Orofacial Injuries Research Articles

Peripheral sympathetic mechanisms in orofacial pain.

Sympathetic nervous system (SNS) is a part of the autonomic nervous system which involuntarily regulates internal body functions. It appears to modulate the processing of nociceptive information. Many orofacial pain conditions involve inflammation of orofacial tissues and/or injury of nerve, some of which might be attributed to SNS. Thus, the aim of this review was to bring together the data available regarding the peripheral sympathetic mechanisms involved in orofacial pain. A clearer understanding of SNS–sensory interactions in orofacial pain may provide a basis for novel therapeutic strategies for conditions that respond poorly to conventional treatments.

Pattern of maxillofacial injuries in patients with craniocerebral injuries: a prospective study

Introduction:This prospective study highlights the pattern of oral and maxillofacial injuries in patients with associated craniocerebral injuries.Material and Methods:This was a prospective descriptive study conducted over a 22-month period. Information was collected using a structured questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) Version 13 (SPSS Inc., Chicago, IL, USA) and Microsoft Office Excel 2007 (Microsoft, Redmond, WA, USA). Test of statistical significance was set at 0.05.Results:Three hundred and three consecutive patients were studied and this consisted of 254 males and 49 females. The difference in the gender distribution was statistically significant (p = 0.008). Road traffic crashes (n = 262; 86.5%) was the most common cause of injury and soft tissues orofacial injuries accounted for 61.7% of injuries. Le Fort II fractures were the major skeletal injuries. Glasgow Coma Score (GCS) of 13–15 had the highest frequency (n = 157; 53.4%). Intracerebral haemorrhage was the most common cerebral injury recorded and the commonest complication noted was dysocclusion.Discussion:Although middle third facial fractures were the most common skeletal injury, fractures of the upper third facial skeleton appear to be associated with lower GCS.Conclusion:Fractures of the facial skeleton are fairly common in craniocerebral injuries.

Awareness, Prevention and Management of Dental Injuries among the Kabbadi Players of Madurai District

Aim: The aim of this study is to evaluate the occurrence of dental injuries among kabaddi players, the level of knowledge of the participants about preventive measures and management of dental trauma. Materials and Methods: A cross-sectional study was carried out, among 100 players aged 16–25 years. A structured interviewer-guided questionnaire was used to determine the prevalence of oral injuries sustained during sports activities, the use of mouthguard and the athlete's awareness regarding the use of mouthguard. Results: The respondents consisted of males (84%) and females (16%) with a mean age of 18.5 years. Out of the total participants, 29% had chipping or fracture of teeth, 100% had soft-tissue laceration, 12% had avulsion of teeth, and 30% had suffered fracture of jaw/bones. Nearly 5% knew that it was possible to replant the teeth. 83% did not know what is the best time to put the teeth back in the mouth, 91% answered that they would carry avulsed tooth in water, 3% wrapped in cloth, and 6% answered others. Nearly 42% were aware that mouthguards prevent injury. Nearly 3% used mouthguards. Conclusion: Level of awareness and knowledge about sports-related orofacial injury are very poor among kabaddi players in Madurai. Education on the prevention of orofacial trauma should be given to the coaches and players. Wearing of mouthguards during sports activity should be compulsory during practice and competition events.

Dental Injuries in a Sample of Portuguese Militaries - A Preliminary Research.

Traumatic dental and maxillofacial injuries are very common and appear to affect approximately 20-30% of permanent dentition, with often serious psychological, economic, functional, and esthetic consequences. Militaries are a highest risk group for orofacial trauma, not only because they are constantly engaged in physical activity (which increase the risk of traumatic injuries) but also because they are exposed to many risk factors. The aim of this study was to evaluate the prevalence of orofacial injuries, militaries knowledge about first-aid procedures following a dental avulsion and the use of mouthguards in a sample of Portuguese militaries. An observational cross-sectional study was conducted for forces of the Infantry Regiment n°14 of Viseu, Portugal. The study involved 122 members of the armed forces who were asked to complete a questionnaire, which enquired about: the occurrence of dental trauma, the use of mouthguards and militaries knowledge with regard to first-aid management of dental avulsions. In our sample, 5.7% reported having experienced a dental trauma. This was further broken down to reveal that 2.5% had experienced an avulsion and 3.3% had a dental fracture. All respondents who reported having suffered dental trauma, reported that this was the only time that they had experienced dental trauma. Within this group, 71.4% visited a dentist, however only one (20%) visited the dentist during the same day that the trauma occurred. In addition, 21.3% mentioned that they had seen a dental trauma in at least one colleague during military trainings/operations. In the case of dental avulsion, the majority (54.9%) did not know how to act. The rate of mouthguard's use among militaries was very low (6.4%). The main reason reported for not using a mouthguard was thinking that it is not necessary (53.3%). Besides that, 31.1% did not know what a mouthguard was for. Prevention programs and promoting actions with this population are important reflections and should be adopted to reduce the incidence of orofacial trauma and to increase knowledge about this topic.

Knowledge and attitudes about sports-related dental injuries and mouthguard use in young athletes in four different contact sports-water polo, karate, taekwondo and handball.

The increasing popularity of participating in sports activities among children and adolescents has increased the risk of sports-related orofacial and dental injuries. Therefore, it is important to establish efficient preventive strategies regarding sports-related dental trauma. The aim of this study was to evaluate the occurrence of sports-related dental injuries in young athletes and to compare the frequency of such injuries between high-risk and medium-risk sports, along with assessing athletes' attitudes and habits regarding mouthguard use. A total of 229 young athletes from four different sports (water polo (n=59), karate (n=58), taekwondo (n=57) and handball (n=55)) participated in this study. A standardized questionnaire about the frequency of orofacial and dental injuries was used. Questions were also asked about athletes' habits related to mouthguard use. Mean age of the participants was 12.9±3.2years, and the average time of playing experience was 4.8±3.1years. Orofacial injury had been experienced by 58 athletes (25.3%), while 31 athletes (13.5%) suffered dental injury. Higher rate of dental injuries was observed in water polo (18.6%), karate (17.2%) and handball (21.8%) than in taekwondo (3.5%) (P=.035). Most participants were aware of mouthguards for dental trauma prevention and considered them efficient for preventing dental injuries during sports activities, but only 94 (41%) used them. There was a statistically significant difference in the use of mouthguards between taekwondo (73.7%) and karate (70.7%) players compared to handball (14.5%) and water polo players (5.1%) (P<.001). Handball and water polo had similarly high occurrence of dental trauma as karate, a high-risk martial art sport. Therefore, the classification of sports according to the risk of dental trauma should be reconsidered. It would be beneficial to make wearing a mouthguard mandatory in all high-risk sports, as well as in those with medium-risk for dental injuries.

Orofacial injuries and use of protective wear among field hockey players of Coorg District, Karnataka, India - A KAP Study.

Traumatic orofacial injuries are frequent among hockey players, often causing aesthetic, functional, psychological, and economic problems. This study was conducted to assess the prevalence and distribution of orofacial injuries and to assess the knowledge, attitude and practices toward the use of protective wear as perceived among hockey players of Coorg district. A cross-sectional descriptive study was conducted among 281 field hockey players of Coorg district, Karnataka, India. Data were collected using a specially designed self-administered, pretested questionnaire containing a set of 19 statements. Chi-square test was performed to assess statistical significance among the variables studied. P value <0.05 was considered statistically significant. The mean age of the study sample was 32.7 ± 4.3 years, and majority of them were semi-professional hockey players (46.6%) with an experience of 5-10 years (41.3%) of playing hockey and having at least a graduate qualification (65.5%). A total of 79% of the players reported to have been injured at least once in the past 1 year, of which orofacial injuries accounted for 33.8% of the injuries. Majority of the players had a fair Knowledge, Attitude and Practice (KAP) score toward the use of protective wear (63.7%). Although 37.7% of the players had good knowledge, it translated to a favorable attitude among 24.1% of the players and favorable practice among 11.7% players. Professional hockey players had a positive association with KAP scores (P < 0.00), whereas experience was found to be negatively associated with KAP scores (P < 0.03). The majority of players had moderate knowledge about the importance of protective wear in preventing orofacial injuries, but their attitude and practices toward the same were relatively poor.

High Rise Syndrome: A Correlation Between Height and Affections in 45 Cats From Urban Areas

Forty five cats of high rise syndrome were admitted to surgery clinic of Mansoura Veterinary Teaching Hospital (MVTH), over a period of 3 years (2015-2018). Cats were admitted for treatment or euthanasia after a fall or jump from a balconies or windows. These cats were admitted after varying period (one to seven days) after the fall. Cats fell from the height of the 2nd to the 5th floor.Their ages were ranged from 3 months to 4 years. Each cat was clinically examined; in addition to that ultrasonographical, radiological and neurological tests were performed. After diagnosis and consultation with the owner a decision was taken for either conservative, surgical treatment or euthanasia. Fractures of the limbs and joint dislocations were seen in 60% (27/45), vertebral fracture 11.1% (5/45) spinal luxation in 6.7% (3/45), Oro-facial injuries in 4.4% (2/45) and head trauma in 17.8% (8/45).Shock was diagnosed in 62.2% (28/45) and survival rate was recorded in 77.8% (35/45). The mean height of fall for the euthanized and dead cats was 2.5 floors (range 2nd to 3th floors).This study founded a relation between types of injuries and the height of the fall where falling from lower floor is more risky and resulted in more dangerous problems than that of higher one.

OSC44: Knowledge, Attitude and Practices Regarding Oro-Facial Injuries and Mouth Guards among Parents in Kedah, Malaysia.

OSC44: Knowledge, Attitude and Practices Regarding Oro-Facial Injuries and Mouth Guards among Parents in Kedah, Malaysia.

A IMPORTÂNCIA DO USO DO PROTETOR BUCAL NA PRÁTICA ESPORTIVA: REVISÃO DE LITERATURA

The Dentistry of Sport, a new area of practice of the dental surgeon, aims to offer the promotionof oral health of the athlete, prevent future orofacial injuries, as well as improve their performance, sinceunsatisfactory oral health can impact their performance. Traumatic injuries can be caused by accidents,maltreatment, parafunctional habits and sports, and the latter presents a significant portion. The main objectiveof the sport is to provide well-being to the practitioner, but in many cases its integrity is compromised bylack of care and protection, and in order to protect the oral cavity from future trauma, it is recommendedto wear mouth guards during the practice of Because it has already been proven that it is capable ofsignificantly reducing the chances of dental trauma. The mouth guard is a rigid yet flexible material, whichfits into the teeth and when used properly, will exert its valuable function. The dentist should be aware ofhis / her sports patients, informing them of the use of mouth guards and encouraging them to use them.This literature review will highlight the importance of the use of mouth guards against dental traumatism,its classification and its way of making.

Study of Mouthguard Design for Endurance and Air-Flow Intake

Mouthguard is one of the important device for athletes. Wearing a mouthguard is a must to prevent them from any orofacial injuries occurs during their sport activities. Therefore, to make sure it is safe and comfort, a study on the mouthguard design is carried out to investigate the performance of the mouthguard, in term of stress distribution and air flow path by improving the pressure difference between ambient and the oral cavity pressure. A preliminary design has been study to simulate its total deformation and stress, in terms of Von Mises Stress by using ANSYS 15.0 Workbench. From the results, the critical parts are identified on the preliminary design and later being used to improve the design to the new one. By increasing the thickness of the preliminary design, the total deformation has been decreased for about 0.20 mm to 0.16 mm for the exerted external forces ranging from 50–500 N, whereas, for internal forces ranging from 100–600 N have reduced deformation from 0.24 mm to 1.44 mm. The simulation process is then followed by the air flow study in the oral cavity with an open mouth about 0.5 mm when the athlete is doing exercise with speed 4.43 m/s of air flow into a mouth. The finding indicates that the modified mouthguard has large value of velocity streamline compared to the preliminary design which is supported by significant pressure difference of 401.86 Pa, compared to 140.09 Pa of the preliminary design. Velocity stream line also shows that the higher speeds occur in the near mouthguard, that is, between the bottom surfaces of the mouthguard and the lower teeth. The results demonstrated that the thicker the mouthguard, the better it is for prevention but less in air flow distribution into the oral cavity.

Orofacial injury by human bite: experience at a rural health centre

Human bite injuries are rare and are usually the result of fight and an inevitable helpless state of opponent who commit such crime. The aim of this article is to present two such cases which were managed at a rural health centre. The first patient is a young 22-year male who was bitten by same age group person over the tip of nose resulting in an avulsion injury. The second case is 29-year male patient was bitten at right upper lip. Both patients were managed at a rural health centre and both had satisfactory results.

Lip and tooth injuries at public swimming pools in Austria.

There is an increased risk of orofacial injuries in swimming pool facilities. Nevertheless, only a few studies have addressed this issue. The aim of this study was to identify the frequency of lip and tooth injuries at public swimming pools in Austria. A further aim was to examine which gender and age groups were affected, where and why these injuries occurred, and whether pool attendants had sufficient knowledge of dental first-aid measures. A total of 764 pool attendants in Austria were contacted by telephone and 689 participated in the study (90.2%). The attendants were interviewed retrospectively about accident occurrences in 2014 by a standardized questionnaire. Responses to the provision of first aid and choice of storage medium for avulsed teeth were subsequently evaluated. The frequency of lip injuries was 19.0%, and tooth injuries were 11.3%. Male bathers (P<.05) and children under 12years (P<.001) most frequently suffered injuries. The waterslide was the most common accident site. The most common cause of lip injuries was slipping on wet surfaces (39.0%), and for tooth injuries it was collisions with other persons or objects (each 28.1%). The pool attendants' responses were predominantly good or sufficient on first aid, with the exception of what storage medium to choose. Tooth rescue boxes were available in only 8.6% of all pool facilities. Orofacial injuries are a frequently occurring problem in swimming pool facilities. The pool attendants' knowledge on first-aid care of tooth injuries could still be improved.

Prevalence of dental trauma and use of mouthguards in professional handball players.

Published data about orofacial injuries and mouthguard use by professional handball players are scarce. The aim of this study was to investigate the prevalence of orofacial trauma and mouthguard use in professional handball players. Data were collected from 100 professional handball players through a questionnaire, which contained 17 questions about age, experience in playing handball, playing position, orofacial trauma experience during the past 12months, type of injury and mouthguard use. Almost half (49%) of the interviewed players experienced head and/or facial trauma during the past year. The most common injuries were soft tissue lacerations (39.6%). Dental injuries occurred in 22% of the participants, with socket bleeding being the most frequent injury (14%). Of the affected teeth, 76.9% were upper incisors. Mouthguards had a statistically significant protective role regarding tooth fractures and tooth avulsion (P=.043). Players who wore a mouthguard had a 5.55 times less chance of suffering dental injuries. Almost 76% of dental injuries resulted in complications afterward. Sixty-seven percentage of the players knew that mouthguards could prevent injuries, but only 28% used them regularly. Of the players who wore a mouthguard regularly, 76.9% were advised to do so by their dentists. The incidence of head and orofacial injuries among professional handball players is high. Mouthguards prevented severe dental injuries such as tooth fracture and avulsion, but their use was still limited.

Orofacial trauma in rural India: A clinical study

PurposeOrofacial trauma is becoming a leading medical problem worldwide. Most of the studies pertaining to orofacial trauma have been done in urban areas but very little scientific literature is available for rural areas. MethodsA prospective medical institute-based study of orofacial injury patients was carried out from May 2013 to April 2016 (36 Months). Data regarding incidence, age and sex distribution, causes, types and site of injury, treatment modalities and trauma associated complications were collected and analysed. ResultsA total of 784 patients were studied. Males outnumbered females by a ratio of 2.9:1. Age range was 9 months–75 years with the peak incidence in the age-group of 18–34 years. Most injuries were caused by road-side accidents (72.7%), followed by assault and falls in 11.6% and 8% respectively. Soft tissue injuries and mandibular fractures were the most common type of injuries. Head/neck (50.29%) and limb injuries (27.2%) were the most prevalent associated injuries. Surgical debridement and soft tissue suturing was the most common emergency procedure. Closed reduction was performed in 61% of patients and open reduction and internal fixation in 30% of cases and 9% were managed conservatively. Complications occurred in 6.88% of patients, mainly due to infection and malocclusion. The mean duration of hospital stay was (10.12 ± 6.24) days. ConclusionThis study highlights the importance of department of dental surgery along with other disciplinaries in the management of orofacial injuries. Road-side accident remains the major etiological factor of orofacial injuries in our setting.

Widespread Volumetric Brain Changes following Tooth Loss in Female Mice.

Tooth loss is associated with altered sensory, motor, cognitive and emotional functions. These changes vary highly in the population and are accompanied by structural and functional changes in brain regions mediating these functions. It is unclear to what extent this variability in behavior and function is caused by genetic and/or environmental determinants and which brain regions undergo structural plasticity that mediates these changes. Thus, the overall goal of our research program is to identify genetic variants that control structural and functional plasticity following tooth loss. As a step toward this goal, here our aim was to determine whether structural magnetic resonance imaging (sMRI) is sensitive to detect quantifiable volumetric differences in the brains of mice of different genetic background receiving tooth extraction or sham operation. We used 67 adult female mice of 7 strains, comprising the A/J (A) and C57BL/6J (B) strains and a randomly selected sample of 5 of the 23 AXB-BXA strains (AXB1, AXB4, AXB24, BXA14, BXA24) that were produced from the A and B parental mice by recombinations and inbreeding. This panel of 25 inbred strains of genetically diverse inbred strains of mice is used for mapping chromosomal intervals throughout the genome that harbor candidate genes controlling the phenotypic variance of any trait under study. Under general anesthesia, 39 mice received extraction of 3 right maxillary molar teeth and 28 mice received sham operation. On post-extraction day 21, post-mortem whole-brain high-resolution sMRI was used to quantify the volume of 160 brain regions. Compared to sham operation, tooth extraction was associated with a significantly reduced regional and voxel-wise volumes of cortical brain regions involved in processing somatosensory, motor, cognitive and emotional functions, and increased volumes in subcortical sensorimotor and temporal limbic forebrain regions including the amygdala. Additionally, comparison of the 10 BXA14 and 21 BXA24 mice revealed significant volumetric differences between the two strains in several brain regions. These findings highlight the utility of high-resolution sMRI for studying tooth loss-induced structural brain plasticity in mice, and provide a foundation for further phenotyping structural brain changes following tooth loss in the full AXB-BXA panel to facilitate mapping genes that control brain plasticity following orofacial injury.

Traumatic orofacial injuries and its prevention

Sports dentistry is one of the most recent and upcoming fields in dentistry. Its main focus is on the prevention and management of athletics-related orofacial injuries. Dental injuries are the most common type of orofacial injury sustained during participation in sports. The most significant aspect in preventing sports-related orofacial injuries is wearing basic protective devices such as properly fitting helmets, face masks, and/or mouthguards. Many athletes are not aware of the health implications of a traumatic injury to the mouth or of the potential for incurring severe head and orofacial injuries while playing. The dentist can play an imperative role in informing athletes, coaches, and patients about the importance of preventing orofacial injuries in sports. The aim of this paper is to increase professional awareness and interest for orientation toward sports dentistry.

Evaluation of Knowledge, Awareness, and Occurrence of Dental Injuries in Participant Children during Sports in New Delhi: A Pilot Study.

AimTo evaluate the occurrence of dental injuries in children, the level of knowledge of the participants about preventive measures, and management of dental trauma during sports, in New Delhi.Materials and methodsA cross-sectional study was carried out among 450 children aged 6 to 16 years. A structured interviewer-guided questionnaire was used to determine the prevalence of oral injuries sustained during sport activities, the use of mouthguard as well as the athlete’s awareness regarding use of mouthguard. The respondents consisted of 313 males (69.6%) and 137 females (30.4%) with a mean age of 12.6 years.ResultsOut of the total participants, 27 (6%) had chipping or fracture of teeth, 25 (5.6%) had soft-tissue laceration, 24 (5.4%) had avulsion of teeth, and 18 (4%) had suffered fracture of jaw/bones. Out of the total participants, 263 (58.4%) knew that it was possible to replant the teeth and 187 (41.6%) did not know that it was possible to replant the teeth. Out of the total participants, 203 (45.1%) did not know what is the best time to put the teeth back in the mouth and 247 (54.9 %) answered in affirmative with variable answer. Of the total participants, 223 (49.6%) answered that they would carry avulsed tooth in water, 94 (20.8%) wrapped in cloth, 57 (12.6%) in mouth/saliva, 9 (2%) in Hanks’ balanced salt solution (HBSS), and 67 (14.8%) answered others. Of the total participants, 321 (71.3%) were aware that mouthguards prevent injury and 129 (28.7%) did not know about mouthguards. Out of the total participants, 94 (20.9%) used mouthguards and 356 (79.1%) had never used mouthguards.ConclusionLevel of awareness and knowledge about sports-related orofacial injury is very poor among children in New Delhi. Education on prevention of orofacial trauma should be given to the coaches and children. Wearing of mouthguards during sport activities should be compulsory during practice and competition events.How to cite this article: Goswami M, Kumar P, Bhushan U. Evaluation of Knowledge, Awareness, and Occurrence of Dental Injuries in Participant Children during Sports in New Delhi: A Pilot Study. Int J Clin Pediatr Dent 2017;10(4):373-378.

Traumatic Dental Injuries In Sports

Sports dentistry is a developing field of dentistry and includes the prevention and management of sports-related dental traumas. Dental injuries are the most frequent type of orofacial injuries that may occur during participation in sports activities. When considering the esthetic, functional, psychological, and economic consequences of traumatic injuries, prevention becomes more of an issue. Decreasing the incidence of sports-related dental trauma is possibly due to the education of athletes, coaches and sports organizations about sports-related orofacial injuries. Athletes, whether in amateur or professional level, should have a knowledge of the prevention strategies including the wearing of mouth-guards, face guards and helmets. Sports related dental injuries together with the prevention and treatment of such injuries will be the focus of this review.

Electronic cigarette explosion: Case report of an emerging cause of orofacial trauma

Electronic cigarettes are a type of electronic nicotine delivery system. In the United States, electronic cigarettes have surged in popularity since their introduction to the market in 2007. Health and safety concerns primarily have focused on e-liquid/aerosol composition and whether these devices represent a gateway versus lower risk alternative to conventional cigarettes. Furthermore, recent incidents have demonstrated the potential for significant orofacial injury caused by device explosion while in use. Herein we report a case of a 20-year-old male who sustained oral burns, lacerations, and tooth loss when an electronic cigarette exploded in his mouth shortly after he charged the battery. Only seven other cases of trauma from intraoral electronic cigarette explosions have been reported in the scientific literature to date, although several similar incidents also have been reported by the news media. Treatment of such patients often requires a multidisciplinary approach. Design/manufacturing issues and improper handling may cause an increase in internal battery temperature. An investigation by the United States Fire Administration concluded that user education may aid in preventing some electronic cigarette explosions, and safety design improvements also could help. Although some studies and authorities support the use of electronic cigarettes for tobacco cessation and harm reduction, recent reports of electronic cigarette explosions raise important safety concerns and point to the need for further studies.

National Athletic Trainers' Association Position Statement: Preventing and Managing Sport-Related Dental and Oral Injuries.

To provide athletic trainers, health care professionals, and all those responsible for the care of athletes with clinical recommendations for preventing and managing sport-related dental and oral injuries. Participation in competitive sports continues to grow at both the interscholastic and intercollegiate levels. Therefore, exposure to, and the incidence of athletic-related injury, including orofacial injury, will also likely increase. At the time of this writing, the leading governing agencies for interscholastic (National Federation of State High School Associations) and intercollegiate (National Collegiate Athletic Association) sports require only protective orofacial equipment (eg, mouthguards) for 5 and 4, respectively, of their sanctioned sports. Although orofacial injuries represent a small percentage of all sport-related injuries, the financial burden associated with these injuries (eg, tooth avulsion) can exceed $15 000 over an adult life. Therefore, effective management of sport-related dental injuries is critical to the long-term financial, physical, and emotional health of people who have experienced dental trauma. Based upon the current evidence regarding sport-related orofacial injury, we provide recommendations related to planning considerations, education, and mouthguard efficacy, material, fabrication, and care considerations. Additionally, suggested best practices for managing sport-related dental injury are also given for athletic trainers and other health care professionals.