Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지

Effect of Mouthguard on Tooth Distortion During Clenching

이악물기 시 발생되는 치아변형에 대한 구강보호장치의 역할

  • Lee, Yun (Dept. of Prosthodontics, School of Dentistry, Kyung Hee University) ;
  • Choi, Dae-Gyun (Dept. of Prosthodontics, School of Dentistry, Kyung Hee University) ;
  • Kwon, Kung-Rock (Dept. of Prosthodontics, School of Dentistry, Kyung Hee University) ;
  • Lee, Richard Sung-Bok (Dept. of Prosthodontics, School of Dentistry, Kyung Hee University) ;
  • Noh, Kwan-Tae (Dept. of Prosthodontics, School of Dentistry, Kyung Hee University)
  • 이윤 (경희대학교 치의학전문대학원 치과보철학교실) ;
  • 최대균 (경희대학교 치의학전문대학원 치과보철학교실) ;
  • 권긍록 (경희대학교 치의학전문대학원 치과보철학교실) ;
  • 이성복 (경희대학교 치의학전문대학원 치과보철학교실) ;
  • 노관태 (경희대학교 치의학전문대학원 치과보철학교실)
  • Received : 2010.09.05
  • Accepted : 2010.12.25
  • Published : 2010.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Previous studies have already shown that mouthguard is effective in protecting jaw bone, teeth and oral tissue against sports trauma. However, other than severe trauma, repetitive force, such as disorders like clenching, cause teeth or oral tissue damage. These kinds of disorders usually present pathologic attrition in the posterior teeth, resorption in alveolar bone, loss of teeth and destruction of occlusion. Wearing a mouthguard is believed to be effective in preventing these disorders. But its effect is not examined thoroughly enough. The purpose of this study is to identify whether mouthguard is effective in reducing strain caused by clenching. Mandibular first molars in the normal occlusal relationship without any history of dental treatment were chosen. Biaxial type strain gauge was placed on the buccal surface of the tooth. Having maximum occlusal force, measured by load cell, as a standard, clenching intensity were divided into three stages; moment of slightly tooth contact, medium bite force (50% of maximum bite force), maximum bite force. Strain occurring in dentition in each stage with and without mouthguard was measured. Changes in strain (on dentition) between each stage and difference in strain, between with or without mouthguard were recorded by PCD-300 analyzer and PCD-30 soft ware. The data was statistically analyzed by Wilcoxon signed rank test. The following results were drawn; Without mouthguard, strain given on dentition increased as the clenching force increased. With mouthguard, strain given on dentition also increased as the clenching force increased. With mouthguard, strain decreased, in all cases of clenching force stages. Data on the moment of slightly tooth contact stage, had no statistical significance. However, with mouthguard, 50-90% of decrease in strain could be obtained in maximum occlusal force, compared to the group without mouthguard. Mouthguard decreased the strain on the dentition, caused by clenching. Therefore, mouthguard seems to be effective in preventing damage on dentition, by acting against clenching, which occurs both consciously and unconsciously during sports activities.

그 동안 많은 연구와 실험에서 운동 중 외상에 대한 마우스가드의 악골, 치아 및 구강조직의 보호 효과를 확인하였다. 그러나 치아 및 구강조직의 장애는 강한 외상 외에도 힘이 반복적으로 가해지는 이악물기와 같은 장애로도 발생한다. 이러한 장애는 주로 구치부의 병적인 교모, 치조골 흡수, 치아 상실 및 교합의 붕괴로 나타난다. 마우스가드의 장착이 이러한 장애를 예방하는데 유효한 것으로 생각되나 그 효과는 충분히 검토되지 않았다. 이 연구에서는 이악물기에 의해 치아에 발생되는 뒤틀림을 마우스가드가 효과적으로 감소시킬 수 있는지를 알아보기 위해 스트레인 게이지를 이용 하였다. 7명의 건강한 성인의 치료경험이 없는 하악 제1대구치를 피검치로 선정하고 이축(bi-axial)의 스트레인 게이지를 치아 협면에 접착 하였다. load cell에 의해 측정된 최대 교합력을 기준으로 최초 치아 접촉, 중간 강도의 교합력, 최대 강도의 교합력으로 이악물기 강도를 3단계로 구분 하였다. 마우스가드 장착 전 세 단계의 이악물기 강도에서 치아에 발생하는 스트레인을 측정하고, 마우스가드 장착 후에도 같은 방법으로 측정하였다. 마우스가드 장착 전과 후 각각 세단계의 이악물기 단계 사이의 치아에 발생하는 스트레인의 변화를 분석하였다. 마우스가드 장착 전 후에 치아에 발생하는 스트레인의 변화를 분석하였다. SPSS 13.0 프로그램을 이용 (Wilcoxon signed rank test) 95%의 유의수준에서 통계분석 하였다. 마우스가드 장착 전 치아에 발생하는 스트레인은 이악물기 강도가 증가함에 따라 증가 하였다. 마우스 장착 후에도 치아에 발생하는 스트레인은 이악물기 강도가 증가함에 따라 증가 하였다. 모든 피검자에서 이 악물기 강도에 상관없이 마우스가드 장착으로 스트레인이 감소하였다. 치아의 최초 접촉 시에만 통계적 유의성이 없었으며 최대 이악물기 강도에서는 치아에 발생되는 스트레인이 50-90% 감소하였다. 마우스가드는 이 악물기에 의해 발생되는 치아의 뒤틀림을 감소시켰다. 그러므로 마우스가드는 운동 중에 의식적 무의식적으로 발생되는 이 악물기에 의한 치아의 손상을 효과적으로 예방할 수 있을 것이다.

Keywords

References

  1. Woodmansey KF. Athletic mouth guards prevent orofacial injuries. J Am Coll Health 1997;45:179-182. https://doi.org/10.1080/07448481.1997.9936880
  2. Winters LR, Schmitt LC. Tooth preservation in contact sports. J Calif Dent Assoc 1961;37:368-370.
  3. Wehner PJ, Henderson D. Maximum prevention and preservation: an achievement of intraoral mouth protectors. Dent Clin North Am 1965;9:493-498.
  4. Oikarinen KS, Salonen MAM. Introduction of four custom made mouth protectors constructed of single and double layers for activities in contact sports. Endod Dent Traumatol 1993;9:19-24. https://doi.org/10.1111/j.1600-9657.1993.tb00455.x
  5. Strener JM, Lawson EA, Wright JM, Ricketts J. Mouthguards: protection against shock to head, neck and teeth. J Am Dent Assoc 1964;69:273-281. https://doi.org/10.14219/jada.archive.1964.0290
  6. Seon-Dall Hwang, Sung-Bok Lee, Hyeong-Seob Kim, Dae-Gyun Choi. The survey for the knowledge of mouth protector to the sports player in Korea. J Korean Acad Stomatog Func Occ 2007;23:205-218.
  7. Maestrello-deMoya MG, Primosch RE. Orofacial trauma and mouth-protector wear among high school varsity basketball players. J Dent Child 1989;56:36-39.
  8. Marrow RM, Conci T, Seals RR. Oral injuries in southwest conference women basketball players. Athletic Training 1991;26: 344-345.
  9. Takeda T, Ishigami K, Ogawa T, Nakajima K, Shibusawa M, Shimada A, Regner CW. Are all mouthguards the same and safe to use? The influence of occlusal supporting mouthguards in decreasing bone distortion and fractures. Dental Traumatol 2004;20:150-156. https://doi.org/10.1111/j.1600-4469.2004.00247.x
  10. Takeda T, Ishigami K, Shintaro K, Nakajima K, Shimada A, Regner CW. The influence of impact object characteristics on impact force and force absorption by mouthguard material. Dental Traumatol 2004;20:12-20. https://doi.org/10.1111/j.1600-4469.2004.00210.x
  11. Takeda T, Ishigami K, Jun H, Nakajima K, Shimada A, Ogawa T. The influence of sensor type on the measured impact absorption of mouthguard material. Dental Traumatol 2004;20:29-35. https://doi.org/10.1111/j.1600-4469.2004.00220.x
  12. Hickey JC, Morris AI, Calson LD, Seward TE. The relation of mouth protectors to cranial pressure and deformation. J Am Dent Assoc 1967;74:735-740 https://doi.org/10.14219/jada.archive.1967.0145
  13. Ou M, Taniguchi H, Ohyama T. Analysis on decay rate of vibration following impact to human dry skull with and without mouthguards. Bull Tokyo Med Dent Univ 1996;43:13-24.
  14. Kumagai H, Suzuki T, Hamada T, Sondang P, Fujitanl M, Nikawa H. Occlusal force distribution on the dental arch during various levels of clenching. J Oral Rehabil 1999;26:932-5. https://doi.org/10.1046/j.1365-2842.1999.00473.x
  15. Miyahara T, Hagiya N, Ohyama T, Nakamura Y. Modulation of human H reflex in association with voluntary clenching of the teeth. J Neurophysiol 1996;76:2033-2041. https://doi.org/10.1152/jn.1996.76.3.2033
  16. Su-Jin An, Sung-Bok Lee. The effect on appendage muscle strength due to increase in occlusal vertical dimension. J Korean Acad Stomatog Func Occ 2001;17:231-244.
  17. Yun Lee, Dae-Gyun Choi, Sung-Bok Lee. Effect of occlusal balance on center of gravity in body. J Korean Acad Stomatog Func Occ 2003;19:57-68.
  18. Dental Materials. 2nd ed. Koonja Publishing; 1998: 45-48.
  19. Ho-Keun Kwon, Ja-Hea Yoo, Young-Sook Kwon, Baek-Il Kim. Comparison of bite force with dental prescale and unilateral bite force recorder in healthy subjects. J Korean Acad Prosthodont 2006;44:103-111.
  20. Helkimo E, Carlsson GE, Helkimo M. Bite force and state of dentition. Acta Odontol Scand 1977;35: 297-303. https://doi.org/10.3109/00016357709064128
  21. Flystrand F, Kleven E, ilo G. A novel miniature bite force recorder and its clinical application. Acta Odontol Scand 1982;40:209-214. https://doi.org/10.3109/00016358209019814
  22. Okiyama S, Ikebe K, Nokubi T. Association between masticatory performance and maximal occlusal force in young man. J Oral Rehabil 2003;30:278-282. https://doi.org/10.1046/j.1365-2842.2003.01009.x
  23. Cho YC, Kim TK. A study on maximum bite force after dental implantation. J Kor Oral Maxillofac Surg 1997;23:541-547.
  24. Seo JC, Kim JR, Yang DY. A study on changes in the maximum bite force after orthognathic surgery. J Kor Oral Maxillofac Surg 1996;22:121-129.
  25. Jung BY, Jeon YS, Han DH. Occlusal force and oral tactile sensibility measured in partially edentulous patients with Brnemark implants and natural teeth: a clinical study. J Kor Acad Prosthodont 1999;37: 23-41.
  26. Shinogaya T, Matsumoto M. Evaluation of prosthodontic treatment by occlusal force distribution: a methodological study. Eur J Prosthodont Rest Dent 1998;6:121-125.
  27. Shinogaya T, Bakke M, Thomsen CE,Vilmann A, Matsumoto M. Bite force and occlusal load in healthy young subjects - a methodological study. Eur J Prosthodont Rest Dent 2000;8:11-15.
  28. Bakke M, Michler L, Han K, Moller E. Clinical significance of isometric bite force versus electrical activity in temporal and masseter muscles. Scand J Dent Res 1989;97:539-551.
  29. Suzuki T, Kumagai H, Watanabe T, Uchida T, Nagao M. Evaluation of complete denture occlusal contacts using pressuresensitive sheets. Int J Prosthodont 1997;10:386-391.
  30. Takeda Tomotaka, Kurokawa Katsuhide, Nara Kazuhiro, Ninagawa Masaharu, Miyajima Shiro, Shoumura Masahito, Handa Jun, Kawamura Shintaro, Kojima Ichiro, Shibusawa Mami, Ogawa Tohru, Nakajima Kazunori, Shimada Atsushi and Ishigami Keiichi. Mouthguard effect of tooth distortion during clenching Nihon Hotetsu Shika Gakkai Zasshi. 2005;49:608-16. https://doi.org/10.2186/jjps.49.608
  31. Takeda T, Ishigami K, Handa J, Naitoh K, Kurokawa K, Shibusawa M, Nkajima K, Kawamura S. Does hard insertion and space improve shock absorption ability of mouthguard. Dent Traumatol. 2006 ;22:77-82. https://doi.org/10.1111/j.1600-9657.2006.00361.x
  32. Westerman B, Stringfellow PM, Eccleston JA. Beneficial effects of air inclusions on the performance of ethylene vinyl acetate (EVA) mouthguard material. Br J Sports Med. 2002;36:51-3. https://doi.org/10.1136/bjsm.36.1.51
  33. Westerman B, Stringfellow PM, Eccleston JA. Harbrow DJ. Effect of ethylene vinyl acetate (EVA) closed cell foam on transmitted in mouthguard material. Br J Sports Med. 2002;36:205-8. https://doi.org/10.1136/bjsm.36.3.205