Stress Concentration of Hybrid Occlusal Splint-Mouthguard during a Simulated Maxillofacial Traumatic Impact: 3D-FEA.

Mouthguards (MG) are protective devices that can reduce the risks of facial trauma. However, many athletes do not use them. Additionally, MG wear with coincidental parafunctional activity has not been considered. The aim of this study was to evaluate the stress distribution as a consequence of a direct impact comparing a conventional MG with a novel hybrid appliance (HMG). Using computer-aided design (CAD) software, a human skull was modeled with the teeth inserted into their respective alveolus. The models were divided according to the MG type (conventional or hybrid). The geometries were exported to the computer-aided engineering (CAE) software and the materials were considered isotropic. Fixation was defined at the base of the maxilla. The load was applied using a hockey puck. The total deformation (mm) and the von Mises stress (MPa) results were obtained for the MGs (conventional and hybrid), upper teeth, lower teeth, and maxillary bone. Despite the presence of an MG, it is still possible to observe generated stress in all structures. However, the hybrid design was more efficient than the conventional design in reducing the displacement during the impact and consequently the stress on the upper teeth, lower teeth, and maxillary bone. Higher stress magnitude was more concentrated at the inner portion of the hybrid design than the conventional device. The HMG appliance decreased the stress concentration in the teeth and in the bone, limiting the areas susceptible to injuries to the regions directly impacted by the hockey puck. Although the novel HMG may mitigate injury, some stress will still result, and any possible injury should be evaluated by a dental professional.