Evaluation of clinical effectiveness and subjective satisfaction of a new toothbrush for postsurgical hygiene care: a randomized split-mouth double-blind clinical trial

In-vitro comparison of two different toothbrush bristles about peri-implant sulcus penetration

OBJECTIVE

The aim of this preclinical study was to compare the ability of tapered and cylindrical bristles to penetrate the peri-implant sulcus.

METHODS

A full mandibular dental arch was reproduced in plaster cast. In site #3.6 a hollow glass cylinder was positioned simulating a 4 mm diameter implant and the gingival component was recreated by using dedicated silicone. A Bass brushing technique was performed from the vestibular side in humid environment. During it, the penetration of the bristles between the gum and the implant was recorded by mean of an optic fibre fixed inside the cylinder. The protocol included 5 toothbrushes per group and 10 tests per toothbrush, for a total of 50 assessments for each of the two groups. A scale of 5 grades for bristle penetration was defined: grade 0 (× < 2 mm), grade 1 (2 ≤ × < 3 mm), grade 2 (3 ≤ × < 4 mm), grade 3 (4 ≤ × < 5 mm) and grade 4 (5 ≤ × < 8 mm). From the video recordings the highest value of penetration was identified for each test.

RESULTS

The tapered bristles showed an 8 times greater penetration capacity (p = 0.001) in respect to the cylindrical bristles (multilevel analysis). The percentage of tests reaching depths ≥3 mm was 86% for tapered group and 28% for the cylindrical group.

CONCLUSION

This preclinical study shows a clear and superior penetration capacity of the tapered bristles in respect to traditional cylindrical ones. For tapered bristles, a potentially greater hygienic efficacy around dental implants is suggested.

Endodontic and periodontal treatment of complete buccal root and apex exposition: A challenging case report with 17 months follow-up

INTRODUCTION

This case report demonstrated a challenging clinical case addressed within a multidisciplinary approach to achieve its maintenance, even though had a poor prognosis. It was associated with the endodontic treatment with mucogingival techniques, including periodontal microsurgery and connective tissue graft.

CASE PRESENTATION

A patient presented a deep gingival recession with the apex-exposed non-vital tooth with interproximal bone loss (RT2) and without mobility. The treatment involved an initial endodontic approach and periodontal therapy (scaling and root planing), microsurgical techniques with coronally advanced flap, root preparation with PrefGel (24% EDTA), enamel matrix derivatives (Emdogain), and connective tissue graft. As a clinical result, it was verified an increase of keratinized tissue width and gingival thickness, and root coverage (RC), reaching good esthetics and a stable result after 17 months.

CONCLUSION

The correct diagnosis and technique selection may affect directly the outcome, especially in challenging cases. Even though there was a poor prognosis, an adequate treatment plan, patient cooperation, and technique mastery help to achieve a high level of RC, esthetic recovering, and successful outcome.

Evaluation of the Effect of Ultra-Soft Toothbrushes with Different Commercial Brands on Plaque and Bleeding Indices

STATEMENT OF THE PROBLEM

Ultra-soft bristles are recommended for individuals with gingival recession, dentinal hypersensitivity, and patients who have undergone periodontal surgeries. However, comparative effectiveness of ultra-soft toothbrushes on dental plaque and bleeding indices has not extensively been studied, and a consensus has yet to be reached on their efficacy.

PURPOSE

The aim of this study was to investigate the effect of ultra-soft toothbrushes with different commercial brands on plaque and bleeding indices.

MATERIALS AND METHOD

In this crossover randomized clinical trial, 30 participants were selected using convenience sampling method. The subjects were randomly divided into three groups (n=10). In the first session, the bleeding index was recorded. Then each subject was given a toothbrush (Oral B, GUM, or Fuchs), asked to brush at least twice a day using the Bass technique, then avoid brushing for 24 hours after a week and refer for recording the indices. During the second session, bleeding on probing was recorded before brushing, and plaque indices were recorded before and after brushing. Plaque indices before brushing were considered the baseline plaque indices. After one week of washout, each subject used the next toothbrush in terms of the group involved. Turesky plaque index, O'Leary plaque index, and bleeding index were evaluated. The distribution of data was normal. Therefore, ANOVA, t-test, and post hoc tests were used for the analysis of data.

RESULTS

The bleeding and plaque indices decreased significantly compared to the baseline with the use of all the three ultra-soft toothbrushes evaluated (p< 0.05), with no significant differences between the three brands (p> 0.05) except for the superiority of Fuchs toothbrush in decreasing the Turesky plaque index.

CONCLUSION

Ultra-soft toothbrushes can reduce plaque index compared to the baseline, but they do not decrease the plaque index up to the optimal level, which might affect their prescription.