Multi-Material 3D Printing of a Customized Sports Mouth Guard: Proof-of-Concept Clinical Case

A multilayer mouth guard is known to have the best protective performance. However, its manufacturing in a digital workflow may be challenging with regards to virtual design and materialization. The present case demonstrates a pathway to fabricate a multilayer individualized mouth guard in a fully digital workflow, which starts with intraoral scanning. A free-form CAD software was used for the virtual design. Two various CAM techniques were used, including Polyjet 3D printing of rubber-like soft material and silicone printing using Drop-on-Demand technique. For both methods the outer layer was manufactured from more rigid materials to facilitate its protective function; the inner layer was printed from a softer material to aid a better adaptation to mucosa and teeth. Both 3D printed multilayer mouth guards showed a clinically acceptable fit and were met with patient appraisal. Their protective capacities must be evaluated in further clinical studies.

Knowledge and Implementation of Protective Measures for Oral and Maxillofacial Injuries of Ice Hockey Players in Primary and Secondary Schools in Beijing

Background: There is little information regarding knowledge and implementation of sports-related oral and maxillofacial injury prevention measures of ice hockey players in primary and secondary schools. Thus, we investigated methods to improve the safety of juvenile ice hockey players in Beijing and reduce the incidence of oral and maxillofacial injuries, including tooth avulsions, tooth fractures, and jaw fractures. Methods: Using a convenience sampling method, we obtained consent from young ice hockey players from five primary and secondary schools and six special sports training institutions in Beijing; we administered a total of 280 questionnaires. Results: Only 12.50% of respondents reported wearing mouth guards during ice hockey; 62.50% of respondents reported never wearing a mouth guard; 43.58% did not know the risk of sports-related oral injury. Not understanding the necessity of wearing teeth protection was the most common reason reported why athletes do not wear protective gear (89.64%). Inconsistent behaviour among teammates (67.14%) was the psychological factor related to refusal to wear the mouth guard. Wearing discomfort (34.33%) and communication influence (33.14%) were also mentioned; 77.14% of the parents reported that the formulation and enforcement of the relevant regulatory agencies' standards were important to encourage young athletes to wear protective gear. Conclusion: Young ice hockey players in Beijing lack knowledge of sports-related oral injuries and effective protective measures, despite the high risks. The most effective way to improve compliance is to draw up and enforce the Ice Hockey Association's relevant standards and the coach's guidance.

ASSOCIATION BETWEEN LEVELS OF SPORTS PARTICIPATION AND ORAL INJURIES AMONG COMBAT ATHLETES

ABSTRACT Introduction Oral injuries are common traumas in combat sports due to the aggressive nature of both offense and defense. Sports mouth guards are made to reduce the risk of traumatic face and jaw injuries and concussions during sports activities. Objective The objective of this study was to determine the prevalence of oral injuries in combat sports and to examine the association between participation levels and percentage of injury occurrence. Methods One hundred and eight participants (mean age: 22.42 ± 2.162 years) who were involved in sparring events were recruited. Data were collected using a questionnaire consisting of 22 questions about the demographic profile of the athletes, their injury experience and type of injuries sustained, awareness and use of mouth guards in sports activities. Descriptive analysis, Chi-square test, and one-way analysis of variance (ANOVA) were applied for data analysis. Results Almost 77% of participants had experienced oral injuries during sports activities and nearly 90% were aware that oral injuries can be reduced by using mouth guards. In addition, 52.7% of participants complained that the mouth guard is not comfortable to use during sports activities. Findings revealed a significant moderate association between levels of participation and number of oral injuries ( p = 0.013). One-way ANOVA showed a significant mean difference in the rate of oral injury for the four levels of participation groups F (3, 104) = 6.21, p = 0.011. Post-hoc comparisons using the Bonferroni test indicated a significant mean difference between university-state levels ( p = 0.033) and university-national levels ( p = 0.028). Conclusion This study revealed that higher levels of participation in sports have a higher risk of injury. It was also found that the discomfort of using a mouth guard can be reduced if the coaches make the athletes wear proper mouth guards that follow the recommended specifications. Level of evidence IIIb; Case control study.

COMPARATIVE ANALYSIS OF EFFECTIVENESS AND SAFETY OF USING DIFFERENT SYSTEMS FOR HOME TEETH WHITENING

In recent years, the aesthetic requirements of patients for dental treatment have significantly increased. More and more often, patients go to the dentist to change the color of their teeth. The achievements of modern science and the development of new technologies have made it possible to expand the arsenal of conservative methods of aesthetic dental treatment. Teeth whitening technologies figure prominently in this row. The method of home teeth whitening using mouth guards is not only one of the most effective, but certainly also the most convenient, used in dental practice today. In his normal daily life, a patient can easily use a mouthguard made by a doctor with a whitening gel, or buy ready-made mouth guards containing a whitening gel, which is an undoubted advantage, because in the modern world one of the problems is lack of time, and the desire to have a beautiful smile does not disappear anywhere.

Dentist in the multiprofessional athlete monitoring team: essential to mitigate the severity of head concussions?

During the 4th International Conference on Concussion in Sport, held in 2012, in the city of Zurich, Switzerland, a consensus statement on concussion in sport was built, based on the principles described in previous documents [1]. The statement brings an additional understanding concerning the risks, diagnosis, and prevention of sports concussion in the amateur or professional athlete. Due to the importance of this topic for the health of sports players, the document is addressed not only to doctors but to all health professionals involved in preventive care and rehabilitation for this population [1].It is well known that concussions could occur in any sport, with a higher prevalence in contact sports [1]. Due to the potential risk of neurodegenerative effects by recurrent exposure to concussion or chronic exposure to head impacts, it is of great importance that this problem is addressed with a multi-professional approach [2]. In dentistry, personalized mouth guards (PBP) can be an interesting tool to reduce the neurodegenerative effects resulting from concussions. This is because PBPs have biomechanical properties to absorb and dissipate forces resulting from impact [3].Concussions result from the acceleration-deceleration process that occurs after the action of biomechanical forces that are transmitted to the brain tissue. The use of PBP can help to control cervical muscle activity, which is increased with trauma, contributing to reduce the severity of concussions after impact. In addition, PBP can distance the condyle of the mandible from direct contact with the mandibular fossa of the temporal bone, preventing this region from absorbing the full force of traumatic impact [3].Although it is impossible to eliminate all chances of concussion occurrences during sports practice, it is very important to create strategies aimed to reduce the number and severity of this situation. Pre-participation assessment and post-trauma follow-up should follow stricter criteria, with the participation of dentists in the multi-professional team that accompanies the athletes. This multi-professional interaction offers additional benefits in the preventive and rehabilitation spheres, as suggested by Sacramento et al. [4].Another strategy that could help prevent concussions is expanding current research, with more robust cross-sectional and longitudinal observational studies, assessing the etiological and epidemiological profile of sports trauma. Especially in youth sports, there is still insufficient research that explores this topic, since most research is directed at professional adult athletes, where the surveillance of these injuries is best performed [5].Finally, we believe that educational and clarification measures for athletes and coaches, about the importance of including the dentist in the multi-professional team, can help prevent concussions from being more harmful, as well as helping athletes to have better outcomes, improving recovery strategies following injury [4]. This could also decrease the athletes' recovery time and ensure a safer return to sports practice.

Exploring the use of mouth guards in Muay Thai: a questionnaire survey

Objective To identify Muay Thai participants’ attitudes towards use of mouth guards and their experiences of dental trauma. Materials and methods An online cross-sectional survey was used to record Muay Thai participants’ experiences and opinions regarding use of mouth guards. Participants were recruited from a Muay Thai gym in the north east of England. Results 92 respondents took part in the survey. 3% reported having never worn a mouth guard, whereas 61% reported routinely wearing mouth guards during a fight. Significantly more (73%) younger participants (18–29 years) reported wearing mouth guards during fights compared to those aged 30 years and older (50%) (p < 0.05). Mouth-formed (‘boil and bite’) were the most frequently used type of mouth guard (60% of users), followed by custom-made mouth guards provided by a dentist (32%). Factors such as protection, breathing, good fit and comfort were all considered important in the choice of mouth guard. 14% of respondents had experienced dental injuries, with chipped/broken teeth being the most common. Conclusion Given the risk for dental trauma in Muay Thai, it is important that participants are advised regarding mouth guard use, particularly those that do not routinely wear them.

Evaluation of Knowledge About Dental Trauma Among Sports School Students

Aim: To evaluate the level of knowledge of the sports school students about the traumatic injuries to teeth, its prevention and management. Materials and Methods: A cross sectional study was carried out among 155 children of age group 13- 17 years who were the inmates of sports school in Kannur district. A structured interview was used to determine the prevalence of dental injuries associated with the sports activity they were engaged, its preventive measures, management and the awareness of the use of mouth guards were also assessed. Results: Among the participants only 18.7% of the group were suffered from accidents involving the teeth and oral region. Out of the total participants, majority had tooth fracture. Only 9.03% of total participant would take a chance to replant the tooth. The transport media chosen for avulsed tooth were, 15.1% in a flask with saline , 14.2% in a flask with water ,and only 4.2% in a flask with milk. Out of the total participants, 69.6% know about the usage of mouth guards during sports practice and only 10.3% use it during sports activity. Conclusion: There is a lack of knowledge on prevention and management of sports related dental injuries among the sports school students of Kannur district. Hence there is a need for developing awareness programs and training on first aid to dental trauma related to sports activities among the sports students.