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Jung K, Giese-Kraft K, Schlenz MA, Wöstmann B, Ganss C. Digital plaque monitoring: An evaluation of different intraoral scanners. J Dent 2024; 145:104978. [PMID: 38556195 DOI: 10.1016/j.jdent.2024.104978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES Intraoral scanners (IOS) display disclosed plaque, and the scientific literature has reported that plaque levels can be monitored on intraoral scans using one IOS system (Dexis 3800; control IOS). This study aimed to investigate whether this is also possible with other IOS systems (i700, Primescan, Trios 5; test IOS). MATERIALS AND METHODS Ten participants (29.6 ± 5.5 years) were enrolled. After plaque accumulation and subsequent toothbrushing, intraoral scans were performed with the control IOS and the three test IOS. All scans were aligned and the vestibular/oral surfaces of the Ramfjord teeth (16, 21, 24, 36, 41, 44) were analysed with automated planimetry using a predefined threshold value. The proportion of pixels assigned to plaque-covered areas was expressed as a percentage of the total number of pixels (P%). We then assessed whether the planimetrically determined plaque-covered areas corresponded to those identified visually. This revealed that a threshold correction (P%corr) was required for approximately 20 % (i700 and Trios 5) to over 65 % (Primescan) of the images. RESULTS Bland-Altman analysis showed no significant systematic bias and limits of agreement ranging from approximately -20 to +20 P% units, with a tendency towards lower values at higher plaque coverage. Manual correction improved the agreement and halved the limits of agreement. All test IOS could detect a reduction in plaque after brushing, as well as the typical site-dependant plaque distribution patterns. CONCLUSIONS All test IOS appeared to be suitable for plaque monitoring. Planimetric methods must be adapted to the colour representation of the IOS. CLINICAL SIGNIFICANCE Plaque monitoring using IOS opens a new field of application in preventive dentistry.
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Affiliation(s)
- Katja Jung
- Department of Operative Dentistry, Endodontics, and Paediatric Dentistry, Section of Cariology, Medical Centre of Dentistry, Philipps-University Marburg, Marburg, Germany.
| | - Katja Giese-Kraft
- Department of Restorative Dentistry and Endodontology, Dental Clinic, Justus-Liebig-University Giessen, Giessen, Germany
| | | | - Bernd Wöstmann
- Department of Prosthodontics, Dental Clinic, Justus-Liebig-University Giessen, Giessen, Germany
| | - Carolina Ganss
- Department of Operative Dentistry, Endodontics, and Paediatric Dentistry, Section of Cariology, Medical Centre of Dentistry, Philipps-University Marburg, Marburg, Germany
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Hotic M, Ackermann M, Bopp J, Hofmann N, Karygianni L, Paqué PN. Critical hydrodynamic force levels for efficient removal of oral biofilms in simulated interdental spaces. Clin Oral Investig 2024; 28:346. [PMID: 38819592 PMCID: PMC11142948 DOI: 10.1007/s00784-024-05739-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 05/23/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES Sonic toothbrushes generate hydrodynamic shear forces for oral biofilm removal on tooth surfaces, but the effective thresholds for biofilm removal remain unexplored. This in vitro study aimed to investigate various threshold values for hydrodynamic biofilm removal in vitro. MATERIALS AND METHODS A specialized test bench was designed with a known water flow field within a gap, ensuring that hydrodynamic shear forces on the wall were solely dependent on the volume flow, which was quantifiable using an integrated flow meter and proven by a computational fluid dynamics simulation. A young 20 h supragingival six-species biofilm was developed on hydroxyapatite disks (∅ 5 mm) and applied into the test bench, subjecting them to ascending force levels ranging from 0 to 135 Pa. The remaining biofilms were quantified using colony forming units (CFU) and subjected to statistical analysis through one-way ANOVA. RESULTS Volume flow measures < 0.1 l/s: Error 1% of reading were established with the test bench. Untreated biofilms (0 Pa, no hydrodynamic shear forces) reached 7.7E7 CFU/harvest and differed significantly from all treated biofilm groups. CFU reductions of up to 2.3E6 were detected using 20 Pa, and reductions of two orders of magnitude were reached above wall shear forces of 45 Pa (6.9E5). CONCLUSIONS Critical hydrodynamic force levels of at least 20 Pa appear to be necessary to have a discernible impact on initial biofilm removal. CLINICAL RELEVANCE Pure hydrodynamic forces alone are insufficient for adequate biofilm removal. The addition of antiseptics is essential to penetrate and disrupt hydrodynamically loosened biofilm structures effectively.
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Affiliation(s)
- Merima Hotic
- School of Engineering, Institute of Thermal and Fluid Engineering, University of Applied Sciences Northwestern Switzerland, Windisch, Switzerland
| | - Mario Ackermann
- School of Engineering, Institute of Thermal and Fluid Engineering, University of Applied Sciences Northwestern Switzerland, Windisch, Switzerland
| | - Joshua Bopp
- University of Applied Sciences Northwestern Switzerland, Windisch, Switzerland
| | - Norbert Hofmann
- School of Engineering, Institute of Thermal and Fluid Engineering, University of Applied Sciences Northwestern Switzerland, Windisch, Switzerland
| | - Lamprini Karygianni
- Center for Dental Medicine, University of Zurich, Clinic for Conservative and Preventive Dentistry, Zurich, Switzerland
| | - Pune Nina Paqué
- Center for Dental Medicine, University of Zurich, Clinic for Reconstructive Dentistry, Plattenstrasse 11, Zurich, CH-8032, Switzerland.
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Schmidlin PR, Schmidlin TM, Gubler A, Brändli S, Attin T. Description of a new laboratory evaluation method of interdental brush abrasion as a clinical hazard. Int J Dent Hyg 2024; 22:458-464. [PMID: 37661658 DOI: 10.1111/idh.12732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/04/2023] [Accepted: 07/30/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES To simulate the abrasive potential of an interdental brush when applied with toothpastes and prophylactic gels/solutions in a novel laboratory brushing simulation set-up. METHODS A brushing device was customized to treat dentin samples mimicking a simplified interdental space with an interdental brush (ISO 2). The brushing, that is, 7200 strokes for 1 h, was performed with artificial saliva (control), a povidone-iodine solution, and slurries of chlorhexidine and fluoride gels as well as three toothpastes with different RDA values ranging from 29 to 100, respectively. The loss of dentin was profilometrically assessed and compared with ANOVA and Fishers LSD. RESULTS While artificial saliva as control, the solution and the gel slurries showed no measurable dentin loss, toothpastes resulted in a measurable linear surface damage with respect to the actual intrinsic RDA values and ranged from 12.6 to 26.5 μm (p < 0.001). CONCLUSIONS Any interdental cleaning product should be tailored and carefully instructed. Any over- and misuse should be avoided, which applies especially to the use of interdental brushes in combination with abrasive toothpastes.
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Affiliation(s)
- Patrick R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Tim M Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Andrea Gubler
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Stephan Brändli
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Härdter AK, Nordloh A, Cyris M, Straßburger M, Rinder T, Dörfer CE, Sälzer S, Graetz C. New design of interdental rubber picks - does the archimedean screw design bring an improvement for experimental cleaning efficacy and force? BMC Oral Health 2024; 24:404. [PMID: 38553668 PMCID: PMC10981285 DOI: 10.1186/s12903-024-04162-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Up to date, interdental brushes (IDB) are the first choice for interdental cleaning because of their cleaning efficacy. Cylindrical ones must be selected individually according to the size/morphology of the interdental area (IDR), whereas conical ones cover a larger variability of IDR. However, there is a trend on the part of patients towards interdental rubber picks (IRP) which are in general conically shaped, and which seem to be linked with lower cleaning efficacy. A new IRP with an Archimedes´ screw design was developed to overcome this limitation. Therefore, the in vitro study aimed to measure the experimental cleaning efficacy (ECE) and force (ECF) during interdental use of IDBs versus the new IRP type. METHODS Three IRPs with different tapers (PHB angled: 0.039, PHB straight S: 0.027, Vitis straight M: 0.045; all Flexipicks, Dentaid, Cerdanyola del Vallès, Spain) were compared to one IDB (Interprox micro PHD 0.9, Dentaid, Cerdanyola del Vallès, Spain). IDR were reproduced by a 3D-printer (Form2, Formlabs Sommerville, MA, USA) according to human teeth and matched to equivalent pairs (isosceles triangle, concave, convex) in three different diameters (1.0 mm,1.1 mm,1.3 mm). Covered with simulated biofilm, pre-/ post-brushing situations of IDR (standardized, computer-aided ten cycles) were photographed and quantified by digital image subtraction to calculate ECE [%]. ECF were registered with a load cell [N]. Statistically significant differences were detected using the Mann-Whitney-U-test and the Kruskal-Wallis-test with Bonferroni correction for multiple testing. RESULTS Overall, the ECE (mean ± SD) was higher for IDB micro 0.9 (45.95 ± 11.34%, p < 0.001) compared to all IRPs (PHB angled: 25.37 ± 15.29%; PHB straight: 22.28 ± 16.75%; Vitis straight: 25.24 ± 12.21%; p ≤ 0.001), whereat best ECE was achieved in isosceles triangle IDR of 1.0-1.1 mm (IDB micro 0.9: 70.7 ± 7.7%; PHB angled S: 57.30 ± 4.43%; p < 0.001). The highest ECF occurred for Vitis straight M with 2.11 ± 0.46 N, while IDB micro 0.9 showed lowest ECF values (0.64 ± 0.14 N; p < 0.001). CONCLUSIONS IRP with an Archimedes´ screw design and a higher taper were associated with advanced ECE but also higher ECF, nevertheless, ECE didn't reach the cleaning efficacy of conventional IDBs.
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Affiliation(s)
- Ann-Kristin Härdter
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Anna Nordloh
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Miriam Cyris
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Martin Straßburger
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Thomas Rinder
- Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
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Kim SE, Song ES, Lee SP. Efficacy of an interdental brush in cleaning artificial plaque on a 3D-printed model base. BMC Oral Health 2022; 22:420. [PMID: 36138454 PMCID: PMC9494839 DOI: 10.1186/s12903-022-02451-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Among interdental cleaning aids (ICAs), interdental brushes (IDBs) are in the spotlight because they can effectively remove plaque from interdental surfaces. Guidance on the correct use of ICAs, such as IDBs, is required to prevent dental plaque accumulation. Since it is impossible to confirm the interdental proximal surface unless extracted, it is difficult to conduct quantitative experiments. This study presented an efficient way to evaluate IDBs by realizing dental structures and embrasures using a Dental computer-aided design (CAD) software and a 3D printer. METHODS Two different sizes of embrasure (0.7 and 1.2 mm) crown models were prepared with CAD software and a 3D printer. To evaluate the cleaning efficacy of IDBs of each size (0.6, 0.7, 0.8, 1.0, 1.2, and 1.5 mm diameters), the 9th cycle of brush move was performed where artificial plaque was spread and a digital camera was used to record the process. The pixels and percentage of cleaning from the recorded digital images were analyzed. RESULTS The plateau was formed after the 5th brushing cycle under all conditions-after the 5th cycle, the cleaning efficacy of the two crown models was 69.3-86.4% and 49.8-75.4%. In these results, the optimal diameters for the IDB were 1.2 and 1.5 mm for embrasure sizes of 0.7 and 1.2 mm, respectively. Moreover, the cleaning efficacy was the highest at 86.4% and 75.4% after the 9th cycle. CONCLUSIONS The 3D-printed model base for the human oral embrasure structure is an adequate model to test artificial plaque removal using IDB. The use of IDBs for more than five cycles does not support the conventional idea that a greater number of IDB brushing moves is more effective in a statistically substantial manner.
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Affiliation(s)
- Seo Eun Kim
- grid.31501.360000 0004 0470 5905Department of Oral Anatomy, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Eun Sun Song
- grid.31501.360000 0004 0470 5905Department of Oral Anatomy, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Seung Pyo Lee
- Department of Oral Anatomy, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
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