A technique for bleaching nonvital teeth: inside/outside bleaching.
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Nightguard vital bleaching, or NGVB, which involves the use of a 10 percent carbamide peroxide in a custom-fitted mouthguard, has been used with much success since its introduction in 1989. Normal bleaching treatment time is one to two weeks, although times may be extended to months for difficult stains. When used in a professionally supervised manner, nightguard vital bleaching is as safe as any other routinely used dental treatment.
The authors assessed high-school athletic coaches' perceptions about oral-facial injuries and mouthguard use in sports that do not mandate mouthguard use. About 72 percent of the coaches said that their athletes sustained oral-facial injuries, 28 percent that some athletes used mouthguards regularly, 48 percent that athletes had sustained injuries and did not use mouthguards regularly, and 31 percent said they would not encourage mouthguard use. Advocacy for mouthguard use should focus on coaches, coaches' associations and rule-making organizations.
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BACKGROUND: Treatment recommendations for patients with painful temporomandibular disorders (TMDs) range from conservative treatments such as physiotherapy to aggressive and irreversible treatments such as restorative reconstruction and joint surgery. METHODS: The authors randomized 200 subjects diagnosed with TMD into three groups: usual conservative, dentist-prescribed self-care treatment without any intraoral splint appliance (UT); UT plus a conventional flat-plane hard acrylic splint (HS); and UT plus a soft vinyl (a low-cost athletic mouth guard) splint (SS). Subjects completed questionnaires and clinical examinations at three, six and 12 months. RESULTS: The authors observed no significant differences among the groups in TMD-related pain levels or other common signs and symptoms of TMD at baseline (BL) or at any follow-up. The changes from BL were comparable for all three groups. The authors did not note any significant differences at any follow-up for compliance with study protocols or for occurrences of adverse effects from either splint type. For HS versus SS, there were significant differences in rates of splint use, but these differences were not accompanied by differences in either self-reported symptoms or in clinical findings. CONCLUSIONS: All patients improved over time, and traditional splint therapy offered no benefit over the SS splint therapy. Neither splint therapy provided a greater benefit than did self-care treatment without splint therapy. CLINICAL IMPLICATIONS: These findings suggest that clinicians who treat patients with TMD should consider prescribing low-cost nonsplint self-care therapy for most patients.
Bite guards are useful in the treatment of a number of occlusal and temporomandibular joint problems. These include clenching, bruxism, temporary stabilization of loose teeth and temporomandibular joint dysfunctions. A method has been presented for the construction of hard acrylic bite guards using a direct functional chew-in technique. This method produces bite guards which require little or no adjustment in just three short office visits.
There has been a significant increase in the number of individuals participating in contact sports. As a result, every effort must be made to provide the athletes with protection against mouth injuries. In this review the use, construction and benefits of mouthguards in all sports has been described. There is unanimous opinion attesting to the benefits of such protective devices and in those sports where the athlete is required to wear a mouth guard, a dramatic decrease in the number and severity of injuries has been reported. Custom-fitted mouth guards should be used in many sports that do not already have a compulsory rule requiring their use. Physicians, dentists, trainers and coaches need to be educated on the data supporting the benefits described. Studies on performance enhancement as a result of mandibular orthopaedic repositioning appliances have also been reviewed. Long term studies are required to assess the claims of ergogenic enhancement utilising proper study design. Current evidence exists relating to the effects of psychological phenomena on athletic performance, and it is believed the placebo effect contributes to the findings of performance improvement.
The mouthguard is a resilient device or appliance which is placed inside the mouth to protect against injuries to the teeth, lacerations to the mouth and fractures and dislocations of the jaw. There is clear support in the scientific literature for the use of mouthguards in contact sports such as rugby. Moreover, there is evidence that mouthguards are effective in protecting against concussion and injuries to the cervical spine. There is a high level of acceptance of mouthguards by players and an increasing number are regularly wearing mouthguards. This is especially true among the elite players, but acceptance and wearing rates are moderately high among club players as well. There is strong support among players and researchers for mouthguard wearing to be made compulsory. It is generally recommended that: (i) mouthguards be worn during both practice sessions and games; (ii) the habit of wearing a mouthguard begins at an early age; (iii) mouthguards be regularly replaced while children are still growing; and (iv) adult players replace their mouthguards at least every 2 years. The selection of a mouthguard will depend on a number of factors including the age of the individual, effectiveness and cost. The type I (stock), or 'off-the-shelf', mouthguards are considered inferior when compared with the other available types, and their use is discouraged. Type II (mouth-formed) mouthguards come in 2 forms, the shell-liner version and the popular thermoplastic 'boil and bite' version. While the effectiveness of the shell-liner mouthguard was examined in one experimental study, no such research has been reported for the thermoplastic mouthguard. Type III (custom-fabricated) mouthguards are recommended for players playing in the more vulnerable positions and in the higher grades. Most experimental studies in which the effectiveness of mouthguards has been demonstrated have involved type III mouthguards.
Individuals worldwide are participating in an expanding arena of vigorous physical activities as well as competitive sports at all levels. The healthful benefits of such activities are unfortunately associated with injury risks that include orofacial soft- and hard-tissue trauma. This article describes the scope and emergency management of sports-related orofacial traumatic injuries that may be encountered by physicians in the field of sports medicine. Since most of these injuries are preventable with the use of protective equipment, specific recommendations are provided for the use of properly fitted mouthguards.
PURPOSE: A mouthguard can protect stomatognathic systems from traumatic damage. However, severe occlusal wear of teeth and loss of teeth have often been found in players clinically. These problems might originate in strong clenching during sports. Although it is thought that a mouthguard may be effective for these types of clenching, the relation between mouthguards and clenching has not been sufficiently examined. In this study, the effect of a mouthguard (Drufosoft 3mm, EVA) on tooth distortion caused by clenching was measured and examined at three different clenching strengths. METHODS: As a test tooth, a lower first molar was selected. A strain gauge applied to the outer surface of the buccal cusp was used to measure the distortion. A muscle balance monitor (GC) was used to regulate clenching strengths (10, 50, and 100%). The maximum-effort clenching without a mouthguard was assumed to be the 100% clenching strength. Measurements were conducted with or without mouthguard. A maximum value during clenching was assumed to be date of distortion by using analytical software AcquKnowledge (BIOPAC System Inc.). Statistical analysis software SPSS (SPSS Japan Inc.) was used for the Mann-Whitney test. RESULTS: 1. The tooth distortion by clenching, regardless of the presence of the mouthguard, increased as clenching power strengthened, from 10, 50 to 100%. 2. The tooth distortion, regardless of strength of clenching, was decreased by wearing the mouthguard in all subjects. At 50 and 100% clenching, it was decreased significantly by the mouthguard in all subjects. CONCLUSIONS: Mouthguards decreaseed the tooth distortion caused by clenching. Therefore, a mouthguard may prevent not only traumatic injuries in contact sports but also damage to teeth and periodontal tissues and so on, which occur due to frequent strong clenching in many sports.
PURPOSE: Most of the mouthguards on the market are inferior in fit and occlusion related to feeling and injury prevention capacity. Therefore, it is necessary to use appropriate custom-made mouth-guards. This research aimed to obtain data for the selection, improvement, and spread of mouthguards in the future. A questionnaire survey of dentists who had made four kinds of mouthguard was conducted in a mouthguard seminar. METHODS: The questionnaire survey concerning "feeling", "difficulty of production", and "selection when considering use and spread" was done for four kinds of mouthguard. The evaluations were made using a ten-point method with the Kruskal-Wallis test and Mann-Whitney U-test. RESULTS: Concerning the feeling: The laminated mouthguard was evaluated the highest, followed in order by improvement type, vacuum, and boil & bite. Concerning the production: The evaluation differed from other questionnaire items. No significant difference was found among all four kinds of mouthguard, so there was no difference in the fabrication difficulty. Concerning the selection and spread: The evaluation was almost the same as for the feeling. The laminated mouthguard was assessed to be the best mouthguard. CONCLUSIONS: The boil & bite mouthguard which is widespread was evaluated the lowest in all items except production. Therefore, it is necessary to encourage players to use an appropriate custom-made type in view of safety, wearing feeling, and dental occlusion.
PURPOSE: To consider changes in the physical properties of mouthguard materials with the change of temperature, shock-absorbing examination and Shore hardness measurement of existing MG materials and other elastic materials were carried out. METHODS: Both examinations were done under two temperature conditions: at room temperature (25 degrees C) and simulated intraoral temperature (37 degrees C). In addition, a comparative study of the relation between Shore hardness and shock absorption of the materials was made. A self-made drop impact machine was used for the shock-absorbing examination. The thickness of a sample was assumed to be 3 mm. The loading was applied by dropping 3 kinds of steel ball, phi 10 mm (4.0 g), phi 15 mm (13.7 g), and phi 20 mm (32.6 g) from a height of 60 cm. The shock absorption of all materials was compared by the maximum impact force. Shore hardness was measured based on the JIS standard. RESULTS: The shock absorption of each material showed a different tendency depending on the loading condition. Furthermore, the shock absorption of the same material showed different results depending on the temperature condition. Shore hardness measurements tended to show low values with the condition of 37 degrees C for all materials. CONCLUSION: From the relation between shock absorption and Shore hardness, it was confirmed that there is a correlation between hardness and the maximum impact force in the materials that showed shock absorption by elastic deformation. Some materials showed high shock absorption compared with existing MG materials.
PATIENT: A 57-year-old female complained of aesthetic disturbance, dysmasesis and phonation disorder by attrition. She had severe attrition of almost teeth. To avoid metal color exposure and attrition of opposing teeth, hybrid ceramics were used for veneered crowns and fixed partial denture. Since the prosthetic treatment, the patient wears a night guard to prevent attrition of her teeth and prosthesis. DISCUSSION: There has been no specific trouble during the 4-year follow-up. CONCLUSION: It is considered that using hybrid ceramics for veneering crowns and fixed partial denture and night guard help to prevent the attrition of opposing teeth and abrasion of prosthesis.
Damage to teeth is a well known complication of peroral endoscopy. A case is described in which potentially fatal complications of such damage occurred. This spurred on the development of a dental splint as an aid in the prevention of such damage. This splint is described, and evidence for the beneficial results of its use is presented.
The hypothesis that absence of dyspnea during airflow obstruction is caused by habituation to sensory information was tested. Adolescents without respiratory disease breathed through a mouthpiece interrupting airflow analogous to approximately 64% reduction in forced expiratory volume in 1 sec. They were randomly assigned to labored breathing for 1 min, 30 min, or twice 30 min (with a 30-min interval in between). Dyspnea was measured pretest without mouthpiece and posttest with mouthpiece in. Results showed no significant difference in posttest dyspnea between conditions. Dyspnea remained remarkably mild. Severe secondary symptoms (excessive saliva) during the experiment made habituation unlikely and the results were interpreted in favor of the alternative hypothesis: lack of or mild dyspnea is associated with a low-anxiety situation without connotation of suffocation, irrespective of level of airflow obstruction.
As computer-interactive technologies become more widely used in neurosurgery, radiology, and radiation therapy, the need for an optimum skull fiducial marker system increases. In the past, intracranial localization methods required precisely machined metal frames and rigid pin fixation to the skull. Recently, this function has been performed using "frameless" computer-based systems that calculate brain position relative to a series of external reference points, the most accurate of which are screwed directly into the skull. A penetrating fiducial marker system, however, is not well suited for applications requiring multiple volume registrations over an extended time period. We describe a new skull fiducial marker system that attaches to the maxillary teeth and can be used repeatedly on different occasions. A curved bar, known as a Banana Bar (BB) extends backward from a custom mouthpiece around the side of the patient's head; the bar contains sites of attachment for screw-in radiographic fiducial markers. Repositioning accuracy was quantitated using a photographic technique. A BB prototype was constructed and tested in three subjects. The BB weighs less than 100 g and can be comfortably held in position for up to 30 minutes. It takes less than 1 minute to screw in the mouthpiece and only seconds to secure the BB to the teeth. One hundred twenty photographic measurements were analyzed from 60 repositionings over a minimum 3-week period. Standard deviations for the measurement series ranged from 0.29 to 0.86 mm. Results suggest that the BB may be an inexpensive, efficient, and accurate method for providing the external reference points needed for a wide range of emerging computer-interactive applications.