Reinforcement Positioning in Custom-Made Mouthguards for Maxillofacial Trauma Protection: A Combined In Vitro and In Silico Analyses

Talita Suelen de Queiroz; João Paulo Mendes Tribst; Larissa Haddad E Borro; Guilherme da Rocha Scalzer Lopes; Alexandre Luiz Souto Borges; Tarcisio Jose de Arruda Paes Junior

doi:10.1111/edt.13060

Reinforcement Positioning in Custom-Made Mouthguards for Maxillofacial Trauma Protection: A Combined In Vitro and In Silico Analyses

Talita Suelen de Queiroz, João Paulo Mendes Tribst, Larissa Haddad E Borro, Guilherme da Rocha Scalzer Lopes, Alexandre Luiz Souto Borges, Tarcisio Jose de Arruda Paes Junior

Reconstructive Oral Care

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

BACKGROUND/AIM: This study evaluated the dentoalveolar responses of central incisors to anterior maxillary trauma in vitro and in silico using mouthguards (MGs) reinforced with polyamide mesh at three distinct positions.

MATERIAL AND METHODS: Forty 4-mm thick MGs were categorized based on mesh location: Group MG1 + 3 (reinforcement 1 mm from the vestibular limit), Group MG2 + 2 (2 mm), Group MG3 + 1 (3 mm), and a control group without reinforcement. A 3D-printed skull model (Spin Red Resin, Quanton 3D) simulated the dentoalveolar complex, with Resilab Clear resin (Wilcos) for teeth and addition-cured silicone for the periodontal ligament. This setup was connected to a custom impact device to ensure forces remained within the materials' elastic limits. Microstrains were measured using four strain gauges placed on the vestibular surfaces of the central incisors and the alveolar process of the maxilla. The impact was applied at Ep = 0.5496 J, parallel to the ground, using a 35-mm diameter steel sphere. For the in silico test, the setup was modeled in CAD software (Rhinoceros 7.0) and analyzed in CAE software (Ansys 2021 R1) through explicit dynamic simulation. All materials were assumed homogeneous, isotropic and linearly elastic. A 1 m/s impact was simulated using a 7.8 g/cm 3 steel sphere. Physical contact conditions were defined as frictional and glued, with tetrahedral mesh elements applied after a 10% convergence test to ensure accuracy.

RESULTS: The maximum principal strains and stresses in teeth and maxilla were presented through colorimetric graphs. Statistical analysis (Shapiro-Wilk, Kruskal-Wallis, and Dunn's tests, 5% significance) revealed significant differences for the non-reinforced group (p = 6.8 × 10 -5) but none between impact zones (p = 0.879), confirming uniform stress distribution.

CONCLUSIONS: Reinforcement systems significantly improved impact absorption in oral tissues, enhancing protection. However, the reinforcement location did not significantly affect absorption. Finite element analysis validated the in vitro results supporting both theoretical and practical models for further study and future improvements.

Original language	English
Journal	Dental traumatology
DOIs	https://doi.org/10.1111/edt.13060
Publication status	E-pub ahead of print - 27 Mar 2025

Bibliographical note

Funding

This study was supported by the Department of Dental Materials and Prosthodontics of the Science and Technology Institute of the Sao Paulo State University (UNESP), and granted by Sao Paulo Research Foundation (FAPESP), process no. 2021/11159\u20107 and 2022/11307\u20109; by National Council of Scientific Research PIBIC, process 3961 (UNESP) and Coordination for the Improvement of Higher Education Personnel (CAPES). Funding:

Funders	Funder number
National Council of Scientific Research PIBIC
Science and Technology Institute of the Sao Paulo State University
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Universidade Estadual Paulista
Fundação de Amparo à Pesquisa do Estado de São Paulo	2021/11159‐7, 2022/11307‐9

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10.1111/edt.13060

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Cite this

@article{a70dc3e829ce4f76a76b6bbac74c48c0,

title = "Reinforcement Positioning in Custom-Made Mouthguards for Maxillofacial Trauma Protection: A Combined In Vitro and In Silico Analyses",

abstract = "BACKGROUND/AIM: This study evaluated the dentoalveolar responses of central incisors to anterior maxillary trauma in vitro and in silico using mouthguards (MGs) reinforced with polyamide mesh at three distinct positions.MATERIAL AND METHODS: Forty 4-mm thick MGs were categorized based on mesh location: Group MG1 + 3 (reinforcement 1 mm from the vestibular limit), Group MG2 + 2 (2 mm), Group MG3 + 1 (3 mm), and a control group without reinforcement. A 3D-printed skull model (Spin Red Resin, Quanton 3D) simulated the dentoalveolar complex, with Resilab Clear resin (Wilcos) for teeth and addition-cured silicone for the periodontal ligament. This setup was connected to a custom impact device to ensure forces remained within the materials' elastic limits. Microstrains were measured using four strain gauges placed on the vestibular surfaces of the central incisors and the alveolar process of the maxilla. The impact was applied at Ep = 0.5496 J, parallel to the ground, using a 35-mm diameter steel sphere. For the in silico test, the setup was modeled in CAD software (Rhinoceros 7.0) and analyzed in CAE software (Ansys 2021 R1) through explicit dynamic simulation. All materials were assumed homogeneous, isotropic and linearly elastic. A 1 m/s impact was simulated using a 7.8 g/cm 3 steel sphere. Physical contact conditions were defined as frictional and glued, with tetrahedral mesh elements applied after a 10% convergence test to ensure accuracy. RESULTS: The maximum principal strains and stresses in teeth and maxilla were presented through colorimetric graphs. Statistical analysis (Shapiro-Wilk, Kruskal-Wallis, and Dunn's tests, 5% significance) revealed significant differences for the non-reinforced group (p = 6.8 × 10 -5) but none between impact zones (p = 0.879), confirming uniform stress distribution. CONCLUSIONS: Reinforcement systems significantly improved impact absorption in oral tissues, enhancing protection. However, the reinforcement location did not significantly affect absorption. Finite element analysis validated the in vitro results supporting both theoretical and practical models for further study and future improvements.",

author = "{de Queiroz}, {Talita Suelen} and Tribst, {Jo{\~a}o Paulo Mendes} and {Haddad E Borro}, Larissa and {da Rocha Scalzer Lopes}, Guilherme and Borges, {Alexandre Luiz Souto} and {de Arruda Paes Junior}, {Tarcisio Jose}",

note = "{\textcopyright} 2025 The Author(s). Dental Traumatology published by John Wiley & Sons Ltd.",

year = "2025",

month = mar,

day = "27",

doi = "10.1111/edt.13060",

language = "English",

journal = "Dental traumatology",

issn = "1600-4469",

publisher = "Blackwell Munksgaard",

}

TY - JOUR

T1 - Reinforcement Positioning in Custom-Made Mouthguards for Maxillofacial Trauma Protection

T2 - A Combined In Vitro and In Silico Analyses

AU - de Queiroz, Talita Suelen

AU - Tribst, João Paulo Mendes

AU - Haddad E Borro, Larissa

AU - da Rocha Scalzer Lopes, Guilherme

AU - Borges, Alexandre Luiz Souto

AU - de Arruda Paes Junior, Tarcisio Jose

PY - 2025/3/27

Y1 - 2025/3/27

N2 - BACKGROUND/AIM: This study evaluated the dentoalveolar responses of central incisors to anterior maxillary trauma in vitro and in silico using mouthguards (MGs) reinforced with polyamide mesh at three distinct positions.MATERIAL AND METHODS: Forty 4-mm thick MGs were categorized based on mesh location: Group MG1 + 3 (reinforcement 1 mm from the vestibular limit), Group MG2 + 2 (2 mm), Group MG3 + 1 (3 mm), and a control group without reinforcement. A 3D-printed skull model (Spin Red Resin, Quanton 3D) simulated the dentoalveolar complex, with Resilab Clear resin (Wilcos) for teeth and addition-cured silicone for the periodontal ligament. This setup was connected to a custom impact device to ensure forces remained within the materials' elastic limits. Microstrains were measured using four strain gauges placed on the vestibular surfaces of the central incisors and the alveolar process of the maxilla. The impact was applied at Ep = 0.5496 J, parallel to the ground, using a 35-mm diameter steel sphere. For the in silico test, the setup was modeled in CAD software (Rhinoceros 7.0) and analyzed in CAE software (Ansys 2021 R1) through explicit dynamic simulation. All materials were assumed homogeneous, isotropic and linearly elastic. A 1 m/s impact was simulated using a 7.8 g/cm 3 steel sphere. Physical contact conditions were defined as frictional and glued, with tetrahedral mesh elements applied after a 10% convergence test to ensure accuracy. RESULTS: The maximum principal strains and stresses in teeth and maxilla were presented through colorimetric graphs. Statistical analysis (Shapiro-Wilk, Kruskal-Wallis, and Dunn's tests, 5% significance) revealed significant differences for the non-reinforced group (p = 6.8 × 10 -5) but none between impact zones (p = 0.879), confirming uniform stress distribution. CONCLUSIONS: Reinforcement systems significantly improved impact absorption in oral tissues, enhancing protection. However, the reinforcement location did not significantly affect absorption. Finite element analysis validated the in vitro results supporting both theoretical and practical models for further study and future improvements.

AB - BACKGROUND/AIM: This study evaluated the dentoalveolar responses of central incisors to anterior maxillary trauma in vitro and in silico using mouthguards (MGs) reinforced with polyamide mesh at three distinct positions.MATERIAL AND METHODS: Forty 4-mm thick MGs were categorized based on mesh location: Group MG1 + 3 (reinforcement 1 mm from the vestibular limit), Group MG2 + 2 (2 mm), Group MG3 + 1 (3 mm), and a control group without reinforcement. A 3D-printed skull model (Spin Red Resin, Quanton 3D) simulated the dentoalveolar complex, with Resilab Clear resin (Wilcos) for teeth and addition-cured silicone for the periodontal ligament. This setup was connected to a custom impact device to ensure forces remained within the materials' elastic limits. Microstrains were measured using four strain gauges placed on the vestibular surfaces of the central incisors and the alveolar process of the maxilla. The impact was applied at Ep = 0.5496 J, parallel to the ground, using a 35-mm diameter steel sphere. For the in silico test, the setup was modeled in CAD software (Rhinoceros 7.0) and analyzed in CAE software (Ansys 2021 R1) through explicit dynamic simulation. All materials were assumed homogeneous, isotropic and linearly elastic. A 1 m/s impact was simulated using a 7.8 g/cm 3 steel sphere. Physical contact conditions were defined as frictional and glued, with tetrahedral mesh elements applied after a 10% convergence test to ensure accuracy. RESULTS: The maximum principal strains and stresses in teeth and maxilla were presented through colorimetric graphs. Statistical analysis (Shapiro-Wilk, Kruskal-Wallis, and Dunn's tests, 5% significance) revealed significant differences for the non-reinforced group (p = 6.8 × 10 -5) but none between impact zones (p = 0.879), confirming uniform stress distribution. CONCLUSIONS: Reinforcement systems significantly improved impact absorption in oral tissues, enhancing protection. However, the reinforcement location did not significantly affect absorption. Finite element analysis validated the in vitro results supporting both theoretical and practical models for further study and future improvements.

U2 - 10.1111/edt.13060

DO - 10.1111/edt.13060

M3 - Article

C2 - 40145372

SN - 1600-4469

JO - Dental traumatology

JF - Dental traumatology

ER -