Effect of Different Ethylene‐Vinyl Acetate ( EVA ) Brands Used for Customized Mouthguards on Athlete Preferences, Wearability, Willingness to Pay, Clinical Performance, and Structural Deformation in Elite Soccer Players: A Randomized Double‐Blind Crossover Clinical Trial

BACKGROUND/AIM: Custom-made mouthguards are widely used to prevent sports-related dentoalveolar injuries, but evidence comparing commercial ethylene-vinyl acetate materials under real sporting conditions remains limited. This randomized crossover clinical trial evaluated whether three commercial ethylene-vinyl acetate brands (BioArt, Proform, and Polyshok) influence wearability, athlete preference, willingness to pay, clinical performance, and structural deformation in elite soccer players. MATERIALS AND METHODS: Fourteen athletes were randomized to six sequences of three customized mouthguards in a double-blind crossover design. Each mouthguard underwent one week of clinical adjustment followed by four weeks of sports use. Wearability and preference were assessed using a questionnaire, willingness to pay by an auction method, and clinical performance by adaptation, retention, and stability. Structural deformation was evaluated before and after use by three-dimensional optical scanning and digital superimposition. Inferential comparisons were performed using Friedman and Wilcoxon tests, whereas categorical outcomes were summarized descriptively. RESULTS: Eleven athletes completed all phases. Overall wearability did not differ significantly among brands, although breathing differed among the three materials. Proform was the most preferred brand (72.7%), whereas Polyshok showed the highest median willingness to pay (70 United States dollars). Deformation was greatest at the occlusal/incisal surface in several sectioning regions, but occlusal/incisal deformation did not differ significantly among brands. Most mouthguards remained adequately adapted after use. Descriptively, BioArt showed the highest final retention, whereas Proform showed the lowest final retention and was the only brand with reduced stability over time. CONCLUSIONS: The commercial ethylene-vinyl acetate brand did not significantly influence overall wearability or occlusal/incisal deformation, whereas athlete preference and willingness to pay varied among brands. Customized mouthguards showed measurable structural deformation after sports use while most remained adequately adapted, supporting material selection based on athlete-centered outcomes together with periodic clinical monitoring.