Overcoming objections: providing professionally made custom mouthguards.
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Using a modal analysis system, we carried out a comparative assessment of the vibratory properties of the maxillary dentition of a human dry skull with a different distal end of a mouthguard. Mouthguards used in this study were: 1. a mouthguard covering up to the third molar (8MG), 2. the second molar (7MG), 3. the first molar (6MG), and 4. the second premolar (5MG). To identify the modal shape, the frequency response functions were recorded on a fast Fourier transform analyzer from the force signal impacted with a vibration generator and the response signal picked up using a laser-doppler vibrometer. The transient response waves were obtained throughout the transient response simulation procedures after curve-fitting procedures. Mean decay rates (sec(-1)) of the transient response waves were calculated for the anteriors, premolars and molars, and compared among different sets of experimental conditions. The decay rates became lower as the distal end of a mouthguard was short. The decay rates with 8MG, 7MG and 6MG (anteriors) exceeded the no mouthguard's decay rate + 2S.D. values. These results imply that a mouthguard should distally cover up to the second molar at least to ensure efficient absorption and/or dispersion of a traumatic force.
OBJECTIVE: The purpose of this investigation was to assess the effects of aging on the dimensional stability of vacuum-formed, pressure-formed, and pressure-laminated custom-made mouthguards. METHOD AND MATERIALS: A master model representing the dental arch was fabricated in acrylic resin. Two ethylene vinyl acetate thermoplastic materials were tested: Essix (regular) and Proform (prelaminated). The model was benchmarked in five places along the curvature of the arch. The model was used to fabricate 10 specimens for each of the following groups: 1 = vacuum-formed (3-mm) Essix; 2 = vacuum-formed (4-mm) Proform; 3 = pressure-formed (3-mm) Essix; 4 = pressure-formed (4-mm) Proform; 5 = pressure-laminated (3-mm + 2-mm) Essix; 6 = pressure-laminated (3-mm + 3-mm) Essix. Die stone was poured into the newly made specimens and measured. Aging of the specimens was simulated by reproducing cleaning cycles (48 hours' soaking in water at 60 degrees F and brushing 100 times with a soft denture brush in soapy water at 140 degrees F for 20 minutes). Die stone was poured into the aged specimens and measured. Initial and postaging measurements were compared. RESULTS: All specimens showed dimensional changes post-aging, mainly decreases. Pressure-laminated specimens showed the best dimensional stability. CONCLUSION: Aging induced various dimensional changes in mouthguards, depending on the materials and processing techniques used. Most of the dimensional change for all mouthguards occurred at the central incisor region, the most important area for the protection of the anterior teeth and the premaxilla. Pressure-laminated mouthguard specimens showed the smallest range of changes at the central incisor region, suggesting potentially improved fit, comfort, and protection.
Avulsions and intrusions are the most complicated and controversial displacement injuries of permanent teeth. Clinical guidelines published by authorities such as the American Association of Endodontists, the Royal College of Surgeons of England and the International Association of Dental Traumatology are inconsistent. While a certain amount of inconsistency might be expected, some of these guidelines recommend treatments that are experimental or have not incorporated research information from the past 5 years, and in one case the guidelines incorrectly describe the nature of Hank's balanced salt solution. Recent laboratory studies support previous clinical outcome studies in emphasizing that only for teeth replanted within 5 minutes of avulsion is there a chance of regeneration of the periodontal ligament and normal function. Teeth replanted beyond 5 minutes will take another path, that of repair followed by root resorption, ankylosis and eventual extraction. Dentists should explain these outcomes at the time of the replantation decision. Severe intrusions also have predictable outcomes. Teeth intruded beyond 6 mm cannot regenerate a functional periodontal ligament and so are prone to root resorption and eventual extraction as well. In this situation the decision is one of immediate extraction or repositioning, with the understanding that it is inevitable that the tooth will eventually be extracted. Authoritative clinical guidelines available on the Internet provide the clinician with useful outlines for treatment. However, individual inconsistencies stimulate academic controversies and, in some cases, clinical misdirection.
This article describes a simple but effective method of bleaching single vital discolored teeth. The patient applies a viscous 10% carbamide peroxide gel in a plastic mouth-guard designed to confine the gel only to the discolored tooth. This method has been effective for lightening vital teeth with calcified pulpal spaces.
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Recent developments in restorative materials, placement techniques, preparation design, and adhesive protocols allow clinicians to predictably restore fractured teeth. Using a minimally invasive approach, treatment of the maxillary anterior region can be effortlessly completed within a single appointment. If the original tooth fragment is retained following fracture, the natural tooth structures can be reattached using adhesive protocols to ensure reliable strength, durability, and aesthetics. This article discusses the adhesive reattachment of a tooth fragment to a fractured incisor using a conservative preparation technique.
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The management and prevention of dental trauma is an integral part of the medical services provided at major athletic events. This paper reviews the organization and delivery of the dental services provided at the 1989 Canada Games. The nature, incidence and management of the dental problems reported in the participant population of 3,411 athletes are also described. During the two-week competition, 15 participants were assessed and treated for various dental conditions, including hard- and soft-tissue injury of the oral cavity, and temporomandibular joint sprain. The sports with the highest incidence of dental injury for the male population were wrestling (one per cent) and basketball (0.8 per cent). For the female population, these sports were basketball (2.5 per cent) and field hockey (1.3 per cent). The dental services provided during the games included emergency assessment and treatment, fabrication of mouthguards, and in-service education to medical team members.
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