Dennis N. Ranalli

Orofacial injuries from sport: preventive measures for sports medicine.

AbstractIndividuals worldwide are participating in an expanding arena of vigourous physical activities as well as competitive sports at all levels. The healthful benefits of such activities are unfortunately associated with injury risks that include orofacial soft-and hard-tissue trauma. This article describes the scope and emergency management of sports-related orofacial traumatic injuries that may be encountered by physicians in the field of sports medicine. Since most of these injuries are preventable with the use of protective equipment, specific recommendations are provided for the use of properly fitted mouthguards.

Prevalence of dental trauma in Pan American Games athletes

The aim of this cross-sectional epidemiological survey was to assess the prevalence of dental trauma in athletes representing 42 countries competing at the most recent Pan American Games (XV Pan Am) held in Rio de Janeiro, Brazil in July of 2007, and to determine prior use and type of mouthguard among this group of athletes. The examiners participated in standardization and calibration training sessions before the field phase began. Invitations were sent to >5500 participating athletes competing in 41 sports and to the Medical Committee of the Pan American Sports Organization before and during the XV PAN. A convenience sample of 409 athletes was recruited. After signing an informed consent, all athletes answered a questionnaire. Data were collected at the clinical examination and recorded on a specific trauma form. The mean age of the athletes was 24.4 +/- 5.3 years. Males comprised 55% of the sample; females 45%. The prevalence of dental trauma among the athletes was 49.6% (n = 203) with no gender-based differences. Most of these injuries (63.6%) were related to activities during training or competition. Sports with the highest injury prevalence were wrestling (83.3%), boxing (73.7%), basketball (70.6%) and karate (60%). The most common injury was enamel fracture (39.8%); root fracture was the least common (0.4%). The teeth most affected were the maxillary permanent central incisors (n = 113), followed by the mandibular central incisors (n = 19). Based on the results of this study, nearly one-half of the subjects had experienced previous dental trauma; the majority related to sports activities. Furthermore, only 17% of the athletes reported prior mouthguard use; the most frequent mouthguards reported were boil-and-bite. These results suggest the importance of enhanced educational efforts and the use of properly fitted mouthguards to reduce dental trauma among athletes in international sports competition, especially in sports where mouthguards are not mandatory.

Dental injuries in sports.

The expanding arena of sports and vigorous recreational activities is associated with an increased risk for sportsrelated injuries, including trauma to the teeth. Because dental professionals may not be present on site, in the best interest of athletes, it is suggested that sports medicine professionals who are present be provided with current evaluative, emergent, and referral protocols for proper management of sports-related dental injuries to address the immediate needs of the athlete and to enhance the long-term prognosis of the traumatized tooth. This article provides information related to some of the more common dental injuries encountered in sports, including crown fractures, root fractures, and traumatic tooth displacements. Use of properly fitted, custom-fabricated athletic mouth guards for the prevention of dental injuries is recommended strongly, as is the inclusion of a dentist on the sports medicine team roster.

Stevens-Johnson syndrome. A report of fourteen pediatric cases.

Abstract Stevens-Johnson syndrome is a symptom complex which includes prodromal symptoms followed by severe mucosal, ocular, and cutaneous lesions. Numerous agents have been suggested as possible etiologic factors. The current study reviews fourteen confirmed cases of Stevens-Johnson syndrome in children, with emphasis on possible etiology, type and severity of lesions, distribution, and complications. Implications for dentists are discussed.

Prevalence of oral trauma in Para-Pan American Games athletes

The aim of this cross-sectional epidemiological survey was to assess the prevalence of oral trauma in athletes representing 25 countries competing at the most recent Para-Pan American Games (III PARAPAN) held in Rio de Janeiro, Brazil. The study was approved by the appropriate institutional review board. The examiners participated in standardization and calibration training sessions before the field phase began. Invitations were sent to >1200 participating athletes competing in eight sports and to the Medical Committee of the Para-Pan American Sports Organization before and during the III PARAPAN. A convenience sample of 120 athletes was recruited. After signing an informed consent, all athletes answered a questionnaire. Data were collected at the clinical examination and recorded in a specific trauma form. The mean age of the athletes was 32.5 years. Males comprised 79.2% of the sample; females 20.8%. The prevalence of oral trauma among the athletes was 47.5% (N = 57). However, only 15 athletes reported that these traumatic injuries were sports-related. The sport with the highest prevalence of oral trauma was judo (75%); the least was volleyball with no reported traumatic injuries. The most common traumatic injury was enamel fracture (27.4%). The teeth most affected were the maxillary permanent central incisors (N = 19), followed by the maxillary premolars (N = 8). On the basis of the results of this study of oral trauma among athletes examined at the III PARAPAN, a recommendation for enhanced educational efforts and the use of properly fitted mouthguards to prevent traumatic injuries among high-performance athletes with disabilities seems warranted.

Pulp test response of the maxillary anterior teeth in cleft palate patients

The relative pulpal responsiveness of the six maxillary incisors to electrical and cold thermal stimuli was tested in patients with complete unilateral and bilateral clefts. The six maxillary anterior teeth were tested at random to electrical stimuli. After a 5-minute interval, the same teeth were tested at random to cold stimuli with an ice pencil. Unilateral and bilateral cleft palate patients had statistically significant higher mean electrical pulp test thresholds for the maxillary anterior teeth than the noncleft palate patients. No statistically significant difference between unilateral and bilateral cleft palate patients was found in electric pulp test responses of the maxillary anterior teeth. No statistically differences in electric pulp test responses and cold test responses of the maxillary anterior teeth in both cleft palate and noncleft palate individuals based on differences in sex were observed. No statistically significant difference in cold test responses were observed between cleft palate and noncleft palate patients. Cleft palate patients who completed orthodontic treatment within 1 year of testing showed elevated mean electrical pulp test thresholds as did noncleft palate patients who received orthodontic treatment within 1 year of testing.