Mouthguard use and TMJ injury prevention with different occlusions: A three-dimensional finite element analysis.
BACKGROUND/AIMS
There is a lack of data regarding the mechanical responses of the temporo-mandibular joints during an impact to the orofacial region. The aim of this study was to analyze the biomechanical effects of wearing a mouthguard (MG) on the impact response of the mandibular condyle and articular disk according to the type of occlusion. The hypothesis was that the MG would minimize the effect in those structures, regardless of the occlusion type.


METHODS
Using modeling software, a human skull with jaw, teeth and articular disk was created. The models were divided according to the occlusion type (Class I, II, or III) and the presence of a mouthguard (with or without). The geometries were exported to analysis software, and the materials were considered ideal. Fixation occurred at the base of the foramen magnum. The load (0-500N, 1s) was applied to the upper central incisors with a steel ball. Maximum principal stress and Von Mises results (MPa) were obtained in the mandibular condyle and articular disk. Minimum principal stress and maximum shear stresses were also recorded in the articular disk.


RESULTS
For both structures, the MG caused a decrease in stress concentration regardless of the occlusion and stress criteria. The condyle neck was the most tensile-stressed area while for the articular disk, both the superior and inferior surfaces were the most stressed areas. The highest stress peaks in the disk were found for compression followed by tensile and then shear stress.


CONCLUSION
This biomechanical analysis of the effects of using a mouthguard exhibited considerably decreased stresses on the mandibular condyle and articular disk, regardless of the occlusion type.
['Tribst|João Paulo Mendes|JPM|https://orcid.org/0000-0002-5412-3546', 'Dal Piva|Amanda Maria de Oliveira|AMO|https://orcid.org/0000-0002-3844-2053', 'Bottino|Marco Antonio|MA|https://orcid.org/0000-0003-0077-3161', 'Kleverlaan|Cornelis Johannes|CJ|https://orcid.org/0000-0002-3218-8031', 'Koolstra|Jan Harm|JH|https://orcid.org/0000-0002-1202-2296']
D020342:Finite Element Analysis D006801:Humans D008335:Mandibular Condyle D009064:Mouth Protectors D013314:Stress, Mechanical D013704:Temporomandibular Joint
custom mouthguards maxillofacial trauma sports dentistry temporomandibular joint