Tapered toothbrush filaments in relation to gingival abrasion, removal of plaque and treatment of gingivitis

A novel toothbrush with a thin-head, slender-neck and super-tapered bristles enhancing accessibility in hard-to-reach areas: a crossover randomized trial

BACKGROUND

Toothbrushing is the most commonly used method to physically remove dental plaque. However, there are many areas of the mouth that are difficult to reach with a toothbrush. The type of toothbrush is a critical factor influencing the effectiveness of oral care. The purpose of the study was to evaluate a toothbrush with a thin head, slender-neck and super-tapered bristles to target hard-to-reach areas in the oral cavity for reducing dental plaque and gingivitis.

METHODS

This crossover study included 58 adults aged 20 years and older. All participants were randomly assigned to use test and control toothbrushes (the latter had a normal head and round bristles) for two 4-week phases. Participants brushed their teeth twice daily in their habitual manner. At the start and end of each phase the Silness-Lӧe plaque index (PI), Lӧe -Silness gingival index (GI) and bleeding-on-probing index (BOP) were assessed and performed plaque fluorescence tests using quantitative light-induced fluorescence technology.

RESULTS

After using the test toothbrush, PI, GI and BOP decreased by 25%, 30% and 48%, respectively (P < 0.05). For the rearmost molars, PI, GI and BOP decreased by 18%, 26% and 47%, respectively (P < 0.05). For the implants, GI and BOP decreased by 31% and 57%, respectively (P < 0.05). The plaque fluorescence tests indicated that after using the test toothbrush, the dental plaque area for the anterior teeth and the simple plaque score for the rearmost molars decreased by 25% (P < 0.05) and 14% (P = 0.527), respectively.

CONCLUSIONS

The test toothbrush was markedly better than the control toothbrush at reducing dental plaque and gingivitis. In particular, the test toothbrush produced an excellent reduction in dental plaque and gingivitis for the rearmost molars and the implants.

TRIAL REGISTRATION

KCT0009669, retrospectively registered 02/08/2024.

Analysis of the Deflection, Bristle Splaying, and Abrasion of a Single Tuft of a Polybutylene Terephthalate Toothbrush after Use: A Randomized Controlled Trial

The aim of this study is to clarify the deflection, splaying, and abrasion of single tufts of polybutylene terephthalate (PBT) toothbrushes after use. A single-center randomized controlled trial is performed. The changes in deflection, bristle splaying, and abrasion are investigated for the middle single tuft of the top line (top–middle tuft) and the middle single tuft of the bottom line (bottom–middle tuft) of PBT toothbrushes with medium stiffness after 1 month, 2 months, and 3 months of use by 34 participants. A soft-material bending-resistance tester is used to assess the deflection of the single tufts. The deflection value of the top–middle tuft significantly increased after 1 month of use compared with the baseline. In contrast, the deflection of the bottom–middle tuft significantly increased after 3 months of use compared with the baseline and after 1 month and 2 months of use. Importantly, the change in deflection was distinctly different between the top– and bottom–middle tufts. The bristle splaying of both tufts significantly increased after use, but a significant change in bristle abrasion was not found. The bending stiffness of the top tuft of a PBT toothbrush may decrease more rapidly than that of the bottom tuft with use.

ANTI-PLAQUE AND ANTI-GINGIVITIS EFFICACY OF DIFFERENT BRISTLE STIFFNESS AND END-SHAPE TOOTHBRUSHES ON INTERPROXIMAL SURFACES: A SYSTEMATIC REVIEW WITH META-ANALYSIS

OBJECTIVE

This systematic review aimed to evaluate the efficacy of interproximal plaque scores and gingival inflammation reduction of different toothbrush bristle stiffness and end-shape.

METHODS

Randomized clinical trials evaluating the effect of different toothbrushes on interproximal plaque/gingivitis reduction, with a minimum follow-up of 1 week. MEDLINE-PubMed, Scopus and Embase were searched. Soft tapered-tip bristle toothbrushes were compared to soft end-rounded, medium (any end-shape), or hard (any end-shape) bristle toothbrushes. Two meta-analyses were performed for plaque and gingivitis reduction. For plaque index (PI) and gingival index (GI), a standard mean difference (SMD) and mean difference between baseline and 4 weeks were calculated, respectively. In all analyses, random effect models were used.

RESULTS

Nine studies were included. All included studies demonstrated statistically significant improvement, in at least one parameter, in favor of the tapered-tip bristle toothbrush compared to the end-rounded bristle toothbrush. When analyzing toothbrush stiffness, medium and hard toothbrushes presented significantly higher improvement when compared to soft toothbrushes in all parameters. In the meta-analyses, groups that used soft tapered-tip bristle toothbrushes demonstrated significant greater reductions in PI (SMD -2.64; 95% CI: -4.26 - -1.01) and in GI (MD -0.14; 95% CI: -0.18 - -0.10) when compared to soft end-rounded bristle toothbrushes.

CONCLUSION

It is concluded that, when considering interproximal surfaces, better results may be expected for tapered-tip bristle toothbrushes when compared to end-rounded bristles toothbrushes. Additionally, better results may be expected in medium or hard toothbrushes, regardless of the bristle end-shape, in non-interproximal cleaners.

Comparison of different tooth brushes on the degree of plaque removal

Background

At present, different designs of tooth brushes are available, each one is being claimed to be the best by their manufacturers. There is a need to compare the plaque removal efficacy of the most popular designs.

Aim

The aim of the present study was to compare the degree ofplaque removal obtained with the use of two commercially available tooth brushes with round ended and thinner tip bristles.

Materials and Methods

The study involved 60 subjects within age range 18-40 years, randomly distributed into 2 groups, 30 in each: Group A- round ended bristle, Group B- thinner tip bristle. Turesky, Gilmore, Glickman Modification of Quigley-Hein Plaque Index, (1970), (PI) was assessed at baseline, 2 weeks, 4 weeks, and 6 weeks; and Muhlemann and Son, (1971), Sulcus bleeding index (SBI) at baseline and 2 weeks were assessed in each subject. Scaling was done at 2^nd week, 4^th week, and 6^th week after assessment of parameter. At 4^th week the subjects were switched over to another type of brush for crossover evaluation.

Results

Over 2 weeks, both the groups showed significant (P < 0.05) reduction in plaque score, better reduction in Group A with mean differences of 0.48 than 0.41 in Group B, though it was insignificant on intergroup comparison (P = 0.09). There was reduction in SBI in both groups with mean difference of 0.50 in Group A and 0.11 in Group B and this was statically insignificant. But on comparison, between the two groups at 2 weeks, statically significant reduction was there in Group A. Brushing with specified brush, after scaling, at 4^th week Group A had significantly better plaque control (P < 0.01). Upon crossover analysis, better efficiency of round ended bristles was observed but it did not reach the significance level (P = 0.126).

Conclusion

Within the limitations of the study, the data derived from the study show that both the toothbrushes had shown decrease in plaque scores. Round ended bristles were more efficient.

Are bristle stiffness and bristle end-shape related to adverse effects on soft tissues during toothbrushing? A systematic review

BACKGROUND

Toothbrushing might be associated with the development of soft tissue lesions. This systemic review aimed to examine soft tissue lesions caused by different bristle stiffnesses and bristle end-shapes in manual toothbrushes in adult individuals.

MATERIALS AND METHODS

Scopus, EMBASE and PubMed databases were searched to find controlled trials that evaluated manual toothbrush bristle stiffness and/or end-shape in regard to soft tissue safety. The grey literature was also included in the search strategy. Two reviewers independently performed the screening, final selection and data extraction. To be included, studies had to have been performed using at least two manual toothbrushes differing in bristle stiffness and/or end-shape, and had to report any adverse effects on oral soft tissues after at least 7 days of follow-up. A meta-ethnography strategy was used for qualitative data synthesis. The Cochrane Collaboration tool was assessed to evaluate the risk of bias.

RESULTS

Thirteen studies were included from the 1,945 initially retrieved. Toothbrush bristle end-shape was investigated in six studies, bristle stiffness in two, and both features were investigated in five studies. Hard-bristle toothbrushes produced more gingival lesions than medium- and soft-bristle brushes. A slight gingival recession width increase was identified in the end-rounded group, compared with the tapered group. Only four studies presented adverse effects as the primary outcome.

CONCLUSION

Soft and extra-soft toothbrushes tend to be safer. Oral soft tissue injuries are similar for both tapered and end-rounded bristles. Further studies investigating adverse effects as a primary outcome are recommended.

A 5-week randomized clinical evaluation of a novel electric toothbrush head with regular and tapered bristles versus a manual toothbrush for reduction of gingivitis and plaque

Objective

To evaluate the efficacy of an oscillating‐rotating (O‐R) electric rechargeable toothbrush with a novel round brush head comprised of regular and tapered bristles in reducing plaque and gingivitis versus a manual toothbrush.

Methods

This was a randomized, examiner‐blind, parallel group, five‐week study. Participants with mild‐to‐moderate plaque and gingivitis received an oral examination and were evaluated for baseline plaque (Rustogi Modified Navy Index), gingivitis (Modified Gingival Index) and gingival bleeding (Gingival Bleeding Index). Qualifying participants were randomly assigned to the novel Oral‐B sensitive brush head (EB60) on an Oral‐B Vitality O‐R handle (D12) or an ADA manual toothbrush. Participants brushed twice daily with the assigned brush and a standard fluoride dentifrice for 5 weeks before returning for an oral examination and plaque and gingivitis evaluations.

Results

A total of 150 participants were randomized to treatment and completed the study (mean age = 45.7 years). Both brushes demonstrated a statistically significant reduction in number of bleeding sites versus baseline (P < 0.001). At Week 5, the number of bleeding sites was reduced from baseline by 11.15 (52.2%) for the O‐R brush and 5.04 (23.6%) for the manual brush. The treatment difference was statistically significant (P < 0.001). Significant reductions versus baseline (P < 0.001) were also seen for both brushes for MGI, GBI and Rustogi plaque measures (whole mouth, gingival margin and proximal), but the O‐R brush produced significantly greater reductions versus the manual brush (P < 0.001).

Conclusion

The O‐R handle and round brush head with tapered and regular bristles produced greater plaque and gingivitis reductions than the manual brush.

Effect of Toothbrushing-mouthrinse-cycling on Surface Roughness and Topography of Nanofilled, Microfilled, and Microhybrid Resin Composites

The purpose of this study was to evaluate the influence of toothbrushing-mouthrinse-cycling (TMC) on the surface roughness and topography of three resin composites with different filler particle systems (Z350, nanofilled [Nf]; Durafill, microfilled [Mf], and Empress Direct, microhybrid [Mh]). Twenty specimens of each resin composite (8.0 mm diameter and 2 mm height) were randomly divided into four groups (n=5) according to the mouthrinses: alcohol-free (Plax – P) and alcohol-containing (Listerine – L and Plax Fresh Mint – PM) and artificial saliva (control – AS). The specimens were submitted to TMC for nine weeks. A surface roughness tester and a three-dimensional profilometer were used to measure the roughness (Ra) and the topography (Sa) before and after TMC. The data were analyzed by multifactor analysis of variance and Tukey post hoc test (α=0.05). In all media, Mh presented greater roughness than Mf (p&lt;0.05). The highest value of roughness was presented by Mh immersed in L (p&lt;0.05). The lowest values of roughness were presented by Mf (p&lt;0.05). The three resin composites presented the highest roughness after immersion in mouthrinses containing alcohol (PM and L) (p&lt;0.05). For the three resin composites, the increase in roughness was noticeable after the fifth week. Topographic analysis showed that the smoothest surfaces were present after immersion in AS.