Awake teeth grinding in participants with canine guidance or group function: Effect on diaphragm EMG activity, heart rate, and oxygen saturation

Therapeutic routine with respiratory exercises improves posture, muscle activity, and respiratory pattern of patients with neck pain: a randomized controlled trial

Neck pain and forward head posture (FHP) are typical in prolonged smartphone users and need to be targeted for treatment. We aimed to compare the effect of a routine therapeutic program with and without respiratory exercises on smartphone users with FHP and non-specific chronic neck pain (NSCNP). Sixty patients (aged 24.7 ± 2.1 years) with FHP and NSCNP were randomly assigned to the routine therapeutic program (n = 20), combined respiratory exercises with a routine therapeutic program (n = 20), or control (n = 20) groups. At baseline, there was no difference among groups at all variables. Each programme was implemented three times a week for eight weeks. Primary Outcome was pain measured by visual analogue scale (VAS), and secondary ones were forward head angle, the activity of specific muscles, and respiratory patterns, measured by photogrammetry, electromyography and manual, respectively. All outcomes were measured at baseline and eight weeks post-treatment. We used the repeated measures analysis of variance to examine the interaction between time and group, paired t-test for intragroup comparison, one-way analysis of variance for intergroup comparison, and Tukey post hoc test at a significant level 95% was used. There were significant differences in the combined group compared with the routine therapeutic group (P = 0.03) for diaphragm muscle activation, respiratory balance (P = 0.01), and the number of breaths (P = 0.02). There were significant within-group changes from baseline to post-treatment in the combined group for all outcomes above, but no changes in the therapeutic exercise routine group. Despite respiratory pattern, none of the secondary outcomes proved to be superior in the combination group compared to the routine therapeutic program in smartphone users with FHP and NSCNP. Future studies with longer follow-up assessments could strengthen these results.

Trial registration: Current Controlled Trials using the IRCT website with ID number of, IRCT20200212046469N1 “Prospectively registered” at 04/03/2020.

Canine Rise Method: A Conservative Approach for Worn Teeth Rehabilitation with Different Adhesive Restorative Materials

Background

In this article, two cases with generalized dental wear and four cases with localized dental wear are reported. In some of the cases, the worn teeth were restored with direct composite techniques with no mock-up and articulator mounting according to the canine rise method. This method is used without any change in the intercuspation of posterior teeth without a muscle relaxation appliance. It introduces a stable occlusal condition that can alter neuromuscular reflex activity, leading to improvements in certain muscle pain disorders. It is also used to protect the teeth and supporting structures from abnormal forces that might create a further breakdown and/or tooth wear.

Methods

The first step of treatment in all the cases was a composite build-up for maxillary and mandibular canines to restrict and guide the horizontal and vertical jaw movements and create adequate space for restorations. The second step was the placement of direct or indirect restorations on upper and lower anterior teeth efficiently and accurately.

Results

This method enhanced the esthetic outcomes in a conservative approach with no reduction in tooth material or time-consuming treatments.

Conclusions

This technique can be suggested for the treatment of worn teeth in patients with Angle's Cl I and Cl II classifications of malocclusion based on the follow-up results. It is not applicable for the treatment of worn teeth in patients with Angle's class III because occlusion is reversed, and canine teeth do not have guidance role. Practical Implications. This method significantly reduces the overall treatment time, and additional steps are required to restore the worn-out teeth and/or occlusion using the canine rise method.