Utilising survey data and qualitative information to inform a logic model to support older people in custody with common mental and physical health problems: Addressing the physical and mental health needs of older prisoners (the PAMHOP study).

A growing number of older people remain in custody each year resulting in an increasing number of common mental and physical health concerns. No prior evidenced-based targeted psychological interventions support this group of people, and little is known about their needs, current activities, and health-related problems. We addressed these gaps through a project involving older prisoners, prison staff and a project advisory group in one male and one female prison site in the North of England. Systematic review evidence supports the development of an implementation tool kit addressing strategies to develop and deliver interventions that are sustainable, acceptable, and feasible in the prison environment. Prison strategies need to specifically address the needs of older people in custody. Relatively inexpensive activities, with some thought to delivery and flexibility have the potential to benefit common mental and physical health, increasing quality of life, reducing high economic and social cost, mortality, and reoffending in this age group.

Management of primary snoring in adults: A scoping review examining interventions, outcomes and instruments used to assess clinical effects.

While various treatment options for primary snoring are available, evidence-based recommendations to determine the optimal intervention remain unestablished. To inform future directions of research to guide clinical decision-making, this scoping review was conducted to map the existing evidence on interventions for primary snoring, the outcomes and instruments used to assess their clinical effects in adults. The feasibility of conducting further systematic reviews and comparing outcomes across these therapies using network meta-analysis was also assessed. Of the 1673 records identified, 38 interventional studies met the inclusion criteria with three-fifths of them being before-after studies. The most common reason for study exclusion was results being reported for patients with primary snoring and obstructive sleep apnoea (OSA) combined. Interventions were surgical (73 %), behavioural and the use of devices/medications. Twenty-six common outcomes were identified and categorised into six domains. Fifty-nine instruments were used to assess the outcomes and based mainly on non-validated questionnaires. Our findings indicated (1) the need for randomised controlled trials with strict discrimination between patients with primary snoring and OSA, (2) further network meta-analyses using some outcomes is feasible, and (3) a core outcome set to inform standardised reporting for future research should be developed.

P2X7R and P2X4R expression of mice submandibular gland in high-fat diet/streptozotocin-induced type 2 diabetes.

Type 2 diabetes mellitus (T2DM) is a chronic inflammatory disease that can compromise the functioning of various organs, including the salivary glands (SG). The purinergic system is one of the most important inflammatory pathways in T2DM condition, and P2X7R and P2X4R are the primary purinergic receptors in SG that regulate inflammatory homeostasis. This study aimed to evaluate P2X7R and P2X4R expression, and morphological changes in the submandibular gland (SMG) in T2DM. Twenty-four 5-week-old mice were randomly assigned to control (CON) and diabetes mellitus (DM) groups (n = 12 each). Body weight, diet, and blood glucose levels were monitored weekly. The histomorphology of the SMG and the expression of the P2X7R, and P2X7R was evaluated by immunohistochemistry (IHC) staining and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) at 11 and 13 weeks of age. Our findings indicate a significant increase in food consumption, body weight, and blood glucose levels in the DM group. Although a significant increase in P2X7R and P2X4R expression was observed in the DM groups, the receptor location remained unchanged. We also observed a significant increase in the acinar area in the DM13w group, and a significant decrease in the ductal area in the DM11w and DM13w groups. Targeting purinergic receptors may offer novel therapeutic methods for diabetic complications.

Mandibular advancement devices used with morning occlusal guides for treating obstructive sleep apnea-changed incisor inclination and its associated factors.

PURPOSE: Mandibular advancement devices (MADs) effectively treat patients with obstructive sleep apnea (OSA). Although the use of morning occlusal guides (MOGs) along with MADs is recommended to prevent dental side effects, there is no evidence to support this. The aim of this study was to evaluate the change in incisor inclination in patients with OSA treated with MADs and MOGs, and to identify its predictive factors. METHODS: Patients with OSA who received MAD and MOG therapy and had a reduction in their apnea-hypopnea index greater than 50% were analyzed. Cephalometric measurements were performed at baseline and at a 1-year follow-up or longer to assess the dentoskeletal side effects of MAD/MOG treatment. Multivariable linear regression analysis was used to assess the association between the change in incisor inclination and the independent variables that may cause the observed side effects. RESULTS: Among 23 patients enrolled in the study, there was significant upper incisor retroclination (U1-SN: 2.83° ± 2.68°, U1-PP: 2.86° ± 2.46°; P < 0.05) and significant lower incisor proclination (L1-SN: 3.04° ± 3.29°, L1-MP: 1.74° ± 3.13°; P < 0.05). However, no significant skeletal changes were observed. Multivariable linear regression revealed that advancement ≥ 95% of the patients' maximal mandibular protrusion was associated with greater upper incisor retroclination. Increased treatment duration was also associated with increased upper incisor retroclination. No \measured variables were associated with the change in lower incisor inclination. CONCLUSIONS: Dental side effects occurred in patients who used MADs with MOGs. The amount of mandibular protrusion by MADs and treatment duration were predictive factors associated with upper incisor retroclination.

Assessment of masticatory performance in patients undergoing orthognathic surgery: A systematic review and meta-analysis.

BACKGROUND: One of the main goals of orthognathic surgery is to improve the masticatory performance in patients with maxillofacial deformities. OBJECTIVE: The aim of this study was to evaluate the literature on assessing masticatory performance before, after orthognathic surgery and normal occlusion. METHODS: An electronic search was performed via Pubmed, Scopus, LILACs and Web of Science without any restrictions until June 2022. The articles assessing masticatory performance using a comminution assay, bite force or occlusal contact area in patients undergoing orthognathic surgery with or without comparing controls were included. The risk of bias of the selected articles was assessed using the appropriate tools according to the study design. RESULTS: Of the 2507 records identified, 21 studies were included in the qualitative evaluation and 17 studies in the meta-analysis. Nine articles were cohort studies, and the other eight were before-after studies. Moderate to high risks of bias were found among the articles. Comparing the values before and after surgery, the meta-analysis revealed a significant improvement in the bite force and occlusal contact area at 1- and 2-year post-surgery. However, regardless of the assessed parameters, the masticatory performance in patients with normal occlusion was significantly greater than those in patients undergoing orthognathic surgery at all evaluated time points. CONCLUSION: Although combined surgical orthodontic treatment can improve impaired masticatory function, assessed by the comminution method, bite force and occlusal contact area, the improvement may not reach that of normal occlusion.

Simple approach for correcting an entrapped ectopic permanent mandibular first molar caused by poor marginal adaptation of a preformed metal crown on an adjacent primary second molar: a case report with a 5-year follow-up.

Ectopic eruption of the permanent first molar can lead to malocclusion if left untreated. Despite several reported etiologic factors and treatment options, ectopic eruption caused by an improper restoration on an adjacent tooth and a simple solution have never been documented. Case report: An 8-year-old boy presented with an entrapped ectopic permanent mandibular first molar under the poorly adapted margin of a preformed metal crown (PMC) on the adjacent primary second molar. Replacement with a PMC that had well-contoured margins followed by inserting a separating module between the proximal contact of the two teeth resulted in successful management of this situation in 1 month. Conclusion: This simple approach with good interdisciplinary communication is practical for correcting eruption problems due to a poorly adapted PMC, with long-term satisfactory results. To avoid subsequent malocclusion and unnecessary treatments, dental practitioners must be vigilant when manipulating PMCs and assessing the marginal adaptation prior to their cementation.

Masticatory muscle activity and oral health-related quality of life in patients wearing clear thermoplastic versus wrap-around retainers : A randomized controlled trial.

AIM: To evaluate the surface electromyography (sEMG) activity of the superficial masseter and anterior temporalis muscles at rest, during maximum voluntary clenching (MVC), and mastication, over 6 months of wearing clear thermoplastic or wrap-around retainers. Furthermore, the patients' oral health-related quality of life was assessed using the Oral Impacts on Daily Performance (OIDP) index at 6 months. MATERIALS AND METHODS: Sixty patients aged 14-39 years (19 males/41 females) who received upper and lower retainers after finishing orthodontic treatment were recruited. The patients were randomly divided into a clear thermoplastic retainer group (n = 30) or a wrap-around retainer group (n = 30). The sEMG activity was recorded at retainer delivery (T0), after 3 months (T1), and after 6 months of wearing (T2). The OIDP index was evaluated at T2. RESULTS: None of the sEMG parameters for the masseter and temporalis muscles were different between the two groups at T0, T1, or T2. Over the period of 6 months, both masticatory muscles in both groups demonstrated increased sEMG activity during MVC and mastication; however, only the temporalis muscle demonstrated decreased normalized sEMG activity at rest (P < 0.05). The frequency and severity of the OIDP in the eating aspect at T2 was low and similar in both groups. CONCLUSIONS: sEMG activity of the two masticatory muscles tended to increase during MVC and mastication, while temporalis muscle activity tended to decrease at rest during the observation period, regardless of retainer type. Notably, these sEMG changes did not affect the patients' subjective masticatory function.

Intermittent hypoxia inhibits mandibular cartilage growth with reduced TGF-ß and SOX9 expressions in neonatal rats.

Intermittent hypoxia (IH) has been associated with skeletal growth. However, the influence of IH on cartilage growth and metabolism is unknown. We compared the effects of IH on chondrocyte proliferation and maturation in the mandibular condyle fibrocartilage and tibial hyaline cartilage of 1-week-old male Sprague-Dawley rats. The rats were exposed to normoxic air (n = 9) or IH at 20 cycles/h (nadir, 4% O2; peak, 21% O2; 0% CO2) (n = 9) for 8 h each day. IH impeded body weight gain, but not tibial elongation. IH also increased cancellous bone mineral and volumetric bone mineral densities in the mandibular condylar head. The mandibular condylar became thinner, but the tibial cartilage did not. IH reduced maturative and increased hypertrophic chondrocytic layers of the middle and posterior mandibular cartilage. PCR showed that IH shifted proliferation and maturation in mandibular condyle fibrocartilage toward hypertrophic differentiation and ossification by downregulating TGF-ß and SOX9, and upregulating collagen X. These effects were absent in the tibial growth plate hyaline cartilage. Our results showed that neonatal rats exposed to IH displayed underdeveloped mandibular ramus/condyles, while suppression of chondrogenesis marker expression was detected in the growth-restricted condylar cartilage.

Masticatory function after bite-raising with light-cured orthodontic band cement in healthy adults.

OBJECTIVES: To evaluate the effects of bite-raising with light-cured orthodontic band cement, a method commonly used in contemporary orthodontic treatment, on masticatory function, as assessed by objective and subjective methods. MATERIALS AND METHODS: The objective evaluation of masticatory performance and subjective evaluation of masticatory ability were performed on 30 healthy volunteers (19 females and 11 males, 22.3 ± 1.56 years) with a normal occlusion. Assessment was performed before and immediately after bite-raising. The bite-raising was done by adding light-cured orthodontic band cement (3 × 5 × 2-mm width × length × height) on the palatal cusps of the upper first molars. The masticatory performance index (MPI) was calculated from chewed test food particles using a sieving method. For the subjective evaluation, the participants performed the food intake ability (FIA) test using a questionnaire with six types of food. The correlation between the evaluation methods was determined. RESULTS: The MPI and FIA scores of the participants were significantly reduced after bite-raising (P < .001). The MPI and FIA score reduction was not significantly different between females and males. No significant correlations were found between the changes in MPI and FIA scores. CONCLUSIONS: Masticatory function after bite-raising with light-cured orthodontic band cement was immediately reduced, both objectively and subjectively. However, because there was no significant correlation between the objective and subjective results, an individual may not perceive his/her decreased masticatory ability to the same degree as masticatory performance was reduced. Further study is required to evaluate the long-term adaptation to this bite-raising method.

Comparison of cold-hardening bending and direct electric resistance heat treatment on the mechanical properties and transformation temperature of NiTi archwire: An in vitro study.

OBJECTIVES: The aim of this investigation was (1) to compare the effects of cold-hardening bending and direct electric resistance heat treatment (DERHT) methods; and (2) to compare the effects of offsets and angulations on the mechanical properties and thermal analysis of NiTi alloy archwire. METHODS: Nickel-titanium (NiTi) archwires (Ormco, Glendora, CA), 0.016×0.022-inch, were bent by cold-hardening bending and DERHT methods into 1-mm, 2-mm, or 3-mm offset for a 3-point bending test, and at angles of 30°, 45°, or 60° to the horizontal plane for testing the change in transformation temperature (Af) measured by differential scanning calorimetry (DSC). The data were analysed using ANOVA followed by the Scheffe post-hoc test. RESULTS: The 3-point bending test results of the cold-hardening bending and DERHT methods were not significantly different between the 1-mm, 2-mm and 3-mm offset groups (95% CI: -0.05 to 0.97; P=0.082, 95% CI: -0.65 to 0.74; P=0.983 and 95% CI: -0.61 to 0.98; P=0.813, respectively). Increasing the offset resulted in a significantly decreased force in the 3-point bending test (P<0.001). The Af temperatures of the cold-hardening bending and DERHT methods were not significantly different for the 30°, 45°, and 60° bending angulations (95% CI: -1.93 to 1.39; P=0.876, 95% CI: -1.2 to 0.87; P=0.878, 95% CI: -2.24 to 1.18; P=0.636, respectively). Af temperatures were not influenced by different bending angulations. CONCLUSIONS: NiTi archwire shape can be modified by using both cold-hardening and DERHT bending methods, because the mechanical properties and Af temperature are not affected. However, the bending distance has an effect on the mechanical properties.

Orthodontic Removable Appliance with Posterior Bite Plane Use is not Associated with Developing Sleep-Disordered Breathing Symptoms in Healthy Children.

Purpose: The purpose of this study was to assess the development of sleep-disordered breathing (SDB) symptoms and the relationship between the amount of increased vertical dimension and severity of SDB symptoms in healthy children wearing orthodontic removable appliances with posterior bite planes.
Methods: The Obstructive Sleep Apnea-18 (OSA-18) questionnaire and Pediatric Sleep Questionnaire (PSQ) were used as data collecting tools. The questionnaires were filled out by 16 parents of children who had an anterior crossbite with Class I skeletal pattern. The data were collected three times: one month pre-insertion of the appliance; one day post-insertion; and one month post-insertion.
Results: There were no significant differences between the OSA-18 or PSQ results collected at different times. Pearson's correlation revealed no significant relationship between the posterior bite plane thickness and the difference in scores (P>0.05).
Conclusion: Short-term treatment using such appliances does not initiate SDB symptoms, and the amount of increased posterior bite plane thickness does not relate to the severity of SDB symptoms. (J Dent Child 2019;86(3):145-9).

Immediate effects of temporary bite-raising with light-cured orthodontic band cement on the electromyographic response of masticatory muscles.

To assess the immediate effects of temporary bite-raising using light-cured orthodontic band cement on the superficial masseter and anterior temporalis electromyography (EMG) activity in healthy adults. Surface EMG signals were recorded bilaterally from the superficial masseter and anterior temporalis muscles of 30 volunteers with a normal occlusion, before and after having temporary bite-raising. The bite-raising was done by adding light-cured orthodontic band cement (3x5x2 mm WxLxH) on the lingual cusps of both upper first molars. The measurements were recorded (i) at rest, (ii) while clenching in centric occluding position and (iii) while chewing on an artificial test food. The EMG activity at rest and during clenching, the maximum voltage, and the duration of the identified EMG signal burst while chewing the artificial test food before and after temporary bite-raising were statistically compared using the paired t-test or the Wilcoxon signed-rank test based on the normality of the variables. The significance level was set at 5%. After temporary bite-raising, we found no significant change in integral EMG activity at rest position for the superficial masseter (mean difference (MD)=7.5 µVs) and for the anterior temporalis muscle (MD=36.8 µVs); however, the integral EMG activity during clenching was significantly reduced for the superficial masseter (MD=201.2 µVs) and for the anterior temporalis muscle (MD=151.8 µVs). During mastication, the maximum voltage of the identified burst was significantly reduced on the preferred chewing side of the superficial masseter and anterior temporalis muscles (MD=127.9 and 47.7 µV, respectively), while no significant change was found for the duration of the identified burst (MD=-34.1 and 3.4 ms, respectively) after temporary bite-raising. The results point to an altered neuromuscular behavior during clenching and chewing immediately after temporary bite-raising with light-cured orthodontic band cement. This information is relevant for orthodontists to inform their patients what will happen to their masticatory muscle activity when this bite-raising method is used.

Immediate effects of temporary bite-raising with light-cured orthodontic band cement on the electromyographic response of masticatory muscles

Abstract Objective: To assess the immediate effects of temporary bite-raising using light-cured orthodontic band cement on the superficial masseter and anterior temporalis electromyography (EMG) activity in healthy adults. Materials and Methods: Surface EMG signals were recorded bilaterally from the superficial masseter and anterior temporalis muscles of 30 volunteers with a normal occlusion, before and after having temporary bite-raising. The bite-raising was done by adding light-cured orthodontic band cement (3x5x2 mm WxLxH) on the lingual cusps of both upper first molars. The measurements were recorded (i) at rest, (ii) while clenching in centric occluding position and (iii) while chewing on an artificial test food. The EMG activity at rest and during clenching, the maximum voltage, and the duration of the identified EMG signal burst while chewing the artificial test food before and after temporary bite-raising were statistically compared using the paired t-test or the Wilcoxon signed-rank test based on the normality of the variables. The significance level was set at 5%. Results: After temporary bite-raising, we found no significant change in integral EMG activity at rest position for the superficial masseter (mean difference (MD)=7.5 μVs) and for the anterior temporalis muscle (MD=36.8 μVs); however, the integral EMG activity during clenching was significantly reduced for the superficial masseter (MD=201.2 μVs) and for the anterior temporalis muscle (MD=151.8 μVs). During mastication, the maximum voltage of the identified burst was significantly reduced on the preferred chewing side of the superficial masseter and anterior temporalis muscles (MD=127.9 and 47.7 μV, respectively), while no significant change was found for the duration of the identified burst (MD=-34.1 and 3.4 ms, respectively) after temporary bite-raising. Conclusion: The results point to an altered neuromuscular behavior during clenching and chewing immediately after temporary bite-raising with light-cured orthodontic band cement. This information is relevant for orthodontists to inform their patients what will happen to their masticatory muscle activity when this bite-raising method is used.

Attitudes of orthodontists and laypersons towards tooth extractions and additional anchorage devices.

BACKGROUND: This study investigated the attitudes of orthodontists and laypersons towards the choice of extracting second premolars, rather than first premolars, based on tooth condition and the use of additional anchorage devices. METHODS: Questionnaires were sent to two groups: 324 orthodontists who were members of the Thai Association of Orthodontists, and 100 randomly selected Thai laypersons aged above 20 years and who were unrelated to the field of dentistry. Descriptive and chi-square statistics were used to analyze the data. RESULTS: Questionnaires were returned by 142 orthodontists (43.8%) and completed by 100 laypersons. The larger the size of the caries lesion in the maxillary second premolar was found, the more orthodontists and laypersons both chose to extract a carious maxillary second premolar instead of a healthy maxillary first premolar. For orthodontists, the use of mini-implant anchorage was significantly related to their extraction decision. Orthodontists who were familiar with mini-implants usage would choose to extract the second premolar at a lower size of extent of caries. Besides, when larger sizes of caries lesions in maxillary second premolars were considered, laypersons tended to have greater acceptance of the use of additional anchorage devices in order to keep the healthy maxillary first premolar. CONCLUSIONS: In this study, tooth condition and the use of anchorage devices are currently the main considerations by both orthodontists and laypersons when selecting the teeth to be extracted for orthodontic treatment.

Masticatory function and maturation of the jaw-opening reflex.

OBJECTIVE: To test the null hypothesis that alteration in masticatory function due to liquid-diet feeding during growth does not affect jaw-opening reflex (JOR) maturation. MATERIALS AND METHODS: Soon after weaning, 70 female Wistar rats were divided into two equal groups and fed either solid (control group) or liquid (experimental group) diets. At 5, 9, and 13 weeks, the rats were anesthetized and the JOR was recorded in the anterior belly of the digastric muscles as evoked by a low-intensity electrical stimulation of the left inferior alveolar nerve. RESULTS: There were similar tendencies at each recording age. Peak-to-peak amplitude of the JOR was significantly smaller, and the latency was significantly longer in the experimental group, although the duration was not significantly different between the two groups. CONCLUSIONS: These data suggest that long-term masticatory functional change due to liquid-diet feeding during growth may impede the learning for JOR maturation, and thus may affect the masticatory performance in the adult.