Sleep Bruxism in Puerperal Women: Data from a Population-Based Survey.

OBJECTIVE: To evaluate the self-reported SB prevalence and explore associated risk factors in puerperal women who had given birth in Rio Grande, Southern Brazil. METHODS: A single, standardized questionnaire was given within the 48 h postpartum period. Self-reported SB was the main outcome investigated. Chi-square test was used to compare proportions, and Poisson regression with robust variance adjustment was used in the multivariate analysis. RESULTS: A total of 2225 women were included. Only 79 (3.6%) of these reported clenching or grinding their teeth during sleep. Adjusted analysis showed that the higher education level of the mothers (PR = 3.07; 95% CI 1.49-6.28; P = 0.006); living with three or more persons in the household (PR = 0.54; 95% CI 0.34-0.84; P = 0.007); medication intake during pregnancy (PR = 1.68; 95% CI 1.09-2.58; P = 0.017); smoking (PR = 1.93; 1.16-3.23; P = 0.024), or ever smoked (PR = 1.82; 95% CI 0.85-3.90; P = 0.024); severe anxiety (PR = 1.36; 95% CI 0.61-3.02; P = 0.005); and headache upon waking (PR = 4.19; 95% CI 1.95-9.00; P < 0.001) were significantly associated with self-reported SB. CONCLUSION FOR PRACTICE: Our data pointed towards new factors in a specific group of women that may be relevant for preventing sleep-related behaviors in the pregnancy-puerperal cycle. The higher levels of education, medication intake, smoking or even smoked, severe anxiety, the higher the probability of puerperal woman to self-report SB. The nighttime tooth clenching strongly increased headache upon waking.

Invasive surgical procedures for the management of internal derangement of the temporomandibular joint: a systematic review and meta-analysis regarding the effects on pain and jaw mobility.

OBJECTIVES: This systematic review compared minimally and invasive surgical procedures to manage arthrogenous temporomandibular joint (TMJ). MATERIALS AND METHODS: The review included clinical trials assessing surgical procedures of arthrogenous temporomandibular disorder (TMD) management by carrying out comparisons within the same surgical procedure (pre- and post-treatment) as well as between different surgical procedures. Meta-analyses were conducted only for similar comparison reporting the same outcome measures, visual analog scale (VAS) values to evaluate pain and maximum incisal opening (MIO) values. RESULTS: Of the 1,015 studies identified by the search strategy, 26 were selected for full-text reading, and 19 were included in the review. Of these, 16 studies were included in the meta-analysis and 3 in the qualitative analysis. The VAS scores showed significantly lower values after discectomies (p < 0.001) and discoplasties (p < 0.001) in the within-group comparison. Moreover, significantly lower VAS scores and higher MIO values were observed after discectomy compared to arthroscopy, eminectomy, and discoplasty (p < 0.05). CONCLUSION: The findings of this systematic review suggest that although significantly lower VAS scores and higher MIO values were observed after discectomy, the currently available scientific evidence is unclear, and the use of invasive surgical procedures should not be implemented as an efficient first-line treatment option for arthrogenous TMD management. CLINICAL SIGNIFICANCE: VAS and MIO outcomes could be insufficient to describe the success or failure of open surgical procedures like discectomy and discoplasty.

Prevalence of Abnormal Morphology of the Temporomandibular Joint in Asymptomatic Subjects: A Retrospective Cohort Study Utilizing Cone Beam Computed Tomography.

PURPOSE: This retrospective cohort study in an asymptomatic nonpatient population evaluated the prevalence of specific morphologic changes usually associated with the presence of degenerative joint diseases (DJD) using cone beam computed tomography (CBCT) and examined the associations between DJD and age, sex, and number of teeth present. MATERIALS AND METHODS: CBCT images (268 TMJs) of 134 asymptomatic patients were studied. Patient data were obtained from clinical records, and calibrated examiners interpreted the CBCT images. The presence or absence of traditional radiographic signs of DJD (erosion, generalized sclerosis, osteophytes, and subchondral cysts) in the condyle and articular eminence of each TMJ were evaluated. The data were submitted to bivariate (chi-square and Fisher exact tests) and multivariate (Poisson regression) analyses (α = .05). RESULTS: The sample was primarily composed of men (52.24%) and individuals aged ≥ 61 years (55.64%); 61.94% were partially edentulous with ≤ 12 teeth in the oral cavity. The most common DJD diagnoses were mandibular condyle osteophytes (30.22%) and erosion (12.69%), followed by articular eminence erosion (8.58%) and mandibular condyle subchondral cysts (7.09%). The bivariate analysis showed a statistically significant association between women and subchondral cysts (P = .007), between edentulous individuals and subchondral cysts (P = .008), and between individuals with ≤ 12 teeth and mandibular condyle erosion (P = .005). In the adjusted Poisson regression analysis, a significant association was found between DJD and gender (P = .015). CONCLUSION: Despite the limitations of this study, the results show a high prevalence of morphologic changes usually associated with the presence of DJD in asymptomatic subjects. Osseous TMJ abnormalities were most present in women, individuals with a lower number of teeth, and older individuals.