ISSN : 0376-4672
Pediatric sleep-disordered breathing(SDB) is a common sleep disorder in children caused by obstruction of upper air way during sleep. It is often unrecognized early in life and causes various complications, including abnormal craniofacial growth and oral muscle dysfunctions. Dentist can play a significant role in managing SDB by early screening SDB risk factors and timely referring for diagnosis. SDB risk factors can be easily screened in dental office through medical history, sleep history, physical factors, sleep questionnaire, and cephalometric x-ray. In case of abnormal craniofacial development, rapid maxillary expansion, oral appliances, and myofunctional therapy can be used to reduce SDB symptoms and restore normal craniofacial development and muscular tones. Understanding continuous interaction between oral-facial muscle tone, maxillary-mandibular growth and development of SDB is important in managing pediatric SDB. The ultimate goal of pediatric SDB treatment is to change mouth breathing to nasal breathing, and a multidisciplinary approach in medicine and dentistry is necessary
Signs and symptoms of Temporomandibular disorder(TMD) may appear before, during, or even after orth odontic treatment. It is recommended for all patients who visit clinics for orthodontic treatment to check the presence or absence of symptoms through a simple TMD evaluation and inform them of the results in advance. Also, modifying the orthodontic treatment strategy depending on the presense of TMD is beneficial to patients. In patients with weak physiologic tolerance who initially have no signs or symptoms of TMD, signs or symp toms may develop if the temporomandibular joint complexes fail to adapt to the changes following orthodontic treatment. To this end, periodic TMD inspections should be continued throughout treatment period and appro priate medical interventions for the temporomandibular joint should be performed. In addition, patients should be informed that it may be necessary to receive TMD treatment after stopping orthodontic treatment when TMD symptoms occur during orthodontic treatment, and that orthodontic treatment can be resumed when symptoms improve.
Osteoarthritis (OA) is common disease that can lead to severe pain and dysfunction in any joint, including the temporomandibular joint (TMJ). The treatment strategy for TMJ OA aims at reducing pain, preventing the progression of condylar bone destruction, and restoring joint function. Conservative therapy including nonste roidal anti-inflammatory drugs, occlusal splint, and physical therapy, and arthrocentesis are the most common treatments for TMJ OA. These therapies are effective in most cases in relieving the signs and symptoms.
Temporomandibular joint Osteoarthritis (TMJ OA) is a subtype of temporomandibular disorders (TMDs) and refers to a debilitating degenerative disorder involving inflammatory conditions accompanying bone changes of the TMJ. Once the physical load exceeds physiologic resistance of TMJ, gradual damage to the cartilage layer occurs and leads to bone destruction with various signs and symptoms related to the defect of adjacent tissues. TMJ OA is a relatively common phenomenon, not only in patients complaining of TMJ symptoms, but also found incidentally through radiographs taken for any other dental treatments. TMJ OA is known to be more common in women and related to age closely, but the results of the studies are inconsistent. Deformity of the TMJ condyle due to OA can be easily confirmed with radiography and diagnosis is becom ing more effective with the development of imaging modalities such as computed tomography. Also, as osseous changes of TMJ OA cause dysfunction of TMJ due to pain and/or restriction of motion and eventually can lead to irreversible changes in occlusion and facial morphology, accurate and in-depth understanding based on sci entific evidence is essential for dentists. Therefore, this review on the basis of the documents published so far will describe the pathophysiologic mechanisms, epidemiology and diagnosis of TMJ OA.
