Fabricating a better mouthguard. Part I: Factors influencing mouthguard thinning.

Resident’s Name: Brian Schmid DMD Date: 11/13/09
Article title: Fabricating a better mouthguard. Part I: Factors influencing mouthguard thinning.
Author(s): De Rossi G. Leyte Bidal MA.
Journal: Dental Traumatology
Month, Year: 2007
Major topic: Mouthguard fabrication and thermoforming effect on mouthguard thickness
Type of Article: Technique analysis
Findings: Fifteen patients had alginate impressions taken and each was poured up 3 times. They were trimmed for mouthguard fabrication with cast thicknesses of 20, 25 and 30mm. The mouthguards were made via pressure lamination with EVA in a Drufomat machine. The thickness of various parts of the mouthguard including the occlusal table and the facial of the incisors and canines were measured and analyzed. There was a significant difference in incisor and canine thickness between the 3 groups, with the shortest cast being the thickest progressing up to the tallest cast being the thinnest. Also, the thinnest group kept the difference between anterior and posterio thickness to a minimum suggesting that a shorter cast will provide a mouthguard with the most uniform thickness, which has been shown to be the most comfortable and allow the greatest freedom of speech and breathing. The short cast mouthguards were also analyzed for thickness related to jaw size and arch length for which there was a positive correlation.
Key points/Summary: Shorter casts will generally give you a mouthguard of uniform thickness and increased protection in the anterior. Patients with larger arch length and jaw size may be at an advantage since the fabrication process lends itself to thicker mouthguards for these patients.
Assessment of article: A small N, particularly for the arch length/area analysis, makes this study a step in the right direction but well shy of a definitive study. Also, they fabricated their mouthguards with a landing present on the casts; all of the instruction I’ve seen has you grind off the landing, which allows you to make the cast even shorter. Definitely an interesting opportunity for future research.