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You are here: Home / Archives for July 2011

U.K. Political Party Leader has Surgery to Deal with Sleep Apnea

July 28, 2011 by SleepDT Leave a Comment

Ed Miliband leader of the U.K. Labour party, has had surgery on his nose to deal with a sleep condition.

The operation – aimed at curing his sleep apnea, was successful, a spokesman said.

Sleep apnea is thought to affect over 180,000 people in the UK, and is more common among men than women.

It is a respiratory condition in which the throat repeatedly narrows or closes during sleep, stopping air getting into the lungs and waking up the sufferer.

Mr Miliband’s suffering was exacerbated by a deviated septum, upon which the operation was performed.

A Labour spokeswoman said: “The hour-long operation was done with the National Health Service and was performed at the Royal National Throat, Nose and Ear Hospital in central London.

“He is now recovering for a few days before going on holiday with his family.

Sources close to the Labour leader have dismissed media speculation that he was hoping the operation would make his voice sound less nasal.

One source who spoke to him after the operation said he sounded “exactly the same”.

Originally published BBC UK

Filed Under: Uncategorized

Leader of U.K. Political Party has Surgery to Deal with Sleep Apnea

July 28, 2011 by SleepDT Leave a Comment

Labour leader Ed Miliband has had surgery on his nose to deal with a sleep condition.

The operation – aimed at curing his sleep apnoea, which interrupts breathing – was successful, a spokesman said.

Mr Miliband will rest at home with his family for a few days before leaving for a summer holiday.

Sleep apnoea is thought to affect 180,000 people in the UK, and is more common among men than women.

It is a respiratory condition in which the throat repeatedly narrows or closes during sleep, stopping air getting into the lungs and waking up the sufferer.

Mr Miliband’s suffering was exacerbated by a deviated septum, upon which the operation was performed.

A Labour spokeswoman said: “The hour-long operation was done with the National Health Service and was performed at the Royal National Throat, Nose and Ear Hospital in central London.

“He is now recovering for a few days before going on holiday with his family.”

Sources close to the Labour leader have dismissed media speculation that he was hoping the operation would make his voice sound less nasal.

One source who spoke to him after the operation said he sounded “exactly the same”.

Originally published BBC UK

Filed Under: Uncategorized

Identification of a Sleep Bruxism Subgroup with a Higher Risk of Pain

July 28, 2011 by Bradley Eli DMD, MS Leave a Comment
  1. P.H. Rompré1
  2. D. Daigle-Landry1
  3. F. Guitard1
  4. J.Y. Montplaisir2
  5. G.J. Lavigne1,2,*
  1. 1Faculty of Dental Medicine, Université de Montréal, C.P. 6128, succ. Centre-Ville, Montréal, Canada, H3C 3J7; and
  2. 2Centre d’étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Coeur, Canada

Abstract

Sleep bruxism research diagnostic criteria (SB-RDC) have been applied since 1996. This study was performed to validate these criteria and to challenge the hypothesis that pain is associated with lower frequencies of orofacial activities. Polygraphic recordings were made of 100 individuals presenting with a clinical diagnosis of sleep bruxism and 43 control individuals. TwoStep Cluster analyses (SPSS) were performed with sleep bruxism variables to reveal groupings among sleep bruxers and control individuals. Participants completed questionnaires during screening, diagnosis, and recording sessions. Cluster analysis identified three subgroups of sleep bruxers. Interestingly, 45 of the 46 sleep bruxers with values below SB-RDC were classified in the low-frequency cluster. These individuals were more likely to complain of pain and fatigue of masticatory muscles than were the higher-frequency sleep bruxers (odds ratios > 3.9, p < 0.01). Sleep bruxers were distributed among three heterogeneous groups. Sleep bruxers with low frequencies of orofacial activities were more at risk of reporting pain.

J DENT RES 2007 86: 837

Filed Under: Uncategorized Tagged With: Bruxism, facial pain, toothgrinding

Scottsdale Study Club Announces and Sets Dates for Clinical Workshops and Meetings Focused on Dental Treatments of Sleep Disordered Breathing, Bruxism and TMD/Headache

July 28, 2011 by Randy Clare Leave a Comment

The Scottsdale Study Club announces its 12-month meeting schedule to include monthly club meetings as well as monthly hands-on clinical workshops with patients. The focus of this educational environment is to provide direct one-on-one experience with Dentists who have successfully integrated sleep dentistry into their practices.

About the Workshops and Meetings

General session fees are $1,499 and Workshops are $2,200. Each Dentist is welcome to bring an assistant or auxiliary to the club meeting. For information or to register to attend the meeting, please call 760-633-4162..

Topics and focus of each meeting will be determined by the mentors and may change without notice depending on the number attendees and perceived areas of academic interest. There will be no exhibits at the Study Club meetings.

Background on the Mentors

Dr. Edward Spiegel, DDS: After treating a series of patients in the 1980′s with temporomandibular joint disorder by way of oral appliances, in 1992, he discovered an interesting correlation. As he treated these patients with oral appliances their snoring stopped. Having confirmed this finding after a retrospective case review, he began to evaluate the use of oral appliances to stop patients snoring and in turn the utility of oral appliances in solving a much larger health problem: Sleep Disordered Breathing conditions such as Obstructive Sleep Apnea (OSA).

He designed a rudimentary treatment protocol within his own office based on the dental management of Sleep Disordered Breathing by way of Oral Appliance Therapy.  The local success of his clinical program in Erie, PA was mirrored nationally by dental practices emulating his treatment plan. He then created a clinical protocol intended for the dental assessment and treatment of snoring and other airway-related sleep disorders. The result is a turn-key system for the dental management of Sleep Disordered Breathing.

 

Bradley Eli, DMD, MS: Bradley Eli has a 20 year history of work in the field of Orofacial Pain management (head and neck). Upon completion of his UCLA program there were less than 10 like providers within the United States. In 1995, he began the work in the field of Sleep Medicine and then began the STAR (Sleep Treatment and Research) Institute.  This unique early look at the field has assisted him in the development of methods and solutions to assist patients with these life changing pain and sleep disorders.

 

Location

SleepScholar Study Club General Session

14635 N Kierland Blvd., Ste. 154

Scottsdale, AZ, 85254

Seating is limited and will be assigned on a first come first serve basis

Calendar of Events 2011

September 16- 17, 2011

Where are the patients?

  • Evaluation of dental patients at each dental appointment for signs and symptoms of untreated sleep disorders
  • Conversion from dental to medical
  • Dental insurance vs. Medical Insurance including Medicare
    AASM as well as AADSM guidelines for treatment in the dental office
  • Hands-on workshop for patient evaluation and treatment

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Michael Childres, Bradenton, FL

Dr. Michael Gluhareff, Ocala, FL

Dr. Edward Spiegel, Scottsdale, AZ

Dentists and one staff member will learn proper patient evaluation, examination, jaw registration, and dental and medical records.

October 14-15, 2011

Bruxism, TMD and Sleep

  • Etiology of Bruxism, use of the Ordinal Scale as well as tie in to TMD and Sleep Disorders
  • Evaluation of the patient, documentation and medical billing for ABI
  • Treatment options in the pediatric patient as well as adult patient
  • Orthodontic evaluation and early treatment
  • TMD evaluation of patients as well as treatment planning
  • Sleep patient present with symptoms of pain and pre existing conditions
  • Hands-on evaluation of patient dentition and treatment planning
  • Proper medical referral and medical billing

Mentor Spotlight

Dr. Devin Croft, Orthodontist, Peoria, AZ

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

 

November 4-5, 2011

Diagnostic Testing

  • Diagnostic testing in the dental office for TMD and Oral Appliance
  • Evaluating diagnostic testing for use id the dental office
  • Literature support, clinical guidelines for treatment planning as well as follow-up records and documentation to insurance carriers
  • AAOP as well as AACP Guidelines for treatment and evaluation of patients
  • Hands-on evaluation for patients as well as discussion on treatment planning

Mentor Spotlight

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

December 2-3, 2011

Oral Appliance Selection

  • Discussion on the most used oral devices for Bruxism, TMD and OSA
  • Pricing as well as indications and contra indications of oral devices with a 510(k) number
  • Various jaw registration devices for recording the maxillary/mandibular relationship
  • Long-term use of Oral Appliances
  • Trouble-shooting problems associated with oral appliances
  • Materials for accurate impressions for oral devices

Mentor Spotlight
Mr. Randy Clare, Aliso Viejo, CA

Dr. Edward Spiegel, Scottsdale, AZ

Calendar of Events 2012

February 10-11, 2012

Where are the patients?

  • Evaluation of dental patients at each dental appointment for signs and symptoms of untreated sleep disorders
  • Conversion from dental to medical
  • Dental insurance vs. Medical Insurance including Medicare
    AASM as well as AADSM guidelines for treatment in the dental office
  • Hands-on workshop for patient evaluation and treatment

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Michael Childres, Bradenton, FL

Dr. Michael Gluhareff, Ocala, FL

Dr. Edward Spiegel, Scottsdale, AZ

Dentists and one staff member will learn proper patient evaluation, examination, jaw registration, and dental and medical records.

March 9-10, 2012

Bruxism, TMD and Sleep

  • Etiology of Bruxism, use of the Ordinal Scale as well as tie in to TMD and Sleep Disorders
  • Evaluation of the patient, documentation and medical billing for ABI
  • Treatment options in the pediatric patient as well as adult patient
  • Orthodontic evaluation and early treatment
  • TMD evaluation of patients as well as treatment planning
  • Sleep patient present with symptoms of pain and pre existing conditions
  • Hands-on evaluation of patient dentition and treatment planning
  • Proper medical referral and medical billing

Mentor Spotlight

Dr. Devin Croft, Orthodontist, Peoria, AZ

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

April 13-14, 2012
Diagnostic Testing

  • Diagnostic testing in the dental office for TMD and Oral Appliance
  • Evaluating diagnostic testing for use id the dental office
  • Literature support, clinical guidelines for treatment planning as well as follow-up records and documentation to insurance carriers
  • AAOP as well as AACP Guidelines for treatment and evaluation of patients
  • Hands-on evaluation for patients as well as discussion on treatment planning

Mentor Spotlight

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

May 11-12, 2012

Oral Appliance Selection

  • Discussion on the most used oral devices for Bruxism, TMD and OSA
  • Pricing as well as indications and contra indications of oral devices with a 510(k) number
  • Various jaw registration devices for recording the maxillary/mandibular relationship
  • Long-term use of Oral Appliances
  • Trouble-shooting problems associated with oral appliances
  • Materials for accurate impressions for oral devices

Mentor Spotlight
Mr. Randy Clare, Aliso Viejo, CA

Dr. Edward Spiegel, Scottsdale, AZ

 

June 8-9, 2011

Where are the patients?

  • Evaluation of dental patients at each dental appointment for signs and symptoms of untreated sleep disorders
  • Conversion from dental to medical
  • Dental insurance vs. Medical Insurance including Medicare
    AASM as well as AADSM guidelines for treatment in the dental office
  • Hands-on workshop for patient evaluation and treatment

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Michael Childres, Bradenton, FL

Dr. Michael Gluhareff, Ocala, FL

Dr. Edward Spiegel, Scottsdale, AZ

Dentists and one staff member will learn proper patient evaluation, examination, jaw registration, and dental and medical records.

July 13-14, 2012

Bruxism, TMD and Sleep

  • Etiology of Bruxism, use of the Ordinal Scale as well as tie in to TMD and Sleep Disorders
  • Evaluation of the patient, documentation and medical billing for ABI
  • Treatment options in the pediatric patient as well as adult patient
  • Orthodontic evaluation and early treatment
  • TMD evaluation of patients as well as treatment planning
  • Sleep patient present with symptoms of pain and pre existing conditions
  • Hands-on evaluation of patient dentition and treatment planning
  • Proper medical referral and medical billing

Mentor Spotlight

Dr. Devin Croft, Orthodontist, Peoria, AZ

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

Clinical Workshops

The intention of the workshop format is to exercise the new skills as learned at the general session in a controlled environment. There will be time provided in this forum for attendee case presentations and the exchange of information that will lead to an excellent educational outcome.

The Apnea and TMJ/Headache workshop will be conducted in small groups with patients in a dental office.

The PSG course will be conducted in a hotel room where a complete sleep diagnostic facility will be re-created for the purpose of demonstrating and teaching the process of collecting sleep study data.

 

Location for Apnea and TMJ/Headache Workshops

Vistancia Ortho

9772 W. Yearling Rd Suite A-1600

Peoria, AZ 85383

(All materials for the training will be provided onsite)

 

Location for the Overnight Polysomnography Workshops

Embassy Suites

4415 E. Paradise Village Pkwy South
Phoenix, AZ 85032

 

Calendar of Events 2011

September 23-25, 2011

Overnight PSG (Limited to 12 Dentists)

  • Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
  • Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
  • Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel

October 21-22, 2011

Chairside Sleep Apnea

  • Medical legal aspects involved in treating the Bruxing, TMD and Sleep patient
  • Health care attorney will review medical insurance guidelines. Medicare guidelines including anti-fraud, anti-kickback and Stark Laws.
  • Informational seminars for Snoring, TMD as well as Sleep Disorders.
  • How to organize market and follow-up.
  • Working with the sleep lab.  How to legally refer patients with medical insurance as well as Medicare.

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

November 18-19, 2011

TMD and Headache

  • Headache classifications relationship between Headache/TMD/Sleep
  • Diagnostic Process-unique for headache and unique for sleep
  • Recommended Communication with Physicians
  • Medications in Headache Management
  • Oral Appliance Therapy

Headache

Jaw Disorders

Sleep Disorders

  • Injection uses in Headache Disorders
  • Injection techniques for Headache
  • Injection technique for TMD
  • Review of Tx  method of action PAP vs Mandibular advancement

 

 

Mentor Spotlight

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

December 16-18, 2011

Overnight PSG (Limited to 12 Dentists)

  • Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
  • Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
  • Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel


Calendar of Events 2012

February 24-25, 2012

Chairside Sleep Apnea

  • Medical legal aspects involved in treating the Bruxing, TMD and Sleep patient
  • Health care attorney will review medical insurance guidelines. Medicare guidelines including anti-fraud, anti-kickback and Stark Laws.
  • Informational seminars for Snoring, TMD as well as Sleep Disorders.
  • How to organize market and follow-up.
  • Working with the sleep lab.  How to legally refer patients with medical insurance as well as Medicare.

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

March 23-24, 2012

TMD and Headache

  • Headache classifications relationship between Headache/TMD/Sleep
  • Diagnostic Process-unique for headache and unique for sleep
  • Recommended Communication with Physicians
  • Medications in Headache Management
  • Oral Appliance Therapy

Headache

Jaw Disorders

Sleep Disorders

  • Injection uses in Headache Disorders
  • Injection techniques for Headache
  • Injection technique for TMD
  • Review of Tx  method of action PAP vs Mandibular advancement

 

Mentor Spotlight

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

April 27-29, 2012

Overnight PSG (Limited to 12 Dentists)

  • Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
  • Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
  • Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel

 

May 25-26, 2012

Chairside Sleep Apnea

  • Medical legal aspects involved in treating the Bruxing, TMD and Sleep patient
  • Health care attorney will review medical insurance guidelines. Medicare guidelines including anti-fraud, anti-kickback and Stark Laws.
  • Informational seminars for Snoring, TMD as well as Sleep Disorders.
  • How to organize market and follow-up.
  • Working with the sleep lab.  How to legally refer patients with medical insurance as well as Medicare.

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

June 22-23, 2012

TMD and Headache

  • Headache classifications relationship between Headache/TMD/Sleep
  • Diagnostic Process-unique for headache and unique for sleep
  • Recommended Communication with Physicians
  • Medications in Headache Management
  • Oral Appliance Therapy

Headache

Jaw Disorders

Sleep Disorders

  • Injection uses in Headache Disorders
  • Injection techniques for Headache
  • Injection technique for TMD
  • Review of Tx  method of action PAP vs Mandibular advancement

 

Mentor Spotlight

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

July 27-29, 2012

Overnight PSG (Limited to 12 Dentists)

  • Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
  • Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
  • Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel

 

Filed Under: cpap compliance, David Gergen, Dental, dental appliances, dental labs, dental sleep medicine, dentists, Gergens Ortho Lab, glidewell dental lab, obstructive sleep apnea, osa patients, sleep apnea, sleep appliances, sleep disorder Tagged With: Articles, Blog, CPAP compliance, dental, dental appliances, dental labs, dental sleep medicine, dentists, Glidewell Dental Lab, obstructive sleep apnea, OSA Patients

Survival of veterans with sleep apnea: continuous positive airway pressure versus surgery

July 26, 2011 by Randy Clare Leave a Comment
Weaver EM, Maynard C, Yueh B.

Source

Surgery and Perioperative Care Service, Veterans Affairs Puget Sound Healthcare System, Seattle, WA 98108, USA. eweaver@u.washington.edu

Erratum in

  • Otolaryngol Head Neck Surg. 2004 Jul;131(1):144.

Abstract

OBJECTIVES:

Continuous positive airway pressure (CPAP) improves sleep apnea survival. We tested whether CPAP is associated with better survival than uvulopalatopharyngoplasty (UPPP).

STUDY DESIGN AND METHODS:

This retrospective cohort database study included all sleep apnea patients treated with CPAP or UPPP in Veteran Affairs facilities from October 1997 through September 2001. Treatment groups were compared with Cox regression, adjusting for age, gender, race, year treatment was initiated, and comorbidity. Sleep apnea severity and CPAP use data were not available.

RESULTS:

By September 2002, 1339 (7.1%) of 18,754 CPAP patients and 71 (3.4%) of 2,072 UPPP patients were dead (P < 0.001). After adjustment, CPAP patients had 31% (95% confidence interval, 3% to 67%, P = 0.03) higher probability of being dead at any time, relative to UPPP patients [corrected].

CONCLUSIONS:

UPPP confers a survival advantage over CPAP, after adjustment for age, gender, race, year of treatment, and comorbidity. However, we were unable to adjust for sleep apnea severity or CPAP use. Surgical treatment should be considered in sleep apnea patients who use CPAP inadequately.

Otolaryngol Head Neck Surg. 2004 Jun;130(6):659-65.

Filed Under: Uncategorized

Sleep and primary headaches.

July 25, 2011 by Randy Clare Leave a Comment
Aguggia M, Cavallini M, Divito N, Ferrero M, Lentini A, Montano V, Tinebra MC, Saracco MG, Valfrè W.

Source

Neurological Department, Cardinal Massaja Hospital, Via Conte Verde 200, 14100 Asti, Italy. aguggiamarco@tiscali.it

Abstract

The relationship between sleep and primary headaches has been known for over a century, particularly for headaches occurring during the night or early morning. Migraine, tension-tyre headache, and cluster headache may cause sleepfragmentation, insomnia, and hypersomnia, causing considerable social and economical costs and several familial problems. By contrast, sleep disorders may themselves trigger headache attacks. Finally, headaches and sleep disorders can also be symptoms of other underlying pathologies. Despite this background, there is still no clarity about the mechanism that links these two entities and their interdependence remains to be defined. Patients with primary headache should undergo a careful assessment of sleep habits.

Neurol Sci. 2011 May;32 Suppl 1:S51-4.

 

Filed Under: Uncategorized

Five years of sleep apnea treatment with a mandibular advancement device. Side effects and technical complications

July 23, 2011 by Randy Clare Leave a Comment
Martínez-Gomis J, Willaert E, Nogues L, Pascual M, Somoza M, Monasterio C.

Source

Department of Prosthodontics, Faculty of Dentistry, University of Barcelona, Campus de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain. jmartinezgomis@ub.edu

Abstract

OBJECTIVE:

To determine the variation in prevalence of temporomandibular disorders (TMD), other side effects, and technical complications during 5 years of sleep apnea treatment with a mandibular advancement device.

MATERIALS AND METHODS:

Forty patients diagnosed with obstructive sleep apnea received an adjustable appliance at 70% of the maximum protrusion. The protrusion was then progressively increased. TMD (diagnosed according to the Research Diagnostic Criteria for TMD), overjet, overbite, occlusal contacts, subjective side effects, and technical complications were recorded before and a mean of 14, 21, and 58 months after treatment and analyzed by the Wilcoxon test (P < .05).

RESULTS:

Fifteen patients still used the oral appliance at the 5-year follow-up, and no significant variation in TMD prevalence was observed. Subjective side effects were common, and a significant reduction was found in overjet, overbite, and in the number of occlusal contacts. Furthermore, the patients made a mean of 2.5 unscheduled dental visits per year and a mean of 0.8 appliance repairs/relines per year by a dental technician. The most frequent unscheduled visits were needed during the first year and were a result of acrylic breakage on the lateral telescopic attachment, poor retention, and other adjustments to improve comfort.

CONCLUSIONS:

Five-year oral appliance treatment does not affect TMD prevalence but is associated with permanent occlusal changes in most sleep apnea patients during the first 2 years. Patients seek several unscheduled visits, mainly because of technical complications.

Angle Orthod. 2010 Jan;80(1):30-6

Filed Under: Uncategorized

Analysis of the influence of a mandibular advancement device on sleep and sleep bruxism scores by means of the BiteStrip and the Sleep Assessment Questionnaire

July 23, 2011 by Randy Clare Leave a Comment
Saueressig AC, Mainieri VC, Grossi PK, Fagondes SC, Shinkai RS, Lima EM, Teixeira ER, Grossi ML.

Source

Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.

Abstract

PURPOSE:

A before-and-after experimental clinical study was carried out with the objective of evaluating the effect of a mandibular advancement device (MAD; 75% advancement), made of a thermoplastic material, on sleep bruxism (SB) and sleep scores.

MATERIALS AND METHODS:

After a habituation period of 1 week, SB scores were taken at baseline and after use of the MAD for 30 days. Scores were compared using the newly developed BiteStrip, which registers the number of contractions of the unilateral masseter muscle after a 5-hour period, giving a severity score from 0 to 3 after the registrations. To assess sleep, the Sleep Assessment Questionnaire (SAQ), a screening tool with scores ranging from 0 to 68, was used before and after use of the MAD. Twenty-eight subjects (13 women, 15 men; mean age: 42.9 +/- 12.0 years) with a clinical history of SB and no spontaneous temporomandibular disorder (TMD) pain were selected. The clinical diagnosis of either moderate or severe SB was further confirmed through use of the BiteStrip (scores 2 or 3) at baseline. A 30-day follow-up period was used for evaluation. Both methods were validated against polysomnography. In addition, common signs and symptoms of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders were also evaluated before and after use to assess the side effects of the MAD.

RESULTS:

There was a statistically significant improvement in both SB and sleep scores based on the BiteStrip and the SAQ (Wilcoxon signed rank and Student paired t test, P < .05). In the signs and symptoms of TMD, there was a significant reduction in temporomandibular joint sounds as well as in masseter and temporalis tenderness to palpation. None of the SB subjects experienced any breakage of the MAD.

CONCLUSION:

The MAD had a positive effect on SB and sleep scores, measured by the BiteStrip and the SAQ, respectively, and did not increase any traditional signs and symptoms of TMD in a 30-day evaluation period.

Int J Prosthodont. 2010 May-Jun;23(3):204-13.

Filed Under: Uncategorized

Z-palatopharyngoplasty plus genioglossus advancement and hyoid suspension for obstructive sleep apnea hypopnea syndrome

July 23, 2011 by Randy Clare Leave a Comment
Yi HL, Sun XQ, Chen B, Zhang YJ, Guan J, Wu HM, Meng LL, Yin SK.

Source

Department of Otolaryngology, Affiliated Sixth People’s Hospital, Otolaryngology Institute, Shanghai Jiao Tong University, Shanghai, China.

Abstract

OBJECTIVE:

To explore the feasibility and efficiency of Z-palato-pharyngoplasty (ZPPP) plus genioglossus advancement and hyoid suspension (GAHM) for severe obstructive sleep apnea hypopnea syndrome (OSAHS).

STUDY DESIGN:

Case series with planned data collection.

SETTING:

A university medical center.

SUBJECTS AND METHODS:

Twenty-six patients who had OSAHS with Friedman obstructive sleep apnea stage II/III and posterior airway space <11 mm received GAHM and ZPPP. All patients were reevaluated 6 months after surgery using the preoperative methods.

RESULTS:

Based on success criteria, defined as an apnea-hypopnea index (AHI) of <20 and a decrease >50%, the success rate was 46.2% at 6 months postoperatively. The AHI showed a significant reduction from 65.6 ± 17.6 preoperatively to 30.1 ± 23.1 postoperatively. The percentage of time with oxyhemoglobin saturation below 90% (CT(90)) decreased from 30.9% ± 28.1% preoperatively to 15.5% ± 25.6% postoperatively (P < .01). Sleep architecture was effectively changed. The S3 + S4 percentage of total sleep time increased from 3.6% ± 4.4% to 8.7% ± 5.0% (P < .05). The success rates were 100% (8/8) and 22.2% (4/18) in patients with Friedman obstructive sleep apnea stage II and III, respectively.

CONCLUSION:

The success rate of ZPPP plus GAHM for patients with severe OSAHS who suffer from oropharyngeal and hypopharyngeal obstruction was limited. Friedman stage was a predictor of ZPPP plus GAHM surgical success.

Otolaryngol Head Neck Surg. 2011 Mar;144(3):469-73.

Filed Under: Uncategorized

Effects of electrical stimulation on neuromuscular junction morphology in the aging rat tongue

July 23, 2011 by Randy Clare Leave a Comment
Johnson AM, Connor NP.

Source

Department of Surgery, University of Wisconsin-Madison, Madison, WI 53792, USA.

Abstract

Alterations in neuromuscular junction (NMJ) structure in cranial muscles may contribute to age-related deficits in critical sensorimotor actions such as swallowing. Neuromuscular electrical stimulation (NMES) is used in swallowing therapy, but it is unclear how NMJ structure is affected or if NMJ morphology is best measured in two or three dimensions. Two- and three-dimensional measurements of NMJ morphology in the genioglossus muscle were compared in rats that had undergone 8 weeks of hypoglossal nerve stimulation vs. untreated controls. The relationship between motor endplate volume and nerve terminal volume had a mean positive slope in 90% of the young adult controls, but it was positive in only 50% of the old controls; 89% of NMES old rats had a positive slope. NMJ measurements were more accurate when measured in three dimensions. In the NMJ, aging and NMES are associated with changes in the pre- and post-synaptic relationship.

Muscle Nerve. 2011 Feb;43(2):203-11.

Filed Under: Uncategorized
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Editorial Board

Randy Clare
Managing Editor of SleepScholar and RespiratoryScholar
Dr. Steve Carstensen
Pankey Institute for Advanced Dental Education, American Academy of Dental Sleep Medicine.
Ruchir Patel MD
Founder & Medical Director at the Insomnia and Sleep Institute of Arizona.
Dr. John S. Viviano
AADSM Diplomate and member of various sleep organizations. Has lectured internationally on the treatment of Sleep-Disordered Breathing and the use of Acoustic Reflection.
Jeffroy Wyscarver
President, DDME Online, Sleep Lab Technology and Services for the Dental Community.
Claude Albertario
RPSGT, speaker, author and mentor in the field of sleep diagnostics with 25 yrs of management experience in one of New York's premier sleep centers.
Joseph Anderson
Co-Founder and Director of Education for Priority Health Education and Priority Scoring.
Todd Austin
Managed sleep labs and has 15 experience in sleep diagnostics and therapeutic systems. .
Marietta Bibbs
Sleep specialist and manager of Sleep and Neurodiagnostics at Morton Plant Mease Healthcare.
Bradley Eli DMD, MS
Director, San Diego Headache and Facial Pain Center / Sleep Treatment and Research Institute
Edward Grandi
Executive Director of the American Sleep Apnea Association.
Edward Michaelson MD
Board Certified in Pulmonary Medicine, Internal Medicine and Sleep Medicine
Ashley Truitt
Founder & Director of Dental Sleep Medicine Worldwide, Co-Founder of TPT Dental.

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