology and no further need for treatment, because their symptoms had either disappeared or improved to an acceptable level. Regardless of treatment groups and diagnostic subgroups, the current subjective signs and symptoms were negligible in most patients, and mean mouth openings were in the normal range. No particular diagnostic subgroups seemed to have significantly better outcome following Phase II occlusal therapy. These results suggest that the majority of TMD signs and symptoms improve to an acceptable level with only reversible therapy, and the long-term value of additional occlusal therapy following reversible therapy is minimal. Therefore, permanent occlusion-changing therapies apparently are not generally needed to maintain TMD symptom reduction over time.

Activities of Daily Living↗
PubMed1997

A comparison of TMD patients with or without prior motor vehicle accident involvement: treatment and outcomes.

The influence of previous trauma in the management of patients with temporomandibular disorders (TMD) is controversial. The objectives of this study were to compare treatment regimens and outcomes in motor vehicle accident trauma-related versus nontrauma-related TMD patients. Files of 50 trauma and 50 matched nontrauma TMD patients were reviewed. Information concerning treatment received, progress of symptoms with treatment, and findings from the final examination were recorded. As a whole group, posttraumatic TMD patients tended to receive more types of treatment (P < .0001), have more medications prescribed (including analgesics, P < .001; nonsteroidal anti-inflammatory drugs, P = .001; muscle relaxants, P = .001; and tricyclic antidepressants, P < .001), have more oral medicine clinic visits (P = .07) over a longer period of time (P = .06), and have a poorer treatment outcome (P < .001) as compared to the nontrauma group. When the patients were separated into TMD diagnostic classification subsets, only some of these differences between trauma and nontrauma patients were seen, but the subset group sizes were small and only a few of the groups could be compared. There did not seem to be a significant effect from settling insurance claims prior to the last clinic visit. Trauma may be an important prognostic factor in the management of some TMD patients.

Accidents, Traffic↗
PubMed1997

Orthodontics and the creation of localised inter-occlusal space in cases of anterior tooth wear.

Creation of inter-occlusal space using conventional orthodontics can be achieved by a number of techniques. It is important that the most appropriate is chosen for each clinical case. Failure to do so may result in protracted treatment or ultimate failure. Alternative orthodontic techniques may offer advantages over conventional techniques in some circumstances. However, they should be seen as replacement for conventional methods, rather as an extra option for some patients. For all treatment options it is important that the orthodontist works closely with his restorative colleagues to ensure that the correct and most appropriate treatment option is chosen.

Cuspid↗
PubMedDate not supplied

Occlusal appliance therapy in a short-term perspective in patients with temporomandibular disorders correlated to condyle position.

PURPOSE: The purposes of this study were to compare changes in the condyle-fossa relationship in patients with temporomandibular disorders of arthrogenous origin treated with either a stabilization or a control appliance in a double-blind controlled study, and to compare the changes in the condyle-fossa relationship with the short-term treatment effect in the two treatment groups. The radiographic appearance of the temporomandibular joint was also studied. MATERIALS AND METHODS: Fifty-eight patients with temporomandibular disorders of arthrogenous origin were assigned to two equally sized groups: a treatment group given a stabilization appliance; and a control group, given a control appliance. The study covered 10 weeks. The treatment outcome regarding changes in severity of temporomandibular joint pain on a verbal scale was compared to changes in the condyle-fossa relationship in horizontally corrected oblique lateral transcranial radiographs taken with and without the appliance. Condyle-fossa relationship and structural bone changes were observed before treatment in corrected lateral tomograms. RESULTS: The group treated with a stabilization appliance showed a changed condylar position significantly more often (P = 0.004) than the control group. Of the patients reporting a successful treatment outcome, significantly more (P = 0.006) showed a changed condyle position in the group treated with a stabilization appliance than in the group treated with a control appliance. CONCLUSION: In patients with temporomandibular disorders of arthrogenous origin, the short-term occlusal appliance therapy resulting in a changed condylar position gave relief of symptoms more often than if the condylar position was unchanged.

Adolescent↗
PubMed1998

Treatment of obstructive sleep apnoea in edentulous patients--design of a combination appliance: a case study.

This report describes the fabrication of a prosthesis to prevent obstructive sleep apnoea in edentulous patients. The objective of treatment in a 62-year-old man was to establish a comfortable protrusive and vertical position of the mandible that minimised hypopharyngeal obstruction nocturnally. An appliance was designed incorporating two concepts in the elimination of obstructive sleep apnoea: mandibular advancement, which maintains hypopharyngeal width nocturnally; and advancement of the tongue with the aid of a device holding the tongue in a protrusive position by vacuum pressure. This combination appliance offers a treatment modality to a large group of otherwise forgotten patients.

Humans↗
PubMed1998

Treatment outcome in patients with craniomandibular disorders of muscular origin: a 7-year follow-up.

The outcome of different treatment modalities after 7 years was investigated in a selected group of 50 patients with craniomandibular disorders of muscular origin. To minimize the possible effects of selection on the clinical material, the selected treatment group was compared to a consecutive group of patients in terms of age, gender, intensity/duration of pain, and socioeconomic profile. Both groups were comparable in most respects, but the selected group had a longer duration and a higher intensity of pain at baseline. There were more men in the consecutive group than in the selected group. A combined treatment approach resulted in a better outcome than single treatments. Sixty-five percent of all patients in the selected group reported improvement at the 7-year follow-up. All of the 19 patients who received counseling combined with different occlusal treatments improved. Forty-three percent of the patients treated otherwise showed improvement. Patients who were aware of stress responded better to treatment.

Adolescent↗
PubMed1998

Dental injuries during general anaesthesia: can the dentist help the anaesthetist?

Endotracheal intubation is widely used in anaesthesia. Although it offers many advantages to the anaesthetic management of patients, this procedure carries the possibility that damage to the teeth may result. Dental damage in fact accounts for one-third of all medicolegal claims against anaesthetists and, although this problem has been widely discussed in anaesthetic circles, few dental articles have addressed the problem.

Anesthesia, General↗
PubMed1998

The lingual pearl.

Explore the source record for details and available documents.

Acrylic Resins↗
PubMed1998

Snoring and obstructive sleep apnea from a dental perspective.

Proper diagnosis and treatment of sleep-related disorders are best handled via a team approach. This team may include a general dentist treating in conjunction with other sleep specialists. However, to provide care, dentists must have a basic understanding of sleep disorders. This paper provides a dental overview of sleep-related breathing disorders, including key definitions, an outline of a diagnostic protocol, a discussion of the factors involved in decision-making, and a summary of the wide variety of treatment modalities.

Adult↗