The use of mouthguards in grappling sports: a survey of grapplers in the United Kingdom.

Background Mouthguards are routinely used in many sports, however their use in grappling sports has not really been examined to date, and to the authors' knowledge, there is no available data on the level of dental trauma experienced by this group.Materials and method The authors approached six different grappling schools, as well as leaving an invite on a grappling event page for volunteers to fill out a short survey.Results Around 81 respondents took part in the survey, with nearly 25% reporting that they never wore a mouthguard during grappling, and less than 50% not wearing a mouthguard all the time. Sixty-three percent of respondents had either seen dental and peri-oral injuries, or had experienced dental injuries as a result of grappling.Conclusion More work is needed to investigate whether mouthguards have a positive effect on the dental injury experience, and to establish the percentage of grapplers who at some point will be affected by dental trauma.

Facial Palsy Masquerading as an Acute Dental Abscess.

Facial nerve palsy has specific symptomology, but varied aetiology. Prompt and thorough assessment is required to ascertain if upper or lower motor neurone damage has occurred. This report discusses a 6-year-old female, presenting in the Emergency Department with unilateral facial weakness. Initially thought to be facial swelling relating to her carious dentition, clinical assessment from the maxillofacial team identified that the patient had a unilateral facial palsy, later diagnosed as Bell's palsy. Her delayed presentation was due to initial misdiagnoses in primary care. This case report aims to highlight its aetiology, clinical features and appropriate management. Clinical relevance: To make the general dental practitioner aware of different causes of facial paralysis, and to provide GDPs with an algorithm to follow in the presentation of a facial palsy in the primary care setting.

Management of facial asymmetry due to overgrowing costochondral graft: A case report.

Costochondral grafts are used to replace the mandibular condyle in cases of TMJ ankylosis, and are generally viewed as a gold standard for autogenous reconstruction of the mandibular condyle (Güven, 2000; Posnick and Goldstein, 1993 [1,2]). We report a case where overgrowth of costochondral grafts is seen, resulting in asymmetric mandibular growth and dentofacial asymmetry (Posnick and Goldstein, 1993 [2]). A 17 year old male patient presented with an existing costochondral graft performed due to TMJ ankylosis during childhood. He fell from a height at the age of 4, and was lost to follow up through non-attendance until the age of 9, when he presented with a progressive reduction in maximal incisal opening (MIO). At this stage his maximal incisal opening was noted to be 11mm, and the CT showed a grossly deformed ankylosed left TMJ. This post traumatic ankyloses was managed with gap arthroplasty and costochondral graft reconstruction. This immediately improved his MIO to 22mm and at 1 year follow up was noted to be 30mm. At age 12 he was noted to have a clinically obvious overgrowth of the left ramus of the mandible, and deviation of the chin point to the right. MIO remained at 38mm. He declined orthognathic surgery and represented 2 years later requesting treatment without orthodontic intervention for his facial asymmetry. He subsequently underwent a Le Fort 1 impaction osteotomy, right BSSO and left condylar ostectomy, coronoidectomy and left lower border mandibulectomy. Regrowth of the CCG occurred during the 6 months of follow up. This case illustrates the problems that can occur after condylar trauma. It also highlights issues with costochondral grafts which can continue to grow.