The assessment of the performance and usability of custom intraoral mouthguards during surgery with endotracheal intubation – A preliminary study

Gawlak, Dominika; Mańka-Malara, Katarzyna; Świderska, Magdalena; Kosieradzki, Maciej; Trzebicki, Janusz; Mierzwińska-Nastalska, Elżbieta

doi:10.1016/j.jclinane.2019.08.013

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…Additionally, their shape may be adjusted to the user's requirements. 40 The findings from this study indicated that more than half of the anesthetists did not know about mouthguards. Studies have shown that a lack of knowledge of mouthguards poses a challenge for PADT prevention.…”

Section: Ta B L Ementioning

confidence: 73%

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An analysis of anesthetists' awareness, knowledge, and attitudes toward peri‐anesthetic dental trauma

Doğan

Altıntepe

et al. 2021

Dental Traumatology

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Background/Aim: Peri-anesthetic dental trauma is a common anesthesia-related complication. It is the reason for a significant number of malpractice lawsuits against anesthetists through insurance companies. The frequency, outcomes, and risk factors related to peri-anesthetic dental trauma have been well documented. The aim of this study was to evaluate anesthetists' awareness, knowledge, and attitudes toward perianesthetic dental trauma. Material and Methods: This nationwide, cross-sectional, descriptive study comprising 220 anesthetists was conducted in Turkey between June 2019 and May 2020. A specific questionnaire was created using Google Forms and delivered to 591 participants via WhatsApp. Pearson's Chi-squared test and the Fisher-Freeman-Halton tests were used to analyze the results. Results:The overall response rate was 37.2% (220 out of 591 participants). Of the 80.5% of the participants who encountered peri-anesthetic dental trauma during their practice, 32.8% had encountered avulsion and 32.8% reported that they had caused soft tissue injuries. More than one-third of the participants (38.9%) stated that the patient group that was the most at-risk for peri-anesthetic dental trauma was older people with missing teeth. Half of the participants (50.9%) stated that avulsed teeth could be replanted; among them, 21.8% and 11.8% specified that the ideal replantation time was <30 min and that the ideal storage medium for the avulsed tooth was fresh milk, respectively. Furthermore, 88.1% of the participants noted that perianesthetic dental trauma occurred more frequently during emergency intubations and only 20.9% were aware of custom-made mouthguards.Conclusions: Anesthetists lack knowledge around peri-anesthetic dental trauma and its interventions.

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Section: Ta B L Ementioning

confidence: 73%

“…Mouthguards are flexible appliances that are placed within the oral cavity to protect oral tissues from traumatic forces. 40 Custom-made mouthguards, which are prepared by a dentist, are characterized by their excellent retention, small size, and comfort.…”

Section: Ta B L Ementioning

confidence: 99%

An analysis of anesthetists' awareness, knowledge, and attitudes toward peri‐anesthetic dental trauma

Doğan

Altıntepe

et al. 2021

Dental Traumatology

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Periodontal disease in preoperative patients with digestive cancer: a retrospective, single-institution experience in Fukui, Japan

et al. 2021

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Background The careful preoperative oral assessment may be useful for safe surgery under general anesthesia. The purpose of this study was to investigate the presence of periodontitis in patients with malignant digestive disease before surgery under general anesthesia. Methods Patients with digestive malignant disease who underwent periodontal examination and orthopantomograph examination for preoperative oral health assessment were participated. The authors investigated the patients’ general characteristics and clinical oral information, including the presence of periodontitis. Results One hundred twenty patients participated in this study. The mean and standard deviation of the number of teeth was 20.8 ± 8.2, and there was a statistically significant correlation between age and number of teeth. The periodontal pocket depth was 3.0 ± 1.0, and mobile teeth were observed in 62 patients. There was a statistically significant correlation between number of teeth and number of mobile teeth. However, there was no significant difference between the age of patients without mobile teeth and the age of patients with mobile teeth. Conclusions This retrospective study performed in single-institution clarified the presence of periodontitis in patients with malignant digestive disease before surgery. Regardless of age, it is important to assess the oral health, including periodontitis, for safe surgery under general anesthesia.

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Anti-Toothbreaker: A Novel Low-Budget Device Enabling Contactless Dental Protection and a Forbidden Technique during Direct Laryngoscopy for Endotracheal Intubation

Razaeian

Liebich

2023

Diagnostics

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Background: Iatrogenic dental injury is the most common complication of conventional laryngoscopy during orotracheal intubation. The main cause is unintended pressure and leverage forces from the hard metal blade of the laryngoscope. The aim of this pilot study was to introduce and test a novel, reusable low-budget device not only providing contactless dental protection during direct laryngoscopy for endotracheal intubation, but also enabling, in contrast to established tooth protectors, active levering with conventional laryngoscopes for easier visualization of the glottis. Methods: A constructed prototype for intrahospital usage was evaluated by seven participants on a simulation manikin for airway management. Endotracheal intubation was performed with and without the device using a conventional Macintosh laryngoscope (blade size 4) and a 7.5 mm endotracheal tube (Teleflex Medical GmbH, Fellbach, Germany). Necessary time and success of first pass were determined. Degree of visualization of the glottis with and without the device was stated by the participants according to the Cormack and Lehane (CL) classification system and the Percentage of Glottic Opening (POGO) scoring system. In addition, subjective physical effort, feeling of safety regarding successful intubation, and risk for dental injury were queried on a numeric scale between 1 and 10. Results: All participants except one stated that the intubation procedure was easier with usage of the device than without it. On average, this was subjectively perceived as being approximately 42% (range, 15–65%) easier. In addition, time to first pass success, as well as degree of glottis visualization, subjective physical effort, and feeling of safety regarding risk for dental injury, were clearly better with usage of the device. Concerning feeling of safety regarding successful intubation, there was only a minor advantage. No difference in first pass success rate and number of total attempts could be observed. Conclusion: The Anti-Toothbreaker is a novel, reusable low-budget device which might not only provide contactless dental protection during direct laryngoscopy for endotracheal intubation, but also enables, in contrast to established tooth protectors, active levering with conventional laryngoscopes for easier visualization of the glottis. Future human cadaveric studies are needed to investigate whether these advantages also prove themselves there.

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The assessment of the performance and usability of custom intraoral mouthguards during surgery with endotracheal intubation – A preliminary study

Cited by 3 publications

References 4 publications

An analysis of anesthetists' awareness, knowledge, and attitudes toward peri‐anesthetic dental trauma

An analysis of anesthetists' awareness, knowledge, and attitudes toward peri‐anesthetic dental trauma

Periodontal disease in preoperative patients with digestive cancer: a retrospective, single-institution experience in Fukui, Japan

Anti-Toothbreaker: A Novel Low-Budget Device Enabling Contactless Dental Protection and a Forbidden Technique during Direct Laryngoscopy for Endotracheal Intubation

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