Useful design of custom-made mouthguard for athletes undergoing orthodontic treatment with brackets and wires.

BACKGROUND/PURPOSE: Custom-made mouthguards (MGs) are strongly recommended for athletes during sports activities to prevent dental injuries. Athletes undergoing orthodontic treatment and wearing brackets require specially designed MGs for better protection and to create more space that will not hinder the planned orthodontic tooth movement. The purpose of this study was to fabricate effective, specially designed, custom-made MGs for patients or athletes with ongoing orthodontic treatment and to evaluate the shock absorption abilities of these MGs by an in vitro comparison of three different designs. MATERIALS AND METHODS: Three different types of specially designed, double-layered MGs, (i) creating inter bracket space inside the MG, (ii) embedding silicon wax inside the MG, and (iii) creating a buffer space with additional hard insertion, were fabricated from a simulated bracket attached model. Impact test was performed using a free-falling object on a vertical rod, and the strain-gauge system was used to assess the strain on the dentition with the MGs for the comparison of the shock absorption abilities of the three types. Analysis of variance at a significance level of 5% and multiple comparisons were performed for statistical analysis. RESULTS: The strains on the dentition with the MG creating buffer space with hard insertion were significantly lower than those with the other two types of MG (P < 0.001). CONCLUSION: Insertion of a hard material and ensuring buffer space between the MG and the teeth and/or appliance was more effective than other methods of fabricating custom-made MGs to prevent sports-related traumatic dental injuries in athletes undergoing orthodontic treatment.

Use of the fiberglass reinforcement method in thermoplastic mouthguard materials to improve flexural properties for enhancement of functionality.

The purpose of this study was to evaluate the application of fiberglass reinforcement method in thermoplastic mouthguard materials to improve flexural properties and adhesive strength. Commonly used two types of commercial mouth guard materials (ethylene-vinyl acetate copolymer-based and polyolefin-based) were reinforced with glass fiber clothes by two-step hot press. Flexural strength and adhesive strength with each base material were examine via three-point bending test and delamination test, respectively. Ethylene-vinyl acetate copolymer-based fiberglass-reinforced material has significantly greater adhesive strength with base material and improvement of flexural properties compared with polyolefin-based material. These results suggest that flexural properties of both conventional commercial mouthguard materials were improved when the glass-fiber-reinforced method was applied to reinforce mouthguard materials, and more, ethylene-vinyl acetate copolymer was more desirable for the base material.

Thickness change and deformation of custom-made mouthguards after two years of use by Bangladeshi field hockey players.

BACKGROUND/AIM: Sports mouthguards are effective devices that prevent dental trauma in sports activities. Players should change mouthguards on a regular basis because of thickness reduction and shape deformation. However, there is no guidance regarding the best timing to change mouthguards. The aims of this study were to analyze the thickness change and deformation of mouthguards after 2 years of use in Bangladesh field hockey players and to consider appropriate evaluation criteria. MATERIAL AND METHODS: Fifty-seven field hockey players belonging to the Bangladesh Sports Education Institute participated in this study. Participants were provided with double-layered mouthguards made of polyolefin-based material using a vacuum-forming machine. Mouthguards were fabricated using 2-mm-thick sheet as the first layer and 3-mm-thick sheet as the second layer. Players used the mouthguards for 2 years. Before and after using the mouthguards, the thicknesses of nine areas were measured. In addition, the lengths of five areas were used to analyze shape deformation. RESULTS: After 2 years, the thicknesses of all measured areas had significantly reduced, and the lengths had significantly increased. Thickness reduction of the posterior-occlusal and anterior-incisal areas and deformation of the posterior-buccal and posterior-palatal areas were significantly larger than those in other measured areas. CONCLUSIONS: Mouthguards should be changed on a regular basis to minimize thickness reduction and deformation. Occlusal and incisal thickness and length of the buccal-posterior area and the palatal-posterior area are factors to be considered in establishing guidelines regarding the timing of mouthguard change.

Improving the Wearing Rate of Mouthguards in the Youth Rugby Category Affects the Total Future Mouthguard Wearing Rate.

The aim of this study is to consider the hypothesis that wearing mouthguards (MGs) from a young age helps to shape players' habit of continuing to wear MGs as adults. In addition, we consider the mandatory rule of wearing mouthguards in the youth category on the future wearing rates of mouthguards. Eighty-five Japanese male amateur rugby players were included in this study. We examined the relationship between the wearing rates of mouthguards when participants were high school students and as adults (in 2018) using a questionnaire. Collected data were classified into categories (age, mouthguard type, and applied mandatory rule or not), and their relationships were analyzed. The wearing rate of mouthguards in high school was significantly related to the wearing rate of mouthguards in adulthood (χ2 = 12.1, p < 0.01). The mandatory rule to wear mouthguards at high school was related to the wearing rates of mouthguards as adults, but not significantly (χ2 = 3.42, p = 0.06). Participants' mouthguard wearing rates as adults were affected by their high school wearing rates. The mandatory rule of wearing mouthguards in the youth category may be somewhat effective for improving mouthguard wearing rates; however, it is more important to provide knowledge about their importance.

Erratum to: Application of addition-cured silicone denture relining materials to adjust mouthguards.

The purposes of this study were to examine the shock absorption capability of addition-cured silicone denture relining materials and the bonding strength of addition-cured silicone denture relining materials and a commercial mouthguard material to determine its applicability to mouthguard adjustment. Two addition-cured silicone denture relining materials were selected as test materials. The impact test was applied by a free-falling steel ball. On the other hand, bonding strength was determined by a delamination test. After prepared surface treatments using acrylic resin on MG sheet surface, 2 types of addition-cured silicone denture relining materials were glued to MG surface. The peak intensity, the time to peak intensity from the onset of the transmitted force and bonding strength were statistically analyzed using ANOVA and Tukey's honest significant difference post hoc test (p<0.05). These results suggest that the silicone denture relining materials could be clinically applicable as a mouthguard adjustment material.

Application of addition-cured silicone denture relining materials to adjust mouthguards.

The purposes of this study were to examine the shock absorption capability of addition-cured silicone denture relining materials and the bonding strength of addition-cured silicone denture relining materials and a commercial mouthguard material to determine its applicability to mouthguard adjustment. Two addition-cured silicone denture relining materials and eleven commercial mouthguard materials were selected as test materials. The impact test was applied by a free-falling steel ball. On the other hand, bonding strength was determined by a delamination test. After prepared surface treatments using acrylic resin on MG sheet surface, 2 types of addition-cured silicone denture relining materials were glued to MG surface. The peak intensity, the time to peak intensity from the onset of the transmitted force and bonding strength were statistically analyzed using ANOVA and Tukey's honest significant difference post hoc test (p<0.05). These results suggest that the silicone denture relining materials could be clinically applicable as a mouthguard adjustment material.

Difference among shock-absorbing capabilities of mouthguard materials.

PURPOSE: The purpose of this study was to investigate the shock absorption capability of commercial thermoforming mouthguard sheet materials. MATERIALS AND METHODS: Twelve commercial thermoforming mouthguard sheet materials were selected as test materials. The impact test was applied by a free-falling steel ball. When impact forces of approximately 660 N were applied on the commercial thermoforming mouthguard materials, the peak intensities were measured using the load cell sensor. The peak intensity and the time to peak intensity from the onset of the transmitted force were statistically analyzed using one-way anova and Tukey's honest significant difference post hoc test (P < 0.05). RESULTS: Statistical analysis for the peak intensity and the time to peak intensity from the onset of the transmitted force revealed significant differences among the thirteen groups including the control. The peak intensity of the polystyrene-polyolefin copolymer-based material was lower than the peak intensity of the EVA-, polyolefin-based material. Polyolefin-based materials had a tendency of a long duration to reach peak intensity from the onset of the transmitted force. CONCLUSION: These results suggest that all of the commercially available mouthguard sheet materials had high shock-absorbing capabilities.

Combined analysis of shock absorption capability and force dispersion effect of mouthguard materials with different impact objects.

The aims of the present study were to investigate the shock absorption capability and force dispersion effect of mouthguard (MG) materials using load cell and film sensors. Two kinds of MG materials, ethylene vinyl acetate and polyolefin, were chosen for this study. When impact forces of approximately 5,000 N were applied on the MG materials using a round flat-nosed rod and a bluntly pointed rod, peak intensities were measured using the load cell sensor while peak stresses and impressed stress distribution areas were measured using the film sensor. Combined analysis using both load cell and film sensors clearly showed the shock absorption properties and force dispersion effects of different MG materials with different impact object shapes. Therefore, impact analysis involving a combined use of these sensor systems was useful and reliable in assessing the shock absorption capability and force dispersion effect of MG materials.