BackgroundThe purpose of this prospective cross-over study is to evaluate the effect of bilateral balanced occlusion and canine guidance occlusion on the masseter muscle activity using implant-retained mandibular overdentures.MethodsAfter evaluation of 12 completely edentulous patients using cone beam computed tomography (CBCT), mucoperiosteal flaps were reflected exposing the mandibular interforaminal region. Two implants were placed in the interforaminal region for each of the 12 patients. After a healing period of 3 months, acrylic maxillary complete dentures and mandibular overdentures were fabricated with bilateral balanced occlusion for 6 patients and canine guidance occlusion for the other 6 patients. Electromyographic evaluation of the masseter muscles, during clenching on a silicon index and chewing peanuts and cake, was conducted on the patients after using their dentures for 4 weeks. Each occlusion concept was then converted into the other concept using the same dentures, and the procedure of evaluation was repeated after 4 weeks. The recordings were analyzed statistically using Wilcoxon signed ranks test. p < 0.05 was considered statistically significant.ResultsThe highest electromyographic activity of the masseter muscles was recorded during clenching on a preformed silicon index followed by chewing peanut then cake for both occlusal concepts. The recordings of the masseter muscle associated with canine guidance occlusion were higher than bilateral balanced occlusion but with no statistically significant difference except between the right masseter muscles during clenching (p = 0.042*).ConclusionsBoth bilateral balanced occlusion and canine guidance occlusion can be used successfully in implant-retained mandibular overdentures without affecting masseter muscle activity.

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Phrenic nerve conduction abnormality is an appreciated finding in COPD. Nerve stretching associated with diaphragmatic descent can be a suggested mechanism for nerve lesion. The presence of phrenic neuropathy may be an additional contributing factor to diaphragmatic dysfunction in COPD patients.

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To study clinical, electrophysiological, and laboratory properties of peripheral neuropathy (PN) in systemic lupus erythematosus (SLE) and their association with disease activity. Patients and methods A total of 30 patients who met the American College of Rheumatology case definition criteria for SLE-PN and 30 age-matched and sex-matched patients with SLE without PN were selected from the Main Alexandria University Hospital Physical Medicine, Rheumatology and Rehabilitation clinic. Demographic data, SLE-related clinical, laboratory data, Systemic Lupus Activity Measure (SLAM) index, and nerve conduction studies were done. This case-control study compared clinical and SLE-related features, laboratory, and SLAM index in patients with SLE with PN versus those without neuropathy. Results The results showed that the most common PN subtype was sensorimotor polyneuropathy which occurred in 18 (60%) patients; the most common PN pathology was axonal degeneration, which occurred 19 (63.3%) patients; and the most common associated nerve entrapment was carpal tunnel syndrome in 10 (33.3%) patients. In comparison between group I (SLE with PN) and group II (SLE without PN), there was no statistically significant difference between the two groups regarding demographic data, disease duration, and lupus clinical features, except malar rash and lupus nephritis, which showed significant increase in patients with SLE with PN compared with patients with SLE without PN (P=0.003 and P<0.001, respectively). There was no statistically significant difference among PN subtype groups regarding sex, age, and immunological markers. Regarding diseases activity, SLAM index showed a significant increase in patients with SLE with PN compared with patients with SLE without PN (P=0.006). Conclusion The pattern of neuropathy in SLE is mainly axonal. Moreover, the most common PN subtype is sensorimotor polyneuropathy. The study suggests significant association of PN in patients with SLE with nephritis, malar rash, and SLAM index.

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