Factors Affecting Thermal Shrinkage of Mouthguard Sheet during Thermoforming: Model Shape and Sheet Material Thickness

Abstract
The effectiveness and safety of the mouthguard depend on the sheet material thickness. The thickness of the thermoformed mouthguard is affected by the model undercut and the thermal shrinkage that occurs when the extruded-molded sheet is reheated. The aim of this study was to clarify the influence of the undercut amount of the model and the thickness of the sheet material on the thermal shrinkage of the extruded sheet. The mouthguard sheet used ethylene-vinyl acetate resin with a thickness of 4.0 mm (4M) and 3.0 mm (3M) and was manufactured by extrusion molding. The working models were three hard gypsum models with the undercut amount on the labial side trimmed to 0? (U0), 10? (U10), and 20? (U20). Mouthguard thickness after vacuum formation was compared between the conditions formed so that the extrusion direction was vertical (condition V) or parallel (condition P) to the model midline. Differences in the reduction rate of the mouthguard thicknesses of the labial and buccal side depending on the sheet extrusion direction, model angle, and sheet material thickness were analyzed by three-way ANOVA and Bonferroni method. The reduction rate of the thickness in condition P was significantly greater than in condition V under all conditions except U0-4M on the labial side and U0-4M and U10-4M on the buccal side. In all models, the reduction rate of the thicknesses was significantly greater in 3M than in 4M in the same extrusion direction. In both 4M and 3M, the reduction rate of the thicknesses tended to increase as the amount of undercut increased in each extrusion direction. This study suggested that a model with a large amount of undercut on the labial side or a thin sheet had a significant effect on the thermal shrinkage of the mouthguard sheet during thermoforming, which leads to the thinning of the mouthguard.