Can a mouthguard protect teeth with ceramic veneers during an impact?

Details

Little is known about how dental trauma and mouthguards affect teeth with ceramic laminate veneers (CLV). This study evaluated how veneer thickness and the presence of a mouthguard, with and without contact with an antagonist (opposing) tooth, influence impact stresses during dental trauma.

The researchers created twelve two-dimensional finite element models of a head with maxillary structures and upper incisors: six with an antagonist tooth and six without one. The models covered three conditions: a sound incisor without a veneer, a 0.3-mm CLV, and a 1.0-mm CLV. They were evaluated with and without a 4.0-mm ethylene-vinyl acetate (EVA) mouthguard, and with and without an antagonist tooth. The impact analysis simulated the head hitting a rigid surface frontally at 1 m/s (3.6 km/h). Results were analyzed using Critical modified von Mises stress (MPa). For each structure, the mean of the highest 10% of modified von Mises stresses was collected.

The presence of a mouthguard substantially reduced impact stresses in the veneers and tooth structures. Contact with the antagonist tooth improved stress distribution and reduced stress levels in the traumatized tooth. In every model without a mouthguard, critical stress areas occurred in the palatal enamel, incisal enamel, labial cervical area, and enamel beneath the veneer. In models with a mouthguard, stresses were significantly reduced. The Critical modified von Mises analysis showed that sound or prepared enamel experienced more critical impact stresses than the 0.3-mm or 1.0-mm veneers.

The researchers concluded that a 4.0-mm EVA mouthguard reduced impact stress levels in models with 0.3-mm and 1.0-mm veneers, similar to a sound tooth. Antagonist tooth contact and the mouthguard improved stress distribution and reduced impact stress in the traumatized tooth.