Dental trauma prevention with mouthguard in a nose fracturing blow to the face: Case report.

Orofacial injuries are common in sports activities and may vary in complexity and the tissues involved. Most sports-related trauma occurs when a player hits another player, an object or the ground. This report presents a case of an injury caused by a punchlike blow to the face during a handball college team practice session. The patient suffered a traumatic blow to the left side of the nose and mouth and promptly attended a dentist. After a clinical examination and a CBCT scan, the following injuries were diagnosed: upper lip laceration, upper left lateral incisor subluxation and anterior nasal spine fracture. More severe teeth injuries were likely prevented because the patient was wearing a mouthguard.

Eight-year follow-up of autogenous tooth transplantation involving multidisciplinary treatment.

Although autogenous tooth transplantation is a widely reported procedure, its success is dependent on a number of factors. Here we describe the surgical technique, endodontic treatment and rehabilitation employed for a patient in whom a lower right third molar was transplanted to substitute an adjacent second molar with extensive caries. During an 8-year follow-up period, normal periodontal healing was observed and no infection, ankylosis or progressive resorption occurred. It may be concluded that transplantation of a third molar is a practicable approach for replacement of a lost permanent tooth, with restoration of esthetics and function.

Impact absorption and force dissipation of protective mouth guards with or without titanium reinforcement.

BACKGROUND: Mouth guards are used to reduce the risk of experiencing dental injuries. Various individual and commercial designs are available. METHODS: The authors prepared 20 artificial maxillae from a polyether-resin to simulate teeth, jaw bone and gingiva. They customized two designs of mouth guards by using stone models from impressions of the artificial maxillae; one (n = 10) was constructed of four layers of ethylene vinyl acetate (EVA) (total thickness = 4.0 millimeters) (group EVA), and the other (n = 10) was constructed of EVA with an intermediate layer of 1.0-mm-thick sheet titanium from the left maxillary canine to the right maxillary canine (total thickness = 4.0 mm) (group EVA-Ti). They used a drop-weight impact testing machine (DTM 1000-S, Omnipotent Instruments, Seremban, Negeri Sembilan Darui Khusus, West Malaysia) for a frontal impact with 1.7 kilograms of mass dropped at 0.34 meter per second. The force of the drop was verified by means of a laser Doppler vibrometer (laser model OFV-323 and controller model OFV-3020, Polytec, Irvine, Calif.) to calculate the absorbed energy. They used a high-speed camera (FastCam APX-RS, Photron, San Diego) to obtain images of energy dissipation over the length of the mouth guard. RESULTS: The mean effective total impact energy that reached the maxillae-mouth guard models was 5.66 (standard deviation [SD], 0.035) joules. The mean absorbed energy in group EVA was 4.39 (0.023) J (77.8 percent of total impact energy). The mean (SD) absorbed energy in group EVA-Ti was 4.28 (0.013) J (75.9 percent of total impact energy). The mean (SD) total dissipated energy was 1.26 (0.21) J in group EVA and 1.36 (0.11) J in group EVA-Ti. The mean (SD) transmitted energy for the mouth guards was 1.08 (0.19) J in group EVA and 0.99 (0.05) J in group EVA-Ti. There was no statistically significant difference between the groups in terms of any energy transmission or absorption. CONCLUSION: The results of this study suggest that an additional intermediate titanium layer in the anterior area of a mouth guard may not have a beneficial effect on impact absorption and dissipation. PRACTICAL IMPLICATIONS: The use of mouth guards is a general requirement for physical sports activities, and it should be strongly encouraged for people playing contact sports in particular. However, the authors' results indicate that the total thickness of a mouth guard is more important than is the use of an additional intermediate layer (in this case, titanium).

Effects of 3-dimensional conformal or intensity-modulated radiotherapy on dental pulp sensitivity during and after the treatment of oral or oropharyngeal malignancies.

INTRODUCTION: Radiation therapy (RT) of malignant tumors in the head and neck area may have damaging effects on surrounding tissues. The aim of this investigation was to evaluate the effects of RT delivered by 3-dimensional conformal radiotherapy (3D-RT) or intensity-modulated radiotherapy (IMRT) on dental pulp sensitivity. METHODS: Twenty patients with oral or oropharyngeal cancer receiving RT with 3D-RT or IMRT underwent cold thermal pulp sensitivity testing (PST) of 2 teeth each at 4 time points: before RT (TP1), the beginning of RT with doses between 30 and 35 Gy (TP2), the end of RT with doses between 60 and 70 Gy (TP3), and 4 to 5 months after the start of RT (TP4). RESULTS: All 40 teeth showed positive responses to PST at TP1 (100%) and 9 at TP2 (22.5%; 3/16 [18.8%] for 3D-RT and 6/24 [25.0%] for IMRT). No tooth responded to PST at TP3 and TP4 (0%). A statistically significant difference existed in the number of positive pulp responses between different time points (TP1 through TP4) for all patients receiving RT (P ≤ .05), IMRT (P ≤ .05), and 3D-RT (P ≤ .05). No statistically significant differences in positive sensitivity responses were found between 3D-RT and IMRT at any time point (TP1, TP3, TP4, P = 1.0; TP2, P = .74). A statistically significant correlation existed between the location of the tumor and PST at TP2 for IMRT (P ≤ .05) but not for 3D-RT (P = .14). CONCLUSIONS: RT decreased the number of teeth responding to PST after doses greater than 30 to 35 Gy. The type of RT (3D-RT or IMRT) had no influence on the pulp responses to PST after the conclusion of RT.

Cytotoxicity evaluation of sodium alendronate on cultured human periodontal ligament fibroblasts.

External root resorption processes are usually associated with dental trauma, mainly avulsion and intrusion. In such cases endodontic therapy aims to prevent this process by using medications that can inhibit osteoclastic activity, such as bisphosphonates. However, these drugs must be biocompatible to the periapical tissues. The aim of this study was to analyze the cytotoxicity of a bisphosphonate (sodium alendronate) on human periodontal ligament fibroblasts (PDL cells). Cells were plated in a density of 1 x 10(3) cells per dish. The experimental groups were GI (control) no sodium alendronate, and GII, GIII, and GIV with sodium alendronate at the concentrations of 10(-5), 10(-6), and 10(-7) M, respectively. The experimental times were 1, 6, 12, and 24 h (short-term) for viability and 2, 4, 6, and 8 days (long-term) for cell survival. Data in triplicate were statistically analyzed. Cultures treated with the highest alendronate concentration (GII) showed cell viability percentages significantly lower (P < 0.01) than those of the other groups (GI, GIII, and GIV), at 12 and 24 h. Cell growth on GII and GIII groups was similar. GII presented smaller growth than the other groups (P < 0.05). We concluded that sodium alendronate, on direct contact with human periodontal ligament fibroblasts, is cytotoxic in concentrations higher than of 10(-6) M.