Mihalik Jason P, McCaffrey Meghan A, Rivera Eric M, Pardini Jamie E, Guskiewicz Kevin M, Collins Michael W, Lovell Mark R
Sports Medicine Research Laboratory, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Dent Traumatol. 2007 Feb;23(1):14-20. doi: 10.1111/j.1600-9657.2006.00488.x.
Although it is widely accepted that mouthguards decrease the incidence of dental injuries, there is a controversy among sports medicine professionals as to the effectiveness of mouthguards in decreasing the incidence or severity of sports-related cerebral concussion (SRCC). While some experimental data suggest that this may be the case, there exist a number of reports suggesting that mouthguards do not serve this purpose. These conclusions have been drawn, however, without actually measuring the extent of neurocognitive dysfunction in athletes following sports-related concussion. The purpose of this study was to determine whether mouthguard use reduces the neurocognitive and symptomatic impairments that follow an injurious episode of SRCC. Preseason baseline data were collected as part of an ongoing clinical program that uses a computerized neurocognitive test to assess various faculties of brain function and symptoms reported at the time of testing. Follow-up testing from 180 student-athletes who had sustained an SRCC was analyzed for the purpose of this study. These athletes were separated into one of two groups: those who reported using mouthguards and those who did not. Neurocognitive testing was accomplished using the Immediate Post-Concussion and Assessment Test (ImPACT). Results suggest that neurocognitive deficits at the time of the athletes' first follow-up assessment did not differ between mouthguard users and non-users, suggesting that mouthguard use does little to reduce the severity of neurocognitive dysfunction and onset of symptoms following sports-related head trauma. However, an interesting finding in this study was that athletes experienced significantly lower neurocognitive test scores and reported higher symptom scores following SRCC regardless of mouthguard use. This emphasizes a thorough clinical evaluation of athletes that have sustained an SRCC. Although it was found in this study that mouthguard use does not decrease the severity of concussion, it is important to note that the use of mouthguards is paramount in reducing maxillofacial and dental trauma and their use should continue to be mandated by athletic associations and supported by all dental and sports medicine professionals.
尽管人们普遍认为护齿器可降低牙齿损伤的发生率，但在运动医学专业人士中，对于护齿器在降低与运动相关的脑震荡（SRCC）发生率或严重程度方面的有效性存在争议。虽然一些实验数据表明可能如此，但也有许多报告表明护齿器并无此作用。然而，这些结论是在未实际测量与运动相关脑震荡后运动员神经认知功能障碍程度的情况下得出的。本研究的目的是确定使用护齿器是否能减少SRCC损伤事件后的神经认知和症状损伤。作为一个正在进行的临床项目的一部分，收集了季前基线数据，该项目使用计算机化神经认知测试来评估脑功能的各个方面以及测试时报告的症状。为了本研究的目的，对180名遭受SRCC的学生运动员的随访测试进行了分析。这些运动员被分为两组之一：报告使用护齿器的运动员和未使用护齿器的运动员。使用即时脑震荡后评估测试（ImPACT）进行神经认知测试。结果表明，在运动员首次随访评估时，使用护齿器者和未使用者之间的神经认知缺陷并无差异，这表明使用护齿器对减轻与运动相关的头部创伤后的神经认知功能障碍严重程度和症状发作作用不大。然而，本研究中的一个有趣发现是，无论是否使用护齿器，运动员在SRCC后神经认知测试得分显著较低且报告的症状得分较高。这强调了对遭受SRCC的运动员进行全面临床评估的重要性。尽管本研究发现使用护齿器并不能降低脑震荡的严重程度，但需要注意的是，使用护齿器对于减少颌面和牙齿创伤至关重要，运动协会应继续强制要求使用护齿器，所有牙科和运动医学专业人士也应予以支持。
