Objectives: To present a grading system of the protection offered by various types of mouthguard, together with an indication of associated risks, in order to make athletes aware of the consequences of improper or no mouth protection. Methods: A review of the literature on mouthguards, mouthguard materials, and novel laminates for mouthguards was carried out as it was apparent that information on mouthguards was lacking. Studies on stock (or unfitted) mouthguards, mouth formed (boil and bite) mouthguards, and custom mouthguards are reviewed. Results: A scale of protection offered by various mouthguards and novel laminates has been produced, where 0 indicates no mouthguard and 10 indicates a custom made mouthguard offering excellent protection. Conclusions: From work carried out on laminates and the manufacturing processes of mouthguards, it became apparent that information was lacking to enable athletes make informed decisions about the best oral protection for their chosen sport.

Statement of Problem. Direct metal laser sintering (DMLS) is a technology that allows fabrication of complex-shaped objects from powder-based materials, according to a three-dimensional (3D) computer model. With DMLS, it is possible to fabricate titanium dental implants with an inherently porous surface, a key property required of implantation devices. Objective. The aim of this review was to evaluate the evidence for the reliability of DMLS titanium dental implants and their clinical and histologic/histomorphometric outcomes, as well as their mechanical properties. Materials and Methods. Electronic database searches were performed. Inclusion criteria were clinical and radiographic studies, histologic/histomorphometric studies in humans and animals, mechanical evaluations, and in vitro cell culture studies on DMLS titanium implants. Meta-analysis could be performed only for randomized controlled trials (RCTs); to evaluate the methodological quality of observational human studies, the Newcastle-Ottawa scale (NOS) was used. Results. Twenty-seven studies were included in this review. No RCTs were found, and meta-analysis could not be performed. The outcomes of observational human studies were assessed using the NOS: these studies showed medium methodological quality. Conclusions. Several studies have demonstrated the potential for the use of DMLS titanium implants. However, further studies that demonstrate the benefits of DMLS implants over conventional implants are needed.

This report documents the clinical, radiographic, and histologic outcome of a custom-made computer-aided-design/computer-aided-manufactured (CAD/CAM) scaffold used for the alveolar ridge augmentation of a severely atrophic anterior mandible. Computed tomographic (CT) images of an atrophic anterior mandible were acquired and modified into a 3-dimensional (3D) reconstruction model; this was transferred to a CAD program, where a custom-made scaffold was designed. CAM software generated a set of tool-paths for the manufacture of the scaffold on a computer-numerical-control milling machine into the exact shape of the 3D design. A custom-made scaffold was milled from a synthetic micromacroporous biphasic calcium phosphate (BCP) block. The scaffold closely matched the shape of the defect: this helped to reduce the time for the surgery and contributed to good healing. One year later, newly formed and well-integrated bone was clinically available, and two implants (AnyRidge, MegaGen, Gyeongbuk, South Korea) were placed. The histologic samples retrieved from the implant sites revealed compact mature bone undergoing remodelling, marrow spaces, and newly formed trabecular bone surrounded by residual BCP particles. This study demonstrates that custom-made scaffolds can be fabricated by combining CT scans and CAD/CAM techniques. Further studies on a larger sample of patients are needed to confirm these results.

SUMMARYObjective: This study investigated the influence of a disposable light cure sheath on both the surface hardness and hardness at varying thicknesses of resin composite.Methods: A series of resin composite discs (Spectrum) were fabricated with varying depths up to 6 mm. The light curing units used were a standard halogen unit (Elipar Trilight) and an LED unit (Elipar Freelight 2). Recommended curing times from the manufacturer were followed. The disposable light-curing sheath (Cure Sleeve) was used with both light-curing units. Two additional groups without the sheath were employed as controls. Each specimen (n=4) was subjected to hardness testing to evaluate hardness from 0 mm to 5 mm thick. A 200g load was applied for 10 seconds using a Vickers diamond indenter and six indentations were obtained from each specimen. Statistical analysis was performed using two-way ANOVA.Results: The LED without a sheath achieved the highest surface hardness value (47.2 VHN ± 5.5). There was no significant difference between the groups regarding surface hardness (p>0.05). As the thicknesses of the resin composite increased, the hardness values decreased in all groups. The LED light curing unit, in combination with a sheath, demonstrated the lowest hardness values at a 5 mm thickness of resin composite (p<0.05). Conclusion Clinical RelevanceDisposable sheaths are now recommended as a method of cross infection control when light curing resin composite. However, these sheaths may affect the depth of cure of the resin composite, resulting in a compromise of the mechanical properties of the restorative material.ical properties of the resin composite. However, the use of the light cure sheaths still provided an acceptable depth of cure when used following the 2 mm increment rule. It was not until 3 mm that the use of the light cure sheaths compromised the hardness results. It is recommended that the curing depth should not exceed 2 mm, regardless of light curing method.

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