Paired maxillary and smaller mandibular mouthguard for rugby player with malalignment

Lower limb balance, ankle dorsiflexion, orofacial tissue pressure, and occlusal force of rugby players

This cross-sectional study examined the lower limb balance, ankle dorsiflexion, orofacial tissue pressure, and occlusal strength of rugby players. Twenty-six participants were divided into groups: rugby players (n ​= ​13) and healthy sedentary adults (n ​= ​13). Participants underwent an analysis of lower limb balance using a composite score (Y-Balance Test). Ankle dorsiflexion was measured using the Lunge Test. The Iowa Oral Performance Instrument was employed to measure orofacial tissue pressure. Bite force was measured with a dynamometer, and T-Scan assessed occlusal contact distribution. Data were analyzed using the t-test (p ​< ​0.05) and ANCOVA with age and weight as covariates, where it is possible to verify that these factors did not influence the results obtained. Significant differences were observed in the balance of the right (p ​= ​0.07) and left (p ​= ​0.02) lower limbs, where rugby players had lower composite scores. There were significant differences in the right (p ​= ​0.005) and left (p ​= ​0.004) lunges, with rugby players showing lower values, as well as lower tongue pressure (p ​= ​0.01) and higher lip pressure (p ​= ​0.03), with significant differences to sedentary participants. There was no significant difference in molar bite force and distribution occlusal contacts between groups. Rugby seems to reduce lower limb displacement, cause ankle hypomobility, lead to changes in orofacial tissues, particularly the tongue and lips. This study is significant for identifying significant differences between rugby players and sedentary individuals, providing new insights into the impact of rugby on health and performance, which can benefit sports training and injury prevention.

Effect of mouthguard design on retention and potential issues arising with usability in sport

BACKGROUND/AIMS

Mouthguard retention could potentially increase an athlete's motivation to wear the device, due to potential improvements in physical comfort. The aim of this study was to examine the retentive properties of selected customised mouthguard designs, during normal conditions (dry) and within the presence of artificial saliva (wet). Additionally, the correlation between thickness and retention was investigated.

MATERIAL AND METHODS

Six different custom mouthguard designs (MG1-MG6) reported in previous studies, were pressure-formed with 2 and 4 mm blanks accordingly. Thickness was measured 10 times at seven anatomical points and the mean (±SD) was recorded. A novel rig was fabricated to connect the mouthguards to a Hounsfield H10KS Tensometer, which was used to fully displace each device from the model at a constant rate of 50 mm/min. The test was repeated under both dry and wet conditions.

RESULTS

Retention forces recorded at the anterior region demonstrated higher measurements under wet conditions than dry (P < 0.001). The total retention of the mouthguards was influenced by alterations in their design. Trend analysis indicated that 64% of MG retention could be explained by their thickness under dry conditions and 55% when wet.

CONCLUSIONS

Design and thickness of mouthguards are key factors in retention. Mouthguard fabrication techniques should be considered in order to minimize dislodgment of the devices as well as potentially increasing the wearability of mouthguards during sport.

The Role of Mouthguards in Preventing and Reducing Sports-related Trauma

a mouthguard, also known as a gumshield, mouth protector or sports guard is an appliance that covers the teeth and surrounding mucosa with the aim of preventing or reducing trauma to the teeth, gingival tissue, lips and jaws. The device is usually worn on the maxillary arch and works by separating the maxillary and mandibular dentition, protecting the teeth from the surrounding soft tissue, absorbing or redistributing shock and/or stabilising the mandible during traumatic jaw closure. They may also play a role in preventing and reducing concussion by absorbing impact forces that would otherwise be transmitted through the base of the skull to the brain, although the evidence for this is less conclusive. A mouthguard will usually fall into one of three categories: stock mouthguards (which are made ready to use and are believed to give the least protection), the mouth-formed or 'boil and bite' type (which are heated in hot water, placed in the mouth and moulded to the teeth) and custom-made mouthguards (which are usually made on a stone model of the maxillary teeth and surrounding tissue and are thought to give the most protection). These devices can be made from various materials but ethylene-vinyl acetate is by far the most popular material, probably because of the ease with which it can be used for the production of custom-made mouthguards. This paper gives a review of the role of mouthguards in preventing and reducing sports-related trauma and examines the materials that are used to fabricate them.

Effect of mouthguards on impact to the craniomandibular complex

BACKGROUND

The aim of this study was to investigate the effect of wearing a mouthguard and teeth-clenching on impact to the head and temporomandibular joint (TMJ) during a blow to the jaw.

MATERIAL AND METHODS

A custom-made mouthguard was fabricated for five participants. A 4.1-N impact load was applied to the chin with a pendulum. Two acceleration sensors were attached to the forehead and left TMJ. The amplitudes and durations of the accelerations were obtained under five conditions: mouth-open without mouthguard; light teeth-clenching without mouthguard; maximum voluntary clenching (MVC) without mouthguard; mouth-open with mouthguard and MVC with mouthguard.

RESULTS

Wearing a mouthguard led to significant decreases in the amplitude (mouth-open with mouthguard vs mouth-open without mouthguard, P = 0.035 at forehead, P = 0.022 at TMJ) and duration (mouth-open with mouthguard vs mouth-open without mouthguard, P = 0.043 at forehead, not significant at TMJ). Similarly, teeth-clenching caused significant decreases in the amplitude (mouth-open without mouthguard vs MVC without mouthguard, P = 0.024 at forehead, P = 0.025 at TMJ) and duration (mouth-open without mouthguard vs MVC without mouthguard, P = 0.033 at forehead, not significant at TMJ). Furthermore, wearing a mouthguard in itself provided an impact reduction effect similar to the combination of teeth-clenching and wearing a mouthguard.

CONCLUSIONS

Wearing a mouthguard and/or teeth-clenching reduced the impact to the head and TMJ during a blow to the jaw. However, it should be noted that the findings are the results from a small impact load to the jaw.