Impact of mouthguards on the prevention of dentofacial injuries and sports performance among athletes: An umbrella review.

Does the use of mouthguards (MGs) effectively prevent dentofacial injuries in athletes? Research Protocol: An umbrella review of systematic reviews (SRs) with or without meta-analyses was conducted. The study followed the Preferred Reporting Items for Overviews of Reviews guidelines, and the AMSTAR 2 tool was used for methodological quality assessment. A comprehensive search was conducted across MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Cochrane Library, and gray literature sources. Hand searches of references from key journals and SRs were also performed. Studies focusing on nonorofacial trauma, protective equipment other than MGs, and non-English publications were excluded. Two independent reviewers extracted data on study demographics, participant characteristics, intervention details, and reported outcomes. Discrepancies were resolved through discussion. The Corrected Covered Area Index was used to assess the overlap among SRs. The AMSTAR 2 tool was applied to evaluate the methodological quality of the included reviews, focusing on factors such as risk of bias, data synthesis methods, and transparency of reporting. Out of 466 records, nine SRs met the inclusion criteria. MGs significantly reduced dentofacial injuries, particularly avulsions and fractures, with custom-made MGs offering superior protection and comfort. The impact of MGs on athletic performance showed mixed results, with some evidence suggesting improved occlusion and neuromuscular alignment. However, methodological variability and low-quality evidence in several reviews limited the strength of these findings. MGs, especially custom-made designs, are effective in orofacial injury prevention and may have potential performance benefits. The study recommends mandatory MG use policies and athlete education to enhance compliance and safety. Further high-quality research is needed to optimize MG design and address existing evidence gaps.