1
|
Gomes TC, Gomes Moura JL, Baia-da-Silva DC, Lima RR, Rodrigues PDA. Twenty-first century knowledge mapping on oral diseases and physical activity/exercise, trends, gaps, and future perspectives: a bibliometric review. Front Sports Act Living 2024; 6:1410923. [PMID: 39170688 PMCID: PMC11335734 DOI: 10.3389/fspor.2024.1410923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Maintenance and improvement of an individual's overall well-being require a multidisciplinary approach that encompasses everything from oral health care to regular physical exercise. The notion that poor oral health can influence general health and athletic performance has sparked an interest in this relationship. This study offers an overview of relevant research and a knowledge map,and discusses publication metrics and key topics concerning the relationship between physical activity or exercise and oral diseases. We searched the Web of Science database for articles published in the 21st century that addressed the relationship between physical activity and oral diseases. Under the stipulated inclusion criteria, a rigorous selection process yielded 276 from 3,883 retrieved articles. The articles were classified by what was assessed as follows: occurrence of oral diseases in athletes or sports enthusiasts (n = 174); impact of physical activity or exercise on the oral cavity (n = 59); effects of oral changes on sports performance and physical fitness (n = 31); and the connection between oral health status, physical activity or exercise, and systemic conditions (n = 12). Orofacial trauma has received the most attention among all investigated oral diseases. However, there is a need for greater attention of dysfunctional habits that can contribute to premature tooth wear, as well as oral inflammatory diseases that can have systemic implications. This mapping can encourage the development of new primary research.
Collapse
Affiliation(s)
- Thamires Campos Gomes
- Graduate Program in Dentistry, Institute of Health Sciences, Federal University of Pará, Belém, Brazil
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Pará, Brazil
| | - José Lucas Gomes Moura
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Pará, Brazil
| | - Daiane Claydes Baia-da-Silva
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Pará, Brazil
| | - Rafael Rodrigues Lima
- Graduate Program in Dentistry, Institute of Health Sciences, Federal University of Pará, Belém, Brazil
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Pará, Brazil
| | | |
Collapse
|
2
|
Rondón AKA, Lozada MIT, Soares PBF, Raposo LHA, Soares CJ. Effect of different materials for conventional and 3D-printed models on the mechanical properties of ethylene-vinyl acetate utilized for fabricating custom-fit mouthguards. Dent Traumatol 2024; 40:281-288. [PMID: 37997541 DOI: 10.1111/edt.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND/AIM The interaction between the ethylene-vinyl acetate (EVA) with distinct materials utilized for obtaining dental models can affect the performance of resulting mouthguards. This study attempted to evaluate the effect of different materials for conventional (dental stone) or 3D-printed (resin) models on EVA's physical and mechanical properties and surface characteristics. MATERIAL AND METHODS EVA sheets (Bioart) were laminated over four model types: GIV, conventional Type IV dental stone model (Zhermak); ReG, resin-reinforced Type IV dental stone model (Zero Stone); 3DnT, 3D resin printed model (Anycubic) without surface treatment; 3DT, 3D-printed model (Anycubic) with water-soluble gel (KY Jelly Lubricant, Johnson & Johnson) coating during post-curing process. The EVA specimens were cut following the ISO 37-II standard (n = 30). Shore A hardness was measured before and after plasticization on the contact (internal) or opposite (external) surfaces with the model. The breaking force (F, N), elongation (EL, mm), and ultimate tensile strength (UTS, MPa) were measured using a universal testing machine. Macro-photography and scanning electron microscopy were adopted for classifying the EVA surface alteration. Data were analyzed by one-way ANOVA with repeated measures, followed by Tukey's test (α = .05). RESULTS Plasticization significantly decreased Shore A values for the tested EVA regardless of the model type (p < .001). Higher F, El, and UTS values were verified for the EVA with 3DT and GIV models compared to ReG and 3DnT (p < .001). 3DnT models resulted in severe surface alteration and a greater reduction of the mechanical properties of the EVA. CONCLUSION The interaction of EVA with 3D resin-printed models without surface treatment or resin-reinforced Type IV dental stone models significantly affected the physical and mechanical properties of this material. The utilization of water-soluble gel coating during the post-curing process of 3D resin printed models improved the mechanical properties of the EVA, similarly when this material was plasticized over conventional Type IV dental stone model.
Collapse
Affiliation(s)
| | | | | | - Luis Henrique Araujo Raposo
- Department of Occlusion and Prosthodontic, School of Dentistry, Universidade de Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Carlos José Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Universidade de Uberlândia, Uberlândia, Minas Gerais, Brazil
| |
Collapse
|
3
|
Raghavan S, Abu Alhaija ES, Nasrawi Y, Al-Khateeb S, Sunna S. Un "boxing" the reality: Knowledge, attitude, and perception of orthodontists, dental practitioners, and orthodontic patients toward mouthguards' wear during contact sports-A cross-sectional study. Clin Exp Dent Res 2024; 10:e904. [PMID: 38837625 DOI: 10.1002/cre2.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/06/2024] [Accepted: 05/09/2024] [Indexed: 06/07/2024] Open
Abstract
INTRODUCTION Mouthguards (MGs) have the potential to prevent contact sport-related dental injuries. However, varying perceptions of their effectiveness persist, influencing recommendations by dental professionals. AIM To assess the attitudes, knowledge, and perceptions of orthodontists, other dental practitioners (general dentists and other dental specialists), and orthodontic patients involved in contact sports regarding the use of MGs. METHODOLOGY A cross-sectional survey was designed to collect information from dental clinicians (orthodontists and other dental practitioners) and their orthodontic patients about using MGs during sports participation. A convenience sampling technique was used to recruit the participants for an online survey. A total of 107 (32 males/75 females) dental clinicians and 147 (75 males/72 females) orthodontic patients (mean age 17.5 ± 5.84 years) participated in the study. Pre-validated questionnaires, specifically designed for dental clinicians and orthodontic patients, were used. Data were analyzed using SPSS software (version 28.0; SPSS). RESULTS Nearly 50% of dental clinicians have recently recommended MGs to their patients in their clinical practice out of which 59% preferred the stock type; 33% of dental clinicians enquired their patients about involvement in contact sports during initial visits. The majority of orthodontic patients acquired knowledge about MGs through the Internet. More than half of orthodontic patients expressed unwillingness to pay for MGs, and 89% of orthodontic patients found using MGs during contact sports uncomfortable. CONCLUSION The findings provide valuable insights into the practices and attitudes of dental clinicians and orthodontic patients regarding MGs, their recommendations, and the comfort levels associated with using them during contact sports.
Collapse
Affiliation(s)
- Shailaja Raghavan
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Yousef Nasrawi
- Orthodontics and Dentofacial Orthopedics Department, Henry M. Goldman School of Dental Medicine, Boston University Massachusetts, Boston, United States
| | - Susan Al-Khateeb
- Department of Preventive Dentistry, Division of Orthodontics, School of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | | |
Collapse
|
4
|
Yohan A, Aurélie B, Laurent T, Baptiste S, Sylvain P, Jean-Pierre A, Christophe RB. Comparison of shock absorption capacities of three types of mouthguards: A comparative in vitro study. Dent Traumatol 2024. [PMID: 38794914 DOI: 10.1111/edt.12968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 04/02/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND/AIM 3D printing processes can be used to manufacture custom-made mouthguards for sports activities. Few studies have compared the impact performance of industrial-created mouthguards with that of custom-made mouthguards manufactured by thermoforming or 3D printing. The objective of this in vitro study was to compare the shock absorption capacities of custom-made mouthguards manufactured by 3D printing with industrial mouthguards and thermoformed ethylene vinyl acetate (EVA) mouthguards. MATERIALS AND METHODS For each type of mouthguard, eight samples were produced. 3D-printed mouthguards were manufactured using digital light processing technology. Each mouthguard was subjected to an impact performance test defined by the standard AFNOR XP S72-427, which evaluate maximum deceleration and force transmitted during impact. The thickness of each mouthguard before and after a series of five impacts was measured at the impacted inter-incisal area. RESULTS The mean maximum decelerations during impact ranged from 129 to 189 g for industrial mouthguards, 287 to 425 g for thermoformed EVA mouthguards, and 277 to 302 g for 3D-printed mouthguards. The mean reduction in mouthguard thickness at the impact zone after five tests was 1.2 mm for industrial mouthguards, 0.6 mm for 3D-printed mouthguards, and 2.2 mm for thermoformed EVA mouthguards. CONCLUSIONS Custom-made 3D printed mouthguards showed slightly better shock absorption ability than thermoformed mouthguards with respect to the indicator proposed in XP S72-427. They seemed to combine the practical advantages of thermoformed mouthguards in sports with better shock absorption capacity and lower cost. Furthermore, they had the least thickness variation during the test, and their shock absorption capacity was the least affected by repeated mechanical tests. Other types of 3D-printing resin materials that will become available must continue to be tested for shock absorption to provide the best protection to users at low cost.
Collapse
Affiliation(s)
- Arfi Yohan
- Innovative Biomaterials and Interfaces Research Unit - UR4462, University Paris Cité, Montrouge, France
| | - Benoit Aurélie
- Innovative Biomaterials and Interfaces Research Unit - UR4462, University Paris Cité, Montrouge, France
| | - Tapie Laurent
- Innovative Biomaterials and Interfaces Research Unit - UR4462, University Paris Cité, Montrouge, France
- EPF School of Engineering, Cachan, France
| | - Sandoz Baptiste
- Arts et Métiers Institute of Technology, University Sorbonne Paris Nord, IBHGC, University HESAM, Paris, France
| | - Persohn Sylvain
- Arts et Métiers Institute of Technology, University Sorbonne Paris Nord, IBHGC, University HESAM, Paris, France
| | - Attal Jean-Pierre
- Innovative Biomaterials and Interfaces Research Unit - UR4462, University Paris Cité, Montrouge, France
- Charles Foix Hospital - AP-HP, Ivry-sur-Seine, France
| | - Rignon-Bret Christophe
- Innovative Biomaterials and Interfaces Research Unit - UR4462, University Paris Cité, Montrouge, France
- Charles Foix Hospital - AP-HP, Ivry-sur-Seine, France
| |
Collapse
|
5
|
van Vliet K, van Splunter A, de Lange J, Lobbezoo F, Brand H. Protein Deposition on Sport Mouthguards and the Effectiveness of Two Different Cleaning Protocols. J Clin Med 2024; 13:3023. [PMID: 38892734 PMCID: PMC11172541 DOI: 10.3390/jcm13113023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Objective: To determine which salivary proteins adhere onto sport mouthguards, and to evaluate the effectiveness of different cleaning strategies in removing deposited protein. Methods: Fifteen healthy volunteers used a mouthguard for 1 h. The deposited salivary proteins were analyzed using gel electrophoresis and Western blotting techniques and compared with the protein composition of unstimulated saliva. In addition, the effectiveness of two different cleaning strategies to remove proteins from the mouthguards were compared: rinsing the mouthguards after use with cold tap water and cleaning the mouthguard with a soluble effervescent tablet. Results: Gel electrophoresis showed deposition of proteins of 50-60 kDa and 14 kDa on the mouthguards used in the mouth for 1 h. Western blotting identified these bands as amylase and lysozyme, respectively. Rinsing the mouthguard with cold tap water after use removed 91% of the total amount of deposited proteins, while cleaning with an effervescent tablet removed 99%. Conclusions: During the use of mouthguards, salivary proteins are deposited on their surface. Because salivary proteins can potentially affect bacterial adhesion to mouthguards, proper cleaning after use is recommended. Cleaning the mouthguard with cold tap water or using an effervescent tablet both seem to be effective strategies to remove proteins deposited on sport mouthguards.
Collapse
Affiliation(s)
- Kirsten van Vliet
- Academic Centre for Dentistry (ACTA)—Academic Medical Center Amsterdam (UMC), Department of Oral and Maxillofacial Surgery, 1081 HV Amsterdam, The Netherlands
| | - Annina van Splunter
- Academic Centre for Dentistry (ACTA), Department of Oral Biochemistry, 1081 LA Amsterdam, The Netherlands
| | - Jan de Lange
- Academic Centre for Dentistry (ACTA)—Academic Medical Center Amsterdam (UMC), Department of Oral and Maxillofacial Surgery, 1081 HV Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Academic Centre for Dentistry (ACTA), Department of Orofacial Pain and Dysfunction, 1081 LA Amsterdam, The Netherlands
| | - Henk Brand
- Academic Centre for Dentistry (ACTA), Department of Oral Biochemistry, 1081 LA Amsterdam, The Netherlands
| |
Collapse
|
6
|
Togo S, Sakaue T, Tsutsui A, Matsuda Y, Nakajima K, Takeda T, Fukuda K, Vallittu P, Lassila L. Effect of Vinyl Acetate, Glass Fibers Contents, and Buffer Space on EVA's Mechanical Property and Shock Absorption Ability. Eur J Dent 2024. [PMID: 38744336 DOI: 10.1055/s-0044-1779427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES The aim of the study was to evaluate the mechanical properties and impact absorption capacity of prototype materials comprising ethylene vinyl acetate (EVA) of different hardness reinforced using different amounts of glass fibers (GFs), considering a buffer space. MATERIALS AND METHODS Six prototype materials were made by adding E-GFs (5 and 10 wt%) to EVA with vinyl acetate (VA) contents of 9.4 wt% ("hard" or HA) and 27.5 wt% ("soft" or SO). Durometer hardness and tensile strength tests were performed to evaluate the mechanical properties of the materials. Moreover, an impact test was conducted using a customized pendulum impact tester to assess the impact absorption capacity (with or without a buffer space) of the specimens. RESULTS The mechanical properties of the prototypes, namely, durometer hardness, Young's modulus, and tensile strength, were significantly higher in the HA group than in the SO group, regardless of the presence or added amount of GFs. The addition of GFs, particularly in a large amount (10 wt%), significantly increased these values. In terms of the impact absorption capacity, the original hardness of the EVA material, that is, its VA content, had a more substantial effect than the presence or absence of GFs and the added amount of GFs. Interestingly, the HA specimens with the buffer space exhibited significantly higher impact absorption capacities than the SO specimens. Meanwhile, the SO specimens without the buffer space exhibited significantly higher impact absorption capacities than the HA specimens. Moreover, regardless of the sample material and impact distance, the buffer space significantly improved impact absorption. In particular, with the buffer space, the impact absorption capacity increased with the added amount of GFs. CONCLUSION The basic mechanical properties, including durometer hardness, Young's modulus, and tensile strength, of the EVA prototype were significantly increased by reducing the amount of VA regardless of the presence or added amount of GFs. Adding GFs, particularly in large amounts, significantly increased the values of aforementioned mechanical properties. Impact absorption was significantly affected by the hardness of the original EVA material and enhanced by the addition of the buffer space. The HA specimen had a high shock absorption capacity with the buffer space, and the SO specimen had a high shock absorption capacity without the buffer space. With the buffer space, impact absorption improved with the amount of added GFs.
Collapse
Affiliation(s)
- Shinji Togo
- Division of Sports, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
| | - Takahiro Sakaue
- Division of Sports, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
| | - Arata Tsutsui
- Division of Sports, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
| | - Yoshiaki Matsuda
- Division of Sports, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
| | - Kazunori Nakajima
- Division of Sports, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
| | - Tomotaka Takeda
- Division of Sports, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
| | - Kenichi Fukuda
- Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
| | - Pekka Vallittu
- Department of Biomaterials Science and TCBC, Institute of Dentistry, University of Turku, Turku, Finland
| | - Lippo Lassila
- Department of Biomaterials Science and TCBC, Institute of Dentistry, University of Turku, Turku, Finland
| |
Collapse
|
7
|
Box MW, Wilson F, Pasque CB, Smith CD. Characteristics of Rodeo Injuries and Suggestions for Injury Prevention: A Systematic Review. Orthop J Sports Med 2024; 12:23259671241227217. [PMID: 38628461 PMCID: PMC11020730 DOI: 10.1177/23259671241227217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 06/06/2023] [Indexed: 04/19/2024] Open
Abstract
Background Rodeo is a globally popular sport, with its athletes prone to various types of injuries. There is no systematic review discussing rodeo injuries across all age groups. Purpose To (1) review the published literature on incidence, types of injuries, and factors leading to injuries in rodeo athletes; (2) provide prevention recommendations for health care providers; and (3) identify gaps in the research. Study Design Systematic review; Level of evidence, 4. Methods A comprehensive search of available literature was electronically performed through MEDLINE, Embase, and SPORTDiscus databases using the key terms "rodeo" and "injury" or "trauma" between 1995 and 2021. A systematic review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, which identified 116 eligible studies. Outcome data included frequency of injuries, risk factors for injury, and types of injury. Results A total of 23 studies met the inclusion criteria (N = 2105 athletes), of which 13 were retrospective studies. In the included studies, the injury rate per competition exposure (CE) ranged from 4.2 to 19.1 injuries per 1000 CE. Sprains and strains accounted for the highest percentage of injury types, ranging from 15% to 34%. The knee was the most common location of injury, making up 11.1% to 17% of injuries. Concussions occurred in up to 15.3% of injuries for all events and up to 77% of injuries in roughstock events. Of all rodeo events reported, bull riding caused the highest percentage of injuries, making up 19.4% to 58.4% of injuries, and bareback had the second highest at 15.3% to 28.8% of injuries. Conclusion There was a high prevalence of various injury types and mechanisms in rodeo. Improved injury surveillance and the introduction of a comprehensive standardized injury reporting system would be helpful in the future prevention, diagnosis, and treatment of rodeo injuries.
Collapse
Affiliation(s)
- McKenna W. Box
- Department of Orthopaedic Surgery & Rehabilitation, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Freddie Wilson
- Department of Orthopaedic Surgery & Rehabilitation, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Charles B. Pasque
- Department of Orthopaedic Surgery & Rehabilitation, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Chase D. Smith
- Department of Orthopaedic Surgery & Rehabilitation, University of Oklahoma, Oklahoma City, Oklahoma, USA
- Southern Bone & Joint Specialists, Dothan, Alabama, USA
| |
Collapse
|
8
|
Zhou J, Wu Q, Pan P, Xiong H, Hou Y, Chen Y, Wu J, Tang T. A Shear-Stiffening Mouthguard with Excellent Shock Absorption Capability and Remoldability via a Dynamic Dual Network. ACS APPLIED BIO MATERIALS 2024; 7:1694-1702. [PMID: 38373327 DOI: 10.1021/acsabm.3c01134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Mouthguards are used to reduce injuries and the probability of them to orofacial tissues when impacted during sports. However, the usage of a mouthguard is low due to the discomfort caused by the thickness of the mouthguard. Herein, we have constructed a dynamic dual network to fabricate a shear-stiffening mouthguard with remoldability, which are called remoldable shear-stiffening mouthguards (RSSMs). Based on diboron/oxygen dative bonds, RSSMs show a shear-stiffening effect and excellent shock absorption ability, which can absorb more than 90% of the energy of a blank. Even reducing the thickness to half, RSSMs can reduce approximately 25% of the transmitted force and elongate by about 1.6-fold the buffer time compared to commercial mouthguard materials (Erkoflex and Erkoloc-pro). What is more, owing to the dynamic dual network, RSSMs show good remolding performance with unchanged shear-stiffening behavior and impact resistance, which conforms to the existing vacuum thermoforming mode. In addition, RSSMs exhibit stability in artificial saliva and biocompatibility. In conclusion, this work will broaden the range of mouthguard materials and offer a platform to apply shear-stiffening materials to biomedical applications and soft safeguarding devices.
Collapse
Affiliation(s)
- Jing Zhou
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Qi Wu
- State Key Laboratory of Polymer Materials Engineering, College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, Sichuan, China
| | - Peiyue Pan
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Hui Xiong
- State Key Laboratory of Polymer Materials Engineering, College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, Sichuan, China
| | - Yujia Hou
- State Key Laboratory of Polymer Materials Engineering, College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, Sichuan, China
| | - Yafei Chen
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jinrong Wu
- State Key Laboratory of Polymer Materials Engineering, College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, Sichuan, China
| | - Tian Tang
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| |
Collapse
|
9
|
Othman NH, Rajali A, Zulkifeli NRN, Shaharuddin IM, Hussein KH, Hassan MIA. Sports-related dental injuries and oral health status among Malaysian para-athletes: A cross-sectional study. SPECIAL CARE IN DENTISTRY 2024; 44:221-230. [PMID: 37055924 DOI: 10.1111/scd.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Athletes with disabilities may be at an even greater risk of orofacial trauma than their counterparts, and the risk may vary depending on the type of sports. This study aimed to assess the incidence of sports-related dental injuries and oral health status among Malaysian para-athletes. METHODS A questionnaire survey was conducted to assess self-reported dental injuries and knowledge of their management. An intraoral examination was performed using the decayed, missing, and filled teeth (DMFT) index following the World Health Organization guidelines. RESULTS A total of 61 para-athletes (men = 90.16%, n = 55; women = 9.84%, n = 6) from different sports categories with different disabilities randomly participated in this study. The incidence of self-reported dental injuries was 18.0% (n = 11), with the most common injury being crown tooth fracture (72.7%) and lip laceration (63.6%). However, the majority of the athletes (70.5%, n = 43) did nothing after experiencing dental trauma, and 82.0% (n = 50) were unaware of the immediate management of dental trauma. Based on the intraoral examination, only 9.8% (n = 6) of the athletes had perfectly sound teeth. The mean total DMFT index was 3.49 ± 2.371, while the mean DMFT index for decayed, missing, and filled teeth was 1.28 ± 1.293, 0.74 ± 0.705, and 1.48 ± 1.120, respectively. The mean DMFT index for decayed, missing, and filled teeth and total DMFT index significantly differed among the types of disabilities (P < .05) but not between the sexes (P > .05). CONCLUSION The most commonly reported injuries among para-athletes are crown tooth fractures and lip lacerations. The total DMFT index among para-athletes is moderate, emphasising the need for improvements.
Collapse
Affiliation(s)
- Nurul Hanim Othman
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Sungai Buloh, Selangor, Malaysia
- School of Dental Sciences, Universiti Sains Malaysia (USM), Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Aiemeeza Rajali
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Sungai Buloh, Selangor, Malaysia
| | - Nik Rahayyu Nik Zulkifeli
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Sungai Buloh, Selangor, Malaysia
| | - Izzati Mohd Shaharuddin
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Sungai Buloh, Selangor, Malaysia
| | | | - Mohamed Ibrahim Abu Hassan
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Sungai Buloh, Selangor, Malaysia
| |
Collapse
|
10
|
Kasum M, Gavic L, Mandic P, Tadin A. Knowledge of traumatic dental injuries and mouthguard behavior among Croatian soccer players. Dent Traumatol 2023; 39:555-564. [PMID: 37341423 DOI: 10.1111/edt.12862] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 05/13/2023] [Accepted: 05/26/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVES/AIM Sports-related dental injuries occur frequently among athletes due to inadequate knowledge and prevention measures. The aim of the study was to assess knowledge, attitudes, and practices of active soccer players from all leagues in Croatia regarding traumatic dental injuries and the use of mouthguards. MATERIAL AND METHODS 393 respondents completed a questionnaire-based online survey from March 2022 to April 2022. The questionnaire consisted of 37 questions divided in four sections: demographic characteristics, experience with orofacial injuries, knowledge of emergency therapeutic procedures for dental injuries, and behaviors related to the use of a mouthguard. RESULTS Insufficient knowledge was confirmed by a total score of 2.8 ± 2.8 points, with a possible maximum of 11. Respondents' better knowledge can be associated with educational level (p = .002), playing position (p = .046), and personally experienced injuries to the face and jaw (p ≤ .001) and teeth (p = .022). Less than 40% of respondents suffered facial and jaw injuries while playing football and 18.6% suffered dental injuries. Although most respondents (93.9%) were familiar with mouthguards and 68.9% believed that they help prevent injuries while playing football, only 16% used them. CONCLUSION The study revealed significant gaps in knowledge regarding dental injuries and the practice of mouthguard usage among Croatian soccer players. Therefore, it is evident that additional education is needed to prevent dental injuries and take proper procedures when taking care of them among the examined population.
Collapse
Affiliation(s)
- Marin Kasum
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Lidia Gavic
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | | | - Antonija Tadin
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
- Department of Maxillofacial Surgery, Clinical Hospital Centre Split, Split, Croatia
| |
Collapse
|
11
|
Cao R, Zhang X, Xu Y, Zhao W, Qiu P, Liu W. Influence of wearing mouthguards on performance among athletes: A systematic review. J Sci Med Sport 2023; 26:493-503. [PMID: 37524627 DOI: 10.1016/j.jsams.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 07/09/2023] [Accepted: 07/16/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES While the use of mouthguards is well established to prevent orofacial and dental trauma occurrence, limited evidence exists regarding their influence on athletic performance. The objective of this study was to conduct a systematic review of the literature to assess the effect of wearing mouthguards on athletic performance. DESIGN Systematic review. METHODS An extensive search was performed in the databases of PubMed/MEDLINE, Embase, Scopus and Cochrane Library for studies published up to August 2022. Only peer-reviewed studies involving humans in vivo and investigating the use of mouthguards on performance among athletes were included. Quality assessment was performed using the Cochrane Collaboration's risk of bias tool. RESULTS The initial query yielded 4785 citations, of which 41 studies met the inclusion criteria, comprising a total of 852 athletes. Overall, wearing mouthguards was found to improve athletic performance compared to the control group (without mouthguards). Custom-made mouthguards were found to be more effective in enhancing athletic performance compared to other types of mouthguards. CONCLUSIONS Wearing mouthguards should be advocated by athletes not only for the prevention of orofacial and dental trauma but also for their potential improvements in athletic performance in specific actions. However, caution must be exercised in interpreting these findings due to the variability in outcome measures and the lack of important methodological details.
Collapse
Affiliation(s)
- Rongkai Cao
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, PR China
| | - Xuehan Zhang
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, PR China
| | - Yifan Xu
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, PR China
| | - Wei Zhao
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, PR China
| | - Piaopiao Qiu
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, PR China
| | - Weicai Liu
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, PR China.
| |
Collapse
|
12
|
Dulle JF, Moore ML, Brinkman JC, Pollock JR, Dulle DL, Jenkins AS, Chhabra A. The Most Cited and Influential Publications Relating to Ice Hockey Since 2000 Focus Primarily on Concussion and Traumatic Brain Injuries. Arthrosc Sports Med Rehabil 2023; 5:e613-e622. [PMID: 37388886 PMCID: PMC10300535 DOI: 10.1016/j.asmr.2023.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/26/2023] [Indexed: 07/01/2023] Open
Abstract
Purpose To determine the most frequently cited articles relating to ice hockey since 2000 and conduct a bibliometric analysis of these publications. Methods The Clarivate Web of Knowledge database was used to gather data and generate a list of publications relating to "ice hockey" on June 20, 2022. Articles were filtered by the total number of citations accrued and were included or excluded on the basis of relevance to ice hockey; no date of publication, language, or journal restrictions. After the 50 most highly cited articles were identified, articles published before the year 2000 were excluded to avoid bias. The information analyzed from each article included author name (first and last), publication year, country of origin, institutional affiliation (of the first and last author), journal name, research design, main research topic, competition level, and the level of evidence. Results Ultimately, 46 studies were included in this analysis. The total number of citations was 8,267 times with an average of 179.7 citations per article. The most cited article was cited 926 times. The articles came from 5 different countries, with the United States and Canada comprising 27 and 13 articles, respectively. All articles were published in English. The American Journal of Sports Medicine published the greatest number of articles. The most studied topic was concussion/traumatic brain injury (n = 26). Professional hockey was the most studied level of competition (n = 15), while college followed (n = 13). Three institutions, University of Calgary, Dartmouth School of Medicine, and University of North Carolina at Chapel Hill were responsible for 32.6% of the top articles (n = 15). Conclusions The majority of the most cited articles relating to ice hockey are cohort studies, review articles, and epidemiological studies originating from the United States or Canada. The majority of publications included in the analysis focused on concussion and traumatic brain injury prevalence, identification, diagnosis, outcomes, and prevention, as well as the most studied level of competition was professional, but the greatest number of participants arose from the youth and high school level. Level of Evidence Level IV, cross-sectional study.
Collapse
Affiliation(s)
- Jamie F. Dulle
- University of Redlands, Biology Department, Redlands, California
| | - M. Lane Moore
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, U.S.A
| | | | - Jordan R. Pollock
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, U.S.A
| | - Donald L. Dulle
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A
| | - Anna S. Jenkins
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, U.S.A
| | - Anikar Chhabra
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A
| |
Collapse
|
13
|
Kolstad AT, Eliason PH, Galarneau JM, Black AM, Hagel BE, Emery CA. Protective equipment in youth ice hockey: are mouthguards and helmet age relevant to concussion risk? Br J Sports Med 2023; 57:571-577. [PMID: 36918257 PMCID: PMC10176392 DOI: 10.1136/bjsports-2022-105585] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES To compare the incidence rates and odds of concussion between youth ice hockey players based on mouthguard use and helmet age. MATERIALS AND METHODS Within a 5-year longitudinal cohort (2013/2014 to 2017/2018) of male and female ice hockey players (ages 11-18; n=3330 players) in Alberta (Canada), we analysed the relationship of equipment and concussion in both a prospective cohort and nested case (concussion) control (acute musculoskeletal injury) approach. The prospective cohort included baseline assessments documenting reported mouthguard use (yes/sometimes, no use), helmet age (newer/<2 years old, older/≥2 years old) and important covariables (weight, level of play, position of play, concussion history, body checking policy), with weekly player participation throughout the season. The nested case-control component used injury reports to document equipment (mouthguard use, helmet age) and other information (eg, mechanism and type of injury) for the injury event. Multivariable mixed effects negative binomial regression (prospective cohort, incidence rate ratios (IRRs)) and multivariable mixed effects logistic regression (nested case-control, odds ratios (OR)) examined the association between equipment and concussion. RESULTS Players who reported wearing a mouthguard had a 28% lower concussion rate (IRR=0.72, 95% CI 0.56 to 0.93) and 57% lower odds of concussion (OR=0.43, 95% CI 0.27 to 0.70) compared with non-wearers. There were no associations in the concussion rate (IRR=0.94, 95% CI 0.75 to 1.15) and odds (OR=1.16, 95% CI 0.73 to 1.86) between newer and older helmets. CONCLUSIONS Wearing a mouthguard was associated with a lower concussion rate and odds. Policy mandating use should be considered in youth ice hockey. More research is needed to identify other helmet characteristics (eg, quality, fit) that could lower concussion risk.
Collapse
Affiliation(s)
- Ash T Kolstad
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Paul H Eliason
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jean-Michel Galarneau
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
| | - Amanda Marie Black
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Brent E Hagel
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Departments of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Departments of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
14
|
Mańka-Malara K, Szerszeń M, Górski B, Tanabe G, Ueno T, Mierzwińska-Nastalska E. Disinfection and Isotonic Drinks' Influence on Hardness and Color Stability of Ethylene-Vinyl-Acetate Copolymer Mouthguards Used in Martial Arts: An In Vitro Study. Polymers (Basel) 2023; 15:polym15081822. [PMID: 37111969 PMCID: PMC10146693 DOI: 10.3390/polym15081822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/19/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
This in vitro study aimed to evaluate the hardness and color change of an ethylene-vinyl-acetate copolymer (EVA) material for mouthguards after exposition to different cleaning agent solutions and isotonic drinks. Four hundred samples were prepared and divided into four equinumerous groups (n = 100), in which there were 25 samples from each color of EVA (red, green, blue and white). The hardness, using the digital durometer, and the color coordinates (CIE L*a*b*), using the digital colorimeter, were measured before the first exposition and after 3 months of exposition to spray disinfection and incubation in the oral cavity temperature, or immersion in isotonic drinks. The values of Shore A hardness (HA) and color change (ΔE-calculated by Euclidean distance) were statistically analyzed using the Kolmogorov-Smirnov test, multiple comparison ANOVA/Kruskal-Wallis and appropriate post-hoc tests. Statistically significant changes in color and hardness between the tested groups were demonstrated after the use of agents predestined for disinfecting the surface of mouthguards on the tested samples. There were no statistically significant differences in color and hardness between the groups immersed in isotonic sport drinks potentially consumed by competitors practicing combat sports using mouthguards. Despite the changes in color and hardness after the use of disinfectants, the deviations were minor and limited to specific colors of the EVA plates. The intake of isotonic drinks practically did not change either the color or the hardness of the samples, regardless of the tested color of the EVA plates.
Collapse
Affiliation(s)
| | - Marcin Szerszeń
- Department of Prosthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Bartłomiej Górski
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Gen Tanabe
- Department of Sports Dentistry, Tokyo Medical and Dental University, 113-8510, Tokyo, Japan
| | - Toshiaki Ueno
- Department of Sports Dentistry, Tokyo Medical and Dental University, 113-8510, Tokyo, Japan
- Department of Sports Dentistry, Meikai University School of Dentistry, 350-0248, Saitama, Japan
| | | |
Collapse
|
15
|
Sun Z, Zhang J, Sun R, Zhang M, Zhong Q, Huang M, Yan X, Li J. Effects of different custom-made mouthguard palatal extensions on the stress-state of dentoalveolar structures: a 3D-FEA. Clin Oral Investig 2023:10.1007/s00784-023-04998-0. [PMID: 37010637 DOI: 10.1007/s00784-023-04998-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/28/2023] [Indexed: 04/04/2023]
Abstract
OBJECTIVES The present study aimed to simulate the influence of palatal extensions for custom-made mouthguards (MGs) on protecting dentoalveolar structures and to provide a theoretical basis for designing a comfortable MG. MATERIALS AND METHODS Based on finite element analysis (3D-FEA), five groups of maxillary dentoalveolar models of wearing MGs were established: no MG on palatal side (NP), on palatal gingival margin (G0), 2 mm from the palatal gingival margin (G2), 4 mm from the palatal gingival margin (G4), 6 mm from the palatal gingival margin (G6), and 8 mm from the palatal gingival margin (G8). A cuboid was created to simulate the solid ground impacted in falls, a gradually increasing force was applied from 0 to 500 N on the vertical ground, and the distribution and peak values of the Critical modified von-Mises stress, maximum principal stress, and displacement of dentoalveolar models were calculated. RESULTS Stress distribution range, stress, and deformation peak value of dentoalveolar models increased as the impact strength increased, at 500 N. Maximum critical modified von-Mises stress, peak maximum principal stress and maximum displacement of dentoalveolar models G4, G3, G2, G1, G0, and NP were 154.5 MPa, 154.5 MPa, 154.4 MPa, 154.7 MPa, 154.4 MPa, and 154.7 MPa; 191.65 MPa, 192.11 MPa, 191.62 MPa, 191.81 MPa, 191.56 MPa, and 191.62 MPa; and 88.78 μm, 88.57 μm, 88.19 μm, 88.67 μm, 88.43 μm, and 89.04 μ, respectively. However, the position of the MG palatal edge had little effect on stress distribution, stress, and deformation peak values of the dentoalveolar models. CONCLUSIONS Different extension ranges of the MG palatal edge have little effect on the protective effects of MGs on maxillary teeth and maxilla. An MG with palatal extension on the gingival margin is more appropriate than other models and may help dentists to design a suitable MG and increase its usage. CLINICAL RELEVANCE MGs with palatal extensions on the gingival margin may provide a more comfortable wearing experience for individuals involved in sports and encourage increased MG usage.
Collapse
Affiliation(s)
- Zhe Sun
- Department of Physical Education, Northeastern University, Shenyang, China
| | - Jiayun Zhang
- Sports School, Shenyang University, Shenyang, China
| | - Ruitong Sun
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Meng Zhang
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Qinqiu Zhong
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Minghao Huang
- Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Xu Yan
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
| | - Jian Li
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
| |
Collapse
|
16
|
Trzaskowski M, Mańka-Malara K, Szczesio-Włodarczyk A, Sokołowski J, Kostrzewa-Janicka J, Mierzwińska-Nastalska E. Evaluation of Mechanical Properties of 3D-Printed Polymeric Materials for Possible Application in Mouthguards. Polymers (Basel) 2023; 15:898. [PMID: 36850182 PMCID: PMC9964375 DOI: 10.3390/polym15040898] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/05/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Custom mouthguards are used in various sports disciplines as a protection for teeth, temporomandibular joints, and soft tissues of the oral cavity from impact forces. The purpose of this research was to evaluate the mechanical properties of flexible polymeric 3D-printable materials and to select a material with the most favourable physical properties for making intraoral protectors. Four 3D-printable polymeric materials were selected for the evaluation: IMPRIMO LC IBT (Scheu-Dental, Iserlohn, Germany), Keyortho IBT (EnvisionTEC, Gladbeck, Germany), IBT (Formlabs, Somerville, MA, USA), and Ortho IBT (NextDent, Utrecht, Netherlands). A total of 176 samples (44 from each material) was 3D-printed using the stereolitography (SLA) technique. Tensile strength, flexural strength, notch-toughness, Shore hardness, sorption, and solubility tests were conducted. The materials were compared using a series of analyses of variance (one-way ANOVA) with Bonferroni post hoc tests. Statistical analyses were performed with the use of IBM SPSS Statistics 28.0.0 software (IBM, New York, NY, USA). Each material was assigned a score from 1 to 4 depending on the individual test results, and tests were given indexes according to the significance of the parameter in the mouthguard protective function. The number of points obtained by each material in each test was then multiplied by the test index, and the results were tabulated. The material with the highest result among the ones studied-most suitable for the application in mouthguard fabrication-was Keyortho IBT from EnvisionTEC.
Collapse
Affiliation(s)
- Maciej Trzaskowski
- Department of Prosthodontics, Medical University of Warsaw, ul. Binieckiego 6, 02-097 Warsaw, Poland
| | - Katarzyna Mańka-Malara
- Department of Prosthodontics, Medical University of Warsaw, ul. Binieckiego 6, 02-097 Warsaw, Poland
| | - Agata Szczesio-Włodarczyk
- University Laboratory of Materials Research, Medical University of Lodz, Pomorska 251, 92-216 Łódź, Poland
| | - Jerzy Sokołowski
- University Laboratory of Materials Research, Medical University of Lodz, Pomorska 251, 92-216 Łódź, Poland
| | - Jolanta Kostrzewa-Janicka
- Department of Prosthodontics, Medical University of Warsaw, ul. Binieckiego 6, 02-097 Warsaw, Poland
| | | |
Collapse
|
17
|
Prevention in Sports Dentistry. Int Dent J 2023; 73:5-6. [PMID: 36653074 PMCID: PMC9875225 DOI: 10.1016/j.identj.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
|
18
|
Play Ball: A 10-Year Comparative Analysis of Craniofacial Safety in Baseball and Softball. J Craniofac Surg 2022; 33:1690-1692. [PMID: 35767476 DOI: 10.1097/scs.0000000000008487] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/11/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Within the United States, the number of players participating in baseball increased by nearly 21% to 15.9 million between 2014 and 2019. Additionally, batting helmets with face-masks are encouraged yet optional in youth baseball as well as college baseball and softball. in light of inconsistencies in safety equipment enforcement and usage, this study aims to perform a comparative analysis of the number and frequency of baseball and softball-related craniofacial injuries (CFis). METHODS Data regarding baseball and softball-related injuries were gathered from the National Electronic Injury Surveillance System database from 2011 to 2020. Craniofacial injuries were isolated and organized into 5-year age groups beginning with 5 to 9 years and ending with 25 to 29 years of age. Data was further stratified by location and type of injury. Injury types specifically reported in this study included concussion, contusion, fracture, and laceration. RESULTS Distribution of injuries across age groups differed significantly between baseball and softball (P < 0.001). When comparing the 10 to 14 year old group to the 15 to 19 year old group, we found that concussions and head contusions comprise a significantly greater proportion of all injuries in softball than in baseball. Conversely, facial fractures, facial lacerations, and mouth lacerations comprise a significantly greater proportion ofinjuries in baseball than in softball. CONCLUSION Future prospective studies aiming to better characterize the within-game nature of these reported CFIs would certainly be beneficial in guiding the baseball and softball communities toward consideration of implementing maximally efficacious updates to current safety equipment standards.
Collapse
|
19
|
Shelley A, Winwood K, Allen T, Horner K. Effectiveness of hard inserts in sports mouthguards: a systematic review. Br Dent J 2022:10.1038/s41415-022-4089-x. [PMID: 35379927 DOI: 10.1038/s41415-022-4089-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 07/20/2021] [Indexed: 11/09/2022]
Abstract
Objectives To improve the protective capacity of conventional ethylene-vinyl acetate mouthguards, some authors have suggested reinforcement with a hard material to distribute impact energy more widely. The research question for this systematic review was: 'does the inclusion of a hard insert in mouthguards improve the protection of anterior teeth from a direct blow?'Data sources Three bibliographic databases (PubMed/Medline, Ovid/Embase and the Cochrane CENTRAL databases) were searched up to 20 February 2021. Additional searches included hand searching of key articles and journals.Data selection A systematic search of the literature included studies where the intervention was the incorporation of hard material into sports mouthguards and where the comparator was conventional mouthguard material. Eligibility required the use of anatomical specimens or anatomical analogues which included or represented anterior maxillary teeth. Twelve eligible publications were identified.Data extraction Data extraction was first carried out independently by two reviewers. Discrepancies were resolved by discussion.Data synthesis Results of individual studies were conflicting and methodological diversity created difficulty in making a synthesis of results. All studies employed low-energy impacts that did not represent the potentially high-energy impacts encountered in sport.Conclusion The efficacy of hard inserts in sports mouthguards has not been demonstrated.
Collapse
Affiliation(s)
- Andrew Shelley
- Dental Practitioner, Shelley and Pope Dental Practice, 117 Stockport Road, Denton, Manchester, M34 6DH, UK; Honorary Research Fellow, University of Manchester, Manchester, UK; Team Dentist, Manchester Storm Ice Hockey Club, Manchester, UK.
| | - Keith Winwood
- Musculoskeletal Science and Sports Medicine, Department of Life Science, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Thomas Allen
- Department of Engineering, Manchester Metropolitan University, Faculty of Science and Engineering, Manchester, UK
| | - Keith Horner
- Emeritus Professor of Oral and Maxillofacial Imaging, Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
| |
Collapse
|
20
|
Meyfarth SRS, Rodrigues KAB, Von Held R, Sarkis P, Gouvea Junior LEC, Antunes LAA, Antunes LS. An analysis of athletes' knowledge, acceptance and usability toward custom-made mouthguards: uncontrolled before–after study. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00919-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
21
|
Saunders J, Lißner M, Townsend D, Petrinic N, Bergmann J. Impact behaviour of 3D printed cellular structures for mouthguard applications. Sci Rep 2022; 12:4020. [PMID: 35256721 PMCID: PMC8901696 DOI: 10.1038/s41598-022-08018-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/28/2022] [Indexed: 11/09/2022] Open
Abstract
Ethylene-Vinyl Acetate (EVA) is the most popular material for manufacturing mouthguards. However, EVA mouthguards are problematic, for example inconsistent thicknesses across the mouthguard. Additive manufacturing provides a promising solution to this problem, as it can manufacture mouthguards with a greater precision. This paper compares the energy dissipation of EVA, the current material used for mouthguards, to various designs of a 3D printed material, some of which contain air cells. Impact testing was carried out at three different strain rates. The Split-Hopkinson bar was used for medium and high strain rate tests, and an Instron test rig was used for low strain rate testing. The best performing design dissipated 25% more energy than EVA in the medium and high strain rate testing respectively while the low strain rate testing was inconclusive. This research has shown that additive manufacturing provides a viable method of manufacturing mouthguards. This opens up the opportunity for embedding electronics/sensors into additive manufactured mouthguards.
Collapse
Affiliation(s)
- John Saunders
- Department of Engineering Science, University of Oxford, Oxford, OX1 3PJ, UK
| | - Maria Lißner
- Department of Engineering Science, University of Oxford, Oxford, OX1 3PJ, UK.
| | - David Townsend
- Department of Engineering Science, University of Oxford, Oxford, OX1 3PJ, UK
| | - Nik Petrinic
- Department of Engineering Science, University of Oxford, Oxford, OX1 3PJ, UK
| | - Jeroen Bergmann
- Department of Engineering Science, University of Oxford, Oxford, OX1 3PJ, UK
| |
Collapse
|
22
|
Carmona AR, Colorado Lopera HA. A new composite made from Luffa Cylindrica and ethylene vinyl acetate (EVA): Mechanical and structural characterization for its use as Mouthguard (MG). J Mech Behav Biomed Mater 2022; 126:105064. [PMID: 34968944 DOI: 10.1016/j.jmbbm.2021.105064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 12/30/2022]
Abstract
The use of Mouthguards (MGs) in contact sports is an interesting biomedical topic. MGs are protective personal equipment made principally from the copolymer ethylene vinyl acetate (EVA). EVA is a thermoplastic whose thickness and rigidity are variables of concern for a good shock energy absorption capability in an MG. A natural fiber polymer composite is an interesting attempt for tackling these variables. Luffa cylindrica (luffa) is a sponge gourd that grows in 3D structure, which is used mainly as an ornament, a filling, or is trimmed for its use as a bathing product. In this work, a new EVA-luffa composite (EVLc) was made from commercial EVA sheets and luffa mat acting as reinforcement. FTIR, DSC, and TGA tests of EVA revealed its nature compared to literature data. A mechanical testing was applied to eight EVLc ASTM D-638 type V dumbbells (D1-D8) that showed low tensile strength values compared to EVA resistance ranges in literature. SEM images of EVLc's D1-D8 confirmed good adhesion between the reinforcement and matrix without surface treatment, and a descriptive statistical analysis indicated an intrinsic variation.
Collapse
Affiliation(s)
- Alejandro Restrepo Carmona
- CCComposites Laboratory, University of Antioquia, Calle 67 No. 53 - 108, Medellín, Colombia; Advanced Biomaterials and Regenerative Medicine Group, University of Antioquia, Calle 67 No. 53 - 108, Medellín, Colombia
| | - Henry A Colorado Lopera
- CCComposites Laboratory, University of Antioquia, Calle 67 No. 53 - 108, Medellín, Colombia.
| |
Collapse
|
23
|
Dias A, Redinha L, Tavares F, Silva L, Malaquias F, Pezarat-Correia P. The effect of a controlled mandible position mouthguard on upper body strength and power in trained rugby athletes - A randomized within subject study. Injury 2022; 53:457-462. [PMID: 34785082 DOI: 10.1016/j.injury.2021.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 10/17/2021] [Accepted: 11/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND It is widely accepted that mouthguards are effective for injury protection in sports. However, findings on the effects of mouthguards in strength and power production remains controversial. Therefore, the aim of this study was to determine whether controlled-mandible position mouthguards influence strength and power production in well trained athletes. METHODS Twenty-two male amateur rugby players (25 ± 3.84 yrs; 1.92 ± 0.07 m; 93.91 ± 11.99 kg) volunteered for this study. Every participant performed an 1RM bench press test (113.20 ± 16.83 kg) to determine his maximal strength. In a randomized order, a ballistic bench press using 40% of the obtained 1RM (44.93 ± 6.76 Kg) was performed in a guided bar attached to a linear position transducer (LPT) for the following conditions: a) no mouthguard (CON); b) controlled mouthguard (MCM - jaw in centric relation); c) non-controlled mouthguard (NCM) and d) occlusal splint (OS). Vertical dimension of occlusion was also assessed for each of the testing conditions. RESULTS Athletes using a controlled mouthguard demonstrate a significant (p < 0.05) higher peak acceleration and peak force than those using no mouthguard. Additionally, when analysing the results of vertical dimension of occlusion, a significant difference (p < 0.05) was observed between controlled mouthguard and the other tested conditions. CONCLUSION Controlled mouthguards enhance peak force and peak acceleration in the ballistic bench press exercise without negatively affecting any other measure assessed in this study. We speculate that this is possibly due to an increased stability of temporomandibular joint.
Collapse
Affiliation(s)
- Amândio Dias
- Neuromuscular Research Lab, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal; Department of Science and Technology, Polytechnic Institute of Setúbal, School of Higher Education, Setúbal, Portugal; Kinesiolab - Laboratory of Human Movement Analysis, Instituto Piaget, Almada, Portugal.
| | - Luís Redinha
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Francisco Tavares
- Medical and Performance Department, Sporting clube de Portugal, Portugal
| | - Luís Silva
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, United States; NOVA School of Science and Technology, Largo da Torre, 2825-149 Caparica, Portugal
| | - Frederico Malaquias
- Neuromuscular Research Lab, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Pedro Pezarat-Correia
- Neuromuscular Research Lab, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| |
Collapse
|
24
|
Modeling the Contact Interaction of a Pair of Antagonist Teeth through Individual Protective Mouthguards of Different Geometric Configuration. MATERIALS 2021; 14:ma14237331. [PMID: 34885485 PMCID: PMC8658410 DOI: 10.3390/ma14237331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 12/03/2022]
Abstract
This study carried out modeling of the contact between a pair of antagonist teeth with/without individual mouthguards with different geometric configurations. Comparisons of the stress–strain state of teeth interacting through a multilayer mouthguard EVA and multilayer mouthguards with an A-silicon interlayer were performed. The influence of the intermediate layer geometry of A-silicone in a multilayer mouthguard with an A-silicon interlayer on the stress–strain state of the human dentition was considered. The teeth geometry was obtained by computed tomography data and patient dental impressions. The contact 2D problem had a constant thickness, frictional contact deformation, and large deformations in the mouthguard. The strain–stress analysis of the biomechanical model was performed by elastoplastic stress–strain theory. Four geometric configurations of the mouthguard were considered within a wide range of functional loads varied from 50 to 300 N. The stress–strain distributions in a teeth pair during contact interaction at different levels of the physiological loads were obtained. The dependences of the maximum level of stress intensity and the plastic deformation intensity were established, and the contact parameters near the occlusion zone were considered. It was found that when using a multilayer mouthguard with an A-silicone interlayer, there is a significant decrease in the stress intensity level in the hard tissues of the teeth, more than eight and four times for the teeth of the upper and lower teeth, respectively.
Collapse
|
25
|
Cicek T, Dhamo B, Wolvius EB, Wesselink PR, Kragt L. Effectiveness of the new mandatory mouthguard use and orodental injuries in Dutch field hockey. PHYSICIAN SPORTSMED 2021; 49:455-462. [PMID: 33216663 DOI: 10.1080/00913847.2020.1853487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
ObjectivesUp to 68% of field hockey players have experienced at least one orodental injury in their sport career. Therefore, the Royal Dutch Hockey Association (KNHB) made mouthguard use mandatory for field hockey players during competition and training from August 2015 onwards.This study evaluates the effects of the new regulations on mouthguard use and the occurrence of injuries in Dutch field hockey.MethodsA 35-item online questionnaire about mouthguard use and orodental injuries was sent to 13 field hockey clubs in the Netherlands. Absolute numbers and percentages of mouthguard ownership, mouthguard use, number and type of injuries were assessed. The results were related to comparable data before mandatory mouthguard use. Associations of gender and training frequency with the number of injuries were analysed with logistic regression.ResultsIn total, 1169 hockey players were included in the study and almost all owned a mouthguard (females:99.6%, males:93.7%), which significantly increased after implementation (p < 0.001). 90.6% of the respondents wore a mouthguard during matches and 70.1% during training. Of the 1169 players, 68(5.8%) experienced at least one orodental injury after the implementation with a total of 100 injuries. Injuries happened more often during matches (63.2%) than during training (36.8%). Lip cuts account for most of the injuries, the number of broken (p = 0.116) and knocked out teeth (p = 0.026) decreased.ConclusionAlthough mouthguard use already increased in recent years, the new regulations led to an additional increase and a successful change of attitude towards mouthguard use. Most importantly, the severity of orodental injuries decreased measurable.
Collapse
Affiliation(s)
- Tevfik Cicek
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Brunilda Dhamo
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Eppo B Wolvius
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Paul R Wesselink
- Department of Cariology, Endodontology and Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Lea Kragt
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Erasmus University Medical Centre, Rotterdam, The Netherlands
| |
Collapse
|
26
|
The Effectiveness of Dental Protection and the Material Arrangement in Custom-Made Mouthguards. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11209363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Experimental research studies have shown that wearing a mouthguard (MG) is an effective way to prevent tooth or maxillofacial trauma. However, there is a lack of scientific information regarding how the material arrangement within the mouthguard can modify its mechanical response during an impact. Hence, this study aimed to evaluate the influence of material arrangement within custom-made mouthguards on stress transmitted to anterior teeth, bone, and soft tissue after impact. Four 3D finite element models of a human maxilla were reconstructed based on the CBCT of a young patient and analyzed according to the presence or absence of a mouthguard and the type of material arrangement within those with a mouthguard: model NMG with no mouthguard; model CMG representing the conventional arrangement with a single 4 mm-thick ethylene-vinyl acetate (EVA) foil; model FMG presenting layer arrangement with two 1 mm-thick foils of EVA in the outer shell and one 2 mm-thick foil of EVA foam in the core; model HMG presenting a 1 mm-thick compact inner and outer shell of EVA and a 2 mm wide air-filled zone in the core. Linear quasi-static analysis and frontal load were used to simulate an impact with an energy of 4.4 J. Isotropic linear elastic properties were assumed for the bone and teeth but not for the mouthguard protection and oral soft tissues. The results were evaluated and compared in terms of displacement, stretches, and stresses. All the mouthguards analyzed reduced the risk of injury to teeth and bone, reducing the displacement and stress of these structures. However, the implementation of a honeycomb structured layer allowed more significant displacement and deformation of the mouthguard’s external layer, thus promoting higher protection of the anatomic structures, namely the root dentin and the bone tissue. Nevertheless, the results also indicate that improving the mouthguard flexibility might increase the soft tissue injuries.
Collapse
|
27
|
Haughey JP, Fine P. Effects of the lower jaw position on athletic performance of elite athletes. BMJ Open Sport Exerc Med 2021; 6:e000886. [PMID: 34422287 PMCID: PMC8323458 DOI: 10.1136/bmjsem-2020-000886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 12/26/2022] Open
Abstract
When an athlete wears a mouthguard, the position of the lower jaw is changed by virtue of the teeth being unable to occlude. Little research is available in in this area, which have indicated both positive impact and no positive impact.
Collapse
Affiliation(s)
| | - Peter Fine
- CPD, UCL Eastman Dental Institute, London, UK
| |
Collapse
|
28
|
Nii M, Yoda N, Putra RH, Aida J, Sasaki K. Evaluation of the optimal hardness and thickness of music splints for wind instrument players. J Prosthet Dent 2021; 129:754-762. [PMID: 34364689 DOI: 10.1016/j.prosdent.2021.06.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM As players of single-reed wind instruments such as the clarinet and saxophone are likely to experience pain and trauma of the lower lip, a method to prevent these symptoms without disturbing the music quality and performance is required. PURPOSE The purpose of this clinical study was to produce a custom music splint, an oral appliance for the players of single-reed wind instruments, by using sports mouthguard sheet materials and to determine its suppression effect on the pressure and pain of the lower lip and teeth and on fatigue and pain of the jaw. MATERIAL AND METHODS The soft type and soft and hard 2-layer type of sheet materials for sports mouthguards were used to fabricate the music splints. Each type of material has 1-mm and 2-mm thicknesses; therefore, 4 kinds of music splint were produced. The participants, students who played wind instruments in university orchestras, were instructed to use each music splint when playing the instruments for 1 week (for at least 3 hours for each music splint) and to answer a questionnaire about the effect of each appliance. Eighteen participants answered the questionnaire. Based on the usual usage of oral appliances when playing instruments, the participants were classified into 2 groups; oral appliance typically used (group OA) (n=7) and oral appliance not used (group noOA) (n=11). To determine the effects of the 4 types of music splint, a multilevel linear regression analysis was applied to evaluate the nested structure of the data (α=.05). RESULTS The use of the music splint significantly relieved pressure and pain on the lower lips. The soft type was more effective in group OA, and the thin type was more effective in group noOA. The thin- and soft-type music splints were associated with significantly better playing sensation and sound quality than other types of splint in both groups. CONCLUSIONS The thin- and soft-type music splints can be effective and useful for suppressing oral symptoms when playing a single-reed wind instrument without disturbing the quality of the performance.
Collapse
Affiliation(s)
- Maki Nii
- Graduate student, Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Nobuhiro Yoda
- Senior Assistant Professor, Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.
| | - Ramadhan Hardani Putra
- Graduate student, Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Jun Aida
- Professor, Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; and Professor, Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Keiichi Sasaki
- Professor, Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| |
Collapse
|
29
|
Lässing J, Falz R, Schulze A, Pökel C, Vondran M, Schröter T, Borger MA, Busse M. Decreased exercise capacity in young athletes using self-adapted mouthguards. Eur J Appl Physiol 2021; 121:1881-1888. [PMID: 33713202 PMCID: PMC8192374 DOI: 10.1007/s00421-021-04659-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/01/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE There is evidence of both the preventive effects and poor acceptance of mouthguards. There are various effects on performance depending on the type of mouthguard model. Hemodynamic responses to wearing a mouthguard have not been described. The aim of this study was to investigate the effects of self-adapted mouthguards with breathing channels (SAMGvent). METHODS In this randomized crossover study, 17 healthy, active subjects (age 25.12 ± 2.19 years) underwent body plethysmography and performed two incremental exertion tests wearing a (SAMGvent) and not wearing (CON) a mouthguard. Blood lactate, spirometrics, and thoracic impedance were measured during these maximum exercise tests. RESULTS The mean values using a SAMGvent revealed significantly greater airway resistance compared to CON (0.53 ± 0.16 kPa·L-1 vs. 0.35 ± 0.10 kPa·L-1, respectively; p = < 0.01). At maximum load, ventilation with SAMGvent was less than CON (118.4 ± 28.17 L min-1 vs. 128.2 ± 32.16 L min-1, respectively; p = < 0.01). At submaximal loads, blood lactate responses with SAMGvent were higher than CON (8.68 ± 2.20 mmol·L-1 vs. 7.89 ± 1.65 mmol·L-1, respectively; p < 0.01). Maximum performance with a SAMGvent was 265.9 ± 59.9 W, and without a mouthguard was 272.9 ± 60.8 W (p < 0.01). Maximum stroke volume was higher using a SAMGvent than without using a mouthguard (138.4 ± 29.9 mL vs. 130.2 ± 21.2 mL, respectively; p < 0.01). CONCLUSION Use of a self-adapted mouthguard led to increased metabolic effort and a significant reduction in ventilation parameters. Unchanged oxygen uptake may be the result of cardiopulmonary compensation and increased breathing efforts, which slightly affects performance. These results and the obvious preventive effects of mouthguards support their use in sports.
Collapse
Affiliation(s)
- Johannes Lässing
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany.
| | - Roberto Falz
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Antina Schulze
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Christoph Pökel
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Maximilian Vondran
- University Department for Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
- Department of Cardiovascular Surgery, Philipps-University Marburg, University Hospital Gießen and Marburg, Marburg, Germany
| | - Thomas Schröter
- University Department for Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Michael A Borger
- University Department for Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| |
Collapse
|
30
|
Prevalence of Dentofacial Injuries and Concussions Among College Athletes and Their Perceptions of Mouthguards. J Craniofac Surg 2021; 32:1600-1603. [PMID: 33710051 DOI: 10.1097/scs.0000000000007615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The purpose of this study was to determine the rates of dento-facial injuries and concussions among National Collegiate Athletic Association (NCAA) division 1 college athletes and their perceptions of mouth-guards and their protection role in injury prevention. MATERIALS AND METHODS A specific survey regarding the experiences of dento-facial injuries and concussions, attitudes towards the mouthguards, and knowledge of dental first aid was distributed to 682 NCAA division I college athletes registered at Columbia University. The independent predictor variable was sport type (contact versus noncontact). The dependent outcome variables were dental injury rate, facial injury rate, concussion rate, mouthguard use, knowledge of dental first aid. Chi-squared and independent sample tests were used for statistical analysis. RESULTS The mean age of the athletes was 19.4 years (range: 17 to 22). 107 (47.6%) athletes were male. Only 62 (27.6%) athletes reported mouthguard use during gameplay. The most popular choice of mouthguard was the mouth-molded type (56.7%). Mouthguard use was significantly more prevalent among contact sport athletes (43.3% versus 1.2%; P < 0.01). Contact sport athletes were more likely to experience dental injuries (14.3% versus 0.0%; P < 0.01)., facial injuries (35.0% versus 6.2%; p < 0.01), and concussions (32.6% versus 2.4%; P < 0.01) relative to noncontact sport athletes. No significant difference was identified between contact and noncontact sport athletes with regards to knowledge of dental first aid. CONCLUSIONS Contact sport athletes are significantly more inclined to suffer dento-facial injuries and concussions relative to noncontact sport athletes. Thus, mouthguard use and knowledge of dental first aid should be particularly reinforced amongst contact sport athletes.
Collapse
|
31
|
Tripodi D, Cosi A, Fulco D, D’Ercole S. The Impact of Sport Training on Oral Health in Athletes. Dent J (Basel) 2021; 9:51. [PMID: 34063591 PMCID: PMC8147607 DOI: 10.3390/dj9050051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/16/2021] [Accepted: 04/28/2021] [Indexed: 12/28/2022] Open
Abstract
Athletes' oral health appears to be poor in numerous sport activities and different diseases can limit athletic skills, both during training and during competitions. Sport activities can be considered a risk factor, among athletes from different sports, for the onset of oral diseases, such as caries with an incidence between 15% and 70%, dental trauma 14-70%, dental erosion 36%, pericoronitis 5-39% and periodontal disease up to 15%. The numerous diseases are related to the variations that involve the ecological factors of the oral cavity such as salivary pH, flow rate, buffering capability, total bacterial count, cariogenic bacterial load and values of secretory Immunoglobulin A. The decrease in the production of S-IgA and the association with an important intraoral growth of pathogenic bacteria leads us to consider the training an "open window" for exposure to oral cavity diseases. Sports dentistry focuses attention on the prevention and treatment of oral pathologies and injuries. Oral health promotion strategies are needed in the sports environment. To prevent the onset of oral diseases, the sports dentist can recommend the use of a custom-made mouthguard, an oral device with a triple function that improves the health and performance of athletes. During training, the sports dentist must monitor the athletes and the sports examination protocol must be implemented with the inclusion of the clinical examination, quantitative and qualitative analysis of saliva and instructions on the use, cleansing and storage of the mouthguard.
Collapse
Affiliation(s)
| | | | | | - Simonetta D’Ercole
- Department of Medical, Oral and Biotechnological Sciences, University “G. D’Annunzio” of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (D.T.); (A.C.); (D.F.)
| |
Collapse
|
32
|
van Ierssel J, Ledoux AA, Tang K, Zemek R. Sex-Based Differences in Symptoms with Mouthguard Use Following Pediatric Sport-Related Concussion. J Athl Train 2021; 56:1188-1196. [PMID: 33848349 PMCID: PMC8582634 DOI: 10.4085/1062-6050-0393.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Current evidence regarding the protective effect of mouthguard use on symptom severity in children and adolescents who sustain sport-related concussions is insufficient to make clinical recommendations. OBJECTIVE To compare the association between mouthguard-use and symptoms stratified by sex in the first 4-weeks after pediatric sport-related concussion. We hypothesized that mouthguard-use would be associated with lower symptoms. DESIGN Prospective cohort study. SETTING Nine Canadian pediatric emergency departments (EDs). PATIENTS Children aged 5-18 years presenting ≤48 hours of concussion sustained during a collision or contact sport. MAIN OUTCOME MEASURES Injury characteristics were collected using the Acute Concussion Evaluation. Primary outcome measure was symptom score (0-6), measured using age-appropriate versions (5-7 years; 8-12 years; 13-18 years) of the Post-Concussion Symptom Inventory. Independent variable was time postconcussion (at initial assessment, 1-, 2-, 4, weeks). RESULTS Of 1019 children (73% male; median [IQR] age=13.43[11.01,15.27] years), 42% wore a mouthguard at time of injury. There was no significant group by sex by time interaction for symptoms (χ23=0.27; p=.965). Male mouthguard users reported similar symptom scores in the ED (diff=-0.07; 95%CI:-0.23,0.09), at week-1 (diff=-0.02; 95%CI:-0.18,0.14), week-2 (diff=-0.03; 95%CI:-0.19,0.13), and week-4 (diff=-0.13; 95%CI:-0.29,0.04) compared with males who didn't wear a mouthguard. Female mouthguard users reported minimally higher symptom scores at week-1 compared with non-mouthguard users (diff=0.29; 95%CI:0.01,0.56). Symptom scores were not significantly different for females who wore a mouthguard and those who didn't in the ED (diff=0.22; 95%CI:-0.04,0.48), at week-2 (diff=0.22; 95%CI:-0.06,0.51), or week-4 (diff=0.08; 95%CI:-0.20,0.36). CONCLUSION Wearing a mouthguard at time of injury is not associated with reduced acute and subacute symptoms after sport-related concussion in either males or females who were treated in the ED compared with those who did not wear a mouthguard. Athletes are still encouraged to wear a mouthguard during sports since overwhelming evidence supports their use in preventing dental injuries.
Collapse
Affiliation(s)
| | - Andrée-Anne Ledoux
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.,University of Ottawa, Faculty of Medicine, Ottawa, Canada
| | - Ken Tang
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Roger Zemek
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.,University of Ottawa, Faculty of Medicine, Ottawa, Canada
| |
Collapse
|
33
|
Kadota T, Okawa R, Otsugu M, Ohata J, Hanaoka I, Nakano K. Mouthguards for a childhood hypophosphatasia patient to protect periodontal tissue of immature permanent teeth – Case report. PEDIATRIC DENTAL JOURNAL 2021. [DOI: 10.1016/j.pdj.2021.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
34
|
Ahmed I, Kipps C, Fine P. Investigating the effect of mouth guard use on aerobic performance in amateur boxers. Clin Exp Dent Res 2021; 7:888-893. [PMID: 33783141 PMCID: PMC8543476 DOI: 10.1002/cre2.422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives To assess if wearing a mouth guard impacts maximal aerobic capacity in amateur boxers. Materials and Methods A prospective crossover cohort (pilot) study was conducted to assess maximal aerobic capacity in amateur boxers using the 20 m multi stage fitness test (MSFT). Two primary outcomes measures were recorded: (1) the maximum oxygen uptake (peak VO2—mL/kg/min) and (2) distance run (meters—m). Thirteen amateur boxers completed the MSFT 7 days apart under control (no mouth guard—C) and intervention conditions (mouth guard—MG). Participants also submitted data on height, weight, type of mouth guard and Rate of Perceived Exertion (RPE) during the test. Statistics Paired T‐test. Results Mouth guard use was shown to reduce peak VO2 and distance run during the 20 m MSFT from 56.31 to 54.12 mL/kg/min and 2572 to 2380 m respectively (p < 0.05). Twelve out of 13 participants wore a Boil & Bite mouthguard and recorded lower peak VO2 scores (−4.38%) when wearing a mouth guard compared to control conditions, (Mean = −2.46 mL/kg/min, Range of decrease = 4.2–0.9 mL/kg/min; p < 0.05). Ten participants submitted data on RPE—One participant with a custom made mouthguard reported no change in RPE in mouthguard conditions, while nine participants reported an average (+30.5%) increase in mean RPE in Boil & Bite mouthguard conditions compared to control conditions. Conclusions Boil & Bite mouth guard use was shown to significantly reduce aerobic performance in amateur boxers and increase the perceived rate of exertion during the 20 m MSFT.
Collapse
Affiliation(s)
- Irfan Ahmed
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - Courtney Kipps
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - Peter Fine
- University College London Eastman Dental Institute, London, UK
| |
Collapse
|
35
|
Rolling With the Punches: A National Electronic Injury Surveillance System Database Study of Craniofacial Injuries in Boxing. J Craniofac Surg 2021; 32:1576-1580. [PMID: 33741888 DOI: 10.1097/scs.0000000000007640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Boxing is a popular combat sport in which competitors may sustain high impact blows to the face. For this reason, they are at high risk for craniofacial injuries; however, data on facial injuries specific to boxing remains sparse. Studies on safety measures, such as headgear, to prevent such injuries in boxing have been inconclusive. Boxing is popular with a wide audience. However, there is no consensus on safety measures across different populations involved in boxing due to lack of data. The objective of this study is to characterize the demography and incidence of injury types of patients presenting to emergency departments with boxing-related craniofacial injuries on a national scale in order to facilitate the establishment of evidence-based safety guidelines for prevention of boxing-related injuries. METHODS The National Electronic Injury Surveillance System database was searched for boxing-related craniofacial injuries from the last 10 years (2010-2019). Injuries involving boxing were isolated and organized into 5-year age groups. Information on demographics and injury type was extracted from the National Electronic Injury Surveillance System database. Statistical analysis was performed between different age and gender groups. RESULTS A total of 749 boxing-related craniofacial injuries treated in US emergency departments between 2010 and 2019 were recorded. The 19 to 34-year-old age group had the highest number of cases (54%), followed by the 12 to 18-year-old age group (31%). The most common injury types within both of these age groups were concussions and lacerations. This difference was found to be significant when compared to other craniofacial injury types (P < 0.05). The majority of athletes in these age groups were male (93% and 91%, respectively). Analysis of sex differences demonstrated concussions were more common in females compared to other injury types, whereas lacerations in males were more common compared to other injury types; these differences were found to be significant (P < 0.05). CONCLUSIONS The high incidence of boxing-related craniofacial injuries such as concussions and lacerations incurred in young adults (19-34 years) and adolescents (12-18 years) indicate that protective measures such as community-based safety interventions and revised guidelines for protective equipment may be indicated in these groups to protect against craniofacial injuries such as lacerations and concussions. Further studies are required to develop algorithms for management of boxing-related craniofacial injuries and to evaluate the safety and efficacy of protective equipment such as boxing headgear on concussions.
Collapse
|
36
|
Wang J, Yu J, Wang T, Li C, Wei Y, Deng X, Chen X. Emerging intraoral biosensors. J Mater Chem B 2021; 8:3341-3356. [PMID: 31904075 DOI: 10.1039/c9tb02352f] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Biomedical devices that involved continuous and real-time health-care monitoring have drawn much attention in modern medicine, of which skin electronics and implantable devices are widely investigated. Skin electronics are characterized for their non-invasive access to the physiological signals, and implantable devices are superior at the diagnosis and therapy integration. Despite the significant progress achieved, many gaps remain to be explored to provide a more comprehensive overview of human health. As the connecting point of the outer environment and human systems, the oral cavity contains many unique biomarkers that are absent in skin or inner organs, and hence, this could become a promising alternative locus for designing health-care monitoring devices. In this review, we outline the status of the oral cavity during the communication of the environment and human systems and compare the intraoral devices with skin electronics and implantable devices from the biophysical and biochemical aspects. We further summarize the established diagnosis database and technologies that could be adopted to design intraoral biosensors. Finally, the challenges and potential opportunities for intraoral biosensors are discussed. Intraoral biosensors could become an important complement for existing biomedical devices to constitute a more reliable health-care monitoring system.
Collapse
Affiliation(s)
- Jianwu Wang
- Innovative Centre for Flexible Devices (iFLEX), School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, 639798, Singapore.
| | | | | | | | | | | | | |
Collapse
|
37
|
Ahmed I, Fine P. 'Injury prevention versus performance': has the time come to mandate the use of mouthguards in all contact sports? BMJ Open Sport Exerc Med 2021; 7:e000828. [PMID: 33500783 PMCID: PMC7812105 DOI: 10.1136/bmjsem-2020-000828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Mouthguard use continues to be a hotly debated issue in the domain of contact sports. Regulations from sports governing bodies on wearing mouthguards and attitudes towards their use from athletes vary significantly across ‘at-risk sports’. We explore how recent advances in sports dentistry have led to the widespread availability of new customisable mouthguards and whether their use may impact athletic performance, reduce orofacial trauma or sport related concussion. We also discuss whether ‘no mouthguard, no play’ policies designed to mandate their use may help to promote a culture of safe participation in contact sport.
Collapse
Affiliation(s)
- Irfan Ahmed
- Public health department, Barts and The London NHS Trust, London, UK
| | - Peter Fine
- Director of Sports Dentistry MSc Programme, UCL Eastman Dental Institute, London, UK
| |
Collapse
|
38
|
Otsugu M, Suehiro Y, Hanaoka I, Okawa R, Nakano K. Oral management with mouthguards during the mixed dentition period: A case report. Dent Traumatol 2020; 37:531-536. [PMID: 33369093 DOI: 10.1111/edt.12650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
Custom-made mouthguards are widely used by athletes during training and sporting events for the prevention of oral injuries. However, even though the prevalence of dental injuries in children in the primary or mixed dentition stages is high, few reports have focused on mouthguard use for such cases due to the difficulties associated with adapting them as teeth are lost and replaced. This report presents a case of a Japanese boy in the mixed dentition stage with a custom-made mouthguard. For fabrication, self-curing acrylic resin was used to fill portions of a working model to keep space for the later eruption of permanent teeth. However, adjustment was necessary when gingival swelling occurred in association with maxillary canine eruption, after which refabrication was necessary. Regular management of a custom-made mouthguard by the attending dentist is important for children in the mixed dentition period, especially during maxillary canine eruption, which causes drastic dentition changes. In the present case, custom-made mouthguards were fully effective based on the prediction of changes in the dentition and with regular dental management.
Collapse
Affiliation(s)
- Masatoshi Otsugu
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuto Suehiro
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | | | - Rena Okawa
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| |
Collapse
|
39
|
Kriz PK, Roberts WO. Prevention of Sport-Related Concussion. Clin Sports Med 2020; 40:159-171. [PMID: 33187606 DOI: 10.1016/j.csm.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Concussion remains a common injury among sports participants. Implementing risk-reduction strategies for sport-related concussion (SRC) should be a priority of medical professionals involved in the care of athletes. Over the past few decades, a multifaceted approach to reducing SRC risk has been developed. Protective equipment, rule and policy change/enforcement, educational programs, behavioral modifications, legislation, physiologic modifications, and sport culture change are a few of the programs implemented to mitigate SRC risk. In this article, the authors critically review current SRC risk-reduction strategies and offer insight into future directions of injury prevention for SRC.
Collapse
Affiliation(s)
- Peter K Kriz
- Division of Sports Medicine, Department of Orthopedics, Warren Alpert Medical School, Brown University, Rhode Island Hospital/Hasbro Children's Hospital, 1 Kettle Point Drive, Suite 300, East Providence, RI 02915, USA; Department of Pediatrics, Warren Alpert Medical School, Brown University, Rhode Island Hospital/Hasbro Children's Hospital, 1 Kettle Point Drive, Suite 300, East Providence, RI 02915, USA.
| | - William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota, 516 Delaware Street Southeast, 6-240 Phillips-Wangensteen Building, Minneapolis, MN 5545, USA. https://twitter.com/WilliamORoberts
| |
Collapse
|
40
|
Kim HN, Kwon YB, Jun EJ, Kim JB. Health-Risk Behavior-, Mental Health-, and Physical Exercise-Related Risk Factors for Tooth Fractures in Korean Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7815. [PMID: 33114513 PMCID: PMC7662374 DOI: 10.3390/ijerph17217815] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/13/2020] [Accepted: 10/21/2020] [Indexed: 12/25/2022]
Abstract
We aimed to determine factors related to tooth fracture experience in Korean adolescents. This study used data from the 14th Korea Youth Risk Behavior Survey in 2018, a cross-sectional web-based survey of health-risk behaviors among a representative sample of Korean middle- and high-school students aged 12-17 years. A total of 60,040 participants were selected using a complex sampling design of the survey from 400 middle schools and 400 high schools. They answered a self-administered questionnaire survey in classrooms. Explanatory variables included those pertaining to health-risk behaviors, mental health, and physical exercise. Complex-sample multivariable logistic regression models were applied to identify factors related to tooth fracture experience in the past 12 months. The overall prevalence of dental fracture experience was 11.4%. Risk factors related to tooth fractures in Korean adolescents were unhealthy behaviors such as alcohol and tobacco consumption; mental health problems including stress, depression, and suicidal ideation; and intensive physical exercise. The major risk factor related to tooth fractures was depression. To prevent tooth fractures among adolescents, schools should strengthen mental health education, encourage mouthguard use during intensive physical exercise, and develop school environments to prevent orofacial injuries. Further studies on various risk factors related to tooth fractures are warranted.
Collapse
Affiliation(s)
- Han-Na Kim
- Department of Dental Hygiene, College of Health and Medical Sciences, Cheongju University, Cheongju 28503, Korea;
| | - Yong-Bong Kwon
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (Y.-B.K.); (E.-J.J.)
| | - Eun-Joo Jun
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (Y.-B.K.); (E.-J.J.)
| | - Jin-Bom Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (Y.-B.K.); (E.-J.J.)
- BK21 FOUR Project, School of Dentistry, Pusan National University, Yangsan 50612, Korea
| |
Collapse
|
41
|
Abstract
Dental trauma and injuries to the dentition are difficult to treat because the treatment goals serve to restore esthetics and function. The oral and maxillofacial surgeon is often called on to coordinate the efforts of rehabilitation after a dentoalveolar injury. A comprehensive understanding of the ideal treatments and use of endodontic, orthodontic, periodontal, and pediatric dental colleagues leads to the best possible results with regards to a restoration of form and function. This article provides a succinct review of the oral and maxillofacial surgeon's treatment in dentoalveolar trauma. Epidemiology, treatment, and preventative measures are discussed in this article.
Collapse
Affiliation(s)
- Lewis C Jones
- Private Practice, Oral and Maxillofacial Surgery, Elizabethtown OMFS, Louisville, KY, USA; Oral and Maxillofacial Surgery, University of Louisville, Louisville, KY, USA.
| |
Collapse
|
42
|
Mouthguards during orthodontic treatment: Perspectives of orthodontists and a survey of orthodontic patients playing school-sponsored basketball and football. Am J Orthod Dentofacial Orthop 2020; 157:516-525.e2. [PMID: 32241358 DOI: 10.1016/j.ajodo.2019.04.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The objectives of this research were to identify the beliefs and practices of orthodontists about mouthguard use in orthodontic patients and to survey orthodontic patients currently playing school-sponsored basketball and/or football about mouthguards. METHODS Fifteen orthodontists were interviewed about mouthguard use in their patients. Patients (aged 11-18 years) playing organized school basketball (n = 53) or football (n = 22) from 13 of those 15 orthodontic practices participated in an online survey about mouthguards. RESULTS Approximately half of the orthodontists interviewed had initiated discussions about mouthguards with their patients. Although boil-and-bite mouthguards were recommended most often by orthodontists with only a single orthodontist recommending a stock type, stock was the most commonly used type (football [59%], basketball [50%]) followed by boil-and-bite (football [27%], basketball [35%]). Only 2 of the 75 patients surveyed (<3%) reported using a custom mouthguard. All football players reported using a mouthguard, as mandated by this sport. Basketball does not mandate mouthguard use, and only 38% of basketball players reported wearing one. Players who used mouthguards cited forgetting as the most frequent reason for not always using one. A greater percentage of football (91%) than basketball (32%) players reported that their coach recommended a mouthguard (P <0.001). CONCLUSIONS Orthodontists differ in how they approach mouthguard use by their patients, which likely reflects a lack of evidence-based guidelines. The beliefs, recommendations, and practices of orthodontists concerning mouthguard use and the use of mouthguards by orthodontic patients are discussed. Research directions to improve mouthguard use are suggested.
Collapse
|
43
|
Abstract
This study reviews the epidemiology, diagnostic heuristics, and field management of sports-related facial injuries for sideline physicians.Facial injuries account for 3% to 29% of sports injuries, and sports injuries account for 11.3% to 42.1% of facial fractures. In a previous series, fractures of the nasal bone were the most common in all sports (40%-60.5%); mandibular fractures were common in martial arts (33.3%) and soccer (11.1%), orbital bone fractures were common in basketball (20.0%), ice sports (18.2%), and baseball (15.8%), and fractures of the zygoma occurred frequently in martial arts (13.3%) and soccer (10.0%).Facial lacerations may injure nerves (facial and trigeminal), salivary ducts (parotid or submandibular), and the lacrimal apparatus. Facial fractures are inspected by palpating the bony prominences bilaterally. For simple lacerations, if the player does not have to return to the court, the wound should be cleansed as needed, and surgical adhesives can be applied in the field. However, if return to play is an issue, sutures are recommended rather than surgical adhesives.For nasal injuries involving a gross deformity, immediate closed reduction may not be necessary unless airway competency is compromised. Severe cases of nasal fracture treated immediately by closed reduction should be evaluated by a trained plastic surgeon.In sports, facial injuries are prone to be missed, but their importance should not be neglected. Therefore, sideline physicians should be aware of the relatively high frequency of facial injuries, including facial bone fractures. They should have the knowledge needed to manage these injuries, and must prepare emergency management kits.
Collapse
|
44
|
Improving the Wearing Rate of Mouthguards in the Youth Rugby Category Affects the Total Future Mouthguard Wearing Rate. Dent J (Basel) 2020; 8:dj8030077. [PMID: 32727018 PMCID: PMC7560065 DOI: 10.3390/dj8030077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/24/2020] [Accepted: 07/07/2020] [Indexed: 11/27/2022] Open
Abstract
The aim of this study is to consider the hypothesis that wearing mouthguards (MGs) from a young age helps to shape players’ habit of continuing to wear MGs as adults. In addition, we consider the mandatory rule of wearing mouthguards in the youth category on the future wearing rates of mouthguards. Eighty-five Japanese male amateur rugby players were included in this study. We examined the relationship between the wearing rates of mouthguards when participants were high school students and as adults (in 2018) using a questionnaire. Collected data were classified into categories (age, mouthguard type, and applied mandatory rule or not), and their relationships were analyzed. The wearing rate of mouthguards in high school was significantly related to the wearing rate of mouthguards in adulthood (χ2 = 12.1, p < 0.01). The mandatory rule to wear mouthguards at high school was related to the wearing rates of mouthguards as adults, but not significantly (χ2 = 3.42, p = 0.06). Participants’ mouthguard wearing rates as adults were affected by their high school wearing rates. The mandatory rule of wearing mouthguards in the youth category may be somewhat effective for improving mouthguard wearing rates; however, it is more important to provide knowledge about their importance.
Collapse
|
45
|
Sousa AM, Pinho AC, Messias A, Piedade AP. Present Status in Polymeric Mouthguards. A Future Area for Additive Manufacturing? Polymers (Basel) 2020; 12:E1490. [PMID: 32635307 PMCID: PMC7407806 DOI: 10.3390/polym12071490] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 12/18/2022] Open
Abstract
Athletes from contact sports are more prone to orofacial injuries because of the exposure to possible shocks and collisions derived from physical proximity. The use of protector polymeric mouthguards proved to be useful in the prevention of the described injuries. There are different types of mouthguards with varying ranges of protection and prices, but they are all made from polymers and share the same propose: to absorb and dissipate the impact energy resulting from the shocks. As they are used inside the mouth, they should not impair breathing and speaking nor compromise the comfort of the athlete. However, the ideal mouthguard is yet to be created. The choice of the most appropriate polymeric material and the standard required properties have not yet been reported. Regardless of the numerous studies in this field, normalized control parameters for both material characterization and mouthguard fabrication are absent. This paper aims to present a review of the current types of available mouthguards and their properties/characteristics. Moreover, a detailed description of the most common polymers for the fabrication of mouthguards, together with the manufacturing techniques, are discussed.
Collapse
Affiliation(s)
- Ana M. Sousa
- Department of Mechanical Engineering, University of Coimbra, CEMMPRE, 3030-788 Coimbra, Portugal; (A.M.S.); (A.C.P.)
| | - Ana C. Pinho
- Department of Mechanical Engineering, University of Coimbra, CEMMPRE, 3030-788 Coimbra, Portugal; (A.M.S.); (A.C.P.)
| | - Ana Messias
- Faculty of Medicine, Dentistry Department, University of Coimbra, CEMMPRE, 3000-075 Coimbra, Portugal;
| | - Ana P. Piedade
- Department of Mechanical Engineering, University of Coimbra, CEMMPRE, 3030-788 Coimbra, Portugal; (A.M.S.); (A.C.P.)
| |
Collapse
|
46
|
Matsuda Y, Nakajima K, Saitou M, Katano K, Kanemitsu A, Takeda T, Fukuda K. The effect of light-cured resin with a glass fiber net as an intermediate material for Hard & Space mouthguard. Dent Traumatol 2020; 36:654-661. [PMID: 32304262 DOI: 10.1111/edt.12560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND/AIMS Despite the use of conventional mouthguards, preventable sports-related dental injuries continue to occur. The authors have developed a two-layered ethylene polyvinyl acetate (EVA) mouthguard with a hard polyethylene terephthalate (PET) insert and a buffer space (H&SMG). However, adapting the PET onto the EVA layer requires skill. A light-cured Splint Resin (SRLC) and a glass fiber net (NET) reinforcement appear to resolve this issue. The aim of this study was to investigate whether SRLC with NET could replace PET and find a more practical application for NET. MATERIALS AND METHODS A pendulum impact testing machine and a dental model with strain gages were used. Six types of mouthguards were made: one with two laminated EVA blanks (LAM-MG), a three-layer type with a PET insert and an intermediate space (PET-H&SMG), a H&SMG with SRLC insert (LC-H&SMG), and three other types with differential NET-SRLC reinforcement; NET on the outer surface of SRLC, NET on the inner surface of SRLC, and NET on both the outer and inner surfaces. Five mouthguards of each type were fabricated and tested ten times with impact distances of 15 and 30 cm. Forty more impacts were applied to all H&SMGs to confirm the durability of the hard inner layer. RESULTS All H&SMGs showed significant strain reduction compared to the LAM-MG. PET-H&SMG and the four types of LC-H&SMG exhibited an equally slight strain (approximately 95% shock absorbing ability) in all conditions. During the test against the smaller impact, all H&SMGs showed no cracks. When tested against the stronger impact, only the LC-H&SMG with the reinforced inner surface, the double NET-reinforced LC-H&SMG, and the PET-H&SMG remained intact. CONCLUSION The NET-reinforced SRLC can replace PET as an intermediate mouthguard material. The NET application, at least on the internal surface, is indispensable for the LC-H&SMG reinforcement.
Collapse
Affiliation(s)
- Yoshiaki Matsuda
- Division of Sports Dentistry, Department of Oral Health and Clinical Science, Tokyo Dental Collage, Tokyo, Japan
| | - Kazunori Nakajima
- Division of Sports Dentistry, Department of Oral Health and Clinical Science, Tokyo Dental Collage, Tokyo, Japan
| | - Maho Saitou
- Division of Sports Dentistry, Department of Oral Health and Clinical Science, Tokyo Dental Collage, Tokyo, Japan
| | - Katsushi Katano
- Division of Sports Dentistry, Department of Oral Health and Clinical Science, Tokyo Dental Collage, Tokyo, Japan
| | - Anna Kanemitsu
- Division of Sports Dentistry, Department of Oral Health and Clinical Science, Tokyo Dental Collage, Tokyo, Japan
| | - Tomotaka Takeda
- Division of Sports Dentistry, Department of Oral Health and Clinical Science, Tokyo Dental Collage, Tokyo, Japan
| | - Kenichi Fukuda
- Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental Collages, Tokyo, Japan
| |
Collapse
|
47
|
OZSİN OZLER C, GÜÇİZ DOĞAN B, BİLGİN E, DEMİRHAN G, ARAS D, ÇETİN E, ŞİMŞEK H, UZAMIŞ TEKÇİÇEK M. What do Turkish sports sciences students know about dental trauma and mouthguards? A descriptive study. ACTA ODONTOLOGICA TURCICA 2020. [DOI: 10.17214/gaziaot.602908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
48
|
Chisholm DA, Black AM, Palacios-Derflingher L, Eliason PH, Schneider KJ, Emery CA, Hagel BE. Mouthguard use in youth ice hockey and the risk of concussion: nested case–control study of 315 cases. Br J Sports Med 2020; 54:866-870. [DOI: 10.1136/bjsports-2019-101011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2019] [Indexed: 11/04/2022]
Abstract
BackgroundConcussion is the most common injury in youth ice hockey. Whether mouthguard use lowers the odds of concussion remains an unanswered question.ObjectiveTo determine the association between concussion and mouthguard use in youth ice hockey.MethodsNested case–control design. Cases and controls were identified from two prospective cohort studies using valid injury surveillance methods. Cases were players concussed during a game or practice; controls were players who sustained a non-concussion injury during a game or practice. The primary exposure was mouthguard use at time of injury; mouthguard type (dental custom fit or off the shelf) was a secondary exposure. Physician-diagnosed or therapist-suspected concussion was the primary outcome. Dental injury was a secondary outcome. Multilevel logistic regression with random effect at a team level was used to obtain ORs for the mouthguard effect, adjusted for level of play, age group, position, concussion history, mechanism of injury, cohort, session type and body checking policy.ResultsAmong cases, 236/315 (75%) were wearing a mouthguard at time of injury, while 224/270 (83%) controls were wearing a mouthguard at time of injury. Any mouthguard use was associated with an adjusted OR for concussion of 0.36 (95% CI 0.17 to 0.73). Off-the-shelf mouthguards were associated with a 69% lower odds of concussion (adjusted OR: 0.31; 95% CI 0.14 to 0.65). Dental custom-fit mouthguards were associated with a non-significant 49% lower odds of concussion (adjusted OR: 0.51; 95% CI 0.22 to 1.10). No dental injuries were identified in either cohort.ConclusionMouthguard use was associated with lower odds of concussion. Players should be required to wear mouthguards in youth ice hockey.
Collapse
|
49
|
van Vliet KE, Kleverlaan CJ, Lobbezoo F, de Lange J, van Wijk AJ. Maximum impact heights of currently used mouthguards in field hockey. Dent Traumatol 2020; 36:427-432. [PMID: 31880846 PMCID: PMC7508175 DOI: 10.1111/edt.12538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/14/2019] [Accepted: 12/16/2019] [Indexed: 12/01/2022]
Abstract
Background/Aim The effectiveness of mouthguards used in field hockey is unknown. The aim of this study was to compare the maximum impact heights between currently used mouthguards in field hockey to prevent dental injury. Methods Four boil‐and‐bite mouthguards (Dita, Shock Doctor, SISU, and Stag) and one custom‐made mouthguard (Elysee) were tested for maximum impact height. A hockey ball was released in a tube from increasing heights onto plaster and polymethylmethacrylate (PMMA) dental models. Models were tested without mouthguard as a control. The experiment was repeated 10 times per mouthguard and for the control on each dental model. The maximum impact height for when the dental model broke was used to calculate the speed. The mouthguards and controls were compared. Results The maximum impact heights (median [25%‐75%] in meters) onto plaster dental models were as follows: control 0.23 (0.15‐0.25), Dita 0.35 (0.30‐0.35), Elysee 0.45 (0.34‐0.50), Shock Doctor 0.68 (0.60‐0.74), SISU 0.23 (0.20‐0.26), and Stag 0.35 (0.35‐0.46). The maximum impact height for Shock Doctor was significantly higher than all other mouthguards and the control (all P < .05). The maximum impact heights onto PMMA dental models were as follows: control 2.00 (1.30‐2.50), Dita 3.80 (2.65‐6.95), Elysee 3.30 (2.30‐4.20), Shock Doctor 6.20 (2.80‐8.10), SISU 2.60 (1.90‐3.15), and Stag 3.90 (1.25‐5.15). The maximum impact height for Shock Doctor was significantly higher than for SISU, Stag, and the control (all P < .05), but did not differ significantly from Dita (P = .43) and Elysee (P = .12). Conclusion Shock Doctor had the highest maximum impact height compared to the other mouthguards and appears to be the most effective mouthguard tested in this study.
Collapse
Affiliation(s)
- Kirsten E van Vliet
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam/Academic Centre for Dentistry (ACTA), Amsterdam, The Netherlands
| | - Cees J Kleverlaan
- Department of Material Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam/Academic Centre for Dentistry (ACTA), Amsterdam, The Netherlands
| | - Arjen J van Wijk
- Department of Social Dentistry and Behavioral Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
50
|
Dorney K, Dodington JM, Rees CA, Farrell CA, Hanson HR, Lyons TW, Lee LK. Preventing injuries must be a priority to prevent disease in the twenty-first century. Pediatr Res 2020; 87:282-292. [PMID: 31466080 DOI: 10.1038/s41390-019-0549-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 08/03/2019] [Accepted: 08/13/2019] [Indexed: 02/08/2023]
Abstract
Injuries continue to be the leading cause of morbidity and mortality for children, adolescents, and young adults aged 1-24 years in industrialized countries in the twenty-first century. In this age group, injuries cause more fatalities than all other causes combined in the United States (U.S.). Importantly, many of these injuries are preventable. Annually in the U.S. there are >9 million emergency department visits for injuries and >16,000 deaths in children and adolescents aged 0-19 years. Among injury mechanisms, motor vehicle crashes, firearm suicide, and firearm homicide remain the leading mechanisms of injury-related death. More recently, poisoning has become a rapidly rising cause of both intentional and unintentional death in teenagers and young adults aged 15-24 years. For young children aged 1-5 years, water submersion injuries are the leading cause of death. Sports and home-related injuries are important mechanisms of nonfatal injuries. Preventing injuries, which potentially cause lifelong morbidity, as well as preventing injury deaths, must be a priority. A multi-pronged approach using legislation, advancing safety technology, improving the built environment, anticipatory guidance by clinical providers, and education of caregivers will be necessary to decrease and prevent injuries in the twenty-first century.
Collapse
Affiliation(s)
- Kate Dorney
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - James M Dodington
- Department of Pediatrics, Yale-New Haven Hospital, New Haven, CT, USA
| | - Chris A Rees
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Caitlin A Farrell
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Holly R Hanson
- Division of Pediatric Emergency Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Todd W Lyons
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Lois K Lee
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA.
| | | |
Collapse
|