Background and study aims: After upper endoscopy, patients have complained of symptoms involving teeth or the
temporomandibular joint; however, these endoscopy-related complications are usually
ignored with few attempts to prevent them. The aim of this study was to identify the
incidence of endoscopy-related complications involving teeth or temporomandibular
joint, and to compare the effectiveness of a newly developed teeth-protecting mouthpiece
(TPM) with a traditional mouthpiece (the MB-142) in preventing these complications.
Patients and methods: 872 patients from 28 centers, who were undergoing their first upper endoscopy, were
randomly assigned to TPM and MB-142 groups. At 3 - 4 days after the procedure, the
occurrence of endoscopy-related complications involving the teeth or the temporomandibular
joint was investigated using a structured questionnaire. Finally 865 patients (TPM
group, n = 423; MB-142, n = 442) responded to this questionnaire and were included
in the analysis.
Results: Overall, the incidence of complications was significantly lower in the TPM than in
the MB-142 group (0.9 % vs. 3.2 %). With stratification according to sedation status,
in nonsedated patients no significant difference was found between the two groups
(0.7 % vs. 0.9 %). In sedated patients, however, the TPM group showed a significantly
lower incidence of complication than the MB-142 group (1.7 % vs. 11.6 %). Clinically
serious problems such as a tooth fracture or a loose tooth occurred only in sedated
patients in the MB-142 group.
Conclusions: The TPM showed an advantage over the MB-142 mouthpiece for preventing endoscopy-related
complications involving teeth or the temporomandibular joint.
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1 The first two authors contributed equally to this work.
P.-L. Rhee, MD
Department of Medicine
Sungkyunkwan University School of Medicine
Samsung Medical Center
Irwon-dong, Gangnam-gu
Seoul, 135 - 710
Korea
Fax: + 822-3410-3849
Email: plrhee@skku.edu