Fabricating a better mouthguard. Part II: The effect of color on adaptation and fit

Resident: Adam J. Bottrill
Date: 20NOV09
Region: Providence
Article title: Fabricating a better mouthguard. Part II: The effect of color on adaptation and fit.
Author(s): Del Rossi et al
Journal: Dental Traumatology
Volume #; Page #s: 24, pp. 197-200
Year: 2008

Major topic: Mouthguard adaptation and fit
Minor topic(s): NA
Type of Article: Statistical analysis of the effect of mouthguard color on fit and adaptation.

Main Purpose: The purpose of this study was to establish if material color affected the adaptation and fit of custom-made mouthguards.



















Overview of method of research:
A. Manually-driven, vertically oriented strain gauge apparatus fabricated in order to measure the level of adaptation. Used to measure the amount of force needed to remove the mouthguard from the corresponding model. Block of wood at base was placed either at 0 or 45 degrees angulation.
B. 12 individuals used for stone model fabrication. Each model was tested 3 times at both different angles. The 45 degree angle was chosen to best-mimic the angle of actual removal.
C. ANOVA and t-test used in analysis.

Key points in the article discussion:
A. General
1. Knowing that mouthguards are formed using a thermoforming process, it seems logical that the fit of the mouthguard would be effected by the material’s ability to absorb heat.
2. Pressure-formed is preferred of vacuum formed (also uses higher heat in the process).
3. Color may influence ability of material to absorb and attain the proper heat for best fit.

















B. Results
1. Significant difference between force required to remove the clear and dark-colored mouthguards.
2. No significant difference between “similarly-colored” mouthguards.
C. Discussion
1. Mouthguards must fit properly and firmly (imagine that).
2. Ability of the material to fit the model is a function of the pliability of the material, which in turn is a function of the material’s ability to absorb heat and internal temperature.
a. it seems expected that dark-colored mouthguards would be able to absorb the most heat and possibly form a tighter fit to the model.
b. clear colored mouthguards showed least suitable fit of all the colors tested.
3. Applies to us as dentists when considering which color mouthguard to fabricate for a patient.
4. Because comfort seems to play a role in pt compliance, a better fitting mouthguard may increase compliance.
5. Note: pulling the mouthguard at a 45 degree angle ALSO reduced the force needed to remove the mouthguard from the model.
6. Limitations:
a. all mouthguards made from same vendor
b. not ALL colors tested
c. did not test a variation in heating temperature or times.
7. The findings of this study SUGGEST that, all else being equal, dark-colored sheets of Ethylene Vinyl Acetate. achieve superior adaptation during the fabrication process. when compared to light-colored or transparent material. This increased firmness and retention may also increase user compliance and decrease the chances of displacement.

Assessment of article: Great conclusions but very limited in scope (see “limitations”). Serious potential for shenanigans, but useful none-the-less.