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Mandibular orthotics in the prevention of brain injury in football players

October 30, 2011 Leave a comment

I’m grateful to Dhru Shah for the link to this paper by Prof Dave Singh of the SMILE Foundation, California- full title of which is:

“Customized mandibular orthotics in the prevention of concussion/mild traumatic brain injury in football players: a preliminary study”

Prof Dave Singh

Prof Dave Singh

It’s an American paper, so it refers to American Football, not “soccer”, but it’s interesting nonetheless I think, especially as I make appliances very similar to this for a number of Premiership footballers (soccer players) and the main benefit for them seems to be a reduction in pelvic strain and hamstring injuries.

Here’s the abstract:

Abstract

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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

Link to full paper HERE – you might need to log in or register with Dentinal Tubules to read this.

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2012 American Equilibration Society Meeting, Feb 22nd/23rd, Chicago

October 27, 2011 Leave a comment

Nice to see so many big names back on the list of speakers for the 2012 AES meeting, looks like a great programme.

“Evidenced Based TMD: Paradigms for a New Decade”
http://goo.gl/x4aPm

Programme:
Wednesday February 22, 2012
7:00 – 8:00 AM: Registration and Continental Breakfast
8:00 – 8:20 AM: Opening Ceremony
8:20 – 8:30 AM: Introductions
Panel 1: Orofacial Pain: Mechanisms and Treatment Considerations
8:30 – 9:15 AM: Evidence: What is the Value? – Peter Baragona, DMD
9:15 – 10:00 AM: Orofacial Pain: Looking at the Big Picture – Jeffrey Okeson, DMD
10:00 – 10:30 AM: Break with Exhibitors
10:30 – 11:15 AM: Glia as the “Bad Guys” in Dysregulating Pain & Opioid Actions: Clinical Implications – Linda Watkins, PhD
11:15 AM – 12:00 PM: Psychological Considerations in the Management of TMD: Red Flags – Charles Carlson, PhD
12:00 – 12:15 PM: Morning Panel Discussion
12:15 – 1:30 PM: Lunch
Panel 2: Occlusion, TMJ Imaging, and Arthrocentesis
1:30 – 2:15 PM: Functional Occlusal Assessment: The 3 Ps –John Kois, DDS, MS
2:15 – 3:00 PM: Intracapsular Disorders: Imaging Considerations – Gerhard Undt, DMD, MD
3:00 – 3:30 PM: Break with Exhibitors
3:30 – 4:15 PM: Arthrocentesis: A Technique for the Treatment of Adhesive TMJ Disorders – Steven Shall, DDS and Matthew Lark, DDS
4:15 – 4:45 PM: Afternoon Panel Discussion
6:30 – 8:30 PM: President’s Reception
Thursday February 23, 2012
7:00 – 8:15 AM: Registration and Continental Breakfast
7:15 – 8:15 AM: New Member Breakfast
8:15 – 8:30 AM: Introductions
Panel 3: Sleep and Medical considerations of Orofacial Pain
8:30 – 9:15 AM: The Efficacy of Hard Splint in Treating TMD: Results of a Systematic Review – James Fricton, DDS
9:15 – 10:00 AM: Medical Conditions Posing as TMD – Donald R. Tannenbaum, DDS
10:00 – 10:30 AM: Break with Exhibitors
10:30 – 11:15 AM: Daytime Bruxism and the TMD/OFP Patient – Alan G. Glaros, PhD
11:15 AM – 12:00 PM: Sleep Medicine and The Dentist – Dennis R. Bailey, DDS
12:00 to 12:15 PM: Morning Panel Discussion
12:15 to 1:45 PM: Lunch and AES Membership Meeting
Panel 4: The Restoraive TMD Connection
1:45 – 2:30 PM:
TMD Related Topics – Frank Spear, DDS, MS
2:30 – 3:15 PM: Advanced Implant Reconstruction for the Parafunctional Patient – Ricardo Mitrani, DDS, MSD
3:15 – 3:45 PM: Break with
:45 – 4:30 PM: Is Occlusion Dead or Just Sleeping it Off? , Dr. Jeffrey Rouse
4:30 – 5:00 PM: Afternoon Panel Discussion
5:00 – 5:15 PM: Closing Remarks

Playing with Vertical Dimension? Know the Rules!

October 9, 2011 1 comment

There’s a great position paper on the subject of when, how and by how much it is OK to change the Vertical Dimension of Occlusion (VDO) from M. Rebibo et al of the Université de la Méditerranée, Marseille HERE

There is a discussion of the myths around whether one can or cannot increase or decrease VDO and a very useful chart (Table 2) showing the effect that a change in height at the molars will have on position of the incisors and the incisal pin of the articulator. There are also several very interesting case presentations, including the use of occlusal equilibration alone to close down a significant anterior open bite. Please read the article and comment below if you have any questions of observations.

I might put a few similar cases of my own up if there’s sufficient interest, or if you have some photos and a case report you are prepared to share and have discussed please send them to me and I will publish them on here for you.

Andy