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The rectus femoris (RF) has a region-specific functional role; that is, the proximal region of the RF contributes more than the middle and distal regions during hip flexion. This study aimed to investigate whether RF strain injury affected the region-specific functional role of the muscle. We studied seven soccer players with a history of unilateral RF strain injury. Injury data were obtained from a questionnaire survey and magnetic resonance imaging (MRI). Multichannel surface electromyographic (SEMG) signals were recorded from the proximal to distal regions of the RF with 24 electrodes during isometric knee extension and hip flexion. The SEMG signals of each channel during hip flexion were normalised by those during knee extension for the injured and non-injured RF (HF/KE), and compared among the proximal, middle, and distal regions. Six RF strain injuries showed a low signal area in MRI. There was no significant difference in muscle strength between the injured and non-injured RF. While the HF/KE in the proximal region was significantly higher than those in the middle and distal regions in the non-injured RF, a difference in the HF/KE was seen only between the proximal and distal regions of the injured RF. Furthermore, the HF/KE of the most proximal channel in the injured RF was significantly lower than that in the non-injured RF. However, there was no significant difference between injured and non-injured areas in the HF/KE. Our findings suggest that the region-specific functional role of the RF muscle is partly affected by RF strain injury.

Background: The authors previously identified that COL11A1 gene polymorphism is not a susceptibility factor for lumbar disc degeneration (LDD) in athletes. However, the relationship between COL11A1 gene polymorphism and cervical disc degeneration (CDD) remains unclear. We hypothesized that significant associations between COL11A1 4603C/T gene polymorphism and CDD, but not LDD, in collegiate wrestlers exist. This study aims to examine the relationship between CDD, LDD, and COL11A1 4603C/T gene polymorphism in collegiate wrestlers., Methods: The subjects enrolled in this study were 92 (Study-1) and 123 (Study-2) Japanese collegiate male wrestlers. Study-1 and Study-2 were conducted in 2010-2012 and 2012-2015, respectively., Results: CDD and LDD prevalence among the wrestlers was 51.1% (47/92) and 43.9% (54/123), respectively. We found that COL11A1 4603C/T was significantly associated with CDD, but not with LDD. Using logistic regression analysis with concomitant confounding factors, we further confirmed that COL11A1 4603C/T was a significant risk factor for CDD (co-dominant genetic model [CC vs. CT+TT]: adjusted odds ratio [OR] 2.28; 95% CI: 1.13-4.59; dominant genetic model [CC+CT vs. TT]: adjusted OR 11.71; 95% CI: 1.36-101.06)., Conclusions: Results suggest that COL11A1 4603C/T gene polymorphism is associated with an increased risk of CDD, but not LDD, in Japanese collegiate wrestlers.

Objective: To review and evaluate drug-induced vasculitis, which is an extremely rare complication of chemotherapy., Case Report: A 47-year-old woman with ovarian cancer developed aortitis during bevacizumab combination chemotherapy. Contract-enhanced CT showed concentric thickening of the descending aorta. Antibiotics were administered, but a repeat CE-CT scan showed no resolution of the aortitis. To treat the aortitis, she was started on oral prednisolone. A subsequent CE-CT scan showed no signs of aortitis. She was thus re-started on a modified chemotherapy regimen., Conclusion: Aortitis should be considered in patients receiving bevacizumab combination therapy who develop persistent fever and upper-abdominal pain. Contrast-enhanced CT is useful for detecting drug-induced aortitis., (Copyright © 2018. Published by Elsevier B.V.)

Background: Stinger syndrome frequently occurs in athletes who compete in collision sports. Sharp pain and impairment of neck motion are major symptoms. Cervical intervertebral disc degeneration (CIDD) is also frequently observed in those who compete in collision sports., Purpose/hypothesis: To investigate whether CIDD and neck functionality are related to a history of stinger syndrome. The hypothesis was that a significant relationship exists between CIDD and neck motion and a history of stinger syndrome in Japanese collegiate football players., Study Design: Cross-sectional study; Level of evidence, 3., Methods: A total of 49 male Japanese collegiate football players (mean age, 20.0 ± 1.1 years; mean athletic experience, 3.8 ± 2.3 years; mean height, 172.3 ± 4.8 cm; mean weight, 83.1 ± 12.2 kg) were subdivided into athletes with stinger syndrome (stinger group) and those without (control group). Stinger syndrome was confirmed based on a questionnaire and interview. CIDD was assessed by using T2-weighted magnetic resonance imaging. Range of motion (ROM) and isometric muscle strength were measured for neck function testing., Results: Thirty-nine percent (19/49) of athletes had at least 1 episode of stinger syndrome. The prevalence of CIDD was significantly higher in the stinger group (68%) than in the control group (30%) ( P < .01). A statistically significant difference in cervical extension ROM was found between the stinger group (50.9° ± 11.1°) and the control group (60.2° ± 11.4°) ( P < .01). Logistic regression analysis showed that CIDD and low cervical extension were independently associated with a history of stinger syndrome., Conclusion: Study results suggest that stinger syndrome is associated with CIDD and low cervical extension in collegiate football players., Competing Interests: The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.

The aim of this study was to assess sciatic nerve conductivity in athletes with a history of hamstring strain injuries. Twenty-seven athletes with a history of hamstring strain injuries were included in the injured group. The control group consisted of 16 uninjured participants. We measured the proximal and distal latencies and calculated the sciatic nerve conduction velocity to evaluate neuronal conductivity. The results were expressed as median values and interquartile ranges. Both proximal latency and distal latency of the injured limb in the injured group were significantly longer than those of the uninjured limb (p<0.05). The nerve conduction velocity of the injured limb in the injured group was significantly lower than that of the uninjured limb (p<0.05). There were no significant side-to-side differences in the control group. Sciatic nerve conductivity impairments may exist in athletes with a history of hamstring strain injuries., Competing Interests: Conflict of interest: The author have no conflict of interest to declare., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Lumbar intervertebral disc degeneration (LDD) frequently occurs in athletes. Associations between LDD and trunk muscles still remain unclear., Purpose: This study examined whether there is an association between the prevalence of LDD and the symmetry and size of the cross-sectional areas (CSAs) of the trunk muscles in combat sports athletes., Methods: Participants in this study were 151 collegiate male combat sports athletes. A total of 755 lumbar intervertebral discs from L1-2 to L5-S1 in 151 athletes were assessed using magnetic resonance imaging (MRI) and a comprehensive grading system of LDD (grades I-V). All 151 athletes were divided into 2 groups: LDD and non-LDD. CSAs of trunk muscles at the L3-4 disc level were measured using MRI., Results: Sixty-nine athletes had LDD at 1 or more disc levels (45.7 %). The LDD grade for the lower 2 disc levels was significantly higher than that for the other disc levels (p < 0.001). The CSAs of the left and right sides in trunk muscles were significantly asymmetrical, independent of the LDD which was prevalent in the disc levels (obliques: p = 0.040; quadratus lumborum: p < 0.001). The relative CSAs of trunk muscles to their body weight in the LDD group were significantly smaller than those in the non-LDD group (rectus abdominis: p = 0.011; obliques: p = 0.024; quadratus lumborum: p = 0.006; lumbar erector spinae plus multifidus: p = 0.001)., Conclusion: This study suggests that the prevalence of LDD is associated with asymmetrical and relatively smaller CSAs of trunk muscles in combat sports athletes.

The extracellular matrix protein nephronectin (Npnt), also called POEM, is considered to play critical roles as an adhesion molecule in development and functions of various tissues, such as the kidneys, liver, and bone. In the present study, we examined the molecular mechanism of Npnt gene expression and found that vitamin D3 (1α,25-dihydroxyvitamin D3,VD 3) strongly enhanced Npnt mRNA expression in MC3T3-E1 cells from a mouse osteoblastic cell line. The VD 3-induced increase in Npnt expression is both time- and dose-dependent and is mediated by the vitamin D receptor (VDR).

Nephronectin (Npnt), also called POEM, is an extracellular matrix protein considered to play critical roles as an adhesion molecule in the development and functions of various tissues, such as the kidneys, liver, and bones. In the present study, we examined the molecular mechanism of Npnt gene expression and found that oncostatin M (OSM) strongly inhibited Npnt mRNA expression in MC3T3-E1 cells from a mouse osteoblastic cell line. OSM also induced a decrease in Npnt expression in both time- and dose-dependent manners via both the JAK/STAT and MAPK pathways. In addition, OSM-induced inhibition of osteoblast differentiation was recovered by over-expression of Npnt. These results suggest that OSM inhibits Npnt expression via the JAK/STAT and MAPK pathways, while down-regulation of Npnt by OSM influences inhibition of osteoblast differentiation.

Introduction: We examined the effects of gastrocnemius eccentric contractions (ECs) on the sciatic nerve in rats., Methods: Rats were divided randomly into the following 3 groups: control, 180EC (ECs with 180°/s angular velocity), and 30EC (ECs with 30°/s angular velocity). Twenty ECs were induced by electrical stimulation of the gastrocnemius. On days 3, 7, and 10 after the ECs, nerve conduction velocity (NCV) was measured, and sciatic nerve branches were harvested for analysis., Results: A significant decrease in NCV was observed between the control and day-7 180EC. Significant reduction in the levels of myelin sheath protein zero (p0) between day 7 and day 3 180EC and a significant increase of macrophage-related protein and tyrosine kinase receptor C were observed between day 7 180EC and day 7 30EC., Conclusions: ECs with fast angular velocities induce functional and structural damage in innervating nerve., (Copyright © 2013 Wiley Periodicals, Inc.)

Objective: Lumbar disc degeneration (LDDG), recently reported to have strong genetic determinants, is a major cause of discopathy and lower back pain. However, most studies have only evaluated the effects of a single susceptibility polymorphism. Our purpose was to examine the effect of two susceptibility polymorphism for LDDG in Japanese collegiate athletes., Design: We investigated two susceptibility genes for LDDG-cartilage intermediate layer protein (CILP) and asporin (ASPN)-in 516 collegiate athletes and genotyped the risk allele of CILP (1184T/C) and ASPN (D14). LDDG was evaluated using T2-weighted magnetic resonance imaging., Results: By using logistic regression analysis, we found that the ASPN D14 allele and CILP genotype were associated with an increased risk of LDDG in male but not female athletes (CILP CT: odds ratios [OR] = 1.77, 95% confidence interval [CI] = 1.07-2.93; CILP CC: OR = 4.38, 95% CI = 1.42-13.54; ASPN D14: OR = 2.17, 95% CI = 1.10-4.28]. We also found that CILP C and ASPN D14 were independent variables. The ORs with more than two risk alleles were largely increased., Conclusions: The CILP and ASPN polymorphisms are independent genetic risk factors for LDDG in male but not female Japanese collegiate athletes.

Background: Magnetic resonance imaging (MRI) studies have shown that gymnasts have a high prevalence of radiological abnormalities, such as intervertebral disk degeneration (IDD) and anterior limbus vertebra (ALV). These 2 abnormalities may coexist at the same spinal level. However, the relationship between IDD and ALV remains unclear., Hypothesis: A significant relationship exists between IDD and ALV in Japanese collegiate gymnasts., Study Design: Case-control study., Methods: A total of 104 Japanese collegiate gymnasts (70 men and 34 women; age, 19.7 ± 1.0 years) with 11.8 ± 3.6 years of sporting experience participated. T1- and T2-weighted MRIs were used to evaluate ALV and IDD., Results: The prevalence among the gymnasts of IDD and ALV was 40.4% (42/104) and 20.2% (21/104), respectively. The prevalence of IDD was significantly higher in gymnasts with ALV than those without ALV, as determined using the chi-square test. Logistic regression analysis demonstrated a significant association between IDD and ALV (adjusted odds ratio [OR], 6.60; 95% confidence interval [CI], 2.14-20.35). IDD was further grouped by whether it was present in the upper lumbar region (L1-2, L2-3, and L3-4 disks) or in the lower lumbar region (L4-5 and L5-S1 disks). Upper IDD had a greater association with ALV (adjusted OR, 33.17; 95% CI, 7.09-155.25) than did lower IDD (adjusted OR, 6.71; 95% CI, 1.57-28.73)., Conclusion: In Japanese collegiate gymnasts, ALV is a predictor of IDD, especially in the upper lumbar region., Clinical Relevance: Information regarding ALV is important to prevent IDD in Japanese collegiate gymnasts.

Background: The authors previously identified a significant association between lumbar disc degeneration (LDDG) and cartilage intermediate layer protein (CILP) single nucleotide polymorphism (SNP) in collegiate male judokas., Hypothesis: A significant association between LDDG and the CILP SNP is observed in Japanese collegiate athletes., Study Design: Cross-sectional study; Level of evidence, 3., Methods: The participants were 601 trained collegiate athletes (male, 403; female, 198) from 7 different sports. Lumbar disc degeneration was evaluated using T2-weighted magnetic resonance imaging. Genotyping of the CILP gene (1184T/C) was performed by using DNA sequencing., Results: Among the 601 collegiate athletes, the odds ratio (OR) for the occurrence of LDDG with the CILP C allele was 1.4 (95% confidence interval [CI], 1.05-1.86). By using logistic regression analysis concomitant with the interaction term and the Wald test, the authors found that weight (OR, 1.04; 95% CI, 1.02-1.06), CILP genotype (CT: OR, 2.0; 95% CI, 1.24-3.15; CC: OR, 2.9; 95% CI, 1.09-7.74), and gender (OR, 2.1; 95% CI, 1.21-3.67) were significant risk factors for LDDG. These analyses also indicated that there was no effect of the CILP genotype on LDDG in female athletes., Conclusion: The CILP SNP 1184T/C is a risk factor for male collegiate athletes. Information regarding the CILP gene polymorphism may be important for preventing and managing lumbar disc diseases, especially in male athletes.

This study aimed to investigate torque deficit and activation of protein synthesis and/or protein degradation signaling pathways during the early and recovery phase after high- and low-velocity eccentric contractions (ECs). Male Wistar rats (n = 36) were randomly divided into fast angular velocity ECs group (FAST; 180 degrees/s; n = 12), slow ECs group (SLOW; 30 degrees/s; n = 12), and control group (control; n = 12). ECs comprised four sets of five forced dorsiflexions combined with electrical stimulation of the plantar flexors. Isometric tetanic torque was measured before and after ECs. Tissue contents of Akt(P) (P, phosphorylated), mammalian target of rapamycin (mTOR)(P), 70-kDa ribosomal protein S6 kinase (P70S6k), P70S6k(P), forkhead transcription factor 1 of the O class (FOXO1), FOXO1(P), FOXO3, FOXO3(P), myostatin, and activin receptor type IIB (ActRIIB) were measured. The isometric tetanic torque after ECs was significantly lower in FAST than in SLOW (days 1, 3, and 5, P < 0.05; day 2, P < 0.01). The ratio of P70S6k(P) against total P70S6k on days 2 and 7 was significantly higher in SLOW than in the control. The ratio of FOXO1 against total FOXO1, the ratio of FOXO3a against total FOXO3a, and myostatin on days 2 and 7 were significantly higher in FAST than in the control, while that of ActRIIB on day 7 was significantly lower in SLOW than in the other two groups. These results suggest that EC intensity plays a key role in impairment of muscular function and activation of protein synthesis and/or protein degradation signaling pathways.

We aimed to examine the association between the angiotensin I-converting enzyme (ACE) gene (insertion (I) and deletion (D)) polymorphism in Japanese university track athletes and race distance, as well as to evaluate the gender effects on this association. The ACE I/D allele frequency was determined in 277 athletes (176 men, 101 women; aged 19.7 +/- 1.2 years), who were then grouped on the basis of their major competitive race distances (short distance (SD), < or = 200 m; middle distance (MD), 400-800 m, and long distance (LD), > or =1500 m). The ACE I allele frequency increased with the distance (44.4%, 48.4%, and 66.2% for the SD (n = 107), MD (n = 62), and LD (n = 108) groups, respectively; p < 0.001, chi(2) test). On multinomial logistic regression analysis, significant associations between ACE genotype and race distance were observed only in male athletes (ID vs. SD, p = 0.004; ID vs. LD, p = 0.030; II vs. LD, p = 0.001). There was no significant association between ACE genotype and race distance in female athletes. We conclude that the ACE I allele is overrepresented in endurance athletes, and that its frequency varies depending on gender.

Background: Treatment of Achilles tendon rupture has long been at the center of debate., Hypothesis: A new technique in surgical Achilles tendon repair allows for more stability and earlier rehabilitation., Study Design: Case series; Level of evidence, 4., Methods: One hundred Achilles tendon rupture patients (70 men, 30 women; age range, 16-54 years; mean age, 32 years) were treated by a newly modified method of repair. Twenty-one of these patients were high-level athletes, and 79 were recreational-level athletes. The average length of follow-up was 2.4 years (range, 1-6.3 years), and none of the ruptures included avulsion fractures. After adjusting the tendon to an adequate length using a Tsuge suture, each fibrous bundle was gathered in a longitudinal direction and fixed with a Bunnell-type suture. The same postoperative physical therapy protocol was applied to all patients: at 1 week, early full weightbearing with a walking cast was initiated, and at 2 weeks, patients began range of motion (ROM) exercises and were instructed to wear a hinged ankle-foot orthosis that permitted full plantar flexion but limited full dorsiflexion. From 6 weeks, patients started practicing double-legged heel raises., Results: At an average of 10 weeks, ankle ROM was comparable to that of the nonoperated leg, and double-legged heel raises were achieved at an average of 7.6 weeks. On average, patients were able to do 20 continuous single-legged heel-raising motions (equivalent to manual muscle testing grade 5) at 15.4 weeks, and jogging started at 12.3 weeks. High-level athletes returned to their original sports level at an average of 5 months. Two reruptures (2%) were experienced, but no other complications occurred., Conclusion: This surgical technique allows for strong repair stability and subsequent early weightbearing and ROM exercises.

Electromyographic (EMG) activities of the superior (SUP) and inferior heads (INF) of the lateral pterygoid muscle (LPT) were recorded in humans during voluntary stepwise changes in biting force and jaw position that were adopted to exclude the effects of acceleration and velocity of jaw movements on the muscle activity. The SUP behaved like a jaw-closing muscle and showed characteristic activity in relation to the biting force. It showed a considerable amount of background activity (5-32% of the maximum) even in the intercuspal position without teeth clenching and reached a nearly maximum activity at relatively lower biting-force levels than the jaw-closing muscles during increment of the biting force. Stretch reflexes were found in the SUP, the function of which could be to stabilize the condyle against the biting force that pulls the condyle posteriorly. This notion was verified by examining the biomechanics on the temporomandibular joint. The complex movements of the mandibular condyle in a sagittal plane were decomposed into displacement in the anteroposterior direction (Ac) and angle of rotation (RAc) around a kinesiological specific point on the condyle. In relation to Ac, each head of the LPT showed quite a similar behavior to each other in all types of jaw movements across all subjects. Working ranges of the muscle activities were almost constant (Ac <3 mm for the SUP and Ac >3 mm for the INF). The amount of EMG activity of the SUP changed in inverse proportion to Ac showing a hyperbola-like relation, whereas that of the INF changed rather linearly. The EMG amplitude of the SUP showed a quasilinear inverse relation with RAc in the hinge movement during which the condyle rotated with no movement in the anteroposterior direction. This finding suggests that the SUP controls the angular relationship between the articular disk and the condyle. On the other hand, the position of the disk in relation to the maxilla, not to the condyle, is controlled indirectly by the INF because the disk is attached to the condyle by tendinous ligaments.

We superimposed hydropathic indexes of the human fibronectin cell binding domain (CBD) on the lambda phage J protein by computer, and substituted 22 amino acids from the fibronectin CBD for a part of the lambda phage J protein. The fibronectin cell binding domain -Arg-Gly-Asp-Ser- (-RGDS-) localizes at the junction of hydrophobicity and hydrophilicity. We selected a similar hydrophobic-to-hydrophilic junction in the J protein region for substitution. This junction corresponds to 150 bp of the PstI fragment of J protein cDNA. We synthesized 150 bp of the relevant PstI fragment that includes the cell binding domain region. The region was then constructed by serial cloning as an expression vector, pJCBD. The vector pJCBD expressed the fused protein named JCBD (M(r) 32 kDa) in E coli XL1-BLUE. The expressed JCBD protein was identified by Western blot analysis in the extract of the pJCBD carrying bacterial lysate using both rabbit anti-lambda phage antiserum and anti-CBD of fibronectin antibody. The JCBD protein appeared to recognize retinoblast cell membrane RGDS-directed receptors, detected by enzyme-linked immuno-sorbent assay and also by binding competition assay with synthetic pentapeptides, Gly-Arg-Gly-Asp-Ser (GRGDS) and Gly-Arg-Gly-Glu-Ser (GRGES). The former competitor inhibited completely fibronectin CBD-dependent binding activity of JCBD, the latter had no inhibitory activity. These results suggest that certain functional proteins engineered by computer design between human fibronectin cell binding domain and lambda phage J protein can be produced.

The traditional denture fabrication technique using resin teeth with metal occlusal surfaces is rather complicated and time consuming. To improve this, a new two-piece artificial resin tooth has been developed. The teeth are arranged on the wax denture and processed in the usual manner. The patient is allowed to use the completed denture for a period of time to harmonize the occlusal surfaces with oral function. The occlusal portions of the teeth are then separated from the base and invested as a resin pattern for casting. The new cast occlusal portions are reset on the base portions with a resin adhesive.

High abrasion resistance plastic teeth made of microfilled urethane dimethacrylate resin were developed around ten years ago. In recent years, several of this same type of resin teeth were developed and introduced commercially in Japan. Many studies have reported the properties of restorative resin materials, but few comparative studies have been conducted among the various resin teeth on the market. The purpose of this study was to compare the basic physical properties of conventional acrylic resin teeth as dental materials with an experimental high abrasion resistance plastic for posterior teeth made of microfilled urethane dimethacrylate. In addition, we compared the properties of the experimental teeth with the other high abrasion resistance plastic teeth including a comparative study of anterior and posterior teeth already on the market. The results indicated that basic physical properties of the experimental posterior resin teeth were better than those of the conventional acrylic resin teeth, but the staining resistance of the former was a little lower than that of the latter. Further, the experimental posterior teeth appeared to have physical properties equal to those of other resin teeth of the same type, but the staining resistance of the experimental resin teeth was higher.

The purpose of this study was to evaluate the newly developed computer-assisted image processing method. We applied this method for the evaluation of masticatory efficiency and the analysis of occlusal pattern factors: the number and the size of occlusal contact areas, the number of and the size of the projected facets. We compared this new method with our conventional one which is the simplified particle counting method using a sieve and measuring the occlusal pattern factors with a planimeter. The results were as follows: 1. It is possible to count the number of particles within an optional range of size with the new method. 2. The new method may be used with minimum error for the measurement of occlusal pattern factors. We believe that this newly developed computer-assisted image processing method can be put to practical use for clinical evaluation of masticatory efficiency and analysis of occlusal pattern factors.

The present report discusses our new simplified measuring method of masticatory efficiency by counting particles in the matter of making test materials and the standard equation for subjects with normal dentition. 1. Two kinds of hydrocolloid impression materials, reversible and irreversible, were used as the test materials. 2. For evaluating the shape of test materials, 12 subjects with normal dentition were tested and for calculating the standard equation, 108 subjects with normal dentition were tested. 3. Each subject was investigated by the simplified method of counting particles through a sieve system. The number of remaining particles on the mesh was calculated as a masticatory performance. 4. As indicated in a previous report by Dr. Ozawa about cubical test materials, columnar test materials are easier to make than the others and these were avairable for the present particle counting method for investigating masticatory efficiency. 5. We obtained the standard equation for both kinds of test material using 108 subjects with normal dentition. To simplify the measuring method, we selected the standard equation of a 5-mesh sieve with 10 strokes chewing for the index of masticatory efficiency. The standard equation of a 5-mesh sieve for both test materials are as follows; 1) Reversible hydrocolloid test material: Y = -1.605X+29.058 2) Irreversible hydrocolloid test material: Y = -1.116X+23.868 6. 5, 10-mesh sieve with 10 strokes chewing showed the smallest variation in the individual coefficient of variation with both kinds of test material.

Recent reports have shown an increase of oral and maxillofacial injuries caused by sports activities. In European and American countries, mouthguards are the popular measure against these injuries. The purpose of this study was to survey the rate of incidence of oral and maxillofacial injuries caused by contact sports, the diffusion and the evaluation of mouthguards and the interest in mouthguards in Japan. Questionnaires were sent to 244 Rugby football teams in Aichi prefecture and 27 American football teams in the Tokai area. We received replies from 153 Rugby football teams and 17 American football teams, and the results were as follows: 1) The rate of incidence of oral and maxillofacial injuries was 239 players out of 4721 players, which means 5.1% in Rugby football and 22 players out of 428 players, which means 5.1% in American football. 2) The diffusion of mouthguards was 20 out of 153 teams in Rugby football and 16 out of 17 teams in American football. And most of them are using commercially available mouthguards. 3) Almost all teams were not satisfied with their mouthguards and complained of speaking difficulties, discomfort and easy dislocation. 4) Almost all teams desire the improvement of mouthguards. 5) Teams with no experience of mouthguards were very much interested in the use of mouthguards but they do not have enough information about mouthguards. 6) We have to enlighten players and their instructors about mouthguards and diffuse the use of mouthguards more positively to contact sports players.