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Clinical Evaluation of Toothbrushes for Elderly Patients: A Crossover Study. Int Dent J 2022; 73:93-100. [PMID: 36435664 PMCID: PMC9875263 DOI: 10.1016/j.identj.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 09/25/2022] [Accepted: 10/01/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the efficacy of 2 newly designed toothbrushes used by elderly individuals based on plaque removal and gingival inflammation reduction compared with 2 commercially available toothbrushes. MATERIALS AND METHODS This was a randomised, controlled, single-blind, 4-period crossover clinical trial. Thirty elderly participants meeting the inclusion criteria were randomly allocated into 4 groups, which determined the sequence of the 4 toothbrushes: CUdent/extra soft, CUdent/soft, GoodAge, and Colgate. The participants' baseline bleeding on probing (BOP) and plaque index (PI) were assessed by one blinded calibrated examiner, then their teeth were professionally cleaned. The participants were assigned to use the tested toothbrush and were recalled for postbrushing examination 2 weeks later to evaluate their BOP and PI. At the end of each test period, the participants used their own toothbrush during the 2-week washout period before using the next tested toothbrush. RESULTS The mean age of the 30 participants was 63.2 years. The mean baseline BOP score was 44.4%, and mean baseline PI was 2.7. Three participants dropped out; thus, 27 participants (15 females and 12 males) provided data throughout the study period. The participant characteristics and baseline data between the groups were similar. CUdent/extra soft and CUdent/soft demonstrated significantly better PI scores at the buccal surfaces than GoodAge (P < .05). CUdent/soft had the lowest PI scores and Colgate presented the lowest BOP score in every comparison for other areas; however, the differences were not significant. No signs of tissue trauma or abrasion were observed. CONCLUSIONS The newly designed toothbrushes were comparable to the commercially available toothbrushes in plaque removal efficacy and reducing gingival inflammation. CUdent/extra soft and soft were significantly more effective in plaque removal in the buccal regions than GoodAge.
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Dental Biofilm Removal and Bacterial Contamination of a New Doubled-Side Thermoplastic Polyurethane-Based Toothbrush: A Crossover Study in Healthy Volunteers. Antibiotics (Basel) 2022; 11:antibiotics11101296. [PMID: 36289954 PMCID: PMC9598934 DOI: 10.3390/antibiotics11101296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 11/23/2022] Open
Abstract
Multiple toothbrush designs have been developed to enhance dental biofilm removal and decrease bacterial contamination and retention over time. Therefore, the aim of this clinical study was to compare the efficacy of a prototype of a new double-sided thermoplastic polyurethane-based toothbrush with that of a conventional nylon-bristle toothbrush. A crossover study was conducted in systemically healthy volunteers (n = 24) for two one-week periods plus one washout week. As outcome variables, plaque and gingival indices, total bacterial contamination of the toothbrushes by quantitative polymerase chain reaction (qPCR), and patient-reported outcomes were measured. Clinical and microbiological variables were analysed using a general linear model and Friedman and Wilcoxon signed-rank tests. No statistically significant differences between toothbrushes were detected neither for full-mouth PlI (p > 0.05) nor for GI (p > 0.05). Similarly, no statistically significant differences were detected for bacterial contamination after 40 seconds or 1 week of use, with results expressed either in CFU/mL or in CFU/mm2 (p > 0.05). In conclusion, the tested prototype toothbrush was as effective and safe as the control toothbrush, and the participating subjects did not experience any adverse effects from its use and rated its efficiency and effectiveness in cleaning their teeth as satisfactory.
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Thomassen TMJA, Van der Weijden FGA, Slot DE. The efficacy of powered toothbrushes: A systematic review and network meta-analysis. Int J Dent Hyg 2022; 20:3-17. [PMID: 34877772 PMCID: PMC9303421 DOI: 10.1111/idh.12563] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/03/2021] [Accepted: 12/05/2021] [Indexed: 01/17/2023]
Abstract
AIM This systematic review and network meta-analysis synthesizes the available clinical evidence concerning efficacy with respect to plaque scores following a brushing action with oscillating-rotating (OR) or high-frequency sonic (HFS) powered toothbrushes (PTB) compared with a manual toothbrush (MTB) as control. MATERIAL AND METHODS Databases were searched up to 1 August 2021, for clinical trials that evaluated the efficacy of a PTB with OR or HFS technology compared with an MTB on plaque removal after a single-brushing action and conducted with healthy adult patients. Meta-analysis (MA) and a network meta-analysis (NMA) were performed. RESULTS Twenty-eight eligible publications, including 56 relevant comparisons, were retrieved. The overall NMA results for the mean post-brushing score showed a statistically significant difference for the comparison between an OR PTB and an MTB (SMD = -0.43; 95% CI [-0.696;-0.171]). The change in plaque score data showed a significant effect of a PTB over an MTB and OR over HFS. Based on ranking, the OR PTB was highest, followed by the HFS PTB and the MTB. CONCLUSION Within the limitations of the present study design, based on the outcome following a single-brushing action, it can be concluded that for dental plaque removal, there is a high certainty for a small effect of a PTB over an MTB. This supports the recommendation to use a powered toothbrush for daily plaque removal. There is moderate certainty for a very small benefit for the use of a powered toothbrush with an OR over an HFS mode of action.
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Affiliation(s)
- Tim M. J. A. Thomassen
- Department of Periodontology Academic Centre for DentistryAmsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Fridus G. A. Van der Weijden
- Department of Periodontology Academic Centre for DentistryAmsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Dagmar E. Slot
- Department of Periodontology Academic Centre for DentistryAmsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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van der Sluijs E, Slot DE, Hennequin‐Hoenderdos NL, Valkenburg C, van der Weijden F. Dental plaque score reduction with an oscillating-rotating power toothbrush and a high-frequency sonic power toothbrush: a systematic review and meta-analysis of single-brushing exercises. Int J Dent Hyg 2021; 19:78-92. [PMID: 32940391 PMCID: PMC7839525 DOI: 10.1111/idh.12463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 01/08/2023]
Abstract
AIM To establish the effect of a single-brushing exercise on dental plaque removal using an oscillating-rotating power toothbrush (OR-PTB) as compared to a high-frequency sonic power toothbrush (HFS-PTB). MATERIALS AND METHODS The MEDLINE-PubMed and Cochrane-CENTRAL databases were searched up to September 2019. The inclusion criteria contained (randomized) controlled clinical trials involving healthy adult participants brushing with an OR-PTB as compared to an HFS-PTB. Plaque index (PI) scores were evaluated after a single-brushing exercise. RESULTS A total of 15 publications were included, representing 34 comparisons, of which 8 were professional brushing exercises and 26 participant brushing exercises. The potential risk of bias was estimated to be low. In the overall descriptive analysis of 34 comparisons, 19 comparisons showed a statistically significant difference in favour of the OR-PTB and 4 in favour of the HFS-PTB. The meta-analysis using the professional brushing study design showed a significant difference of means (DiffM) in favour of the OR-PTB (PI score) (DiffM 0.19; P < .0001) (95% CI [013; 0.25]). In those studies where the participants brushed themselves, the data were inconclusive. PI scores showed no difference between the two brushes (P = .15), while one plaque index (the Rustogi Modified Navy plaque index) indicated significant favour for the OR-PTB (DiffM 0.06; P = .002) (95% CI [0.02; 0.09]). CONCLUSION Based on the estimated evidence profile, there is moderate certainty of evidence of a very small but significant beneficial effect on plaque removal after a single-brushing exercise with the OR-PTB over the HFS-PTB.
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Affiliation(s)
- Eveline van der Sluijs
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)The Faculty of Dentistry of the University of Amsterdam and The Faculty of Dentistry of the Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Dagmar Else Slot
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)The Faculty of Dentistry of the University of Amsterdam and The Faculty of Dentistry of the Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Nienke L. Hennequin‐Hoenderdos
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)The Faculty of Dentistry of the University of Amsterdam and The Faculty of Dentistry of the Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Cees Valkenburg
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)The Faculty of Dentistry of the University of Amsterdam and The Faculty of Dentistry of the Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- General Dentist and Clinical EpidemiologistHoevelakenThe Netherlands
| | - Fridus van der Weijden
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)The Faculty of Dentistry of the University of Amsterdam and The Faculty of Dentistry of the Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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Durgesh P, Sridharan S, Prabhu SK, Rao R, Rudresh V, H. Bangalore D. Microbial contamination and plaque scores of nanogold‐coated toothbrush. Int J Dent Hyg 2020; 18:278-284. [DOI: 10.1111/idh.12433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/07/2020] [Accepted: 02/24/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Pavithra Durgesh
- Department of Periodontology and Oral implantology Bangalore Institute of Dental Sciences and Research Centre Bangalore India
| | - Srirangarajan Sridharan
- Department of Periodontology and Oral implantology Bangalore Institute of Dental Sciences and Research Centre Bangalore India
| | - Srikumar K. Prabhu
- Department of Periodontology and Oral implantology Bangalore Institute of Dental Sciences and Research Centre Bangalore India
| | - Ravi Rao
- Department of Periodontology and Oral implantology Bangalore Institute of Dental Sciences and Research Centre Bangalore India
| | - Vinaya Rudresh
- Department of Periodontology and Oral implantology Bangalore Institute of Dental Sciences and Research Centre Bangalore India
| | - Durgesh H. Bangalore
- Dental Health Department College of Applied Medical Sciences King Saud University Riyadh Kingdom of Saudi Arabia
- Department of Biomaterials Science University of Turku Turku Finland
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Elkerbout TA, Slot DE, Rosema NAM, Van der Weijden GA. How effective is a powered toothbrush as compared to a manual toothbrush? A systematic review and meta-analysis of single brushing exercises. Int J Dent Hyg 2019; 18:17-26. [PMID: 31050195 PMCID: PMC7004084 DOI: 10.1111/idh.12401] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/11/2019] [Accepted: 04/26/2019] [Indexed: 12/16/2022]
Abstract
Objectives In adult participants, what is, following a single brushing exercise, the efficacy of a powered toothbrush (PTB) as compared to a manual toothbrush (MTB) on plaque removal? Methods MEDLINE‐PubMed and Cochrane‐CENTRAL were searched from inception to February 2019. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects ≥18 years of age, in good general health and without periodontitis, orthodontic treatment, implants and/or removable prosthesis. Papers evaluating a PTB compared with a MTB in a single brushing exercise were included. When plaque scores were assessed according to the Quigley‐Hein plaque index (Q&HPI) or the Rustogi modified Navy plaque index (RMNPI). From the eligible studies, data were extracted. A meta‐analysis and subanalysis for brands and mode of action being oscillating‐rotating (OR) and side‐to‐side (SS) were performed when feasible. Results Independent screening of 3450 unique papers resulted in 17 eligible publications presenting 36 comparisons. In total, 28 comparisons assessed toothbrushing efficacy according to the Q&HPI and eight comparisons used the RMNPI. Results showed a significant effect in favour of the PTB. The difference of Means (DiffM) was −0.14 (P < 0.001; 95%CI [−0.19; −0.09]) for the Q&HPI and −0.10 (P < 0.001; 95%CI [−0.14; −0.06]) for the RMNPI, respectively. The subanalysis on the OR mode of action showed a DiffM −0.16 (P < 0.001; 95%CI [−0.22, −0.10]) for the Q&HPI. For the SS mode of action using RMNPI, the DiffM showed −0.10 (P < 0.001; 95%CI [−0.15; −0.05]). The subanalysis for brands showed for the P&G OR PTB using the Q&HPI a DiffM of −0.15 (P < 0.001; 95%CI [−0.22; −0.08]) and the Colgate SS for RMNPI showed a DiffM of −0.15 (P < 0.001; 95%CI [−0.18; −0.12]). Conclusion There is moderate certainty that the PTB was more effective than the MTB with respect to plaque removal following a single brushing exercise independent of the plaque index scale that was used.
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Affiliation(s)
- Therese A Elkerbout
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - N A Martijn Rosema
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G A Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Laboratory Investigation Comparing Plaque Removal Efficacy of Two Novel-Design Toothbrushes with Different Brushing Techniques. Dent J (Basel) 2018; 6:dj6020008. [PMID: 29642427 PMCID: PMC6023390 DOI: 10.3390/dj6020008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 03/20/2018] [Accepted: 04/03/2018] [Indexed: 11/23/2022] Open
Abstract
Manufacturers of manual toothbrushes have improved novel brush head designs aimed at achieving good plaque removal even with inadequate brushing technique. This study tested the plaque removal efficacy of two novel designs compared with a flat trimmed toothbrush with different brushing techniques. Two novel-design toothbrushes (Colgate® 360° Surround and Oral-B® Pro-Health™ Clinical Pro-Flex) were tested. The control toothbrush was Butler® GUM 311. Artificial plaque was applied on artificial teeth. Brushing with the modified Bass and horizontal scrub technique was then performed independently. After brushing, the remaining plaque index and Proximal Marginal Index (PMI) were evaluated. With the same brushing technique, there was no statistically significant difference in the mean of the whole mouth plaque scores or PMI among the three different toothbrush designs with neither brushing techniques (p > 0.05). When a comparison was made between the mean PMI of the two brushing techniques in each toothbrush design, Colgate® showed no statistically significant difference with either brushing technique (p > 0.05), but Butler® and Oral-B® showed statistically significantly less PMI with modified Bass technique than with horizontal scrub technique (p < 0.05). No difference in the whole mouth plaque removal efficacy was found among the three different toothbrush designs with either brushing technique.
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Van der Sluijs E, Slot DE, Hennequin-Hoenderdos NL, Van der Weijden GA. A specific brushing sequence and plaque removal efficacy: a randomized split-mouth design. Int J Dent Hyg 2016; 16:85-91. [PMID: 27990769 DOI: 10.1111/idh.12262] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2016] [Indexed: 11/27/2022]
Abstract
AIM It has been propagated by the dental care professionals to start toothbrushing the lingual aspect of teeth first. In general, it is assumed that these surfaces of teeth are more difficult to clean. The evidence to support this recommendation is sparse. METHOD In this randomized controlled clinical trial using a split-mouth design, 46 students were included. Before the visit, the participants were requested to refrain from any oral hygiene procedure for 48 h. First, the plaque index (PI) score was assessed full mouth. Two randomly chosen contra-lateral quadrants were used to start brushing from the lingual aspect first. The opposing two quadrants were used to start brushing from the buccal aspect. After the brushing exercise was completed, full-mouth PI was scored again. Subanalyses were performed for the buccal, lingual and approximal surfaces. RESULTS At baseline, there was no statistically significant difference between the two sets of contra-lateral quadrants (P = 0.770). Starting at the lingual aspect of the lower jaw resulted in a 55% reduction of plaque scores in comparison with 58% when the brushing exercise was started buccally. [Correction added on 16 January 2017, after first online publication: In the preceding sentence, the percentage reduction of plaque scores when the brushing exercise was started buccally, was previously wrong and has been corrected to 58% throughout this article.] The difference in mean plaque scores between brushing orders was 0.04, which was not significant (P = 0.219). None of the subanalyses revealed any significant differences for the isolated surfaces. CONCLUSION Using a manual toothbrush reduced the plaque scores between 55 and 58% with no difference between brushing from either the lingual or buccal aspect first. Within the limitations of this study, a recommendation to start toothbrushing the lingual aspect is not supported by the outcome in this young student population.
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Affiliation(s)
- E Van der Sluijs
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - D E Slot
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - N L Hennequin-Hoenderdos
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G A Van der Weijden
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Damle SG, Patil A, Jain S, Damle D, Chopal N. Effectiveness of supervised toothbrushing and oral health education in improving oral hygiene status and practices of urban and rural school children: A comparative study. J Int Soc Prev Community Dent 2014; 4:175-81. [PMID: 25374836 PMCID: PMC4209617 DOI: 10.4103/2231-0762.142021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate and compare the oral health status and the impact of supervised toothbrushing and oral health education among school children of urban and rural areas of Maharashtra, India. MATERIALS AND METHODS A total of 200 school children in the age group 12-15 years were selected by stratified random sampling technique from two schools and were further divided into two groups: Group A (urban school) and Group B (rural school). Both the groups were again subdivided into control group and study group. Supervised toothbrushing was recommended for both the groups. The toothbrushing teaching program included session on oral health education, individual toothbrushing instructions, and supervised toothbrushing. Dental caries increment, plaque scores, and gingival status were assessed as per the World Health Organization (WHO) criteria (1997), Turesky-Gilmore-Glickman modification of the Quigley Hein Plaque Index, and Loe-Silness Gingival Index (1963), respectively. Cronbach's alpha, Chi-square test, paired t-test, and unpaired t-test were utilized for data analysis. RESULTS The mean plaque and gingival score reduction was significantly higher in the study groups as compared to the control groups. An increase in the mean of Decayed, missing, filled teeth (DMFT) and Decayed, missing, filled teeth and surfaces (DMFS) scores throughout the study period was seen in children who participated in study. CONCLUSION Oral health education was effective in establishing good oral health habits among school children and also in enhancing the knowledge of their parents about good oral health.
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Affiliation(s)
- Satyawan G Damle
- Department of Pediatric and Preventive Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar University, Ambala, Haryana, India
| | - Anil Patil
- Department of Pediatric and Preventive Dentistry, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Saru Jain
- Department of Conservative Dentistry and Endodontics, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar University, Ambala, Haryana, India
| | - Dhanashree Damle
- Department of Orthodontics, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar University, Ambala, Haryana, India
| | - Nilika Chopal
- Department of Pediatric and Preventive Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar University, Ambala, Haryana, India
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Cifcibasi E, Koyuncuoglu CZ, Baser U, Bozacioglu B, Kasali K, Cintan S. Comparison of manual toothbrushes with different bristle designs in terms of cleaning efficacy and potential role on gingival recession. Eur J Dent 2014; 8:395-401. [PMID: 25202222 PMCID: PMC4144140 DOI: 10.4103/1305-7456.137655] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim was to compare the efficacy of plaque control and potential effects on gingival recession of the toothbrushes with angled and straight bristles. MATERIALS AND METHODS A total of 40 healthy dental students (25 females and 15 males; age range: 23-25 years) participated and two study groups were constituted. Participants were randomly distributed into two groups to use either angled or standard design manual tooth brushes with soft bristles. Oral hygiene indicators and soft tissue levels were monitored for 6 months. Plaque index, gingival index (GI), probing depth, clinical attachment level, and bleeding on probing were measured at six sites. Vertical recession (VR) and horizontal recession (HR) were also recorded. All measurements were repeated at 3 and 6 months. RESULTS Plaque scores were reduced significantly at 6 months compared to baseline in both groups (P < 0.05 and P < 0.005 in criss-cross and standard design brushes, respectively). Mean GI scores of the criss-cross design were reduced significantly at 6 months (P < 0.05). Inter-group comparisons revealed that gingival recession (GR) values were not statistically significant (P > 0.05) at baseline, 3 and 6 months suggesting no pronounced impact of bristle design in terms of GR (VR = 0.596, HR = 0.572; VR = 0.884, HR = 0.572; VR = 0.884, HR = 0.572 in the groups). CONCLUSIONS Bristle design has little impact on plaque removal capacity of a toothbrush. Both designs are safe enough to prevent GR as long as soft bristle material is used.
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Affiliation(s)
- Emine Cifcibasi
- Department of Periodontology, Faculty of Dentistry, University of Istanbul, Istanbul, Turkiye
| | - Cenker Zeki Koyuncuoglu
- Department of Periodontology, Faculty of Dentistry, University of Istanbul Aydin, Istanbul, Turkiye
| | - Ulku Baser
- Department of Periodontology, Faculty of Dentistry, University of Istanbul, Istanbul, Turkiye
| | | | - Kamber Kasali
- Department of Biostatistics, Faculty of Medicine, University of Istanbul, Istanbul, Turkiye
| | - Serdar Cintan
- Department of Periodontology, Faculty of Dentistry, University of Istanbul, Istanbul, Turkiye
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Rosema NAM, Hennequin-Hoenderdos NL, Versteeg PA, van Palenstein Helderman WH, van der Velden U, van der Weijden GA. Plaque-removing efficacy of new and used manual toothbrushes - a professional brushing study. Int J Dent Hyg 2013; 11:237-43. [DOI: 10.1111/idh.12021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2013] [Indexed: 11/30/2022]
Affiliation(s)
- NAM Rosema
- Department of Periodontology; Academic Centre for Dentistry; Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam; the Netherlands
| | - NL Hennequin-Hoenderdos
- Department of Periodontology; Academic Centre for Dentistry; Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam; the Netherlands
| | - PA Versteeg
- Department of Periodontology; Academic Centre for Dentistry; Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam; the Netherlands
| | | | - U van der Velden
- Department of Periodontology; Academic Centre for Dentistry; Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam; the Netherlands
| | - GA van der Weijden
- Department of Periodontology; Academic Centre for Dentistry; Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam; the Netherlands
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Slot DE, Wiggelinkhuizen L, Rosema NAM, Van der Weijden GA. The efficacy of manual toothbrushes following a brushing exercise: a systematic review. Int J Dent Hyg 2012; 10:187-97. [DOI: 10.1111/j.1601-5037.2012.00557.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lee DW, Moon IS. The plaque-removing efficacy of a single-tufted brush on the lingual and buccal surfaces of the molars. J Periodontal Implant Sci 2011; 41:131-4. [PMID: 21811688 PMCID: PMC3139046 DOI: 10.5051/jpis.2011.41.3.131] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 05/17/2011] [Indexed: 12/03/2022] Open
Abstract
PURPOSE To test the plaque-removal efficacy of a single-tufted toothbrush on the posterior molars compared with a flat-trimmed toothbrush. METHODS Forty-nine subjects were selected. Professional instruction and written brushing instructions were given. After thorough supra-gingival scaling and polishing, all subjects were asked to abstain from oral hygiene procedures for 24 hours prior to the first experiment. The subjects were randomized to a treatment sequence. The modified Quigley and Hein plaque index was recorded pre- and post-tooth brushing, at 6 surfaces of the posterior molars. After a wash-out period, all the remaining plaque was removed professionally. Twenty-four hours of brushing abstinence was again performed. The plaque index was recorded pre- and post-tooth brushing after the subjects were given the second toothbrush in the cross-over sequence. RESULTS The percentage reductions in plaque scores achieved with the single-tufted brushes were significantly higher than those of the flat-trimmed brush at the maxillary buccal interproximal, marginal and mandibular lingual interproximal site. The other locations showed no significant difference. CONCLUSIONS The results of the present study implied that the single-tufted brush could be an effective tool for the removal of plaque at some, but not all, sites of the posterior molars.
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Affiliation(s)
- Dong-Won Lee
- Department of Periodontology, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Ik-Sang Moon
- Department of Periodontology, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Stroski ML, de Souza Dal Maso AM, Wambier LM, Chibinski ACR, Pochapski MT, Santos FA, Wambier DS. Clinical evaluation of three toothbrush models tested by schoolchildren. Int J Dent Hyg 2011; 9:149-54. [PMID: 21356018 DOI: 10.1111/j.1601-5037.2010.00476.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED AIM The aim of this single-blind cross-over study was to compare the performance of three different toothbrush models in the control of dental biofilm and maintaining a healthy gingival condition. METHODS Twenty-seven schoolchildren (aged 9-10 years) participated in the study. Three toothbrushes with different bristle arrangements were used: T1 - bristles on the same plane, straight arrangement; T2 - bristles on different planes, straight arrangement; T3 - bristles on different planes, straight and circular arrangement. The participants were then randomly divided into three groups for brushing with one of the three toothbrushes. Each experimental period lasted 15 days each, with three daily brushings and a 7-day washout interval was used between periods. The oral hygiene and gingival bleeding indices were recorded by a single, calibrated examiner blind to the brush used. Bristle wear was measured with a digital calliper at the end of each period. The data were analysed using parametric (anova and Student's t-test) and non-parametric (Cochran's Q and McNemar) tests. RESULTS The toothbrushes achieved similar results (P>0.05) for the clinical parameters investigated. The three models exhibited a similar degree of bristle wear (P>0.05). CONCLUSION The arrangement of the bristles had little influence over the removal of biofilm and gingival conditions. Thus, there is no clinical justification for replacing conventional toothbrushes with more expensive models.
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Affiliation(s)
- M L Stroski
- Department of Dentistry, Ponta Grossa State University, School of Dentistry, Ponta Grossa, Paraná, Brazil
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Mantokoudis D, Joss A, Christensen MM, Meng HX, Suvan JE, Lang NP. Comparison of the clinical effects and gingival abrasion aspects of manual and electric toothbrushes. J Clin Periodontol 2008. [DOI: 10.1111/j.1600-051x.2001.280110.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Van der Weijden GA, Timmerman MF, Piscaer M, IJzerman Y, Van der Velden U. Plaque removal by professional electric toothbrushing compared with professional polishing. J Clin Periodontol 2004; 31:903-7. [PMID: 15367196 DOI: 10.1111/j.1600-051x.2004.00582.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This parallel examiner blind study was designed to compare the results of professional brushing with an electric toothbrush (ETB, Braun Oral-B 3D Excel) to a professional polish session. MATERIAL AND METHODS For this study, 90 non-dental students were selected. All received a single oral prophylaxis where plaque and calculus were removed and the teeth were polished so that all subjects started with equally clean teeth. Approximately 4 weeks later the subjects received a new appointment prior to which they were asked to abstain from oral hygiene procedures for at least 48 h. At baseline the examiner (M.P.) evaluated the amount of dental plaque (Sillness & Löe) at six surfaces of each tooth. Subsequently, in the absence of this examiner, the subject's teeth were brushed or polished by a dental hygienist (Y.I.J.). Three groups were formed; the subjects in Group 1 received 10 min of polishing with a rubber cup/point using dentifrice as abrasive paste, in Group 2 subjects were brushed for 2 min with an ETB and dentifrice by the hygienist and in Group 3 brushing for 10 min was performed with an ETB and dentifrice. Care was taken to call upon the examiner always >10 min after her leaving the room so that she was unaware of the treatment. Electric brushing was carried out carefully following the contour of the teeth and turning the brush head separately in the direction of the mesial and distal aspect of each tooth in each approximal space. After finishing with the brushing/polishing, the examiner re-evaluated the amount of remaining dental plaque. RESULTS The baseline plaque levels in Groups 1-3 were 1.54, 1.62 and 1.55, respectively. The reduction in plaque scores in Group 1 was 94.8% (+/-4.0), for Group 2 94.2% (+/-4.7) and for Group 3 99.4% (+/-0.5). The results in Group 3 were significantly better than in Groups 1 and 2. Explorative analysis revealed that these differences were due to a higher plaque removal from the approximal surfaces and molars. CONCLUSION Two minutes of professional brushing with an ETB was as effective as 10 min of professional polishing. Whereas 10 min with an ETB was even more effective.
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Affiliation(s)
- G A Van der Weijden
- Department of Periodontology, Academic Center for Dentistry Amsterdam, ACTA, Amsterdam, The Netherlands.
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Claydon N, Moran J, Newcombe RG, Smith SR, Addy M. Clinical development and evolution in plaque removal performance of a battery powered toothbrush. J Clin Periodontol 2004; 31:835-9. [PMID: 15367185 DOI: 10.1111/j.1600-051x.2004.00596.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM There is growing evidence that the new generation of electric toothbrushes are more effective than manual toothbrushes. The primary aim of these studies was to compare, as an indication of the stage of development, the plaque removal properties of a prototype battery powered toothbrush with an established product. A secondary aim was to utilise the data to appraise plaque accumulation together with the patterns of removal. METHOD The three studies presented used the same, single-examiner, randomised, single-blind cross-over design involving up to 24 healthy volunteers. The prototype brushes, E6500 versions s1, s2 and s3 and E8000 with head speeds of 6500 and 8000 oscillations/min were compared with a similar design marketed product (MP) with a head speed of 8800 oscillations/min. All brushes had circular brush heads with oscillating rotating actions. Subjects accumulated plaque over a 4-day period during which no oral hygiene measures were performed. On day 4, the plaque accumulation was scored by index. Subjects then used the allocated toothbrush for 2 min. This was followed by a re-scoring of the remaining plaque. RESULTS Studies 1 and 2 showed significantly less plaque removed by prototype E6500 (s1) and prototype E6500 (s2), respectively, than by MP. In study 3, prototype E8000 removed similar quantities of plaque to MP (approximately 65%). In contrast prototype E6500 (s3) only removed 60% of accrued plaque. Differences, however, did not reach statistical significance. CONCLUSIONS The study methodology was appropriate to distinguish between the study toothbrushes and was furthermore able to establish a level of comparability for one of the prototype modifications with a similar MP.
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Affiliation(s)
- N Claydon
- Division of Restorative Dentistry, Dental School, University of Bristol, Bristol, UK
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Lazarescu D, Boccaneala S, Illiescu A, De Boever JA. Efficacy of plaque removal and learning effect of a powered and a manual toothbrush. J Clin Periodontol 2003; 30:726-31. [PMID: 12887341 DOI: 10.1034/j.1600-051x.2003.00361.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Subjects with high plaque and gingivitis scores can profit most from the introduction of new manual or powered tooth brushes. To improve their hygiene, not only the technical characteristics of new brushes but also the learning effect in efficient handling are of importance. AIM : The present study compared the efficacy in plaque removal of an electric and a manual toothbrush in a general population and analysed the learning effect in efficient handling. METHOD Eighty healthy subjects, unfamiliar with electric brushes, were divided into two groups: group 1 used the Philips/Jordan HP 735 powered brush and group 2 used a manual brush, Oral-B40+. Plaque index (PI) and gingival bleeding index (GBI) were assessed at baseline and at weeks 3, 6, 12 and 18. After each evaluation, patients abstained from oral hygiene for 24 h. The next day a 3-min supervised brushing was performed. Before and after this brushing, PI was assessed for the estimation of the individual learning effect. The study was single blinded. RESULTS Over the 18-week period, PI reduced gradually and statistically significantly (p<0.001) in group 1 from 2.9 (+/-0.38) to 1.5 (+/-0.24) and in group 2 from 2.9 (+/-0.34) to 2.2 (+/-0.23). From week 3 onwards, the difference between groups was statistically significant (p<0.001). The bleeding index decreased in group 1 from 28% (+/-17%) to 7% (+/-5%) (p<0.001) and in group 2 from 30% (+/-12%) to 12% (+/-6%) (p<0.001). The difference between groups was statistically significant (p<0.001) from week 6 onwards. The learning effect, expressed as the percentage of plaque reduction after 3 min of supervised brushing, was 33% for group 1 and 26% for group 2 at week 0. This percentage increased at week 18 to 64% in group 1 and 44% in group 2 (difference between groups statistically significant: p<0.001). CONCLUSION The powered brush was significantly more efficient in removing plaque and improving gingival health than the manual brush in the group of subjects unfamiliar with electric brushes. There was also a significant learning effect that was more pronounced with the electric toothbrush.
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Affiliation(s)
- D Lazarescu
- Department of Periodontology, Conservative Dentistry, Dental School, Carol Davila University, Bucharest, Romania
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Danser MM, Timmerman MF, Jzerman Y, Piscaer MI, van der Velden U, van der Weijden GA. Plaque removal with a novel manual toothbrush (X-Active) and the Braun Oral-B 3D Plaque Remover. J Clin Periodontol 2003; 30:138-44. [PMID: 12622856 DOI: 10.1034/j.1600-051x.2003.00114.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The study was designed to test the efficacy in plaque removal of three toothbrushes: two manual brushes, the Butler GUM 311 and the Dr Best X-Active, and one electric toothbrush the Braun Oral-B 3D Plaque Remover (3D). METHOD The study was a split-mouth, single-blind, randomized clinical study consisting of three identical experiments testing three combinations of toothbrushes (experiment 1: 3D versus Butler; experiment 2: 3D versus Dr Best; experiment 3: Butler versus Dr Best), in which the teeth of the panellists were brushed by a dental hygienist. In a fourth experiment, the panellists brushed their own teeth (3D versus Dr Best). Thirty-five subjects participated in the study and received a professional prophylaxis prior to the first experiment. They were requested to refrain from brushing their teeth for 48 h prior to each experiment. Plaque was assessed according to the Silness & Löe plaque index at six sites per tooth. Next, the dental hygienist (experiments 1-3) or the panellist (experiment 4) brushed for 60 s with their first assigned brush in two randomly selected contralateral quadrants. Brushing was repeated (60 s) with the second brush in the opposing two contralateral quadrants. Prior to experiment 4, panellists were given two thorough hands-on professional instructions in the use of the 3D and the Dr Best toothbrushes. RESULTS In experiment 1, the 3D showed a mean plaque reduction of 72% compared to 63% with the Butler (P<0.01). In experiment 2, the 3D showed a mean plaque reduction of 79% and the Dr Best 76% (P<0.05). In experiment 3, the Butler showed a mean plaque reduction of 81% and the Dr Best 85% (P=0.01). In the hands of the panellists (experiment 4), the 3D showed a mean plaque reduction of 88% and the Dr Best 84% (P<0.05). CONCLUSIONS A 5-week training period with repeated hands-on instruction gives panellists the skill to perform brushing with efficacy comparable to that of professional brushing. In agreement with a previous study, the 3D was more effective than a flat-trimmed manual toothbrush (Van der Weijden et al. 1994). Brushing with the criss-cross resulted in small statistical differences with the 3D and the flat-trimmed manual toothbrush. The clinical relevance of these statistically significant results should be the subject of a longitudinal study.
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Affiliation(s)
- M M Danser
- Department of Periodontology, ACTA, Academic Centre for Dentistry Amsterdam, The Netherlands.
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Claydon N, Addy M, Scratcher C, Ley F, Newcombe R. Comparative professional plaque removal study using 8 branded toothbrushes. J Clin Periodontol 2002; 29:310-6. [PMID: 11966928 DOI: 10.1034/j.1600-051x.2002.290406.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Considerable interest has been shown in the plaque removal properties of modern toothbrush designs. The primary aim of the study was to compare the plaque removal properties of 8 relatively recent designs of manual toothbrush using a professional tooth brusher and within a commonly used time frame. A secondary aim was established to utilise the data to observationally appraise plaque accumulation together with the patterns of removal as a consequence of using the timed professional tooth brusher. METHOD The method was an 8-period, single-examiner, randomized, blind cross-over study involving 24 healthy volunteers, balanced for residual effects. Subjects accumulated plaque over a 4 day no oral hygiene period. On day 4, the accumulated plaque was scored by plaque index at the mesial, mid and distal sites of each of the buccal and lingual surfaces of the assessed teeth. Subjects were then removed from the assessment area where they received a professional brushing timed to last 48 s. Brushing was completed according to pre-study training without toothpaste and was followed by a re-scoring of the remaining plaque. A washout period of 3 days was then allowed prior to the next period during which normal oral hygiene was resumed. RESULTS Similar quantities of plaque accumulated in each arch, although the difference between the buccal and lingual surfaces was of the order of 30%. The professional toothbrusher removed approximately 40% of the accumulated plaque in the 48 s allocated. The buccal surfaces were most effectively cleaned (approximately 45%) compared with the lingual (approximately 25%), with the plaque removal in the mesial and mid sections approaching 40% and 60% respectively. The difference in performance between the test brushes corresponded to 5% of the residual plaque values with none being significantly more efficient overall. Pair wise site comparisons did produce differences of the order of 10% (p=0.004) at the mesio-buccal, and 8% (p=0.030) at the mid-buccal sites respectively in favour of 2 brushes compared to one other brush. CONCLUSIONS These data derived from a standardized brushing method support the contention of many researchers that there is no one superior design of manual toothbrush. The minor and few site differences in favour of some brushes are unlikely to be of clinical significance to gingival health. This leaves uncontested the conclusion that the user is by far the most significant variable. Perhaps methods such as used in the present study could be more gainly employed to set a minimum standard of toothbrush efficacy.
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Affiliation(s)
- N Claydon
- Division of Restorative Dentistry, Dental School, Bristol, UK
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Mantokoudis D, Joss A, Christensen MM, Meng HX, Suvan JE, Lang NP. Comparison of the clinical effects and gingival abrasion aspects of manual and electric toothbrushes. J Clin Periodontol 2001; 28:65-72. [PMID: 11142669 DOI: 10.1034/j.1600-051x.2001.280110.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS The clinical effects and gingival abrasion aspects of 2 electrical tooth-brushes (Braun Oral-B Plak Control Ultra and the novel development Braun Oral-B Plak Control 3D) were to be compared with conventional manual tooth-brushing. MATERIAL AND METHODS In a cross-over study, 26 dental student volunteers participated and were assigned to 1 of 3 groups. Following instruction in the use of the electric as well as manual toothbrushes, the volunteers were timed for 2 min each day to apply one electric or the manual toothbrush, respectively, during 3 experimental phases of 2 weeks. No other methods of tooth cleaning were to be performed except the one specified for the respective test period. When brushing manually, the Bass toothbrushing technique was applied. Between each test period, a recovery period of 1 week was allowed during which no oral hygiene was performed at all. At the start and the end of each of the experimental periods, the extension of plaque deposits from the gingival margin in coronal direction was assessed using the Turesky et al. modification of the Quigley and Hein plaque index. Presence or absence of gingival inflammation was evaluated by bleeding and probing (BOP). The extent and severity of gingival abrasions were assessed by use of a modified method of Breitenmoser et al. and adapted by Danser et al. RESULTS The plaque-reducing effect was similar in all groups with the same cleaning regime. For that reason, the result of the different experimental phases with the respective cleaning modalities were collapsed. Cleaning with the Braun Oral-B Plak Control Ultra electric toothbrush resulted consistently in the lowest plaque scores when compared to both the Braun Oral-B Plak Control 3D and the manual toothbrush. Although the differences in plaque reduction were statistically significant between cleaning with Braun Oral-B Plak Control Ultra and 3D, they were small and of questionable clinical relevance. No significant differences in plaque reductions were found between manual brushing and any of the 2 electric brushes. Gingival abrasions were least pronounced following brushing with the Braun Oral-B Plak Control 3D electric toothbrush. However, no significant differences in gingival abrasion were encountered following brushing with the Braun Oral-B Plak Control Ultra electric in comparison with the manual toothbrush. CONCLUSIONS The results of the present study have shown that in a group of dental students trained in manual brushing technique, where efficacy was similar with the 3 toothbrushes tested, there is no evidence of greater gingival abrasion with either Braun Oral-B Plak Control Ultra or 3D when compared with a manual brush.
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Affiliation(s)
- D Mantokoudis
- University of Berne School of Dental Medicine, Switzerland
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Savill G, Grigor J, Huntingdon E, Jackson R, Lynch E. Toothbrush design: adapting for the future. Int Dent J 1998. [DOI: 10.1111/j.1875-595x.1998.tb00499.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Affiliation(s)
- D Cummins
- Unilever Research Laboratory, Merseyside, United Kingdom
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