Effects of Mouthguards on Skin Damage In Vitro Study

Abstract

Objective: Mouthguards can prevent and reduce orofacial sports traumas, which occur to the players themselves. However, the effect of mouthguards on skin damage has not been clarified. The present study's purpose was to examine whether the mouthguard can reduce or prevent skin damage caused by teeth (including the difference in mouthguard thickness).

Materials and methods: Pigskins, artificial teeth, and Ethylene-vinyl acetate (EVA) mouthguard blanks with 1.5- and 3.0-mm thickness were employed. Each of the two type mouthguards was produced in 10 replicates. Mouthguard incisal thickness and collision touch angle were measured on a PC using imaging software. A pendulum-type machine was used to apply impact. Strain gauges attached to the tooth and impacted plate were used to measure mouthguards' effect on impact stress. Also, a microscope was used to observe the after impacted skin condition, and the extent of damage was assessed as a score.

Results: The pigskin was ruptured in without mouthguard (NOMG) with presenting the highest damage score, whereas the complete rupture was not seen in the 1.5 mm MG, but the damage of the skin (defeat) was observed. No tissue change was found with the 3 mmMG. In both the flat plate and impact tooth strain, no significant difference was observed between NOMG and 1.5 mmMG. However, 3 mmMG had a significantly smaller value than the other two conditions. These results are likely to be strongly influenced by the mouthguard incisal thicknesses and collision touch angles differences.

Conclusion: The present study results clarified that two different thickness mouthguards reduced the skin damage, and the thicker mouthguard showed more effectiveness. Therefore, mouthguards may prevent the wearer's stomatognathic system's trauma and avoid damage to the skin of other athletes they are playing with. This effect seems to be an essential basis for explaining the necessity of using mouthguards for others besides full-contact sports.

Fig. 1

Mouthguard incisal thickness and collision touch angle measurements. Mouthguard incisal thickness and collision touch angle for each specimen were measured on a PC using imaging software.

Fig. 2

Pendulum impact testing machine and measuring system. The customized device used in the current study consisted of an impact iron object with an artificial tooth and plastic plates attached strain gauges to measure the shock absorbing ability of the mouthguard. The impact point was adjusted using the XYZ axis Pack and the Pinion Dovetail Stage.

Fig. 3

Condition of pigskin after impact with microscope. Both the surface and the backside tissues were ruptured in NOMG, whereas when the 1.5 mmMG was attached, complete backside rupture of the tissue was not seen, but surface damage of the skin was observed. No tissue change was observed with the 3 mmMG.

Fig. 4

Strain on plastic plate . No significant difference was observed between NOMG and the 1.5 mmMG, but 3 mmMG showed a significantly smaller value than the other two conditions. Also, a significant difference was observed between 1.5 and 3 mmMG.

Fig. 5

Strain on impact tooth. No significant difference was observed between NOMG and 1.5 mmMG, but 3 mmMG showed a significantly smaller value than the other two conditions. Also, a significant difference was observed between 1.5 and 3 mmMG.