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Objectives: The objective of this paper was to compare the effectiveness of different materials for mouthguards in preventing oral and maxillofacial injuries during sports activities. The present study compares the stress-reduction and energy absorption capabilities of two other fused filament materials — poly(lactic-acid plus) (PLA+) and polycarbonate (PC), with Ethylene-vinyl acetate (EVA), which is the most commonly used material for mouthguard fabrication. Materials and methods: Two human skulls were modelled, and a boxing glove simulated punches along the x, y, and z-axes with 5 mm displacement with 1 kN force. Firstly, the maximum principal stress curve in the skull was compared for forces along the three perpendicular directions. Furthermore, the present study examines materials energy absorption properties, including their specific energy absorption characteristics and initial peak von Mises stresses. Additionally, a topology optimization approach is used to create an alternative design for a mouthguard to improve specific energy absorption. Results: The model without a mouthguard showed the highest stress concentration of 32.298 MPa in the teeth, followed by the EVA material, which resulted in a maximum principal stress of 28.525 MPa. Fused filament 3D materials, such as PLA + and PC, on the other hand, showed better mechanical effectiveness in both lower jaw dislocation and lower maximum principal stress by 30.82% and 51.25% in the mandibular and maxillary teeth. Though EVA comparatively shows better specific energy absorption capability at 2.24 kJ/kg post-optimization than PLA + and PC, the peak principal stress experienced in the mandibular region was comparatively higher. The topology optimization, however, improved the energy-absorbing capabilities of PLA + by 4.5 times, reaching 1.37 kJ/kg and PC from 0.165 kJ/kg to 0.38 kJ/kg. Conclusions: This study demonstrates that PLA + and PC have better stress reduction capabilities than EVA and could be promising materials for the fabrication of mouthguards in sports activities. This study highlights the importance of topology optimization in dental materials science and engineering to develop safer and more effective mouthguard designs. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Materials and Methods Results Conclusions The thickness of the mouthguard is a crucial factor in its protective ability for athletes. This study aimed to investigate the final thickness of double‐layered sports mouthguards, which were fabricated using different methods before pressing the second layer.Seven upper working models (n = 7 per group) were prepared for mouthguard fabrication. The first 3‐mm mouthguard sheet underwent heating, pressing, and vacuuming onto the model, followed by various protocols before the second 3‐mm sheet was pressed. Group 1: The second sheet was pressed immediately. Group 2: The first sheet underwent a 1‐h cooldown period before pressing the second sheet. Group 3: The interproximal areas of the first sheet were punctured followed by immediate pressing of the second sheet. Group 4: The first sheet was punctured followed by a 1‐h cooldown before pressing the second sheet. After 24 h, the mouthguard thickness was measured at various points on the left and right central incisors and first molars using a digital caliper. The thickness analysis was performed using SPSS 29.0 with one‐way ANOVA and Tukey post hoc analysis.At the labial surface of the central incisors, Group 4 exhibited the highest thickness, while Group 3 had the lowest (p < 0.001). Groups 1 and 2 did not show significant differences in thickness. At the incisal edges, Group 3 again had the lowest thickness (p < 0.05), with no significant differences observed among the other groups. There were no significant differences in thickness across all areas at the first molars, including cusp tips, pits, and buccal surfaces (p > 0.05). Group 4 demonstrated greater uniformity at the central incisors in thickness compared with the other groups.Using the puncturing method at interproximal areas combined with a cooldown period could enhance mouthguard thickness at the labial surfaces of the central incisors and improve its thickness uniformity. [ABSTRACT FROM AUTHOR]

ABSTRACT Background/Aim Materials and Methods Results Conclusions This study aims to evaluate and compare the impact absorption capacities of thermoformed ethylene vinyl acetate (EVA) mouthguards and 3D‐printed polyolefin mouthguards used in sports dentistry applications. The objective is to determine whether 3D‐printed polyolefin mouthguards offer superior impact toughness compared to traditional EVA mouthguards commonly used in sports settings.Six material samples were assessed: five pressure‐formed EVA mouthguards (PolyShok, Buffalo Dental, Erkoflex, Proform, and Drufosoft) and one 3D‐printed synthetic polymer (polyolefin). The materials were evaluated using a modified American Society for Testing and Materials (ASTM) D256 Test Method A for Izod pendulum impact resistance of plastics. Polyolefin samples were 3D‐printed using fused filament fabrication (FFF) technology. Notably, the FFF process included samples printed with notches placed either parallel or perpendicular to the build direction. This orientation served as a study factor, allowing for comparison of material behavior under different printing conditions. Impact testing was conducted using an Izod impact tester to assess the materials' performance under controlled impact conditions.The study achieved a high power (1.0) in power analysis, indicating strong sensitivity to detect significant differences. Among molded materials, PolyShok showed significantly lower impact toughness compared to others (p = 0.06). The mean impact absorption of EVA materials was 5.4 ± 0.3 kJ/m2, significantly lower than polyolefin materials, which demonstrated 12.9 ± 0.7 kJ/m2 and superior performance (p = 0.0). Horizontal‐notched polyolefin samples exhibited higher impact strength compared to vertical‐notched samples (p = 0.009).3D‐printed polyolefin mouthguards exhibited significantly higher impact toughness than thermoformed EVA mouthguards. While EVA materials demonstrated structural robustness, their lower impact resistance and observed tearing in other test specimens suggest the need for alternative testing standards to better reflect real‐world conditions. 3D‐printed mouthguards fabricated with build orientations perpendicular to the direction of impact demonstrate significantly enhanced impact absorption. Further research into manufacturing methods and testing protocols is recommended to optimize mouthguard performance under impact scenarios. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aim Methods and Methodology Result Conclusion Traumatic dental injuries related to sports are a significant concern, as they can have severe physical and psychological impacts on children. Using mouthguards is essential, particularly in sports like skating, where high‐impact forces are common.The study aimed to evaluate how stress is distributed on the teeth and surrounding bone in children with proclined anterior teeth when a force of 614.12 N was applied to two different regions of the jaws. The evaluation was conducted using finite element analysis (FEA), both with and without the use of a mouthguard.A 3‐dimensional finite element analysis (FEA) model was constructed using a cone beam computed tomography (CBCT) scan of a 12‐year‐old male patient. An average standardized force of 614.12 N was calculated, based on the average weight of children aged 11 to 13 years and the average speed of 13.4 m/s with which the children skate. The force was applied in two different directions and areas of the jaws: a lateral blow, perpendicular to the crown and root with the maxillary and mandibular teeth in occlusion (between the first molar and second premolar), and a blow obliquely at the pogonion point on the chin. Static simulations were then performed for four realistic scenarios—two with mouthguards and two without mouthguards.The Von Mises stresses were evaluated under all conditions. When the applied force was directed laterally, the stress values observed were 126.76 MPa with a mouthguard and 140 MPa without a mouthguard. When the force was applied to the chin region, the stress values were 37.997 MPa with a mouthguard and 40.67 MPa without a mouthguard.The use of a mouthguard in children is beneficial for protecting teeth and surrounding structures, especially in cases of proclined anterior teeth, as it helps dampen the generated stresses. [ABSTRACT FROM AUTHOR]

Background: Traumatic dental injuries (TDIs) are a common complication in sports, with an overall prevalence ranging from 0.71% to 60%. Kickboxing is a high-risk combat sport for trauma to the facial region. Methods: A total of 142 5-to-65-year-old amateur athletes participated in the survey with a questionnaire that was released during their regular practice days. The questionnaire was structured into three parts: (1) questions about age, gender, type, and time of sports practice; (2) questions about dental injuries, personal experience, and awareness of emergency management, particularly about tooth avulsion; (3) questions about wearing a mouthguard for TDI prevention. Results: A total of 13 percent of athletes suffered a TDI while training or fighting. Regarding first aid, 61% of the participants in this survey are aware of the possibility of replanting a tooth after its avulsion; 10% believe that the tooth should be replanted within 15 min, and 37% of athletes believe that it should be kept wet. The mouthguard is known to the majority of athletes (94%), and 66% were informed by the coach; 68% of the athletes use it. Seventy-four percent of the mouthguards were purchased in a sports shop. Conclusions: A relatively low prevalence of TDIs was observed in players in the sample. A lack of information about the emergency management of tooth avulsion and about the type of mouthguard to wear emphasizes the importance of educational training by dentists to athletes and coaches. [ABSTRACT FROM AUTHOR]

Instrumented mouthguard systems (iMGs) are commonly used to study rigid body head kinematics across a variety of athletic environments. Previous work has found good fidelity for iMGs rigidly fixed to anthropomorphic test device (ATD) headforms when compared to reference systems, but few validation studies have focused on iMG performance in human cadaver heads. Here, we examine the performance of two boil-and-bite style iMGs in helmeted cadaver heads. Three unembalmed human cadaver heads were fitted with two instrumented boil-and-bite mouthguards [Prevent Biometrics and Diversified Technical Systems (DTS)] per manufacturer instructions. Reference sensors were rigidly fixed to each specimen. Specimens were fitted with a Riddell SpeedFlex American football helmet and impacted with a rigid impactor at three velocities and locations. All impact kinematics were compared at the head center of gravity. The Prevent iMG performed comparably to the reference system up to ~ 60 g in linear acceleration, but overall had poor correlation (CCC = 0.39). Prevent iMG angular velocity and BrIC generally well correlated with the reference, while underestimating HIC and overestimating HIC duration. The DTS iMG consistently overestimated the reference across all measures, with linear acceleration error ranging from 10 to 66%, and angular acceleration errors greater than 300%. Neither iMG demonstrated consistent agreement with the reference system. While iMG validation efforts have utilized ATD testing, this study highlights the need for cadaver testing and validation of devices intended for use in-vivo, particularly when considering realistic (non-idealized) sensor-skull coupling, when accounting for interactions with the mandible and when subject-specific anatomy may affect device performance. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Materials and Methods Results Conclusions Sports dentistry aims to prevent and manage orofacial injuries, tooth fractures, tooth loss, and soft tissue trauma during sport activities. Mouthguards are appliances that protect athletes from dental trauma during contact sports. The video‐sharing platform YouTube has a large number of informative videos about mouthguards. This study aimed to analyze the quality, accuracy, and reliability of YouTube videos about mouthguards, investigate the relationship between the features and the quality of mouthguard videos on YouTube, and provide suggestions for future informative content about mouthguards and sports dentistry.The first 100 videos for each keyword from YouTube were collected using the keywords “mouthguard,” “sports mouthguard,” and “mouthguard and dental trauma.” Videos meeting the inclusion criteria were categorized based on publisher (dental professionals and nonprofessionals) and type (animation/slideshow, interview, and product introduction). Video features were recorded. Video content quality, reliability, and accuracy were measured by the Video Information and Quality Index (VIQI), the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN Instrument, the Global Quality Scale (GQS), and the usefulness score. Data were analyzed using SPSS (IBM 29.0) at a 95% statistical significance level (p = 0.05).Out of 300 videos, 80 videos were included. Most of the videos were uploaded by dental professionals (n = 49). The average values of the VIQI, JAMA, DISCERN, and GQS scores were 15.33 out of 20.0, 1.38 out of 4.00, 49.24 out of 80.0, and 2.99 out of 5.00, respectively. Videos uploaded by dental professionals had significantly higher scores in VIQI, JAMA, DISCERN, GQS, and usefulness scores but exhibited a lower number of likes, comments, and views (p < 0.05). Of all included videos, 51% (n = 41) were categorized as “moderately useful” and 10% (n = 8) as “very useful.”Mouthguard videos uploaded by dental professionals are more useful, accurate, and of higher quality. Therefore, patients should consider the information shared by dental professionals. Greater participation from dentists in sharing high‐quality content would be beneficial. [ABSTRACT FROM AUTHOR]

ABSTRACT Background/Objectives Materials and Methods Results Conclusion The use of different models for the fabrication of custom‐fit mouthguards (MTGs) can affect their final thickness, adaptation, and shock‐absorption properties. This study aimed to evaluate the adaptation, thickness, and shock absorption of ethylene‐vinyl acetate (EVA) thermoplastic MTGs produced using conventional plaster or three‐dimensional (3D) printed models.A typical model with simulated soft gum tissue was used as the reference model to produce MTGs with the following two different protocols: plast‐MTG using a conventional impression and plaster model (n = 10) and 3DPr‐MTG using a digital scanning and 3D printed model (n = 10). A custom‐fit MTG was fabricated using EVA sheets (Bioart) plasticized over different models. The MTG thickness (mm), internal adaptation (mm) to the typodontic model, and voids in the area (mm2) between the two EVA layers were measured using cone‐beam computed tomography images and Mimics software (Materialize). The shock absorption of the MTG was measured using a strain‐gauge test with a pendulum impact at 30° with a steel ball over the typodont model with and without MTGs. Data were analyzed using one‐way analysis of variance with repeated measurements, followed by Tukey's post hoc tests.The 3DPr‐MTG showed better adaptation than that of the Plast‐MTG at the incisal/occlusal and lingual tooth surfaces (p < 0.001). The 3DPr‐MTG showed a thickness similar to that of the Plast‐MTG, irrespective of the measured location. MTGs produced using both model types significantly reduced the strain values during horizontal impact (3DPr‐MTG 86.2% and Plast‐MTG 87.0%) compared with the control group without MTG (p < 0.001).The MTGs showed the required standards regarding thickness, adaptation, and biomechanical performance, suggesting that the number and volume of voids had no significant impact on their functionality. Three‐dimensional printed models are a viable alternative for MTG production, providing better adaptation than the Plast‐MTG at the incisal/occlusal and lingual tooth surfaces and similar performance as the MTG produced with the conventional protocol. [ABSTRACT FROM AUTHOR]

Objective. The aim was to design accessible, simple, inexpensive protection for teeth and soft tissues during ETI, compare damage occurrence with and without protection, and investigate post-ETI orofacial pain symptoms. Materials and Methods. The selection procedure for adequate protection was carried out after which a reduced elastomer mouthguard was selected. Fifty patients were divided into 2 groups. In the first group, ETI was carried out using a mouthguard, while in the second group it was performed without it. The mouthguard was fabricated by anesthesiologists. After the ETI procedure, the patients and anesthesiologists were asked to complete a survey. Results. No difference in intubation severity and time required for intubation between the two groups was present. Seven patients from the non-mouthguard group suffered injuries during the ETI procedure. No injuries were present in the mouthguard group. In 92% of cases anesthesiologists agreed that mouthguards should be used during ETI. However, most of them (96% of cases) agree that the mouthguard should be used only when there is an increased risk of tooth loss and/or tooth damage. There was a significant ETI effect on the emergence of new orofacial pain cases. Conclusion. The mouthguard adequately protected dental and soft tissues and did not affect the work of the anesthesiologist. A significantly higher number of patients experiencing temporomandibular joint and masticatory muscles pain after surgery indicates that ETI might be a risk factor for orofacial pain. [ABSTRACT FROM AUTHOR]

Perianaesthetic dental trauma is a common anaesthesia-related complication. Theprevious studies have shown a lack of knowledge regarding mouthguard usage and controversial results related to perianaesthetic dental trauma prevention. This study aimed to conduct a finite element analysis of the compressive and tensile stresses on the tooth-periodontal ligament-bone complex using custom-made mouthguards of different thicknesses and glass fibre splints to prevent perianaesthetic dental trauma. Custom-fitted ethylene-vinyl acetate mouthguards of two different thicknesses (2 and 3 mm) and glass fibre splint were modelled. A linear static finite element analysis was performed by applying a rigid Macintosh laryngoscope to the palatal surface of the maxillary central incisors at 150 N. The model without a mouthguard and glass fibre splint showed the highest stress values at the palatinal root surfaces during the impact. Increasing the mouthguard thickness significantly decreased the stress-strain values regardless of the presence of the glass fibre splint. Maximum stresses in the group using the 3 mm mouthguard were the lowest compared with the other groups. [ABSTRACT FROM AUTHOR]

Finite Element Analysis (FEA) is vital for understanding dental traumatology (DT) biomechanics, aiding diagnosis, treatment planning, and outcome prediction. This review explores FEA applications in DT research, evaluates their quality and outcomes, and assesses methodological aspects. Accordingly, recommendations for future researchers are provided. The study adhered to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines for scoping reviews and registered in Open Science framework. A comprehensive search using relevant text‐words and MeSH terms was performed in established databases. The inclusion criteria encompassed all Finite element analysis (FEA)‐based Dental traumatology (DT) studies without language or publication year restrictions. Risk of bias was assessed with the Risk of bias tool for the use of finite element analysis in dentistry (ROBFEAD) tool. Forty‐six studies published from 2001 to 2023 were included in the qualitative synthesis. The studies were categorized into five domains and six subdomains based on objectives. Maxillary central incisors and surrounding structures were commonly modelled (n = 27). Most studies utilized Computed tomography (CT), Cone Beam CT, or micro CT. Traumatic injury forces ranged from 100 N to 2000 N, and occlusal forces ranged from 150 N to 350 N. All studies were rated as high risk of bias. Fory‐six studies were categorized, with most focusing on stress distribution and fracture patterns in dento‐alveolar structures under various conditions, while few assessed displacements. Methodological quality lacked robustness in model development and substructure properties. Future studies should address these limitations and enhance reporting practices. [ABSTRACT FROM AUTHOR]

Objective:Wearing a mouthguard during contact sports is an effective way to prevent oral trauma; however, the prevalence of mouthguard use remains low, and the incidence of oral trauma has not decreased. In this study, we investigated the relationship between the history of oral trauma and the experience of wearing a mouthguard. We also examined the factors preventing people from wearing a mouthguard with the aim of promoting their use. Method:A total of 478 students(males:233, females:245), aged 19.4±1.14(mean±SD)years, from the sports department of a university were surveyed twice regarding their oral health and the use of a mouthguard. The number of respondents who had used a mouthguard in the male softball team was high whereas that in the female basketball team was low. There was a sufficient number of members for statistical analyses in both teams. Results:The percentage of male softball players who had used a mouthguard was 15.4％, which was higher than that of female basketball players who had used a mouthguard(4.3％)(p=0.082). The incidence of oral trauma was 23.1％ in the male softball team, which was lower than that in the female basketball team (58.7 %) (p< 0.01). Conclusion:The results of this survey showed that few student-athletes use a mouthguard. The results also indicated that it is important for many people, including coaches and parents, as well as dentists, to be involved in raising awareness of mouthguards. [ABSTRACT FROM AUTHOR]

The mouthguard plays a crucial role in preventing damage to the oral and jaw system. However, the popularity of sports mouthguards remains relatively low, and research on sports mouthguards is rather scattered. This paper primarily summarizes the characteristics of materials, production methods, protection principles, and influencing factors of mouthguards, with the aim of providing a theoretical reference for the popularization and application of mouthguards.

Objective: To determine which salivary proteins adhere onto sport mouthguards, and to evaluate the effectiveness of different cleaning strategies in removing deposited protein. Methods: Fifteen healthy volunteers used a mouthguard for 1 h. The deposited salivary proteins were analyzed using gel electrophoresis and Western blotting techniques and compared with the protein composition of unstimulated saliva. In addition, the effectiveness of two different cleaning strategies to remove proteins from the mouthguards were compared: rinsing the mouthguards after use with cold tap water and cleaning the mouthguard with a soluble effervescent tablet. Results: Gel electrophoresis showed deposition of proteins of 50–60 kDa and 14 kDa on the mouthguards used in the mouth for 1 h. Western blotting identified these bands as amylase and lysozyme, respectively. Rinsing the mouthguard with cold tap water after use removed 91% of the total amount of deposited proteins, while cleaning with an effervescent tablet removed 99%. Conclusions: During the use of mouthguards, salivary proteins are deposited on their surface. Because salivary proteins can potentially affect bacterial adhesion to mouthguards, proper cleaning after use is recommended. Cleaning the mouthguard with cold tap water or using an effervescent tablet both seem to be effective strategies to remove proteins deposited on sport mouthguards. [ABSTRACT FROM AUTHOR]

Background/Aim: Thermoplastic mouthguards have been a reliable means of protection against impacts and shocks for a century. Although orofacial injuries are prevalent among basketball players, many athletes still avoid using mouthguards due to concerns regarding impaired breathing, speech interference, and nausea. This study aims to compare basketball players' subjective assessments of two different thicknesses of custom‐made mouthguards (MGs) with boil‐and‐bite MGs (B&B MG). Material and Methods: A total of 60 systematically healthy male professional basketball players, without active orthodontic treatment, were enrolled and randomly assigned to three groups: Group 1 (received B&B MGs; n = 20), Group 2 (received custom‐made MGs with a 3 mm thickness [ethyl vinyl asetat]; n = 20), and Group 3 (received custom‐made MGs with a 5 mm thickness; n = 20). To evaluate MG comfort and usability, 12 key factors, including comfort, fit, stability, tiredness, thirsting, oral dryness, nausea, speaking, breathing, drinking, ease of wear and removal, and inclination to chew, were assessed. The athletes were made to rate these factors using a 10 cm‐long Visual Analog Scale, measured at three‐time intervals, and the values for both inter‐group and intra‐group were compared. Results: Data from 48 basketball players were retrieved, and data analysis revealed that B&B MGs had the least favorable parameter values. Among the B&B MG group, stability was reported to be poorer during the initial measurement (p <.05). In the second measurement, B&B MGs showed significantly lower values for comfort, stability, tiredness, speaking, and inclination to chew (p <.05). During the third measurement, the B&B MG group exhibited significantly reduced values for comfort, breathing, drinking, and speaking (p <.05). In contrast, no statistically significant difference was observed between 3 and 5 mm thickness MGs in these measurements. Conclusions: Custom‐made MGs with different thicknesses consistently outperformed B&B MGs in all measurements, indicating the potential to tailor MG thickness based on sport, age, professional level of athlete, and presence of other protective equipment. While custom‐made mouthguards are considered the gold standard, dentists who provide B&B MGs can lead to cost savings while maintaining protection and encouraging athletes to use higher‐quality custom‐made mouthguards. [ABSTRACT FROM AUTHOR]

Background/Aims: Athletes are susceptible to oral injuries. To reduce the incidence and severity of oral trauma, a custom‐made mouthguard, a device positioned in the mouth to prevent damage to teeth and surrounding structures, is recommended. In field hockey, according to the international rules of this sport, using mouthguards is not mandatory, but it is recommended to wear them at all times while practicing this discipline. We aimed to determine characteristics and differences regarding mouthguard usage among field hockey players from different countries participating in the XII ODESUR Games. Methods: We conducted a cross‐sectional study that included 78 voluntary hockey athletes that met the inclusion criteria. The questionnaire used was validated by Panam Sports, collecting information on the type of mouthguard (custom‐made or prefabricated), and the time of use of the mouthguard (range of 5 years). Results: Of the total number of athletes, 96% used mouthguards, of which 64% were custom‐made type, and 32% were prefabricated (p <.001). Custom‐made mouthguards were used by 100%, 89%, and 64% of athletes in Argentina, Chile, and Peru, respectively, while only 40% of athletes in Paraguay and Uruguay used them. It has also been observed that more than 50% of the individuals have not controlled and replaced their intraoral devices for more than 10 years. Conclusions: Our results reveal a problem with a public health dimension and thus invite the standardization of guidelines with an educational approach to promoting and adopting good sports practices. This report is the first on using mouthguards in high‐performance athletes during an international multisport event. [ABSTRACT FROM AUTHOR]

Background/Aim: The interaction between the ethylene‐vinyl acetate (EVA) with distinct materials utilized for obtaining dental models can affect the performance of resulting mouthguards. This study attempted to evaluate the effect of different materials for conventional (dental stone) or 3D‐printed (resin) models on EVA's physical and mechanical properties and surface characteristics. Material and Methods: EVA sheets (Bioart) were laminated over four model types: GIV, conventional Type IV dental stone model (Zhermak); ReG, resin‐reinforced Type IV dental stone model (Zero Stone); 3DnT, 3D resin printed model (Anycubic) without surface treatment; 3DT, 3D‐printed model (Anycubic) with water‐soluble gel (KY Jelly Lubricant, Johnson & Johnson) coating during post‐curing process. The EVA specimens were cut following the ISO 37‐II standard (n = 30). Shore A hardness was measured before and after plasticization on the contact (internal) or opposite (external) surfaces with the model. The breaking force (F, N), elongation (EL, mm), and ultimate tensile strength (UTS, MPa) were measured using a universal testing machine. Macro‐photography and scanning electron microscopy were adopted for classifying the EVA surface alteration. Data were analyzed by one‐way ANOVA with repeated measures, followed by Tukey's test (α =.05). Results: Plasticization significantly decreased Shore A values for the tested EVA regardless of the model type (p <.001). Higher F, El, and UTS values were verified for the EVA with 3DT and GIV models compared to ReG and 3DnT (p <.001). 3DnT models resulted in severe surface alteration and a greater reduction of the mechanical properties of the EVA. Conclusion: The interaction of EVA with 3D resin‐printed models without surface treatment or resin‐reinforced Type IV dental stone models significantly affected the physical and mechanical properties of this material. The utilization of water‐soluble gel coating during the post‐curing process of 3D resin printed models improved the mechanical properties of the EVA, similarly when this material was plasticized over conventional Type IV dental stone model. [ABSTRACT FROM AUTHOR]

There is a growing need for a mouthguard sheet material with higher shock absorption and dispersion capacity than those obtained by conventional materials. A five-layer mouthguard sheet material was previously developed using laminated ethylene vinyl acetate and polyolefin copolymer resin. In this study, the shock absorption capacity and dispersion capability of the new sheet material were investigated and compared with those of other materials. Impact testing for the new sheet material showed that the force required to displace the sheet by 1 mm was significantly higher at all thicknesses (p<0.001), whereas the puncture energy and displacement were significantly lower than those for ethylene vinyl acetate (p<0.05). The five-layer mouthguard sheet material successfully absorbed and resisted shock. Therefore, the sheet material potentially increases resistance to applied deformation in teeth and alveolar bone and maintains structure. The five-layer sheet material could expand the range of mouthguard products and help prevent oral trauma. [ABSTRACT FROM AUTHOR]

Some sports participants are often reluctant to wear a mouthguard due to issues with comfort, breathing and communication. However, there is limited evidence that investigates the use of custom‐made mouthguards and variations in design as key factors to minimise these issues. Therefore, the aim of this study was to examine the effect of custom‐made mouthguard design on cardiopulmonary function, exercise performance and perception of comfort in rugby union players. Fourteen rugby players (aged 20.2 ± 1.19 years) were recruited to undertake a rugby‐specific exercise protocol on a treadmill over four conditions (no mouthguard and three custom‐made mouthguard designs). Cardiopulmonary responses were assessed using breath‐by‐breath analysis, in conjunction with blood lactate (BLa) and rating of perceived exertion (RPE). Maximum oxygen uptake (VO2max) was assessed before and after the study to identify any changes in players' level of performance. Participants scored each mouthguard in relation to preference, comfort, breathing, protection and retention. There were no differences in oxygen uptake (p = 0.785, ηp2 ${\eta }_{p}^{2}$ = 0.021), ventilation (p = 0.952, ηp2 ${\eta }_{p}^{2}$ = 0.007), respiratory exchange ratio (p = 0.564, ηp2 ${\eta }_{p}^{2}$ = 0.039) and heart rate (p = 0.830, ηp2 ${\eta }_{p}^{2}$ = 0.017), whilst participants performed with the selected custom‐made mouthguards. However, RPE was higher without a mouthguard than whilst using two of the mouthguards during the first 3 min of exercise, in combination with higher BLa accumulation (p ≤ 0.05). Although there was no statistical difference between mouthguard designs in the ratings around comfort, there was a preference towards mouthguards with reduced palatal coverage. Individual preference in design may improve compliance of wearing a mouthguard without affecting physiological parameters. Highlights: Wearing any of the three selected custom‐made mouthguards had no impact on cardiorespiratory parameters, such as oxygen uptake, minute ventilation, respiratory exchange ratio, heart rate and blood lactate.In terms of participants' perceived comfort, there were no differences between the selected mouthguard designs.The findings of the present study may lead to encouraging the use of custom‐made mouthguards amongst rugby players as no negative influence on the examined physiological parameters was found. [ABSTRACT FROM AUTHOR]

The impression materials utilized today in dental medicine offer a good reproducibility and are easily accepted by patients. However, because they are polymer-based, they have issues regarding their dimensional stability. In this respect, the present work proposes a new type of dental impression, which is reinforced with rigid mouthguards. The aim of the study is to test the performances of such new impressions by comparing them to conventional ones—from this critical point of view, of the dimensional stability. Three types of polymeric materials were considered for both types of impressions: alginate, condensation silicone, and addition silicone. In order to obtain the new type of impressions, a manufacturing technique was developed, comprising the following phases: (i) conventional impressions were made; (ii) a plaster model was duplicated, and 15 rigid mouthguards were obtained; (iii) they were inserted in the impression technique, with each mouthguard positioned on the cast before the high-consistency material was inserted in the tray and the practitioner took the impression; (iv) the mouthguard remained in the tray and the low-viscosity material was inserted over the mouthguard; (v) the impression was positioned on the model, and after the material hardened, the mouthguard-reinforced impression was analyzed. In the evaluation of the dimensional stability, rigorous statistical analysis was essential to discern the performance differences between conventional and mouthguard-reinforced dental impressions. Statistical analyses employed non-parametric Mann–Whitney U tests because of the non-normal distribution of the data. They indicated a statistically significant improvement in the dimensional stability of addition silicone impressions when reinforced with mouthguards (p < 0.05), showcasing superior performance over conventional methods. Conversely, alginate and condensation silicone reinforced impressions did not exhibit the same level of stability improvement, suggesting the need for further optimization of these materials. In conclusion, from the three considered elastomers, addition silicone was found to be the prime candidate for high-precision dental impressions, with the potential to improve their quality from conventional impressions by utilizing the proposed reinforcing technique. [ABSTRACT FROM AUTHOR]

Background/Aim: Mouthguards are used to prevent dental trauma and orofacial injuries. The aim of this study was to evaluate the influence of ethylene‐vinyl acetate (EVA) aging by thermocycling on elastic modulus, stress, strain and shock absorption ability of different ethylene‐vinyl acetate brands used for mouthguards. Methods: Thirty EVA samples with a dimension of 70 × 10 × 3 mm were obtained from four commercial brands (Bioart®, Erkodent®, Polyshok® and Proform®). Fifteen samples were submitted to 10,000 cycles (5°C–55°C) in a thermocycling machine with an immersion time of 30 s and a transfer time of 5 s. The samples were submitted to a uniaxial tensile test in a universal testing machine to calculate the elastic modulus. Data were statistically evaluated by two‐way ANOVA and Holm‐Sidak test. A three‐dimensional model of the anterior maxilla was created using Rhinoceros 5.0. A 3 mm custom‐fitted mouthguard was simulated. The three‐dimensional volumetric mesh was generated using the Patran software (MSC Software) with isoparametrics, 4‐noded tetrahedral elements and exported to Marc/Mentat (MSC Software) as element number 134. A non‐linear dynamic impact analysis was performed in which a rigid object struck the central incisor at a speed of 5 m/s. The stresses were evaluated by the modified von Mises criteria and the strains were also recorded. Results: Statistically significant differences were observed for elastic modulus values (p <.001). Mean and standard deviation values (MPa) without thermocycling were: Bioart (34.5 ± 0.9), Erkodent (15.0 ± 0.4), Polyshok (17.3 ± 0.4), Proform: (20.6 ± 0.8); and with thermocycling: Bioart (25.4 ± 0.8), Erkodent (10.7 ± 0.5), Polyshok (13.3 ± 0.6), Proform (13.1 ± 0.6). The thermocycling process reduced stress and strain levels regardless of the mouthguard materials. Shock absorption ability calculated based on the strain values was increased with thermocycling process. Conclusion: The thermocycling process, regardless of the commercial brand, reduced the stress/strain and increased the shock absorption ability of mouthguards. [ABSTRACT FROM AUTHOR]

This investigation presents a critical analysis of mouthguard production, focusing on the evaluation of conventional vs additive manufacturing methods, the materials involved, and aspects such as their failure and prevention. It also summarizes the current trends, perspectives, and the main limitations. It is shown that some of the shortcomings can be solved by implementing additive manufacturing technologies, which are systematically reviewed in this research. Due to the specific materials used to produce mouthguards, there are certain additive manufacturing technologies that dominate and a wide variety of raw materials. The costs vary depending on the technology.

Sports-associated orofacial trauma causes negative sequelae in an athlete. To prevent this, we must closely assess the mechanism as well as the available literature regarding the prevalence. It is easier to apply knowledge of sports dentistry if the injury mechanism, types of injury, and management are known. Every single game is accompanied by its own set of injuries. Basketball is a dynamic game. Athletes involved in this game are at high risk of orofacial injuries. The preventive aspect is often a blind spot, especially in Indian Sports. This review gives a bird's-eye view of the type of orofacial trauma and prevention in athletes playing basketball game.

Salivary turbidity is a promising indicator for evaluating oral hygiene. This study proposed a wearable mouthguard-type sensor for continuous and unconstrained measurement of salivary turbidity. The sensor evaluated turbidity by measuring the light transmittance of saliva with an LED and a phototransistor sealed inside a double-layered mouthguard. The sensor was also embedded with a Bluetooth wireless module, enabling the wireless measurement of turbidity. The mouthguard materials (polyethylene terephthalate-glycol and ethylene-vinyl acetate) and the wavelength of the LED (405 nm) were experimentally determined to achieve high sensitivity in salivary turbidity measurement. The turbidity quantification characteristic of the proposed sensor was evaluated using a turbidity standard solution, and the sensor was capable of turbidity quantification over a wide dynamic range of 1–4000 FTU (formazine turbidity unit), including reported salivary turbidity (400–800 FTU). In vitro turbidity measurement using a saliva sample showed 553 FTU, which is equivalent to the same sample measured with a spectrophotometer (576 FTU). Moreover, in vivo experiments also showed results equivalent to that measured with a spectrophotometer, and wireless measurement of salivary turbidity was realized using the mouthguard-type sensor. Based on these results, the proposed mouthguard-type sensor has promising potential for the unconstrained continuous evaluation of oral hygiene. [ABSTRACT FROM AUTHOR]

Sports-associated orofacial trauma causes negative sequelae in an athlete. To prevent this, we must closely assess the mechanism as well as the available literature regarding the prevalence. It is easier to apply knowledge of sports dentistry if the injury mechanism, types of injury, and management are known. Every single game is accompanied by its own set of injuries. Basketball is a dynamic game. Athletes involved in this game are at high risk of orofacial injuries. The preventive aspect is often a blind spot, especially in Indian Sports. This review gives a bird's-eye view of the type of orofacial trauma and prevention in athletes playing basketball game. [ABSTRACT FROM AUTHOR]

Abstract Objectives Violence among soccer supporters continues to pose a significant public health concern in many parts of the world. In Switzerland, hooliganism is largely uninvestigated. This study aimed to examine incidents of violence and associated dental injuries among different groups of soccer supporters, as well as assess the impact of intoxicants on their behavior, using survey data from regular fans, ultras, and hooligans in the Swiss Football League. Material and Methods A cross‐sectional survey using a standardized questionnaire was conducted among distinct factions of soccer supporters in the Swiss Football League in 2022. A total of 165 participants self‐identified as belonging to one of three subgroups: “regular fan,” “ultra,” or “hooligan.” Data were gathered on physical altercations, dental injuries, possession of mouthguards, intoxicant use, and medical assistance. Descriptive statistics, logistic regression models, and significance tests were used for data analysis (α = .05). Results Hooligans had a higher frequency of dental injuries resulting from fights than ultras and regular fans. Hooligans with 11–20 fights per soccer season had a 9.6 times higher probability of dental trauma than those with 0–5 fights (p = .048). Possession of a mouthguard was associated with a lower risk of dental injuries for hooligans but an increased risk for ultras. Additionally, hooligans were found to differ significantly from other groups in their consumption of amphetamines and cocaine (p

Objectives: The aim of the present study was to examine the plaque removal effectiveness of a personalised 3D-printed dental plaque removal mouthguard device in a clinical trial setting. Methods: A personalised 3D-printed mouthguard was developed to clean dental plaque using micro-mist. A clinical trial was conducted to examine the plaque removal effectiveness of this device. The clinical trial recruited 55 participants (21 males and 34 females) with an average age of 68.4 years (range, 60–81 years). Dental plaque was dyed by plaque disclosing liquid (Ci). Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI) was used to evaluate the level and rate of plaque formation on the tooth surface. The TMQHPI was recorded and intraoral photos were taken before and after mouthguard cleaning. The plaque removal rate was calculated based on TMQHPI and intraoral photos (pixel-based method) before and after cleaning. Results: The personalised 3D-printed micro-mist injection mouthguard can be effective in dental plaque removal on tooth and gingiva, and the effectiveness lies between that of a manual toothbrush and a mouth rinse. The newly proposed pixel-based method can be a practical, high sensitive tool to evaluate the level of plaque formation. Conclusions: Under the conditions of the present study, we conclude that the personalised 3D-printed micro-mist injection mouthguard can be useful in reducing dental plaque and may be especially suitable for older adults and disabled people.

Sports dentistry is a branch of oral sciences concerned with the treatment, management, and prevention of the trauma to the orofacial region sustained while participating in any sports activity. Sports have been frequently reported to be an important cause of overall oral trauma in children, as well as adults. There is an evident lack of knowledge in the general population regarding how sports injuries are to be prevented and dealt with. Dentists, if included in sports teams and schools, can help penetrate this knowledge and awareness barrier. Lifestyle, eating habits, stress, etc., have an impact on the performance of the athletes. Stress in athletes can lead to substance abuse, more precisely, tobacco abuse which can affect their performance. Like physiotherapists, even dentists can be made a part of a professional sports team where they can help prevent the complications arising due to facial traumas by the administration of various protective appliances and handle maxillofacial trauma. The present study aimed to evaluate and comprehend the current opportunities for dentists in the field of sports dentistry, whilst emphasising their significance in the professional sports system.

Background: Traumatic dental injuries (TDIs) are a common complication in sports, with an overall prevalence ranging from 0.71% to 60%. Kickboxing is a high-risk combat sport for trauma to the facial region. Methods: A total of 142 5-to-65-year-old amateur athletes participated in the survey with a questionnaire that was released during their regular practice days. The questionnaire was structured into three parts: (1) questions about age, gender, type, and time of sports practice; (2) questions about dental injuries, personal experience, and awareness of emergency management, particularly about tooth avulsion; (3) questions about wearing a mouthguard for TDI prevention. Results: A total of 13 percent of athletes suffered a TDI while training or fighting. Regarding first aid, 61% of the participants in this survey are aware of the possibility of replanting a tooth after its avulsion; 10% believe that the tooth should be replanted within 15 min, and 37% of athletes believe that it should be kept wet. The mouthguard is known to the majority of athletes (94%), and 66% were informed by the coach; 68% of the athletes use it. Seventy-four percent of the mouthguards were purchased in a sports shop. Conclusions: A relatively low prevalence of TDIs was observed in players in the sample. A lack of information about the emergency management of tooth avulsion and about the type of mouthguard to wear emphasizes the importance of educational training by dentists to athletes and coaches.

Objectives/Aim: Sports‐related dental injuries occur frequently among athletes due to inadequate knowledge and prevention measures. The aim of the study was to assess knowledge, attitudes, and practices of active soccer players from all leagues in Croatia regarding traumatic dental injuries and the use of mouthguards. Material and Methods: 393 respondents completed a questionnaire‐based online survey from March 2022 to April 2022. The questionnaire consisted of 37 questions divided in four sections: demographic characteristics, experience with orofacial injuries, knowledge of emergency therapeutic procedures for dental injuries, and behaviors related to the use of a mouthguard. Results: Insufficient knowledge was confirmed by a total score of 2.8 ± 2.8 points, with a possible maximum of 11. Respondents' better knowledge can be associated with educational level (p =.002), playing position (p =.046), and personally experienced injuries to the face and jaw (p ≤.001) and teeth (p =.022). Less than 40% of respondents suffered facial and jaw injuries while playing football and 18.6% suffered dental injuries. Although most respondents (93.9%) were familiar with mouthguards and 68.9% believed that they help prevent injuries while playing football, only 16% used them. Conclusion: The study revealed significant gaps in knowledge regarding dental injuries and the practice of mouthguard usage among Croatian soccer players. Therefore, it is evident that additional education is needed to prevent dental injuries and take proper procedures when taking care of them among the examined population. [ABSTRACT FROM AUTHOR]

Objectives: Violence among soccer supporters continues to pose a significant public health concern in many parts of the world. In Switzerland, hooliganism is largely uninvestigated. This study aimed to examine incidents of violence and associated dental injuries among different groups of soccer supporters, as well as assess the impact of intoxicants on their behavior, using survey data from regular fans, ultras, and hooligans in the Swiss Football League. Material and Methods: A cross‐sectional survey using a standardized questionnaire was conducted among distinct factions of soccer supporters in the Swiss Football League in 2022. A total of 165 participants self‐identified as belonging to one of three subgroups: "regular fan," "ultra," or "hooligan." Data were gathered on physical altercations, dental injuries, possession of mouthguards, intoxicant use, and medical assistance. Descriptive statistics, logistic regression models, and significance tests were used for data analysis (α =.05). Results: Hooligans had a higher frequency of dental injuries resulting from fights than ultras and regular fans. Hooligans with 11–20 fights per soccer season had a 9.6 times higher probability of dental trauma than those with 0–5 fights (p =.048). Possession of a mouthguard was associated with a lower risk of dental injuries for hooligans but an increased risk for ultras. Additionally, hooligans were found to differ significantly from other groups in their consumption of amphetamines and cocaine (p <.001). Conclusions: The study found a strong link between physical altercations and dental injuries among soccer supporters. To promote better prevention, there is a necessity for enhanced educational initiatives facilitated by dentists to amplify the dissemination of mouthguards. Furthermore, it is crucial to raise awareness regarding their proper fitting to minimize the occurrence of combat‐related dental injuries. Health authorities and other stakeholders should take a comprehensive approach to addressing some of the root causes of violent behavior, which include alcohol abuse and illicit substance consumption. [ABSTRACT FROM AUTHOR]

Objectives/Aim: The purpose of this study was to evaluate oral health knowledge, and the incidence of self-reported dental injuries incidence, the frequency of mouthguard use, oral hygiene habits, and oral health status among professional water polo players. Materials and Methods: During the 2022/2023 season, 114 water polo players from the Croatian First League participated in a questionnaire-based online survey. The data collected included sociodemographic and professional attributes, oral health knowledge questions, dental injury experiences, and practices related to mouthguard use. Respondents also rated their own oral health status and oral hygiene habits. The data were analyzed using descriptive statistics and a regression analysis. Results: The respondents demonstrated inadequate knowledge of oral health, with a mean score of 6.4 ± 2.6 out of 12. Better knowledge correlated positively with older age (p ˂ 0.05) and consistent flossing (p = 0.014). Additionally, 27.2% (31 of 114) of reported dental injuries were related directly to incidents which occurred while participating in water polo. These injuries occurred more frequently during games (54.8%) and often involved the anterior maxillary incisors (71.0%) due to player contact (87.1%). Awareness of mouthguards was high (93.9%), whereas their actual use was low (7.0%) because 35.1% of respondents reported discomfort wearing them. The respondents' self-assessments revealed widespread dental problems, including tooth sensitivity (13.3%), erosion (15.8%), calculus (28.1%), and pigmentation (7.9%). Conclusions: The research results indicate a lack of adequate knowledge among the respondents regarding oral health. This deficit was not associated with oral hygiene habits or oral cavity conditions. These findings highlight the disparities in oral health awareness and practices associated with water polo participation and emphasize the importance of education and prevention efforts. [ABSTRACT FROM AUTHOR]

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD). [ABSTRACT FROM AUTHOR]

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD). [ABSTRACT FROM AUTHOR]

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD). [ABSTRACT FROM AUTHOR]

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD). [ABSTRACT FROM AUTHOR]

Awake bruxism is an understudied manifestation of frontotemporal dementia, yet awake bruxism can have fatal consequences in the aging population. This report presents a patient suffering from awake bruxism associated with frontotemporal dementia being treated with a mouthguard, which ultimately becomes lodged in her posterior oropharynx leading to asphyxiation. The case highlights the need for investigation into the occurrence and treatment of awake bruxism among patients with dementia, and the unique risk-benefit analysis that must be performed to develop proper treatment plans for patients with dementia. [ABSTRACT FROM AUTHOR]

BackgroundTo better understand the biomechanical profile of direct head impacts and the game scenarios in which they occur in Rugby Union, there is a need for an on-field validation of a new instrumented mouthguard (IMG) against the reference standard. This study considers the potential of a combined biomechanical (IMG) and video analysis approach to direct head impact recognition, both of which in isolation have limitations. The aim of this study is to assess the relationship between an instrumented mouthguard and video analysis in detection of direct head impacts in rugby union.DesignPilot Study - Observational Cohort designMethodsThe instrumented mouthguard was worn by ten (3 backs, 7 forwards) professional Rugby Union players during the 2020–21 Gallagher Premiership (UK) season. Game-day video was synchronized with timestamped head acceleration events captured from the instrumented mouthguard. Direct Head Impacts were recorded in a 2 × 2 contingency table to determine sensitivity. Impact characteristics were also collected for all verified head impacts to further the understanding of head biomechanics during the game.ResultsThere were 2018 contact events that were reviewed using video analysis. Of those 655 were categorized as direct head impacts which also correlated with a head acceleration event captured by the IMG. Sensitivity analysis showed an overall sensitivity of 93.6% and a positive predictive value (PPV of 92.4%). When false positives were excluded due to ball out of play, mouthguard removal or handling after a scoring situation or stoppage, PPV was improved (98.3%). Most verified head impacts occurred in and around the ruck contest (31.2%) followed by impacts to the primary tackler (28.4%).ConclusionThis pilot validation study demonstrates that this IMG provides a highly accurate measurement device that could be used to complement video verification in the recognition of on-field direct head impacts. The frequency and magnitude of direct head impacts derived from specific game scenarios has been described and allows for greater recognition of high-risk situations. Further studies with larger sample sizes and in different populations of Rugby Union players are required to develop our understanding of head impact and enable strategies for injury mitigation.

A mouthguard is a piece of equipment worn in sports worldwide to greatly reduce the chance of orodental injuries. This work uses a newly developed method for testing and analysing mouthguards subjected to high impact energies of up to 100 J. This method allows investigation and comparison between the use of additive manufacturing, and current best mouthguard manufacturing technology of thermoforming with Ethylene-vinyl acetate (EVA). The impact experiments are conducted using a drop tower and high-speed images are captured for the further analysis. Important physical parameters such as peak force, impulse and dissipated energy in the mouthguard are determined. The results revealed that the additively manufactured mouthguards made from Arnitel® ID 2045 lead to a peak force and impulse of impact that is on average 10% and 25% lower, respectively, than that experienced when using the EVA mouthguard. A lower peak force and impulse is preferred as it reduces the chance of an orodental injury occurring. The research shows that previously mouthguards have been tested at impact energies far lower than those experienced in impact prone sports such as field hockey. When using impacts with higher energies, the findings show that additive manufacturing provides a viable technology for manufacturing mouthguards, which offers many new benefits.

Background: Head impacts in sports can produce brain injuries. The accurate quantification of head kinematics through instrumented mouthguards (iMG) can help identify underlying brain motion during injurious impacts. The aim of the current study is to assess the validity of an iMG across a large range of linear and rotational accelerations to allow for on-field head impact monitoring. Methods: Drop tests of an instrumented helmeted anthropometric testing device (ATD) were performed across a range of impact magnitudes and locations, with iMG measures collected concurrently. ATD and iMG kinematics were also fed forward to high-fidelity brain models to predict maximal principal strain. Results: The impacts produced a wide range of head kinematics (16–171 g, 1330–10,164 rad/s2 and 11.3–41.5 rad/s) and durations (6–18 ms), representing impacts in rugby and boxing. Comparison of the peak values across ATD and iMG indicated high levels of agreement, with a total concordance correlation coefficient of 0.97 for peak impact kinematics and 0.97 for predicted brain strain. We also found good agreement between iMG and ATD measured time-series kinematic data, with the highest normalized root mean squared error for rotational velocity (5.47 ± 2.61%) and the lowest for rotational acceleration (1.24 ± 0.86%). Our results confirm that the iMG can reliably measure laboratory-based head kinematics under a large range of accelerations and is suitable for future on-field validity assessments. [ABSTRACT FROM AUTHOR]

Background/Aim: Mouthguards (MTG) are used to prevent dental trauma. However, their protective effect on esthetic restorations and whether modified MTGs are beneficial is uncertain. The aim of this study was to evaluate the effect of hard inserts and air spaces in MTGs in protecting direct resin composite veneers during impact. Materials and Methods: Twenty resin composite veneers (1.0 mm) were prepared on upper right central incisors on printed maxilla models using polyether. The effect of the MTGs was evaluated in four groups (n = 5): Con‐MTG, conventional custom‐fit MTGs made with two layers of ethylene vinyl acetate (EVA); Air‐MTG, MTGs with the insertion of 2.0 mm air space between the two layers of EVA and tooth surface; PETG‐MTG, MTGs with 1.0 mm of polyethylene terephthalate glycol‐modified (PETG) inserted between the EVA layers; and No‐MTG, comprising resin composite veneers without MTG. The printed models were fixed in a pendulum device, and the impact was performed at 30°. The strain (μS) and shock absorption (%) of the MTG were recorded using strain gauges. Failure modes and cracks were evaluated using macro photography and transillumination and analyzed using the chi‐square test. Strain and shock absorption data were analyzed using the one‐way analysis of variance followed by Tukey's test (α = 0.05). Results: Mouthguards reduced strain and enhanced shock absorption, regardless of the MTG type (p <.001). Con‐MTG, Air‐MTG, and PETG‐MTG had shock absorption rates of 76.1%, 72.3%, and 33.4%, respectively (p <.001). The single No‐MTG model had a root fracture, while all the others had superficial damage. None of the MTG models had cracks or fractures. Conclusions: Mouthguards protected the resin composite veneers. The Con‐MTG and Air‐MTG groups had lower strain and greater shock absorption than the PETG‐MTG. Resin veneers had no cracks or damage following MTG use. However, 80% of the veneers had surface damage when no MTG was used. [ABSTRACT FROM AUTHOR]

Background/Aim: Contamination of ethylene vinyl acetate (EVA) during mouthguard fabrication can cause delamination. The study evaluated the effects of different EVA surface treatments on the contact angle, laminate bond strength, and elongation capacity. Materials and Methods: Specimens of two bonded EVA plates were prepared (n = 30). The Shore A hardness of standardized EVA plate specimens was measured before and after thermo‐plasticization. The EVA plates were randomly allocated to one of five different surface treatment groups: no treatment (control); isopropyl alcohol, 100%; chloroform, 99.8%; self‐cure acrylic resin monomer (methacrylate, ethylene glycol dimethacrylate, and chemical initiator—amine type); and ethyl alcohol, 70%. The maximum breaking force and elongation at the site of fracture were recorded using a universal testing machine. The contact angle surface was measured using ImageJ software. Scanning electron microscopy of the EVA surface was performed. The laminate bond strength was obtained by dividing the maximum breaking force by the bonding area between the two EVA plates. The laminate bond strength and maximum elongation data were analyzed by one‐way ANOVA, followed by the Tukey's and the Dunnet test. The failure mode data was analyzed using the chi‐square test (α =.05). Results: EVA surface treatment significantly influenced the laminate bond strength and maximum elongation (p <.001). The control group had a higher contact angle and significantly lower laminate bond strength and maximum elongation than the other groups (p <.001). The acrylic resin monomer and chloroform‐treated specimens had similar laminate bond strength and maximum elongation. The acrylic resin monomer group had a significantly lower contact angle (p <.001). Conclusions: All treatments had a significantly higher laminate bond strength and maximum elongation than the control group. The acrylic resin monomer and chloroform groups had a significantly higher laminate bond strength and maximum elongation and the acrylic resin monomer group had a lower contact angle than the other groups. The chloroform should be avoided due its hazardous effects. [ABSTRACT FROM AUTHOR]

Background/Aim: During sports activities, teeth‐related contact can cause injury to both ally and opponent players, which can lead to potential infections and aesthetic problems. However, the extent of such injuries remains unclear. This study aimed to clarify the frequency and situation of head injuries caused by teeth (HICBT) occurring under the supervision of schools in Japan. Material and Methods: HICBT records were extracted from the Japan Sport Council data on head injuries occurring reported during the 7‐year period from 2012 to 2018 under the supervision of schools in Japan. Results: Of the total 463,527 head injury cases during the study period, 4495 cases (approximately 1%) were HICBT. Of the HICBT cases, 3650 (81.20%) were related to sports and athletic activity. Such injuries were reported to occur most often during basketball with a rate of 57.07% and 50.43%; soccer/futsal was the next most common sport with a rate of 13.38% and 24.01% in junior high school and high school students. Tag games were responsible for a similar number of HICBT cases at 22.73% and 39.03% in kindergartens and elementary school students. Conclusions: A total of 4495 cases of HICBT were identified, accounting for about 1% of all head injuries under the supervision of schools in Japan during the study period. This result reminds us that our teeth could be the weapon against the players during sports events. HICBTs occurring during basketball and soccer/futsal, in which mouthguards are not mandatory, were conspicuous among junior and senior high school students. Active use of mouthguards in various sports will protect players as well as their teammates and opponents. Sports dentists should encourage the revision of rules, such as mandating the use of mouthguards, in popular sports with a high incidence of HICBT, such as basketball and soccer/futsal. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to simulate the influence of palatal extensions for custom-made mouthguards (MGs) on protecting dentoalveolar structures and to provide a theoretical basis for designing a comfortable MG. Materials and methods: Based on finite element analysis (3D-FEA), five groups of maxillary dentoalveolar models of wearing MGs were established: no MG on palatal side (NP), on palatal gingival margin (G0), 2 mm from the palatal gingival margin (G2), 4 mm from the palatal gingival margin (G4), 6 mm from the palatal gingival margin (G6), and 8 mm from the palatal gingival margin (G8). A cuboid was created to simulate the solid ground impacted in falls, a gradually increasing force was applied from 0 to 500 N on the vertical ground, and the distribution and peak values of the Critical modified von-Mises stress, maximum principal stress, and displacement of dentoalveolar models were calculated. Results: Stress distribution range, stress, and deformation peak value of dentoalveolar models increased as the impact strength increased, at 500 N. Maximum critical modified von-Mises stress, peak maximum principal stress and maximum displacement of dentoalveolar models G4, G3, G2, G1, G0, and NP were 154.5 MPa, 154.5 MPa, 154.4 MPa, 154.7 MPa, 154.4 MPa, and 154.7 MPa; 191.65 MPa, 192.11 MPa, 191.62 MPa, 191.81 MPa, 191.56 MPa, and 191.62 MPa; and 88.78 μm, 88.57 μm, 88.19 μm, 88.67 μm, 88.43 μm, and 89.04 μ, respectively. However, the position of the MG palatal edge had little effect on stress distribution, stress, and deformation peak values of the dentoalveolar models. Conclusions: Different extension ranges of the MG palatal edge have little effect on the protective effects of MGs on maxillary teeth and maxilla. An MG with palatal extension on the gingival margin is more appropriate than other models and may help dentists to design a suitable MG and increase its usage. Clinical relevance: MGs with palatal extensions on the gingival margin may provide a more comfortable wearing experience for individuals involved in sports and encourage increased MG usage. [ABSTRACT FROM AUTHOR]

In orthodontics, understanding the pressure of oral soft tissues on teeth is important to elucidate the cause and establish treatment methods. We developed a small wireless mouthguard (MG)-type device that continuously and unrestrainedly measures pressure, which had previously been unachieved, and evaluated its feasibility in human subjects. First, the optimal device components were considered. Next, the devices were compared with wired-type systems. Subsequently, the devices were fabricated for human testing to measure tongue pressure during swallowing. The highest sensitivity (51–510 g/cm2) with minimum error (CV < 5%) was obtained using an MG device with polyethylene terephthalate glycol and ethylene vinyl acetate for the lower and upper layers, respectively, and with a 4 mm PMMA plate. A high correlation coefficient (0.969) was observed between the wired and wireless devices. In the measurements of tongue pressure on teeth during swallowing, 132.14 ± 21.37 g/cm2 for normal and 201.17 ± 38.12 g/cm2 for simulated tongue thrust were found to be significantly different using a t-test (n = 50, p = 6.2 × 10−19), which is consistent with the results of a previous study. This device can contribute to assessing tongue thrusting habits. In the future, this device is expected to measure changes in the pressure exerted on teeth during daily life. [ABSTRACT FROM AUTHOR]

Background/Aim: An undercut on the model's labial side affects the mouthguard thickness. The aim of this study was to investigate how the undercut amount on the model's labial side affects the reduction rate of laminated mouthguard thickness. Materials and Methods: Mouthguards were thermoformed using 3.0‐mm‐thick ethylene‐vinyl‐acetate sheets for the first and second laminates and a pressure molding machine. Working models were three hard plaster models trimmed so that the undercut amount on the model's labial side was 0°, 10°, and 20° (U0, U10, and U20). A specialized caliper was used to measure the thickness of the incisal, labial surface, and buccal surface of the first layer and the laminated mouthguards. Thickness reduction rate of the first layer or laminated mouthguard due to the model undercut amount were analyzed using one‐way ANOVA. Additionally, in each model, the difference in the thickness reduction rate between the first layer and the laminated mouthguard were analyzed by Student's t‐test or Welch's test. Results: Differences in the thickness reduction rate depending on the model's undercut amount showed the same tendency between the first layer and the laminated mouthguard. Significant differences were observed between U0 and U10 as well as U0 and U20 at the incisal edge, and these were observed among all models on the labial and buccal surfaces (p <.01). On the labial surface, the rate of decrease in the laminated mouthguard thickness compared to U0 was approximately 10.4% larger for U10 and approximately 14.9% larger for U20 (p <.01). The thickness reduction rate of the laminated mouthguard was significantly smaller than that of the first layer, which was observed in all models at the incisal edge and in U10 and U20 on the labial surface (p <.01). Conclusions: The presence of a 10° or 20° undercut on the model's labial side increases the thickness reduction rate on the labial side of the laminated mouthguard by approximately 10% or 15%. [ABSTRACT FROM AUTHOR]

Background/Aims: Professional and amateur athletes might have veneer restorations. The aim of this study was to investigate the protective effect of mouthguards on veneered anterior restorations. Methods: A nonlinear dynamic analysis was performed to simulate conditions during an impact with or without a custom‐made mouthguard. Using a computer‐aided design (CAD) software, a slice of a human maxilla was designed containing an upper right central incisor. The model was composed of mucosa, cortical bone, trabecular bone, periodontal ligament, dentin, enamel, and pulp tissue. The enamel was prepared (feather design), restored with an indirect veneer (1.0 mm thickness), and duplicated to simulate both conditions with or without a mouthguard (4 mm thickness). Both models were subdivided into finite elements using the computer‐aided engineering (CAE) software. Frictionless contacts were used, and an impact was simulated in which a rigid sphere hit the model at 1 m s−1. Fixation was defined at the base of the bone. The elastic modulus of the veneer was assessed by using five different restorative materials (resin composite, hybrid ceramic, zirconia‐reinforced lithium silicate, lithium disilicate, and zirconia). Von Mises stress, minimal principal stress, and maximum principal stress (in MPa) were obtained and plotted for visual comparison. Results: Von‐Mises results showed higher stress concentrations in the veneer's cervical labial region for models without a mouthguard. Observing the quantitative results for each model, the highest compressive (709 MPa) and tensile (58 MPa) stresses occurred in the situation without a mouthguard with a zirconia veneer, while the lowest occurred in resin composite veneer with a mouthguard (8 and 5 MPa). The mouthguard was able to reduce the stresses in the tooth structure and it also reduced the risk of fracture in all conditions. Conclusions: Mouthguards were beneficial in reducing the effects of dental trauma regardless of the restorative material used to manufacture the indirect veneer, since they act by dampening the generated stresses during the trauma event. Equal impact stresses on a mouthguard will lead to higher stresses in veneered teeth with more rigid restorative materials leading to a less protective effect. [ABSTRACT FROM AUTHOR]

Background/Aim: Polyolefin sheets are fabricated in the same manner as ethylene vinyl acetate sheets. The aim of this study was to examine the difference of vacuum‐formed mouthguard thickness according to each heating condition using ethylene vinyl acetate and polyolefin sheets. Materials and Methods: Mouthguard sheets of 3.0 mm ethylene vinyl acetate and polyolefin were vacuum‐formed on working models at three heating temperatures: 85, 95, and 105°C. The thickness of the mouthguard was measured at the labial surface of the central incisor, the buccal surface of the first molar, and occlusal surface of the first molar. Differences in the thickness of the mouthguards according to the sheet materials and the heating conditions were analyzed by two‐way analysis of variance. Results: Mouthguard thickness varied between the ethylene vinyl acetate and the polyolefin sheets (p <.01), and the thickness of the ethylene vinyl acetate sheet was greater than that of the polyolefin sheet at all heating conditions. The thicknesses of mouthguards fabricated using the ethylene vinyl acetate and the polyolefin sheets were not different for the three heating conditions in this study. Conclusions: The thickness was greater for mouthguards fabricated using ethylene vinyl acetate sheet than when polyolefin sheet was used. The thickness of the mouthguards was not different for the three heating temperatures for both the ethylene vinyl acetate and the polyolefin sheets. [ABSTRACT FROM AUTHOR]