Effectiveness of the new mandatory mouthguard use and orodental injuries in Dutch field hockey

Objectives:Up to 68% of field hockey players have experienced at least one orodental injury in their sport career. Therefore, the Royal Dutch Hockey Association (KNHB) made mouthguard use mandatory for field hockey players during competition and training from August 2015 onwards. This study evaluates the effects of the new regulations on mouthguard use and the occurrence of injuries in Dutch field hockey. Methods:A 35-item online questionnaire about mouthguard use and orodental injuries was sent to 13 field hockey clubs in the Netherlands. Absolute numbers and percentages of mouthguard ownership, mouthguard use, number and type of injuries were assessed. The results were related to comparable data before mandatory mouthguard use. Associations of gender and training frequency with the number of injuries were analysed with logistic regression. Results:In total, 1169 hockey players were included in the study and almost all owned a mouthguard (females:99.6%, males:93.7%), which significantly increased after implementation (p &lt; 0.001). 90.6% of the respondents wore a mouthguard during matches and 70.1% during training. Of the 1169 players, 68(5.8%) experienced at least one orodental injury after the implementation with a total of 100 injuries. Injuries happened more often during matches (63.2%) than during training (36.8%). Lip cuts account for most of the injuries, the number of broken (p = 0.116) and knocked out teeth (p = 0.026) decreased. Conclusion:Although mouthguard use already increased in recent years, the new regulations led to an additional increase and a successful change of attitude towards mouthguard use. Most importantly, the severity of orodental injuries decreased measurable.</p

Effectiveness of the new mandatory mouthguard use and orodental injuries in Dutch field hockey

Objectives:Up to 68% of field hockey players have experienced at least one orodental injury in their sport career. Therefore, the Royal Dutch Hockey Association (KNHB) made mouthguard use mandatory for field hockey players during competition and training from August 2015 onwards. This study evaluates the effects of the new regulations on mouthguard use and the occurrence of injuries in Dutch field hockey. Methods:A 35-item online questionnaire about mouthguard use and orodental injuries was sent to 13 field hockey clubs in the Netherlands. Absolute numbers and percentages of mouthguard ownership, mouthguard use, number and type of injuries were assessed. The results were related to comparable data before mandatory mouthguard use. Associations of gender and training frequency with the number of injuries were analysed with logistic regression. Results:In total, 1169 hockey players were included in the study and almost all owned a mouthguard (females:99.6%, males:93.7%), which significantly increased after implementation (p &lt; 0.001). 90.6% of the respondents wore a mouthguard during matches and 70.1% during training. Of the 1169 players, 68(5.8%) experienced at least one orodental injury after the implementation with a total of 100 injuries. Injuries happened more often during matches (63.2%) than during training (36.8%). Lip cuts account for most of the injuries, the number of broken (p = 0.116) and knocked out teeth (p = 0.026) decreased. Conclusion:Although mouthguard use already increased in recent years, the new regulations led to an additional increase and a successful change of attitude towards mouthguard use. Most importantly, the severity of orodental injuries decreased measurable.</p

The association of maternal folic acid supplementation and prenatal folate and vitamin B12 concentrations with child dental development

OBJECTIVE: Low folic acid, folate and vitamin B12 might affect tooth formation and mineralization. The conversion of folic acid into folate is catalysed by the methylenetetrahydrofolate (MTHFR) enzyme which is encoded by the MTHFR gene. Among 3728 mothers and their 10‐year‐old children from the Generation R Study, we investigated associations of maternal folic acid supplementation and prenatal folate and vitamin B12 concentrations with child dental development. Secondly, we checked the modifying effect of MTHFR‐C677T polymorphism. METHODS: Information on folic acid supplementation was obtained by questionnaires. Concentrations of folate and vitamin B12 were measured from venous samples taken in early pregnancy. Developmental stages of teeth were defined by the Demirjian method at the age‐10 assessment. In addition, dental age of the children was calculated using the Dutch standard. GLM and multivariate linear regression models were built to study the associations. RESULTS: Folic acid supplementation started when pregnancy was known (β = −0.09; 95% CI: −0.17, −0.01) and folic acid supplementation started prior to known pregnancy (β = −0.12; 95% CI: −0.20, −0.04) were both associated with decelerated dental development by 1‐2 months lower dental age of 10‐year‐old children. Folate (β = −0.02, 95% CI: −0.05, 0.02) and vitamin B12 (β = 0.03, 95% CI: −0.00, 0.06) were not associated with dental age. MTHFR‐C677T did not modify the associations. CONCLUSIONS: Maternal folic acid supplementation delays dental development of children by 1‐2 months dental age, whereas maternal folate and vitamin B12 concentrations in early pregnancy do not affect the timing of child dental development

Adherence to dietary guidelines and dental caries among children:a longitudinal cohort study

BACKGROUND: Even though dietary sugars are the most important nutrient for caries development, the disease process is dependent on other dietary practices. The intake of individual nutrient components cannot be evaluated separately from the overall diet which includes other nutrients, foods and habits. Therefore, the aim of this study was to investigate the association between adherence to dietary guidelines and dental caries. METHODS: This study was embedded in the Generation R Study, conducted in Rotterdam, the Netherlands. In total, 2911 children were included in the present analyses. Dietary intake at the age of 8 years was assessed using food-frequency questionnaires. Diet quality scores were estimated, reflecting adherence to Dutch dietary guidelines. Dental caries was assessed at the age of 13 years using intra-oral photographs. Associations were estimated using multinomial logistic regression analyses, adjusted for sociodemographic characteristics and oral hygiene practices. RESULTS: The prevalence of dental caries at the age of 13 years was 33% (n = 969). Better diet quality was associated with a lower occurrence of severe dental caries after adjustments for sociodemographic factors [e.g. highest vs. lowest quartile of diet quality: odds ratio (OR) 0.62, 95% confidence interval (CI) 0.39-0.98]. After additional adjustments for oral hygiene practices, this association was not statistically significant (OR 0.65, 95% CI 0.41-1.03). CONCLUSION:Adherence to dietary guidelines has the potential to reduce dental caries in children; however, with proper oral hygiene practices, this relationship might be attenuated. To understand the role of dietary patterns and dental caries, the contributing role of daily eating occasions needs to be studied further.</p

Developmental characteristics of the permanent upper lateral incisor in unilateral cleft lip and palate

Objectives: This study aims to provide insights into the developmental characteristics of the upper lateral incisor in individuals with unilateral clefts. Materials and methods: Panoramic radiographs of a consistent group of Caucasian children taken over time (ages 6, 9, and 12) were extensively reviewed. The study assessed the distribution pattern, eruption path, tooth development, and crown size of the upper lateral incisor within the cleft region. Results: The most commonly observed distribution pattern was the lateral incisor located distal to the cleft, accounting for 49.2% of cases. Furthermore, a significant delay in tooth development of the upper lateral incisor on the cleft side was noted at ages 6 and 9 (p &gt; 0.001). Compared with the non-cleft side, these incisors often erupted along the alveolar cleft and exhibited microdontia (88.3%, p &lt; 0.041). Conclusion: Lateral incisors on the cleft side display unique distribution patterns, microdontia, and delayed tooth development. Careful monitoring of the cuspid eruption is essential, as it can influence the eruption of the lateral incisor. Clinical relevance: A comprehensive understanding of the development of the upper lateral incisor relative to the cleft is vital for determining its prognosis over time. The position of the upper lateral incisor can also influence the timing and prognosis of secondary alveolar bone grafting. Preserving the upper lateral incisor favors arch length, perimeter, and symmetry in individuals with unilateral clefts.</p

AI-based association analysis for medical imaging using latent-space geometric confounder correction

AI has greatly enhanced medical image analysis, yet its use in epidemiological population imaging studies remains limited due to visualization challenges in non-linear models and lack of confounder control. Addressing this, we introduce an AI method emphasizing semantic feature interpretation and resilience against multiple confounders. Our approach's merits are tested in three scenarios: extracting confounder-free features from a 2D synthetic dataset; examining the association between prenatal alcohol exposure and children's facial shapes using 3D mesh data; exploring the relationship between global cognition and brain images with a 3D MRI dataset. Results confirm our method effectively reduces confounder influences, establishing less confounded associations. Additionally, it provides a unique visual representation, highlighting specific image alterations due to identified correlations.Comment: 18 pages; 7 figure

Early implant placement with or without alveolar ridge preservation in single tooth gaps renders similar esthetic, clinical and patient-reported outcome measures: One-year results of a randomized clinical trial

OBJECTIVES To test whether early implant placement with alveolar ridge preservation (ARP) results in different esthetic, clinical and patient-reported outcome measures (PROMs) compared with early implant placement without ARP. MATERIAL AND METHODS Seventy-five patients requiring single tooth extraction in the anterior maxilla were recruited. Following tooth extraction, the patients were randomly allocated to three groups: (a) ARP using demineralized bovine bone mineral containing 10% collagen (DBBM-C) covered by a collagen matrix (CM) (n = 25), (b) ARP using DBBM-C covered with a palatal graft (PG) (n = 25) and (c) spontaneous healing (control) (n = 25). Eight weeks after tooth extraction, a CBCT was taken and early implant placement was performed in all patients. Esthetic, clinical and PROMs were evaluated one year post-loading. RESULTS A total of 70 patients were available for re-examination at one year post-loading. The median mid-facial mucosal margin change amounted to -0.02 mm (IQR -0.27-0.46) in the CM group, -0.13 mm (IQR -0.44-0.25) in the PG group and -0.14 mm (IQR -0.29-0.07) in the control group, with no significant differences between the groups. Mean PES scores amounted to 7.0 ± 1.4 in the CM group, 7.1 ± 1.5 in the PG group and 7.3 ± 1.7 in the control group without significant differences between the groups. Plaque, bleeding on probing and probing depth did not differ between treatment groups. PROMs in general revealed no significant differences between the groups. CONCLUSION Early implant placement with ARP using either a collagen matrix or a palatal graft rendered similar esthetic, clinical and PROMs to early implant placement without ARP. When a failing tooth can be replaced with an implant within 2 months after tooth extraction, the added value of ARP might be clinically negligible

Effectiveness of the new mandatory mouthguard use and orodental injuries in Dutch field hockey

Objectives Up to 68% of field hockey players have experienced at least one orodental injury in their sport career. Therefore, the Royal Dutch Hockey Association (KNHB) made mouthguard use mandatory for field hockey players during competition and training from August 2015 onwards. This study evaluates the effects of the new regulations on mouthguard use and the occurrence of injuries in Dutch field hockey. Methods A 35-item online questionnaire about mouthguard use and orodental injuries was sent to 13 field hockey clubs in the Netherlands. Absolute numbers and percentages of mouthguard ownership, mouthguard use, number and type of injuries were assessed. The results were related to comparable data before mandatory mouthguard use. Associations of gender and training frequency with the number of injuries were analysed with logistic regression. Results In total, 1169 hockey players were included in the study and almost all owned a mouthguard (females:99.6%, males:93.7%), which significantly increased after implementation (p < 0.001). 90.6% of the respondents wore a mouthguard during matches and 70.1% during training. Of the 1169 players, 68(5.8%) experienced at least one orodental injury after the implementation with a total of 100 injuries. Injuries happened more often during matches (63.2%) than during training (36.8%). Lip cuts account for most of the injuries, the number of broken (p = 0.116) and knocked out teeth (p = 0.026) decreased. Conclusion Although mouthguard use already increased in recent years, the new regulations led to an additional increase and a successful change of attitude towards mouthguard use. Most importantly, the severity of orodental injuries decreased measurable

Evaluating an International Facial Trauma Course for Surgeons: Did We Make a Difference?

Study Design:Retrospective data analysis study.Objective:Attending continuing professional development (CPD) and continuing medical education (CME) activities is a necessity for practicing surgeons in most parts of the world. To enhance best practices in conducting CME/CPD, objective evaluation of these events is crucial. This article aims to evaluate one such international standardized CPD course conducted for facial surgeons across the globe. The Management of Facial Trauma course was developed by an international planning committee of experienced surgeons and has been implemented in all regions of the world.Method:This 2-day course is delivered using a combination of short lectures, small group discussions, and practical hands-on activities. Data collected from pre- and post-course evaluations of 86 Management of Facial Trauma courses conducted worldwide from 2017-2019 were collated and analyzed.Results:Participant demographics and experience levels varied slightly across the regions. Evaluation of the course effectiveness revealed overall high ratings for educational impact, content usefulness, and faculty performance.Conclusion:Our results indicated that this standardized course met the audience needs and enabled participants to plan changes in clinical practice. In addition, it confirmed that the course was relevant across different specialties and across different cultures and countries.</div