In their well-designed, case–control investigation of mouthguard use in youth ice hockey players and the risk of concussion, Chisholm and colleagues1 report that those wearing a mouthguard—whether custom-made or off-the-shelf—had lower rates of concussion than control participants. The point estimate suggests a considerably reduced risk, although the CIs are broad. The authors report differences in the estimate of reduced risk for custom-made and off-the-shelf mouthguards, with the latter (perhaps surprisingly) having a greater reduction, although again the CIs are broad. The authors are explicit that their study is not powered for precise estimates of this secondary analysis, so we must all be cautious in interpreting this latter observation. The primary observation—that mouthguards are associated with a lower rate of concussion—is an important contribution to the literature. The finding differs from that of the most recent systematic review of whether mouthguards can protect against concussion in contact sports, which concluded that ‘the effect of mouthguards on concussion risk was minimal’,2 although …

中文翻译：

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接触性运动应佩戴护齿套

Chisholm 及其同事在对青少年冰球运动员使用护齿器和脑震荡风险进行精心设计的病例对照调查中报告说，佩戴护齿器的人——无论是定制的还是现成的——脑震荡率较低比控制参与者。尽管 CI 范围很广，但点估计表明风险大大降低。作者报告了对定制的和现成的护齿器降低风险的估计存在差异，后者（也许令人惊讶）降低了更大的风险，尽管 CI 也很宽泛。作者明确表示，他们的研究无法准确估计这种二次分析，因此我们在解释后一种观察结果时都必须谨慎。主要观察结果——护齿与较低的脑震荡率有关——是对文献的重要贡献。该发现与最近关于护齿器是否可以防止接触性运动中的脑震荡的系统评价不同，后者得出的结论是“护齿器对脑震荡风险的影响很小”，2尽管……