Wearability and preference of mouthguard during sport in patients undergoing orthodontic treatment with fixed appliances: a randomized clinical trial

Abstract

Summary Background Orthodontic patients wearing fixed appliances are susceptible to traumatic dental injuries during a wide range of sporting activities. This randomized clinical trial investigated wearability and preference of mouthguards during sporting activities in patients undergoing orthodontic treatment with fixed appliances. Methods A prospective three-arm crossover randomized clinical trial conducted in the UK. Thirty patients in active orthodontic treatment with fixed appliances undertaking at least 120 minutes of contact sport per 6–8-week observation period were randomly assigned to one of six mouthguard allocation sequences consisting of three mouthguard types: (MG1) custom-made laboratory constructed, (MG2) mouth-formed OPRO® Gold Braces, and (MG3) pre-fabricated Shock Doctor® Single Brace. Patients completed a nine-outcome 100-mm visual analogue scale (VAS) questionnaire relating to mouthguard wearability during sport. Once feedback was completed, subjects were allocated the next mouthguard in the sequence. At study-end, subjects were asked to identify their preferred mouthguard. Results Twenty-four patients (median age = 13; inter-quartile range 12–14.5 years) completed n = 72 follow-up questionnaires with most playing rugby union or field hockey. Considering VAS score as a continuous variable, for comfort, stability, hardness, ability to breathe, ability to not cause nausea, and inclination to chew, MG2 performed better than MG3. For categorization of VAS score into low (less than 80 mm) or high (at least 80 mm) wearability, for comfort, stability, ability to not cause nausea, and inclination to chew, MG1 and MG2 also rated superior to MG3. Patients preferred MG1 overall. Conclusions This randomized clinical trial found that during contact sport patients in fixed appliances reported superior wearability for custom-made and mouth-formed mouthguards in comparison to pre-fabricated. Overall, patients preferred custom-made mouthguards. Clinical trials registration ClinicalTrials.gov: NCT04588831.

Comfort and wearability properties of custom‐made and boil‐and‐bite mouthguards among basketball players: A randomized parallel arm clinical trial

“…In line with prior research, most wearability values were subjectively assessed by professional athletes. 28,29,56,60,62 However, further studies with similar methodology are required to confirm the results.…”

“…Many parameters were found to be similar between Group 2 and Group 3, which aligns with previous research results, indicating that athletes more readily accept CM MGs. 7,40,59,60 Notably, as the program progressed, significant improvements in the investigated parameter values were observed. 61,62 However, no previous study had compared CM MGs with thicknesses of 3 and 5 mm.…”

“…Consistent with previous studies, this research employed a 10point VAS to evaluate various parameters. 40,60,62,65,68 While some studies in medical and dental research use VAS scales with more than five points, 29,31 studies on MGs have indicated that a 5-point VAS scale can provide more accurate results. In comparing these studies, it was evident that CM MGs, including injection-type CM MGs, were superior to B&B MGs, 29 even when using different statistical tests.…”

“…In comparing these studies, it was evident that CM MGs, including injection-type CM MGs, were superior to B&B MGs, 29 even when using different statistical tests. 62 In some investigations, athletes from different sports were individually assigned specific MG types to use, 28,30,31,60,62,65 which allows for a larger number of participants. However, these studies were often performed in a very short period of MG use, and it cannot be assumed that participants from various sports will react similarly to MGs, which may lead to debatable results.…”

Effect of different materials for conventional and 3D‐printed models on the mechanical properties of ethylene‐vinyl acetate utilized for fabricating custom‐fit mouthguards

“…2,14,15 According to the American National Standards Institute, EVA must have low water absorption, adequate hardness, impact resistance, low incidence of delamination, and be biocompatible, nontoxic, and insipid. 10,13 Dental models can be obtained using Types II, 16 III, [17][18][19] or IV, 2,20 dental stones with different curing times (minutes) and expansion hardening (mm). The dental stones can also be modified, presenting resin reinforcements in their composition, which can also interact with the thermo-plasticized EVA.…”