Acute effects of jaw clenching using a customized mouthguard on anaerobic ability and ventilatory flows

Impact of occlusal stabilization splints on global body posture: a prospective clinical trial

OBJECTIVES

Body posture of patients with temporomandibular disorders (TMD) has been investigated using different methods, whereas outcome and conclusions were controversial. The present clinical trial aimed to investigate the effects of splint therapy on global body posture.

MATERIALS AND METHODS

24 subjects (20 females, 4 males; age 24.2 ± 4.0 years) with TMD symptoms were examined clinically (RDC/TMD) and subsequently, splint fabrication was initiated. Along with routine therapy, all subjects underwent three-dimensional pre- and post-treatment full body scans in standing and upright sitting posture using a Vitus Smart XXL 3D scanner. Each scan was acquired in triplicate and evaluated in duplicate, measuring twelve standing and nine sitting postural parameters. Influencing factors were analyzed using analysis of variance (ANOVA), and additional Bland-Altman analyses verified the significance of the ANOVA results.

RESULTS

The increase of Forward Head angles and the decrease of Round Shoulders angles were consistent for both positions and sides. Forward Head angles were significantly influenced by limited mandibular mobility and myofascial pain. Round Shoulders angles showed a significant correlation with myofascial pain, joint noises and the absence of limited mandibular mobility.

CONCLUSION

The influence of occlusal splints on global posture is limited and only small effects on cervicocranial parameters were found. In the present study, the average head position of post treatment measurements was more centered on the body's core, whereas the shoulders were tilted more anteriorly.

CLINICAL RELEVANCE

Understanding the limited influence of occlusal splints on cervicocranial parameters underscores the need for multimodal treatment strategies for TMD patients.

The production and materials of mouthguards: Conventional vs additive manufacturing - A systematic review

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.

The effects of jaw clenching and mouthpiece use on bat swing velocity in Division II athletes

Research assessing the effects of mouthpieces on an individual's aerobic, anaerobic, or muscular performance have attributed cited improvements to the participant's ability to jaw clench. Jaw clenching research finds positive outcomes with the task of jaw clenching with targeted muscle groups in a controlled laboratory setting. Thus, the study's goal was to determine if the addition of a mouthpiece would positively affect performance outcomes in a field-based whole-body muscle movement. Fourteen participants (8=F and 6=M) NCAA softball and baseball athletes completed 5 maximal bat swings with and without a mouthpiece in 4 conditions: no jaw clenching (NC), mouthpiece and jaw clenching (MP+C), mouthpiece only (MP), and jaw clenching only (C). Significant differences occurred in conditions, with the highest velocity noted in the combined condition of MP+C (71.9 mph) as compared to NC (67.9 mph), MP (68.6 mph), and C (70.9 mph). A repeated measures ANOVA demonstrated significant differences with bat swing velocity (F = 13.19, df 3, p < 0.0001). Pairwise comparisons revealed significant differences in MP+C with MP (p = 0.007); MP+C with NC (p = 0.001), and C with NC (p = 0.009). The results of this study provide evidence of jaw clenching's positive effects on the dynamic, whole-body explosive activity of a bat swing.

Influence of wearing mouthguards on performance among athletes: A systematic review

OBJECTIVES

While the use of mouthguards is well established to prevent orofacial and dental trauma occurrence, limited evidence exists regarding their influence on athletic performance. The objective of this study was to conduct a systematic review of the literature to assess the effect of wearing mouthguards on athletic performance.

DESIGN

Systematic review.

METHODS

An extensive search was performed in the databases of PubMed/MEDLINE, Embase, Scopus and Cochrane Library for studies published up to August 2022. Only peer-reviewed studies involving humans in vivo and investigating the use of mouthguards on performance among athletes were included. Quality assessment was performed using the Cochrane Collaboration's risk of bias tool.

RESULTS

The initial query yielded 4785 citations, of which 41 studies met the inclusion criteria, comprising a total of 852 athletes. Overall, wearing mouthguards was found to improve athletic performance compared to the control group (without mouthguards). Custom-made mouthguards were found to be more effective in enhancing athletic performance compared to other types of mouthguards.

CONCLUSIONS

Wearing mouthguards should be advocated by athletes not only for the prevention of orofacial and dental trauma but also for their potential improvements in athletic performance in specific actions. However, caution must be exercised in interpreting these findings due to the variability in outcome measures and the lack of important methodological details.

Effects of 8-week oral splint usage on body flexibility and muscle strength-endurance performance in Pilates practitioners

Purpose

We investigated the acute and chronic effects of oral splint on muscle strength-endurance performance and body flexibility.

Methods

Twelve Pilates practitioners (age 49.5 ± 5.8 years; mass 58.6 ± 6.5 kg) were evaluated with (OS) and without (CTRL) oral splint. Before (PRE) and after (POST) 8 weeks of oral splint usage during Pilates activity, muscle strength-endurance and body flexibility were evaluated through a frontal plank exercise and a Toe-touch test in OS and CTRL. Before each test, the highest electrical activation (EMG) of masseter and temporal muscles during maximal occlusion was determined. During frontal plank, the time-to-exhaustion, the maximum voluntary activation of masticatory muscles and the time of muscles activation have been determined.

Results

No OS vs CTRL and PRE vs POST differences were found in the maximum voluntary activation of temporal and masseter muscles. The time-to-exhaustion in OS was longer than CTRL in both PRE (P = 0.049) and POST sessions (P = 0.043). Time of masticatory muscles activation during plank was moderately greater in OS at PRE (P = 0.020) and POST (P = 0.022), while no difference between PRE and POST emerged in both conditions. Higher muscular activation was found in OS than CTRL at PRE (P = 0.031) and POST (P = 0.031), whereas no difference between PRE and POST appeared. No effect on flexibility emerged neither acutely nor chronically.

Conclusion

Acute and chronic oral splint usage improved strength-endurance performance but not body flexibility. These findings suggest biomechanical and neural mechanisms influencing the muscle length and the concurrent activation potentiation, but not muscle tone and stiffness.

The effect of a controlled mandible position mouthguard on upper body strength and power in trained rugby athletes - A randomized within subject study

BACKGROUND

It is widely accepted that mouthguards are effective for injury protection in sports. However, findings on the effects of mouthguards in strength and power production remains controversial. Therefore, the aim of this study was to determine whether controlled-mandible position mouthguards influence strength and power production in well trained athletes.

METHODS

Twenty-two male amateur rugby players (25 ± 3.84 yrs; 1.92 ± 0.07 m; 93.91 ± 11.99 kg) volunteered for this study. Every participant performed an 1RM bench press test (113.20 ± 16.83 kg) to determine his maximal strength. In a randomized order, a ballistic bench press using 40% of the obtained 1RM (44.93 ± 6.76 Kg) was performed in a guided bar attached to a linear position transducer (LPT) for the following conditions: a) no mouthguard (CON); b) controlled mouthguard (MCM - jaw in centric relation); c) non-controlled mouthguard (NCM) and d) occlusal splint (OS). Vertical dimension of occlusion was also assessed for each of the testing conditions.

RESULTS

Athletes using a controlled mouthguard demonstrate a significant (p < 0.05) higher peak acceleration and peak force than those using no mouthguard. Additionally, when analysing the results of vertical dimension of occlusion, a significant difference (p < 0.05) was observed between controlled mouthguard and the other tested conditions.

CONCLUSION

Controlled mouthguards enhance peak force and peak acceleration in the ballistic bench press exercise without negatively affecting any other measure assessed in this study. We speculate that this is possibly due to an increased stability of temporomandibular joint.

Effects of wearing a customized bite-aligning mouthguard on powerful actions in highly trained swimmers

Background/objectives

The potential advantages of wearing customized bite-aligning mouthguards on several performance parameters such as muscular strength, power and reaction time have been reported. Literature shows that the concurrent activation potentiation phenomenon, elicited by a powered and balanced jaw clenching, can provide athletes with several neuromuscular advantages. The aim of the present study was to investigate the acute effects of jaw clenching while wearing a customized bite-aligning mouthguard on swimming start, countermovement jump and swim bench test, in contrast to two other conditions: non-jaw clenching and jaw clenching without mouthguard.

Methods

A randomized, repeated measure within study design was used to compare the condition effect on eight highly trained elite male and female swimmers.

Results

Statistical analysis revealed a significant increase in the countermovement jump height (p = 0.041) when comparing the use of mouthguards with the non-jaw condition. In the swim bench, a significant greater time to peak force (p = 0.049) was found when comparing the use of mouthguards with the jaw condition. Although, non-significant effects, small differences were found in the start reaction time and 15-m freestyle swimming when comparing the use of mouthguards with the non-jaw condition.

Conclusion

This study demonstrated that wearing customized, bite-aligning mouthguards had an ergogenic effect on specific measures of vertical jump and swim bench test, whereas non-meaningful but small differences were found in swimming start.

Occlusal Splints and Exercise Performance: A Systematic Review of Current Evidence

The role of the dento-mandibular apparatus and, in particular, occlusion and jaw position, received increased attention during last years. In the present study, we aimed to systematically review, on the light of the new potential insights, the published literature covering the occlusal splint (OS) applications, and its impact on exercise performance. A structured search was carried out including MEDLINE^®/PubMed and Scopus databases with additional integration from external sources, between March and June 2021. To meet the inclusion criteria, studies published in the English language, involving humans in vivo, published from 2000 to 2021 and that investigated the role of occlusal splints on athletes' performance were selected. Starting from the 587 identified records, 17 items were finally included for the review. Four main aspects were considered and analyzed: (1) occlusal splint characteristics and occlusion experimental conditions, (2) jump performance, (3) maximal and explosive strength, and (4) exercise technique and biomechanics. The results of the systematic literature analysis depicted a wide heterogenicity in the experimental conditions and suggested the application of the OS as a way to improve athletes' or individuals' oral health, and as a potential tool to optimize marginal aspects of exercise performance.

The Influence of Customized Mouthguards on the Muscular Activity of the Masticatory Muscles at Maximum Bite and Motor Performance During Static and Dynamic Exercises

Background

Some studies have suggested that a mouthguard is a performance-enhancing device due to a remote voluntary contraction. The extent to which a mouthguard can induce this phenomenon, e.g., by potentially increasing biting, has not been clarified. This study’s aim was to investigate the muscular activity of the maxillary and peripheral musculature and motor performance during a rest and exercise test.

Methods

Our study comprised 12 active, male, professional young handball players (age 18.83 ± 0.39 years). Their performance, electromyographic (EMG) muscle activity (Σ), and lateral deviation (Δ) of the masticatory and peripheral musculature were measured during rest in a maximum bite force measurement, one-legged stand, a kettlebell swing exercise and a jump test while wearing a customized mouthguard (CMG) or not wearing one (Co).

Results

Maximum bite force measurements did not differ significantly in their mean values of muscle activity (Σ) for the masseter and temporalis muscles (Co 647.6 ± 212.8 µV vs. CMG 724.3 ± 257.1 µV p = 0.08) (Co 457.2 ± 135.5 µV vs. CMG 426.6 ± 169.3 µV p = 0.38) with versus without CMG. We found no differences in the mean activation values during a one-legged stand, the kettlebell swing, and jump test (Σ) in any of the muscles tested. Lateral deviations (Δ) wearing a CMG were significantly less in the erector spinae during the kettlebell swing (Co 5.33 ± 3.4 µV vs. CMG 2.53 ± 1.8 µV p = 0.01) and countermovement jump (Co 37.90 ± 30.6 µV vs. CMG 17.83 ± 22.3 µV p = 0.03) compared to the performance without a CMG. Jump height, rotation moment, and balance were unchanged with versus without CMG.

Conclusion

Our results at rest and during specific motor stress show no differences with or without a CMG. The improved peripheral muscular balance while wearing a CMG indicates improved muscular stabilization.

Effects of the lower jaw position on athletic performance of elite athletes

When an athlete wears a mouthguard, the position of the lower jaw is changed by virtue of the teeth being unable to occlude. Little research is available in in this area, which have indicated both positive impact and no positive impact.

Decreased exercise capacity in young athletes using self-adapted mouthguards

PURPOSE

There is evidence of both the preventive effects and poor acceptance of mouthguards. There are various effects on performance depending on the type of mouthguard model. Hemodynamic responses to wearing a mouthguard have not been described. The aim of this study was to investigate the effects of self-adapted mouthguards with breathing channels (SAMGvent).

METHODS

In this randomized crossover study, 17 healthy, active subjects (age 25.12 ± 2.19 years) underwent body plethysmography and performed two incremental exertion tests wearing a (SAMGvent) and not wearing (CON) a mouthguard. Blood lactate, spirometrics, and thoracic impedance were measured during these maximum exercise tests.

RESULTS

The mean values using a SAMGvent revealed significantly greater airway resistance compared to CON (0.53 ± 0.16 kPa·L-1 vs. 0.35 ± 0.10 kPa·L-1, respectively; p = < 0.01). At maximum load, ventilation with SAMGvent was less than CON (118.4 ± 28.17 L min-1 vs. 128.2 ± 32.16 L min-1, respectively; p = < 0.01). At submaximal loads, blood lactate responses with SAMGvent were higher than CON (8.68 ± 2.20 mmol·L-1 vs. 7.89 ± 1.65 mmol·L-1, respectively; p < 0.01). Maximum performance with a SAMGvent was 265.9 ± 59.9 W, and without a mouthguard was 272.9 ± 60.8 W (p < 0.01). Maximum stroke volume was higher using a SAMGvent than without using a mouthguard (138.4 ± 29.9 mL vs. 130.2 ± 21.2 mL, respectively; p < 0.01).

CONCLUSION

Use of a self-adapted mouthguard led to increased metabolic effort and a significant reduction in ventilation parameters. Unchanged oxygen uptake may be the result of cardiopulmonary compensation and increased breathing efforts, which slightly affects performance. These results and the obvious preventive effects of mouthguards support their use in sports.

Acute Effects of Wearing Bite-Aligning Mouthguards on Muscular Strength, Power, Agility and Quickness in a Trained Population: A Systematic Review

The purpose of the present systematic review was to determine the acute effects of wearing bite-aligning mouthguards on muscle strength, power, agility and quickness in athletes. A search of the current literature was performed using the electronic databases (until 1 May 2021) Web of Science, Scopus and Medline. The inclusion criteria were: (1) descriptive design studies; (2) with randomized clinical trials; (3) examining the within-subject acute effects of wearing mouthguards on functional and neuromuscular performance parameters; (4) in physical active, recreational or high-standard athletes. Twenty-seven studies met the inclusion criteria. Sixteen reported positive effects in some of the variables assessed, two reported negative effects and the rest found no significant differences. Overall, the main findings described in the literature are inconclusive concerning the neuromuscular advantages of using mouthguards in muscle strength, power, agility and quickness. These discrepancies might be related to several factors such as differences in testing protocols, poor control of the jaw magnitude and improper mouthguard designs. Despite these differences, after conducting the present systematic review, the authors speculate that jaw clenching while wearing custom-made, bite-aligning oral devices might promote beneficial effects in lower limb power actions, especially in jump ability and knee extension movements. Thus, athletes might consider the use of mouthguards, not only for their protective role but also for the potential ergogenic effects in specific actions, mainly those for which lower limb muscular power are required.

A randomized crossover study on the effects of a custom-made mouthguard on cardiopulmonary parameters and cortisol differences in a validated handball specific course

BACKGROUND

The importance of mouthguards for handball players has been proven however, most players are reluctant to use it. The impact on physical capacity is assessed heterogeneously in the literature. This study aimed to investigate the influence of custom-made mouthguards (CMGs) under handball specific stress.

METHODS

This randomized crossover study used data from 15 youth professional handball players (age 17.0 ±0.5 years, weight 85.1±8.0 kg and height 191.2±6.9 cm) who performed a validated handball specific course and a lung function test. Pulmonary (spirometry), metabolic (blood lactate), and cortisol parameters were observed using a normal custom-made mouthguard without (nCMG) and with respiratory channels (CMGvent) in comparison to no mouthguard (Co).

RESULTS

In resting spirometry, no differences in the parameter peak flow were observed using the CMGvent (9.57±1.59 l·s-1) and nCMG (9.17±1.03 l·s-1) in comparison to the Co (9.38±1.26 l·s-1). Under maximum stress, there were no differences in ventilation using CMGvent (151.2±15.64 L ·min-1), nCMG (148.6±12.51 l·min-1), and without mouthguard (145.8±14.32 l·min-1). Similar oxygen uptake was observed when using a CMGvent (45.51±4.14 L ·min-1·kg-1), nCMG (45.50±5.06 ml·min-1 ·kg-1), and without CMG (Co 43.90±4.02 mL ·min-1). The parameters of HR (CMGvent 185.2±11.63 bpm vs. Co 179.4±13.24 bpm p=0.46, nCMG 178.2±11.54 bpm vs. Co p=0.97; CMGvent vs. nCMG p=0.08) and in the blood lactate values (CMGvent: 9.66±2.3 mmol·l-1 vs. Co 9.07±2.1 mmol·l-1 p=0.63; nCMG 9.39±2.8 mmol·l-1 vs. Co p=0.87; CMGvent vs. nCMG p=0.91) displayed no differences. The cortisol production under stress showed no differences in the performance with the CMGvent (1.78±3.58 ng/ml), nCMG (0.74±4.52 ng/mL), and in the procedure without mouthguard (0.25. ±5.01 ng/ml).

CONCLUSION

The results showed that under stress, there were no differences in the cortisol, ventilation, cardiac, and metabolic responses for all three conditions. Finally, the study shows that the use of a custom-made mouthguard does not negatively affect handball specific performance. Due to the preventive aspect of the mouthguard, the use of a custom-made mouthguard in handball is strongly recommended.

Influence of a Vented Mouthguard on Physiological Responses in Handball

Schulze, A, Laessing, J, Kwast, S, and Busse, M. Influence of a vented mouthguard on physiological responses in handball. J Strength Cond Res 34(7): 2055-2061, 2020-Mouthguards (MGs) improve sports safety. However, airway obstruction and a resulting decrease in performance are theoretical disadvantages regarding their use. The study aim was to assess possible limitations of a "vented" MG on aerobic performance in handball. The physiological effects were investigated in 14 male professional players in a newly developed handball-specific course. The measured values were oxygen uptake, ventilation, heart rate, and lactate. Similar oxygen uptake (V[Combining Dot Above]O2) values were observed with and without MG use (51.9 ± 6.4 L·min·kg vs. 52.1 ± 10.9 L·min·kg). During maximum load, ventilation was markedly lower with the vented MG (153.1 ± 25 L·min vs. 166.3 ± 20.8 L·min). The endexpiratory concentrations of O2 (17.2 ± 0.5% vs. 17.6 ± 0.8%) and CO2 (4.0 ± 0.5% vs. 3.7 ± 0.6%) were significantly lower and higher, respectively, when using the MG. The inspiration and expiration times with and without the MG were 0.6 ± 0.1 seconds vs. 0.6 ± 0.1 seconds and 0.7 ± 0.2 seconds vs. 0.6 ± 0.2 seconds (all not significant), respectively, indicating that there was no relevant airflow restriction. The maximum load was not significantly affected by the MG. The lower ventilation for given V[Combining Dot Above]O2 values associated with MG use may be an effect of improved biomechanics and lower respiratory drive of the peripheral musculature.

Effects of Custom-made Mouthguards on Cardiopulmonary Exercise Capacity

The importance of using mouthguards as well as their low acceptance rate have been demonstrated. The aim of this study was to investigate the influence of customized mouthguards on hemodynamics.. This randomized crossover study used data from 13 subjects (23.5±1.4 years). The cardiopulmonary and metabolic parameters were observed during ergometer tests without mouthguard (control) in comparison to two types of mouthguards (with and normal without breathing channels). Maximum ventilation was significantly decreased with the normal mouthguard (113.3±30.00 l ∙ min^-1) in contrast to the mouthguard with breathing channels (122.5±22.9 l ∙ min^-1) and control (121.9±30.8 l ∙ min^-1). Also the inspiration time was longer when using the normal mouthguard (0.70±0.11 s) compared to the mouthguard with breathing channels (0.63±0.11 s) and control (Co 0.64±0.10 s). Lactate was also increased under the influence of the mouthguard with breathing channels (10.72±1.4 mmol ∙ l^-1) compared to the control (9.40±1.77 mmol ∙ l^-1) and the normal mouthguard (9.02±1.67 mmol ∙ l^-1). In addition, stroke volume kinetics (p=0.048) and maximum heart rates (p=0.01) show changes. Despite equal levels of oxygen uptake and performances under all three conditions, the use of mouthguards showed differences in cardiopulmonary parameters. The use of mouthguards during exercise does not affect physical performance and can be recommended for injury prevention.

Physiological Responses of a Jaw-Repositioning Custom-Made Mouthguard on Airway and Their Effects on Athletic Performance

Martins, RS, Girouard, P, Elliott, E, and Mekary, S. Physiological responses of a jaw repositioning custom-made mouthguard on airway and their effects on athletic performance. J Strength Cond Res 34(2): 422-429, 2020-Advanced dental techniques such as jaw-repositioning have shown to increase lower body muscular power such as vertical jump, but its effects on acceleration and speed have not been studied. Similarly, jaw repositioning is commonly used to increase airways volume and ventilation in a special population (i.e., obstructive sleep apnea); however, its ergogenic effects on aerobic performance have yet not been studied. The purpose of the cross-over study was to investigate the effects of a jaw-repositioning custom-made mouthguard (JCM) on volumetric changes in airway and jaw position and determine the effects this may have on aerobic and anaerobic performance. Results indicated that jaw-repositioning custom-made mouthguard may have an ergogenic effect on performance. The JCM condition showed an increase of 13% in upper airway volume (p = 0.04), 10% in upper airway width (p = 0.004), 7% in ventilation (p = 0.006), 5% in maximal aerobic power (p = 0.003), 4% in time to exhaustion (p = 0.03), 3% in vertical jump (p = 0.03), 2% in broad jump (p = 0.009), and a decrease of 4% in 20-m (p = 0.04) and 2% in 40-m (p = 0.001) sprint times. This is the first study to demonstrate a significant link between jaw repositioning, airway volumetric change, and performance enhancement in both aerobic and anaerobic performances. The results of this study may lead to a change in culture for the use of mouthguards in different sports applications, from high orofacial injury risk sports to other sports, specifically for ergogenic enhancement.

Effects of Wearing a Jaw-repositioning Intra-oral Device in Synchronized Swimming Athletes

The effects of wearing an intra-oral device on several ventilatory and fatigue markers have been reported for a variety of sports. The quality of the figures performed in synchronized swimming is directly affected by fatigue, and can be monitored during training sessions (TS). The aim of the study was to investigate the acute effects of wearing customized intra-oral devices on heart rate variability, rating of perceived exertion, blood lactate accumulation, and salivary cortisol production during a competitive training session. Twelve highly trained elite female athletes (age: 21.0±3.6 years) participated in the study. Fatigue markers were assessed at the beginning and at the end of the 3^rd and 5^th afternoon TS for that week, once with and once without an intra-oral device, in random order. Salivary cortisol levels were higher in relation to the baseline in the intra-oral device condition (P<0.05) but not in athletes without an intra-oral device. No differences between conditions were found in rating of perceived exertion (P=0.465) and blood lactate (P=0.711). No time or condition interactions or main effects were shown for heart rate variability. Thus, there is no evidence that wearing a low-arch intra-oral device is a good recommendation for high-standard athletes performing long and stressful routines.

Respiratory outcomes with the use of a lower custom fit genioglossal-effecting oral appliance

OBJECTIVE

Sleep apnea research cites that an oral appliance, which places the mandible in a more forward position and the genioglossus (tongue muscle) on the floor of the mouth, improves aspects of the pharyngeal opening. Exercise science research has cited improvements in airway dynamics and physiological variables with oral appliance use during exercise. Thus, the purpose of this study was to design an oral appliance that would act on the genioglossus and determine if there were effects on respiratory parameters while exercising.

MATERIALS AND METHODS

Seventeen healthy subjects ages 18-43 participated in this study. Prior to the exercise protocol, the order of the oral applicance (OA) or no oral appliance (no OA) condition was randomly assigned to subjects, with subjects completing both conditions. Respiratory parameters (respiratory rate, ventilation, oxygen, and carbon dioxide) were measured between conditions while subjects ran for 10 min at steady state.

RESULTS

The results demonstrated that both respiratory rate (25.97 BPM, OA and 28.35 BPM, no OA) and ventilation (47.66 l/min, OA and 50.34 l/min, No OA) were significantly lowered (p < .01) in the OA condition. There were no differences in carbon dioxide (1.89 l/min, no OA and 1.88 l/min, OA) or oxygen outcomes (2.17 l/min, no OA and 2.17 l/min OA).

DISCUSSION

The outcomes from this study suggest that the design of the oral appliance elicits an effect on the genioglossus, thereby resulting in lowered respiratory rate and ventilation with no negative effects on oxygen uptake during exercise.

Physiological Effects of Wearing Athletic Mouth Pieces While Performing Various Exercises

The purpose of this study is to evaluate physiological responses associated with exercise using two different mouthpieces compared with not using a mouthpiece. Improved performance while using the PX3 Bite Regulator (PX3) may significantly reduce the risk of concussions by allowing an athlete to better prepare, react, absorb, and/or avoid impact completely compared with the restricted breathing or mandibular instability that occurs when using mouthguards. Twenty-three subjects completed a battery of five physiological tests; the 1.5-mile run, sit and reach, anaerobic endurance, leg press, and bench press. Each test battery was completed under three conditions: wearing a PX3, wearing a mouthguard, or no mouthpiece respectfully. The PX3 resulted in significantly faster 1.5-mile run times (667.4 ± 9.4 vs. 684.9 ± 9.2 vs. 679 ± 7.9 s, p ≤ 0.05) and significantly longer anaerobic endurance runs (311 ± 23 vs. 283 ± 18 vs. 286 ± 18yds, p ≤ 0.05) compared with the mouthguard and no mouthpiece. The leg press lifts (51.8 ± 4.1 vs. 46.0 ± 4.3, p ≤ 0.05) while wearing the PX3 were significantly greater than when wearing a mouthguard. There were improvements, but no significant differences for sit and reach (16.8 ± 0.8 vs. 15.9 ± 0.8 vs. 16.4 ± 0.8 in., p = 0.73) and bench press (17.7 ± 1.8 vs. 17.2 ± 1.6 vs. 17.2 ± 1.7 lifts, p = 0.94). The increased performance with the PX3 could be a result of better jaw alignment and/or decreased resistance to airflow.

Over-the-counter performance enhancing mouthguards are unable to decrease blood lactate and improve power output during a Wingate anaerobic test (WAnT)

Background/Objective

Mouthguards are the primary mode of protection against maxillofacial injuries in contact sports, but recent research has also linked performance enhancement to this piece of equipment. The purpose of this study was to test the claims of the Under Armour ArmourBite (UAAB) mouthguard to decrease blood lactate concentration ([BL]) and increase power when compared to a generic over-the-counter mouthguard (OTC) and no mouthguard (NOMG) during an anaerobic performance test.

Methods

Seventeen recreationally active males (23.4 ± 2.7 years; 179.6 ± 7.4 cm; 83.0 ± 14.0 kg) were tested using the 30 s Wingate anaerobic test (WAnT) during three separate testing sessions.

Results

There were no differences in [BL] between any of the conditions immediately or 5 min posttest. There were also no differences in peak, relative or average power, or fatigue index during the WAnT. The UAAB mouthguard was therefore unsuccessful in improving anaerobic performance.

Conclusion

It is likely that more expensive, custom-fit dental mouthguards may be necessary for individuals to see any benefits to athletic performance.

Effects of Two Different Self-Adapted Occlusal Splints on Electromyographic and Force Parameters During Elbow Flexors Isometric Contraction

Limonta, E, Arienti, C, Rampichini, S, Venturelli, M, Cè, E, Veicsteinas, A, and Esposito, F. Effects of two different self-adapted occlusal splints on electromyographic and force parameters during elbow flexors isometric contraction. J Strength Cond Res 32(1): 230-236, 2018-The study was aimed at determining the acute effects of 2 types of occlusal splints on maximum isometric strength and fatigue of the elbow flexors muscles. The hypothesis was that splint-induced masticatory muscle repositioning might improve primary muscles recruitment by stretching masticatory muscles especially with the thicker splint. On 9 physically active volunteers with no temporomandibular joint and masticatory muscles disorders, we assessed maximum voluntary contraction (MVC) of the elbow flexors with diurnal (OSD, 1-mm thick) and sport (OSSP, 3-mm thick) splints, and without splint (control, Ctrl). On different days, participants performed 60 seconds of isometric contraction at 100% MVC (100%60s) and 80% MVC contraction until exhaustion (80%exh) under OSD, OSSP, and Ctrl in random order. Time of force output within target (t-target), force distance from target (ΔF), and force coefficient of variation were calculated. Percentage of force decay (ΔFi-Fe) was determined during 100%60s. From the electromyographic (EMG) signal, root mean square (EMG RMS) and mean frequency (EMG MF) were determined. Neuromuscular efficiency (NE) was calculated as the ratio between force and EMG RMS. MVC contraction and NE were significantly higher in OSSP and OSD than in Ctrl. During MVC, EMG MF was significantly lower in both splint conditions, and EMG RMS showed a nonstatistical tendency to lower values under both splint conditions. During 80%exh, t-target was longer in OSD and OSSP (+7.8% and +5.2%, respectively) than in Ctrl. ΔFi-Fe was lower in OSSP than in Ctrl and OSD. These results support the hypothesis of a NE improvement of the elbow flexors possibly induced by acute, splint-induced masticatory muscles repositioning.

Effects of jaw clenching wearing customized mouthguards on agility, power and vertical jump in male high-standard basketball players

Background/Objective

Basketball players commonly use mouthguards for protecting their mouths from collisions with other players. Besides, literature reports that specific types of mouthguards may become an ergogenic device that facilitates a powerful jaw clenching, and a subsequent concurrent activation potentiation through this remote voluntary contraction of the mandible muscles.

Methods

A randomized within-subjects design was used to study the effects of this mechanism on muscular performance (vertical jump, agility, bench press power and leg press power) into two different conditions (mouthguard and no mouthguard) in high-standard basketball players (n = 13). A mean differences analysis and a responder analysis were conducted.

Results

Significant improvements were found (p < 0.05) in all vertical jump protocols using the mouthguard when compared to the no mouthguard conditions. However, no significant differences were found between the two conditions in agility and power (except in one load of bench press). Nevertheless, p-values were closer to statistical significance when analyzing the total time for the agility T-Test than when the first split time was under consideration (p = 0.111 and p = 0.944, respectively).

Conclusion

This study demonstrated that the use of custom-made, bite-aligning mouthguard had an ergogenic effect on jump outcomes and inconclusive results in agility T-Test in professional basketball players. From the results obtained in the present study, the use of this type of mouthguards seems to be more justified in power actions on the court than in the strength and conditioning sessions at the gym in well-trained players.

Mouthguard Use and Cardiopulmonary Capacity - A Systematic Review and Meta-Analysis

This study aimed to perform a systematic review and meta-analysis of the literature to determine the effects of the use of mouthguards (MGs) on cardiopulmonary capacity in athletes (oxygen uptake: VO ₂ max, and minute ventilation: VE max). Seven electronic databases and reference lists of relevant papers were searched for randomized clinical trials (RCTs) that compared the cardiopulmonary capacity in athletes with and without the use of an MG. The risk of bias tool of the Cochrane Collaboration was used for quality assessment. Fourteen studies were included. For both the overall VO2 max and VE max analyses, significant differences were observed between the MG and no MG conditions, favoring no MG, which presented the highest VO2 max values (p=0.0001; 95% CI; –2.638 to –1.728) and the highest VE max values (p=0.0001; 95% CI; –4.103 to –1.354). When the results were analyzed separately for each subgroup (type of MG and place of use), the meta-analysis showed that the effect of the use of an MG on VO2 max and VE max was not significant when custom-made MGs were used. The use of an MG overall decreased VO2 max and VE max compared to the control. Nevertheless, custom-made MGs seem to have no effect on these parameters.