Florent Destruhaut

Study Objectives: Obstructive sleep apnoea (OSA) is a prevalent sleep disorder with significant health implications. While complete edentulism has been associated with an increased OSA risk, the relationship with partial edentulism remains unclear. This study aimed to investigate the role of dental formula in OSA severity and mandibular advancement device (MAD) therapy outcomes. Methods: A retrospective study initially included 560 patients diagnosed with OSA by polysomnography (PSG). A subset of 75 patients was selected for analysis based on predefined inclusion criteria. Dental parameters were assessed using baseline orthopantomograms. Objective treatment outcomes were evaluated using baseline PSG and repeat PSG with MAD after 3 months of therapy. Differences in OSA severity and MAD treatment outcomes were analysed, and dental parameters were correlated between groups. Results: The median baseline apnoea–hypopnoea index (AHI) significantly reduced from 27.82 ± 16.77 to 15.51 ± 13.33 following MAD therapy. Partial edentulism parameters did not differ significantly or correlate with baseline OSA severity. However, a correlation was observed between the number of missing teeth and reassessed AHI (rAHI), and an inverse correlation between the masticatory coefficient and rAHI was also noted. Mandibular edentulism—primarily unilateral or bilateral posterior—was positively correlated with MAD treatment outcomes. Conclusion: This study demonstrates a correlation between edentulism parameters and MAD treatment outcomes in patients with OSA. Collaboration between dentists and sleep medicine specialists is crucial for comprehensive OSA management, including oral health assessment. Trial Registration: After evaluation and validation by the data protection officer and according to the General Data Protection Regulation, this study met all the criteria and was registered in the register of data study of the Toulouse University Hospital (Register Number: RnIPH 2023–81) and covered by the MR‐004 (CNIL Number: 2206723 v 0). This study was approved by Toulouse University Hospital and confirmed that ethical requirements were fully met in the above report.

The purpose of this clinical report was to describe the use of a piezographic impression associated with computer-aided design and computer-aided manufacturing (CAD-CAM) for teeth setup and of digital tools for neuro-musculo-kinetic analyses. An edentulous patient with hemiglossectomy and heavily resorbed mandible consulted for complete denture rehabilitation to improve their masticatory function and speech. Master casts, wax rims, and piezographic impression were scanned for digital prosthetic work. Two digital try-ins were performed to respect the neutral zone: try-in 1 with posterior crossbite and try-in 2 without crossbite. Muscle activity and mandibular kinetics were performed for each try-in following the MAC2 protocol (six criteria): muscular tone, contraction synchrony, contraction efficiency, interocclusal rest distance, amplitude of mandibular movement, and velocity. Try-in 2 showed better data than try-in 1 in all criteria: muscle tone (respectively 71% vs. 59%), contraction synchrony (79% vs. 75%), contraction efficiency (85% vs. 77%), an increase in range of motion of 3.3 mm, and a better velocity (0.35 +/- 0.12 s vs. 0.57 +/- 0.14 s, p = 0.008). The piezographic impression, in combination with CAD-CAM, allowed the comparison of two prosthetic designs and the selection of the try-in with the best neuro-musculo-kinetic results.

Introduction. The objective of this study was to establish a baseline of current use in practice of the Canadian Occupational Performance Measure (COPM) by consulting 33 expert French occupational therapists, who trained in this method between 2012 and 2017 and use of the COPM with their clients. The areas of health intervention are pediatrics, psychiatry, neurology, and geriatrics. An email invitation to participate in the research was therefore sent to 113 occupational therapists. We received 33 responses. Methods. A novel mixed method study combined a Delphi method with a lexical analysis of experts responses and principal component analysis (PCA). Results. In the last Delphi round, the consensus of the expert group was attained on 31 benefits and 1 limitation, confirming the generally positive influence of the COPM in French health services. Discussion. The COPM was clearly identified as a tool that supports occupational therapy clinical reasoning, facilitates team decision-making for care pathways, and enables people with disabilities and health conditions to make decisions for their care. Conclusion. The Delphi study revealed that the COPM appears to be well adapted to French culture and should be widely incorporated into preregistration training.

The reconstruction of cephalic defect and more precisely from the face is not a recent issue. Indeed, the use of facial masks in a symbolic perspective was reported in ancient Egypt. Few references to facial prostheses are then found. It is really only with the work of the French surgeon Ambroise Paré that the first surgical techniques concerning facial epithetics are described. Techniques and materials tend to evolve over the centuries. But then came WWI, which marked a major turning point and brought to light the broken faces and the impact of maxillofacial trauma. Rehabilitation became a major issue in society. The war was a driving force for change from both a surgical and prosthetic point of view, revealing in particular such brilliant designers as the American sculptor Anna Coleman Ladd. Today, the profession is undergoing a major upheaval, linked to the growing development of biotechnological constructions. This historical review aims to retrace the evolution of the rehabilitation of facial substance loss over the ages and to outline the prospects for the foreseeable future. (Int J Maxillofac Prosthetics 2021;4:2-8)

Lateral segmental mandibulectomy can be associated with sequelae, such as mouth opening limitation and mandibular deviation, that lead to altered oral functions (chewing, swallowing, speech) and complex prosthetic management. The authors present a new protocol for surface electromyography (sEMG) and mandibular motion recording to help clinicians with decision-making and dental prosthetic treatment planning for segmental mandibulectomy. The clinical case of a patient with a reconstructed titanium endoprosthesis is presented. The MAC2 protocol is used and consists of chronologically performing various recordings by using a device for sEMG and mandibular tracking. During the orofacial reeducation and dental prosthetic reconstruction, three therapeutic steps can benefit from the MAC2 protocol: to analyze the initial muscular imbalance, to provide guidance in the choice of maxillomandibular relationship and to quantify the functional improvement. sEMG of masticatory muscles is a useful diagnostic tool in a context of mandibular kinematic disorders and the MAC2 protocol adds some guidance for dental prosthetic rehabilitation in the context of segmental mandibulectomy. (Int J Maxillofac Prosthetics 2021;4:47-54)

Maxillofacial prostheses now benefit from the growing advances in converging technologies, such as nanotechnologies, biotechnologies, informatics and cognitivism (NBIC). Instead of being laid and passive, prostheses can now ensure true neurophysiological interactions with their wearers through complex phenomena of hybridization and vicariance. These new devices get closer to “maxillofacial amplification prosthesesâ€, by improving the world perception through restored sensory properties and new extra-sensory properties. These technological devices also benefit from the bioengineering revolution that will soon allow the bioprinting of graft prostheses with an intimate integration to the organic maxillofacial support. In this article, the authors would like to present some major advances in cyborgology and bio-printing in maxillofacial hybridization contexts. (Int J Maxillofac Prosthetics 2019;1:20-26)

Objectives: The primary aim of this work was to determine the duration of ultra-low-frequency transcutaneous electrical nerve stimulation (ULF-TENS) application necessary to achieve sufficient relaxation of the masticatory muscles. A secondary aim was to analyze the influence of stimulation on muscle relaxation in pathological subjects and determine whether ULF-TENS has a noteworthy impact on muscle relaxation. Methods: Sixteen adult subjects with temporomandibular disorders (TMD) and muscle pain and a group of four control subjects were included in this study. ULF-TENS was applied, and muscular activities of the masseter, temporal, and sternocleidomastoid muscles (SCM) were recorded for 60 min. Results: Significant relaxation was achieved in the TMD group from 20, 40, and 60 min for the temporal, masseter, and SCM muscles (p < 0.05), respectively. Maximum relaxation was achieved in 12.5% of the subjects after 20 min, in a further 12.5% after 40 min, and in the remaining 75% after 60 min. Significant relaxation was achieved in the control group from 20 to 40 min for the masseter and temporal muscles, respectively (p < 0.05). Discussion: Taken together, the results suggest that an ideal ULF-TENS application would last 40 min to obtain sufficient muscle relaxation both in patients with masticatory system disorders and healthy subjects, a time constraint that is consistent with everyday clinical practice.