Effects of respiratory exercises in sleep bruxism and associated obstructive sleep apnea: a double-blind, placebo-controlled randomized clinical trial.

PURPOSE: The aim of this study is to assess the effects of respiratory exercises (inspiratory and expiratory) in individuals with sleep bruxism (SB) and associated obstructive sleep apnea (OSA). METHODS: This is a double-blind, placebo-controlled randomized clinical trial including individuals with SB and associated respiratory events in OSA. Respiratory physical therapy was performed using inspiratory (Threshold® IMT), expiratory (Threshold® PEP) muscle training, and compared with a placebo group. A total of 30 daily respiratory cycles (inspiration and expiration) were performed five times a week for 12 weeks. Individuals were reassessed at two times, at baseline (T1) and after 12 weeks of training (T2) by means of the Pittsburgh Sleep Quality Index and Polysomnography. RESULTS: Awakening was significantly different (p ≤ 0.05) between the inspiratory group and placebo 12 weeks after respiratory physical therapy. The number of contractions of the masseter muscle differed between the inspiratory, expiratory, and placebo groups (p ≤ 0.05). CONCLUSION: Respiratory physical therapy for OSA improved awaking levels in 80 and 67% of the number of masseter muscle contractions, when compared to placebo. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (No. RBR-9F6JKM).

Effectiveness of educational programs in hearing health: a systematic review and meta-analysis.

OBJECTIVE: To evaluate the effectiveness of hearing health education programs aimed at preventing noise-induced hearing loss (NIHL), of recreational and occupational origin, by means of a systematic review and meta-analysis. DESIGN: The search strategy was carried out in on five electronic databases, as well as referrals from experts. The risk of bias was judged, and the random effects meta-analysis was performed. The certainty of the evidence was assessed. STUDY SAMPLE: Effectiveness studies that used educational intervention in hearing health and prevention of NIHL were included. RESULTS: 42 studies were included. The Dangerous Decibels program was the only one that could be quantitatively analysed and showed improvement in the post-intervention period of up to one week [SMD = 0.60; CI95% = 0.38-0.82; I2 = 92.5%) and after eight weeks [SMD = 0.45; CI95% = 0.26-0.63; I2 = 81.6%) compared to the baseline. The certainty of evidence was judged as very low. CONCLUSIONS: The Dangerous Decibels program is effective after eight weeks of intervention. The other programs cannot be quantified. They still present uncertainty about their effectiveness. The level of certainty is still low for this assessment.

Auditory and Vestibular Findings in Brazilian Adults Affected by COVID-19: An Exploratory Study.

INTRODUCTION: The aim of the study was to describe auditory and vestibular findings in Brazilian adults after COVID-19 in a municipality from the outskirts of the São Paulo state. METHODS: This was a transversal and exploratory study comprising sixteen participants infected by the SARS-CoV-2 virus, confirmed through RT-PCR detection, aged 20 to 55 years. Subjects underwent anamnesis, vestibular and auditory testing. Fisher's exact test was used to evaluate medication use, chemical and physical exposure, and occupational risk and McNemar test was used to compare auditory and vestibular symptoms pre- and post-COVID-19. RESULTS: Most patients were women (75%) and had been exposed to the virus over 90 days before testing (50%). 18.8% used hydroxychloroquine, 68.8% used ivermectin, and 87.5% used azithromycin to treat COVID-19. Auditory complaints were reported by 31.2% and vestibular by 18.7%. There was no statistical difference before and after the disease. Other reported symptomatology was hair loss, pain, fatigue, memory loss, difficulty to concentrate, and headache. Auditory findings were relevant in contralateral acoustic reflex, in the distortion-product otoacoustic emissions, and in the brainstem auditory evoked potential, characterizing a neurosensorial compromise. 43.74% of patients had altered vectonystagmography. When comparing both ears, no statistical relevance was found; however, when results were crossed with medication use and exposures, there was statistical relevance in the amplitude of the V wave for medications and absolute latency of the V wave to exposure to physical agents. DISCUSSION/CONCLUSION: This study demonstrated auditory and vestibular findings of neurosensorial nature, considering hearing and of a peripheral vestibulopathy. As it is a study of transversal nature, it is not possible to extend results to general population; yet it may be a finding to future studies.

Comparison of orthodontic root resorption of root-filled and vital teeth: A meta-analysis.

BACKGROUND: In this systematic review, the authors aimed to answer the following question: Do vital teeth differ in the level of external root resorption induced by means of orthodontic treatment compared with root-filled teeth? TYPES OF STUDIES REVIEWED: The search strategy was performed in 6 electronic databases and in gray literature for articles published until July 29, 2021. Two reviewers independently assessed potentially eligible studies according to the following criteria: studies that evaluated patients undergoing fixed orthodontic therapy and compared the mean difference in millimeters of orthodontically induced external root resorption in endodontically treated teeth with the vital contralateral tooth. Only randomized, quasi-randomized, nonrandomized, cohort, case-control, or cross-sectional studies were considered eligible. There were no restrictions on language or publication time. Two reviewers also independently extracted data on the characteristics of the included studies, methods, and results, and performed risk-of-bias analysis using the Meta-Analysis of Statistics Assessment and Review instrument. Estimates of interest were calculated using random-effects meta-analyses. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS: Eleven studies were included in the quantitative synthesis. Endodontically treated teeth had a lower level of root resorption (mean difference, 0.45 mm; 95% CI, -0.69 to -0.21 mm). However, the level of certainty of the evidence was considered very low owing to confounding factors. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Endodontically treated teeth may have a lower level of orthodontically induced root resorption than vital teeth, but the evidence is still uncertain about this outcome. Furthermore, owing to the small effect size, this difference might not be clinically significant (up to 1 mm).

Effect of fluoxetine on induced tooth movement in rats.

INTRODUCTION: Fluoxetine is a widely used antidepressant. Its various effects on bone mineral density are well described. The aim of this study was to evaluate the effect of fluoxetine on induced tooth movement. METHODS: Seventy-two Wistar rats were divided into 3 groups: M (n = 24; 0.9% saline solution and induced tooth movement), FM (n = 24; fluoxetine, 10 mg/kg, and induced tooth movement), and F (n = 24; fluoxetine, 10 mg/kg only). After 30 days of daily saline solution or fluoxetine administration, an orthodontic appliance (30 cN) was used to displace the first molar mesially in groups M and FM. The animals were killed 3, 7, and 14 days after placement of the orthodontic appliances. The animals in group F did not receive induced tooth movement but were killed at the same times. We evaluated tooth movement rates, collagen neoformation rates by polarization microscopy, numbers of osteoclast by tartrate-resistant acid phosphatase, and trabecular bone modeling by microcomputed tomography of the femur. RESULTS: The tooth movement rates were similar in groups M and FM at all studied time points (P >0.05). The rate of newly formed collagen had a reverse pattern in groups M and FM, but the difference was not statistically significant (P >0.05). There were significantly more osteoclasts in group FM than in group F on day 3 (P <0.01). The trabecular spacing was significantly larger in group F compared with group M on day 14 (P <0.05). CONCLUSIONS: Fluoxetine did not interfere with induced tooth movement or trabecular bone in rats.