Protecting the Base of the Skull and TMJ with Dual Arch TechnologyJuly 30, 2012 No Comments
Even with heightened attention on sports injuries, the prevalence of injuries caused by impacts to the jaw or chin is often overlooked, and outright ignored. Protective equipment exists today that greatly reduces the forces transmitted to the base of the skull and TMJ.
In nearly two decades and three independent biomechanical studies sponsored by NFL Charities and National Operating Committee for Standards in Athletic Equipment (NOCSAE) in 1993, one performed by Wayne State in 2005, and a study fully funded by the NFL with Biokinetics in 2011, the relative effectiveness of the dual arch mouth guard (more properly identified as a “jaw-joint protector” as opposed to a “mouth guard” for protecting teeth) was well established.
The latest tests in 2011 validated using an impact force standard for all head-contact sports, including football. The tests used two different head forms with articulated jaws with instrumentation above the condyle and into the Temporal Mandibular Joint (TMJ) measuring linear force.
Brain-Pad® was originally founded in 1995 by a dental surgeon in Philadelphia and has been protecting athletes, first in combat arts and then in helmeted sports, for more than 16 years. The company has sold literally millions of Brain-Pad Jaw-Joint Protectors™.
The Brain-Pad Jaw-Joint Protector™ is a dual arch mandibular orthotic that positions the jaw in a slightly downand- forward position and achieves stabilization through its design, reducing and redirecting force from the impact to the jaw away from the TMJ and base of skull. The Brain-Pad appliance and the molars – which are the strongest bones in the skull – primarily absorb the impact forces.
As a result of the early work done by Brain-Pad, Dr. Voight Hodgson, the technical director of NOCSAE and a professor at Wayne State University, became interested in jaw interaction and the implication of impact to this region of the head looking at the mandible impacting the fossa and the transfer of force and impact to the basal skull and brain region. Another major concern of Dr. Hodgson was chinstrap loading and the detrimental forces affecting a number of cranial nerves that control sensory and motor functions. Brain-Pad believes that its Brain-Pad Jaw-Joint Protector addresses both of these issues.
Examining The Data
In 2003, a benchmark was established with a study conducted by Biokinetics of Canada, authored by Dr. Elliot Pellman. The study established 9.3 ± 1.9 m/sec of velocity impact as creating concussive forces.
In 2005, at Wayne State University, using the head form with an articulated jaw, Brain-Pad revisited this and found similar results as in a 1993 study, with impact forces delivered directly to the facemask and chin. Both studies found that the Brain-Pad Jaw-Joint Protector reduced jaw-transmitted forces more than any other mouth guard or any other oral protection device.
Brain-Pad found that on a 60-inch drop directly to the facemask, more than 500 pounds of force was transmitted through the chin cup slamming the jaw bone directly up into the base of the skull just below the brain. When wearing a Brain-Pad, impact forces were cut by 40 percent. Then in 2011, in a study fully funded by the NFL using a new head form with an articulated jaw at Biokinetics in Canada, it was shown that the Brain-Pad Jaw-Joint Protector was measurably superior at withstanding and reducing a 9.5 m/sec impact, more than other leading retail mouth guards.
In fact, the study showed, when compared to wearing no mouth guard at all, those single arch mouth guards actually increased velocity impact forces rather than decreased them. Any product, such as the Brain-Pad Jaw-Joint Protector, that reduces impact forces to the thin base of the skull and TMJ can only be a benefit to the athlete.
What To Do Now
With injuries on the minds of all coaches and parents, the only acceptable result is that protective sports equipment must bring about a reduction of velocity impact forces.
We have, in our scientific community, a great understanding of linear impact forces, which were greatly aided by the auto industry’s crash-test programs. However, lateral, angular and rotational forces are not understood as well. Current helmet testing protocols and equipment date from the late 1960s and should be updated to observe more than just skull fractures.
It is time for athletes, coaches, trainers, sports medicine doctors, sports equipment manufacturers, regulating agencies, and state and federal governments to work together to understand the potential causes and detrimental effects of all injuries and to establish realistic standards of design to reduce, as much as possible, the incidence of injuries.
As an example of effective regulation, most of the international combat arts associations (i.e. International Kickboxing Federation, International Sport Combat Association, International Sport Karate and Kickboxing Association, and Kick International) take the Brain-Pad Jaw?Joint Protector’s role in reducing jaw impact forces to the base of skull very seriously with mandated use during competitions and unpaid endorsements from participants. It is time that amateur and professional helmeted sports leagues and associations do likewise.
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