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This retrospective study utilized the National Electronic Injury Surveillance System (NEISS) database to identify pediatric emergency department (ED) patients with playground-associated craniofacial injuries between January 2012 and December 2021. A total of 25 414 patients were identified. The majority of injuries occurred in preschool and elementary school–age children (90.3%) and patients were more commonly boys (59.3%). Injuries most often involved the head/scalp (52.4%), face (30.4%), and mouth (11.9%). Infant (32.7%) and teen (40.0%) injuries most commonly involved swings, whereas preschool (23.1%) and elementary school (28.1%) injuries were mostly associated with slides and climbers, respectively. Most patients were treated in the ED and discharged to home (96.5%), a small portion required hospitalization (1.6%), and one death was reported. Although the majority of the injuries were relatively minor and resulted in same-day discharges, these injuries can result in serious physical harm, emotional stress, and unexpected financial burdens. Proper education and supervision regarding safe play is important to prevent these injuries. [ABSTRACT FROM AUTHOR]

Background: Child maltreatment, the abuse or neglect of children aged 0–18 years, is a severe and underreported global problem. Compared with other body parts, the orofacial region displays more signs of child maltreatment. Dentists and dental hygienists are therefore well situated to identify orofacial signs of child maltreatment. Aim: To map the current literature on orofacial signs of child maltreatment identified by dentists or dental hygienists. Design: A scoping review was conducted based on systematic searches of Medline (Ovid), Embase (Ovid), and CINAHL (EBSCOhost) for primary qualitative and quantitative studies through June 6, 2022. Results: Twenty‐nine studies were included in this scoping review. Though all child maltreatment types were identified in dental settings, physical abuse and dental neglect were most commonly identified. Reports of caries dominated the orofacial signs, followed by bruises (intra‐ and extraoral), poor oral hygiene, dental trauma, and lacerations (intra‐ and extraoral). Case reports were used most commonly to describe orofacial signs of child maltreatment. Conclusion: Dental clinicians identify orofacial signs of all child maltreatment types intraorally. Dentists identify the same extraoral signs as do other healthcare professionals, with bruising being the most common. [ABSTRACT FROM AUTHOR]

Self-injurious behavior has been defined as an act directed at oneself that results in tissue damage. The aim of this study was to verify the prevalence of self-injurious behavior and the presence of oral lesions among adolescents in foster care. This is a cross-sectional study that was carried out in the shelters of the city of Recife (Brazil), with adolescents between 10 and 17 years of age, of both genders, by census survey. Data were collected through document analysis, application of the questionnaire (FASM), and physical examination, in the second half of 2021. The data were systematized by SPSS software using descriptive and inferential statistics. A total of 81 adolescents participated of the research. The average age of the patients evaluated was 13.65 years and the majority were male. As for clinical characteristics, 75.3% had one or more self-injurious behavior. Of these, the most frequent were: poking wounds 53.1%, biting oneself 40.7%, and cutting the skin 34.6%. The most observed oral lesion was linea alba 14.8%. In the association between self-injurious behavior and oral lesions, trauma and dental wear, age group, gender, shelter care situation and violence no association was recorded (p > 0.05). Self-injurious behavior may have a high occurrence percentage among adolescents in shelter/foster care. However, the adolescents had a low prevalence of changes in the oral cavity that could suggest self-injurious behavior. No association was recorded between the variables studied. [ABSTRACT FROM AUTHOR]

Background and Aim: To treat wounds, various treatment methods are used,including chemical, herbal, homeopathic and laser treatments, the main goal of which is faster, less complication, and at the same time lower cost of wounds. Topical phenytoin also has a positive effect on wound healing.The aim of present study was to investigate the antimicrobial effect of topical 1% phenytoin on microbial contamination caused by microorganisms affecting oral ulcer infection in an animal model. Material and Methods: In this experimental animal experimental study in 2019, 36 male rafts were selected. After anesthetizing the rats, the mandibular gingiva was flapped. Three types of microbial microorganisms including Candida albicans, Staphylococcus aureus and Actinomycosis were prepared. An equal number of microorganisms was placed at the incision site. Rats were randomly divided into two groups. In 18 rats 1% topical phenytoin powder was applied to the wounds, and in the remaining 18 rats no drug was applied to the wound. Finally, 36 samples of incisal biopsy were cultured in specific media for each microorganism and transferred to the laboratory. Colonies counted in phenytoin groups were compared with non-phenytoin groups. Data were analysed by Mann-Whitney test by means of SPSS 22 software. Results: Mean±sd and Pvalue colonies of Staphylococcus aureus case and control groups respectively(124827±301378) and(807±1209),(P=0.259), Candida albicans(1750±1339)and(2357±4679),(P=0.423) and Actinomyces (16088±36721)and(47±114)(P=0.049)were not statistically significant between the phenytoin and control groups. Conclusion: It seems that 1% topical phenytoin powder after one use had no effect on reducing the microbial contamination of oral ulcers in laboratory rat. [ABSTRACT FROM AUTHOR]

Purpose Detergent pod-related aerodigestive/ocular chemical burns/ingestion poisoning injuries are a group of injuries of concern to parents/guardians of young children as well as oral healthcare professionals. Each year detergent pod injuries result in thousands of emergency department (ED) visits and significant oral, eye, airway, and digestive trauma. The purpose of this study was to investigate trends in detergent pod injuries resulting in ED visits in children ages >0 to <18 years from 2016-2020. Methods This cross-sectional study used data collected from the National Electronic Injury Surveillance System (NEISS). A secondary data analysis was performed on the NEISS data from 2016-2020 for children ages >0 to <18 years. Injuries were identified as detergent pod-related oral-aerodigestive/ingestion poisonings, detergent pod-related ocular injuries, or other product-related injuries among children. Time trends and demographic characteristics were analysed by age, sex, and race. Results There were an estimated 13,176 detergent pod-related oral-aerodigestive injuries/ingestion poisonings and 8,654 detergent pod-related ocular injuries with ED visits during 2016 - 2020. In adjusted logistic regression, white children were more likely to have oral-aerodigestive injuries/ingestion poisonings than black children (p=0.0006). Time trend (p=0.4358), and sex (p=0.3905) failed to reach significance. Children, ages 5 to<18 years, were less likely to have ED visits for oral-aerodigestive injuries/ingestion poisonings, or any detergent pod-related injury than younger children. Children, ages 3 to ≤5 years, were more likely to have detergent pod-related ocular injuries than younger or older children. Conclusion Time trends for detergent-pod related injuries requiring ED visits remained unchanged from 2016-2020 for oral-aerodigestive injuries/ingestion poisonings. Given the significant health risks associated with detergent pods and the fact that the injuries have not declined, there is a need for improved parent/guardian education and practices in safeguarding detergent pods from children. Dental hygienists are well positioned to provide anticipatory guidance on this safety issue. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of oral-maxillofacial trauma among Brazilian victims of physical aggression and identify its associated factors from a medico-legal and forensic perspective.Materials and Methods: A cross-sectional study was carried out involving the analysis of complete medico-legal and social reports of 3668 victims of physical aggression treated at a centre of legal medicine and forensic dentistry over the course of four years. The dependent variable was the occurrence of oral-maxillofacial trauma. The independent variables were sociodemographic status and characteristics of physical aggression. Statistical analyses included the chi-squared test (p < 0.05) as well as univariate and multivariate logistic regression analyses.Results: Oral-maxillofacial trauma occurred in 1655 cases (45.1%). Individuals who lived in suburban areas (OR = 1.32; 95%CI = 1.11-1.58) and those who were victims of community violence (OR = 1.20; 95%CI = 1.03-1.40) perpetrated by someone known to them (OR = 1.24; 95%CI = 1.03-1.40) using physical force (OR = 2.31; 95%CI = 1.96-2.72) on weekends (OR = 1.19; 95%CI = 1.04-1.37) and during nighttime hours (OR = 1.23; 95%CI = 1.08-1.41) were more likely to exhibit oral-maxillofacial trauma.Conclusion: The prevalence of oral-maxillofacial trauma was high and the associated factors were area of residence, type of violence, type of offender, mechanism of violence, day, and period of occurrence. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate whether individuals with chronic renal failure (CRF) undergoing hemodialysis treatment have more salivary and oral mucosa alterations when compared to healthy individuals, through a systematic review followed by meta-analysis. A systematic literature review was performed, evaluating randomized clinical trials found in the Proquest, Embase, Scopus, Cochrane Library, Web of Science, Lilacs and Pubmed databases, using MeSH terms and other keywords. Initially, 40 articles were included in the study and, after reading the complete articles, only 15 clinical trials that analyzed oral lesions and salivary changes in patients with CRF undergoing hemodialysis treatment were eligible. Most of the clinical studies included were cross-sectional and composed of a study group and a control group. The mean age of participants in the study group was 50.19 years and in the control group, 48.95 years. The most common oral alterations found in the CRF group in relation to the control group were xerostomia, uremic breath, dysgeusia, coated tongue, gingival bleeding, and pale mucosa. The salivary flow of patients with CRF was 46.6% lower than the control group. The salivary pH in the study group was also more alkaline when compared to the control group. Greater amounts of urea, phosphate, C-reactive protein and total proteins were found in the saliva of individuals with CRF. Individuals with CRF undergoing hemodialysis are more prone to changes in both the quantity and quality of saliva, as well as having a greater amount of oral changes. [ABSTRACT FROM AUTHOR]

Numerous mouth injuries have been reported in relation to bit use in horses. Rein tension is a potential risk factor, as it exerts pressure on the rostral parts of the mouth via the bit. The aim of this pilot study was to investigate rein tension during driving and its association with horse behaviour and mouth injuries. Eight horses were driven clockwise on a 1000 m oval racetrack for 3–4 km at walk and trot. Rein tension was measured with two IPOS rein sensors. Researchers filmed the horse's behaviour from a vehicle moving alongside the horse on the outer track. The bit area of the mouth was examined before and after the session. One observer, blinded to the rein tension and mouth injury results, coded behaviours from videos according to a predefined ethogram. Median rein tensions in one rein ranged from 5 N to 36 N. Maximum rein tensions ranged from 106 N to 236 N. Five 30-second data subsets, representing samples of Low, Medium1, Medium2, High and Peak tension, were visually selected from the rein tension graphs to investigate behaviour differences during different rein tension levels. The durations of unrushed walk (P < 0.001) and mouth closed (P = 0.003) were longer in the Low rein tension subset. The durations of slow (P = 0.01) and fast trot (P = 0.003), mouth widely (P = 0.02) or repeatedly open (P = 0.03) were longer in the higher rein tension subsets. None of the horses had any prior mouth injuries in the bit area. After driving, three horses experienced moderate bruising. Their median rein tension was numerically higher (left 35 N; right 34 N) than that in horses without injuries (22 N; 18 N), and they showed longer periods of rushed walk (P = 0.04). Rein tensions were quite high, as previous studies suggest that horses find tensions above 6–10 N aversive. Horse trainers should monitor the horse's mouth behaviour, arousal state and ability to walk calmly and modify training accordingly, as mouth widely or repeatedly open at higher rein tensions may indicate aversion (mouth discomfort/pain) and rushed walk may indicate high arousal, which in turn may increase the risk for mouth injury. • Rein tension in trotters may be high. • With higher rein tension, horses showed longer duration of mouth widely or repeatedly open. • Three of eight horses had moderate bruises after 8–16-minute drive session on the track. • Median rein tension was numerically higher in horses with mouth injuries. • Horses with mouth injuries stayed in rushed walk for longer periods than horses without injuries. [ABSTRACT FROM AUTHOR]

Garlic is one of the most common medicinal plants used since ancient times to treat diverse diseases within several cultures worldwide. Nevertheless, this plant has the potential to cause chemical burns of the skin and mucosa. This report presents a case of a garlic burn in the palate of a 57‐year‐old woman who applied garlic to the palate to relieve the pain of trigeminal neuralgia. This case demonstrates the potential of garlic to cause chemical burns to the oral mucosa and raises an alert to oral health professionals regarding inappropriate self‐treatment methods. [ABSTRACT FROM AUTHOR]

Background/Aim: Mouthguards must have an appropriate thickness to prevent oral trauma during sports. The aim of this study was to establish a thermoforming technique to secure the labial and buccal thicknesses of the mouthguard with a single sheet. Materials and Methods: Mouthguards were thermoformed using 4.0‐mm thick sheets manufactured by extrusion molding, a plaster model, and a vacuum forming machine. Two sheet installation conditions were compared: the sheet extrusion direction was either parallel (P) or vertical (V) to the model's centerline. In each extrusion direction, two forming conditions were compared: (1) the sheet was formed when it sagged 15‐mm below the sheet frame at the top of the post (control group; C‐P, C‐V); and (2) the sheet frame was lowered 50‐mm below the ordinary level and heated, the frame was lowered when it sagged 15‐mm, and the model was moved forward 20‐mm before formation (experimental group; E‐P, E‐V). Difference in thickness (incisal edge, labial surface, cusp, and buccal surface) due to sheet extrusion direction and forming conditions were analyzed by two‐way ANOVA and the Bonferroni method. Results: At all measurement sites, a significant difference in thickness depending on the sheet extrusion direction was observed in the experimental group (p <.01), but not in the control group. Difference in thickness depending on the forming condition was observed at all measurement sites, and the thickness was in the order C‐P, C‐V < E‐P < E‐V. Thicknesses of E‐P and E‐V were 3.01 ± 0.03 mm and 3.25 ± 0.02 mm on the labial surface, and 2.81 ± 0.02 mm and 3.02 ± 0.02 mm on the buccal surface. Conclusions: It was possible to obtain 3 mm or more thickness on the labial and buccal sides with a single sheet by adjusting the sheet extrusion direction and the heating method of the sheet, and by applying the thermoforming method where the model is moved forward just before formation. [ABSTRACT FROM AUTHOR]

Background/Aim: Mouthguard thickness is important to prevent oral and facial trauma during sports. The aim of this study was to establish an effective thermoforming method for maintaining mouthguard thickness with a circular sheet using a circular frame. Materials and Methods: Mouthguards were thermoformed using 4.0‐mm‐thick ethylene vinyl acetate sheets and a vacuum forming machine. Each sheet was pinched at the top and bottom and stabilized by a circular frame. Two heating conditions were compared: (1) condition N, where the sheet was formed when it sagged 10 mm below the level of the sheet frame at the top of the post, and (2) condition L, where the sheet frame was lowered 50 mm below the ordinary level and heated, and the sheet was formed when it sagged 10 mm. In each heating method, two forming conditions were compared: (1) when the sheet softened, the sheet frame was lowered and formed (condition C; N‐C, L‐C), and (2) after the sheet frame was lowered, the model was moved forward 20 mm and then formed (condition MP; N‐MP, L‐MP). Six mouthguards were fabricated for each condition. Thickness differences due to heating conditions and forming conditions were analyzed by the two‐way ANOVA and Bonferroni's multiple comparison test. Results: At the incisal edge and at the labial and buccal surfaces, significant differences were observed among all conditions, and the thicknesses were in the order N‐C < L‐C < N‐MP

Background/Aim: Tooth avulsion (TA) is a severe form of traumatic dental injury. The tooth's prognosis depends on the immediate measures taken. First responders are often laypeople, and the Internet is a favored platform to access health‐related information. The aim of this descriptive study was to evaluate the accuracy, quality, readability, and popularity of patient‐oriented web information regarding the emergency management of TA. Methods: Three search engines (Google, Bing, and Yahoo.com) were browsed with six VPNs using "knocked out tooth," "fallen out tooth," and "tooth avulsion" as keywords. The top 20 results for each were evaluated. Webpages were included if they had information oriented to caregivers. They were analyzed for accuracy (cutoff ≥95%). Quality of web pages was assessed using DISCERN and the Journal of the American Medical Association (JAMA) benchmark. Readability was evaluated using Flesch‐Kincaid Grade Level (FKGL), Gunning Fog (FOG), Coleman–Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG). Popularity was assessed by Alexa Popularity Rank (APR). Accurate and inaccurate webpages were compared using chi‐square analysis and the Mann–Whitney U test. Spearman's correlation between the studied metrics was established. A p <.05 was considered significant. Results: Seventy‐two webpages were included, of which 23 (32%) were accurate. The median DISCERN ratings for accurate and inaccurate webpages were 3.0 [2.5–3.0] and 3.0 [2.0–3.0], respectively (p =.331). Ten (44%) accurate and 12 (24.5%) inaccurate webpages had high‐quality JAMA (p =.089). The median readability scores for accurate webpages were FKGL (8 [6.75–9.2]), FOG (10.6 [9.55–12.3]), CLI (7 [6–7]), SMOG (6.7 [6.15–7.5]), while scores for the inaccurate webpages were FKGL (7.85 [6.275–8.525]), FOG (10.55 [8.875–11.425]), CLI (7 [7–8.25]), and SMOG (7 [6.2–7.925]), with a higher CLI score for inaccurate webpages (p =.0035). The median APRs for accurate and inaccurate webpages were 1,02,538 [26,852–14,43,755] and 7,63,190 [2,19,799–29,92,067], respectively (p =.163). Accuracy had a positive correlation with quality (DISCERN: rho =.293, p =.013; JAMA: rho =.249, p =.036), while popularity (APR) was negatively correlated with quality (DISCERN: rho = −.330, p =.013; JAMA: rho = −.287, p =.032). Conclusion: Relevant webpages were limited and had low accuracy. This can impact the emergency management by laypeople and adversely affect the prognosis following avulsion. [ABSTRACT FROM AUTHOR]

Transoral penetrating foreign body injury of the neck involving the cervical spine is a rare condition. We present an injury caused by transoral penetration of a broken piece of a wooden plank into the neck with injury to the upper cervical spine in a 31-year-old male patient. The foreign body was removed transorally with the patient making a full recovery under close observation and was discharged and followed up with no complications. This paper highlights the types of neck injuries, the key points to be considered in zone III neck injury in light of existing literature and a discussion on the management of these patients.

Background/Aims: Orofacial injuries are a significant public health issue. The evidence‐based knowledge associated with adolescent violence and trauma is highlighted by the World Health Organization with regard to its specific needs related to disability, violence, and unintentional injuries. The main aim of this study was to present evidence‐based information about orofacial traumatic injuries of an adolescent population using Portuguese epidemiological data. The second aim was to report follow‐up data of injuries for disability assessment in a trauma prevention approach. Methods: An observational cohort study was performed using the clinical database of the national‐specialist‐healthcare‐centre‐of‐trauma (2014–2018). Information was collected regarding gender, school age range, etiology, injury type, injury time, and severity. Mann–Whitney (p <.05), Kruskal–Wallis (p <.001), and Cox regression (p <.001) analyses were performed. Results: Orofacial trauma injuries were present in 23.3% of Portuguese adolescents (age range 10–18 years). The majority were male (72.6%), and no age range stood out in frequency. School accidents (90.6%) were the major etiology for all groups of injuries. The diagnosis of superficial intraoral injuries was the most frequent (50.8%), followed by similar injuries to the face (22.5%). A Cox regression model with an adequate fit was yielded (χ2 [6] = 54.893, p <.001), suggesting that variable injury type was a predictor of disability, considering injury time. Tooth and alveolar loss, complicated tooth fracture, complicated face injury, and temporomandibular injuries were more predictive (1

The article presents a case study of a two-year-old boy who experienced delayed internal carotid artery occlusion and paralysis after blunt toothbrush trauma during teeth brushing. Topics discussed include the diagnosis challenges in pediatric blunt cerebrovascular injuries, the importance of early detection through imaging methods like computed tomography angiography, and the safe and beneficial use of antiplatelet or anticoagulant therapy in treating such cases.

Purpose: Studies regarding oral injuries from playground equipment in children remain limited. This study aimed to clarify the characteristics of oral injury caused by playground equipment and identify associations with concomitant head injury., Methods: Children treated between 2011 and 2021 at an oral surgery clinic for oral injuries from playground equipment were retrospectively investigated. The following factors were analyzed: demographic characteristics, mechanism of injury, type of equipment causing the injury, classification of oral injury, and whether the Department of Emergency and Critical Care Medicine was consulted regarding the head injury. The data collected were statistically analyzed using the Fisher-Freeman-Halton test with significance adopted at the 5% level., Results: This study analyzed data from 82 children. Injuries were concentrated in age groups of 2 to 3 years (32.9%), 4 to 5 years (28.0%), and 6 to 7 years (25.6%). Regarding the mechanism of injury, falls were more common (89.0%) than impact/striking (11.0%). The type of equipment most frequently causing injury was slides (29.3%), followed by swings (23.2%) and iron bars (18.3%). Injuries were classified as soft tissue injury alone (56.1%) or tooth injury and/or jaw fracture (43.9%). Consultation with the Department of Emergency and Critical Care Medicine for head injury was uncommon (13.4%), and all consultations for brain injury diagnosed minor injuries., Conclusion: Oral injuries caused by playground equipment were frequent between 2 and 7 years old. The most common cause was falls, with most injuries caused by slides, swings, or iron bars. Approximately half of the oral injuries were soft tissue injuries only, while the other half were associated with tooth and/or jaw injuries. Department of Emergency and Critical Care Medicine consultations for head trauma were uncommon and consistently confirmed minor injuries., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Competing Interests: Competing interests: None declared.

Background: Anti-N-methyl-d-aspartate receptor encephalitis (anti-NMDARE) is a multi-stage autoimmune-mediated disease associated with a multitude of neuropsychiatric and dysautonomic features. Orofacial dyskinesias are frequently associated with this condition and manifest as abnormal movements of the orofacial musculature. These involuntary movements may result in significant trauma to the oral and maxillofacial complex including the avulsion of the dentition and orofacial lacerations. Case presentation: We describe the course of two female patients with anti-NMDARE in whom significant involuntary self-inflicted maxillofacial trauma was suffered despite the use of complex parenteral sedation regimens. The application of traditional maxillomandibular wiring techniques and pharmacologic strategies, including botulinum toxin, to immobilize the mandible were initially unsuccessful. These difficulties led to the fabrication and wire-based fixation of a patient-specific acrylic oral appliance that maintained the mandible in a depressed position and mitigated all lateral and protrusive movements. Discussion and conclusions: These cases illustrate the first known successful use of an appliance-based therapy for managing orofacial dyskinesias in the anti-NMDARE patient population through an adaptation of traditional maxillomandibular fixation techniques. This approach eliminated further orofacial trauma and afforded physicians with safer means to manage and assess patients afflicted with this condition during their protracted intensive care unit admissions. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate the effect of low doses (LD) bone morphogenetic protein-2 (BMP2) and BMP4 micro-immunotherapy (MI) in two in vitro models of periodontal wound healing/regeneration.Methods: We first evaluated the effect of LD of BMP2 and BMP4 MI on a 2D cell culture using human gingival fibroblasts (hGF) under inflammatory conditions induced by IL1β. Biocompatibility, inflammatory response (Prostaglandin E2 (PGE2) release), collagen deposition and release of extracellular matrix (ECM) organization-related enzymes (matrix metalloproteinase-1 (MMP1) and metalloproteinase inhibitor 1 (TIMP1)) were evaluated after short (3 days) and long-term (24 days) treatment with BMP2 or BMP4 MI. Then, given the results obtained in the 2D cell culture, LD BMP4 MI treatment was evaluated in a 3D cell culture model of human tissue equivalent of gingiva (GTE) under the same inflammatory stimulus, evaluating the biocompatibility, inflammatory response and effect on MMP1 and TIMP1 release.Results: LD BMP4 was able to decrease the release of the inflammatory mediator PGE2 and completely re-establish the impaired collagen metabolism induced by IL1β treatment. In the 3D model, LD BMP4 treatment improved tissue viability compared with the vehicle, with similar levels to 3D tissues without inflammation. No significant effects were observed on PGE2 levels nor MMP1/TIMP1 ratio after LD BMP4 treatment, although a tendency to decrease PGE2 levels was observed after 3 days.Conclusions: LD BMP4 MI treatment shows anti-inflammatory and regenerative properties on hGF, and improved viability of 3D gingiva under inflammatory conditions. LD BMP4 MI treatment could be used on primary prevention or maintenance care of periodontitis. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the prevalence of incidental findings, not strictly related to dentistry, viewed with panoramic radiography. Methods: Panoramic radiographs performed between December 2013 and June 2016 were retrospectively collected. These images were analyzed, searching for incidental findings. All the information collected was statistically analysed Results: A total of 2307 Panoramic Radiograph were analyzed and 2017 of them were included in the study. 529 incidental findings were seen: 255 (48.2%) were ESP (Elongation of Styloid Process), 167 were CAC (Carotid Artery Calcification) (31.57%), 36 were maxillary sinus pathologies (6.8%) and 71 were other incidental findings (13.42%). The total prevalence of IF was 26, 23%., CAC was 8.28% in the total population, and it was higher in women (9.82%) than men (6.54%). 48.5% of CAC were bilateral. When unilateral, the right side showed a higher right side prevalence. The prevalence of ESP was 12.64% in total population (men: 13.82%; women: 11.60%). 84.71% of ESP were bilateral and, when present unilaterally, no side difference was seen. 13.33% of the ESP appeared segmented. The prevalence of maxillary sinus pathologies was 1.78% (men: 2.32%; women: 1.31%). Only 8.33% of these pathologies were bilateral, and, when unilateral, they were mostly present on the right side. Between the 71 other IF (prevalence: 3.52%), sialoliths and tonsilloliths were assessed most frequently. Conclusion: Due to the high prevalence of incidental findings detected with panoramic radiography, dental practitioners should be aware of the various pathologic conditions seen on the panoramic radiographs. [ABSTRACT FROM AUTHOR]

Background: Globally, research on oral and maxillofacial lesions among newborns and infants remains limited. Aim: To describe demographic patterns, histopathological findings, and locations of oral and maxillofacial lesions in newborns (birth‐1 month) and infants (>1 month‐2 years) reported over 51 years. Design: A retrospective cross‐sectional study on histopathological records of newborns and infants was conducted. Patients' demographic characteristics (age, gender, and race), histopathological diagnosis, and lesion's location were gathered. Pearson's chi‐square or Fisher's exact test was performed to determine associations between demographic characteristics and different categories of lesions. Results: Out of 66,546 specimens received, 0.44% (290 specimens) were from patients aged 2 years and younger (27 newborns and 263 infants). The most common category was inflammatory/reactive (44.2%), followed by tumour/tumour‐like (42.0%), cystic/pseudocystic (6.6%), and miscellaneous lesions (5.5%). Mucous extravasation cysts (23.4%) and Langerhans cell histiocytosis (7.2%) were the most common histopathological diagnoses. Tumour/tumour‐like lesions were significant in newborns (P =.021), and majority were congenital epulis (40.7%). Inflammatory/reactive lesions were significantly higher in male (P =.025) and infants (P = <.001) with predominant incidences of mucous extravasation cysts (24.7%). There was a more than one ten probability of malignant lesions (11.4%). Conclusion: Routine clinical head and neck examinations in newborns and infants are the key to early detection of lesions. [ABSTRACT FROM AUTHOR]

Purpose: To assess the practices and behaviour among Betel nut users in Ghaziabad and to detect the clinically associated oral mucosal lesions and conditions. Materials and Methods: A community-based survey was conducted in Ghaziabad among 332 betel nut users. Data on betel nut use was obtained through a self-administered questionnaire. Oral mucosal lesions and conditions were recorded using WHO criteria. Results: Out of 332 betel nut users, 32.8% consumed Gutkha. 62.3% users used betel nut with tobacco. Most of the study population started chewing betel nut because of peer pressure and the habit started at the workplace or school. A majority found that there was no physical discomfort due to the habit. The significant oral diseases detected were oral leukoplakia in 11.7% and oral submucous fibrosis in 6.1% of individuals. Conclusion: The findings of the present study revealed that 74.7% of the participants were current chewers. 30.4% of all participants had oral mucosal lesions and conditions. [ABSTRACT FROM AUTHOR]

Recently, wearing a mouthguard (MG) has become mandatory in contact sports. A properly fitted MG protects against sports injuries to the stomatognathic system, and stabilized the occlusal position, which might leads to improved sports performance. The present study uses a questionnaire to determine the amount of dental knowledge and motivation to wear a MG among dental college students. The current situation regarding MG use, discomfort, and experience of oral trauma and concussion was evaluated in 175 rugby football players, 63 American football players, 62 skiers, 55 karate, 27 Shorinji kempo and 32 Nippon kempo athletes who participate d in the Annual Athletic Meet for All Japanese Dental Students (414 participants). The results of the questionnaire about MG use indicated that almost all players experienced discomfort. Dental trauma was experienced in 90% and 43% of rugby football payers and karate athletes, respectively. The rates were lowest among American football players, Shorinji kempo athletes and skiers, being 5.8%, 7.4%, 12.9%, respectively. Concussion was experienced by > 36% of rugby football players and 25% of Nippon kempo athletes. Nippon kempo athletes may use a MG to protect against concussion. In conclusion, rules requiring players to wear a MG should be enforced or rules should be changed to make wearing a MG compulsory, awareness of dental students should be improved, injury should be prevented by wearing a MG and not only organizations but individual players should be educated about the necessity of wearing a MG. [ABSTRACT FROM AUTHOR]

Background: Little information is available about the prevalence of oro-facial injuries sustained by participants in Mixed Martial Arts. There is no data on mouthguard use related to any type of martial arts. Aim: To determine the prevalence and distribution of oro-facial injuries together with the prevalence and attitudes to the use of mouthguards in Mixed Martial Arts participants. Materials and Methods: A questionnaire was distributed to MMA participants at 5 gyms seeking the relevant information regarding oro-facial injuries and mouthguard use. Ninety nine subjects responded over a period of 2 weeks. The response rate was unknown. Results: An oro-facial injury was sustained by 85.9% of subjects. Of all subjects, 79.8% (n=79) experienced a soft tissue cut/bruise and 25.3% (n=23) experienced a dental injury. More injuries were sustained during training (67.0%). A mouthguard was owned by 97% of respondents; however 28.1% of those reported that there were times of possible facial contact where they did not wear their mouthguard and 71.7% of those questioned felt that they did not know enough about mouthguards. Discussion: This retro spective study found that within this sample group, there was a high prevalence of oro-facial injuries amongst those who participate in MMA with more injuries being sustainted during training. Those who owned custom made mouthguards wore their mouthguards more frequently during times of possible facial contact compared to those who owned shop bought mouthguards. Conclusion: This study presents evidence that orofacial injuries are inevitably sustained by MMA participants and that a high number of subjects felt they did not know enough about mouthguards. Club leaders therefore should encourage use of mouthguards at possible times of oro-facial contact, be able to advise members on the different types of mouthguards available, where they would be able to purchase one and be able to provide immediate care and have information on pathways for emergency treatment. [ABSTRACT FROM AUTHOR]

The Academy for Sports Dentistry in the United States was established in 1983 as a group to discuss and study the problems associated with orofacial injuries, disseminate the information gathered, and suggest methods to prevent these injuries. A paper was presented at the 14th Annual Meeting of the Japanese Academy of Sports Dentistry held in Kyoto describing many of the orofacial injury reports from around the world published before 2003. This presentation reviews many of the international articles published since 2000 dealing with maxillofacial and dental injuries sustained during sports activities. This report was presented at the 25th Annual Meeting of the Japanese Academy of Sports Dentistry on June 29th, 2014, in Osaka, Japan. This lecture highlighted changes in orofacial injury patterns since 2003 in the United States and internationally. Recommendations as to how injury reporting agencies may improve data gathering in the future so that information about maxillofacial and dental injuries can be more easily compiled, reported, and accessed was also be presented. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates whether the intraoral approach to mandibular open reduction and internal fixation, through exposure to the oral cavity's microbiome, results in higher infection rates compared to the extraoral approach, thus addressing a critical public health concern, potentially offering an opportunity to reduce health-care costs, and aiming to guide effective clinical practice., Methods: In this systematic review with meta-analyses, a review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A comprehensive literature search was conducted using Embase and PubMed for articles published between 1989 and 2023. Inclusion criteria targeted studies on open reduction and internal fixation mandibular fractures comparing intraoral and extraoral approaches and reporting infection rates. Exclusion criteria eliminated non-English articles, case reports, and studies with insufficient approach-specific data. The primary outcome was the postoperative infection rate, with surgical approach as the predictor. Covariates such as age, sex, diabetes, and smoking status were included when reported. Data were analyzed using R software, employing random-effects models due to anticipated heterogeneity (I 2 statistics)., Results: From 61 studies, 11 provided direct comparisons involving 1,317 patients-937 intraoral and 380 extraoral. Infection rates were 5.9% for intraoral and 10% for extraoral approaches. Pooled relative risk was 0.94 [95% confidence interval, 0.63, 1.39], suggesting no significant risk difference. Prevalence of infections was estimated at 9% for intraoral and 6.1% for extraoral procedures, with significant heterogeneity (I 2  = 84% for intraoral and 56% for extraoral)., Conclusion: Our meta-analysis found no significant difference in infection rates between the two approaches. There is opportunity to expand on reporting complication rates comparing the various approaches to mandibular fixation. Until these data are presented, surgeon preference may dictate the operative approach to expose the mandible for reduction and fixation., (Copyright © 2024 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

The process of domestication of the horse introduced changes limiting accessibility to graze land and roughage while increasing highly digestible carbohydrates content of meal-fed rations. We have tested whether the effect of a higher degree of human contact impacts horses' welfare by assessing the development of sharp enamel points (SEP) and buccal ulcerations (BU) in ridden and unridden horses. We were able to fit logistic regression models significantly differentiating the impact of these two conditions in both groups of horses (p < 0.001 for SEP and p < 0.01 for BU). The impact is higher in ridden horses for both conditions. These two conditions were found to correlate positively (ρ = 0.63, p < 0.001). We argued that human contact may impact on horses' welfare. Further studies may help to clarify this impact with more detail. Dentistry may be helpful to provide improved welfare conditions; however, without regular access to grazed land, the stabled horses' welfare may be at stake.

Background/aim: Oral injuries such as oral soft tissue lacerations and contusions can occur in basketball by mechanisms such as running into other players or falling. Given a high enough impact force, dental injuries such as tooth fractures and avulsions can occur. Previous research has studied the different types of oral injuries as well as the mechanisms that cause them. Yet, the mechanisms resulting in dental injuries have remained unexplored. The aims of this study were to investigate the distribution of different oral injuries within each injury mechanism and evaluate which mechanisms were most likely to lead to a dental injury., Materials and Methods: This is a retrospective cohort study using the National Electronic Injury Surveillance System (NEISS). Subjects who experienced oral injuries from basketball between January 1, 2003 and December 31, 2022 were included in this study. The independent variable was the injury mechanism. The dependent variable was the dental injury outcome (yes/no). Multivariate logistic regression was used to measure the association between the injury mechanism and the dental injury outcome. A p < .05 was considered statistically significant., Results: This study included 4419 subjects who experienced oral injuries (national estimate, 138,980). Approximately 14.7% of oral injuries were dental injuries. Subjects experiencing collisions with objects such as walls or the basketball hoop (odds ratio (OR), 4.39; p < .001), falls (OR, 3.35; p < .001), or contact with the basketball (OR, 1.77; p = .006) had significantly higher odds of sustaining a dental injury relative to those experiencing contact with another player., Conclusions: Basketball players experiencing contact to the mouth have high odds of sustaining a dental injury. An understanding of injury mechanisms is important for medical teams to manage these injuries and for coaches to educate athletes on safe and proper playing styles. Furthermore, healthcare providers and basketball staff should encourage athletes to wear mouthguards to reduce the risk of traumatic dental injuries., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The recognition and reporting of child abuse and neglect continues to be a challenge in the healthcare setting. All healthcare providers, including dentists, should be aware of the high prevalence of orofacial injuries and conditions that are concerning for abuse and neglect. Sentinel injuries may appear trivial and do not require medical attention, but are unlikely caused by accidental mechanisms and, if not properly identified, often precede more severe abusive injuries. Concerning orofacial findings can manifest as bruising, eye injuries, intraoral injuries, pharyngeal perforations, facial bone fractures, and sexually transmitted infections. Abusive caregivers are likely to give inadequate explanations or no history at all to explain concerning findings. Medical providers' failure to make mandated reports about their concerns to the appropriate agencies can have significant long-term impacts on the physical and psychological well-being of children., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The incidence of injuries to the oral and maxillofacial region during judo competitions has been found to exceed 80%, and the use of sports mouthguards (SMGs) is expected to reduce the incidence of injuries among players. However, rules of the International Judo Federation prohibit the use of SMGs. To promote the use of SMGs among judo competitors, we aimed to examine the activity and role of the stomatognathic system during judo competitions. We investigated the occlusal contact and muscle activity while performing judo techniques by simultaneously measuring dynamic occlusal contact areas, occlusal force distribution, and electromyography. We used a custom-made sensor sheet (FPD-T-Sports) to measure occlusal contact, and measured the muscle activity of masseter, temporalis, and digastric muscles on the dominant side of the body. Before the measurements, the subjects were instructed to clench and open their mouths maximally, and the means of the maximum values for occlusal contact force and area as well as electromyographic envelope were considered 100% for the individual. Throws and breakfalls were selected from among the basic judo movements as the test movements during free practice, and groundwork techniques were selected from among the movements during actual contests. Occlusal contact during judo varied among the subjects, and contact was seen beyond the area found in maximum clenching. Although the myoelectric potential in the test muscles increased during practice compared with that before practice, the amount of test muscle activity and occlusal contact did not reach the values found in maximum clenching in any of the subjects. Moreover, increases indigastric muscle potential were found, indicating that maximum clenching was not performed. As the stomatognathic system activity during judo varies according to the athlete, only SMGs that are custom-made for individual athletes are recommended. [ABSTRACT FROM AUTHOR]

The aim of this research was to investigate physical injuries along with oral injuries and their prevention among the cricketers and hockey players of Bangladesh. The study population consisted of 108 cricketers (91 males and 17 females) and 105 male hockey players. Data were collected by means of questionnaires about injury history, use of a mouthguard and the attitude toward using it, and intraoral examinations. In cricket, the most frequent oral injuries were soft tissue lacerations (42.43%), concussions (21.21%) and cracked teeth (18.18%), and the major cause was being hit by the ball (59.26%). No player reported using a mouthguard. In hockey, the most common oral injuries were soft tissue lacerations (57.89%) and cracked teeth (19.73%) mostly due to being hit by the ball 43.42%. Most hockey players (83%) reported using a ready-made mouthguard. When comparing the two groups of players, the incidence of oral injuries was significantly higher in the hockey players than in the cricket players (P=0.0000068). There was no significant difference in physical injuries between hockey players and cricket players. In intra oral examinations, most of the cricketers and hockey players had class I occlusion with a CPI of score 0 or 1. The incidences of physical injuries and traumatic oral injuries are high in Bangladeshi cricket and hockey players. Hockey players had more injuries than cricketers even after wearing a ready-made mouthguard. Thus, a custom-made mouthguard is necessary along with safety education. [ABSTRACT FROM AUTHOR]

Background/aims: Ketamine sedation has not been reported to be widely used as a pharmacological behavioural management strategy to facilitate the treatment of acute paediatric oro-dental trauma. The aim of this study was to investigate the safety and effectiveness of intramuscular ketamine sedation for managing paediatric oro-dental trauma in a paediatric Emergency Department (ED).Methods: The database of all paediatric procedural sedations performed in the hospital ED from 01 January 2014 to 31 December 2016 was reviewed to identify cases where intramuscular ketamine sedation was administered for dentists' treatment of oro-dental trauma. Patient demographics and epidemiological data, the type and number of sedation-related adverse events, and interventions performed were extracted from the database. Clinical notes were reviewed to verify the dental diagnoses and dental treatment performed. Adverse events were further risk stratified using the World SIVA adverse event reporting tool.Results: In the study period, 167 intramuscular ketamine sedations were administered by ED doctors for dental treatment of oro-dental trauma. The patients' median age was 3.6 years (range 1.1 to 12 years). All dental procedures were successfully completed. Nineteen adverse events were reported (11.4%, n = 19) with the most common being emesis (9.0%) followed by transient desaturation (1.8%) and hypersalivation (0.6%). The lowest oxygen saturation level was 90%. None of the patients aspirated, and none required assisted ventilation or chest compression. The most common dental diagnosis was primary tooth luxation (49.1%). The most common dental treatment was primary teeth extraction (70.7%). When adverse events were stratified using the World SIVA tool, there were only 17 (10.2%) minor risk outcomes.Conclusions: The data support the safety and effectiveness of intramuscular ketamine sedation administered by trained ED doctors to facilitate the management of paediatric oro-dental trauma emergencies. [ABSTRACT FROM AUTHOR]

Background: Endoscopic nasobiliary drainage (ENBD) is widely used for biliary decompression in patients with biliary disease. However, it is difficult to reposition a nasobiliary catheter from the mouth to nostril. We developed a new device, which has a curved flexible loop and bar-handle, for repositioning of ENBD catheter. The aim of this study was to evaluate the usefulness of the new loop-device for facilitating the repositioning of an ENBD catheter from the mouth to nostril.Methods: Between January 2015 and December 2017, a comparative observational study was performed to evaluate the time taken for repositioning a nasobiliary catheter during endoscopic retrograde cholangiopancreatography (ERCP) and compare the results of ENBD procedure between the new loop-device and conventional techniques. In the subgroup analysis, we evaluated the occurrence of oral cavity injury and the time taken to transfer ENBD catheter from the mouth to nostril.Results: In all, 145 ENBD procedures were performed using these two techniques. The procedure time was significantly shorter in the new technique group than in the conventional group. (44 s vs. 194 s, p < 0.001). The total success rate of new device technique was 97.3%. No complication, including oral cavity injury, was observed.Conclusions: The technique using our new loop-device was useful for repositioning a nasobiliary catheter from the mouth to nostril in ERCP. The new device does not require the removal of the mouthpiece before ENBD positioning, which can help perform the ENBD procedure rapidly and avoid the finger injury of endoscopists. [ABSTRACT FROM AUTHOR]

This case report describes the use of dental implants to treat a non-professional boxer with dental trauma. The 25-year-old boxer presented with a fistula in relation to the lateral incisor which was palatally inclined. He was also concerned about the esthetics. A dental implant restoration was recommended to address the concerns of the patient. Several studies have demonstrated that trauma to existing implant restorations typically results in a damaged implant crown and a bent fixation screw leaving the implant undamaged. Only the fixation screw has to be changed without replacing the implant. Therefore, implant-supported crowns may be a good option to restore missing teeth after dental trauma. In addition, the dental practitioner should educate contact sports players about the risk of sports-related dental trauma and the benefits of a mouth guard. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the incidence of oral injury before and after wearing mouthguards in rugby football. Methods: Since 2004, we have been providing custom-made mouthguards (CMG) to an adult rugby team and mandated CMG usage during matches and full-contact practice. In the present study, the number of players who missed more than 1 day of practice due to external force injury or spontaneous injury and those who stopped participating in a practice session due to external force injury or spontaneous injury was recorded. The incidence of injuries before and after mandatory CMG usage was also statistically analyzed. Results: A total of 161 injuries occurred over a 2-year period before mandatory CMG usage, of which 12 were oral injuries. A total of 391 injuries occurred over a 5-year period after mandatory CMG usage, of which only three were oral injuries. When compared to before mandatory CMG usage, the number of oral injuries had significantly decreased (p<0.01). Conclusion: In rugby football, mandatory CMG usage during matches and practice significantly lowered the incidence of oral injury. [ABSTRACT FROM AUTHOR]

Orofacial injuries are prevalent in contact and non-contact sports. Considering that 13-39% of all dental injuries are sports related, the need for effective methods of orofacial protection is crucial. Researchers have proposed that the mouthguard could act as a protective device that can potentially reduce the extent and severity of orofacial injuries. Hence, the effectiveness of mouthguards in reducing sports related orofacial injuries is an area of research that deserves further inquiry. An evidence-based review was performed to determine if mouthguards are effective in reducing sport related orofacial injuries. A Scopus pilot test, an Ovid systematic search, expert opinions, and a review of reference lists resulted in the compilation of 15 studies intended for critical appraisal. A checklist was utilized to systematically assess the evidence of efficacy of prevention, after which 6 studies met the strict criteria. Results demonstrated that mouthguards significantly decrease the incidence of dental trauma. Inconclusive evidence was found regarding the ability of mouthguards to reduce soft tissue injury and concussion. Overall, there is fair evidence to suggest the mandatory use of mouthguards in sports related activities. Further research is warranted to confirm these results. [ABSTRACT FROM AUTHOR]

Objective: To investigate oral Candida strain diversity in patients receiving radiation therapy for head and neck cancer compared to controls by conventional procedures, including cultivation of imprint samples on chromogenic medium and subsequent identification using Analytical Profile Index testing. Method and Materials: Twenty-two irradiated patients aged 18 to 55 years were recruited from the Maxillofacial Prosthetic Service, Mahidol University. Concomitantly, 22 healthy individuals whose age and sex matched that of the patient group were selected for a control group. Results: All patients studied were Candida carriers and were predominantly infected with Candida albicans (86.36%). Besides C albicans, other yeasts colonizing the oral cavity of these patients were C glabrata, C krusei, and C tropicalis. Candida carriage was found relatively less frequently (45.45%) in control subjects. However, C albicans was still the predominant species detected. No C dubliniensis was found in either group. Conclusion: Head and neck cancer patients who had received radiotherapy had a high prevalence of Candida colonization in the oral cavity. Consequently, prophylaxis to reduce Candida infection in these patients is required. This may improve the quality of life for patients who receive irradiation treatment for malignant cancer. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the results of treatment of buccal mandibular Class II furcation defects with a combination of autologous bone grafts and enamel matrix derivative over a 24-month period. Eleven individuals with chronic periodontitis were selected and contributed one furcation defect each. Statistically significant improvements in mean vertical probing attachment level and horizontal probing attachment level were obtained at the 2-year evaluation. Complete clinical closure was achieved in four sites, which exhibited favorable defect morphology for this regenerative procedure. All other residual defects were reduced to Class I. [ABSTRACT FROM AUTHOR]

Purpose: To determine the location of mucosal injuries that appear following placement of complete dentures, as well as the number of adjustments necessary to achieve patient comfort. The frequency of mucosal injuries in female and male patients and their connection with clinical anatomic features were also investigated. Materials and Methods: Sixty-one completely edentulous healthy patients who wore dentures (47 women and 14 men) took part in the study; 122 newly fabricated complete maxillary and mandibular dentures were investigated. All patients were seen for a 1-week adjustment appointment. Areas where signs of denture-induced mucosal injuries appeared were marked on an anatomic illustration. The follow-up period was in 1-week increments as deemed necessary by the patient. Associations between variables were analyzed with analysis of variance. Results were recorded as mean ± SD. Statistical significance was set at P ≤ .05. Results: Eighty-seven percent of the dentures required adjustment at week 1, 50% at week 2, and only 7% at week 3. No patients required a further visit. Most frequently injured maxillary areas were the vestibular sulcus (41%), maxillary tuberosity (21%), and hamular notch (12%). In the mandible, the most frequently injured areas were the retromylohyoid area (17%), lingual sulcus (14%), and vestibular sulcus (13%). Denture-induced irritations were detected in a higher ratio in the mandible (P < .001), especially in male denture wearers at the first adjustment (P < .05). Men had a higher ratio of lesions at the region of the maxillary vestibular sulcus between the labial and buccal frenum and at the mandibular vestibular sulcus of the buccal shelf region (P < .001). Conclusions: Denture-induced irritations appeared most often in the vestibular sulcus of the maxilla and mandible, indicating that it is necessary to evaluate the area of the facial seal of the prosthesis by applying a medium- or a heavy-pressure indicator paste to the borders, and to make adjustments at the delivery stage and subsequent adjustment appointments. Denture placement must not be the final patient-clinician encounter when treating with complete dentures. Denture adjustments are very important clinical phases of denture fabrication and essential in patient care. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this investigation was to assess the effects of aging on the dimensional stability of vacuum-formed, pressure-formed, and pressure-laminated custom-made mouthguards. Method and materials: A master model representing the dental arch was fabricated in acrylic resin. Two ethylene vinyl acetate thermoplastic materials were tested: Essix (regular) and Proform (prelaminated). The model was benchmarked in five places along the curvature of the arch. The model was used to fabricate 10 specimens for each of the following groups: 1 = vacuum-formed (3-mm) Essix; 2 = vacuum-formed (4-mm) Proform; 3 = pressure-formed (3-mm) Essix; 4 = pressure-formed (4-mm) Proform; 5 = pressure-laminated (3-mm + 2-mm) Essix; 6 = pressure-laminated (3-mm + 3-mm) Essix. Die stone was poured into the newly made specimens and measured. Aging of the specimens was simulated by reproducing cleaning cycles (48 hours' soaking in water at 60°F and brushing 100 times with a soft denture brush in soapy water at 140°F for 20 minutes). Die stone was poured into the aged specimens and measured. Initial and post-aging measurements were compared. Results: All specimens showed dimensional changes post-aging, mainly decreases. Pressure-laminated specimens showed the best dimensional stability. Conclusion: Aging induced various dimensional changes in mouthguards, depending on the materials and processing techniques used. Most of the dimensional change for all mouthguards occurred at the central incisor region, the most important area for the protection of the anterior teeth and the premaxilla. Pressure-laminated mouthguard specimens showed the smallest range of changes at the central incisor region, suggesting potentially improved fit, comfort, and protection. (Quintessence Int 2002;33:700-705) [ABSTRACT FROM AUTHOR]

Aims: According to the Research Diagnostic Criteria (J Craniomandib Disord 1992;6(4):301-355), an anterior disc displacement with reduction (ADD) is characterized by reciprocal clicking with the opening click occurring at a mouth opening at least 5 mm greater than that of the closing click. The aim of this study was to test whether the E-ram criterion of the RDC is characteristic for a click due to an ADD. Methods: From 30 participants with a unilateral ADD, recordings of mandibular movements with 6 degrees of freedom as well as joint sound recordings were made. The participants performed free open movements and loaded closing movements. Results: In 8 joints (27%), the 5-nnn criterion was not fulfilled. For 2 participants, the click while closing occurred with an even larger mouth opening than that while opening. Recordings of the condylar movements showed that the opening clicks occurred over a broad range of the opening movement, whereas all the closing clicks occurred just before the condyle reached its terminal position in the fossa. Conclusion: The 5-ram criterion of the RD C is not characteristic of all anterior disc displacements with reduction. [ABSTRACT FROM AUTHOR]

Background: Cryotherapy is the deliberate destruction of tissue by the application of extreme cold, and has been indicated as a treatment modality for the management of commonly occurring benign oral pathologies. The aim of this study was to investigate treatment protocol parameters and effectiveness of a closed cryotherapy system for the management of oral mucoceles and vascular malformations.Methods: This retrospective study analyzed data collected from a specialist oral medicine clinic referred for treatment of oral mucoceles or vascular malformations. Data was analyzed to determine lesion characteristics, treatment parameters, and clinical effectiveness of a closed cryotherapy system.Results: The closed cryotherapy system achieved 100% success rate in lesion resolution. For both pathologies, increased lesion diameter was related to increased number of cryotherapy appointments, increased number of freeze cycles, and increased cumulative freeze time. 95% of vascular malformations and 83.34% of mucoceles resolved with no signs of post-operative complication, and patients did not report postoperative pain.Conclusions: Cryotherapy is an excellent treatment option for benign lesion management. It is minimally invasive, causes minimal discomfort, and has a high rate of clinical success. [ABSTRACT FROM AUTHOR]

Objectives: Oral potentially malignant disorders (OPMD) include a variety of mucosal lesions such as oral lichen planus (OLP), oral lichenoid lesions (OLL) and oral lichenoid dysplasia (OLD). Their rate of malignant transformation ranges from 0% to 34% and is dependent on OPMD type, lesion site and a range of risk factors. This study seeks to determine the proportion of oral lichenoid conditions that transform into oral squamous cell carcinoma (OSCC) in an Australian population.Methods: The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLP, OLL or OLD using clinical and histopathological data between 2006 and 2014. Patients were cross-matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation determined.Results: OLP and OLL patients displayed a low risk of malignant transformation; 0.49% (1/206) for OLP and 0% (0/31) for OLL. In contrast, OLD patients, all of whom presented clinically as OLP, were at much higher risk with 6.81% (3/44) developing OSCC over an average time of 4.6 years (±2.4 SD). Rates of smoking and alcohol consumption were no higher in OLD patients compared to others.Conclusions: Compared with other oral lichenoid conditions, OLD lesions are at a particularly high risk of malignant transformation and should be managed based on the presence of dysplasia and not the lichenoid inflammatory infiltrate. OLP demonstrates a relatively low rate of malignant transformation. Diagnostic histopathology is important for discriminating OLP from OLD. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Nonsuicidal self-inflicted injuries are socially unacceptable and may cause mild to severe damages. Purpose: This study aimed to evaluate the demographic features of the subjects with orodental self-injuries referred to a forensic medicine center in Shiraz, Iran. Materials and Method: This cross-sectional study evaluated 51 participants (49 men and 2 women) with orodental injuries referred to forensic medicine administration. Orodental self-injury was detected in the subjects, based on the last forensic criterion of self-injuries, considering their history, clinical examinations, and panoramic radiographs. Results: The findings of this study revealed that dental self-injuries were more prevalent among married men from urban areas with secondary education levels. Most of the cases were due to the monetary compensation received. In the majority of cases, a hard object was used for this self-injury. Moreover, no statistical association was observed between the economic status and orodental self-injury. Conclusion: This study concluded that dental self-injury could be regarded as an unplanned incident because no significant correlation was observed between the participants, their economic status, and the type of dental trauma. Furthermore, detailed investigations on the latent variables are required. [ABSTRACT FROM AUTHOR]

Study serratiopeptidase effects on healing of buccal mucosal wound in rabbits. Material and Method: Twenty male rabbits, divided into 2 groups; 10 untreated animals (control) and another 10 animals treated by serratiopeptidase (5 mg/kg orally), once a day for 10 days. Rabbits of both groups received general anesthesia (xylazine hydrochloride and ketamine hydrochloride), a standard incisions were done on oral mucosa of all rabbits, wound healing assessment was determined by histopathological, and hematological investigations. Results: statistics was used to study the differences in wound characters for study groups, Significant differences were shown between 2 groups (p< 0.001). Conclusions: Use of serratiopeptidase cannot improve and even delay healing of buccal mucosal wound in rabbits. [ABSTRACT FROM AUTHOR]

Background/aim: Approximately 50% of water polo players have suffered orofacial injuries. However, fewer than 8% of players wear a mouthguard. A more comfortable mouthguard design is therefore needed to increase compliance. The aim of this study was to assess the effect of reducing the palatal extension of a custom-made mouthguard on the degree of satisfaction with a mouthguard among water polo players.Materials and Methods: Eighteen elite water polo players participated in this randomized crossover trial. Two custom-made mouthguards were fabricated for each participant using 4-mm-thick ethyl vinyl acetate foils, defined by the extension of the palatal margin from the cervical line: conventional (6 mm) and shortened (2 mm). The mouthguards were worn during all training sessions and matches, in a randomized sequence (one mouthguard type for the first and fourth weeks and the other for the second and third weeks). Mouthguards were evaluated on 10-point scales for discomfort, interference with oral functions, protection, and general satisfaction after each training session or match.Results: Players evaluated the shortened mouthguard as having less interference with speech (Effect 1.30; P < 0.001), breathing (Effect 0.98; P = 0.004), swallowing (Effect 1.30; P < 0.001), and athletic performance (Effect 0.61; P = 0.03) compared with the conventional mouthguard. The perceived degree of protection was similar among participants when wearing each type of mouthguard. Overall, players were more satisfied with the shortened mouthguard (Effect 0.64; P = 0.03).Conclusions: Reducing the palatal extension of a custom-made mouthguard from 6 to 2 mm improves the overall satisfaction of elite water polo players without affecting the perceived degree of protection. [ABSTRACT FROM AUTHOR]

Objectives A toothbrush is a medical device that is widely used for oral hygiene practices at almost all ages. Descriptive studies of toothbrush-related injuries (TRI) are fairly limited, with existing studies mainly focusing on case reports. The present study sought to describe TRIs in Canada, including the contexts within which they occur. Methods The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database, years 1990 to 2016, was queried for cases of TRI. The circumstance, mechanism and type of injury are described based on an examination of narrative text, using data mining techniques and corresponding variable codes. Average annual percent change estimates are presented to describe trends over time. Results The rate of TRIs is low (16.9 of 100,000 CHIRPP cases among ages 14 years and below [0.02%], and 2.4 of 100,000 CHIRPP cases among ages 15 years and above [0.002%]) and has been relatively stable over the past quarter century. A majority of cases occurred among individuals aged 14 years and below; falls were the most common circumstance (50.0%) and mechanism (39.8%) of injury and laceration to the internal mouth was the most frequent type of injury (51.9%). Intentional injuries due to a toothbrush were only observed among individuals aged 15 years and older, such as in cases of inducing vomiting. Conclusions Although rare, TRIs are occurring in Canada and risk can be mitigated. Behaviours associated with routine habits of toothbrushing are an area that might assist with injury prevention efforts. The safe and appropriate use of toothbrushes should be considered at all ages. [ABSTRACT FROM AUTHOR]

Background/aims: The evidence that mouthguards prevent dental trauma is inconsistent. The aim of this study was to determine, through a systematic review and meta-analysis (MA), the impact of mouthguards (MG) on the prevalence of dento-alveolar trauma (DT) among athletes of contact sports.Material and Methods: Searches were performed at Medline, Scopus, Web of Science, Lilacs, Cochrane Library, and SIGLE without restriction of language or publication date. After the application of eligibility criteria, studies were evaluated regarding their methodology quality and risk of bias. Two meta-analyses (MA) were performed considering: studies free of problems or with minor problems (MA1) and only free of problems studies (MA2). DT prevalence (events) and total number of athletes from each group (use of MG and non-use of MG) were used for odds ratio calculation (α = 5%). The evidence was quality tested using the GRADE approach.Results: A total of 256 articles were identified. After applying the eligibility criteria, 14 studies were selected for qualitative synthesis, and 11 were used in quantitative synthesis. Meta-analyses showed that 73% (MA1) and 83% (MA2) of mouthguard users have a lower prevalence of DT. In MA1 (eight studies), DT prevalence among MG users was 7.75% (n = 183), while non-users had 48.31% (n = 974) (OR = 0.18, 95% CI = 0.07-0.45, P < 0.001). In MA2 (three studies), DT prevalence among MG users was 7.5% (n = 160), while DT prevalence among non-users was 59.48% (n = 750) (OR = 0.10, 95% CI = 0.05-0.08, P < 0.001), with moderate evidence quality level.Conclusion: Mouthguards contribute to a lower prevalence of dento-alveolar trauma among athletes of contact sports. [ABSTRACT FROM AUTHOR]

Objective: To test whether or not topically administered recombinant human epidermal growth factor (rhEGF) accelerates the early healing phase of oral soft tissue wounds. Methods: One day following the creation of palatal defects (n = 6/animal), 14 dogs were allocated to one of the following five groups: spontaneous healing (SH), vehicle ointment (V), vehicle ointment + rhEGF at concentrations of 1 μg/g (EGF1), 10 μg/g (EGF10) or 50 μg/g (EGF50). Topical administration of ointments was repeated twice per day until sacrifice at days 8 and 16. Wound area was clinically monitored. Keratinocytes proliferation (Ki67‐immunolabelling), inflammatory response (IR) and areas of collagen (C) and granulation tissue (GT) were histologically measured. Kruskal–Wallis test with Dunnett correction was used for multiple group statistical comparisons. Results: Clinically, in comparison with SH, a significantly smaller wound area was observed in groups EGF1 and EGF10 at day 8 (p < 0.05). At day 16, wound closure reached 97.8% in group EGF1 compared to 83.2% in group SH, albeit no statistically different. Histologically, at day 8, significantly more GT was observed in group EGF10 compared to all other groups (p < 0.05). At day 16, in addition to a higher Ki67‐immunolabelling, groups EGF1 and EGF10 demonstrated a significant decrease in GT and IR with more deposition of C compared to the other groups (p < 0.05). Conclusion: Application of rhEGF enhanced the early healing of acute oral soft tissue wounds compared to SH, predominantly at concentrations of 1 and 10 μg/g. [ABSTRACT FROM AUTHOR]