Background Obstructive sleep apnea (OSA) is marked by daytime sleepiness, loud snoring, gasping or choking, and at least 5 obstructive breathing events per hour of sleep. Though polysomnography is the "gold standard" for diagnosing OSA, it is costly and time-consuming; alternatives like cone-beam computed tomography (CBCT) exist. CBCT, provides a large field of view of upper airway, making it a valuable adjunctive tool for airway evaluation in patients at risk for OSA. Aim To evaluate the upper airway dimensions of patients with snoring and controls using CBCT and the role of CBCT as an adjunctive screening tool. Materials and methods Study was done on 20 patients, 10 snoring subjects and 10 without snoring. Berlin questionnaire was given to the patients, to assess the risk for OSA. CBCT was used to measure the airway dimensions. Length of ramus and body of mandible was also estimated. Results Out of 10 snoring patients, 9 were at high risk for OSA. Snoring subjects had significantly smaller mean A-P oropharynx dimensions, lateral dimensions, and oropharynx volume, but a longer oropharynx and shorter mandibular length than controls. Additionally, their mean BMI was higher. Conclusion The findings highlight 3D imaging's role in identifying patients at risk for OSA by showing differences in airway dimensions, volume, and mandibular morphology.
Statement of problem The relationship between occlusomuscular temporomandibular disorders (TMD) and stress measured by salivary cortisol and the effect that disclusion time reduction (DTR) therapy may have on cortisol levels remains unclear. Objective evidence is lacking as to whether modifying the occlusal dynamics with DTR therapy will objectively reduce stress responses in affected patients. Purpose The purpose of this clinical study was to evaluate the stress levels among patients with occlusomuscular TMD by measuring salivary cortisol levels before and after DTR therapy. Material and methods Thirty patients diagnosed with occlusomuscular TMD had salivary cortisol level samples collected and assayed by passive drool at baseline and 1-month after DTR therapy with enzyme-linked immunosorbent assay (ELISA). All 30 participants were treated with the T-Scan 10 Novus digital occlusion analyzer synchronized with temporalis and masseter surface electromyography (sEMG) to achieve disclusion times of less than 0.5 seconds during left and right lateral excursive movements. The Kolmogorov-Smirnov tested normality and the Student’s paired t test evaluated pre-and posttreatment cortisol levels, the disclusion times, and muscular comparisons (P<.05), with 95% confidence levels reported. Results Mean salivary cortisol levels significantly decreased from 11.43 ±1.48 ng/mL before DTR to 6.57 ±1.20 ng/mL after DTR, which equaled a 4.85 ng/mL reduction (P<.001). DTR significantly reduced the left mean disclusion time from 2.32 ±1.25 seconds to 0.28 ±0.06 seconds (mean difference=2.04 seconds, P<.001) and the right mean disclusion time from 2.60 ±1.97 seconds to 0.28 ±0.05 seconds (mean difference=2.32 seconds, P<.001). The average EMG muscle activities of the bilateral masseter and temporalis muscles increased significantly from pretreatment to 1 month after DTR (P<.001). Conclusions DTR therapy significantly reduced salivary cortisol levels in patients with occlusomuscular TMD. Stress reduction was achieved with high precision, time-based computer-guided occlusal adjustments that controlled the participants’ occlusal neurophysiology responsible for their elevated cortisol production.
Background and objective Regenerative endodontic treatment (RET) promotes continued root development in immature permanent teeth with pulp necrosis; however, the optimal scaffold for maximizing regenerative outcomes remains uncertain. The objective of this study is to compare the clinical and radiographic effectiveness of platelet-rich fibrin (PRF) and conventional blood clot scaffolds using standardized cone-beam computed tomography (CBCT)-based assessment and to identify independent predictors of regenerative success. Methods This prospective, non-randomized comparative clinical study was conducted at the Department of Pediatric Dentistry, Pacific Hospital, Udaipur, Rajasthan, India, and included 40 children with non-vital immature permanent maxillary incisors treated with RET using either a blood clot scaffold (n = 20) or a PRF scaffold (n = 20). CBCT-based radiographic analyses were performed at baseline and the 15-month follow-up. The primary outcome was the percentage increase in radiographic root area (RRA), while secondary outcomes included percentage changes in root length, apical diameter, and periapical lesion size. Clinical outcomes were evaluated throughout follow-up. Between-group comparisons were performed using independent t-tests or Mann-Whitney U tests, as appropriate, and multivariable linear regression was used to identify independent predictors of RRA improvement. Results Radiographic analysis included 37 teeth (blood clot, n = 18; PRF, n = 19). The PRF group demonstrated a significantly greater increase in RRA than the blood clot group (19.15 ± 6.22% vs. 9.72 ± 5.18%; mean difference, 9.43%; 95% confidence interval (CI), 5.86-13.00; p < 0.001; Cohen's d = 1.58). PRF also achieved significantly greater reductions in apical diameter (p = 0.028) and periapical lesion size (p < 0.001), whereas the increase in root length did not differ significantly between groups (p = 0.415). Both groups exhibited significant within-group radiographic improvement and high clinical success rates (blood clot: 90%; PRF: 95%). Multivariable regression identified PRF as the strongest independent predictor of RRA improvement (β = 9.43, p < 0.001), while larger baseline periapical lesion size was negatively associated with regenerative outcomes. Conclusions PRF was associated with significantly greater structural root maturation and periapical healing than the conventional blood clot scaffold while maintaining comparable clinical success. Standardized CBCT-based quantitative assessment supports PRF as an effective scaffold for RET and provides robust evidence to inform clinical decision-making.
Radicular cysts are the most common inflammatory odontogenic cysts and usually arise in relation to a non-vital tooth, whereas odontomas arecommon benign mixed odontogenic lesions that are often discovered incidentally and treated with conservative surgical excision. The coexistence of a radicular cyst with an odontoma in the anterior maxilla appears uncommon in the available literature, making clinic-radiographic recognition and complete surgical management important for diagnosis and rehabilitation. A patient presented with pain and swelling in the upper anterior teeth region for 15 days, with no significant medical history. Clinical examination revealed a labial swelling extending from the right central incisor to the left lateral incisor and palatal swelling extending from the right central incisor to the right canine. Deep dentinal caries were present in both maxillary central incisors. Surgical management consisted of enucleation of the radicular cyst with removal of the odontome through a trapezoidal labial flap, with additional palatal flap elevation for complete retrieval of the odontome, followed by extraction of both central incisors and placement of platelet-rich fibrin with a bone graft before closure.This report highlights the diagnostic challenge posed by a mixed inflammatory and odontogenic hard-tissue lesion in the aesthetic zone and underscores the importance of complete enucleation, histopathologic confirmation, and defect reconstruction in managing extensive anterior maxillary lesions.
Spinal muscular atrophy (SMA) is an uncommon crippling hereditary condition that primarily affects the motor neurons in the spinal cord, resulting in skeletal muscle weakness and atrophy. Skeletal muscle is an important regulator of glucose, amino acid, and lipid homeostasis and is a protein reservoir of the body. Atrophy of the skeletal muscle can affect locomotion, general metabolism, eating, and respiration. Maintaining skeletal muscle mass and strength throughout life is essential for longevity and good health. Currently, orofacial muscle electromyographic evaluation and digital occlusion analysis serve as a functional assessment tool and source of crucial information for diagnostic clarification in neuromuscular disorders related to the stomatognathic system. The article presented here highlights the electromyographic and digital occlusion analysis of a rare case of SMA type II with cutis marmorata telangiectatica congenita (CMTC) in an 11-year-old male patient. How to cite this article:Thimmegowda U, Thumati P, Jayadevappa CG, et al. The Digital Occlusion and Electromyographic Analysis of a Child with Spinal Muscular Atrophy II and Cutis Marmorata Telangiectatica Congenita: A Report of Rare Case. Int J Clin Pediatr Dent 2026;19(4):532-536.
