The positive effects of wearing a mouthguard have been indicated in various epidemiological surveys and experiments, and their usage appears to be increasing in many sports. However, many preventable sports-related dental injuries still occur even with the use of a conventional mouthguard. We have developed a mouthguard (the Hard & Space mouthguard) with sufficient injury prevention ability (more than 95% shock absorption ability against impact with a steel ball carrying 15.2 kgm 2 /S 2 potential energy) and ease of clinical application. This mouthguard consists of an outer and an inner EVA layer and a middle layer of acrylic resin (hard insert), with a space to prevent contact between the inner surface of the mouthguard and the buccal surfaces of the maxillary front teeth or teeth already weakened through prior damage or treatment. The purpose of this article is to describe the method by which the Hard & Space mouthguard may easily be fabricated. We believe that this new type of mouthguard has the potential to reduce sports-related dental injuries. OutlineThe positive effects of wearing a mouthguard have been indicated in various epidemiological surveys and experiments (1-5), and their usage appears to be increasing in many sports. However, many preventable sports-related dental injuries still occur despite the use of a conventional mouthguard. For example, in a study of NCAA basketball teams, although athletes wearing custom-made mouthguards sustained significantly fewer oral injuries than those who did not, injuries did still occur (1.16injuries per 1,000 athletic exposures versus 3.00 injuries per 1,000 athletic exposures, respectively)(6).It is clear that when the impact force far exceeds the protective capability of the mouthguard, injury will occur. This is particularly true in cases where the wearer has restored(7-9) or endodontically treated(10) teeth as the strength and resiliency of a treated tooth never returns to normal levels. Furthermore, if a dental implant (11) is used, the periodontal tissues become susceptible to secondary injury due to a high elasticity modulus. However, the ordinal impact power in sports is estimated to be smaller than that found in traffic accidents(12). Therefore, most sports-related dental injuries not only in sound teeth, but also in treated teeth are assumed to be preventable by use of an appropriate mouthguard with high shock absorption ability.Many studies have investigated new methods for improving the shock absorption capabilities of mouthguards. These have included use of air cells(13), Sorbothane(14), a metal wire(15), a sponge(16), and a hard material (17)(18)(19). Most of these studies showed that these materials or fabrication methods were effective. However, the results of these studies have not been clinically applied.The ability of a mouthguard to protect against frequent injuries, often caused by a direct blow to the teeth, is believed to depend on 3 factors: 1) its ability to absorb and dissipate the force of impact throughout the mouthguard materi...
A rugby player who had frequently experienced soft tissue injuries while playing rugby and wearing a conventional custom-made mouthguard came to the hospital clinic. The patient had suffered traumatic soft tissue injuries such as lip lacerations and bite trauma. Severe crowding due to ectopic maxillary and mandibular canines was observed. In response to the patient's request for better protection, a set of maxillary and mandibular mouthguards was designed: one covering the entire maxillary dentition and the other the mandibular front teeth only. The mouthguards were to be worn simultaneously. In this paper, we describe how these mouthguards were fabricated and discuss the results. The patient has experienced no injury to the stomatognathic system, including the lips, for five seasons since he began wearing this set of mouthguards. This new pairing of mouthguards appears to offer sufficient protection against injury, despite severe malalignment. We believe that this new type of paired maxillary and mandibular mouthguards has the potential to reduce sports-related dental injuries.
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