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At least 415 records · Page 23Linked to original sources
PubMed1993

Attitudes to mouthguards and prevalence of orofacial injuries in four teams competing at the second Rugby World Cup.

The opportunity was taken to conduct a questionnaire survey of the members of four competing countries at the second Rugby World Cup tournament (Australia, Ireland, Scotland, Wales) regarding the prevalence of orofacial injuries and attitudes to mouthguards. The results show that while all players in each team believed that mouthguards provided local protection, approximately one in five of each team did not wear one. The average age when players first started wearing mouthguards varied from 12.7 years for Australia to 18.1 years for Wales, while the percentage of wearers willing to play without their mouthguard ranged from only 4.6% for Australia to 15.8% for Wales. Just less than half of the total group had previously sustained an orofacial injury playing rugby.

Adult↗
PubMed1996

Airway efficiency during the use of SCUBA diving mouthpieces.

OBJECTIVE: To investigate the effect of varying interdental bite platform thickness of the scuba mouthpiece on airway efficiency. METHODS: 10 male divers had their mean peak flow measured for free breathing, maximum flow with diving mouthpiece, teeth in occlusion, and for five experimental mouthpieces with different thickness of interdental bite platform (1 mm, 2 mm, 3 mm, 4 mm, and 5 mm). RESULTS: The connecting airway between the demand valve and mouthpiece was found to be a major limiting factor in airway efficiency. An interdental bite platform of 4 mm resulted in the greatest air flow with a further increase in thickness resulting in air flow restriction. CONCLUSIONS: The use of an interdental bite platform of 4 mm placed between the premolar and molar teeth ensures the greatest airway efficiency and also results in a design which provides the least temporomandibular joint discomfort for the diver.

Adult↗
PubMed1997

Towards the development of a standard test procedure for mouthguard assessment.

A simulated upper jaw, made from a rubber arch containing replaceable ceramic teeth and a renewable composite jawbone, offers promise in assessing the performance of custom made mouthguard designs. Impact tests, involving precise assessment of jaw and tooth fractures caused by projectiles of various energies and profiles, simulate conditions that approximate to common clinical observation. Such conditions offer the most sensitive indices for assessing both improved mouthguard designs and product quality and reliability. Damage caused by the dissipation of the impact energy may be transferred within this simulated oral cavity by minor changes to the impact conditions.

Equipment Design↗
PubMed1998

Application of a standard test to the in vitro performance of mouthguards.

OBJECTIVE: To use a simulated upper jaw made from a rubber arch containing replaceable ceramic teeth and a renewable composite ceramic jawbone to compare the effectiveness of seven custom made mouthguard designs and a "boil and bite" mouthguard. METHODS: Following an earlier development of a standard impact test using a selection of projectile shapes and energies, the most sensitive conditions were selected. These were then applied to a series of six guards constructed in ethylene vinyl acetate and styrene butadiene. The guards were constructed to reflect possible variations in both design and materials. RESULTS: Significant differences between the mouthguard performances were observed in response to the impact conditions selected. All the custom made designs gave better performance than the "boil and bite" mouthguard. CONCLUSIONS: The differences observed indicated that the standard test should be sensitive enough to be used as an assessment procedure for the approval of the manufacture of these safety devices. A sequence of tests on eight identical mouthguards selected from a batch of 12, based on the best design, gave remarkably consistent results, indicating that both the manufacturing technique and the test method are reliable. The features of the best design should be incorporated into the current "best practice" for the construction of these devices.

Equipment Design↗
PubMed2001

Dental evaluation of scuba diving mouthpieces using a subject assessment index and radiological analysis of jaw position.

OBJECTIVE: To compare two experimental scuba mouthpieces with a commercially available design. METHODS: A laboratory study using six men to assess effort, muscle pain, muscle fatigue, facial discomfort, tooth discomfort, and loss of lip sensation using a visual analogue scale. Cephalometric radiographs and analysis of jaw position with each mouth piece were also used. RESULTS: Fully customised mouthpieces caused the least discomfort, muscle pain, fatigue, and effort. They also resulted in the least mandibular displacement from the resting position. Radiographic analysis of jaw position showed that the fully customised design resulted in the least displacement from normal jaw position. CONCLUSIONS: A fully customised design gives the greatest comfort, least effort, and least mandibular displacement. This design is recommended, particularly for divers who experience temporomandibular dysfunction associated with diving.

Adult↗
PubMed2001

Transient forces generated by projectiles on variable quality mouthguards monitored by instrumented impact testing.

OBJECTIVES: (a) To determine the force-time trace that occurs when a spring mounted simulated upper jaw is impacted; (b) to examine if mouthguards of variable quality have significant influence on such force-time traces; (c) to attempt to relate physical events to the profile of the force-time traces recorded. METHODS: A simulated jaw, consisting of ceramic teeth inserted into a hard rubber arch reinforced with a composite jawbone, was fitted with various mouthguards as part of a previous round robin study. A clinical assessment distinguished good, bad, and poor mouthguards, and these were each fitted to the jaw, which was then submitted to instrumental impact tests under conditions expected to produce tooth fractures. The force-time trace was recorded for such impact events. RESULTS: The spring mounting method caused two distinct peaks in the force-time trace. The initial one was related to inertia effects and showed an increase in magnitude with impactor velocity as expected. The second peak showed features that were related to the differences in the mouthguards selected. CONCLUSIONS: The use of a force washer within a conical ended impactor enabled force-time traces to be recorded during the impact of a spring mounted simulated jaw fitted with mouthguards of variable quality. The spring mounting system causes an initial inertial peak followed by a second peak once the spring mount has fully compressed. Good fitting guards, which keep most teeth intact, result in high stiffness targets that in turn generate high reaction forces in the impactor. If the spring mounting is omitted, the two peaks are combined to give even higher reaction forces. The force-time trace offers some potential for assessing both overall mouthguard performance and individual events during the impact sequence. Mouthguards with good retention to the jaw remained attached during the impact event and helped to preserve the structural integrity of the target. This in turn developed high forces in the second part of the force-time trace. Guards that detached during impact and allowed tooth fractures showed lower forces in the second part of the test. The force profile measured offered some quantitative support to, and agreement with, the observed clinical quality of the mouthguards.

Athletic Injuries↗
PubMed2002

The impact of face shield use on concussions in ice hockey: a multivariate analysis.

OBJECTIVE: To identify specific risk factors for concussion severity among ice hockey players wearing full face shields compared with half face shields (visors). METHODS: A prospective cohort study was conducted during one varsity hockey season (1997-1998) with 642 male ice hockey players (median age 22 years) from 22 teams participating in the Canadian Inter-University Athletics Union. Half of the teams wore full face shields, and half wore half shields (visors) for every practice and game throughout the season. Team therapists and doctors recorded on structured forms daily injury, participation, and information on face shield use for each athlete. The main outcome measure was any traumatic brain injury requiring assessment or treatment by a team therapist or doctor, categorised by time lost from subsequent participation and compared by type of face shield worn. RESULTS: Players who wore half face shields missed significantly more practices and games per concussion (2.4 times) than players who wore full face shields (4.07 sessions (95% confidence interval (CI) 3.48 to 4.74) v 1.71 sessions (95% CI 1.32 to 2.18) respectively). Significantly more playing time was lost by players wearing half shields during practices and games, and did not depend on whether the athletes were forwards or defence, rookies or veterans, or whether the concussions were new or recurrent. In addition, players who wore half face shields and no mouthguards at the time of concussion missed significantly more playing time (5.57 sessions per concussion; 95% CI 4.40 to 6.95) than players who wore half shields and mouthguards (2.76 sessions per concussion; 95% CI 2.14 to 3.55). Players who wore full face shields and mouthguards at the time of concussion lost no playing time compared with 1.80 sessions lost per concussion (95% CI 1.38 to 2.34) for players wearing full face shields and no mouthguards. CONCLUSIONS: The use of a full face shield compared with half face shield by intercollegiate ice hockey players significantly reduced the playing time lost because of concussion, suggesting that concussion severity may be reduced by the use of a full face shield.

Adult↗
PubMed2002

Beneficial effects of air inclusions on the performance of ethylene vinyl acetate (EVA) mouthguard material.

OBJECTIVE: To investigate the impact characteristics of an ethylene vinyl acetate (EVA) mouthguard material with regulated air inclusions, which included various air cell volumes and wall thickness between air cells. In particular, the aim was to identify the magnitude and direction of forces within the impacts. METHOD: EVA mouthguard material, 4 mm thick and with and without air inclusions, was impacted with a constant force impact pendulum with an energy of 4.4 J and a velocity of 3 m/s. Transmitted forces through the EVA material were measured using an accelerometer, which also allowed the determination of force direction and magnitude within the impacts. RESULTS: Statistically significant reductions in the transmitted forces were observed with all the air inclusion materials when compared with EVA without air inclusions. Maximum transmitted force through one air inclusion material was reduced by 32%. Force rebound was eliminated in one material, and reduced second force impulses were observed in all the air inclusion materials. CONCLUSION: The regulated air inclusions improved the impact characteristics of the EVA mouthguard material, the material most commonly used in mouthguards world wide.

Acceleration↗
PubMed2002

Effect of ethylene vinyl acetate (EVA) closed cell foam on transmitted forces in mouthguard material.

OBJECTIVES: To compare transmitted forces through ethylene vinyl acetate (EVA) mouthguard material and the same EVA material with gas inclusions in the form of a closed cell foam. METHOD: EVA mouthguard materials with and without foam gas inclusions and 4 mm thick were impacted with a constant force from an impact pendulum. Various porosity levels in the foam materials were produced by 1%, 5%, and 10% by weight foaming agent. The forces transmitted through the EVA after energy absorption by the test materials were measured with a force sensor and compared. RESULTS: Only minor non-significant differences in transmitted forces through the EVA with and without foam were shown. CONCLUSIONS: The inclusion of gas in the form of a closed cell foam in 4 mm thick EVA mouthguard materials did not improve the impact performance of the EVA mouthguard material.

Dental Stress Analysis↗
PubMed2002

The avoidability of head and neck injuries in ice hockey: an historical review.

The number of minor traumatic brain injury (mTBI), cerebral concussions, is increasing and cannot be eliminated by any kind of equipment. Prevention strategies, such as the introduction of "checking from behind" rules have become effective in decreasing the number of severe spinal injuries. A new "head checking" rule should reduce mTBI in the same way in the following years. Mouthguards should be mandatory as an effective device for the prevention of dental and orofacial injuries, as well as reducing the incidence and severity of mTBI. A new internet database system, the International Sports Injury System (ISIS) should improve epidemiological analysis of head, face, and spinal injuries worldwide. ISIS should provide an internationally compatible system for continuous monitoring of risk factors, protective effects of equipment, and protective effects of equipment and effects of changes in rules through the years.

Craniocerebral Trauma↗
PubMed2004

Parental perceptions regarding mandatory mouthguard use in competitive youth soccer.

OBJECTIVE: To understand factors that influence parental perceptions regarding mandatory mouthguard use in competitive youth soccer. SETTING AND SUBJECTS: A web based survey of parents whose 8-14 year old children participated in outdoor competitive youth soccer during the fall of 2002. Questions focused on: previous injury, education provided, dentist/physician recommendations, and parental perceptions of mouthguard use. MAIN OUTCOME MEASURE: The outcome variable was parental agreement with the statement "mouthguards should be mandatory for competitive youth soccer". Logistic regression and chi(2) were performed using STATA 8.0. RESULTS: Altogether 120 parents participated. The children had a mean (SD) age of 11.8 (1.5) years and 48% were female; 14% wore mouthguards and 11% suffered orofacial injuries. Nineteen percent of parents reported receiving educational material from the youth soccer organization. Although 92% of parents believed that mouthguards were effective in reducing orofacial injuries, only one half agreed that mouthguards should be mandatory. Thirty percent of respondents reported that their dentist/physician recommended mouthguards for competitive youth soccer. Logistic regression showed that dentist/physician recommendation and parental female gender were independently associated with parental agreement for mandatory mouthguard use (odds ratio 2.9, 95% confidence interval (CI) 1.2 to 7.3; odds ratio 3.0, 95% CI 1.1 to 6.5). CONCLUSIONS: Few athletes wear mouthguards during competitive youth soccer. Health care professionals in this study did not capitalize on the apparent influence they have on parental beliefs regarding mouthguard use. Efforts are needed by both health professionals and soccer organizations to educate parents about orofacial injuries and mouthguard use in competitive youth soccer.

Adolescent↗
PubMed2005

Should football players wear custom fitted mouthguards? Results from a group randomised controlled trial.

OBJECTIVE: Head/orofacial (H/O) injuries are common in Australian rules football. Mouthguards are widely promoted to prevent these injuries, in spite of the lack of formal evidence for their effectiveness. DESIGN: The Australian football injury prevention project was a cluster randomized controlled trial to evaluate the effectiveness of mouthguards for preventing H/O injuries in these players. SETTING AND SUBJECTS: Twenty three teams (301 players) were recruited from the largest community football league in Australia. INTERVENTION: Teams were randomly allocated to either the MG: custom made mouthguard or C: control (usual mouthguard behaviours) study arm. MAIN OUTCOME MEASURES: All injuries, participation in training and games, and mouthguard use were monitored over the 2001 playing season. Injury rates were calculated as the number of injuries per 1000 person hours of playing time. Adjusted incidence rate ratios were obtained from Poisson regression models. RESULTS: Players in both study arms wore mouthguards, though it is unlikely that many controls wore custom made ones. Wearing rates were higher during games than training. The overall rate of H/O injury was 2.7 injuries per 1000 exposure hours. The rate of H/O injury was higher during games than training. The adjusted H/O injury incidence rate ratio was 0.56 (95% CI 0.32 to 0.97) for MG versus C during games and training, combined. CONCLUSIONS: There was a significant protective effect of custom made mouthguards, relative to usual mouthguard use, during games. However, the control players still wore mouthguards throughout the majority of games and this could have diluted the effect.

Adolescent↗
PubMed2000

Acceptability of baseball face guards and reduction of oculofacial injury in receptive youth league players.

GOALS: To assess the relative injury reduction effect and acceptability of face guards on batter's helmets. METHODS: A non-randomized prospective cohort study among 238 youth league baseball teams in Central and Southern Indiana during the 1997 season. Coaches, parents, and players were asked to respond to pre-season and post-season questionnaires. Approximately one half of the teams were supplied with face guard helmets (intervention); all others used this protection at their discretion (comparison). RESULTS: Parents, players, and coaches on the intervention teams reported a reduction in the incidence of oculofacial injuries compared with comparison team respondents (p=0.04). There was no reported adverse effect of face guard use on player performance. CONCLUSIONS: Helmet face guards should be required for batters to prevent facial injuries in baseball.

Attitude to Health↗
PubMed2000

Head and neck tumors: fractionated frameless stereotactic interstitial brachytherapy-initial experience.

The authors used a frameless stereotactic navigation system, the Vogele-Bale-Hohner head holder, and a targeting device to reproducibly position brachytherapy needles for fractionated interstitial brachytherapy in 12 patients with inoperable cancers of the head and neck. In all cases, deviations of the needle relative to the planned position were within 1-15 mm depending on the location of the tumor.

Brachytherapy↗
PubMed1982

Human breathing patterns on mouthpiece or face mask during air, CO2, or low O2.

Steady-state breathing patterns on mouthpiece and noseclip (MP) and face mask (MASK) during air and chemostimulated breathing were obtained from pneumotachometer flow. On air, all 10 subjects decreased frequency (f) and increased tidal volume (VT) on MP relative to that on MASK without changing ventilation (VE), mean inspiratory flow (VT/TI), or mean expiratory flow (VT/TE). On elevated CO2 and low O2, MP exaggerated the increase in VE, f, and VT/TE due to profoundly shortened TE. On elevated CO2, MASK exaggerated VT increase with little change in f. Increased VE and VT/TI were thus due to increased VT. During low O2 on MASK, both VT and f increased. During isocapnia, shortened TE accounted for increased f; during hypocapnia, increased f was related primarily to shortened TI. Thus the choice of a mouthpiece or face mask differentially alters breathing pattern on air and all components of ventilatory responses to chemostimuli. In addition, breathing apparatus effects are not a simple consequence of a shift from oronasal to oral breathing, since a noseclip under the mask did not change breathing pattern from that on mask alone.

Adult↗
PubMed2005

Basketball injuries.

OBJECTIVE: To identify and quantify, to the best extent possible from the existing literature, injury characteristics and factors (risk; protective) associated with injury in young basketball players. DATA SOURCES: Database searches principally involving Medline and SportDiscus. In addition, web-based searching and filtering of the reference lists of papers found in the preliminary searches were utilized. MAIN RESULTS: Few well-controlled studies of this population have been conducted. However, from the information available: basketball is the most frequent cause of sports-related emergency department visits for youth and adolescents; the risk of being injured in a game is greater than for practice; girls are more likely to be injured than boys, especially with knee and ankle injuries and the knee injuries are more likely to be severe; acute injuries are more common than chronic; strains/sprains are the most common types of injuries but overall time loss is minimal, indicating that the majority of pediatric basketball injuries are minor (less than 7 days away from activity). Intervention studies show that: mouthguards reduce orofacial/dental injuries; mouthguard use can be increased in young players; neuromuscular training can reduce the incidence of knee injuries in female participants; postural sway is related to risk of ankle injury. CONCLUSIONS: The current state of epidemiological research involving youth and adolescent basketball injuries is poor. With an increasing number of young participants, in situations ranging from informal play and physical education classes to organized community and school teams, the need for comprehensive and authoritative information on risk and protective factors is significant.

Adolescent↗