Die obstruktive Schlafapnoe (OSA) ist nur eine Schlafstörung unter vielen, die Auswirkungen auf die orale Gesundheit haben kann. Eine Identifizierung der damit assoziierten zahnärztlichen Befunde, z. B. vermehrter Zahnverschleiß, hilft bei der Früherkennung dieser Atmungsstörungen, die aber abschließend durch Schlafmediziner diagnostiziert werden müssen. Zusätzlich kommt Zahnärzten bei der Behandlung dieser schlafbezogenen Atmungsstörung (SBAS) mit Unterkieferprotrusionsschiene (UPS) eine besondere Rolle zu. Über eine ausführliche zahnärztliche Diagnostik und Aufklärung findet eine Risikobewertung für das stomatognathe System statt, um medizinische Wirkung und Nebenwirkungen der UPS gegeneinander abzuwägen. Je stärker der Effekt der UPS auf die OSA durch einen vermehrten Vorschub ist, desto höher ist die Wahrscheinlichkeit für Nebenwirkungen. Das Management von Schmerzen sowie dentalen und okklusalen Veränderungen im Zuge einer UPS-Therapie wird in Anlehnung an die aktuelle S1-Leitlinie aus dem Jahr 2021 der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF) beschrieben. Manuskripteingang: 27.11.2022, Manuskriptannahme: 30.03.2023 Keywords: Obstruktive Schlafapnoe (OSA), Unterkieferprotrusionsschiene (UPS), Diagnostik, Risikoprofil, Nebenwirkungen

Mandibular advancement devices (MADs) for the treatment of obstructive sleep apnea (OSA) have been part of contractual dental care since 2022 and are becoming more widespread in dental practices. Based on the corresponding specifications of the S1 guideline from 2021 of the Association of the Scientific Medical Societies in Germany (AWMF), the clinical steps required for this in collaboration with medical sleep medicine are explained on the basis of a case study. Non-adherence to positive pressure therapy has triggered a dental treatment cascade resulting in the successful treatment of OSA. Special attention is given to the assessment of the dental risk profile and the management of the potential side effects. MAD therapy in the context of dental sleep medicine consequently reinforces the integration of dentistry into general medicine. Keywords: therapeutic jaw relation, obstructive sleep apnea, snoring, mandibular advancement splint

The present case report describes a rare case of a lateral and anterior open bite caused by a right trigeminal nerve paresis due to compression of the trigeminal ganglion by a meningioma. Based on the initial diagnosis of TMD, the patient was treated conservatively (also with occlusal splints) for over a year without success, although sensory deficits in the face and tongue, wave-like pain, and a continuous increase in pain symptoms were observed simultaneously. This case report emphasizes the importance of carefully taking the medical history in cases of unclear orofacial pain, supplemented by a clinical examination in which all symptoms and signs can be systematically identified and assigned to a diagnosis. Keywords: lateral open bite, meningioma, malocclusion, numbness, chewing difficulties

The following article describes the interdisciplinary collaboration of a dentist with a sleep medicine specialist, by presenting the case of a patient with orofacial pain and sleep disorders. Patients with myofacial pain of the masticatory musculature or arthralgia are particularly prone to suffering from insomnia or from another form of sleep disorder, such as sleep bruxism or sleep-related respiratory disturbances. The identification and reduction of these perpetuating risk factors can be beneficial, with regard to the treatment of painful craniomandibular dysfunctions in the dental practice. Keywords: arthralgia, insomnia, orofacial pain, sleep bruxism, sleep-related breathing disorders, snoring, sleep medicine, temporomandibular disorders

It is the aim of the present paper to introduce a systematic, practical approach for the state-of-the-art management of patients with orofacial pain in a private office setting. The use of the RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders) has proven especially useful for the diagnosis in patients with craniomandibular dysfunctions (CMD). The RDC/TMD is an internationally renowned and validated procedure using checklists that includes other orofacial pain diagnoses to allow for a differential diagnosis. Through prioritizing the treatment options for CMD patients, evidence-based dentistry has become an integral part of practice routines. A correct assessment of the results from scientific studies combined with the practitioner's own clinical expertise allows a dentist to create a purposeful and efficient treatment strategy within his or her network of therapists and in cooperation with the patient. Keywords: in-house protocol/treatment, orofacial pain, craniomandibular dysfunction, CMD, myoarthropathy, RDC/TMD, protocol/private office setting, evidence-based dentistry, checklist