US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
99th Medical Group, Nellis Air Force Base, Las Vegas Valley, NV, USA.
Sports Med. 2019 Aug;49(8):1217-1232. doi: 10.1007/s40279-019-01121-w.
Sport activities can account for up to one-third of all orofacial injuries. Mouthguards (MGs) have been proposed as a way to reduce these injuries.
To present a systematic review and meta-analysis of the effectiveness of MGs for the prevention of sports-related orofacial injuries and concussions.
Using specific search terms, PubMed, Ovid Embase, and the Cumulative Index to Nursing and Allied Health Literature were searched to find studies that (1) contained original quantitative data on MGs and orofacial injuries and/or concussions, (2) included groups involved in sports or exercise activities, (3) included MG users and non-MG users, and (4) provided either risk ratios (RRs) and 95% confidence intervals (95% CIs) comparing injuries among MG users and non-MG users, or data that could be used to calculate RRs and 95% CIs.
Twenty-six studies met the review criteria. Investigations employed a variety of study designs, utilized different types of MGs, used widely varying injury case definitions, and had multiple methodological weaknesses. Despite these limitations, meta-analyses indicated that the use of MGs reduced the overall risk of orofacial injuries in 12 cohort trials (summary RR [nonusers/users] = 2.33, 95% CI 1.59-3.44), and 11 trials involving self-report questionnaires (summary RR [nonusers/users] = 2.32, 95% CI 1.04-5.13). The influence of MGs on concussion incidence in five cohort studies was modest (summary RR [nonusers/users] = 1.25, 95% CI 0.90-1.74).
These data indicate that MGs should be used in sports activities where there is significant orofacial injury risk.
运动活动可能占所有口腔颌面部损伤的三分之一。口腔防护用具（MGs）已被提议作为减少这些损伤的一种方法。
对 MGs 预防运动相关口腔颌面部损伤和脑震荡的效果进行系统评价和荟萃分析。
使用特定的搜索词，在 PubMed、Ovid Embase 和 Cumulative Index to Nursing and Allied Health Literature 中进行搜索，以查找包含以下内容的研究：（1）MGs 和口腔颌面部损伤和/或脑震荡的原始定量数据，（2）包含参与运动或运动活动的群体，（3）包含 MG 用户和非 MG 用户，以及（4）提供 MG 用户和非 MG 用户之间的损伤风险比（RR）和 95%置信区间（95%CI），或可用于计算 RR 和 95%CI 的数据。
26 项研究符合审查标准。这些研究采用了多种研究设计，使用了不同类型的 MGs，采用了广泛不同的损伤病例定义，并且存在多种方法学上的缺陷。尽管存在这些局限性，荟萃分析表明，在 12 项队列研究中，使用 MGs 降低了口腔颌面部损伤的总体风险（非使用者/使用者的汇总 RR=2.33，95%CI 1.59-3.44），在 11 项涉及自我报告问卷的研究中（非使用者/使用者的汇总 RR=2.32，95%CI 1.04-5.13）。在五项队列研究中，MGs 对脑震荡发生率的影响较小（非使用者/使用者的汇总 RR=1.25，95%CI 0.90-1.74）。
这些数据表明，在存在明显口腔颌面部损伤风险的运动活动中，应使用 MGs。
