Simulation of mouthguard use in preventing dental injuries caused by different impacts in sports activities

Purpose: Due to recurring doubts by athletes regarding the effectiveness of mouthguards (MG), this study evaluated the stress distribution in the skull and teeth as a consequence of different impacts. Methods: Two human skulls were created using modeling software: one in maximum intercuspidal position and the other with a MG. Next, a boxing glove was allocated into each of the coordinate axes (x, y and z) to represent a boxing punch (1000N): Jab (x), Cross (y) or Uppercut (z). The six models were imported to the analysis software and the geometries were subdivided into a specific number of elements. The bonded contacts simulated a situation in which the athlete would not lose their MG during impact. The system constriction was in the foramen magnum region. The results were presented in stress maps and graphs. Results: A higher stress concentration in teeth was shown for the model without a MG under direct impact on the upper central incisors. According to von Mises stress, each punch resulted in stress being produced in distinct areas of the skull. The displacement was proportional to the Maximum Principal Stress result. MG use decreased the jaw movement relative to the maxilla and reduced the stress magnitude during impact in all situations. Conclusions: MG use is beneficial for all simulated impacts and assists in dampening the generated stresses. Direct impacts on tooth regions showed the higher stress values and the most efficacy in protection was evidenced when using a MG.