Many molding techniques have been researched to ensure the thickness of custom mouthguards. The aim of this study was to clarify the effect on the thickness of a laminated mouthguard of a molding technique in which th...Many molding techniques have been researched to ensure the thickness of custom mouthguards. The aim of this study was to clarify the effect on the thickness of a laminated mouthguard of a molding technique in which the model position is moved forward just before molding. Mouthguards were molded using a 3.0-mm-thick ethylene vinyl acetate mouthguard sheet and a pressure molding machine. The molding method was the normal molding method (condition C) and the molding technique (condition MP) in which the model position was moved 20 mm forward just before molding. Regarding the molding of the first layer (F) and the second layer (S), the following four molding methods based on the combination of conditions C and MP were compared;FC-SC, FC-SMP, FMP-SC, and FMP-SMP. Differences in mouthguard thickness due to molding conditions for the first and second layers were analyzed by two-way ANOVA and Bonferroni’s multiple comparison test. Significant differences were observed among all molding conditions on the labial surface, and the thicknesses were in the order FC-SC < FC-SMP < FMP-SC < FMP-SMP. FMP-SMP was 4.67 mm thick, which was 1.39 mm thicker than FC-SC. FC-SC was the thinnest at the cusp, and a significant difference was observed between other molding conditions. On the buccal side, significant differences were observed between all conditions except FC-SMP and FMP-SC, and the thicknesses were in the order FC-SC < FC-SMP, FMP-SC < FMP-SMP. The results of this study suggested that the labial and buccal sides of laminated mouthguards could be made 1.4 and 1.2 times thicker when a molding technique that moves the model position just before formation was used for the first and second layers. The reduction in thickness was suppressed by approximately 23.2% and approximately 10.7% on the labial and buccal sides, respectively, compared with the normal molding method.展开更多
Wearing a mouthguard reduces the risk of sports-related injuries, but the material and thickness of the mouthguard has a substantial impact on its effectiveness and safety. The aim of this study was to establish a the...Wearing a mouthguard reduces the risk of sports-related injuries, but the material and thickness of the mouthguard has a substantial impact on its effectiveness and safety. The aim of this study was to establish a thermoforming technique in which the model position is moved just before formation to suppress the reduction in thickness. Mouthguards were vacuum formed using ethylene-vinyl-acetate sheets with a thickness of 2.0, 3.0, and 4.0 mm. The working model was trimmed to the height of 25-mm at the maxillary central incisor and 20-mm at first molar. The model was placed with its anterior rim positioned 40-mm from the front of the forming table. Two forming methods were compared: 1) the sheet was formed when it sagged 15-mm at the top of the post under normal conditions (control);and 2) the sheet frame at the top of the post was lowered and the model was covered when the sheet sagged 15-mm, the rear side of the model was pushed forward 20-mm, and the mouthguard was formed (MP;model position). Sheet thickness after fabrication was determined for the incisal edge, labial surface, and buccal surface using a specialized caliper accurate to 0.1-mm. The difference in the reduction in thickness depending on the forming methods and sheet thicknesses were analyzed by two-way ANOVA and Bonferroni’s multiple comparison tests. Reduction in thickness was greater for thicker sheets, and the reduction in thickness for the MP was less than that for the control. The reduction in labial for the MP was an exception;the reduction in thickness was only about half that of the control. The thermoforming technique of moving the model forward just before vacuum formation was effective for suppressing the mouthguard thickness reduction, which in thickness of the labial side can be reduced to about half of the normal forming method.展开更多
Wearing a mouthguard reduces the risk of sports-related injuries, but a more comfortable design is required in order to increase the wearing rate. The aim of this study was to investigate a thermoforming method that d...Wearing a mouthguard reduces the risk of sports-related injuries, but a more comfortable design is required in order to increase the wearing rate. The aim of this study was to investigate a thermoforming method that decreases palatal thickness while maintaining labial and buccal thickness. Mouthguards were fabricated from an ethylene-vinyl acetate sheet (thickness: 4.0 mm) by using a vacuum forming machine. Four working models were prepared: 1) the anterior height was 25-mm and the posterior height was 20-mm (model A), 2) model A with the palate trimmed (model B), 3) heights 5 mm greater than model A (model C), and 4) model C with the palate trimmed (model D). The two forming conditions were as follows: 1) The sheet was formed when it sagged 15 mm below the level of the sheet frame at the top of the post under ordinary use (control);2) The sheet frame at the top of the post was lowered and the sheet covered the model when it sagged by 15 mm. The rear side of the model was pushed to move the model forward 20 mm, and then the sheet was formed (MP). Differences in mouthguard thickness due to forming conditions and model forms were analyzed by two-way analysis of variance and Bonferroni’s multiple comparison tests. Difference in forming conditions was similar for all model forms;for the MP, the thickness of the incisal edge, labial surface, cusp and buccal surface were greater, and the palatal surface was thinner than the control. On the labial and buccal surface, the thickness difference due to the model form was observed only for the MP, and models A and B were thicker than models C and D. The palatal thickness tended to be thin in the models with the trimmed palate. This study suggested that the labial and buccal thickness of the mouthguard can be maintained, and the palatal thickness can be decreased by using the model with the palate trimmed with the forming method in which the model position is moved forward immediately before the vacuum formation.展开更多
The purpose of this study is to analyse the neuromuscular balance of the masticatory muscles and the influence on the athlete respiratory parameters induced by custom-made mouthguard. Twenty-six athletes (24 males and...The purpose of this study is to analyse the neuromuscular balance of the masticatory muscles and the influence on the athlete respiratory parameters induced by custom-made mouthguard. Twenty-six athletes (24 males and 2 females), of different disciplines, average age of 32.12 ± 12.05, were recruited. Each athlete received a custom-made mouthguard in the Ethylene-Vinyl-Acetate (EVA) thermoplastic material and using surface electromyography, the masseter muscles and the frontal beams of the temporal muscles were analysed, with and without mouthguard. The athletes were then subjected to a medical examination and cardiopulmonary test, in the condition with and without mouthguard. The use of mouthguard caused an improvement of all the electromyographic indexes analysed. In particular, GLOBAL INDEX (p = 0.0021), BAR (p = 0.0005), IMPACT (p = 0.0076) and ASIM (p = 0.0290) showed an enhancement statistically significant. For the cardiopulmonary test indexes as maximum oxygen uptake (VO2max), minute ventilation (VE), breathing reserve (BR), not statistically differences (p > 0.05) were reported. The custom-made mouthguard improved the neuromuscular balance of the masticatory muscles, symmetrizing the masseters and temporalis muscles work. It produced a better balancing distribution of occlusal loads both in the anterior-posterior direction and in the lateral direction and offered the possibility to produce more muscular work. Moreover, it did not constitute an impediment that can significantly disturb the athlete’s breathing during physical activity.展开更多
BACKGROUND Anaesthetic care during upper gastrointestinal(GI)endoscopy has the unique challenge of maintaining ventilation and oxygenation via a shared upper airway.Supplemental oxygen is recommended by international ...BACKGROUND Anaesthetic care during upper gastrointestinal(GI)endoscopy has the unique challenge of maintaining ventilation and oxygenation via a shared upper airway.Supplemental oxygen is recommended by international society guidelines,however,the optimal route or rate of oxygen delivery is not known.Various oxygen delivery devices have been investigated to improve oxygenation during upper GI endoscopy,however,these are limited by commercial availability,costs and in some cases,the expertise required for insertion.Anecdotally at our centre,higher flows of supplemental oxygen can safely be delivered via an oxygenating mouthguard routinely used during upper GI endoscopic procedures.AIM To assess the incidence of hypoxaemia(SpO2<90%)in patients undergoing upper GI endoscopy receiving supplemental oxygen using an oxygenating mouthguard at 20 L/min flow compared to standard nasal cannula(SNC)at 2 L/min flow.METHODS A single centre,prospective,randomised clinical trial at two sites of an Australian tertiary hospital between October 2020 and September 2021 was conducted.Patients undergoing elective upper gastrointestinal endoscopy under deep sedation were randomised to receive supplemental oxygen via high-flow via oxygenating mouthguard(HFMG)at 20 L/min flow or SNC at 2 L/min flow.The primary outcome was the incidence of hypoxaemia of any duration measured by pulse oximetry.Intraprocedural-related,procedural-related,and sedation-related adverse events and patient-reported outcomes were also recorded.RESULTS Three hundred patients were randomised.Eight patients were excluded after randomisation.292 patients were included in the intention-to-treat analysis.The incidence of hypoxaemia was significantly reduced in those allocated HFMG.Six patients(4.4%)allocated to HFMG experienced an episode of hypoxaemia,compared to thirty-four(22.1%)patients allocated to SNC(P value<0.001).No significant difference was observed in the rates of adverse events or patient-reported outcome measures.CONCLUSION The use of HFMG offers a novel approach to reducing the incidence of hypoxaemia during short upper gastrointestinal endoscopic procedures in low-risk patients undergoing deep sedation.展开更多
Mouthguards can reduce the risk of sports-related injuries, but the sheet material and thickness have a large effect on their efficacy and safety. This study was intended to predict the changes in thickness of molded ...Mouthguards can reduce the risk of sports-related injuries, but the sheet material and thickness have a large effect on their efficacy and safety. This study was intended to predict the changes in thickness of molded products by clarifying the effect of the time interval between repeat moldings during the continuous use of a vacuum-forming machine. Ethylene vinyl acetate mouthguard sheets were used for thermoforming with a vacuum-forming machine. The working model was trimmed to a height of 23 mm at the maxillary central incisor and 20 mm at maxillary first molar. Five molding conditions were investigated: 1) molding was carried out after the sag at the center of the softened sheet was 15 mm (control);2) sheet heating was started 5 min after the molding of the control (AF5-Re1);3) sheet heating started 5 min after the molding of AF5-Re1 (AF5-Re2);4) sheet heating started 10 min after the molding of the control (AF10-Re1);and 5) sheet heating started 10 min after the molding of AF10-Re1 (AF10-Re2). Sheet thickness after fabrication was determined for the incisal edge, labial surface, cusp, and buccal surface using a special caliper accurate to 0.1 mm. Thickness differences of the molding conditions were analyzed by two-way analysis of variance. Significant differences between the control and AF5-Re1 were observed at all measurement points (p < 0.01), but not between the control and AF10-Re1. AF10-Re2 became thinner than AF10-Re1 (p < 0.01). Reproducible molding results were obtained by waiting 10 min between the first and second moldings, but the third molded mouthguard was significantly thinner, despite this 10 min wait interval.展开更多
Two customized mouthguards were developed for a 35-year-old male kickboxer. These were identical in thickness (the vertical dimension between the upper and lower jaws), the material, and similar in form (visible outli...Two customized mouthguards were developed for a 35-year-old male kickboxer. These were identical in thickness (the vertical dimension between the upper and lower jaws), the material, and similar in form (visible outline);however, one mouthguard was designed such that the horizontal jaw position was determined by the maximal grip strength obtained by the subject during the Bi-Digital O-Ring Test. Both mouthguards were satisfactory in terms of how they felt during wearing and breathing;however, the subject achieved higher kicking force, punching force, and back muscle strength while using the mouthguard with an optimized horizontal jaw position. These findings suggest that to enhance sports performance, it may be important to determine the optimal biting position. The grip strength obtained during the Bi-Digital O-Ring Test is a useful parameter for this assessment.展开更多
Mouthguard thickness is affected by the softened state of the sheet during thermoforming. The aim of this study is to establish an effective method for controlling the softened state of the sheet to prevent the mouthg...Mouthguard thickness is affected by the softened state of the sheet during thermoforming. The aim of this study is to establish an effective method for controlling the softened state of the sheet to prevent the mouthguard thickness from decreasing during mouthguard fabrication using a vacuum-forming machine. Mouthguards were thermoformed using an ethylene-vinyl acetate sheet (thickness: 4.0 mm) and a vacuum-forming machine. The working model was trimmed to the anterior height of 25 mm and the posterior height of 20 mm. The following two heating methods were compared: 1) the sheet was formed when it sagged 15 mm below the level of the sheet frame at the top of the post (condition T);and 2) the sheet frame was lowered to and heated at 50 mm below its usual height and the sheet was formed when it sagged 15 mm below the level of the sheet frame (condition L). For each heating method, the vacuum was applied immediately (T0, L0) or 5 s (T5, L5) after the sheet frame was lowered to the forming unit. The sheet surface temperature immediately before the vacuum was applied under each condition was measured. The differences in mouthguard thickness due to forming conditions were analyzed by one-way ANOVA and Bonferroni’s multiple comparison tests. The temperature difference between the center and the posterior depending on the condition decreased in the order T0 > T5 > L0 > L5, and that was 20<span style="white-space:nowrap;">°</span>C or higher for T0 and T5, and 10<span style="white-space:nowrap;">°</span>C or less for L0 and L5. At the incisal edge and the cusp, L0 and L5 were significantly thicker than T0. No significant differences were observed between conditions L0 and L5 at any measurement points. For the labial and buccal surfaces, significant differences in thicknesses among all conditions, except L0 and L5, were observed and were in the order T0 < T5 < L0 and L5. This study was suggested that the lowering the sheet frame and heating was more effective than adjusting the vacuum timing for uniform softening of the sheet.展开更多
Effectiveness and safety of mouthguards are greatly affected by its thickness. The aim of this study was to clarify the effect of model height and model position on the forming table on the mouthguard thickness in the...Effectiveness and safety of mouthguards are greatly affected by its thickness. The aim of this study was to clarify the effect of model height and model position on the forming table on the mouthguard thickness in thermoforming using a circular frame. Mouthguards were thermoformed using 4.0-mm-thick ethylene-vinyl-acetate sheets and a vacuum forming machine. The sheet was sandwiched between circular frames and fixed to the clamp of the forming machine. Working models were two types of hard gypsum models trimmed so that the height of the anterior part was 25 mm (Model A) and 30 mm (Model B). The model was placed with its anterior rim positioned 40 mm (P40), 30 mm (P30), 20 mm (P20), or 10 mm (P10) from the front of the forming table. Differences in the reduction rate of the thickness due to the model height and model positions were analyzed by two-way ANOVA and Bonferroni’s multiple comparison test. Differences depending on the model height were observed at P40 at the incisal edge and P30, P20, and P10 on the labial surface, and the reduction rate of the thickness was significantly smaller in Model A (P < 0.01). As the distance from the model anterior rim to the front of the forming table was smaller, the rate of the thickness of the incisal edge and the labial surface decreases became larger. The rate of decrease in the thickness of the cusp and buccal surface was the smallest at P20. This study indicated that the difference in the thickness of the single-layer mouthguard depending on the model position on the forming table is affected by the model height. However, that is only the anterior part of the mouthguard, and the difference in thickness reduction rate is less than 5%. Additionally, in order to perform stable forming, it is useful to increase the distance from the model to the frame, and it is important to position the part whose thickness is desired to be maintained in the center of the forming table.展开更多
The height of the working model affects the mouthguard thickness. The aim of this study was to clarify the difference in the effect of model height on the thickness between single- and double-layered mouthguards. Mout...The height of the working model affects the mouthguard thickness. The aim of this study was to clarify the difference in the effect of model height on the thickness between single- and double-layered mouthguards. Mouthguards were thermoformed using ethylene-vinyl-acetate sheets and a pressure molding machine. Working models were three hard gypsum models with the height of the anterior part trimmed to 25 mm (model A), 30 mm (model B), and 35 mm (model C). Three molding conditions were compared: a single-layered mouthguard using a 4.0-mm thick-sheet (S4);a double-layered mouthguard using a 3.0-mm-thick sheet on the first-layer and a 2.0-mm-thick sheet on the second-layer (L32);and a double-layered mouthguard using 3.0-mm-thick sheets on first- and second-layers (L33). Analysis was performed by two-way ANOVA and a simple main effect test for the differences in the mouthguard thickness depending on the model height and the molding condition. Under all molding conditions, the labial and buccal thicknesses tended to become thinner as the model height increased, and models B and C were thinner by about 6% - 7% and about 14% - 16% than model A, respectively. The cusp thickness was not affected by the model height in L32 and L33, but in S4, models B and C were thinner about 14% or more than model A. Significant differences were observed among molding conditions, and S4 P < 0.01). This study suggested that the degree of the decrease in mouthguard thickness due to the increase the model height was similar for the single- and double-layered mouthguards on the labial and buccal sides, and increasing the model height by 5 mm and 10 mm decreased the thickness by about 6% - 7% and about 14% - 16%, respectively. At the cusp, only the single-layered mouthguard was affected by the model height.展开更多
The effectiveness and safety of the mouthguard depend on the sheet material thickness. The thickness of the thermoformed mouthguard is affected by the model undercut and the thermal shrinkage that occurs when the extr...The effectiveness and safety of the mouthguard depend on the sheet material thickness. The thickness of the thermoformed mouthguard is affected by the model undercut and the thermal shrinkage that occurs when the extruded-molded sheet is reheated. The aim of this study was to clarify the influence of the undercut amount of the model and the thickness of the sheet material on the thermal shrinkage of the extruded sheet. The mouthguard sheet used ethylene-vinyl acetate resin with a thickness of 4.0 mm (4M) and 3.0 mm (3M) and was manufactured by extrusion molding. The working models were three hard gypsum models with the undercut amount on the labial side trimmed to 0? (U0), 10? (U10), and 20? (U20). Mouthguard thickness after vacuum formation was compared between the conditions formed so that the extrusion direction was vertical (condition V) or parallel (condition P) to the model midline. Differences in the reduction rate of the mouthguard thicknesses of the labial and buccal side depending on the sheet extrusion direction, model angle, and sheet material thickness were analyzed by three-way ANOVA and Bonferroni method. The reduction rate of the thickness in condition P was significantly greater than in condition V under all conditions except U0-4M on the labial side and U0-4M and U10-4M on the buccal side. In all models, the reduction rate of the thicknesses was significantly greater in 3M than in 4M in the same extrusion direction. In both 4M and 3M, the reduction rate of the thicknesses tended to increase as the amount of undercut increased in each extrusion direction. This study suggested that a model with a large amount of undercut on the labial side or a thin sheet had a significant effect on the thermal shrinkage of the mouthguard sheet during thermoforming, which leads to the thinning of the mouthguard.展开更多
The effectiveness and safety of the mouthguard are greatly affected by its thickness. The aim of this study was to investigate the effect of thermal shrinkage of the extruded sheet on the mouthguard thickness dependin...The effectiveness and safety of the mouthguard are greatly affected by its thickness. The aim of this study was to investigate the effect of thermal shrinkage of the extruded sheet on the mouthguard thickness depending on the amount of undercut of the model. Mouthguard sheet was used a 4.0 mm thick ethylene-vinyl acetate resin manufactured by extrusion molding. The sheets were placed in the vacuum forming machine with the sheet extrusion direction either vertical (condition V) or parallel (condition P) to the model’s centerline. The working models were three hard plaster models trimmed so that the angles of the anterior teeth to the model base were 90?, 100?, and 110? (Models A, B, and C). The sheet was softened until it sagged 15 mm, and then suction was continued for 30 s. Measurement points of the mouthguard were the incisal portion (incisal edge and labial surface) and molar portion (cusp and buccal surface). The differences in the reduction rate of the thickness due to model form and extrusion direction were analyzed using two-way ANOVA and Bonferroni’s multiple comparison tests. Differences in thickness depending on the extrusion direction of the sheet were observed in Models B and C on the labial surface and in all models on the buccal surface, and the thicknesses obtained under condition P were significantly thinner than those obtained under condition V. The thicknesses of the incisal edge and the cusp were not affected by the extrusion direction. The result of this study was suggested that the labial and buccal thickness of the mouthguard was secured by placing the sheet in the extrusion direction vertical to the model’s centerline. Furthermore, it was clarified that the presence of the undercut of the model tends to increase the influence of the extrusion direction of the sheet on the thickness of the mouthguard.展开更多
文摘Many molding techniques have been researched to ensure the thickness of custom mouthguards. The aim of this study was to clarify the effect on the thickness of a laminated mouthguard of a molding technique in which the model position is moved forward just before molding. Mouthguards were molded using a 3.0-mm-thick ethylene vinyl acetate mouthguard sheet and a pressure molding machine. The molding method was the normal molding method (condition C) and the molding technique (condition MP) in which the model position was moved 20 mm forward just before molding. Regarding the molding of the first layer (F) and the second layer (S), the following four molding methods based on the combination of conditions C and MP were compared;FC-SC, FC-SMP, FMP-SC, and FMP-SMP. Differences in mouthguard thickness due to molding conditions for the first and second layers were analyzed by two-way ANOVA and Bonferroni’s multiple comparison test. Significant differences were observed among all molding conditions on the labial surface, and the thicknesses were in the order FC-SC < FC-SMP < FMP-SC < FMP-SMP. FMP-SMP was 4.67 mm thick, which was 1.39 mm thicker than FC-SC. FC-SC was the thinnest at the cusp, and a significant difference was observed between other molding conditions. On the buccal side, significant differences were observed between all conditions except FC-SMP and FMP-SC, and the thicknesses were in the order FC-SC < FC-SMP, FMP-SC < FMP-SMP. The results of this study suggested that the labial and buccal sides of laminated mouthguards could be made 1.4 and 1.2 times thicker when a molding technique that moves the model position just before formation was used for the first and second layers. The reduction in thickness was suppressed by approximately 23.2% and approximately 10.7% on the labial and buccal sides, respectively, compared with the normal molding method.
文摘Wearing a mouthguard reduces the risk of sports-related injuries, but the material and thickness of the mouthguard has a substantial impact on its effectiveness and safety. The aim of this study was to establish a thermoforming technique in which the model position is moved just before formation to suppress the reduction in thickness. Mouthguards were vacuum formed using ethylene-vinyl-acetate sheets with a thickness of 2.0, 3.0, and 4.0 mm. The working model was trimmed to the height of 25-mm at the maxillary central incisor and 20-mm at first molar. The model was placed with its anterior rim positioned 40-mm from the front of the forming table. Two forming methods were compared: 1) the sheet was formed when it sagged 15-mm at the top of the post under normal conditions (control);and 2) the sheet frame at the top of the post was lowered and the model was covered when the sheet sagged 15-mm, the rear side of the model was pushed forward 20-mm, and the mouthguard was formed (MP;model position). Sheet thickness after fabrication was determined for the incisal edge, labial surface, and buccal surface using a specialized caliper accurate to 0.1-mm. The difference in the reduction in thickness depending on the forming methods and sheet thicknesses were analyzed by two-way ANOVA and Bonferroni’s multiple comparison tests. Reduction in thickness was greater for thicker sheets, and the reduction in thickness for the MP was less than that for the control. The reduction in labial for the MP was an exception;the reduction in thickness was only about half that of the control. The thermoforming technique of moving the model forward just before vacuum formation was effective for suppressing the mouthguard thickness reduction, which in thickness of the labial side can be reduced to about half of the normal forming method.
文摘Wearing a mouthguard reduces the risk of sports-related injuries, but a more comfortable design is required in order to increase the wearing rate. The aim of this study was to investigate a thermoforming method that decreases palatal thickness while maintaining labial and buccal thickness. Mouthguards were fabricated from an ethylene-vinyl acetate sheet (thickness: 4.0 mm) by using a vacuum forming machine. Four working models were prepared: 1) the anterior height was 25-mm and the posterior height was 20-mm (model A), 2) model A with the palate trimmed (model B), 3) heights 5 mm greater than model A (model C), and 4) model C with the palate trimmed (model D). The two forming conditions were as follows: 1) The sheet was formed when it sagged 15 mm below the level of the sheet frame at the top of the post under ordinary use (control);2) The sheet frame at the top of the post was lowered and the sheet covered the model when it sagged by 15 mm. The rear side of the model was pushed to move the model forward 20 mm, and then the sheet was formed (MP). Differences in mouthguard thickness due to forming conditions and model forms were analyzed by two-way analysis of variance and Bonferroni’s multiple comparison tests. Difference in forming conditions was similar for all model forms;for the MP, the thickness of the incisal edge, labial surface, cusp and buccal surface were greater, and the palatal surface was thinner than the control. On the labial and buccal surface, the thickness difference due to the model form was observed only for the MP, and models A and B were thicker than models C and D. The palatal thickness tended to be thin in the models with the trimmed palate. This study suggested that the labial and buccal thickness of the mouthguard can be maintained, and the palatal thickness can be decreased by using the model with the palate trimmed with the forming method in which the model position is moved forward immediately before the vacuum formation.
文摘The purpose of this study is to analyse the neuromuscular balance of the masticatory muscles and the influence on the athlete respiratory parameters induced by custom-made mouthguard. Twenty-six athletes (24 males and 2 females), of different disciplines, average age of 32.12 ± 12.05, were recruited. Each athlete received a custom-made mouthguard in the Ethylene-Vinyl-Acetate (EVA) thermoplastic material and using surface electromyography, the masseter muscles and the frontal beams of the temporal muscles were analysed, with and without mouthguard. The athletes were then subjected to a medical examination and cardiopulmonary test, in the condition with and without mouthguard. The use of mouthguard caused an improvement of all the electromyographic indexes analysed. In particular, GLOBAL INDEX (p = 0.0021), BAR (p = 0.0005), IMPACT (p = 0.0076) and ASIM (p = 0.0290) showed an enhancement statistically significant. For the cardiopulmonary test indexes as maximum oxygen uptake (VO2max), minute ventilation (VE), breathing reserve (BR), not statistically differences (p > 0.05) were reported. The custom-made mouthguard improved the neuromuscular balance of the masticatory muscles, symmetrizing the masseters and temporalis muscles work. It produced a better balancing distribution of occlusal loads both in the anterior-posterior direction and in the lateral direction and offered the possibility to produce more muscular work. Moreover, it did not constitute an impediment that can significantly disturb the athlete’s breathing during physical activity.
文摘BACKGROUND Anaesthetic care during upper gastrointestinal(GI)endoscopy has the unique challenge of maintaining ventilation and oxygenation via a shared upper airway.Supplemental oxygen is recommended by international society guidelines,however,the optimal route or rate of oxygen delivery is not known.Various oxygen delivery devices have been investigated to improve oxygenation during upper GI endoscopy,however,these are limited by commercial availability,costs and in some cases,the expertise required for insertion.Anecdotally at our centre,higher flows of supplemental oxygen can safely be delivered via an oxygenating mouthguard routinely used during upper GI endoscopic procedures.AIM To assess the incidence of hypoxaemia(SpO2<90%)in patients undergoing upper GI endoscopy receiving supplemental oxygen using an oxygenating mouthguard at 20 L/min flow compared to standard nasal cannula(SNC)at 2 L/min flow.METHODS A single centre,prospective,randomised clinical trial at two sites of an Australian tertiary hospital between October 2020 and September 2021 was conducted.Patients undergoing elective upper gastrointestinal endoscopy under deep sedation were randomised to receive supplemental oxygen via high-flow via oxygenating mouthguard(HFMG)at 20 L/min flow or SNC at 2 L/min flow.The primary outcome was the incidence of hypoxaemia of any duration measured by pulse oximetry.Intraprocedural-related,procedural-related,and sedation-related adverse events and patient-reported outcomes were also recorded.RESULTS Three hundred patients were randomised.Eight patients were excluded after randomisation.292 patients were included in the intention-to-treat analysis.The incidence of hypoxaemia was significantly reduced in those allocated HFMG.Six patients(4.4%)allocated to HFMG experienced an episode of hypoxaemia,compared to thirty-four(22.1%)patients allocated to SNC(P value<0.001).No significant difference was observed in the rates of adverse events or patient-reported outcome measures.CONCLUSION The use of HFMG offers a novel approach to reducing the incidence of hypoxaemia during short upper gastrointestinal endoscopic procedures in low-risk patients undergoing deep sedation.
文摘Mouthguards can reduce the risk of sports-related injuries, but the sheet material and thickness have a large effect on their efficacy and safety. This study was intended to predict the changes in thickness of molded products by clarifying the effect of the time interval between repeat moldings during the continuous use of a vacuum-forming machine. Ethylene vinyl acetate mouthguard sheets were used for thermoforming with a vacuum-forming machine. The working model was trimmed to a height of 23 mm at the maxillary central incisor and 20 mm at maxillary first molar. Five molding conditions were investigated: 1) molding was carried out after the sag at the center of the softened sheet was 15 mm (control);2) sheet heating was started 5 min after the molding of the control (AF5-Re1);3) sheet heating started 5 min after the molding of AF5-Re1 (AF5-Re2);4) sheet heating started 10 min after the molding of the control (AF10-Re1);and 5) sheet heating started 10 min after the molding of AF10-Re1 (AF10-Re2). Sheet thickness after fabrication was determined for the incisal edge, labial surface, cusp, and buccal surface using a special caliper accurate to 0.1 mm. Thickness differences of the molding conditions were analyzed by two-way analysis of variance. Significant differences between the control and AF5-Re1 were observed at all measurement points (p < 0.01), but not between the control and AF10-Re1. AF10-Re2 became thinner than AF10-Re1 (p < 0.01). Reproducible molding results were obtained by waiting 10 min between the first and second moldings, but the third molded mouthguard was significantly thinner, despite this 10 min wait interval.
文摘Two customized mouthguards were developed for a 35-year-old male kickboxer. These were identical in thickness (the vertical dimension between the upper and lower jaws), the material, and similar in form (visible outline);however, one mouthguard was designed such that the horizontal jaw position was determined by the maximal grip strength obtained by the subject during the Bi-Digital O-Ring Test. Both mouthguards were satisfactory in terms of how they felt during wearing and breathing;however, the subject achieved higher kicking force, punching force, and back muscle strength while using the mouthguard with an optimized horizontal jaw position. These findings suggest that to enhance sports performance, it may be important to determine the optimal biting position. The grip strength obtained during the Bi-Digital O-Ring Test is a useful parameter for this assessment.
文摘Mouthguard thickness is affected by the softened state of the sheet during thermoforming. The aim of this study is to establish an effective method for controlling the softened state of the sheet to prevent the mouthguard thickness from decreasing during mouthguard fabrication using a vacuum-forming machine. Mouthguards were thermoformed using an ethylene-vinyl acetate sheet (thickness: 4.0 mm) and a vacuum-forming machine. The working model was trimmed to the anterior height of 25 mm and the posterior height of 20 mm. The following two heating methods were compared: 1) the sheet was formed when it sagged 15 mm below the level of the sheet frame at the top of the post (condition T);and 2) the sheet frame was lowered to and heated at 50 mm below its usual height and the sheet was formed when it sagged 15 mm below the level of the sheet frame (condition L). For each heating method, the vacuum was applied immediately (T0, L0) or 5 s (T5, L5) after the sheet frame was lowered to the forming unit. The sheet surface temperature immediately before the vacuum was applied under each condition was measured. The differences in mouthguard thickness due to forming conditions were analyzed by one-way ANOVA and Bonferroni’s multiple comparison tests. The temperature difference between the center and the posterior depending on the condition decreased in the order T0 > T5 > L0 > L5, and that was 20<span style="white-space:nowrap;">°</span>C or higher for T0 and T5, and 10<span style="white-space:nowrap;">°</span>C or less for L0 and L5. At the incisal edge and the cusp, L0 and L5 were significantly thicker than T0. No significant differences were observed between conditions L0 and L5 at any measurement points. For the labial and buccal surfaces, significant differences in thicknesses among all conditions, except L0 and L5, were observed and were in the order T0 < T5 < L0 and L5. This study was suggested that the lowering the sheet frame and heating was more effective than adjusting the vacuum timing for uniform softening of the sheet.
文摘Effectiveness and safety of mouthguards are greatly affected by its thickness. The aim of this study was to clarify the effect of model height and model position on the forming table on the mouthguard thickness in thermoforming using a circular frame. Mouthguards were thermoformed using 4.0-mm-thick ethylene-vinyl-acetate sheets and a vacuum forming machine. The sheet was sandwiched between circular frames and fixed to the clamp of the forming machine. Working models were two types of hard gypsum models trimmed so that the height of the anterior part was 25 mm (Model A) and 30 mm (Model B). The model was placed with its anterior rim positioned 40 mm (P40), 30 mm (P30), 20 mm (P20), or 10 mm (P10) from the front of the forming table. Differences in the reduction rate of the thickness due to the model height and model positions were analyzed by two-way ANOVA and Bonferroni’s multiple comparison test. Differences depending on the model height were observed at P40 at the incisal edge and P30, P20, and P10 on the labial surface, and the reduction rate of the thickness was significantly smaller in Model A (P < 0.01). As the distance from the model anterior rim to the front of the forming table was smaller, the rate of the thickness of the incisal edge and the labial surface decreases became larger. The rate of decrease in the thickness of the cusp and buccal surface was the smallest at P20. This study indicated that the difference in the thickness of the single-layer mouthguard depending on the model position on the forming table is affected by the model height. However, that is only the anterior part of the mouthguard, and the difference in thickness reduction rate is less than 5%. Additionally, in order to perform stable forming, it is useful to increase the distance from the model to the frame, and it is important to position the part whose thickness is desired to be maintained in the center of the forming table.
文摘The height of the working model affects the mouthguard thickness. The aim of this study was to clarify the difference in the effect of model height on the thickness between single- and double-layered mouthguards. Mouthguards were thermoformed using ethylene-vinyl-acetate sheets and a pressure molding machine. Working models were three hard gypsum models with the height of the anterior part trimmed to 25 mm (model A), 30 mm (model B), and 35 mm (model C). Three molding conditions were compared: a single-layered mouthguard using a 4.0-mm thick-sheet (S4);a double-layered mouthguard using a 3.0-mm-thick sheet on the first-layer and a 2.0-mm-thick sheet on the second-layer (L32);and a double-layered mouthguard using 3.0-mm-thick sheets on first- and second-layers (L33). Analysis was performed by two-way ANOVA and a simple main effect test for the differences in the mouthguard thickness depending on the model height and the molding condition. Under all molding conditions, the labial and buccal thicknesses tended to become thinner as the model height increased, and models B and C were thinner by about 6% - 7% and about 14% - 16% than model A, respectively. The cusp thickness was not affected by the model height in L32 and L33, but in S4, models B and C were thinner about 14% or more than model A. Significant differences were observed among molding conditions, and S4 P < 0.01). This study suggested that the degree of the decrease in mouthguard thickness due to the increase the model height was similar for the single- and double-layered mouthguards on the labial and buccal sides, and increasing the model height by 5 mm and 10 mm decreased the thickness by about 6% - 7% and about 14% - 16%, respectively. At the cusp, only the single-layered mouthguard was affected by the model height.
文摘The effectiveness and safety of the mouthguard depend on the sheet material thickness. The thickness of the thermoformed mouthguard is affected by the model undercut and the thermal shrinkage that occurs when the extruded-molded sheet is reheated. The aim of this study was to clarify the influence of the undercut amount of the model and the thickness of the sheet material on the thermal shrinkage of the extruded sheet. The mouthguard sheet used ethylene-vinyl acetate resin with a thickness of 4.0 mm (4M) and 3.0 mm (3M) and was manufactured by extrusion molding. The working models were three hard gypsum models with the undercut amount on the labial side trimmed to 0? (U0), 10? (U10), and 20? (U20). Mouthguard thickness after vacuum formation was compared between the conditions formed so that the extrusion direction was vertical (condition V) or parallel (condition P) to the model midline. Differences in the reduction rate of the mouthguard thicknesses of the labial and buccal side depending on the sheet extrusion direction, model angle, and sheet material thickness were analyzed by three-way ANOVA and Bonferroni method. The reduction rate of the thickness in condition P was significantly greater than in condition V under all conditions except U0-4M on the labial side and U0-4M and U10-4M on the buccal side. In all models, the reduction rate of the thicknesses was significantly greater in 3M than in 4M in the same extrusion direction. In both 4M and 3M, the reduction rate of the thicknesses tended to increase as the amount of undercut increased in each extrusion direction. This study suggested that a model with a large amount of undercut on the labial side or a thin sheet had a significant effect on the thermal shrinkage of the mouthguard sheet during thermoforming, which leads to the thinning of the mouthguard.
文摘The effectiveness and safety of the mouthguard are greatly affected by its thickness. The aim of this study was to investigate the effect of thermal shrinkage of the extruded sheet on the mouthguard thickness depending on the amount of undercut of the model. Mouthguard sheet was used a 4.0 mm thick ethylene-vinyl acetate resin manufactured by extrusion molding. The sheets were placed in the vacuum forming machine with the sheet extrusion direction either vertical (condition V) or parallel (condition P) to the model’s centerline. The working models were three hard plaster models trimmed so that the angles of the anterior teeth to the model base were 90?, 100?, and 110? (Models A, B, and C). The sheet was softened until it sagged 15 mm, and then suction was continued for 30 s. Measurement points of the mouthguard were the incisal portion (incisal edge and labial surface) and molar portion (cusp and buccal surface). The differences in the reduction rate of the thickness due to model form and extrusion direction were analyzed using two-way ANOVA and Bonferroni’s multiple comparison tests. Differences in thickness depending on the extrusion direction of the sheet were observed in Models B and C on the labial surface and in all models on the buccal surface, and the thicknesses obtained under condition P were significantly thinner than those obtained under condition V. The thicknesses of the incisal edge and the cusp were not affected by the extrusion direction. The result of this study was suggested that the labial and buccal thickness of the mouthguard was secured by placing the sheet in the extrusion direction vertical to the model’s centerline. Furthermore, it was clarified that the presence of the undercut of the model tends to increase the influence of the extrusion direction of the sheet on the thickness of the mouthguard.