Research Article Journal of Translational Science J Transl Sci, 2018 doi: 10.15761/JTS.1000235 Volume 4(6): 1-5 ISSN: 2059-268X Orofacial trauma management in a wind instrument player Miguel Pais Clemente 1 *, Joaquim Gabriel Mendes 2 , André Moreira 3 , Afonso Pinhão Ferreira 4 and José Manuel Amarante 5 1 Dentist, PhD Student, Faculty of Dental Medicine Porto, Portugal 2 INEGI, Labiomep, Faculty of Engineering, University of Porto, Portugal 3 Dentist, Specialization Student in Prosthodontics, Faculty of Dental Medicine Porto, Portugal 4 Department of Orthodontics, Faculty of Dental Medicine, University of Porto, Portugal 5 Department of Surgery, Faculty of Medicine, University of Porto, Portugal Abstract Background: Regarding the orofacial structures, musical performance in wind instrumentalists can promote undesirable pressures on teeth which can be the origin of orofacial pain. Objective: Tis article addresses the therapeutic options for a clarinet player, which has tooth mobility and orofacial pain due to the occurrence of an orofacial trauma. Methods: Te clarinetist had an alteration in his embouchure due to an orofacial trauma and consequent difculty on playing his instrument. Te authors had to deal with the mobility and restoration of the compromised endodontically tooth. After the stages of the oral rehabilitation a homemade ftted appliance, the Embouchure Stabilization Mouthpiece Appliance – ESMA was made to reduce abnormal and undesired forces on the upper central incisors, evaluated by piezoresistive sensors. Results: Te implemented treatment of the central incisor is crucial for the embouchure and musical performance of the clarinetist. Te dental treatment fulflled the necessary conditions for its maintenance; otherwise, the placement of a removable prosthodontics on the upper right central incisor would probably not allow the clarinetist to play anymore. However, the proposed device, ESMA, was constructed for the anterior upper incisal block, allowed the musician to perform and continuing playing the clarinet. Conclusions: Te evolution of dental techniques will enhance better solutions for patients in general. Tere will be always uncertainty towards the response of the biological tissues; however, by understanding the forces that are being applied during musical performance, one may contribute to player’s well-being. Introduction During musical performance, wind instrumentalists have to play diferent repertoires, which obliges to a high demand of neurologic and physical activity. Only a good synchronization of the mind and the body will allow the musician to play the correct notes in the precise time. It is of common knowledge that musicians are subjected to high physical demand during training and performance that may eventually lead to back, cervical, orofacial pain in addition to neurologic disorders like focal dystonia, carpal tunnel syndromes and ulnar neuropathies, Schuele [1-3]. Tus, the health care professionals and dentists must understand the background of a musician, in particular the relation between the instrument and the body, namely the type of eforts that appear while performing. Irina Foxman et al. [4] also confrmed on a survey that the time musicians are exposed to the awkward postures when playing instruments may result in playing–related musculoskeletal disorders. Leaver et al. collected data regarding musculoskeletal pain in elite professional musicians from British symphony orchestras (243), 58% had worked as professional musicians for more than 20 years, playing on average for 30 h/week [5]. Altogether 86% of the subjects reported musculoskeletal pain in the past 12 months, including 41% with disabling pain. Te anatomical sites where pain was mostly referred were the neck, low back and shoulder (51-56% in the past year) [5]. Eczema in the lip of brass players, like trumpet, tuba, french horn or trombone is also referred. Regarding the orofacial region, an injury that is well known among trumpet players due to the high pressure required *Correspondence to: Miguel Pais Clemente, Dentist, PhD Student, Faculty of Dental Medicine Porto, Portugal, E-mail: miguelpaisclemente@hotmail.com Key words: occupational healthcare, wind instrumentalists, musician`s embouchure, orofacial trauma, piezo-resistive sensors Received: March 20, 2018; Accepted: April 11, 2018; Published: April 13, 2018 to play the trumpet, is the “Satchmo’s syndrome” which is the rupture of the orbicularis oris muscle. Yeo et al. dedicated his research to specifc orofacial problems experienced by musicians, where orthodontic problems, sof tissue trauma, focal dystonia, denture retention, herpes labialis, dry mouth and temporomandibular joint disorders (TMD) were identifed as orofacial problems of career musicians [6]. Te area of TMD has been subject of several studies in professional orchestra musicians, with 408 responses to a questionnaire; TMJ pain was reported in between 15% (lower strings) and 34% (woodwinds) as a common problem [7]. From a sample of 41 violinists from the Murcia Regional Symphonic Orchestra, Rodríguez-Lozano et al., found that the violinist group had signifcantly more pain in maximum mouth opening, parafunctional habits and occurrence of temporomandibular joint sounds, which led to a conclusion that violin playing appears to be a factor associated with TMD related fndings [8]. To understand the orofacial issues that are present during the performance of string and wind instrumentists, other type of parameters as e.g. accelerometers, or infrared thermography can be used for the interpretation and diagnoses of certain pathologies involving the