Changes in oral functions and speech when using custom-fitted mouthguards: An uncontrolled before-and-after study.

BACKGROUND/AIM: Mouthguards are crucial for protecting athletes against orofacial injuries, yet concerns persist regarding their potential impact on oral functions. This study aimed to investigate the effects of sports mouthguards on oral functions and speech over time. MATERIAL AND METHODS: Thirty national rugby players received custom-fitted mouthguards. Questionnaire responses and speech recordings were collected before mouthguard use and at various intervals after using mouthguards: immediately, 1 week, 2 month, and 6 months. Spectrographic analysis was performed to measure voice onset time (VOT) for /p, b, t, d/ phonemes. Questionnaire responses were assessed with Friedman's test, while VOT changes were examined using one-way repeated measure analysis of variance. RESULTS: Compliance with mouthguard use improved during training and competitions, with consistent wear reported during matches. Over time, speaking difficulties and lisping decreased significantly (p < .001). The perception of nausea improved (p < .001), stabilizing after 1 month (p = .414). Sensations of bulkiness declined (p < .001). Mouth dryness reduced steadily, with no occurrences reported by all players by the end of the study. None of the participants reported bad breath, ulcers, or redness in the mouth. VOT changed immediately after wearing mouthguards (p < .001), gradually regressing toward the baseline, although not completely reaching it. Players held a favorable view of mouthguard use, with comfort and support for mandatory use increasing over time. CONCLUSIONS: Custom-fitted mouthguards do not lead to significant long-term disruptions in oral functions. Athletes generally adapt to mouthguard use, reporting improved comfort and greater support for their use.

The impact of vitamin D on clinical parameters and bone turnover biomarkers in ligature-induced periodontitis: An experimental study in rats.

Objectives and Background: Vitamin D has been associated with an increased risk of tooth loss and the severity of periodontal diseases. This study aimed to evaluate the effect of vitamin D on the clinical, radiographic, and serum level changes of bone turnover biomarkers in ligature-induced periodontitis. Methods: A total of 28 rats were included in this study and divided into test groups: Vitamin D supplement (VS), Vitamin D deficient (VD), and control (CG). Ligature-induced periodontal tissue destruction was performed and kept for 21 days. Clinical attachment and radiographic changes were recorded, and serum samples were tested for Osteoprotegerin (OPG), Dickkopf-1 (DKK1), Sclerostin (SOST), and Fibroblast growth factor 23 (FGF23) on the initial and final day of the study. Results: Groups that were made VD exhibited a more significant amount of clinical attachment loss (1.05 ± 0.50 mm) compared to the CG (0.83 ± 0.14 mm) and VS group (0.60 ± 0.13 mm), showing significant differences (p < 0.05). The radiographic alveolar bone loss amount was greater in the VD group compared to the other groups. For serum level assessment, the VD groups also exhibited a statistically significant reduction in the levels of OPG. They showed higher concentrations of DKK1, SOST, and FGF23 than other groups, with significant differences (p < 0.05). Conclusion: The results revealed that Vitamin D may play a role in the progression of periodontal disease. It was found to affect both clinical parameters and bone turnover biomarkers, suggesting its potential impact on the disease process.

Re-attachment of a Fractured Maxillary Central Incisor: A Case with Two Years Follow-up.

Crown re-attachment is the most conservative treatment that can be used to restore fractured tooth, even in an emergency situation. The re-attachment maintains original contour and incisal translucency of the tooth, and reduces the chair time and cost. In case of crown fracture with pin-point pulp exposure, irritation to the pulp should be minimised and consideration must be taken for pre-treatment pulpal status, choice of pulp capping material, choice of bonding system and treatment sequence during crown re-attachment procedures. This article reported a crown fracture case with pin-point pulp exposure that was treated using crown re-attachment with direct pulp capping. At two-year follow-up, the tooth was asymptomatic, remained functional, vital, and the appearance of restoration was acceptable with no colour change to the crown.

Achieving the Sustainable Development Goals for water and sanitation in Indonesia - Results from a five-year (2013-2017) large-scale effectiveness evaluation.

BACKGROUND: Access to safe sanitation and the elimination of open defecation are pre-conditions for improved child health and nutrition and wider achievement of the Sustainable Development Goals (SDGs). While Indonesia has a solid policy framework, the country ranks third globally in terms of numbers of people practicing open defecation. OBJECTIVES: Our aim was to assess the effectiveness of a five-year strategy to reduce open defecation through accelerating implementation of the national sanitation program across districts receiving variable levels of external support. METHODS: Among three provinces with poor sanitation program performance, districts were selected to receive one of three levels of external support. High intensity districts (n = 6) benefitted from enabling environment strengthening support including political and social mobilization, direct capacity development, and efforts to strengthen planning, budgeting, monitoring and supervision; learning districts (n = 16) benefitted from cross-district learning opportunities and political mobilization through provincial government advocacy efforts; and comparison districts (n = 58) were monitored under routine program conditions. Outcomes included open defecation free (ODF) status and new toilet facility construction and were assessed through village level monitoring systems across all districts. Negative binomial regression and multivariate analysis were used to assess associations between levels of intervention intensity and outcomes. FINDINGS: Among districts receiving high-intensity external support improvements in political commitment, planning, coordination, financing, monitoring and supervision were observed. Relative to comparison districts, high intensity districts were more likely to be ODF (aRR 4.65, CI 2.12-10.20) with greater increase in household toilet coverage (aRR 11.15 CI 1.04-119.82). Weaker non-significant associations with ODF were observed among learning districts relative to comparison districts. INTERPRETATION: Efforts to strengthen provincial and district government capacity to implement sanitation programming in Indonesia can yield substantial improvements in outcomes in a relatively short period of time.