scholarly journals The Effectiveness of Dental Protection and the Material Arrangement in Custom-Made Mouthguards

2021 ◽  
Vol 11 (20) ◽  
pp. 9363
Author(s):  
Ana Messias ◽  
Inês J. Gomes ◽  
Paulo N. B. Reis ◽  
Ana M. Amaro ◽  
Maria A. Neto
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Mechanical Response ◽  
Scientific Information ◽  
Soft Tissue Injuries ◽  
Ethylene Vinyl Acetate ◽  
Outer Shell ◽  
The Core ◽  
Anterior Teeth ◽  
Custom Made

Experimental research studies have shown that wearing a mouthguard (MG) is an effective way to prevent tooth or maxillofacial trauma. However, there is a lack of scientific information regarding how the material arrangement within the mouthguard can modify its mechanical response during an impact. Hence, this study aimed to evaluate the influence of material arrangement within custom-made mouthguards on stress transmitted to anterior teeth, bone, and soft tissue after impact. Four 3D finite element models of a human maxilla were reconstructed based on the CBCT of a young patient and analyzed according to the presence or absence of a mouthguard and the type of material arrangement within those with a mouthguard: model NMG with no mouthguard; model CMG representing the conventional arrangement with a single 4 mm-thick ethylene-vinyl acetate (EVA) foil; model FMG presenting layer arrangement with two 1 mm-thick foils of EVA in the outer shell and one 2 mm-thick foil of EVA foam in the core; model HMG presenting a 1 mm-thick compact inner and outer shell of EVA and a 2 mm wide air-filled zone in the core. Linear quasi-static analysis and frontal load were used to simulate an impact with an energy of 4.4 J. Isotropic linear elastic properties were assumed for the bone and teeth but not for the mouthguard protection and oral soft tissues. The results were evaluated and compared in terms of displacement, stretches, and stresses. All the mouthguards analyzed reduced the risk of injury to teeth and bone, reducing the displacement and stress of these structures. However, the implementation of a honeycomb structured layer allowed more significant displacement and deformation of the mouthguard's external layer, thus promoting higher protection of the anatomic structures, namely the root dentin and the bone tissue. Nevertheless, the results also indicate that improving the mouthguard flexibility might increase the soft tissue injuries.

Intensive, Extensive, Expensive: Management of Distal Limb Shearing Injuries in Cats

2009 ◽  
Vol 11 (9) ◽  
pp. 747-757 ◽  
Author(s):  
Sandra Corr
Keyword(s):  
Soft Tissue ◽  
Traffic Accidents ◽  
Soft Tissues ◽  
Road Traffic ◽  
Skin Grafting ◽  
Soft Tissue Injuries ◽  
Wound Management ◽  
Prolonged Treatment ◽  
Distal Limb ◽  
Superficial Skin

Practical relevance Cats often present with distal limb shearing injuries as a result of road traffic accidents (RTAs). Many apparently unsalvageable limbs can be saved through intensive and appropriate early treatment if the basic principles of good wound management are followed. Clinical challenges When a limb is crushed under the wheel of a car, the skin, soft tissues and bone can be injured in a variety of ways, and the wounds are invariably heavily contaminated. Management of such cases is intensive, extensive and expensive. As well as the client's financial constraints, the ethics of prolonged treatment versus the alternative of amputation should be carefully considered. This article reviews the priorities for managing these cases, and presents a logical approach for achieving optimal outcomes. Patient group Any cat allowed access to the outdoors is potentially at risk of sustaining RTA injuries, young cats particularly so. Evidence base Many textbooks and original articles have been published on aspects of managing soft tissue injuries and skin grafting. To the author's knowledge, only two peer-reviewed papers have dealt specifically with shearing injuries, both presenting a retrospective analysis of cases in dogs. The prognosis is rarely determined by the extent of superficial skin loss, but rather by the underlying soft tissue and bone damage.

The role of acetic acid in orthopaedic surgery

2021 ◽  
pp. 175045892110156
Author(s):  
Yousuf Hashmi ◽  
Andrew Kailin Zhou ◽  
Anam Jawaid ◽  
Anli Yue Zhou ◽  
Vianca Shah ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Soft Tissue ◽  
Orthopaedic Surgery ◽  
Soft Tissues ◽  
Pain Syndrome ◽  
Soft Tissue Injuries ◽  
Conclusive Evidence ◽  
Tissue Injuries ◽  
Calcifying Tendonitis

Acetic acid has become more commonly used in orthopaedic surgery. The purposed roles include biofilm eradication and surgical debridement, postoperative scar reduction and managing soft tissue injuries. Current research is scarce and does not provide conclusive evidence behind acetic acid’s efficacy in orthopaedic procedures such as biofilm eradication or acetic acid iontophoresis in soft tissue injuries. Current literature on acetic acid’s effects on biofilm eradication is composed of in-vitro studies, which do not demonstrate the potential clinical efficacy of acetic acid. Acetic acid iontophoresis is a novel technique which is now more commonly accepted for soft tissues injuries. Our literature search identified calcifying tendonitis of the shoulder, rotator cuff tendinopathy, heel pain syndrome, plantar fasciitis, achilles tendonitis, calcifying tendonitis of the ankle, myositis ossificans and cervical spondylosis as documented clinical uses. In this narrative review, we present the current uses of acetic acid and acetic acid iontophoresis, while evaluating the evidence revolving around its efficacy, benefits and risks.

scholarly journals Soft Tissue Injuries Management in Emergency Department: A Review

2021 ◽  
pp. 57-63
Author(s):  
Sultan Suliman Q. Al-Ruwaili ◽  
Mohammed Abdullah S. Alasmari ◽  
Reem Hammad M. Albalawi ◽  
Raghad Adnan M. Alghazzawi ◽  
Sultan Abdulrahman S. Alamrani ◽  
...  
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Soft Tissues ◽  
Soft Tissue Injuries ◽  
Accident And Emergency ◽  
Tissue Injuries ◽  
Tissue Flaps ◽  
Critical Aspects

Soft tissue injuries (STI) is the damage of muscles, ligaments and tendons and they are one of the most common injuries that also being presented to the different emergency department but often approached differently. Accident and emergency (A&E) services frequently see acute soft tissues injuries. To achieve the best potential results for patients with soft tissue injuries, the quality of emergency department (ED) care offered is crucial. The unstable situations of injured people are caused by these critical aspects, which include polytrauma in many cases, a lack of precise recovery periods, the use of definite tissue flaps, and the type of circulation. Soft tissue injuries are also sometimes complicated with another injury.

scholarly journals A clinical study: management of distal tibial fractures with minimally invasive plating osteosynthesis

2019 ◽  
Vol 5 (4) ◽  
pp. 665
Author(s):  
Gaurav Singla
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Functional Outcome ◽  
Blood Supply ◽  
Soft Tissues ◽  
Soft Tissue Injuries ◽  
Tibial Fractures ◽  
Minimally Invasive Osteosynthesis ◽  
Distal Tibial Fractures ◽  
Excellent Functional Outcome

<p class="abstract"><strong>Background:</strong> Distal tibial fractures of bone poses major challenge to the trauma orthopaedic surgeons as this bone is subcutaneous associated with soft tissue injuries and precarious blood supply. Distal tibial fractures require accurate reduction, perfect articular restoration with stable fixation with minimal stripping of soft tissues, thereby preserving the blood supply. Minimally invasive osteosynthesis using locking plates has emerged as viable option of fixing such fractures due to poor results associated with open plating which leads to extensive soft tissues stripping and subsequently poor blood supply.</p><p class="abstract"><strong>Methods:</strong> 27 patients with closed distal tibial fractures with or without articular involvement without vascular compromise were treated with LCP fixation using MIPO technique studied from June 2017 to December 2018.<strong></strong></p><p class="abstract"><strong>Results:</strong> All fractures in our series united well at the end of 5 months with mean time to clinical and radiological union was 17 weeks. There was no case of implant failure while 2 patients had varus angulation. Very few soft tissue complications with excellent functional outcome were seen.</p><p><strong>Conclusions:</strong> We concluded that distal tibial fractures can be effectively managed with LCP using MIPPO technique with excellent functional outcome and avoiding the complications associated with other treatment methods. </p>

Imaging in trauma of the facial skeleton and soft tissues of the neck

2020 ◽  
Vol 81 (6) ◽  
pp. 1-15
Author(s):  
George Bitar ◽  
Philip Touska
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Penetrating Trauma ◽  
Soft Tissue Injuries ◽  
Imaging Features ◽  
Facial Skeleton ◽  
Pictorial Review ◽  
The Face ◽  
Craniofacial Trauma ◽  
Tissue Injuries

Trauma to the face and neck is a frequent reason for emergency department attendance. Imaging is invaluable in the characterisation of such injuries, enabling delineation of fracture patterns as well as identification of vascular and other soft tissue injuries. It may also be used to prevent long-term mortality and morbidity and provide a roadmap for surgical intervention so that form and function may be restored. This article gives a pictorial review of the imaging of craniofacial trauma, stratified according to the thirds of the face, followed by a review of blunt and penetrating trauma of the neck. It discusses appropriate imaging modalities for each trauma category, describes major patterns of craniofacial trauma on cross-sectional imaging and identifies clinically relevant imaging features that should trigger subspecialist review or be of relevance to pre-surgical planning. It starts with the upper third comprising frontal sinus fractures before describing the component fractures of the middle third (including nasal, zygomaticomaxillary and orbital fractures) and then focusing on the lower third (specifically mandibular and dentoalveolar fractures). The article concludes with a review of soft tissue injuries of the neck, particularly penetrating, blunt and laryngeal trauma.

scholarly journals Guide Hook to Prevent Trauma to Soft Tissues by Retraction Element Used with TAD

2019 ◽  
Vol 53 (3) ◽  
pp. 215-216
Author(s):  
Ramkishore Ratre ◽  
Sandhya Jain ◽  
Sunny Chourse
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Soft Tissue Trauma ◽  
Anterior Teeth ◽  
Tissue Trauma ◽  
Temporary Anchorage Device

We do retraction of anterior teeth as routine part of our orthodontic practice, and for this retraction to happen, we apply some form of retraction element. This retraction element runs straight on a curved arch from molars or temporary anchorage device (TAD) anteriorly, which contacts the soft tissues on most prominent part and causes trauma. This article gives a simple remedy to this problem by applying “guide hook” to the main archwire, which prevents the soft tissue trauma.

Biomechanical Analysis of a Custom-Made Mouthguard Reinforced With Different Elastic Modulus Laminates During a Simulated Maxillofacial Trauma

2020 ◽  
pp. 194338752098023
Author(s):  
João Paulo Mendes Tribst ◽  
Amanda Maria de Oliveira Dal Piva ◽  
Pietro Ausiello ◽  
Arianna De Benedictis ◽  
Marco Antonio Bottino ◽  
...  
Keyword(s):  
Elastic Modulus ◽  
Bone Tissue ◽  
Periodontal Ligament ◽  
Mechanical Response ◽  
Element Model ◽  
Biomechanical Analysis ◽  
Hard Material ◽  
Anterior Teeth ◽  
Custom Made ◽  
Root Dentin

Background/Aims: There is a lack of data regarding the influence of different laminates for mouthguard reinforcement in the mechanical response during an impact in the orofacial region. The aim of this study was to verify the influence of the laminate framework on the stresses and strains of the anterior teeth and displacement of ethylene-vinyl acetate (EVA) custom-made mouthguards during a simulated impact. The null hypotheses was that the different laminates reinforcement would present the similar effect in maxillary structures, regardless the elastic modulus. Methods: A finite element model of human maxillary central incisors with an antagonist contact was used. A linear quasi-static analysis was used to simulate the force exerted during an impact. A total of 5 different layers were simulated inside the mouthguard at the labial portion according to the Elastic Modulus 1 MPa (Extremely flexible), 9 GPa (Low modulus reinforcement), 18 GPa (Without reinforcement), 50 GPa (Flexible alloy), 100 GPa (Titanium alloy) and 200 GPa (Hard material). The results were evaluated by means of Maximum Principal Stress (in the tooth and bone), Microstrain (periodontal ligament) and Displacement (mouthguard) criteria. Results: The elastic modulus of the material inside the MG influenced the stress distribution on the enamel buccal face. However, it did not affect the bone tissue stress, periodontal ligament strain or root dentin tissue stress. Conclusion: The use of reinforcement inside the custom-made mouthguard can modify the stress generated in the enamel buccal surface without improvement to the root dentin, periodontal ligament or bone tissue.

scholarly journals Multi-color and Multi-Material 3D Printing of Knee Joint models

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Oliver Grimaldo Ruiz ◽  
Yasin Dhaher
Keyword(s):  
Soft Tissue ◽  
3D Printing ◽  
Knee Joint ◽  
Soft Tissues ◽  
Medical Training ◽  
Matrix Structure ◽  
Joint Models ◽  
Anatomical Models ◽  
Diverse Range ◽  
Custom Made

Abstract Objective This study reports on a new method for the development of multi-color and multi-material realistic Knee Joint anatomical models with unique features. In particular, the design of a fibers matrix structure that mimics the soft tissue anatomy. Methods Various Computer-Aided Design (CAD) systems and the PolyJet 3D printing were used in the fabrication of three anatomical models wherein fibers matrix structure is mimicked: (i) Anterior cruciate ligament reconstruction (ACL-R) model used in the previous study. (ii) ACL-R model, incorporating orientations, directions, locations, and dimensions of the tunnels, as well as a custom-made surgical guide (SG) for avoiding graft tunnel length mismatch. (iii) Total knee arthroplasty (TKA) model, including custom-made implants. Before models 3D printing, uni-axial tensile tests were conducted to obtain the mechanical behaviors for individual No. 1 (A60-A50), No. 2 (A50-A50), No. 3 (A50-A40), and No. 4 (A70-A60) soft tissue-mimicking polymers. Each material combination represents different shore-hardness values between fiber and matrix respectively. Results We correlated the pattern of stress-strain curves in the elastic region, stiffness, and elastic modulus of proposed combinations with published literature. Accordingly, material combinations No. 1 and No. 4 with elastic modules of 0.76-1.82 MPa were chosen for the soft tissues 3D printing. Finally, 3D printing Knee Joint models were tested manually simulating 50 flexo-extension cycles without presenting ruptures. Conclusion The proposed anatomical models offer a diverse range of applications. These may be considered as an alternative to replacing cadaver specimens for medical training, pre-operative planning, research and education purposes, and predictive models validation. The soft tissue anatomy-mimicking materials are strong enough to withstand the stretching during the flexo-extension. The methodology reported for the design of the fiber-matrix structure might be considered as a start to develop new patterns and typologies that may mimic soft tissues.

Management of Acute Soft Tissue Injuries

2003 ◽  
Vol 16 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Nayahmka McGriff-Lee
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Wrist Joint ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Pharmacological Therapy ◽  
Acute Injury ◽  
Appropriate Treatment ◽  
Inflammatory Drugs

Participation in sports-related activities increases the risk for acute injury to soft tissues. In adults, the sites most often affected include the ankle, knee, and wrist joint structures, along with the muscles of the back and extremities. The subsequent inflammatory response to tissue damage results in pain and swelling, which limits mobility. A thorough patient assessment is required for accurate diagnosis and provides a guide for appropriate treatment. Initial management is based on the principles of basic first aid: rest, ice, compression, and elevation. Pharmacological therapy can also be used to achieve pain relief and improve mobility. There are few well-controlled studies addressing the pharmacotherapy of acute soft tissue injury, but clinical experience with nonsteroidal anti-inflammatory drugs is extensive. Both traditional and nontraditional therapeutic approaches are discussed.

scholarly journals A novel elimination method of preloading force on the unconfined compression tests of soft tissue

2021 ◽  
Vol 13 (4) ◽  
pp. 168781402110106
Author(s):  
Jing Yang ◽  
Ming Hu ◽  
Zejie Han ◽  
Deming Zhao ◽  
Tao Qin
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Mechanical Response ◽  
Model Parameters ◽  
Compression Tests ◽  
Unconfined Compression ◽  
Estimation Model ◽  
Elimination Method ◽  
The Real ◽  
Material Parameters

Accurate description of the mechanical properties for soft tissues can help surgeon predict the state during surgery. In unconfined compression tests (UCT) of soft tissue, a tiny force is typically applied to determine the starting position of compression. The preloading force will cause the obtained material parameters to deviate from the real parameters. In this paper, a novel elimination method was proposed to eliminate the effect of the preloading force. The effects of preloading force on mechanical response were analyzed by performing unconfined compression numerical tests. Different preloading force were applied in the simulation. The parameters obtained by traditional optimization method were defined as preloading material parameters. In the proposed method, an estimation model between the preloading material parameters and the preloading force was established to estimate real parameters. The proposed elimination method was verified by three sample diameters and material parameters. The results show that the material parameters obtained by proposed method are closer to the real parameters (estimated accuracy exceeds 97%). The proposed method can obtain more accurate constitutive model parameters, and eliminate the effect of preloading force.

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