Mouthguards for contact sports: current state of use

Thesis (M.A.)--Boston UniversityTraumatic dental injury (TDI) is a public health problem that affects millions of individuals each year. Contact sports and sports-related activities such as boxing, basketball, and bicycling are the number one cause for TDI’s. The most common TDI’s resulting from sporting accidents are soft tissue laceration, tooth fracture, luxation and avulsion. Some individuals are more at risk than others in sustaining a TDI due to various predisposing factors. Individuals are at greater risk of dental trauma if they have protruding teeth, insufficient lip closure, and/or teeth that have received restorative dental treatment. Adolescents and teenagers are known to be most affected by TDI’s because they are the subset of the population most involved in contact sports and other physical activities. Mouthguards were developed to prevent the occurrence and severity of these dental injuries. There are three different types of mouthguards currently in use. They are the stock, mouth-formed, and custom-made mouthguards. Stock and mouth-formed mouthguards are the least recommended by dental professionals, yet in combination are worn the most because of their affordability and ease of use. Custom-made mouthguards are the most accepted mouthguards by the dental community because they are the most adapted to the particular individual, and are associated with the lowest number of TDI’s out of the three types of mouthguards. Users of mouthguards are nearly three times less likely to sustain a TDI while participating in a sport, compared to non-users. Unfortunately, many active individuals do not utilize mouthguards. Non-users of mouthguards associate wearing of mouthguards with undesirable effects, such as breathing difficulties and speech impairment. The side-effects of mouthguards can be so prevalent that they can potentially cause impairment in ones playing ability. In hopes of increasing the number of mouthguard users, researchers and manufactures have continually found new ways to eliminate the negative side-effects of mouthguards, while enhancing their protective function. Researchers have found mouthguards made from ethylene vinyl acetate (EVA) to have the lowest report of wearer opposition. EVA materials are soft and durable, but more importantly, can be tailored to satisfy the needs of the individual. Also, certain materials and designs can be incorporated into the EVA material to better the mouthguards protective function. For instance, past experiments have shown the placement of compliant materials, such as Sorbothane, in between two sheets of EVA material will significantly enhance the mouthguards protective capability. However, the joining of multiple materials may result in thicker and less comfortable mouthguards. More recent mouthguard trials have focused on limiting the thickness of mouthguards, while achieving the same level of protection seen in mouthguards made from multiple materials. Researchers have found the insertion of air cells within the EVA material to be useful technique in minimizing the overall thickness of mouthguards, while preserving the mouthguards protective function. In continuing to meet the high demands of athletes and active individuals, researchers and manufactures must develop newer mouthguards by exploring the effectiveness of other materials, as well as finding alternative methods in which mouthguards can be made

Assessment of the Need for Dental Treatment Resulting From Dental Trauma in 12-Year-Old Brazilian Schoolchildren: A Cross-Sectional Study

Objective: To identify the need for restorative treatment in 12-year-old Brazilian schoolchildren with dental trauma and its association with clinical and socioeconomic factors. Material and Methods: A cross- sectional population-based study was carried out with sample composed of 588 12-year-old students from the city of Diamantina, Minas Gerais, Brazil. Data were collected from August to November 2016 through clinical examination, adopting the Andreasen classification and semi-structured questionnaire to verify the etiology and location of the accident that resulted in dental trauma. Statistical analysis included the frequency distribution and bi and multivariate analysis, with 5% significance level. Results: The presence of 219 traumatized teeth in 176 students was observed (29.9%). The main lesion was enamel fracture (41.4%), followed by enamel and dentin fracture (39.4%). The presence of restorative treatment was observed only in 11.5% of students. Fall (43.5%) was the most frequent etiology, followed by accidents on the streets (35.8%). Need for treatment was present in 53.4% of adolescents. Statistically significant association between males (p=0.010), severe overjet (p<0.0001) and inadequate lip protection (p<0.0001) and  presence of dental trauma was observed. Maternal schooling over 8 years of study was statistically associated with need for restorative treatment (OR = 2.047; CI: 1.099-3.813; p=0.023). Conclusion: Prevalence of dental trauma, need for restorative treatment and number of adolescents with no access to restorative treatment in this study were high, point out that the health system is unable to satisfactorily prevent dental trauma and absorb all dental treatment demand resulting from dental trauma

PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery

Integrating social and health services for people, communities, homes, and places

The challenge of an ageing population requires a paradigmatic shift in the way we provide social and healthcare services, demanding the need to prioritize the functionality and independence of older adults. The risk and subsequent fear of falling is one of the most high-risk states for older adults, as it generates a destabilizing effect on their health that is often hard to recover. It is essential to thoroughly address their risk factors and mitigators. This discussion needs to be made in light of a person-centered perspective that goes beyond fragilities to capitalize on the strengths of the older adults. The chapter provides examples of how to connect assessment, interventions, and monitoring to a coherent framework approach that mitigates the risks and the impact of falls on an ageing society. The authors explore how technological innovation, urban planning, and regional policies that are culturally relevant can be incorporated in creating a circular economy while meeting the needs of an aging population and preventing falls and cognitive decline

CT Scanning

Since its introduction in 1972, X-ray computed tomography (CT) has evolved into an essential diagnostic imaging tool for a continually increasing variety of clinical applications. The goal of this book was not simply to summarize currently available CT imaging techniques but also to provide clinical perspectives, advances in hybrid technologies, new applications other than medicine and an outlook on future developments. Major experts in this growing field contributed to this book, which is geared to radiologists, orthopedic surgeons, engineers, and clinical and basic researchers. We believe that CT scanning is an effective and essential tools in treatment planning, basic understanding of physiology, and and tackling the ever-increasing challenge of diagnosis in our society

Multi-Mode adhesives performance and success/retention rates in NCCLs restorations: randomised clinical trial one-year report

Aim: Compare clinical performance and success/retention rates of two multi-mode (MM) adhesives, applied in self-etch (SE) or etch-and-rinse (ER) modes, with SE-all-in-one adhesive (SE/SE with enamel etching) in NCCL restorations at one-year follow-up. Material and methods: Prospective, double-blind RCT approved by the University Fernando Pessoa and the National-Clinical-Research-Ethics Committees (CEIC-20150305), ClinicalTrials.gov registered (NCT02698371), in 38 participants with 210 restorations (AdmiraFusionVR ) randomly allocated to six groups (Adhesives_Adhesion mode), each with 35 restorations: G1-Control FuturabondVRDC_SE; G2-Control FuturabondVRDC_SE with enamel etching; G3-FuturabondVRU_ER; G4-FuturabondVR U_SE; G5-AdheseVR Universal_ER; G6-AdheseVR Universal_SE. Restorations evaluated at baseline and one-year by three calibrated examiners (ICC 0.952) using FDI criteria and statistical analysis with nonparametric tests (alpha=0.05). Results: At one-year recall 36 participants, 199 restorations were available for examination; five (2.5%) restorations (G1 n=2; G2, G3, G4 n=1) were lost due to retention (p>.05); G1 showed less satisfying marginal adaptation (p<.05) than G2 and MM adhesives groups, particularly G6. Overall success rates (p>.05) were: 93.9% (G1), 97.0% (G2; G3; G4) and 100.0% (G5; G6). Conclusions: MM adhesives (FuturabondVRU and AdheseVR Universal) showed similar and acceptable performance/success rates but also better clinical outputs than the SE-all-in-one adhesive (FuturabondVR DC), particularly in SE mode. Success and retention rates were similar and not dependent on materials or adhesion modes.Fundacão Fernando Pessoa, Porto, Portugalinfo:eu-repo/semantics/publishedVersio

The Alteration on Malondialdehyde Content on Wistar Rats’ Blood and Lungs Tissue to Ward the Exposure of Electric Cigarette Smoke

The effect of electric cigarette smoke exposure had increased due to the number of electric cigarette smoker that raised every year. The smoke which enters the respiratory tract enhance the free radical inside the body, either in blood or lung tissue. The exceeding amount of free radical could trigger the oxidative stress which causes cell damage. The increase of cell damage within lung tissue is accompanied by the enhancement of malondialdehyde content. Therefore, this study aimed to know the malondialdehyde content alteration on blood and lung tissue against the exposure of electric cigarette smoke. This study used experimental methodology with posttest control group design using male Wistar rats as the sample. Wester rats were divided into groups and examined the cell damage through malondialdehyde content within the blood and the malondialdehyde expression within the lung tissue. The exposure of electric cigarette smoke was given to each group with different amount and duration. The lung tissue damage was measured using malondialdehyde content parameter within the blood and immunohistochemistry (IHC) on lung tissue. The finding showed that there was differentiation on malondialdehyde content within the blood and malondialdehyde expression on lung tissue (p< 0.05). Whereas the relation between two groups showed a strong and significant relationship for (r=0.945) and (p=0.000). The duration of electric cigarette smoke exposure could affect the enhancement of malondialdehyde content within the blood and lung tissue