Microbiological evaluation in invisible aligner chemical cleaning methods against Candida albicans and Streptococcus mutans.

INTRODUCTION: This study aimed to assess the efficacy of chemical agents in removing Candida albicans and Streptococcus mutans biofilm from invisible aligners. METHODS: The samples were made of EX30 Invisalign trays, biofilm was cultured by standardized suspensions of C. albicans ATCC strain and S. mutans clinical strain on the sample. The treatments used were 0.5% sodium hypochlorite (NaClO) (20 minutes), 1% NaClO (10 minutes), chlorhexidine (5 minutes), peroxide (15 minutes), and orthophosphoric acid (15 seconds). The control group received phosphate-buffered saline for 10 minutes. The colony-forming units per milliliter of each microorganism were determined by serial dilutions seeded in plates with selective culture mediums for each one. Data were analyzed by the Kruskal-Wallis and Conover-Iman tests at an α of 0.05. RESULTS: For the C. albicans biofilm group, the control group had 9.7 Log10 of microorganism growth, and all treatment groups had statistically significant biofilm reduction, in which chlorhexidine presented the highest inhibition of 3 Log10, followed by alkaline peroxide and orthophosphoric acid both with 2.6 Log10, 1% NaClO (2.5 Log10), and 0.5% NaClO (2 Log10). As for S. mutans, the control group had 8.9 Log10 of growth, and a total microorganism inhibition was reached by chlorhexidine, 1% NaClO, and orthophosphoric acid, whereas alkaline peroxide inhibited growth to 7.9 Log10 and 0.5% NaClO 5.1 Log10. CONCLUSIONS: Within the limitations, chlorhexidine and orthophosphoric acid had greater efficacy in both biofilms. In addition, 1% NaClO and alkaline peroxide also had significant effects; therefore, their incorporation aligners disinfection protocols are valid.

Evaluation of the masticatory biomechanical function in Down syndrome and its Influence on sleep disorders, body adiposity and salivary parameters.

OBJECTIVE: To evaluate the phenotypic features of the masticatory biomechanics in atypical subjects with Down syndrome (DS). Its influence was analysed on sleep disorders, body adiposity and its risks, and some physicochemical properties of saliva. METHODS: Seventy subjects were enrolled to assess masticatory biomechanical function and divided into two groups: DS and control groups. Electrical activities of the masseter and temporal muscles (at rest and in maximum voluntary clench-MVC), maximum bite force-MBF and maximum mouth opening-MMO were investigated. Among the atypical subjects, just 24 participants underwent the anthropometry, the polysomnography II and the saliva testing (salivary flow rate-SFR, buffer capacity-BC and salivary cortisol levels, morning/SC-AM and night/SC-PM). RESULTS: MVC and MBF values showed high statistical significance in the control group (P < .001) than in the DS group of 35. MMO values were slightly increased in the DS group in relation to the control group. Overweight and obesity were found in both genders. Atypical women showed higher risk to develop cardiovascular-metabolic diseases than in atypical men. OSA severe was 20% for atypical women and 42.8% for atypical men, whereas snoring index was present in all genders. SFR was reduced in 100% of atypical subjects (hyposalivation in 10% women and 28.5% men). Furthermore, 100% BC, 66.6% SC-AM and 91.6% SC-PM showed normal patterns. CONCLUSION: Masseter and temporal muscle hypotonia was found in all atypical subjects with DS. This muscle dysfunction strongly was related to overweight/obesity, risks for development of cardiovascular/metabolic diseases, OSA severity, successive snoring episodes and salivary flow reduction in DS.

Influence of Chronic Alcohol Use on Osteoblastic Differentiation of Bone Marrow Cells, Bone Properties, and Hepatic and Renal Morphology of Rats.

Chronic alcohol exposure can affect the osteoblastic activity and the proliferation and differentiation of cells due to its toxic effect, which can affect negatively bone repair and bone microarchitecture. The aim of this study was to evaluate the effects of chronic use of 20% alcohol on rats regarding osteoblastic differentiation, extrinsic and intrinsic properties of the tibia, and hepatic and renal morphology. Wistar rats were divided into three groups (n = 9) in accordance with a 24-week diet. After euthanasia, kidneys, liver, and tibias were removed for analysis and femurs mesenchymal cells were collected. The results showed that chronic use of 20% alcohol influenced neither the alkaline phosphatase production nor total protein (p > 0.05) in rats, with similar formation of nodules in all groups (p > 0.05). However, significant changes in the liver and kidneys and adverse effects on the mechanical properties of the tibia were observed. According to the results, it can be concluded that the chronic use of alcohol for 24 weeks had no negative influence on the activity and differentiation of osteoblasts, but the mechanical properties of the tibia were impaired and the organs responsible for metabolism and excretion were also affected due to the consumption of alcohol.

Implementation of dental specialty centers: a descriptive analysis of the current status in the Brazilian territory.

This study aimed to assess the current implementation status of Dental Specialty Centers (Centros de Especialidades Odontológicas - CEO) in Brazil. The sample included CEOs implemented up to November 2015 in the 27 Brazilian federative units. Data were obtained directly from the database of the Informatics Department of the Brazilian Unified Health System, according to the National Registry of Health Facilities (NRHF) of Dental Specialty Centers of all Brazilian regions. Primary care data were also collected from the cities with implemented CEOs, including coverage status of the Family Health Strategy (FHS) and number of Oral Health Teams (OHT) I and II, at 2 collection periods (January 2006 and November 2015). There were 1019 CEOs implemented in Brazil, which were unequally distributed among the Brazilian states, with prevalence of implementation of CEOs type II (n=503, 49.4%). The statistical analysis showed significant difference between the three types of CEO (I, II, and III) and the variables of coverage rate (FHS) and number of teams (OHT I, OHT II) at both data collection periods. Although presenting an evolutionary aspect in the implementation of CEOs, the implementation of medium-complexity care in Brazil is disorganized.

Perception, knowledge and attitudes of Brazilian orthodontists on the treatment of Class II malocclusions.

The present study aimed to assess the perception and knowledge of Brazilian orthodontists on the ideal moment to treat Class II malocclusions. Questionnaires with open, semi-open and close questions were sent by e-mail to 1653 Brazilian orthodontists. These orthodontists were registered in the Brazilian Association of Orthodontics and Dentofacial Orthopedics (ABOR). One-hundred and three (9.86%) Orthodontists replied to the questionnaires. Most of them were males (60.5%) with specialization as the highest level of professional qualification (59.9%). Most of the orthodontists (51%) reported preference for treating Class II malocclusions in late mixed dentition, followed by the early mixed dentition (29%). The age range between 10 and 12 years old figured as the most prevalent in patients searching for treatment (42.7%). Most of the patients searching for treatment were females (69.7%). Preferences for functional orthopedic appliances were reported by 35% of the orthodontists. Brazilian orthodontists revealed a trend for treating patients with Class II malocclusions in the late mixed dentition. Female patients aged from 10 to 12 years old represented the majority of patients that search for orthodontic treatment. Functional orthopedic appliances were preferred by Brazilian orthodontists for treating Class II malocclusions.

A scientific survey on 1550 cases of oral lesions diagnosed in a Brazilian referral center.

The present study aimed to perform an epidemiological survey on the prevalence rate of oral lesions diagnosed in a referral center in Brazil and to establish association between the lesions and the age and gender of the affected patients. This analytical observational study analyzed 3521 medical records of anatomopathological exams of the Pathological Anatomy and Cytopathology Laboratory of the Cancer Hospital of the state of Mato Grosso (Brazil), from December 2011 to September 2015. A total of 1550 relevant medical records was detected. Patients aging between 41 and 60 consisted of 42.84% of the sample. Males were more affected than females (60.13%). Inflammatory processess consisted of the most prevalent diagnosis (43.29%), followed by squamous cell carcinoma (6.06%), and periapical granuloma (5.23%). Oral health public policies must give major attention to Brazilian males aged between the fourth and sixth decades of life in order to improve their quality of life.

The influence of non-steroidal anti-inflammatory drugs and paracetamol used for pain control of orthodontic tooth movement: a systematic review.

The present study aimed to perform a systematic literature review to determine if there is a non-steroidal anti-inflammatory drug (NSAID) that interferes less within tooth movement. This research was performed according to the PRISMA statement. Articles were searched in eight electronic databases (PubMed, Scopus, Embase, Web of Science, LILACS, SciELO, Google Scholar, and Open Grey). Only experimental studies on male Wistar rats were selected, which included experiments related to the influence of NSAIDs on orthodontic movement. Studies in animals with pathological conditions, literature review articles, letters to the editor and/or editorials, case reports, abstracts, books, and book chapters were excluded. Each of the steps of this systematic literature review was performed by two examiners independently. RESULTS: the total sample consisted of 505 articles, from which 6 studies were eligible after a qualitative analysis. From the drugs assessed, paracetamol was unanimous for not interfering within orthodontic movement when compared to the control group. However, drugs such as aspirin, ibuprofen, sodium diclofenac, and selective cyclooxygenase-2 inhibitors caused a reduction in tooth movement when compared to the control group. CONCLUSION: paracetamol could be considered the drug of choice for pain relief because it interferes less within tooth movement.

Effect of laser photobiomodulation on the periodontal repair process of replanted teeth.

BACKGROUND/AIM: Tooth replantation is the optimal treatment in cases of avulsion. However, its success is limited due to the occurrence of external root resorption. The aim of this study was to assess the effect of laser photobiomodulation (LPBM) at λ808 nm and λ660 nm and of storage media on the periodontal repair process of replanted teeth in rats. MATERIAL AND METHODS: Sixty maxillary right incisors were extracted from sixty Wistar rats and randomly assigned to six groups (n = 10). Groups consisted of 10 teeth stored in paper napkins (PN), whole milk (WM), and soy milk (SM), for 45 min; and PNL, WML and SML, in which teeth were stored in the same storage media, but the root surface and the alveolus were treated with LPBM at λ808 nm before replantation, and the buccal and palatal mucosa of the alveolus were treated with LPBM at λ660 nm after replantation. Five rats from each group were euthanized after 15 or 30 days. The right hemimaxilla including the replanted incisor was removed and processed for histomorphometric analysis to assess root resorption areas, replacement root resorption, perimeter with ankylosis and periodontal repair, and areas of type I and III collagen deposition, using the ImageJ 1.50b software. Data were analyzed statistically by anova followed by Tukey's multiple comparison test (α = 5%). RESULTS: WM and SM showed smaller root resorption areas and higher collagen deposition in both experimental periods, and SM showed the largest perimeter of periodontal repair. LPBM reduced the occurrence of root resorption only in the PNL group, both at 15 and 30 days, and increased the perimeter of periodontal repair in all groups at 30 days. There was higher collagen deposition in the irradiated groups regardless of the experimental period. CONCLUSIONS: The LPBM protocol at λ808 nm and λ660 nm as well as whole milk and soy milk favored the periodontal repair process of replanted teeth in rats.

Influence of dental chair backrest inclination on the registration of the mandibular position.

STATEMENT OF PROBLEM: Varying the inclination of the dental chair backrest might alter the distribution of occlusal contact points. PURPOSE: The purpose of this study was to identify the influence of backrest inclination on the registration of the mandibular position. MATERIAL AND METHODS: Ten participants aged between 18 and 30 years with a complete permanent dentition, uncompromised motor function, no tooth mobility, and no temporomandibular disorders were selected. To register interocclusal contacts, an autopolymerizing methylmethacrylate device was adapted to the maxillary anterior teeth and a composite resin increment was added to the mandibular central incisors. Contacts were registered with the following variations in the inclination of the dental chair backrest: 90 degrees, 120 degrees, and 180 degrees. A standardized digital photograph was made of each mark in each backrest position, and the images were superimposed to measure the distances in registration from 90 to 120 and from 90 to 180 degrees. Data were analyzed with the Student paired t test (α=.05). RESULTS: When the chair was inclined from the 90-degree to the 120-degree position, the mandible was repositioned posteriorly by a mean of 0.67 mm, but the difference was not statistically significant. When the chair was inclined from the 90-degree to the 180-degree position, however, the mandible was repositioned posteriorly by a statistically significant mean of 1.41 mm. CONCLUSIONS: Mandibular position is influenced by increasing inclination, and this influence was statistically significant at a 180-degree incline.

Conventional and whitening toothpastes: cytotoxicity, genotoxicity and effect on the enamel surface.

PURPOSE: To evaluate the cytotoxicity and genotoxicity of whitening and common toothpastes, and the surface roughness of tooth enamel submitted to brushing with both toothpastes. METHODS: Samples of whitening toothpastes [Colgate Whitening (CW) and Oral-B Whitening (OBW)] and regular (non-whitening) toothpastes (Colgate and Oral-B) were extracted in culture medium. Gingival human fibroblasts (FMM-1) were placed in contact with different dilutions of culture media that had been previously exposed to such materials, and the cytotoxicity was evaluated using the MTT assay. The genotoxicity was assessed by the micronucleus formation assay in Chinese hamster fibroblasts (V79). The cell survival rate and micronuclei number were assessed before and after exposure to the toothpaste extracts. For the surface roughness evaluation, 20 bovine tooth specimens, divided into four groups according to toothpastes, were submitted to 10,000 brushing cycles. The results were analyzed using the Mann-Whitney U and two-way ANOVA tests (P < 0.05). RESULTS: MTT assay showed that Colgate was significantly less cytotoxic than CW, Oral-B and OBW at all dilutions (P < 0.01). CW was the most cytotoxic toothpaste (P < 0.01). The whitening toothpastes showed the highest numbers of micronuclei compared to the untreated control (UC) (P < 0.01). Colgate and Oral-B toothpastes were not genotoxic compared to UC (P = 0.326). The OBW toothpaste was statistically significantly abrasive to the enamel surface (P < 0.01). The whitening toothpastes and Oral-B were cytotoxic to the cells. The whitening toothpastes were more genotoxic to cells in vitro than the common toothpastes, and genotoxicity was more pronounced in the OBW toothpaste.

Influence of vitamin D on muscle strength and botulinum toxin dosage through surface electromyography.

PURPOSE: To evaluate the influence of patients' serum vitamin D levels on muscle strength characteristics and whether it impacts the durability of botulinum toxin (BT) treatment. METHODS: The muscle strength of the frontal and corrugator muscles was evaluated before and after the application of TB with pre- and post-application control measurements, and at weeks 2, 5 and 12. The effect of vitamin D on muscle strength and its interaction with BT were investigated in 20 patients. The muscle contraction force was measured by surface electromyography. RESULTS: The results revealed statistically significant differences between the frontal measurement groups at weeks 2 and 5, as well as for the corrugator in the same weeks and at week 12. Regarding vitamin D, significant differences were observed only in the initial group with vitamin D > 30 ng/mL compared to < 30 ng/mL for the frontal muscles. Patients with higher levels of vitamin D had higher average muscle strength compared to those with lower levels in all evaluations. CONCLUSIONS: It was observed that vitamin D influences muscle strength and the necessary dosage of BT.

Effect of photobiomodulation therapy on pain perception during anesthetic puncture of dental local anesthesia: A systematic review.

BACKGROUND: Local anesthetic puncture is often related to the experience of pain. This study aimed to systematically analyze the literature on changes in pain perception during the anesthetic puncture of dental local anesthesia after Photobiomodulation Therapy (PBMT). MATERIAL AND METHODS: An electronic search was performed in eight primary databases (Embase, LILACS, BBO, LIVIVO, MedLine via PubMed, SciELO, Scopus, and Web of Science) and three additional ones (EASY, Google Scholar, and OATD) to partially capture the "gray literature". The PICO strategy was used to identify randomized clinical trials evaluating the analgesic effect of PBMT in the anesthetic puncture site of dental local anesthesia compared to placebo or control groups, without restrictions on publication language and year. Two reviewers extracted the data and assessed the individual risk of bias of the eligible studies using the Cochrane Collaboration Risk of Bias Tool version 2.0. RESULTS: The electronic search found 3,485 records, of which eight met the eligibility criteria and were included in the qualitative synthesis. The studies were published from 2011 to 2022. None of the included studies had a low risk of bias. PBMT groups showed no significant difference in pain scores compared to placebo and control groups of most studies. CONCLUSION: Based on a low to very low certainty of evidence, PBMT seems to have no effect on pain perception during anesthetic puncture in patients undergoing dental local anesthesia.

Prevalence of condylar morphological changes in individuals with class II malocclusion.

This observational, cross-sectional study with retrospective collection was aimed to evaluate the prevalence of morphological changes in mandibular condyles in individuals with class II malocclusion, classified according to different vertical growth patterns (brachyfacial, mesofacial, and dolichofacial), through cone beam computed tomography (CBCT). Seventy CBCT images (140 mandibular condyles) were selected from individuals without orthodontic treatment, of both sexes, aged between 25 and 50 years. No statistically significant differences were found between facial patterns; however, there was a higher relative prevalence of bone changes in dolichofacial individuals with flattening (62%), sclerosis (44%), and subchondral bone cyst (20%). Erosion and osteophytes prevailed in mesofacial (39%), and brachyfacial individuals (32%), respectively. Thus, there was no statistically significant difference in the prevalence of degenerative changes between the vertical skeletal patterns. Flattening was the most prevalent change, whereas subchondral bone cyst was the least prevalent among the three groups studied. The observational design of this study makes it possible to analyze image banks to verify the correlation of morphological changes in the temporomandibular joint in different facial patterns in patients with class II malocclusion. A limitation of the study is that clinical characteristics were not evaluated.

Macrophage migration inhibitory factor and oral cancer.

BACKGROUND: Macrophage migration inhibitory factor (MIF) is a pleiotropic cytokine with pro-inflammatory functions and involved in tumorigenesis. The aim of this study was to evaluate the expression and localization of the macrophage MIF in oral squamous carcinoma (OSC). In addition, the relationship between MIF expression and clinicopathological parameters such as survival data, tobacco use, alcohol habits, TNM stage, tumor graduation, and peritumoral inflammatory infiltrate were evaluated. METHODS: Using immunohistochemistry, expression and localization of MIF was detected in 44 specimens of OSC. The absolute number and relative proportions of MIF-positive cells detected were also determined separately for tumor parenchyma vs. stroma. All counts were determined from 10 consecutive high-power fields using an integration graticule. Moreover, some parameters were analyzed separately for lip and intra-oral cancers. RESULTS: Migration inhibitory factor-positive cells were observed in both the tumor parenchyma and in inflammatory cells of all specimens. In contrast, MIF expression was not detected in tumoral nests associated with poorly differentiated tumors. In specimens of lip cancer, a greater number of MIF-positive stromal immune cells were detected than in intra-oral cancer specimens (Mann-Whitney test, P = 0.049). CONCLUSIONS: Oral squamous carcinoma cells consistently express MIF independent of their location. Lip tumors presented more MIF-positive peritumoral inflammatory cells, similar to control, suggesting that immunological differences in leukocyte activation exist between in lip and intra-oral cancers.

Efficacy, safety, and potential industry bias in using deoxycholic acid for submental fat reduction ‒ A systematic review and meta-analysis of randomized clinical trials.

Lipolytic substance injections to reduce localized fat have been extensively used because it is a low-invasive method. This review aimed to evaluate the efficacy and safety of deoxycholic acid in submental fat reduction compared to a placebo and investigate the potential industry sponsorship bias in the results of randomized clinical trials on this topic. Ten electronic databases were extensively searched for randomized clinical trials without restriction on language and year of publication. Two reviewers extracted the data and assessed the individual risk of bias in the studies with the RoB 2.0 tool. The industry sponsorship bias was evaluated according to citations in the articles regarding industry funding/sponsorship throughout the texts. Fixed and random effects meta-analyses were performed, and the results were reported in Risk Ratio (RR) at a 95% Confidence Interval (95% CI). The initial search provided 5756 results, of which only five were included. Only two studies had a low risk of bias. All studies showed a potential industry bias. The meta-analysis showed that patients treated with deoxycholic acid had significant positive results for all efficacy outcomes and a higher risk of fibrosis, pain, erythema, numbness, swelling, edema, pruritus, nodules, headache, and paresthesia. The low to moderate certainty of evidence found allows concluding that deoxycholic acid is effective in submental fat reduction, causing well-tolerated adverse effects. However, all eligible studies showed a potential industry bias.

Influence of loading and use of occlusal splint in implant-supported fixed prostheses.

The aim of the study was to assess the tensions generated in the long axis of the implants and the interimplants in the cervical, middle, and apical regions when subjected to different loads with or without interposition of the flat occlusal plane splint. A photoelastic model was made with 2 external hexagon implants located in the space corresponding to the second premolar and molar inferiors. A screw-retained metal superstructure was installed on the implants with a torque of 20 N·cm, and the set (photoelastic model with superstructure) were positioned in the circular polariscope in the dark-field configuration to observe the distribution of isochromatic fringes around the implants and interimplant areas. Photographic records were obtained before the application of the occlusal load with the following loading conditions: 300, 600, and 900 N, with and without interposition of the occlusal plane splint. The decrease in stress with the application of the flat occlusal plane splint became more evident after the application of the 600-N load. Generally, the major stress magnitude occurred in the cervical region for interimplant areas and in the apical region around implants. Use of occlusal splint in the loading of 300, 600, and 900 N reduced tension 33.22%, 66.66%, and 73.33%, respectively, in the samples. It can be concluded that the interposition of the occlusal plane splint caused a reduction in tension resulting from the simulation of occlusal overload.

Tooth embedded in lower lip following dentoalveolar trauma: case report and literature review.

One of the most frequent consequences of trauma to the maxillofacial region is damage to teeth and supporting structures. Such damage can occur either in isolation or in conjunction with other fractures and soft tissue lacerations. In emergency situations, the harm caused to teeth could go unnoticed during the clinical examination, depending on the nature and complexity of the trauma and the primary care team's awareness of orofacial injuries. Fractured incisors often cause lacerations to the soft tissues at the time of trauma. During the diagnosis, particular care must be taken when such a fracture is associated with a soft tissue injury.

Influence of re-using reversible hydrocolloids on the linear alteration of coating models.

Reusing reversible hydrocolloids too many times may cause alterations of the coating model and produce unsatisfactory RPPs. The aim of this study was to analyze the linear alterations of coating models reproduced from molds obtained with two commercial brands of reversible hydrocolloid (RH) with 15 reuse cycles of the material. A metal model was used with 4 marks (A, B, C and D) on which the distances AB, BC, CD, DA, BD and AC could be measured lineally. Ten models were divided into two groups according commercial brand of RH: group VIPI-Duplicator VIPI and group K27--Duplicator K27l. The RH was heated in a microwave oven and poured into a flask containing the model. The mold was filled with the ethyl silicate coating, and after crystallization, refractory models were obtained. This was repeated in the 15 re-use cycles of each RH. The refractory models obtained from the 1st, 5th, 10th and 15th times of re-use of RHs were measured under a measuring microscope. The means were submitted to the Analysis of Variance, Tukey and Dunnet tests, to a 5% level of significance. Group VIPI showed linear alterations in relation to the plaster models, for distances AB (1 use = -1.25% and 5th re-use = -1.20%); AD (1st use = 0.76%, 10th re-use = 0.65% and 15th re-use = 0.52%); BD (1st use = 0.58%). Both commercial brands analyzed produced coating models with acceptable linear alterations in up to 15 reuse cycles, no statistical difference being observed between them.

Impact of bruxism on craniomandibular morphology: A cone-beam computed tomographic study.

OBJECTIVE: The main goal of this work was to address craniomorphological characteristics of patients with bruxism when compared to those without bruxism using cone beam computed tomography (CBCT) imaging. METHODS: Seventy CBCT images of an equal number (n = 35) of orthodontic patients with and without bruxism (age range, 18-44 years) were retrospectively analyzed. Sagittal evaluation, mandibular shape, and skeletal asymmetry were systematically assessed in both groups. RESULTS: Significant differences (p < 0.05) were observed between groups for Right Articular Fossa (AF) - Axial Plane (AP) and Left AF - AP (B > NB), Right Gonial Angle (GA), Left GA, Sella-Nasion and Occlusal Plane (B < NB). Age (13%), Condyle-Gonion (18%), AF to AP (67%), and Mental-AP (16%) had the greatest impact on bruxers. CONCLUSION: In this study, the CBCT 3D image showed significant differences in craniofacial morphology, particularly in the mandibular structure of bruxers compared with non-bruxers.

Down syndrome: orofacial pain, masticatory muscle hypotonia, and sleep disorders.

The aim of the present study was to investigate orofacial pain in individuals with Down syndrome (DS) and determine possible associations with masticatory muscle hypotonia (MMH), maximum mouth opening (MMO), and sleep disorders. Twenty-three individuals with DS underwent a standardized clinical examination using Axis I of the Diagnostic Criteria for Temporomandibular Disorders, for the diagnosis of pain in the masseter and temporal muscles and temporomandibular joint (TMJ). MMH was investigated using electromyography of the temporal and masseter muscles and the measurement of maximum bite force (MBF). MMO was measured using an analog caliper. Sleep disorders (obstructive sleep apnea [OSA], snoring index [SI], and sleep bruxism index [SBI]) were investigated using type II polysomnography. Statistical analysis was performed. Nonsignificant differences were found in muscle and TMJ pain between the sexes. However, myalgia and referred myofascial pain in the left masseter muscle were more frequent in males (69%) than females (40%). Electrical activity of the temporal (left: p = .002; right: p = .004) and masseter (left: p = .008) muscles was significantly lower in males than in females. MBF range was lower in males than females, indicating the highest MMH among males. OSA, SI, and SBI were identified in both sexes, but with no statistically significant differences. We concluded that myalgia and referred myofascial pain were found in some individuals with DS, especially in males. Arthralgia was found mainly in females. Temporal and masseter myalgia may have exerted an influence on the severity of MMH in males, particularly on the left side.