Use Of Headgear Research Articles

Change in the vertical dimension of Class II Division 1 patients after use of cervical or high-pull headgear.

The goals of this study were to compare the effects thatcervical and high-pull headgear have on the vertical dimensions in Class II Division 1 patients during phase 1 treatment and to compare these effects with untreated predicted growth for the sample population. Pretreatment and posttreatment cephalometric radiographs of children who had undergone Class II Division 1 correction with cervical (n=22) or high-pull headgear (n=19) were analyzed for the measurements that describe the changes in the vertical component of growth and mandibular position. The groups were matched for age (mean, 9±2.5years), treatment time (mean, 14months), malocclusion, and similar skeletal features. The groups were compared with each other and also with an untreated growth model. Treatment with cervicalheadgear resulted in smaller increases in measurements that describe the vertical dimension than with high-pull headgear. Cervical headgear showed more favorable changes in mandibular growth that were statistically significant when compared with the untreated growth models. In this study, the cervical headgear showed more control over the vertical dimension and produced more favorable changes in mandibular position by normalizing the occlusal plane. Compared with the untreated growth model, cervical headgear worked synergistically with growth to produce more optimal changes in mandibular position.

Minimizing Head Acceleration in Soccer: A Review of the Literature.

Physicians and healthcare professionals are often asked for recommendations on how to keep athletes safe during contact sports such as soccer. With an increase in concussion awareness and concern about repetitive subconcussion, many parents and athletes are interested in mitigating head acceleration in soccer, so we conducted a literature review on factors that affect head acceleration in soccer. We searched electronic databases and reference lists to find studies using the keywords 'soccer' OR 'football' AND 'head acceleration'. Because of a lack of current research in soccer heading biomechanics, this review was limited to 18 original research studies. Low head-neck segment mass predisposes athletes to high head acceleration, but head-neck-torso alignment during heading and follow-through after contact can be used to decrease head acceleration. Additionally, improvements in symmetric neck flexor and extensor strength and neuromuscular neck stiffness can decrease head acceleration. Head-to-head impacts and unanticipated ball contacts result in the highest head acceleration. Ball contacts at high velocity may also be dangerous. The risk of concussive impacts may be lessened through the use of headgear, but headgear may also cause athletes to play more recklessly because they feel a sense of increased security. Young, but physically capable, athletes should be taught proper heading technique in a controlled setting, using a carefully planned progression of the skill.

Rugby headgear and concussion prevention: misconceptions could increase aggressive play.

OBJECTIVE Multiple studies have illustrated that rugby headgear offers no statistically significant protection against concussions. However, there remains concern that many players believe rugby headgear in fact does prevent concussions. Further investigation was undertaken to illustrate that misconceptions about concussion prevention and rugby headgear may lead to an increase in aggressive play. METHODS Data were constructed by Internet survey solicitation among United States collegiate rugby players across 19 teams. Initial information given was related to club, age, experience, use of headgear, playing time, whether the rugger played football or wrestling in high school, and whether the player believed headgear prevented concussion. Data were then constructed as to whether wearing headgear would increase aggressive playing style secondary to a false sense of protection. RESULTS A total of 122 players responded. All players were male. The average player was 19.5 years old and had 2.7 years of experience. Twenty-three of 122 players (18.9%) wore protective headgear; 55.4% of players listed forward as their primary position. Overall, 45.8% (55/120) of players played 70-80 minutes per game, 44.6% (54/121) played football or wrestled in high school, 38.1% (45/118) believed headgear prevented concussions, and 42.2% (51/121) stated that if they were using headgear they would be more aggressive with their play in terms of running or tackling. Regression analysis illustrated that those who believed headgear prevented concussions were or would be more likely to engage in aggressive play (p = 0.001). CONCLUSIONS Nearly 40% of collegiate rugby players surveyed believed headgear helped to prevent concussions despite no scientific evidence that it does. This misconception about rugby headgear could increase aggressive play. Those who believed headgear prevented concussion were, on average, 4 times more likely to play with increased aggressive form than those who believed headgear did not prevent concussions (p = 0.001). This can place all players at increased risk without providing additional protection. Further investigation is warranted to determine if headgear increases the actual measured incidence of concussion among rugby players in the United States.

Prohibiting Headgear for Safety in Amateur Boxing? Opinion of the Canadian Boxing Community: an Online Poll.

BackgroundIn 2013, the Amateur International Boxing Association (AIBA) introduced a rule banning headgear for male-senior open class boxers during competition. The AIBA has defended the rule change as motivated by safety and supported by internal unpublished studies. As a result, in 2018, the AIBA plans to universally prohibit headgear in competition: for all competitors (male and female), all ages and all levels. Within Canada, this ruling has generated controversy in the boxing community, yet there has been no overall measure of opinion.MethodsTo address this, we instituted a voluntary, anonymous, online open-access poll to allow members of the boxing community to express their stance on headgear use in competition.ResultsIn total, 636 responses were received. A total of 71.5 % of Canadian respondents believed headgear should be mandatory at all levels. Only 5.8 % agreed that headgear should be prohibited, as planned for 2018. Estimating results on a representative breakdown of boxing membership in Canada, a similar pattern emerged, whereby 68.2 % concurred with mandatory headgear while only 4.95 % supported its prohibition. Parents of boxers were almost unanimously against banning headgear, stating they would change sports as a result. Similarly, only 1.7 % of women believed headgear should be prohibited.ConclusionsThe consensus of the Canadian boxing community largely opposes the rule changes that the AIBA has implemented. The results highlight risks posed to the long-term viability of the sport, if significant grassroots safety concerns are disregarded.

Extra-oral Appliances in Orthodontic Treatment.

Extra-oral appliances are used in orthodontics to apply forces to the jaws, dentition or both and the popularity of these appliances is cyclical. Although the use of retraction headgear for the management of Class II malocclusion has declined over the last 20 years with the refinement of non-compliance approaches, including temporary anchorage devices, headgear still has a useful role in orthodontics. The use of protraction headgear has increased as more evidence of its effectiveness for the treatment of Class lIl malocclusion has become available. This paper describes the mechanics and contemporary uses of headgear in orthodontics for primary care dentists and specialist orthodontists. CPD/CLINICAL RELEVANCE: Extra-oral appliances have specific uses in orthodontic biomechanics. Clinicians using retraction headgear and protraction headgear should be familiar with their clinical indications, the potential problems and how these can be avoided.

Prevalence of injuries in competitive boxers: A retrospective study

Background and Purpose: Several changes have occurred in Olympic boxing in last few decades. In March 2013, the use of headgear was banned to reduce the incidence of cerebral concussion. This reduced the concussion rate to 0.17% but affected the boxer's psychology and also the way boxers and coaches prepare. The boxers feel safer to take the risk wearing headgear that they simply would not do if they are not wearing one. Furthermore, three fatal incidents of professional boxing make it important to find out the prevalence of injuries in competitive boxers. The aim of this study was to find out the prevalence of injuries in national level boxers of India that occurred during the bout or training. Materials and Methods: The study was conducted as a retrospective and was carried on 54 national level boxers ranging between 11 and 35 years. Results: Fifty-four boxers reported with 820 injuries in 2 years. Each boxer sustained 15.18 injuries in 2 years on an average, i.e., 7.59 injuries/year on an average. The injury rate per boxer was 9.64/1000 h of training. The injuries of head and face (42.92%) are more frequent followed by the injuries of upper limb (33.90%). Soft tissue lacerations and contusions are common. Furthermore, frequent low back pain (5%), calf cramp (3.41%), and high ankle sprain (4.4%) were reported because of training. Conclusions: The study suggests that the most common type of injuries in boxers is the soft tissue lacerations and contusions, and the most common site of injury is the head and face region. Common injuries due to training are low back pain, calf cramp, and high ankle sprain.

Considerations for the performance requirements and technical specifications of soft-shell padded headgear

Laboratory and epidemiological research in Australian football, rugby league and rugby union has demonstrated that commercially available soft-shell padded headgear is currently ineffective in reducing the risk of concussion. However, modified headgear studies have demonstrated that significant improvements in impact energy attenuation performance are possible with small design changes, such as increases in foam density and thickness. A literature review of the design, performance and use of headgear in Australian football, rugby league and rugby union was conducted. A total of 23 articles were identified using primary and secondary search strategies, which included epidemiological field studies, laboratory impact test studies and studies investigating the behaviours and attitudes of players. The results of the review were synthesised and used to identify injury reduction objectives and appropriate design criteria. The need for a headgear standard was identified and performance requirements were discussed, which drew upon human tolerance and sports-specific head impact exposure data. Usability and behavioural issues, which require consideration during the design process, were also assessed.

Current trends in headgear use for the treatment of Class II malocclusions.

To investigate American and Canadian orthodontists' opinions and perceptions on the use of headgear in the treatment of Class II malocclusions. An online survey was sent to randomly chosen orthodontists (n = 1000). The study was completed by 948 orthodontists; 62% of the orthodontists indicated that they were using headgear in their practice. Those who were not using the appliance (38%) reported that this was mainly due to the availability of better Class II correctors in the market and lack of patient compliance. Of those who use headgear, 24% indicated that the emphasis on headgear use during their residency was an influential aspect of their decision making (P < .05). Nearly a quarter of those who do not use headgear reported that learning about other Class II correctors through continuing education courses was an important factor (P < .05). There was no difference between the headgear users and nonusers in the year and location of practice. Compared with previous studies, this study showed a decline in the use of headgear among orthodontists. Despite a decline, more than half of the orthodontists (62%) believe headgear is a viable treatment. Availability of Class II correctors in the market and familiarity with these appliances though continuing education courses are the reasons for the remaining 38% of orthodontists to abandon use of the headgear.

Because not all blows to the head are the same

This case illustrates a specific medical risk with this rule change where an amateur boxer suffered an acute subdural haematoma following an Amateur International Boxing Association (AIBA) sanctioned event. Boxing,...

Is there an Increased Incidence of Cervical Degenerative Disease in Surgeons who use Loupes and a Headlight?

Background context: The ergonomic effects of headgear on spine surgeons are poorly understood. Assessment of cervical degenerative disease resulting from prolonged use of loupes and/or headlights was performed via data drawn from spine surgeons. Methods: A questionnaire was distributed to 54 fellowship trained spine surgeons. Part one assessed the current level of neck pain compared to prior to residency. The amount of exposure to headgear usage was determined using this formula for headgear hours: Headgear Hours=Years in practice * Number of months per year of headgear usage * Number of cases per month * Number of hours per case. Part two assessed whether a specific diagnosis or treatment associated with neck symptoms was rendered or received. The respondents were placed into two groups for comparison: Group A (non- or infrequent users of headgear), Group B (frequent users). Results: 28 of the 41 (68%) surgeons in Group B experienced worsening of their neck symptoms since the start of their residency versus 5 of the 13 (38%) in Group A (p=0.027). Only 1 surgeon from group A was diagnosed with a degenerative cervical disorder compared to 14 from Group B. Conclusions: Neck pain among spine surgeons is not uncommon. Poor ergonomics during surgery combined with frequent headgear use may contribute to increased neck pain and cervical degenerative disease.

Injuries can be prevented in contact flag football!

This original prospective cohort study was conducted in an attempt to significantly reduce the incidence and the severity of injuries in an intervention cohort as compared to a two-season historical cohort, and to provide recommendations to the International Federation of Football (IFAF) pertaining to prevention measures to make the game safer. A total of 1,260 amateur male (mean age: 20.4±3.9years) and 244 female (mean age: 18.5±1.7years) players participated in the study. Four prevention measures were implemented: the no-pocket rule, self-fitting mouth guards, ankle braces (for those players with recurrent ankle sprains) and an injury treatment information brochure. All time-loss injuries sustained in game sessions were recorded by the off-the-field medical personnel and followed up by a more detailed phone injury surveillance questionnaire. There was a 54% reduction in the total number of injuries and a significant reduction in the incidence rate and incidence proportion between the intervention cohorts as compared to the historical cohort (p<0.001). There was no statistically significant reduction in the number of injuries in any of the body parts, except for in hand/wrist injuries related to the use of pockets (p<0.001), as well as the severity of mild-moderate injuries (p<0.05). This study provided evidence that hand/wrist injuries can be significantly reduced in flag football. Recommendations to the IFAF include strict enforcement of the no-pocket rule, the use of soft headgear, comfortable-fitting ankle braces and mouth guards and additionally, to change game rules concerning blocking. II.

Classification and treatment of Class II subdivision malocclusions

Patients with Class II subdivision malocclusions are a challenge for clinicians because reestablishing symmetry in 1 arch or both arches is often a treatment goal. In patients with mandibular skeletal asymmetry, surgery is often a treatment option. However, patients may be unwilling to undergo surgery, and other options might have to be considered. The aim of this study was to evaluate the etiologies and outcomes of Class II subdivision patients treated at the University of Washington graduate orthodontic clinic in Seattle from 1995 through2011. A search of patients treated between 1995 and 2011 resulted in the identification of 110 consecutively treated Class II subdivision subjects with complete records. Ninety-eight subjects could be classified into 1 of 3 groups, based on midline position and dental or skeletal etiology. Initial and final models were used to measure the peer assessment rating scores, midlines, overjet, overbite, and molar positions. Initial and final cephalograms were traced and measured. Charts were reviewed for information regarding treatment. Twenty-five percent of the 98 subjects had their maxillary and mandibular midlines coincident with the facial midline; their asymmetries were due to a maxillary posterior dental asymmetry. Another 15% had maxillary midlines deviated from their facial midlines, caused by maxillary anterior and posterior dental asymmetry. About 50% of the subjects had mandibular midlines that were not coincident with their facial midlines, and most of them exhibited some degree of mandibular skeletal asymmetry. Over the past 15 years, treatment strategies used at the University of Washington indicated trends toward less surgery, fewer extractions, less use of headgear, and more reliance on fixed functional appliances. Ideal correction of midlines was not always achieved, especially in patients with mandibular skeletal asymmetry, with undercorrection occurring more commonly than overcorrection. Final peer assessment rating scores were comparable, regardless of the origin of the asymmetry or the extractions status. Mandibular incisor proclination was increased when fixed functional appliances were used, as well as when a Class I molar relationship was the target for the Class II side. Class II subdivision malocclusions were grouped into 3 main categories; the largest category was mandibular asymmetry. Interesting trends were noted with regard to treatment strategies, midline and molar corrections, and mandibular incisor proclination.

IMPACT ATTENUATION OF PROTECTIVE BOXING AND TAEKWONDO HEADGEAR

BackgroundTo date, only one study reported the impact attenuation of protective taekwondo headgear. Although Olympic boxing has discontinued the use of headgear, similarities in designs are thought to provide a...

INJURIES CAN BE PREVENTED IN CONTACT FLAG FOOTBALL!

BackgroundEpidemiological studies in American Flag Football have revealed a high incidence of injuries. No previous study has attempted to prevent injuries.ObjectiveTo significantly reduce the incidence and the severity of injuries...

Impact-absorbing Materials in Reducing Brain Vibration Caused by Ball-to-head Impact in Soccer

There has been a long debate among researchers on whether soccer heading is capable of causing brain trauma. A recent study suggests that headings exceeding a threshold level of 855 to 1,550 per year, results in microstructural abnormalities in the brain's white matter. This shows that brain trauma is caused by cumulative effect of repetitive headings. The use of protective headgear is one of the suggested preventive measures to protect the brain especially for younger players. Researchers have tested several commercial headgears and found that they are only effective in head-to-head impact, but ineffective in attenuating impact caused by heading. This is due to the fact that soccer ball is compliant in nature relative to the head. The aim of this study is to investigate materials that can be utilised to minimise the acceleration of the brain caused by soccer heading. A vertical drop ball test was conducted on an instrumented dummy skull. The inner cavity of the skull is filled with ultrasound gel that represents the brain. Six impact-absorbing materials were tested to determine the most effective material that reduces the acceleration of the brain substitute. The speed of the ball before and after impact as well as impact duration were measured using high-speed camera. Coefficient of restitution was calculated to ensure the material is not only capable of reducing the brain acceleration, but also maintains heading performance. It was found that polymer kneepad foam is the most effective material that minimises the acceleration of brain substitute whilst maintaining the speed of the ball after impact.

Mouth Guard - A Dental Gift for Sports

s www.ijhrs.com Sports dentistry deals with the correct diagnosis, prevention and treatment of sports related orofacial injuries and related oral diseases, as well as the collection and assessment of information on dental athletic injuries and the encouragement of research for prevention of such injuries which involves orthodontic correction of protruding anterior teeth and using facemasks and mouth guards while taking part in sports. Several functions and types of mouth guards have been explained in this article. Different studies have provided enough evidence that the use of specific mouth guard headgear or helmets reduces the risk of facial trauma. Currently there is a very limited data regarding sports dentistry in India. There is no dental institute in India that have course on Sports Dentistry. The Sports Authority of India does not have any policy on Sports Dentistry. Dentists should educate the general public, parents/guardians, staffs of emergency department, coaches and athletes regarding health risks and benefits of mouth guards including the importance of emergency care for orofacial injuries.

The management of palatally displaced maxillary canines: Considerations and challenges

This article opens with a recognition that ectopic maxillary canines may lead to frank impactions requiring a coordinated and multidisciplinary approach to their surgical/orthodontic management and the potential benefit of managing canine ectopia, particularly palatally displaced canines, more conservatively in their pre-eruptive ectopic positions in an effort to avoid impaction. The prevalence of palatally displaced canines (PDC) in various populations and corroborating as well as competing or conflicting opinions of etiology are briefly reviewed. Some of the traditional as well as relatively newer strategies and associated investigations of managing pre-eruptive palatally displaced maxillary canines are discussed, and the imaging techniques utilized to identify and locate ectopic maxillary canines are also discussed. Early detection of ectopic canines must include at the very least panoramic and/or periapical radiographs as part of any mixed dentition orthodontic examination and assessment. The sometimes unpredictable continued path of the ectopic maxillary canine poses clinical and ethical issues to the clinician when developing treatment strategies as part of any overall orthodontic treatment plan for young patients presenting with maxillary canine ectopia. The need for more thoughtful and carefully designed randomized clinical trials with a greater emphasis on subject sample scrutiny is strongly recommended to add much needed clarity to the clinical management of ectopic maxillary canines.

Maxillary Growth After the Use of Protraction Head Gear in Conjunction With Presurgical Orthopedics and Gingivoperiosteoplasty for Complete Bilateral Cleft Lip and Alveolus Patients

Maxillary development is often inadequate in bilateral cleft patients. The use of presurgical orthopedics (PSO) and gingivoperiosteoplasty (GPP) may promote bone formation at the alveolar cleft, but can also have detrimental effects on maxillary development. Our objective was to investigate the effect of PSO and GPP on maxillary development in bilateral cleft lip and alveolus (BCLA) patients. We had 3 complete BCLA patients who had received PSO. All patients underwent cheiloplasty and GPP simultaneously. At 4 years, maxillary protraction head gear was used as part of the protocol. They were evaluated by cephalometric analysis at 4 and 8 years of age, and by CT imaging at 5 years of age. At 4 years of age, patients with all BCLA had anterior crossbite of deciduous central incisors. As a result of maxillary protraction, jaw development at 8 years was good. Among all patients, only one showed bone formation at the alveolar cleft sufficient to avoid alveolar bone grafting (ABG). All patients presented anterior crossbite in the premaxillary region, but had good maxillary growth at 8 years old as a result of maxillary protraction. The combination of PSO and GPP can potentially eliminate the need for ABG and does not significantly retard maxillary development. PSO with GPP and protraction head gear may be an option, but long-term growth is not known.

Surfing Injuries Requiring First Aid in New Zealand, 2007-2012

In an island nation such as New Zealand with easy access to surf beaches, surfing activities are very popular and, while generally perceived as a healthy form of outdoor recreation, they do have attendant risks. This study reports on nondrowning, surfing-related incidents that required medical first aid on beaches during five summer seasons from 2007-2012. Retrospective descriptive analysis of data from lifeguard first aid reports found that 16% (n = 1,327) of injuries were the consequence of surfing activity. More males than females were treated for surfing injuries (68% male, 31% female). Lacerations (59%) and bruising (15%) accounted for most of the injuries. The head was the most common site of injury (32%) and most injuries were caused by contact with the victims own board (50%). Ways of promoting surf safety via equipment modification, the use of protective head gear, the management of surfing activity by lifeguards, and public education are discussed.

Treatment of Class II Division 1 Malocclusion using Cervical Headgear

Class II division 1 malocclusions have many variation and treatment options. Choosing the right treatment begins with a correct diagnosis. The aim of this article is to describe treatment of Class II division 1 malocclusion in a growing patient using combined cervical headgear and non-extraction fixed orthodontic therapy. Class I molar and canine relationship was achieved with normal overbite and overjet. There is improvement in jaw relationship and facial profile. This correction was achieved by downward displacement and inhibition of the forward growth of maxilla with favorable growth of mandible, upper molar distalization and retraction of upper incisors from cervical headgear use. There was neither downward rotation of the mandible nor maxillary first molar extrusion. Treatment time, favorable mandibular growth pattern and patient compliance proved to be determining factors in the success of this treatment. DOI: 10.14693/jdi.v16i3.106