Manufacturing and evaluation of the effectiveness of a new custom mouthpiece for wind instrumentists

摘要

Playing a wind instrument requires a complex neuromuscular activity. The musician has to keep under effective control the column of expiratory air passing from the player into his instrument. In an orchestra there are different kinds of wind instruments that require a unique and specific embou-chure. According to the different mouthpiece on each instrument there is a particular relationship in each embouchure involving the palate, lips, tongue, teeth and orofacial muscles. Musicians in general can be affected by soft tissue trauma in the course of playing the wind instrument. In saxophone and clarinet players the instrument is placed intra-orally with the single reed mouthpiece. The lower lip is retruded between the lower surface of the mouthpiece and the mandibular incisors. The saxophone and clarinet players usually use a folded paper to prevent pain and ulceration.Aim: To develop a simplified tech-nique using a thermoforming material for fabricating a custom mouthpiece for wind instruments. Due to the fact that there is a different relationship between the oral cavity and the single-reed instruments, the double-reed instruments, and brass instruments, this research intends to evaluate the specific orofa-cial needs of wind instruments students from a Professional Music School in Oporto, (Escola Superior de Musica e Artes do Espectaculo). Materials and Methods: The maxillary and mandibular casts were obtained after dental impressions of the wind instruments players. A thermoplastic material of ethylene vinyl acetate copolymer (EVA) of 1 mm thick was placed over the mandibular cast, which was taken to a vacuum machine, Bio-Estar. The new device obtained was cut at the edges of both canines. This new custom mouthpiece was limited to the anterior incisors to reduce the space and volume occupied intra-orally. A questionary was answered he the musicians regarding to their general oral health issues and related problems of their embouchure. Results and Discussion: There are specific orofacial considerations to each instrument groups. Usually there is pain associated by an irregularity or sharpness of the lower anterior teeth into the lip when playing in single reed-instruments (saxophone and clarinet). In brass players (trumpet) there can be discomfort and pain due to the pressure of the metal mouthpiece when the lips are pressed against rotated teeth or with protruded teeth. The development of the new custom mouthpiece had general acceptance in the student population of the Music School (E.S.M.A.E.), having a high effectiveness in saxophone and clarinet players. This appliance may change the traditional folded sheet of paper which was a "bulky" situation to a device that has retention. The process of fabrication of the custom mouthpiece for wind instruments is relatively simple, not very expensive and the musician refers that no longer "spits" paper at the end of a concert. Conclusions: It is important that Dentists have a general knowledge of the specificity of each wind instruments and it's relation with their oral health. Providing information that is relevant for musicians and developing medical devices that can be used to optimize their performance may be detrimental to their careers.