Dental Trauma and Mouthguard Usage among Soccer Players in Izmir, Turkey

Knowledge of traumatic dental injuries and mouthguard behavior among Croatian soccer players

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.

Prevalence of sports-related traumatic orofacial and dental injuries in Asian countries: a systematic review and meta-analysis

INTRODUCTION

The head and face, due to their prominent positions, are at risk of intentional and unintentional injuries in the majority of competitive sports. There are regional preferences for sports and differences in infrastructural facilities. The majority of the recommendations for sports have been based on the studies conducted in the western world. Hence, this systematic review aimed to estimate the prevalence of sports-related orofacial and dental injuries in professional-sportspersons living in Asian countries.

EVIDENCE ACQUISITION

A protocol was prepared as per the best practices of evidence-based medicine and registered (PROSPERO-CRD42021252488). Search strategy was based on the research question and conducted in six databases using text words and MeSH terms. Scrutiny of title and abstracts and later full-texts were done as per eligibility criteria. Data extraction was done using a pre-piloted sheet and the risk of bias (ROB) was assessed. Qualitative synthesis and meta-analyses were performed and the strength of evidence was assessed by using GRADE-approach.

EVIDENCE SYNTHESIS

Twenty-three studies published between 1998 to 2021 and from nine countries were included. The highest numbers were from Türkiye (N.=7). The total number of professional sportspersons assessed in all the included studies was 14,457. The highest prevalence of orofacial and dental injuries observed was 66.18% and the highest prevalence of dental injuries was 39.81%. Low risk of bias was seen only in four studies. The changes were observed during the sensitivity analysis with all the meta-analyses showing significant publication bias and heterogeneity.

CONCLUSIONS

The pooled prevalence of the combined orofacial and dental injuries was found to be 40.6%, while that of orofacial injury was 17.1% and dental injuries was 15.9%. There were 23 studies included in this review which covered 27 different sports from nine Asian countries. A high level of heterogeneity and the high ROB were observed in the majority of the studies. Further studies on the basis of the recommendations provided in the systematic review will improve the quality of evidence in this area in future.

External Apical Root Resorption in Orthodontic Patients Who Practice Combat Sports: A Case-Control Observational Pilot Study

Orthodontic treatment could lead to undesirable effects such as external apical root resorption (EARR). Moreover, trauma to both the face and teeth can predispose to EARR. On the other hand, the practice of combat sports results in increased maxillofacial injuries. Consequently, our objective was to determine if there is a statistically significant difference in the EARR of the patients undergoing fixed orthodontic treatment who practice combat sports and controls. Our null hypothesis was that there is no difference in the EARR between patients undergoing orthodontic treatment who practice combat sports and the patients under the same treatment that do not practice combat sports. An observational, descriptive, and prospective case-control pilot study was designed. The exposed group consisted of patients that practice combat sports. Whereas the control group was conformed of patients that do not practice combat sports without a previous history of facial trauma and without face trauma during the orthodontic treatment. EARR of the maxillary and mandibular anterior teeth was measured using cone-beam computed tomography (CBCT). The CBCT scans were obtained from all patients prior to the beginning of the orthodontic treatment and 1 year later. At the end of the follow-up for the maxillary right central and lateral incisors of the exposed group, the EARR was significantly higher than the homologous teeth of the control group (p < 0.05). As a consequence, the patients treated orthodontically who practice combat sports could be more susceptible to EARR.

The effect of a controlled mandible position mouthguard on upper body strength and power in trained rugby athletes - A randomized within subject study

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.

Present Status in Polymeric Mouthguards. A Future Area for Additive Manufacturing?

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.