American World Dentistry November 13-14, 2017 San Antonio, USA

Giorgia Andrisani has completed her PhD from Alfonso X el Sabio in Madrid and is now busy with her Master in Orthodontics. She works full time for a private practice in the Netherlands and part time for the private practice Andrisani. She is part of the ISPID organisation to discover the cause and prevent SIDS.

This article, in addition to reviewing our previous contribution to the literature on this subject, aims to explain bruxism in both its physiological expression, namely rhythmic masticatory muscle activity (RMMA), as well as in its pathological expression, characterized by tooth grinding and/or clenching during sleep. We will begin with a description of the mesencephalic trigeminal

nucleus and then discuss sleep and its macro and micro structure in the non-rapid eye movement (NREM) stage. Finally, we will propose our hypothesis that during NREM sleep the trigeminal motor nucleus (Mo5) is activated: this activation is due to the acute effect of the inhibitory neurotransmitters gamma-aminobutyric acid (GABA) and Galanin, which are released from the ventrolateral preoptic nuclei (VLPO) and from the median preoptic nuclei (MnPO) located in the brainstem. Mo5 activates the mesencephalic trigeminal nucleus (Me5), which in turn releases glutamate. The release of glutamate curbs the inhibitory effect of GABA and Galanin of hypothalamic origin on some nuclei of the brainstem, in particular on those of reticular formation (FR), which is responsible for the ascending reticular activator system (ARAS). When the amount of GABA of hypothalamic origin is in excess, the activity of Mo5 continues; bruxism then becomes pathological.

Meiqing Wang has completed her PhD from Fourth Military Medical University (FMMU). She was the Director of the dept. Oral Anatomy and Physiology and TMJ in College of Stomatology, FMMU during 1997-2014, and is the Vice-Chair, Society of TMJ and Occlusion, Chinese Stomatology Association (CSA). She has published more than 50 papers in reputed journals and is serving as an Editorial Board Member of J Dent Res, J Bone Miner Res, J oral Rehabil and CRANIO. She has treated over 10000 patients with temporomandibular joint problems. She has supervised 51 graduate students to get Master or Doctorial Degree.

To detect whether there were activation of motor neurons of the trigeminal motor neucleus (Vmo), facial nucleus (VII), hypoglossal (XII), ambiguous (Amb) nucleus and spinal nucleus of accessory nerve (SNA) in rats recieved unilateral anterior corssbite (UAC) via the connections of trigeminal mesencephalic nucleus (Vme) with VII, XII, Amb and SNA. Cholera toxin B

subunit (CTb) was injected into the inferior alveolar nerve to help identify the central axon terminals of Vme neurons in the Vmo. Biotinylated dextranamine (BDA) was injected into the Vmes to help identify the central axon terminals of Vme neurons around the motor neurons of VII, XII, Amb and SNA. The protein expression levels of vesicular glutamate transporter 1 (VGLUT1) in neurons in Vmo, VII, XII, Amb and SNA, and the protein level of acetylcholinesterase (AChE), an indicator of the motor activation level, in masseter, stapedius, lingualis, pharyngeal muscle and sternocleidomastoid muscle were compared between UAC and control rats. In CTb-treated rats, many CTb-labeled cell bodies and endings were identified in the Vme and in the Vmo, respectively. In BDAtreated rats, many BDA-labeled cell-bodies were identified in Vme and terminals in the Vmo, VII, XII, Amb and SNA, respectively. UAC rats showed higher VGLUT1 protein expression in the detected nucleus and higher AChE protein level in the detected muscles, except pharyngeal muscle. These findings proposed a central mechanism for the syndrome-like TMD symptoms that was the dental stimulated Vme activated motors behaviors via Vme–Vmo/VII/XII/Amb/SNA circuit.

Intermaxillary (Mandibulo-maxillary fixation, MMF) is regarded as the crucial step in the management of maxillofacial trauma since it secures the interrelationship of the occlusal surfaces, which is the absolute essential step in reduction of fragments in both jaws. In essence, mostly metallic framework is attached to the teeth to provide support and anchor points for fixation of the jaws with interconnecting elastics or wires between the dental arches. Many surgeons agree that the gold standard in MMF is the use of arch bars. Arch bar is one the basic tools used in jaw surgeries, which is extensively used all over the world. This tool is used in all the esthetic surgeries of the jaws and in the majority of surgeries for the fractures of the bones in the mid-face and lower face and no substitute has been introduced for it. The arch bar is placed in each jaw separately; it helps maintain the integrity of the jaw arch and the two jaws are fixed to each other. Arch bar is a flexible metallic piece with some hooks incorporated in its structure. This tool has initially been formed into the jaw shape and is attached to each jaw with the use of wires by surgeon’s hand. The wire is circled around the tooth and is passed from the above and under the arch bar and is fixed to the jaw arch by appliances. Despite all the efforts, there is still no proper substitute for an arch bar. Therefore, an attempt to accelerate the process of placing an arch bar is one of the goals of maxillofacial surgeries all over the world. Based on a search carried out in reference books and valid articles, no mechanical method has been introduced to date to decrease the time necessary to place an arch bar. All the attempts made by the surgeons to this end have relied on improving the personal technical dexterity. There are some problems with manual placement of an arch bar. The high possibility of unfavorable cutting of the wire during twisting it, especially when this is carried out by inexperienced surgeons so that the wire should be untwisted and twisted again. Considering the various problems for fixation of the arch bar in patient by surgeon, a device is designed to minimize human errors during arch bar placement and twisting wires. This device consists of a chargeable motor, with a capacity for sterilization and rotating clockwise and counterclockwise, use in the anterior and posterior regions of the oral cavity.

Khaled Khalaf has completed his PhD from the University of Sheffield, UK, 15 years ago and was awarded Membership in Orthodontics of both the Royal Colleges of Surgeons of England and Edinburgh, UK and a Fellowship in Dental Surgery (Orthodontics) of the Royal College of Surgeons in Ireland. Furthermore, he gained the Intercollegiate Speciality Fellowship in Orthodontics of the Royal Surgical Colleges and accreditation as a Consultant Orthodontist, as well as, a Fellow of the Higher Education Academy, UK. He has many publications in prestigious international journals. He is a reviewer and serves on the Editorial Board of several international journals. He has also presented many papers in renowned international conferences.

Introduction: The dental and oral health has been shown to be highly ignored among the disabled population who are dumb and deaf. This is mainly attributed to their dependence on their guardians and care providers and inadequate measures taken in the health care system.

 

Aim: The purpose of this research was to determine the extent of oral health-related knowledge in the dump and deaf group of patients in Saudi Arabia. Furthermore, it was anticipated that necessary measures for developing awareness in the deaf and dumb population should be taken to improve their oral health status.

 

Method: The deaf and dumb population was selected from four cities of Saudi Arabia namely Al-Kharj, Riyadh, Abha and Dammam. To gather information regarding their oral health-related awareness, a questionnaire was developed and then appropriately filmed in the sign language with the help of a sign interpreter to make the questionnaire feasible for the deaf and dumb population. The questionnaire was divided into two sections; the first was regarding the basic practices followed by them for maintaining the oral hygiene and the second section evaluated the oral health related awareness.

 

Results: It was found from the results of the first section that the oral health hygiene in the disabled population was severely neglected, where 79% did not know how to brush their teeth, 83% never received any instruction regarding good oral and dental health and 90% were not satisfied with the status of their oral and dental health. The results of the second part of the questionnaire showed that the study participants lacked the basic knowledge about the maintenance of oral health and prevention of dental caries, where 75% and 88% did not know the number and duration of tooth brushing respectively. Furthermore, 92% had no awareness of the need for regular dental visits.

 

Conclusions: Oral health was found to be severely neglected in the deaf and dump population studied in terms of basic practices and awareness of dental and oral diseases. Therefore, special measures should be taken