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CC BY 4.0 · Eur J Dent 2023; 17(03): 740-748
DOI: 10.1055/s-0042-1756474
Original Article

Effects of Mouthguards on Skin Damage In Vitro Study

Maho Saito 
1   Division of Sports Dentistry, Department of Oral Health and Clinical Science Dentistry, Tokyo Dental College, Tokyo, Japan
,
Kazunori Nakajima
1   Division of Sports Dentistry, Department of Oral Health and Clinical Science Dentistry, Tokyo Dental College, Tokyo, Japan
,
Arata Tsutsui
1   Division of Sports Dentistry, Department of Oral Health and Clinical Science Dentistry, Tokyo Dental College, Tokyo, Japan
,
Takahiro Sakaue
1   Division of Sports Dentistry, Department of Oral Health and Clinical Science Dentistry, Tokyo Dental College, Tokyo, Japan
,
Anna Kanemitsu
1   Division of Sports Dentistry, Department of Oral Health and Clinical Science Dentistry, Tokyo Dental College, Tokyo, Japan
,
Tomotaka Takeda
1   Division of Sports Dentistry, Department of Oral Health and Clinical Science Dentistry, Tokyo Dental College, Tokyo, Japan
,
Kenichi Fukuda
2   Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science Dentistry, Tokyo Dental College, Tokyo, Japan
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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.

Keywords

mouthguard - prevention - skin - thickness - trauma


Publication History

Article published online:
28 October 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Fernandes LM, Neto JCL, Lima TFR. et al. The use of mouthguards and prevalence of dento-alveolar trauma among athletes: a systematic review and meta-analysis. Dent Traumatol 2019; 35 (01) 54-72
    CrossrefPubMedSearch in Google Scholar
  • 2 Lloyd JD, Nakamura WS, Maeda Y. et al. Mouthguards and their use in sports: report of the 1st International Sports Dentistry Workshop, 2016. Dent Traumatol 2017; 33 (06) 421-426
    CrossrefPubMedSearch in Google Scholar
  • 3 Black AM, Patton DA, Eliason PH, Emery CA. Prevention of sport-related facial injuries. Clin Sports Med 2017; 36 (02) 257-278
    CrossrefPubMedSearch in Google Scholar
  • 4 Galic T, Kuncic D, Poklepovic Pericic T. et al. Knowledge and attitudes about sports-related dental injuries and mouthguard use in young athletes in four different contact sports-water polo, karate, taekwondo and handball. Dent Traumatol 2018; 34 (03) 175-181
    CrossrefPubMedSearch in Google Scholar
  • 5 Piccininni P, Clough A, Padilla R, Piccininni G. Dental and orofacial injuries. Clin Sports Med 2017; 36 (02) 369-405
    CrossrefPubMedSearch in Google Scholar
  • 6 Zamora-Olave C, Willaert E, Montero-Blesa A, Riera-Punet N, Martinez-Gomis J. Risk of orofacial injuries and mouthguard use in water polo players. Dent Traumatol 2018; 34 (06) 406-412
    CrossrefPubMedSearch in Google Scholar
  • 7 ADA Council on Access, Prevention and Interprofessional Relations; ADA Council on Scientific Affairs. Using mouthguards to reduce the incidence and severity of sports-related oral injuries. J Am Dent Assoc 2006; 137 (12) 1712-1720 , quiz 1731
    CrossrefPubMedSearch in Google Scholar
  • 8 de Machado AAF, Oliveira SS, Batista JD, Furtado LM, Rocha FS. Important aspects during advanced lingual laceration management: report of 2 cases. RGO, Rev Gaúch Odontol. 2021; 69: e20210022
    Search in Google Scholar
  • 9 Tribst JPM, Dal Piva AMO, Bottino MA, Kleverlaan CJ, Koolstra JH. Mouthguard use and TMJ injury prevention with different occlusions: a three-dimensional finite element analysis. Dent Traumatol 2020; 36 (06) 662-669
    CrossrefPubMedSearch in Google Scholar
  • 10 Kaur S, Krishan K, Chatterjee PM, Kanchan T. Analysis and identification of bite marks in forensic casework. Oral Health Dent Manag 2013; 12 (03) 127-131
    PubMedSearch in Google Scholar
  • 11 Robsam SO, Ihechi EU, Olufemi WO. Human bite as a weapon of assault. Afr Health Sci 2018; 18 (01) 79-89
    CrossrefPubMedSearch in Google Scholar
  • 12 Yamada K, KIshida N. Trauma during soccer practice and fever and skin redness after 3 days. J Prac Pharm 2014; 65 (06) 95-105
    Search in Google Scholar
  • 13 Rothe K, Tsokos M, Handrick W. Animal and human bite wounds. Dtsch Arztebl Int 2015; 112 (25) 433-442 , quiz 443
    CrossrefPubMedSearch in Google Scholar
  • 14 Gonzalez MH, Papierski P, Hall Jr RF. Osteomyelitis of the hand after a human bite. J Hand Surg Am 1993; 18 (03) 520-522
    CrossrefPubMedSearch in Google Scholar
  • 15 Rerucha CM, Ewing JT, Oppenlander KE, Cowan WC. Acute hand infections. Am Fam Physician 2019; 99 (04) 228-236
    PubMedSearch in Google Scholar
  • 16 Bula-Rudas FJ, Olcott JL. Human and animal bites. Pediatr Rev 2018; 39 (10) 490-500
    CrossrefPubMedSearch in Google Scholar
  • 17 Clem KL, Borchers JR. HIV and the athlete. Clin Sports Med 2007; 26 (03) 413-424
    CrossrefPubMedSearch in Google Scholar
  • 18 Peterson AR, Nash E, Anderson BJ. Infectious disease in contact sports. Sports Health 2019; 11 (01) 47-58
    CrossrefPubMedSearch in Google Scholar
  • 19 Anish EJ. Viral hepatitis: sports-related risk. Curr Sports Med Rep 2004; 3 (02) 100-106
    CrossrefPubMedSearch in Google Scholar
  • 20 Hughes WT. The athlete: an immunocompromised host. Adv Pediatr Infect Dis 1997; 13: 79-99
    PubMedSearch in Google Scholar
  • 21 Fleischmann T, Nicholls F, Lipiski M, Arras M, Cesarovic N. Transplantation of autologous dermo-epidermal skin substitutes in a pig model. Methods Mol Biol 2019; 1993: 251-259
    CrossrefPubMedSearch in Google Scholar
  • 22 Tapking C, Popp D, Branski LK. Pig model to test tissue-engineered skin. Methods Mol Biol 2019; 1993: 239-249
    CrossrefPubMedSearch in Google Scholar
  • 23 Matsuda Y, Nakajima K, Saitou M. et al. The effect of light-cured resin with a glass fiber net as an intermediate material for Hard & Space mouthguard. Dent Traumatol 2020; 36 (06) 654-661
    CrossrefPubMedSearch in Google Scholar
  • 24 Takeda T, Ishigami K, Shintaro K, Nakajima K, Shimada A, Regner CW. The influence of impact object characteristics on impact force and force absorption by mouthguard material. Dent Traumatol 2004; 20 (01) 12-20
    CrossrefPubMedSearch in Google Scholar
  • 25 King D, Hume PA, Brughelli M, Gissane C. Instrumented mouthguard acceleration analyses for head impacts in amateur rugby union players over a season of matches. Am J Sports Med 2015; 43 (03) 614-624
    CrossrefPubMedSearch in Google Scholar
  • 26 Tribst JPM, de Oliveira Dal Piva AM, Borges ALS, Bottino MA. Influence of custom-made and stock mouthguard thickness on biomechanical response to a simulated impact. Dent Traumatol 2018; 34 (06) 429-437
    CrossrefPubMedSearch in Google Scholar
  • 27 Westerman B, Stringfellow PM, Eccleston JA. EVA mouthguards: how thick should they be?. Dent Traumatol 2002; 18 (01) 24-27
    CrossrefPubMedSearch in Google Scholar
  • 28 Wong B, Kieser JA, Ichim I. et al. Experimental simulation of non-ballistic wounding by sharp and blunt punches. Forensic Sci Med Pathol 2008; 4 (04) 212-220
    CrossrefPubMedSearch in Google Scholar
  • 29 Tschan JD, Röthlisberger B, Hegg L, von Arx T. Frequency and nature of anterior tooth injuries and the use of mouth protectors in sports clubs in Bern. Schweiz Monatsschr Zahnmed 2003; 113 (01) 20-26
    PubMedSearch in Google Scholar
  • 30 Newsome PR, Tran DC, Cooke MS. The role of the mouthguard in the prevention of sports-related dental injuries: a review. Int J Paediatr Dent 2001; 11 (06) 396-404
    CrossrefPubMedSearch in Google Scholar
  • 31 Lakshmi KPD, Aswath Narayanan MB, Ramesh Kumar SG, Selvamary AL, Sujatha A. Permanent anterior teeth fractures and its impact on oral health-related quality of life among 8–15-year-old schoolchildren of Chennai city—a cross-sectional survey. Int J Appl Basic Med Res 2020; 10 (01) 30-36
    CrossrefPubMedSearch in Google Scholar
  • 32 Bauss O, Röhling J, Schwestka-Polly R. Prevalence of traumatic injuries to the permanent incisors in candidates for orthodontic treatment. Dent Traumatol 2004; 20 (02) 61-66
    CrossrefPubMedSearch in Google Scholar
  • 33 Bussell MA, Barreto LS. The recommendation and provision of mouthguards: a survey of consultant orthodontists in the UK. J Orthod 2014; 41 (02) 141-146
    CrossrefPubMedSearch in Google Scholar