L' Orthodontie francaise最新文献

{"title":"[Obstructive Sleep disordered breathing, sleep bruxism and periodontal diseases].","authors":"M. Carra","doi":"10.1684/orthodfr.2019.190023","DOIUrl":"https://doi.org/10.1684/orthodfr.2019.190023","url":null,"abstract":"Sleep disordered breathing (SDB) may be associated with sleep bruxism and periodontal diseases. Through a review of the current literature, this article aims to describe the characteristics of sleep bruxism and its relationship with SDB as well as the current evidence supporting an association between periodontal diseases and SDB. Sleep bruxism is characterized by muscle clenching and tooth grinding during sleep, typically during N2 sleep stage and in association with micro-arousals. The probability of observing sleep bruxism is almost 4 times higher in the presence of SDB, with a close temporal relationship between the episode of upper airway obstruction or oxygen desaturation and the episode of bruxism, which most often occurs in the 0-10 seconds following the obstruction. These findings support the hypothesis that sleep bruxism is triggered by SDB and may have a \"protective\" role being a muscular activity that helps restore the permeability of the upper airways. On the other hand, SDB have been linked to periodontal diseases. Periodontal diseases are inflammatory and dysbiotic disorders that can have a negative impact on oral health (leading to the destruction of the periodontium and tooth loss) and on general health. Recently, it has been observed that SDB patients have a 1.6 to 4-fold higher risk of having or developing severe periodontitis, suggesting that SDB may be a new risk factor for periodontal diseases. Dentists, who are part of the team of sleep medicine specialists, have a key role in the detection, prevention and treatment of SDB and their relationship with sleep bruxism and periodontal diseases.","PeriodicalId":299509,"journal":{"name":"L' Orthodontie francaise","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121584906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The beacon of obstructive sleep-disordered breathing has gone out. Foreword].","authors":"P. Amat","doi":"10.1684/orthodfr.2019.190037","DOIUrl":"https://doi.org/10.1684/orthodfr.2019.190037","url":null,"abstract":"","PeriodicalId":299509,"journal":{"name":"L' Orthodontie francaise","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125301336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Etiological treatment of Obstructive Sleep Apnea].","authors":"J. Talmant, J. Talmant, J. Deniaud, P. Amat","doi":"10.1684/orthodfr.2019.190021","DOIUrl":"https://doi.org/10.1684/orthodfr.2019.190021","url":null,"abstract":"Research in the field of Obstructive Sleep Apnea (OSA) has been organized, and has profoundly transformed the quality of life of apneic patients, while even inviting dentofacial orthopedists to contribute to their symptomatic treatment. However, among the points still to be elucidated, the initial cause of the snoring that destabilizes the pharynx occupies a place apart. The objective of this article was to develop the proposal by Jacques Talmant regarding a mechanism capable of explaining the onset of OSA and for a therapy to treat pharyngeal destabilization during sleep. Based on published data, the etiopathogenesis of snoring and its consequences are described. Structural changes secondary to the vibratory trauma caused by snoring can affect each component of the pharyngeal structures and contribute to the collapsibility of this airway segment. By directly optimizing the development of ventilatory capabilities in their patients, orthodontists contribute, indirectly, to optimizing their cardiovascular and neuropsychological functions.","PeriodicalId":299509,"journal":{"name":"L' Orthodontie francaise","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128229002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The contribution of orofacial myofunctional reeducation to the treatment of obstructive sleep apnoea syndrome (OSA): a systematic review of the literature].","authors":"P. Amat, É. Tran Lu Y","doi":"10.1684/orthodfr.2019.190035","DOIUrl":"https://doi.org/10.1684/orthodfr.2019.190035","url":null,"abstract":"Obstructive sleep apnoea syndrome (OSA) is a widespread and under-diagnosed condition, making it a major public health and safety problem. Orofacial myofunctional reeducation (OMR) has been shown to be effective in the multidisciplinary treatment of OSA in children, adolescents and adults and is prescribed at several stages of OSA management. The main objective of this systematic literature review was to evaluate the effectiveness of active or passive orofacial myofunctional reeducation (OMR) in the treatment of obstructive sleep apnoea syndrome in children, adolescents and adults. The systematic literature review was undertaken from the three electronic databases: Medline (via PubMed), Cochrane Library, Web of Science Core Collection, and supplemented by a limited grey literature search (Google Scholar) in order to identify the studies evaluating the effectiveness of the OMR on OSA. The primary outcome of interest was a decrease in the Apnea-Hypopnea Index (AHI) of at least five episodes per hour compared to the baseline state. Secondary outcomes were an improvement in subjective sleep quality, sleep quality measured by night polysomnography and subjectively measured quality of life. Only ten studies met all the inclusion criteria. Eight were randomized controlled clinical trials, one was a prospective cohort study and another was a retrospective cohort study. Six studies were devoted to adult OSA and four to pediatric OSA. All included studies were assessed as \"low risk of bias\" based on the 12 bias risk criteria of the Cochrane Back Review Group. Based on the available evidence, RMO allows a significant reduction in AHI, up to 90.6% in children and up to 92.06% in adults. It significantly reduces the intensity and frequency of snoring, helps reduce daytime sleepiness, limits the recurrence of OSA symptoms after adenoamygdalectomy in children and improves adherence to PPC therapy. Passive RMO, with the assistance provided to the patient by wearing a custom orthosis, increases adherence to reeducation, significantly improves snoring intensity, AHI and significantly increases the upper airway. Published data show that orofacial myofunctional rééducation is effective in the multidisciplinary treatment of OSA in children, adolescents and adults and should be widely prescribed at several stages of OSA management. Passive RMO, with the pearl mandibular advancement orthosis designed by Michèle Hervy-Auboiron, helps to compensate for the frequent non-compliance observed during active RMO treatments.","PeriodicalId":299509,"journal":{"name":"L' Orthodontie francaise","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125786965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[OSA in adults: Role of the mandibular advancement device (MAD)].","authors":"I. Dupuy-Bonafé, Cindy François, V. Lachiche, Manon Castel, G. Duminil","doi":"10.1684/orthodfr.2019.190024","DOIUrl":"https://doi.org/10.1684/orthodfr.2019.190024","url":null,"abstract":"Mandibular advancement devices are an alternative to continuous positive airway pressure for patients with mild or moderate obstructive sleep apnea/ hypopnea syndrome (OSA). Oral appliances advance the mandible and tongue, enlarge and stabilize the upper airways during sleep. Clinical examination is used to select candidates for oral appliances and a particular appliance for a given patient. Titration of the advancement will optimize its effectiveness by resolving subjective clinical symptoms. Polygraphic or ventilatory polysomnography controls the effectiveness of the treatment (IAH reduction, increase of oxygen saturation and improvement of the main symptoms). Clinical follow-up is required to assess longterm outcomes, side effects and treatment adherence. Oral appliances are effective in the short-term provided they achieved a 50% reduction in IAH and complete symptom resolution.","PeriodicalId":299509,"journal":{"name":"L' Orthodontie francaise","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122077230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical treatment for sleep disorders breathing in children and teenagers].","authors":"Julien Briffod","doi":"10.1684/orthodfr.2019.190022","DOIUrl":"https://doi.org/10.1684/orthodfr.2019.190022","url":null,"abstract":"Adenotonsillectomy is the standard surgery for moderate and severe sleep disorders breathing (SDB) in 2 to 6-year-old children, often due to tonsillar and adenoidal hypertrophy. Recently, partial subtotal intracapsular tonsillotomy has been developed to prevent risks linked to surgery, especially haemorrhages leading to death in extreme cases. Children with apnea, poor quality of life (sleep problems, daytime tiredness), poor academic performance or late growth are candidates for adenotonsillectomy. The management of children with mild SDB is still evolving. Adenotonsillectomy is usually not recommended for adenoidal hypertrophy. Treatment options with mild OSA include watchful waiting, inhaled nasal corticosteroids, and adeno-tonsillectomy. The treatment decision should be made after a discussion between the patient, caregivers and the surgeon regarding the risks and benefits of possible therapies. The surgical procedure is efficient in more than 75% of cases. Close clinical follow-up is necessary, especially in obese children. Primary and secondary haemorrhaging, as well as postoperative pain, are considerably reduced in partial tonsillotomy. Tonsillotomy (intracapsular or subtotal tonsillectomy) is a modern technique because it has been suggested that perioperative pain and postoperative haemorrhage are reduced with the tonsillotomy technique. There is no significant difference in subjective outcome between tonsillotomy and tonsillectomy. These findings may support wider use of tonsillotomy for the treatment of sleep disorders breathing in children. Children with residual disorder may be candidates for surgical procedures such as nasal disobstruction, pharyngoplasty, lingual tonsillectomy or maxillofacial surgery.","PeriodicalId":299509,"journal":{"name":"L' Orthodontie francaise","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133012865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Sleep-related breathing disorders in adults: diagnosis, consequences and comorbidities].","authors":"C. Philippe","doi":"10.1684/orthodfr.2019.190031","DOIUrl":"https://doi.org/10.1684/orthodfr.2019.190031","url":null,"abstract":"Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a collapse of the upper airways leading to a decrease (hypopneas) or interruption of air flow (apneas). Since its identification, only forty years ago, definitions, diagnostic techniques have evolved, the consequences of this syndrome have been widely studied but establishing it as an independent cardiovascular (CV) risk factor has come up against the existence of many confounding factors, such as obesity, high blood pressure (hypertension)… Paraclinical diagnosis is based on the results of poly(somno)graphy. Recommendations on measurement techniques and scoring are regularly published, evolving in parallel with technological progress, with the aim of standardizing and ensuring the reliability of the diagnosis. At the same time, large cohort studies were set up in the 1990s, allowing for transversal and longitudinal follow-up of thousands of patients. Finally, the pathophysiological mechanisms of the consequences of SAHOS were explored. OSA has been shown to be responsible for a particularly high accidental risk due to sleep fragmentation induced by abnormal respiratory events. It has been possible to establish an independent statistical relationship between SAHOS and CV diseases, metabolic disorders and more recently cancer, mainly explained by intermittent hypoxia. OSAHOS is a frequent disease, diagnosed on the basis of clinical signs and poly(somno)graphy, now established as an independent risk factor for morbidity and mortality (accidental and CV).","PeriodicalId":299509,"journal":{"name":"L' Orthodontie francaise","volume":"436 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133497673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Upper airways: tridimensional analysis and effect of treatment by functional appliances].","authors":"M. Cornelis, P. Cattaneo","doi":"10.1684/orthodfr.2019.190020","DOIUrl":"https://doi.org/10.1684/orthodfr.2019.190020","url":null,"abstract":"This article revolves around three questions summarizing the main lines of research into the upper airways conducted at Aarhus University. 1. Can the upper airway be reliably evaluated by Cone Beam CT (CBCT)? 2. Is there a link between airway dimension and craniofacial morphology? 3. Do functional appliances increase the volume of the upper airway? 1. The CBCTs of 34 patients were used for this three-dimensional assessment of the upper airway, comparing linear measurements, surfaces and volumes. 2. CBCTs of 90 healthy adults with skeletal class I, II or III were compared. The dimensions of the upper airway were correlated with the cephalometric measurements in 3D. 3. A retrospective CBCT study investigated changes in the upper airway after functional appliance therapy in 20 patients. 1. The upper airway cannot be correctly described using linear measurements. 2. No correlation could be identified between the size and morphology of the upper airway and the morphology of sagittal skeletal class I, II or III malocclusions. 3. An increase in volume of the upper airway was observed after treatment with functional appliances, mainly at the level of the oropharynx. A three-dimensional analysis by CBCT gives a better representation of the anatomical characteristics of the upper airway. This type of 3D analysis revealed a positive effect of treatment by functional appliances on the oropharynx in healthy, growing patients.","PeriodicalId":299509,"journal":{"name":"L' Orthodontie francaise","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127638134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Benef its of innovation in orthognathic surgery for OSA].","authors":"A. Kerbrat, J. Kerbrat, M. N’diaye, P. Goudot, T. Schouman","doi":"10.1684/orthodfr.2019.190026","DOIUrl":"https://doi.org/10.1684/orthodfr.2019.190026","url":null,"abstract":"Obstructive sleep apnea (OSA) is a common, multifactorial disease resulting in high morbidity and mortality. Gold standard treatment is nocturnal positive airway pressure. Maxillomandibular advancement is a surgical technique used to treat obstructive sleep apnea. Development of guided surgery has modified patient care in cases of maxillomandibular dysgnathia. Two case reports illustrate the impact of new technologies on surgical treatment of this condition. New technologies such as the recent development of surgical guides help surgical management.","PeriodicalId":299509,"journal":{"name":"L' Orthodontie francaise","volume":"144 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124887428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Medical treatment of obstructive sleep-disordered breathing in children and adolescents].","authors":"M. Vecchierini","doi":"10.1684/orthodfr.2019.190027","DOIUrl":"https://doi.org/10.1684/orthodfr.2019.190027","url":null,"abstract":"Obstructive sleep disordered breathing (OSDB), in children and adolescents, need to be treated quite soon to avoid complications. A paediatrician, a sleep specialist, an orthodontist, an ENT and a myofunctional therapist will examine together the children with OSDB and determine the best personalised surgical and medical treatments for each of them. Only medical treatments are reviewed in this article. An international consensus recommended adenotonsillectomy as the first line therapy in young with OSDB. Usually adenotonsillectomy is combined with several important adjunctive medical treatments. Overweight and obesity frequent in adolescents, worsen OSDB and increase persistent OSDB after adenotonsillectomy. Weight loss is obtained by dietary restriction, physical activity, psychological support and sleep hygiene rules. Anti-inflammatory drugs (corticosteroids and leukotriene receptor antagonists) have shown their efficacy in children with moderate OSDB. Orthodontic treatments, rapid maxillary expansion or oral appliance, are used in selected patients according to their maxillo-facial disturbances in adjunction to adenotonsillectomy. Nasal CPAP is rarely useful except in severe OSDB specially in persistent OSDB after adenotonsillectomy. Finally, active or passive, myofunctional therapy is, according to some authors, an indispensable adjunct treatment to avoid persistent OSDB after adenotonsillectomy. These personalized medical treatments of OSDB are either administered jointly with adenotonsillectomy or in a hierarchal order.","PeriodicalId":299509,"journal":{"name":"L' Orthodontie francaise","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132493003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}