防护牙托的材料和结构对其性能的影响

随着体育事业在我国的迅速发展,参与到各种体育运动中的青少年也不断增加。在通过运动强身健体的同时,不断增加的口颌系统外伤,尤其是牙外伤也成为非常棘手的问题。为了对这些运动外伤进行预防,防护牙托应运而生。但是不同材料、不同结构的防护牙托的效果也不尽相同,本文对此问题进行综述。     

防护牙托的性能评价

目的 研究标准型定制类牙托对于外力打击的缓冲能力。方法 利用一个特殊的工作模型。将外力打击时,单个中切牙所受的力通过舌侧金属导杆传递到压力传感器上,记录数据。比较戴防护牙托和无防护时的相对值。结果 获得了不同厚度牙托的缓冲率,各组间差异有显著性。结论 牙托的缓冲效果与材料厚度呈正相关。建议在高对抗性、高风险性的体育活动中,参加者应使用适宜的防护牙托以防止牙外伤的发生。     

硬质透明牙托在脱位牙固定中的应用

笔者于2000～2005年采用硬质透明牙托固定脱位牙21例,27颗牙,收到理想效果。1临床资料本组病例21例共27颗牙,其中外伤脱落20例26颗牙,错位扭转牙(右上侧切牙外伤一月余)1例1颗牙。男14例,女7例。年龄8～51岁。脱位牙牙位:上中切牙22颗,上侧切牙3颗,上尖牙2颗。牙槽骨骨折1例、2     

运动防护牙托在少年儿童中的应用及可替换内衬粘接性能的研究

目的检测内村材料和防护牙托主体粘结后的抗剪切强度；探讨将重衬法应用于替牙期定制类防护牙托的可行性。方法为22例少年儿童制作了防护牙托，其中8例进行了牙弓模型的局部缓冲。对使用者进行了临床观察。为2例无法就位的牙托进行了重衬。对内村材料和防护牙托主体粘接面的抗剪切强度进行了测试及耐水试验。结果22纠患者中做防护牙托前有牙外伤史的为17例（77．3％）。在不同牙列阶段的使用者牙托的固位效果均良好。在使用过程中，有4例曾遭遇嘴部碰撞。但未造成软、硬组织损伤。防护牙托主体和内衬层粘接面的抗剪切强度较强，在37℃水中浸泡10天、20天、30天的试验组与对照组间的差异无显著性。重衬并不影响防护牙托的耐用性。结论重衬法的应用可以延长替牙期防护牙托的使用寿命，有利于在青少年中的推广使用。     

外力方向对防护牙托性能影响的有限元分析

目的: 运用有限元分析评估外力方向对牙托缓冲能力的影响。方法: 采集仿真模型锥形束CT（CBCT）影像资料,利用MIMICS软件建立分析模型。运用ABAQUS软件模拟研究在牙托厚度不同的情况下（分别为0、1.5、3、4.5和6 mm）,经不同方向外力（撞击方向与牙长轴交角分别为30°、60°、90°和120°）撞击后,牙体表面的应力变化情况,进而评价牙托的缓冲能力。结果: 在研究实验条件下,当牙托厚度较薄时（1.5 mm和3 mm）,与其他方向相比,牙托缓冲效率在60°交角时最低,在120°交角时最高。而在牙托厚度增加后（4.5 mm和6 mm）,牙托缓冲效率在90°交角时最低,在30°交角时最高。外力方向不同时,牙托的应力缓冲效率随着牙托厚度的增加而提高。结论: 外力方向对防护牙托的缓冲能力有一定影响,但其易受牙托厚度的影响。     

聚合器在中空托牙制作中的应用

聚合器在中空托牙制作中的应用广东省口腔医院修复科技工室（５１０２６０）黄美兰聚合器（ｌｉｑｕｉｓｔｅａｍ－ｅ）是通过电热管加温达到聚合目的的新型牙用树脂热处理设备。它解决了热凝树脂传统工艺过程复杂、繁琐、耗时等问题。我科于１９９３年开始应用于临床制作...     

多功能牙托治疗牙周病的临床应用

研究表明，细菌和菌斑在牙周病的发病中起着重要的作用，综合控制各种致病因素已在牙周病治疗中形成共识［１］。７０年代问世的药物控释系统为牙周病的治疗带来了新的希望，其后各种制剂不断出现［２］。本文介绍有抗生素氧疗控释系统，且具有升牙合和松牙固定作用的多功...     

定制牙托膜片切牙区厚度变化的影响因素

佩戴运动牙托可以缓冲外力,降低颌面部损伤的风险.运动牙托种类较多,其中个性化定制运动牙托具有较好的保护作用和较高的舒适度而备受欢迎.个性化定制运动牙托的膜片加热后可发生延展,随后发生厚度变化,尤以切牙区膜片的厚度变化更能影响其保护性能;因此,笔者就影响个性化定制运动牙托膜片切牙区的厚度变化的膜片硬度、膜片形状和膜片表面设计等膜片因素,工作模厚度和工作模摆放角度等工作模因素,加压方法,夹持托盘形状、夹持方式和夹持托盘与工作模底座的距离等夹持因素,加压时间等的研究进展作一综述.     

预成托牙

<正> 我科从1985年起临床应用预成托牙,实践证明这是一种深受患者欢迎的修复方法。本文试作简要介绍。一、适应症:预成托牙适用于各种年龄,适用于全身及局部健康情况良好,一次能够经受拔除多数牙的患者。(1)最适合于因全口假牙修复而前牙需要拔除的患者;(2)前牙全部缺失,残留个别有一定(牙合)关系的磨牙或双尖牙者,包括上述患者中已有托牙修复者;(3)前牙外伤后牙根折断,或残根残冠以至不能修复而需拔除的患者。     

改良腭托在锁(牙合)病例中的应用

伴发锁[牙合]的错[牙合]畸形约占总错[牙合]畸形的20％,锁[牙合]不仅大大降低了咀嚼效率，而且由于是一种锁结关系，限制了下颌骨的左右自由移动，可造成下颌骨左右发育不对称，甚至诱发颞下颌关节紊乱综合症（TMJDS）^[1]。因此，在临床上应充分重视锁结关系的及早解除，提高咀嚼效率，恢复下颌的自由运动。     

口腔护牙托对上臂三角肌肌力作用的研究

目的：探讨口腔护牙托对上臂三角肌肌力的作用,考察其促进提高运动成绩的可能性。方法：以软质树脂材料,采用直接法分别为8名受试者制作定制护牙托,测试戴托受试者平卧推举5kg重物紧咬时的三角肌前束部和嚼肌的肌电值。将该值经系列转换器输入计算机,进行信息数值化处理并输出肌电积分数值。结果：受试者评价该种护牙托的固位,舒适性和保护性均佳,戴护牙托举重5kg紧咬时的上臂三角肌肌电测试值为1．1600,不戴护托时的测试值为0．6125。前者比后者有明显提高,差异有显著性（P＜0．01）,戴护牙托与不戴紧咬时嚼肌的肌电测试值分别烟0．3825和0．2138,前者比后者亦有明显提高（P＜0．01）。结论：戴口腔护牙托紧咬提高嚼肌的肌力,进而反射性作用于上臂三角肌,使该肌的肌力亦得以增强。     

全颌接触式运动护齿器的制作及临床应用效果观察

目的探讨一种改良的运动护齿器（MG）制作技术,使存在前牙开或深覆盖的患者在戴入MG后达到全颌接触的平衡状态;并对这种全颌接触式MG的临床使用效果进行随访观察。方法依据纳入标准选择大学生篮球运动员60名,随机分为使用组和对照组,采用分区分层热压成型法为使用组球员制作全颌接触式MG。要求使用组球员每次进行篮球运动时均佩戴全颌接触式MG,记录全体球员在18个月观察期内参与篮球活动的次数,并记录进行篮球运动时发生牙松动、折裂、脱落、软组织损伤、颌骨损伤或脱位等口腔颌面部运动创伤的次数,收集使用者对全颌接触式MG的使用评价,比较使用组与对照组各种创伤的发生率。结果应用分区分层热压成型法成功制作了30例全颌接触式MG。多数使用者认为其具有较好的佩戴舒适性,观察期内使用组各种口颌运动创伤总发生率为6‰,而对照组为24‰,两者差异有统计学意义。结论采用分区分层热压成型法可快捷有效地制备全颌接触式MG;使用全颌接触式MG可使口腔颌面部运动创伤的发生率显著降低。     

A review of facial protective equipment use in sport and the impact on injury incidence

Sporting activities have an inherent risk of facial injury from traumatic impacts from fellow competitors, projectiles, and collisions with posts or the ground. This retrospective review systematically describes the interplay between the type of sport (including the level at which specific sports are played), the sex of the players and their musculoskeletal characteristics, the technology behind the materials used, the protective devices commonly used, the anatomical site, and the regularity of incidence of fractures. We describe how variations in sporting activities induce different orofacial fracture patterns, and critically consider the methods used to test protective headgear against more contemporary techniques. Facial injuries can have a profound psychological effect on those injured, can take a long time to heal, and have been known to end promising careers. Use of properly fitted protective head or facial equipment could reduce the number of facial fractures commonly seen in sports. We recommend that individual sports should have full risk assessments, and that mandatory standards should be agreed about protective devices that would be appropriate.     

Effects of mouthguard and paste containing S-PRG filler on remineralization of artificial subsurface carious lesions

ObjectivesThe aim of this in vitro study was to evaluate the remineralization effects of ethylene-vinyl acetate (EVA) sheet (sample; SHOFU) and paste (PRG Pro-Care Gel®; SHOFU) containing surface pre-reacted glass-ionomer (S-PRG) filler.Materials and methodsExtracted human premolars were decalcified to create subsurface carious lesions on the buccal side. Decalcified tooth specimens were then covered by EVA sheets with two different S-PRG filler contents either with application of paste (PRG MG-Paste and EVA MG-Paste groups) or without application of paste (PRG MG and EVA MG groups), then immersed in a remineralization solution. Control group teeth were not covered with any mouthguard and did not receive application of paste. Micro-CT (μCT) images of the teeth before and after the remineralization process were obtained to compare mineral gains. The percentage remineralization (%R) of each group was calculated using the mineral density (MD) profile from μCT. The microstructure of the tooth surface was observed under scanning electron microscopy, and constituent elements were examined using an electron probe micro-analyzer.ResultsThe PRG MG group showed a significantly higher %R than the Control or EVA MG groups. The PRG MG-Paste group showed a significantly higher %R than the PRG MG group. In the PRG MG-Paste group, small precipitations were observed on tooth surface, and silica and aluminum were detected.ConclusionThe combination use of S-PRG filler containing EVA sheet and PRG Pro-Care Gel exhibits a synergetic effect on remineralization of pre-cavitation carious lesions.     

Influence of pre-laminated material on shock absorption ability in specially designed mouthguard with hard insert and space

Purpose

We have developed a new type of laminated mouthguard, the Hard & Space mouthguard, which incorporates a hard material insert and a space to prevent contact between the mouthguard and the buccal surfaces of the teeth. The purpose of this study was to investigate the effect of this new design on shock absorption.

Methods

Three types of mouthguard (a conventional laminated EVA mouthguard and two 3-layer type “Hard & Space” mouthguards made of 1.8-mm or 3.0-mm thick pre-laminated material (Konbiplast) and EVA with a 1.0-mm space) were impacted. Shock absorption was measured by means of a pendulum type steel ball impact testing machine at impact distances of 10, 20, and 30 cm and a dental study model with strain gauges attached to the lingual surfaces and an accelerometer fixed to the maxilla.

Results

Distortion of the impacted tooth and acceleration of the model were significantly reduced by all types of mouthguard at all 3 impact distances. The effect of the mouthguard was remarkable in terms of tooth distortion: both thicknesses of Hard & Space mouthguard showed more than 90% shock absorption, compared with only approximately 55–78% with an EVA mouthguard. Furthermore, shock absorption with the thicker 3.0-mm Hard & Space mouthguard reached more than 95% at the highest impact power.

Conclusion

Within the limitations of this laboratory study, Hard & Space mouthguards showed significantly greater buffer capacity than a conventional EVA mouthguard in terms of tooth distortion at the 3 impact powers tested.     

Clinical evaluation of the remineralizing effect of a mouthguard and paste containing S-PRG filler on white spot lesions

ObjectivesWhite spot lesions (WSLs) are frequently observed on young permanent teeth. The aim of this clinical study was to evaluate the remineralizing effect of paste and a mouthguard containing surface pre-reacted glass-ionomer (S-PRG) filler by observing and measuring lesion area.Materials and methodsA total of 14 children (age range, 8–16 years) with WSLs involving 74 teeth attending Asahi University Medical & Dental Center were examined. Color- and size-matching stickers (Cas Match™, Bear Medic) were photographed with involved teeth. Mouthguards made of an S-PRG filler-containing ethylene-vinyl acetate sheet (sample; SHOFU) with S-PRG filler-containing paste (PRG Pro-Care Gel®; SHOFU) (PRG MG-Paste group) or without paste (PRG MG group; control) were applied to WSLs at bedtime.ResultsNo teeth required restoration due to caries progression during the experimental period. Mean reductions in lesion area at 6 months after treatment in the PRG MG-Paste group and PRG MG group were 1.66 ± 1.84 mm² and 0.81 ± 1.27 mm², respectively. Significant differences were observed between groups (p < 0.05). No significant difference in area reduction was seen between kinds of teeth involved, although significant differences in area reduction were observed among individual subjects.ConclusionThese results suggest that combined use of S-PRG filler-containing paste and a mouthguard is effective for remineralization of WSLs observed on numerous teeth.