[Sedation for outpatient dental procedures].
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Sports dentistry is a new discipline that involves the prevention and treatment of sports-related dental diseases and trauma. As dental professionals, we have responsibility to educate ourselves, and the public community on issues related to sports dentistry, and specifically to the prevention of sports-related dental traumatic injuries. It is incumbent upon us to take the lead in conducting this type of educational and research activities. It is crucial for dental professionals to educate and promote all phases of sports dentistry to the public. Dental professionals should emphasize the continued susceptibility of individual to sports-related dental trauma and the importance of implementing appropriate preventive measures; and seeking early intervention of individual who requires preventive treatments.
The purpose of this study was to determine the extent of mouthguard awareness and use, as well as the amount and type of oro-facial trauma associated with and without mouthguard wear in adolescent Nigerian athletes. A 13-item self-completion questionnaire was completed and returned by 1,127 secondary school athletes (completion rate of 93.9%) comprising 683 (60.6%) males and 444 (39.4%) females ranging in age from 12- to 19 years (mean age 15.18+/-2.97 SD). The athletes were randomly drawn from 23 secondary schools located in different parts of Ibadan city in Nigeria. Sixty-five-and-a-third percent of the athletes professed awareness of the need for mouthguards for sports, but only 19.6% claimed usage of the device. Thirty-four-and-a-half percent of the athletes reported having sustained one form of oro-facial injury or the other previously. The prevalence of oro-facial injuries was significantly lower while wearing a mouthguard (p<0.05), and most of the injuries occurred during contact sports. The study supports the need for the enforcement of mandatory mouthguard use in contact sports.
A 43-year-old healthy female volunteer donor was scheduled for bone marrow harvesting. In the operating room her mouth opening was ascertained to be 5 cm. Anesthesia was induced with thiamylal 250 mg, fentanyl 0.1 mg and vecuronium 6 mg i.v. Her mouth opening was found reduced to 2 cm that was not improved by additional vecuronium 2 mg. A consulted oral surgeon diagnosed temporomandibular disorder. After she was awakened once with resumed mouth opening, anesthesia was reinduced with a bite block placed and with her jaw held open by the oral surgeon, which brought the same results. Laryngoscopy was performed with the jaw forcefully opened and with cricoid pressure applied and the trachea was intubated. The surgical procedure and anesthesia thereafter were uneventful. Postoperative MRI was coincident with the diagnosis of temporomandibular disorder. It was speculated that in the donor patient with preexisted type II temporomandibular disorder, muscle relaxation induced by anesthesia caused the mandibular head fall behind the articular disk and dislocated the disk forwardly ending up in closed lock of temporomandibular joint.
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To assess the awareness and frequency of use of mouth-guards for football among secondary school children in Ibadan, Nigeria, as well as the amount of oro-facial trauma previously associated with football game in these adolescents, a questionnaire - based cross-sectional study was conducted. Six hundred and thirty -one amateur footballers - 465 (73.7%) males and 166 (26.3%) females in the age range of 10 - 19 years (mean age, 15.01 +/- 2.86SD) completed the questionnaire giving a response rate of 90.1%. Majority (58.8%) of the subjects was within the 10-15 years age group. Awareness of mouth-guards was claimed by 69.7% of the respondents but significantly more of them who made the claim were not using the protective device for football games (p<0.05). More boys significantly claimed the usage of mouth-guards than girls (p<0.05). In all, 59.7% agreed that wearing mouth-guard was helpful in oro-facial injury prevention during sports with significantly more boys in agreement than girls (p<0.05). About 36% of the subjects sustained one form of oro-facial trauma or the other with significant sex difference (p<0.05). Secondary schools should serve as good starting points in the campaign for use of mouth-guards for contact sports before some go into professional sports.
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Young athletes with ever-changing transitional dentitions and those wearing fixed orthodontic appliances can benefit from custom-formed protective mouthguards. Modifications of the traditional vacuum-forming method are useful to fabricate mouthguards for such patients and extend the useful life of these devices. The purpose of this case report is to document fabrication of custom-formed protective mouthguards for a 10-year-old boy wearing fixed orthodontic appliances and a 9-year-old girl with a fixed palatal expander in place.
Injuries to the maxillofacial region sustained in sports related trauma are increasing in the United States. The pediatric (age 12 and younger) and teenage populations account for the greatest number of these injuries primarily due to increased team sports participation in these younger age groups. A severe injury to the maxillofacial region can have devastating psychological effects as well as being physically debilitating. Therefore, early treatment of soft tissue and bony injuries will minimize scarring and decrease potentially adverse psychological implications. Sports trauma is a frequent source of maxillofacial injuries especially in the younger population. Basic protective equipment, such as proper fitting helmets, mouth guards and face masks, are still not mandatory, or rules not enforced, in many youth hockey and football leagues. In addition, the increased popularity of multispeed bicycles, dirt bikes, and off-road vehicles (e.g. snowmobiles, go-carts) in the hands of unrestrained and unprotected children and adolescents has contributed to an increasing number of maxillofacial injuries in these groups.
Sports play a significant role in all nations worldwide. More and more people involve in sports so that the incidence of the oral-facial and dental traumas with accidents ascends. The treatment cost is considerable, and the sporters' lives will be influenced by these traumas. This paper examines the status and the reasons of the oral-facial and dental traumas. It reviews not only the principle and the types of the mouthguard but also the evidence of the mouthguard in preventing sports-related traumas. Prevention is thought to be the key element in minimizing traumas that occur in sports, the using of mouthguard is considered essential.
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Many people enjoy sports, it is healthy and relaxing. There is, however, an inherent risk of sustaining injuries and fractures of the maxillofacial skeleton. Adequate diagnostics and treatment are mandatory to minimize the possible long-term consequences of injuries. Dentists may become primary involved in the diagnosis of such traumas, particularly when injuries are limited to the orofacial region. In addition, they can play an important role in caring for sportsmen with orofacial injuries, for instance by endodontic, restorative, and prosthodontic treatments. This paper discusses the assessment and treatment of fractures of the mandible, the zygoma, the mid-face, the orbital bones, the nose, and the frontal sinus. The assessment must followed by treatment as soon as possible. Treatment options of orofacial fractures are conservative treatment by exercising and/or oral splints and surgical reposition, either or not using osteosynthetic materials.
Self-inflicted oral mutilation can result in oral lesions that are difficult for a pediatric dentist to diagnose. Sometimes its execution is premeditated, but it can also happen accidentally or as the result of an unconscious, deleterious habit. The purpose of this case report was to describe: (1) the diagnosis of a gingival lesion caused by self-inflicted oral mutilation in a 9-year-old patient; and (2) the proposed treatment.
A mouthguard is a useful appliance to prevent oral injuries, and their emotional and financial consequences. Most sportsmen are aware of the benefits of a mouthguard. Nevertheless, a relatively small percentage of sportsmen in contact sports are using a mouthguard actually. Whether or not a mouthguard is used, is predominantly determined by its comfort. Therefore, a mouthguard must be optimally comfortable. However, to make sportsmen using an even optimal mouthguard, needs motivation. Stimulating of motivation is the task of parents, coaches, (team) physicians, and (team) dentists. Especially coaches seem to have great influence on sportsmen. Children are very much influenced by their parents. It is the task of general dental practitioners not only to inform sportsmen and their parents, but also their coaches and team physicians about the risks of oral injuries and about the benefits of preparing a mouthguard. General dental practitioners must put themselves disposal to prepare mouthguards for their individual patients as well as for all players of a team who wish to have a mouthguard prepared.
Facial shields are used when practising contact sports, high speed sports, sports using hard balls, sticks or bats, sports using protective shields or covers, and sports using hard boardings around the sports ground. Examples of facial shields are commercially available, per branch of sport standardised helmets. Fabricating individual protective shields is primarily restricted to mouth guards. In individual cases a more extensive facial shield is demanded, for instance in case of a surgically stabilised facial bone fracture. In order to be able to fabricate an extensive individual facial shield, an accurate to the nearest model of the anterior part of the head is required. An accurate model can be provided by making an impression of the face, which is poured in dental stone. Another method is producing a stereolithographic model using computertomography or magnetic resonance imaging. On the accurate model the facial shield can be designed and fabricated from a strictly safe material, such as polyvinylchloride or polycarbonate.
OBJECTIVES: The purpose of this investigation was to determine the thickness of different types of custom-made mouthguards after processing and the deformational changes after simulated occlusal loading. MATERIALS AND METHODS: Ten mouthguards were fabricated for the same dental arch using the following materials and processing techniques: Group I: vacuum-formed (4 mm), Colored Mouthguard; Group II: vacuum-formed (4 mm), Proform; and Group III: pressure-laminated (3 + 3 mm), Drufosoft. After processing, the thickness was measured in three places: lingual cusps of the first molar, distal marginal ridge of the first premolar; and facial of central incisor. The stiffness of each group was determined by applying a simulated clenching force to the first molar lingual cusp areas on an Instron test machine with a blunt probe. The corresponding penetration was measured with a dial gauge. Thickness and force-deflection measurements of the different mouthguard groups were compared using analysis of variance and post hoc tests. RESULTS: The mean thicknesses at the molar for Groups I and II were 1.55 and 1.52 mm, respectively, and were significantly smaller then the corresponding thickness for Group III (3.48 mm). The mean thicknesses at the facial of the incisors for Groups I and II were similar (2.05 and 2.06 mm, respectively), and were significantly smaller than the corresponding thickness for Group III (3.29 mm). Groups I and II demonstrated similar stiffness that was significantly higher than that for Group III. CONCLUSION: These results show that vacuum-formed mouthguards produced smaller thicknesses than the pressure-laminated mouthguards. The pressure-laminated mouthguards produced material thicknesses that were previously shown to be adequate to protect athletes from trauma.
The prevention and treatment of orofacial trauma is now a very important part of the general practice. Children as well as adults are participating more in events where the probability of trauma is apparent. Attendance at health clubs and gymnasiums is on the rise. With the increase in sports participation comes an increase in orofacial injuries. The general population is taking its health more seriously. Athletic participation is on the rise, and Title IX has introduced increased female participation at all levels. This only increases the possibility that our patients will present themselves in our offices with the need for trauma treatment and also our opinions on the methods of preventing such traumatic experiences.
This study compared two Type III ethylene vinyl acetate (EVA) mouthguards for wearability, comfort, fit, and patient preference. Twenty-two athletes each received two custom-fabricated athletic mouthguards, a single-layered vacuum-formed EVA mouthguard and a double-layered heat- and pressure-laminated EVA type. Athletes wore each type of mouthguard for a two-week period while playing basketball. At the end of each two-week period, the athletes completed questionnaires that evaluated 17 characteristics of each mouthguard type. Data were analyzed using the binomial test for small numbers. The double-layered heat- and pressure-laminated EVA mouthguard performed as well as or better than the single-layered vacuum-formed type in 14 of the 17 categories. There was a statistically significant patient preference for the double-layered heat- and pressure-laminated mouthguard.