Director of Continuing Education, SMILE Foundation, Chatsworth, CA 91311, USA.
Dent Traumatol. 2009 Oct;25(5):515-21. doi: 10.1111/j.1600-9657.2009.00808.x. Epub 2009 Jul 9.
BACKGROUND/AIM: It is accepted that sports mouthguards decrease the incidence of dental injuries in athletes, but the value of oral orthotics in the prevention of concussion/mild traumatic brain injuries in footballers remains contentious. However, previous investigations have primarily studied non-customized mouthguards without dental/temporo-mandibular joint examinations of the subjects. Therefore, the aim of this study is to determine whether the use of a customized mandibular orthotic after temporo-mandibular joint assessment reduces the incidence of concussion/mild traumatic brain injuries in high-school football players.
Using a longitudinal, retrospective design, data were collected from a cohort of football players (n = 28) over three seasons using a questionnaire. The mean age of the sample prior to the use of the customized mandibular orthotic was 17.3 years +/- 1.9. Prior to deployment, dental records and temporo-mandibular joint evaluations were undertaken, as well as neurocognitive assessment, including history of concussion/mild traumatic brain injuries. After establishing optimal jaw position, a customized mandibular orthotic was fabricated to the new spatial relations.
The mean age of the sample after three seasons was 19.7 years +/- 2.0. Prior to the use of the customized mandibular orthotic, the mean self-reported incidence of concussion/mild traumatic brain injuries was 2.1 +/- 1.4 concussive events. After the deployment of the customized mandibular orthotic the number of concussive events fell to 0.11 +/- 0.3 with an odds ratio of 38.33 (95% CI 8.2-178.6), P < 0.05.
The preliminary results of this study suggest that a customized mandibular orthotic may decrease the incidence of concussion/mild traumatic brain injuries in high- school football athletes, but a comprehensive study is required to confirm these initial findings. Furthermore, additional research is necessary to indicate the possible mode(s) of action of a customized mandibular orthotic in the prevention of concussion/mild traumatic brain injuries.
背景/目的：运动护齿器可降低运动员牙齿受伤的发生率，这已得到认可，但口腔矫正器在预防足球运动员脑震荡/轻度创伤性脑损伤方面的价值仍存在争议。然而，以前的研究主要研究了没有对受试者的牙齿/颞下颌关节进行检查的非定制护齿器。因此，本研究的目的是确定在颞下颌关节评估后使用定制下颌矫正器是否会降低高中足球运动员脑震荡/轻度创伤性脑损伤的发生率。
使用纵向、回顾性设计，通过问卷调查收集了三个赛季足球运动员（n=28）的队列数据。在使用定制下颌矫正器之前，样本的平均年龄为 17.3 岁±1.9 岁。在部署之前，进行了牙科记录和颞下颌关节评估，以及神经认知评估，包括脑震荡/轻度创伤性脑损伤史。在确定最佳下颌位置后，根据新的空间关系制作定制下颌矫正器。
三个赛季后，样本的平均年龄为 19.7 岁±2.0 岁。在使用定制下颌矫正器之前，自我报告的脑震荡/轻度创伤性脑损伤的平均发生率为 2.1±1.4 次脑震荡事件。在部署定制下颌矫正器后，脑震荡事件的数量下降到 0.11±0.3，优势比为 38.33（95%置信区间 8.2-178.6），P<0.05。
本研究的初步结果表明，定制下颌矫正器可能会降低高中足球运动员脑震荡/轻度创伤性脑损伤的发生率，但需要进行全面研究来证实这些初步发现。此外，需要进一步研究以指出定制下颌矫正器在预防脑震荡/轻度创伤性脑损伤方面的可能作用模式。
