The effect of model inclination during fabrication on mouthguard calliper-measured and CT scan-assessed thickness.

AIM: Excessive material thinning has been observed in the production of custom-made mouthguards in a number of studies, due to production anomalies that may lead to such thinning. This study investigated thinning material patterns of custom-made mouthguards when the anterior angulation of dental model was increased during the thermoforming process. MATERIALS AND METHODS: A total of 60 samples of mouthguard blanks were thermoformed on identical maxillary models under four anterior inclination conditions (n = 4 × 15): control 0, 15, 30 and 45°. Each mouthguard sample was measured, using an electronic calliper gauge at three anatomical points (anterior labial sulcus, posterior occlusion and posterior lingual). Mouthguards were then CT scanned to give a visual representation of the surface thickness. RESULTS: Data showed a significant difference (P < 0.005) in the anterior mouthguard thickness between the four levels of anterior inclination, with the 45° inclination producing the thickest mouthguards, increasing the mean anterior thickness by 75% (2.8 mm, SD: 0.16) from the model on a flat plane (1.6 mm, SD: 0.34). Anterior model inclination of 30 and 45° inclinations increased consistencies between the thickest and thinnest mouthguards in the anterior region of these sample groups. CONCLUSION: This study highlights the importance of standardizing the thermoforming process, as this has a significant effect on the quality and material distribution of the resultant product. In particular, greater model inclination is advised as this optimizes the thickness of the anterior sulcus of the mouthguard which may be more prominently at risk from sport-related impact.

An investigation into the relationship between thickness variations and manufacturing techniques of mouthguards.

BACKGROUND: The aim of this study was to measure the finished thickness of a single identical 4-mm EVA mouthguard model from a large fabricated sample group and to evaluate the degree of material thinning and variations during the fabrication process. MATERIALS AND METHODS: Twenty boxes were distributed to dental technician participants, each containing five duplicated dental models (n = 100), alongside 5 × 4 mm mouthguard blanks and a questionnaire. The mouthguards were measured using electronic callipers (resolution: ±0.01 mm) at three specific points. The five thickest and thinnest mouthguards were examined using a CT scanner to describe the surface typography unique to each mouthguard, highlighting dimensional thinning patterns during the fabrication process. RESULTS: Of the three measurement points, the anterior sulcus point of the mouthguard showed a significant degree of variation (up to 34% coefficient of variation), in finished mouthguard thickness between individuals. The mean thickness of the mouthguards in the anterior region was 1.62 ± 0.38 mm with a range of 0.77-2.80 mm. This variation was also evident in the occlusion and posterior lingual regions but to a lesser extent (up to 12.2% and 9.8% variations, respectively). CONCLUSION: This study highlights variability in the finished thickness of the mouthguards especially in the anterior sulcus region measurement point, both within and between individuals. At the anterior region measurement point of the mouthguard, the mean thickness was 1.62 mm, equating to an overall material thinning of 59.5% when using a single 4-mm EVA blank. This degree of thinning is comparative to previous single operator research studies.

A review of facial protective equipment use in sport and the impact on injury incidence.

Sporting activities have an inherent risk of facial injury from traumatic impacts from fellow competitors, projectiles, and collisions with posts or the ground. This retrospective review systematically describes the interplay between the type of sport (including the level at which specific sports are played), the sex of the players and their musculoskeletal characteristics, the technology behind the materials used, the protective devices commonly used, the anatomical site, and the regularity of incidence of fractures. We describe how variations in sporting activities induce different orofacial fracture patterns, and critically consider the methods used to test protective headgear against more contemporary techniques. Facial injuries can have a profound psychological effect on those injured, can take a long time to heal, and have been known to end promising careers. Use of properly fitted protective head or facial equipment could reduce the number of facial fractures commonly seen in sports. We recommend that individual sports should have full risk assessments, and that mandatory standards should be agreed about protective devices that would be appropriate.