Papers by Lilian C Giannasi
Sleep Science, Jun 1, 2023
American Journal of Orthodontics and Dentofacial Orthopedics, Apr 1, 2010
Introduction: We report on the use of an oral appliance fitted to a few maxillary and mandibular ... more Introduction: We report on the use of an oral appliance fitted to a few maxillary and mandibular teeth to treat obstructive sleep apnea syndrome. Methods: We used a mandibular repositioning appliance, the adjustable PMPositioner. Polysomnograms were taken before and after use of the appliance. Results: The apneahypopnea index decreased from 19.0 to 8.0. Minimum oxygen saturation increased from 80.0% to 86.0%, and rapid eye movement sleep increased from 6.0% to 20.0%, indicating that the device remained in position during sleep. A 2-year follow-up showed that periodontal and gingival health was maintained. Conclusions: Oral appliances such as the PMPositioner are an alternative for treating obstructive sleep apnea in partly edentulous patients.
Sleep Science, Dec 1, 2015
quais os pais receberam educação sobre o sono da criança, orientações sobre o estabelecimento de ... more quais os pais receberam educação sobre o sono da criança, orientações sobre o estabelecimento de horários e rotina para dormir e quanto ao uso das técnicas de extinção e reforço positivo. Os participantes foram avaliados em quatro etapaspré-intervenção, pós-intervenção, seguimento de um e seis mesespor meio dos instrumentos Escala UNESP de Hábitos e Higiene do Sono-Versão Crianças, Escala de Distúrbios do Sono para Crianças e Adolescentes, Inventário de Comportamentos para Crianças entre 1½ a 5 anos (CBCL), Inventário de Autoavaliação para adultos de 18 a 59 anos (ASR), Diário de Sono, Diário de Comportamento e Actigrafia. A partir das medidas subjetivas (questionários e diários), os resultados demonstraram redução na latência para inicio do sono e nos despertares e aumento na duração total do sono. Houve redução nos comportamentos de dormir com os pais e de relutância a ir para a cama. Também houve melhora na latência para início do sono das crianças e na latência, eficiência e despertares de suas mães por actigrafia. Além da melhora na qualidade do sono, foi observada melhora detectável nos problemas de comportamento externalizante, internalizante e total de problemas de comportamento das crianças avaliados pelo CBCL, e um menor número de mães com pontuações clínicas no ASR. Conclui-se que a intervenção comportamental para insônia infantil, por meio de orientação para pais, é eficaz na melhora da qualidade de sono e nos comportamentos diurnos das crianças, além de trazer benefícios no sono e nos comportamentos de suas mães. Tais resultados apontam para a necessidade de disseminação desse conhecimento no Brasil, a partir da possibilidade de aplicação desse protocolo em clínicas-escolas de psicologia e centros de saúde.
Odontoestomatología, Sep 1, 2010
Conscientiae Saúde, Oct 29, 2009
Odontoestomatología, Sep 1, 2010
La elección de un aparato bucal apropiado para lograr los mejores resultados en el tratamiento de... more La elección de un aparato bucal apropiado para lograr los mejores resultados en el tratamiento de la apnea obstructiva del sueño es importante. El objetivo de este estudio fue evaluar el efecto de un aparato bucal específico, el PM-Positioner, para el tratamiento del ronquido y la apnea obstructiva del sueño leve, a través de polisomnografía y la Escala de Epworth del sueño, después de seis meses de uso del mencionado aparato. Se incluyeron en el estudio 17 pacientes divididos en dos grupos: un grupo de roncadores (n=7) y otro grupo (n=10) con apnea obstructiva leve. Los resultados fueron significativos para el segundo grupo, revelando una disminución en el índice de apneahipoapnea de 7,4 ± 5,0 a 3,0 ± 2,5 (p <0,05), un aumento de la saturación de oxígeno en un rango de 88,0 ± 6,0 a 90,0 ± 2,8 (p <0,05), aumento del sueño REM de 16,0±4,0 a 19±6,0 y una mejora de la somnolencia en la Escala Epworth de 12,5±5,4 a 7,4±2,4. Se constató una disminución en los ronquidos y los síntomas subjetivos. PMPositioner, fue efectivo en el tratamiento de los ronquidos y la apnea obstructiva leve, la reducción de la somnolencia y de otros síntomas.
Archives of Medical Science, Oct 15, 2008
I In nt tr ro od du uc ct ti io on n: : Obstructive sleep apnoea (OSA) is regarded as a potential... more I In nt tr ro od du uc ct ti io on n: : Obstructive sleep apnoea (OSA) is regarded as a potentially lifethreatening condition characterized by repeated narrowing/collapse of the pharyngeal walls during sleep. The efficacy of oral appliances (OA) in the treatment of sleepdisordered breathing has been rigorously investigated and proven in the last decades. Due to patients preferring OA therapy, many designs have been developed, including the Adjustable PM Positioner. The aim of this study was to evaluate the efficacy of the Adjustable PM Positioner in the treatment of obstructive sleep apnoea, comparing polysomnograms (PSG) pre-treatment and with the OA in situ. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : Twenty-nine patients were enrolled in this study. The sample was divided into two groups: the non-obstructive sleep apnoea (NOSA) group, with 5 snoring patients, and the OSA group, with 24 patients. They used the appliance for 6 months and then underwent another PSG with the appliance in situ. R Re es su ul lt ts s: : The results showed no statistically significant differences in all variables of the NOSA group, except for the presence of snoring, which was reduced, according to PSG findings. For the OSA group the results for apnoea/hypopnoea index (AHI), rapid eye movement (REM) sleep, nadir, mean and basal oxyhaemoglobin saturation (SaO2), showed statistically significant differences. The presence of snoring also decreased according to PSG findings. C Co on nc cl lu us si io on ns s: : We conclude that the adjustable PM Positioner is effective in the treatment of OSA comparing baseline and post-treatment respiratory variables. K Ke ey y w wo or rd ds s: : sleep apnoea, oral appliance, treatment.
Journal of Sleep Research, Sep 1, 2014
Sao Paulo State Univ Julio de Mesquita Filho UNES, Biosci Dept, Sao Jose Dos Campos, Brazil
BMC Musculoskeletal Disorders, May 15, 2012
Background: Few studies demonstrate effectiveness of therapies for oral rehabilitation of patient... more Background: Few studies demonstrate effectiveness of therapies for oral rehabilitation of patients with cerebral palsy (CP), given the difficulties in chewing, swallowing and speech, besides the intellectual, sensory and social limitations. Due to upper airway obstruction, they are also vulnerable to sleep disorders. This study aims to assess the sleep variables, through polysomnography, and masticatory dynamics, using electromiography, before and after neuromuscular electrical stimulation, associated or not with low power laser (Gallium Arsenide-Aluminun, =780 nm) and LED (= 660 nm) irradiation in CP patients. Methods/design: 50 patients with CP, both gender, aged between 19 and 60 years will be enrolled in this study. The inclusion criteria are: voluntary participation, patient with hemiparesis, quadriparesis or diparetic CP, with ability to understand and respond to verbal commands. The exclusion criteria are: patients undergoing/underwent orthodontic, functional maxillary orthopedic or botulinum toxin treatment. Polysomnographic and surface electromyographic exams on masseter, temporalis and suprahyoid will be carry out in all sample. Questionnaire assessing oral characteristics will be applied. The sample will be divided into 5 treatment groups: Group 1: neuromuscular electrical stimulation; Group 2: laser therapy; Group 3: LED therapy; Group 4: neuromuscular electrical stimulation and laser therapy and Group 5: neuromuscular electrical stimulation and LED therapy. All patients will be treated during 8 consecutive weeks. After treatment, polysomnographic and electromiographic exams will be collected again. Discussion: This paper describes a five arm clinical trial assessing the examination of sleep quality and masticatory function in patients with CP under non-invasive therapies. Trial registration: The protocol for this study is registered with the Brazilian Registry of Clinical Trials-ReBEC RBR-994XFS
Sleep
The aim of the present study was to investigate orofacial pain in individuals with Down syndrome ... more The aim of the present study was to investigate orofacial pain in individuals with Down syndrome (DS) and determine possible associations with masticatory muscle hypotonia (MMH), maximum mouth opening (MMO), and sleep disorders. Twenty-three individuals with DS underwent a standardized clinical examination using Axis I of the Diagnostic Criteria for Temporomandibular Disorders, for the diagnosis of pain in the masseter and temporal muscles and temporomandibular joint (TMJ). MMH was investigated using electromyography of the temporal and masseter muscles and the measurement of maximum bite force (MBF). MMO was measured using an analog caliper. Sleep disorders (obstructive sleep apnea [OSA], snoring index [SI], and sleep bruxism index [SBI]) were investigated using type II polysomnography. Statistical analysis was performed. Nonsignificant differences were found in muscle and TMJ pain between the sexes. However, myalgia and referred myofascial pain in the left masseter muscle were mor...
Sleep Science, 2020
COVID-19 is the offcial name for the disease caused by SARS-CoV-2, which has become a pandemic, i... more COVID-19 is the offcial name for the disease caused by SARS-CoV-2, which has become a pandemic, infecting more than 5 million people worldwide. Transmission occurs by inhaling droplets generated when an infected person coughs, sneezes or exhales, or by touching contaminated surfaces and then rubbing their hands over their eyes, nose or mouth. Some infected people become seriously ill, while others have no symptoms, but even though they are asymptomatic, they can still transmit the virus. As vaccines and effective medications do not yet exist, the only way to handle the devastating consequences of the pandemic is prevention. Quality of sleep is essential for the immune system to be prepared to receive, fight and restore itself after a viral infection. Therefore, patients with obstructive sleep apnea (OSA) should continue treatment, and only suspend or change the therapeutic modality under the guidance of a sleep physician. In the era of COVID-19, due to the high probability of contami...
Sleep, 2012
The aim of this study was to describe the demographic, clinical and polysomnographic variables in... more The aim of this study was to describe the demographic, clinical and polysomnographic variables in patients from the sleep disorders research laboratory an institution of higher education in the city of Sao Paulo, SP Brazil. This study is characterized as case series descriptive and retrospective. We assessed 252 subjects from October 2009 to October 2011, distributed in different study protocols regarding to sleep breathing disorders investigation in the fields of otorhinolaryngologic surgery, difficult to control asthma, morbid obesity, post-polio syndrome and sequelae, sleep apnea in commercial drivers and bronchiectasis. The distribution of the population studied was composed by 137 men and 115 women, with a mean age of 45.4±15.7 years, and weight of 82.6±18.6kg. Among the presented claims, snore was the principal when evaluation all the protocols (66.2%), followed by diurnal sleepiness/fatigue (7%). Regarding to polysomnographic variables, it was observed significant results rel...
Sleep, 2020
Introduction Obstructive sleep apnea (OSA) may trigger systemic changes linked to important cardi... more Introduction Obstructive sleep apnea (OSA) may trigger systemic changes linked to important cardiometabolic risk factors such as hypertension, stroke and diabetes II. As a life-threatening, multifactorial disorder, OSA demands a multiprofessional approach. The most common worldwide treatments are Continuous Positive Airway Pressure (CPAP) and Mandibular Advancement Oral Appliance (OAm). The aim of this study was to evaluate the impact of OAm treatment on CPAP non-adherent patients with severe OSA, comparing objective and subjective data between baseline and follow up. Methods A prospective study was carried out including non-adherent severe OSA patients, which were referred to OAm therapy evaluation. Patients presenting with snoring, gasping/choking during sleep, fatigue and daily sleepiness were evaluated by a sleep medicine specialist and the diagnosis of severe OSA with a basal polysomnography (PSG). All the patients were treated with a standard OAm (PMPositioner®). Baseline and ...
International journal of oral and maxillofacial surgery, 2016
This study evaluated the effects of homogenous demineralized dentin matrix (HDDM) slices and plat... more This study evaluated the effects of homogenous demineralized dentin matrix (HDDM) slices and platelet-rich plasma (PRP) in surgical defects created in the parietal bones of alloxan-induced diabetic rabbits, treated with a guided bone regeneration technique. Biochemical, radiographic, and histological analyses were performed. Sixty adult New Zealand rabbits were divided into five groups of 12: normoglycaemic (control, C), diabetic (D), diabetic with a PTFE membrane (DM), diabetic with a PTFE membrane and HDDM slices (DM-HDDM), and diabetic with PTFE membrane and PRP (DM-PRP). The quantity and quality of bone mass was greatest in the DM-HDDM group (respective radiographic and histological analyses: at 15 days, 71.70±16.50 and 50.80±1.52; 30 days, 62.73±16.51 and 54.20±1.23; 60 days, 63.03±11.04 and 59.91±3.32; 90 days, 103.60±24.86 and 78.99±1.34), followed by the DM-PRP group (respective radiographic and histological analyses: at 15 days 23.00±2.74 and 20.66±7.45; 30 days 31.92±6.06 ...
Sleep, 2020
Introduction To our knowledge, no studies have accessed theawake bruxism (AB) and stage by stage ... more Introduction To our knowledge, no studies have accessed theawake bruxism (AB) and stage by stage sleep bruxism (SB) in adults with Down syndrome. Recent works have shown that portable PSG systems are accurate for SB assessment even in the absence of audio-video recording. We aimed to evaluate the prevalence of awake bruxism, stage-by-stage sleep bruxism and Sleep Related Breathing Disorders (SRBD) in adults with Down syndrome. Methods Twenty-three adults with Down Syndrome (DS) were enrolled in this study. General health, dental status, parafunctional habits and temporomandibular symptoms were assessed. The history of SB/AB was taken from a questionnaire to the caregivers. A portable PSG type II system (Embla Embletta MPR+PG ST+Proxy, Natus, California-USA) was used to perform a full-sleep study at patients’ home. RMMA activity was defined as low (>1 and <2 episodes/h of sleep), moderate (>2 and <4 episodes/h of sleep), or high (>4 episodes/h of sleep). PSG diagnose o...
Case report / Caso clinico Use of an occlusal splint to treat temporomandibular joint pain during... more Case report / Caso clinico Use of an occlusal splint to treat temporomandibular joint pain during treatment of sleep apnea with an oral appliance Utilizzo di uno splint occlusale per trattare una disfunzione dell'articolazione temporo-mandibolare in corso di trattamento con protesi endorale per una sindrome delle apnee ostruttive nel sonno
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Papers by Lilian C Giannasi