Search Results (59)

Background/Objectives: Traumatic dental injuries (TDIs), particularly avulsion, require immediate and appropriate first aid to ensure favorable outcomes. Adolescents are often the first responders during school or sports activities, yet their preparedness remains unclear. This study aimed to assess the knowledge, attitude, and awareness of adolescents regarding the emergency management of TDIs. Methods: A descriptive cross-sectional survey was conducted among 400 adolescents aged 15 to 18 years from four randomly selected colleges in Mangaluru, Karnataka. A structured, validated 16-item questionnaire assessed demographic characteristics and domains of knowledge (6 items), attitude (6 items), and awareness (6 items). Data was analyzed using descriptive statistics, chi-square tests, and one-way ANOVA. Results: The mean knowledge score was 2.50 ± 1.04 (95% CI: 2.40–2.60), indicating limited knowledge of dental trauma management; only 26.3% of participants recognized that avulsed permanent teeth can be replanted and 7% identified an appropriate storage medium. The mean attitude score was comparatively high (4.38 ± 1.12; 95% CI: 4.27–4.49), with 88.8% of students willing to assist an injured peer, reflecting a large attitude–knowledge discrepancy (Cohen’s d = 1.47). The mean awareness score was 2.24 ± 1.24 (95% CI: 2.12–2.36), indicating limited awareness of preventive practices, including low mouthguard use (11.5%). Shapiro–Wilk testing confirmed non-normal distribution of KAA scores (p < 0.05); accordingly, non-parametric analyses showed no significant differences across schools, academic streams, gender, or education level (Kruskal–Wallis and Mann–Whitney U tests; p > 0.05). Conclusions: Despite favorable attitudes toward assisting peers, adolescents demonstrated limited knowledge and awareness regarding the emergency management and prevention of traumatic dental injuries, particularly in tooth replantation, appropriate storage media, and mouthguard use, highlighting the need for targeted, school-based dental first-aid education programs. Full article

Instrumented mouthguards (iMGs) enable in vivo monitoring of head-impact exposure by reporting event-level peak linear acceleration (PLA) and peak angular acceleration (PAA) in contact sports. This case study describes head impacts in a world-class Muay Thai fighter during routine sparring sessions over a two-week period leading into a competitive bout. Seven sparring sessions were monitored using an iMG (PROTeQT, HitIQ), and only manufacturer (in-mouth)-flagged events above the device’s 8 g trigger threshold were analyzed. Event-level data were exported from the manufacturer portal; raw time-series signals and proprietary signal-processing parameters were not accessible, and no independent video verification was performed. Across the camp, 590 impacts were recorded. Mean PLA values were modest across sessions (7.6 to 19.5 g), with one event exceeding 106 g (max PLA 162.2 g). In contrast, PAA exhibited greater variability, with multiple device-flagged events exceeding 7900 rad/s², particularly in Sessions 4, 6, and 7, where maximum PAA values reached 19,862 to 26,850 rad/s². Overall, these data indicate that sparring was predominantly low in translational loading, while occasionally producing high recorded rotational peaks. Because outputs are device- and processing-pipeline-specific and were not independently verified, threshold-based severity banding and extreme peaks should be interpreted cautiously. This case demonstrates the potential utility of iMG monitoring to characterize session-to-session variability in sparring exposure and to inform practical sparring load management strategies aimed at reducing cumulative head-impact burden. Full article

When fabricating custom-made mouthguards for children, tooth replacement is an important factor for dentists to consider. In addition, orofacial myofunctional disorders and deleterious oral habits—such as incompetent lip seal and tongue thrusting—are relatively common among children and are associated with an increased risk of oral and dental trauma. Therefore, individual oral functional characteristics should be taken into account when designing custom-made mouthguards for pediatric patients. This report presents a case involving the design, fabrication, and appliance management of a custom-made mouthguard for a Japanese boy exhibiting incompetent lip seal and tongue thrusting. In this case, the anterior palate region of the mouthguard was left uncut, and multiple holes were created using a carbide bur to permit tongue–palate contact and provide sensory feedback related to tongue elevation. Over a 20-month follow-up period, no oral or dental trauma was observed. During appliance use, the patient demonstrated improved tongue elevation and an increased frequency of lip seal at rest. This case illustrates a custom mouthguard design that incorporates individual oral functional characteristics in a pediatric patient. Full article

Aim: Traumatic dental injuries (TDI) in children are a common but often underestimated emergency. Parental knowledge and timely response are crucial for successful treatment. This study aimed to evaluate parental knowledge, experiences, and awareness regarding dental trauma management and the use of protective mouthguards. Methods: A cross-sectional study was conducted using a self-administered questionnaire among 333 parents in dental clinics in Split and Zagreb, Croatia. The questionnaire assessed sociodemographic data, parental knowledge of TDIs, and prior experience with dental trauma. Statistical analysis included chi-square test (p < 0.05). Results: The overall level of parental knowledge regarding traumatic dental injuries was generally low (7.6 out of 15 points). Almost all parents correctly identified the age when children have primary or permanent teeth. However, less than half knew that an avulsed primary tooth should not be replanted, while about three-quarters recognized that professional help should be sought within 30 min after trauma. Overall, 43.5% of parents reported that their child had experienced dental trauma, most often affecting primary teeth (60.7%), particularly the maxillary central incisor (76.6%). Mothers demonstrated significantly higher knowledge than fathers (p = 0.025), and prior experience or information about dental trauma significantly improved awareness (p < 0.001). Although 54.3% of respondents were unaware of the purpose of dental shields, 82.3% considered them necessary during contact sports, yet only 12.9% reported that their child actually uses them. Conclusions: Within the limitations of this clinic-based study, the findings indicate gaps in parental knowledge regarding the appropriate management of dental trauma. Strengthening parents’ understanding of emergency response and preventive measures may support timelier and appropriate care and contribute to improved outcomes for children experiencing traumatic dental injuries. Full article

Objectives: This cross-sectional study aimed to evaluate oral health knowledge, self-perceived oral status, hygiene behaviors, prevalence of dental injuries, and mouthguard use among Croatian basketball players and coaches. Materials and Methods: A total of 414 participants of both sexes, spanning various levels of basketball participation in Croatia, completed an anonymous online questionnaire assessing oral health knowledge, hygiene habits, trauma history, and preventive practices. Data was analyzed using descriptive statistics, Chi-square, Mann–Whitney, and Kruskal–Wallis tests. Results: Participants demonstrated generally poor oral health knowledge, with coaches scoring significantly higher than players (p < 0.05), and knowledge levels varying according to education and socioeconomic status (p ≤ 0.001). A majority reported no prior dental trauma (69.6%), and mouthguard use was notably low (20.8%). While regular toothbrushing was prevalent (87%), the use of dental floss was limited (39.9%). The most reported oral health problems included gingival bleeding (37.9%), dental calculus (35.0%), and tooth sensitivity (34.3%). Conclusions: Despite relatively good hygiene habits, Croatian basketball players demonstrated low oral health knowledge and insufficient preventive practices, particularly regarding mouthguard use. These findings indicate the need for targeted education and preventive strategies within the basketball community. Full article

Sports mouthguards play a crucial role in preventing orofacial injuries. Vacuum thermoforming with ethylene-vinyl acetate is the most common fabrication method; however, digital workflows and 3D printing have introduced promising alternatives. This in vitro study aimed to compare mouthguards produced by vacuum thermoforming and 3D printing in terms of precision, trueness and impact resistance. A maxillary plaster model was used to fabricate two groups: thermoformed mouthguards (GTherm, n = 3; Playsafe Triple Light, Erkodent™) and 3D-printed mouthguards (GPrint, n = 3; high-impact polystyrene via fused deposition modeling). The internal surfaces were scanned with a Medit T500, and precision and trueness were assessed by superimposing STL files using Geomagic software. Ten specimens of each material underwent Charpy impact testing. Data were analyzed with GraphPad Prism. The GPrint group exhibited higher precision (median RMS = 57.8 µm) than GTherm (median RMS = 812 µm), although the difference was not statistically significant (p = 0.10). Trueness in GPrint was within acceptable limits (median RMS = 118 µm). In the Charpy test, impact strength was significantly higher in thermoformable-based specimens than in printed ones (mean 17.33 ± 1.96 vs. 14.33 ± 0.65 kJ/m², respectively). Within the study’s limitations, 3D-printed HIPS mouthguards showed superior precision and acceptable trueness, whereas thermoformed mouthguards demonstrated significantly greater impact resistance. Full article

Objectives: Strong cervical musculature is recognized as a protective factor against sports-related concussions. Evidence suggests that jaw clenching may activate cervical muscles, potentially reducing head acceleration during impact. Methods: This observational cohort study examined the immediate effects of a customized interocclusal orthotic (CIO) on cervical muscle performance. Forty-two healthy adults (≥18 years) underwent strength and endurance testing with and without a CIO using a digital pressure gauge and six directional isometric contractions. Descriptive statistics and two-way repeated-measures MANOVA models were applied to evaluate condition effects. Results: CIO use produced significant improvements in cervical muscle strength and endurance across all directions compared to non-use. Forward flexion strength increased by 12.96% (p < 0.001, ηp² = 0.185), backward extension by 10.34% (p = 0.017, ηp² = 0.091), right rotation by 19.03% (p < 0.001, ηp² = 0.333) and left rotation by 19.86% (p < 0.001, ηp² = 0.353). Endurance gains demonstrated large effect sizes, with flexor endurance improving by 44.57% (p < 0.001, ηp² = 0.447). Conclusions: Optimized jaw alignment using a customized orthotic can elicit immediate, clinically meaningful enhancements in cervical strength and endurance, suggesting a promising adjunct for concussion risk mitigation in contact sports. Full article

Mouthguards are recommended for all sports that may cause injuries to the head and oral cavity. Custom mouthguards, made conventionally in the thermoforming process from ethylene vinyl acetate (EVA), face challenges with thinning at the incisor area during the process. In contrast, additive manufacturing (AM) processes enable the precise reproduction of the dimensions specified in a computer-aided design (CAD) model. The potential use of filament extrusion materials in the fabrication of custom mouthguards has not yet been explored in comparative studies. Our research aimed to compare five commercially available filaments for the material extrusion (MEX) also known as fused deposition modelling (FDM) of custom mouthguards using a desktop 3D printer. Samples made using Copper 3D PLActive, Spectrum Medical ABS, Braskem Bio EVA, DSM Arnitel ID 2045, and NinjaFlex were compared to EVA Erkoflex, which served as a control sample. The samples underwent tests for ultimate tensile strength (UTS), split Hopkinson pressure bar (SHPB) performance, drop-ball impact, abrasion resistance, absorption, and solubility. The results showed that Copper 3D PLActive and Spectrum Medical ABS had the highest tensile strength. DSM Arnitel ID 2045 had the highest dynamic property performance, measured with the SHPB and drop-ball tests. On the other hand, NinjaFlex exhibited the lowest abrasion resistance and the highest absorption and solubility. DSM Arnitel ID 2045’s absorption and solubility levels were comparable to those of EVA, but had significantly lower abrasion resistance. Ultimately, DSM Arnitel ID 2045 is recommended as the best filament for 3D-printing mouthguards. The properties of this biocompatible material ensure high-impact energy absorption while maintaining low fluid sorption and solubility, supporting its safe intra-oral application for mouthguard fabrication. However, its low abrasion resistance indicated that mouthguards made from this material may need to be replaced more frequently. Full article

Background/Objectives: Participation in sports activities is one of the risk factors for traumatic dental injuries. Nevertheless, little data are available in the literature on such problems in persons with disabilities. This study aims to evaluate the prevalence and severity of traumatic dental injuries in athletes with intellectual disabilities and other coexisting chronic diseases, as well as the use of mouthguards and the level of treatment of injuries in this population. Methods: The research was carried out in seven special needs schools. Two calibrated dentists performed dental examinations in 100 subjects practicing sports, aged 8–30 years (study group), and in 128 individuals, aged 8–25 years, who do not perform systematic physical activity (control group). Statistica Software v.10 was used for statistical analysis, with the level of statistical significance at p ≤ 0.05. Results: The majority of individuals had one tooth affected by traumatic injury in the study and control individuals, with the results amounting to 14% and 5%, respectively; the difference between both groups was statistically significant (p = 0.02). Only one athlete used a mouthguard during training and competitions. Restorative treatment of traumatically damaged teeth was performed in six athletes (37%) out of the total sixteen subjects affected by dental injuries from the study group and in two (15%) out of thirteen participants from the controls. Conclusions: This study reveals that dentists should be professionally prepared to meet the special needs of the population with disabilities and chronic disorders to minimize the burden of dental trauma. There is an urgent need for preventive programs for special needs athletes, their parents/caregivers, and trainers concerning the use of mouthguards. Full article

Background: Individuals with ADHD may perform poorly on tasks targeting executive functioning skills such as the ImPACT, which requires the test-taker to employ judgement in non-routine situations Objective: To determine whether ADHD serves as a mediating variable for increasing the likelihood of an invalid score. Materials and Methods: A total of 39,140 collegiate athletes and United States military cadets consented to the Concussion Assessment, Research, and Education (CARE) Consortium study. Participants completed the CARE Baseline Packet which included various sections through which study participants provide self-report data, including demographic, personal, and family history sections. The personal history portion of the CARE Baseline Packet addressed the participant’s neurological history, including self-reported diagnosis of ADHD and history of traumatic brain injury. Variables utilized for the current study included age, gender, race, ethnicity, the participant’s primary college sport, use of mouthguards for athletes competing in sports requiring them, and the presence of an ADHD diagnosis. Participants responded to a question, inquiring if they had ever been diagnosed by a medical professional with ADHD, ultimately producing a dichotomous yes/no response. Results: We found that participants with ADHD were more likely to produce invalid baseline scores (ß = −0.884; p < 0.001). Similar results were found when controlling for sex, race, age, sport played, mouthguard use, and number of previous concussions (ß = −0.786; p < 0.001). Sex, race, sport played, and mouthguard use each played a significant role in determining profile validity, independent of ADHD diagnosis. With ADHD removed from the model, age negatively affected the likelihood of a valid score (ß = −0.052; p = 0.048). Conclusions: Our study suggests that the relationship between age and ImPACT validity is explained by the presence of ADHD. Results support adjusting ImPACT’s validity thresholds for individuals with ADHD. Full article

Background: Research in dental science reveals a need for enhanced oral healthcare among elite athletes due to the stress generated by excessive exercise. Consideration of the inherent biological distinctions between men and women is crucial in sports dentistry. Objectives: Thus, this study aims to analyse the differences in oral health status among elite athletes based on gender. A total of 186 elite athletes (150 men and 36 women) recognised in the region of Aragon (Spain) participated in this study (mean age 24.99 ± 9.34), all of whom practise individual sports. Methods: Oral health status analysis included: periodontal, malocclusion and tooth status measured using the restoration index (RI) and the decayed, missing and filled teeth (DMFT) index. Results: Women had fewer teeth, a lower restoration index (p < 0.05) and lower DMFT index values (p < 0.001); furthermore, this group showed a greater number of missing teeth (p < 0.001) and decayed teeth (p < 0.05). There were no statistical differences in malocclusion, plaque, gingival bleeding, dental erosion or bruxism values between the genders. Mouthguard usage was low (men = 9.4% vs. women = 14.3%; p = 0.57). Conclusions: This study highlights the need for a multidisciplinary approach to address the high prevalence of oral health issues among elite athletes, despite the differences in health status between men and women. Full article

Background/Objectives: Lately, there has been a greater focus on the function of the dento-mandibular apparatus, specifically on the location of the jaw and occlusion. Given the new potential insights, the current study aimed to comprehensively analyze the published literature on the use of occlusal splints and their effects on exercise performance. Methods: A search was conducted on PubMed, Scopus, and Web of Science for papers published between 2014 and 2024. Starting from the 128 identified records, 28 were finally included for review. Results: The extensive literature review revealed significant diversity in the experimental conditions, suggesting that the occlusal splints may enhance exercise performance and support dental health. Conclusions: The present study highlights the growing interest in occlusal splints research and its impact on sport and exercise science. Mouthguards or occlusal splints should continue to be worn in sports with a considerable risk of orofacial injury. Regardless of how they affect performance, mouthguards or occlusal splints are crucial for athletes in many sports to prevent oral and dental injuries. Full article

This study involved the simulation of five real-world head impact events in rugby, to assess the level of protection provided by a novel foam headguard, the N-Pro. The University College Dublin Brain Trauma Model (UCDBTM) was used to estimate the peak resultant head accelerations and brain tissue responses in different head impact scenarios. The input kinematics were obtained from two sources: video analysis of impact events, and real-time data obtained through instrumented mouthguards. The impact events were simulated under both unprotected and protected conditions. All simulations were performed against a rigid, non-compliant surface model. The results obtained in this study demonstrate the significant potential of the N-Pro in reducing peak head accelerations and brain tissue stress/strain responses by up to c. 70% compared to unprotected head impacts. This study highlights the headguard’s promising potential to reduce the severity of impact-related injuries by effectively attenuating stresses and strains, as well as linear and rotational kinematics. Additionally, the study supports the recommendation in the literature that kinematic data collected from wearable sensors should be supplemented by video analysis to improve accident reconstructions. Full article

Technological advancements have led to widespread use of wearable devices that capture external performance metrics in team sports. Tracking systems including global positioning system (GPS) technology with inbuilt microelectromechanical systems (MEMS), instrumented mouthguards (iMGs), and video analysis provide valuable insights into the contact demands of collision sports. In collision sports, successfully “winning the contact” is positively associated with better individual and team performance, but it also comes with a high risk of injury, posing a concern for player welfare. Understanding the frequency and intensity of these contact events is important in order for coaches and practitioners to adequately prepare players for competition and can simultaneously reduce the burden on athletes. Different methods have been developed for detecting contact events, although limitations of the current methods include validity and reliability issues, varying thresholds, algorithm inconsistencies, and a lack of code- and sex-specific algorithms. In this review, we evaluate common methods for capturing contact events in team collision sports and detail a new method for assessing contact intensity through notational analysis, offering a potential alternative for capturing contact events that are currently challenging to detect through microtechnology alone. Full article

Background/Objectives: This study aimed to assess the knowledge of dental injuries in both soccer coaches and players, as well as the impact of educational intervention on coaches and the prevalence of traumatic dental injuries and mouthguard usage among soccer players. Methods: The study involved 94 male soccer players (median age 18, IQR: 12–19) and 39 coaches. Data were collected through questionnaires covering age, gender, years of experience, injury history, mouthguard use, and knowledge of tooth rescue kits and tooth repositioning. Results: Of the players, 34 (36.2%) experienced orofacial injuries during soccer, while only 7 (7.4%) used mouthguards. Reasons for not using mouthguards included discomfort (26.1%), belief they are unnecessary (26.1%), and difficulty purchasing them (8.0%). Among coaches, 24 (61.5%) reported handling dental injuries during training, including crown fractures (41.7%), tooth avulsions (33.3%), and tooth luxations (25.0%). Only four (10.3%) coaches personally used mouthguards. Conclusions: The study identified a significant lack of knowledge about dental injuries and limited use of mouthguards among Croatian soccer players. Coaches, while influential in athlete development, should also focus on injury prevention, including dental trauma. Full article