A comprehensive systematic review and meta-analysis comparing the comfort level of customized mouthguards to self-adapted mouthguards in athletes.

Abstract

Objectives: This systematic review and meta-analysis aimed to evaluate and compare the comfort levels of custom-made mouthguards and self-adapted mouthguards used by athletes. Key parameters assessed included fit, speech interference, and breathing difficulties.

Materials and methods: The review was registered with the Prospective International Registration of Systematic Reviews (PROSPERO). A comprehensive literature search was conducted across PubMed, EBSCOhost, Scopus, and Google Scholar, supplemented by additional citation searches. Two independent reviewers assessed the relevance of the studies, and studies were included based on predefined eligibility criteria. Nine studies were included for qualitative analysis, with the risk of bias assessed using standard NIH and revised JBI tools. Meta-analysis was performed with three studies to synthesize the results.

Results: The analysis demonstrated that custom-made mouthguards significantly outperformed self-adapted types in comfort metrics, particularly in fit (p=0.0002) and reducing speech difficulty (p<0.00001). At the same time, breathing difficulty was also less in custom-made mouthguards (p<0.00001).

Conclusions: Custom-made mouthguards provide superior comfort (fit and speech) compared to self-adapted alternatives, enhancing their potential for widespread adoption. The findings highlight the need for further research as limited clinical studies were available for meta-analysis.