Informationen aus Orthodontie & Kieferorthopädie 2014; 46(02): 65-70
DOI: 10.1055/s-0034-1376994
Übersichtsartikel
© Georg Thieme Verlag KG Stuttgart · New York

Prävention von Zahnverletzungen durch Mundschutze

Mouthguards for Prevention of Sports Related Dental Injuries
E. Gündüz
1   Fachbereich Kieferorthopädie, Universitätszahnklinik Wien, Medizinische Universität Wien, Österreich
,
J. W. Freudenthaler
1   Fachbereich Kieferorthopädie, Universitätszahnklinik Wien, Medizinische Universität Wien, Österreich
,
G. D. Strbac
2   Fachbereich Orale Chirurgie, Universitätszahnklinik Wien, Medizinische Universität Wien, Österreich
,
H.-P. Bantleon
1   Fachbereich Kieferorthopädie, Universitätszahnklinik Wien, Medizinische Universität Wien, Österreich
› Author Affiliations
Further Information

Publication History

Publication Date:
17 June 2014 (online)

Zusammenfassung

Studien zeigen, dass unter Zahnärzten, Ärzten, Trainern und Sportlern weltweit wenig über die Möglichkeiten eines Schutzes vor sportbedingten Zahntraumata bekannt ist. Bei den meisten Sportarten besteht ein Risiko für orofaziale Verletzungen, wobei es am häufigsten zu Schädigungen der Zähne kommt. Ein im Zusammenhang mit einem Sportunfall erlittenes Schneidezahntrauma stellt hohe Anforderungen an Kieferorthopäden und Chirurgen, da es sowohl im Kindes- als auch im Erwachsenenalter einer umfassenden Diagnostik und Therapie bedarf. Speziell beim Verlust von Frontzähnen ist eine exakt aufeinander abgestimmte interdisziplinäre Zusammenarbeit besonders wichtig.

Mithilfe eines individuell angefertigten Mundschutzes lässt sich die Schwere orofazialer und dentaler Verletzungen verringern. Ein Sportlermundschutz mindert dabei die Stärke eines ­gegen die Zähne gerichteten Schlages und absorbiert die dabei übertragene Energie. Bei Kontaktsportarten ist das Tragen eines Mundschutzes sowohl beim Training als auch bei Wettkämpfen vorgeschrieben. Speziell Profisportler und Amateure mit vorstehenden oberen Schneidezähnen oder Träger von kieferorthopädischen Geräten sollten beim Sport einen Mundschutz tragen. Der vorliegende Beitrag stellt die einschlägige Literatur vor und ­erläutert die generellen Prinzipien für die Anfertigung eines individuellen Mundschutzes.

Abstract

Reports globally show that there is lack of information about prevention of sports related dental traumas in the communities of dentists, physicians, coaches and players. Most of the sports have the potential to cause orofacial injuries, and dental injuries are the most common type. Incisor trauma caused by accidental sports related dental injuries, places high demands on physicians in orthodontics, maxillofacial – and oral – surgery and requires comprehensive diagnostic and treatment in childhood and adulthood. Effective interdisciplinary teamwork is absolutely essential, especially when anterior teeth have been lost. Custom-made mouthguards reduce the severity of orofacial and dental injuries. The purpose of a sports mouthguard is to reduce the stresses and absorb the energy generated by the impact to the teeth. Mouthguards are mandatory in contact sports, and must be used during practice – and game – days. Especially professional and/or amateur sportsmen and children with protruded upper incisors and orthodontic braces should use a mouthguard. This article reviews the literature and explains the general principles of fabricating a custom-made mouthguard.

 
  • Literatur

  • 1 Dorney B. Mouthguards are not one size fits all. Inside Dentistry 2013; 9: 92-94
  • 2 Kumamoto DP, Maeda Y. A literature review of sports-related orofacial trauma. Gen Dent 2004; 52: 270-280
  • 3 Davis GT, Knott SC. Dental trauma in Australia. Aust Dent J 1984; 29: 217-221
  • 4 Wriedt S, Martin M, Al-Nawas B et al. Long-term effects of traumatic injuries to incisors and periodontal tissues during childhood: a retrospective study. J Orofac Orthop 2010; 71: 318-329
  • 5 Andrade RA, Evans PL, Almeida AL et al. Prevalance of dental trauma in Pan American games athletes. Dent Traumatol 2010; 26: 248-253
  • 6 Andreasen FM, Andreasen JO. Extrusive luxation and lateral luxation. In: Andreasen JO, Andreasen FM, Andersson L. (eds.) Textbook and Color Atlas of Traumatic Injuries to the Teeth. 4th ed. Blackwell; Oxford: 2007: 411-427
  • 7 Bauss O, Röhling J, Schwestka-Polly R. Prevalence of traumatic injuries to the permanent incisors in candidates for orthodontic treatment. Dent Traumatol 2004; 20: 61-66
  • 8 Lee R, Barrett EJ, Kenny DJ. Clinical outcomes for permanent incisor luxations in a pediatric population. II. Extrusions. Dent Traumatol 2003; 19: 274-279
  • 9 Humphrey JM, Kenny DJ, Barret EJ. Clinical outcomes for permanent incisor luxations in a pediatric population. I. Intrusion. Dent Traumatol 2003; 19: 266-273
  • 10 Jagger RG, Abbasbhai A, Patel S et al. The prevalence of dental, facial, and head injuries sustained by schoolboy rugby players. A pilot study. Prim Dent Care 2010; 17: 143-146
  • 11 Andreasen JO, Andreasen FM. Avulsions. In: Andreasen JO, Andreasen FM, Andersson L. (eds.) Textbook and Color Atlas of Traumatic Injuries to the Teeth. 4th ed. Blackwell; Oxford: 2007: 444-488
  • 12 Barret EJ, Kenny DJ. Survival of avulsed permanent maxillary incisors in children following delayed replantation. Endod Dental Traumatol 1997; 13: 269-275
  • 13 Andreasen JO, Borum MK, Jacobsen HL et al. Replantation of 400 avulsed permanent incisors. 1. Diagnosis of healing complications. Endod Dent Traumatol 1995; 11: 51-58
  • 14 Lesić N, Seifert D, Jerolimov V. Orofacial injuries reported by junior and senior basketball players. Coll Antropol 2011; 35: 347-352
  • 15 Soporowski NJ, Tesini DA, Weiss AI. Survey of orofacial sports-related injuries. J Mass Dent Soc 1994; 43: 16-20
  • 16 Kvittem B, Hardie NA, Roettger M et al. Incidence of orofacial injuries in high school sports. J Public Health Dent 1998; 58: 288-293
  • 17 Australian Dental Association . The Fabrication, Use and Maintenance of Sports Mouthguards. Australian Dental Association Inc.; St Leonards: 2013
  • 18 Hickey JC, Morris AL, Carlson LD et al. The relation of mouth protectors to cranial pressure and deformation. J Am Dent Assoc 1967; 74: 735-740
  • 19 Takeda T, Ishigami K, Hoshina S et al. Can mouthguards prevent mandibular bone fractures and concussions? A laboratory study with an artificial skull model. Dent Traumatol 2005; 21: 134-140
  • 20 Finch C, Braham R, McIntosh A et al. Should football players wear custom fitted mouthguards? Results from a group randomised controlled trial. Inj Prev 2005; 11: 242-246
  • 21 Cohenca N, Roges RA, Roges R. The incidence and severity of dental trauma in intercollegiate athletes. J Am Dent Assoc 2007; 138: 1121-1126
  • 22 McIntosh AS, McCrory P, Comerford J. The dynamics of concussive head impacts in rugby and australian rules football. Med Sci Sports Exerc 2000; 32: 1980-1984
  • 23 Daneshvar DH, Baugh CM, Nowinski CJ et al. Helmets and mouthguards: the role of personal equipment in preventing sport-related concussions. Clin Sports Med 2011; 30: 145-163
  • 24 Labella CR, Smith BW, Sigurdsson A. Effect of mouthguards on dental injuries and concussions in college basketball. Med Sci Sports Exerc 2002; 34: 41-44
  • 25 Marshall SW, Loomis DP, Waller AE et al. Evaluation of protective equipment for prevention of injuries in rugby union. Int J Epidemiol 2005; 34: 113-118
  • 26 Wisniewski JF, Guskiewicz K, Trope M et al. Incidence of cerebral concussions associated with type of mouthguard use in college football. Dent Traumatol 2004; 20: 143-149
  • 27 Bourguignon C, Sigurdsson A. Preventive strategies for traumatic dental injuries. Dent Clin North Am 2009; 53: 729-749
  • 28 Gardiner DM, Ranalli DN. Attitudinal factors influencing mouthguard utilization. Dent Clin North Am 2000; 44: 53-65
  • 29 Emerich K, Nadolska-Gazda E. Dental trauma, prevention and knowledge concerning dental first-aid among Polish amateur boxers. J Sci Med Sport 2013; 16: 297-301
  • 30 Cummins NK, Spears IR. The effect of mouthguard design on stresses in the tooth-bone complex. Med Sci Sports Exerc 2002; 34: 942-947
  • 31 Miura J, Maeda Y. Biomechanical model of incisor avulsion: a preliminary report. Dent Traumatol 2008; 248$9: 454-457
  • 32 Maeda Y, Kumamoto D, Yagi K et al. Effectiveness and fabrication of mouthguards. Dent Traumatol 2009; 25: 556-564
  • 33 Knapik JJ, Marshall SW, Lee RB et al. Mouthguards in sport activities: history, physical properties and injury prevention effectiveness. Sports Med 2007; 37: 117-144
  • 34 Takeda T, Ishigami K, Handa J et al. Does hard insertion and space improve shock absorption ability of mouthguard?. Dent Traumatol 2006; 22: 77-82
  • 35 Westerman B, Stringfellow PM, Eccleston JA. Forces transmitted through EVA mouthguard materials of different types and thickness. Aust Dent J 1995; 40: 389-391
  • 36 Westerman B, Stringfellow PM, Eccleston JA. Beneficial effects of air inclusions on the performance of ethylene vinyl acetate (EVA) mouthguard material. Br J Sports Med 2002; 36: 51-53
  • 37 Del Rossi G, Lisman P, Signorile J. Fabricating a better mouthguard. Part II: the effect of color on adaptation and fit. Dent Traumatol 2008; 24: 197-200
  • 38 Yonehata Y, Maeda Y, Machi H et al. The influence of working cast residual moisture and temperature on the fit of vacuum-forming athletic mouth guards. J Prosthet Dent 2003; 89: 23-27
  • 39 Del Rossi G, Leyte-Vidal MA. Fabricating a better mouth-guard. Part I: factors influencing mouthguard thinning. Dent Traumatol 2007; 23: 149-154
  • 40 Yamada J, Maeda Y. Thermoforming process for fabricating oral appliances: influence of heating and pressure application timing on formability. J Prosthodont 2007; 16: 452-456
  • 41 Nishida J, Maeda Y, Machi H et al. Considerations on method of mouthguard fabrication – temperature for sheet removal from working cast. Jpn J Sports Dent 2006; 9: 25-28
  • 42 Machi H, Maeda Y, Tsugawa T et al. Influence of cooling methods for mouthguard fabrication on the deformation with time. Jpn J Sports Dent 2006; 9: 29-32
  • 43 Yamada J, Maeda Y, Satoh H et al. Anterior palatal mouthguard margin location and its effect on shock-absorbing capability. Dent Traumatol 2006; 22: 139-144
  • 44 Westerman B, Stringfellow PM, Eccleston JA. Forces transmitted through EVA mouthguard materials of different types and thickness. Aust Dent J 1995; 40: 389-391
  • 45 Kenyon BJ, Loos LG. Comparing comfort and wearability between Type III single-layered and double-layered EVA mouthguards. Gen Dent 2005; 53: 261-264
  • 46 Geary JL, Kinirons MJ. Post thermoforming dimensional changes of ethylene vinyl acetate used in custom-made mouthguards for trauma prevention – a pilot study. Dent Traumatol 2008; 24: 350-355
  • 47 Waked EJ, Lee TK, Caputo AA. Effects of aging on the dimensional stability of custom-made mouthguards. Quintessence Int 2002; 33: 700-705
  • 48 Miura J, Maeda Y, Machi H et al. Mouthguards: difference in longitudinal dimensional stability between single- and double-laminated fabrication techniques. Dent Traumatol 2007; 23: 9-13
  • 49 McClelland C, Kinirons M, Geary L. A preliminary study of patient comfort associated with customised mouthguards. Br J Sports Med 1999; 33: 186-189
  • 50 Maeda Y, Machi H, Tsugawa T. Influences of palatal side design and finishing on the wearability and retention of mouthguards. Br J Sports Med 2006; 40: 1006-1008
  • 51 Maeda Y, Yonehata Y, Satoh H. Mouthguard retention: is design or accuracy of fit more critical?. Quintessence Int 2009; 40: e13-e18
  • 52 Takeda T, Ishigami K, Nakajima K et al. Are all mouthguards the same and safe to use? Part 2. The influence of anterior occlusion against a direct impact on maxillary incisors. Dent Traumatol 2008; 24: 360-365
  • 53 Tsugawa T, Maeda Y, Yamada J. Influence of occlusal surface morphology of mouthguard on players: a study with cross-over design and visual analog scale. Jpn J Sports Dent 2005; 8: 25-30
  • 54 Newsome PR, Tran DC, Cooke MS. The role of the mouthguard in the prevention of sports-related dental injuries: a review. Int J Paediatr Dent 2001; 11: 396-404
  • 55 Kvittem B, Hardie NA, Roettger M et al. Incidence of orofacial injuries in high school sports. J Public Health Dent 1998; 58: 288-293
  • 56 Salam S, Caldwell S. Mouthguards and orthodontic patients. J Orthod 2008; 35: 270-275
  • 57 Croll TP, Castaldi CR. Custom sports mouthguard modified for orthodontic patients and children in the transitional dentition. Pediatr Dent 2004; 26: 417-420
  • 58 Maeda Y, Matsuda S, Tsugawa T et al. A modified method of mouthguard fabrication for orthodontic patients. Dent Traumatol 2008; 24: 475-478
  • 59 Pacheco G, Clemente MP, Vasconcelos M et al. The orthodontic sports protection appliance. J Clin Orthod 2010; 44: 41-44
  • 60 McNutt T, Shannon Jr SW, Wright JT et al. Oral trauma in adolescent athletes: a study of mouth protectors. Pediatr Dent 1989; 11: 209-213
  • 61 Maestrello-deMoya MG, Primosch RE. Orofacial trauma and mouth-protector wear among high school varsity basketball players. ASDC J Dent Child 1989; 56: 36-39
  • 62 Cetinbaş T, Sönmez H. Mouthguard utilization rates during sport activities in Ankara, Turkey. Dent Traumatol 2006; 22: 127-132
  • 63 Onyeaso CO. Secondary school athletes: a study of mouthguards. J Natl Med Assoc 2004; 96: 240-245
  • 64 Keçeci AD, Cetin C, Eroglu E et al. Do custom-made mouth guards have negative effects on aerobic performance capacity of athletes?. Dent Traumatol 2005; 21: 276-280
  • 65 von Arx T, Flury R, Tschan J et al. Exercise capacity in athletes with mouthguards. Int J Sports Med 2008; 29: 435-438
  • 66 Francis KT, Brasher J. Physiological effects of wearing mouthguards. Br J Sports Med 1991; 25: 227-231
  • 67 Bourdin M, Brunet-Patru I, Hager PE et al. Influence of maxillary mouthguards on physiological parameters. Med Sci Sports Exerc 2006; 38: 1500-1504
  • 68 Filippi A, Pohl Y. Der Zahnschutz: Prävention von Zahnunfällen im Sport. Schweiz Monatsschr Zahnmed 2001; 111: 1074-1085
  • 69 Flores MT, Andersson L, Andreasen JO et al. International Association of Dental Traumatology. Guidelines for the management of traumatic dental injuries. II Avulsion of permanent teeth. Dent Traumatol 2007; 23: 130-136
  • 70 Kugel B, Zeh D, Müssig E. Incisor trauma and the planning of orthodontic treatment. J Orofac Orthop 2006; 67: 48-57
  • 71 Shulman JD, Peterson J. The association between incisor trauma and occlusal characteristics in individuals 8–50 years of age. Dent Traumatol 2004; 20: 67-74
  • 72 Brahim JS. Dental implants in children. Oral Maxillofac Surg Clin North Am 2005; 17: 375-381
  • 73 Huck L, Korbmacher H, Niemeyer K et al. Distraction osteogenesis of ankylosed front teeth with subsequent orthodontic fine adjustment. J Orofac Orthop 2006; 67: 297-307
  • 74 Kawanami M, Andreasen JO, Borum MK et al. Infraposition of ankylosed permanent maxillary incisors after replantation related to age and sex. Endod Dent Traumatol 1999; 15: 50-56
  • 75 Maestrello CL, Mourino AP, Farrington FH. Dentists’ attitudes towards mouthguard protection. Pediatr Dent 1999; 21: 340-346
  • 76 Boffano P, Boffano M, Gallesio C et al. Rugby atheletes’ awareness and compliance in the use of mouthguards in the North West of Italy. Dent Traumatol 2012; 28: 210-213
  • 77 Hersberger S, Krastl G, Kühl S et al. Dental injuries in water polo, a survey of players in Switzerland. Dent Traumatol 2012; 26: 287-290
  • 78 Frontera RR, Zanin L, Ambrosano GM et al. Orofacial trauma in Brazilian basketball players and level of information concerning trauma and mouthguards. Dent Traumatol 2011; 27: 208-216
  • 79 Tulunoglu I, Ozbek M. Oral trauma, mouthguards awareness, and use in two contact sports in Turkey. Dent Traumatol 2006; 22: 242-246
  • 80 Perunski S, Lang B, Pohl Y et al. Level of information concerning dental injuries and their prevention in Swiss basketball – a survey among players and coaches. Dent Traumatol 2005; 21: 195-200
  • 81 Levin L, Friedlander LD, Geiger SB. Dental and oral trauma and mouthguard use during sport activities in Israel. Dent Traumatol 2003; 19: 237-242