Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: Part 2. Study-model analysis

http://diposit.ub.edu/dspace/bitstream/2445/110752/1/561199.pdf

Relationship between chewing side preference and handedness and lateral asymmetry of peripheral factors.

This study investigated the prevalence of a preferred chewing side (PCS) and associations between a PCS and signs of temporomandibular disorders (TMD), antagonist contact and prosthetic restoration. A population representative sample of 4086 adults of the cross-sectional epidemiologic 'Study of Health in Pomerania' (SHIP-0) (age range 20-80 years, female 50.2%) was divided in two groups by the presence or absence of a PCS. PCS was evaluated by a questionnaire. Chi-squared tests and multiple logistic regression were used to determine the impact of the relation between a PCS and signs and symptoms of TMD as well as dental factors. The prevalence of a PCS was 45.4%. Women between 40 and 69 years reported more frequently a PCS. There was a preference for the right side (64%). The following independent variables were significantly associated with a PCS: subjective unilateral pain in the temporomandibular joint (TMJ), odds ratio (OR) 2.4; subjective unilateral joint clicking, OR 1.7; unilateral TMJ/muscle pain on palpation, OR 1.6/OR 1.3; loss of one supporting zone (Eichner-Classification), OR 1.9; loss of both supporting zones on one side, OR 2.2, one supporting zone left, OR 1.4; presence of a removable partial denture, OR 1.6; presence of an attachment restoration, OR 1.5. A PCS was found in almost half the study population and was associated with unilateral signs of TMD, most of all TMJ pain and asymmetrical loss of antagonist contact. Despite replacement of lost teeth not all restorations seemed to support bilateral mastication.

Self-reported chewing side preference and its associations with occlusal, temporomandibular and prosthodontic factors: results from the population-based Study of Health in Pomerania (SHIP-0).

The socioeconomic structure of an early medieval society from the Mikulcice settlement (Czech Republic) was studied on the basis of an evaluation of the fluctuating and directional asymmetry (DA) of skulls. Two distinct inhabited regions, castle and sub-castle, were compared. Fluctuating asymmetry (FA) was used as a bioindicator of environmental stress, which is thought to have been different in the Mikulcice castle and sub-castle regions. DA is consistent with biomechanical loading, and it was expected to reflect different subsistence patterns. The material consisted of 129 crania from what was presumed to be a higher socioeconomic class (Mikulcice castle) and 71 crania from middle and lower socioeconomic classes (Mikulcice sub-castle). As a comparative sample, 138 crania from modern, lower socioeconomic classes (Pachner Collection) were used. The three-dimensional coordinates of 68 landmarks were digitized and analyzed using geometric morphometrics. In terms of DA, the highest values were recorded in the sub-castle sample and confirmed their lower socioeconomic position, with a grittier and lower protein diet compared with the castle sample. In terms of FA, distinctive differences between the sexes were found. In males, no differences were observed between castle and sub-castle, and the lowest FA values were recorded. In females, significantly higher values of FA were found, surprisingly in the castle sample, comparable with the more stressed Pachner Collection. We suspect that the FA reflects a more varied population of castle females as a consequence of patrilocality, although environmental stress remains a possibility.

Skull shape asymmetry and the socioeconomic structure of an early medieval central European society.

The aims of this study were to correlate masticatory performance with mandibular movements during mastication, and to evaluate masticatory performance and mandibular movements of subjects with different types of mastication. Seventy-eight healthy dentate subjects were selected and divided into 2 groups: bilateral and unilateral chewers. This classification was set by using kinesiography during mastication of an artificial material. Unilateral mastication was defined as the majority of the cycles took place at one specific side. The same tracings used to define type of mastication were used to evaluate mandibular movements by means of its parameters. Masticatory performance was analyzed by comminution of the artificial material and a sieving method. Statistical analysis was performed by Spearman's correlation method, and Mann-Whitney and Student's t-test, when appropriate, at 5% significance level. No correlation was found between masticatory performance and parameters of mandibular movement during mastication. Bilateral chewers presented significantly better (p<0.05) masticatory performance than unilateral ones, however no differences in parameters of mandibular movement were found between groups. Within the limits of this study, it may be concluded that parameters of jaw movements during mastication are not related to masticatory performance, and that the presence of a preferred chewing side worsens mastication.

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Correlation of mastication and masticatory movements and effect of chewing side preference.

Chewing side preference is a factor that could effect prosthodontic treatment. The purpose of this study was to determine whether chewing side was another type of hemispheric lateralization comparable with footedness, handedness, eyedness and earedness. Chewing side preference was tested in 189 subjects of whom 84 were partially edentulous, 98 had a full compliment of dental units (81 included implant-supported restoration restoring the missing teeth and 17 with fully intact dentitions), and seven were fully edentulous, restored with complete dentures. Laterality tests were carried out for the first cycle of mastication, handedness, footedness, earedness and eyedness and patient questionnaire. Most patients preferred chewing on the right side (78b3%) and were right sided. Chewing side preference correlated with other tested hemispherical lateralities. Missing teeth, occlusion type, lateral guidance, gender, implant-supported restorations and complete dentures do not affect the side preference for chewing. This presents a strong argument that chewing side preference is centrally controlled and provides food for thought regarding its significance in prosthodontics.

L Tzadok

Papers

Chewing side preference as a type of hemispheric laterality.