Comparative study of 2 electric and 2 manual toothbrushes in patients with fixed orthodontic appliances

doi:10.1067/mod.2001.116402

American Journal of Orthodontics and Dentofacial Orthopedics

Volume 120, Issue 4, October 2001, Pages 353-360

https://doi.org/10.1067/mod.2001.116402 Get rights and content

Abstract

The objective of this prospective single-blind crossover clinical trial was to evaluate the efficacy of 4 toothbrushes in 33 children undergoing fixed appliance orthodontic therapy. The toothbrushes included in this study were the Braun Oral-B 3D Plaque Remover (Kronberg, Germany), the Philips-Jordan HP 510 (Philips Domestic Appliances, Groningen, The Netherlands), the Lactona orthodontic toothbrush (Bergen op Zoom, The Netherlands), and the Oral-B Advantage Control Grip (Braun); the first 2 are electric, and the last 2 are manual. Every patient tested each type of toothbrush in a randomly designed sequence. Plaque and gingival scores were recorded at baseline and after every 4-week test period. All patients received professional prophylaxis after each clinical evaluation. The data were analyzed with the Friedman test, which showed no significant differences among the 4 brushes for any of the parameters measured. The Wilcoxon signed rank test, comparing the plaque and the gingival scores between the upper and lower jaw for each brush, indicated that plaque removal was more efficient in the lower jaw than in the upper. (Am J Orthod Dentofacial Orthop 2001;120:353-60)

Section snippets

Material and methods

This study was a single-blind, crossover clinical trial, carried out in the Department of Orthodontics at the University of Ghent, Belgium, from February 1999 through January 2000.

The study was interrupted for practical reasons during the summer holidays (July and August 1999). For the clinical trial, 36 patients were selected (18 boys and 18 girls). Their mean age was 13 years 6 months (range, 11 years 1 month to 24 years 5 months).

Participants had to be in good health and undergoing full

Results

The between-brush effect was analyzed for each parameter at baseline and after each experimental period. No significant differences were found among the patients for baseline clinical indexes. This indicates that a 1-month washout period brought all participants to a comparable baseline. There were no significant differences among the 4 brushes concerning GI, BOPI, PIT, and PIB in the complete dentition (Fig 3).

. Overall mean values and standard deviations for different indexes.

No statistically

Discussion

Many investigators have compared the efficacy of electric and manual toothbrushes in nonorthodontic patients. However, a toothbrush that performs well in nonorthodontic patients will not necessarily work well in orthodontic patients. Most oral-hygiene studies in orthodontic patients have compared different electric brushes with a manual (control) brush, whereas in this study, 4 different toothbrushes (2 electric and 2 manual) were compared with each other over a longer period and in a larger

Conclusion

This study found no difference in efficacy among the 2 manual and the 2 electric toothbrushes in children undergoing fixed orthodontic appliance therapy concerning gingival index, bleeding on probing index, and plaque index. Therefore, orthodontists should focus on enhancing their patients' dental awareness and oral hygiene along with professional prophylaxis and fluoride applications.

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Randomized multicenter study on the plaque removal efficacy of 2 interdental brushes around the base of orthodontic brackets
2023, American Journal of Orthodontics and Dentofacial Orthopedics
The objective of this multicenter study was to analyze the efficacy of cleaning 2 interdental brushes (IDBs) around brackets in patients with fixed orthodontic appliances.
The study design was a multicenter, randomized, examiner-blinded crossover study with 3 interventions, the first of which was a baseline intervention. This study included 20 patients (12 females, 8 males) aged 12-18 years with fixed orthodontic devices examined at the Department of Orthodontics, University Medical Center of the Johannes Gutenberg University Mainz, and the Children’s Dental Clinic St. Gallen. The outcome was a conventional, cylindrically shaped IDB (IDBG-S [IB]; Top Caredent GmbH, Schönau, Germany) was examined in comparison with an innovative waist-shaped IDB (Circum, CDB-8 [CB]; Top Caredent GmbH). The participants did not use the IDB themselves. The brushing procedure was performed professionally by 1 operator (C.E.). Each buccal tooth surface with a bracket was split into 8 areas, the main areas being 1 and 8. These main areas, which were difficult for toothbrushes to reach, were mesial (area 1) and distal (area 8) of the bracket edges in the gingival direction. Plaque index (PI) scores were assessed at 2 examinations before and after the cleaning procedure on 8 tooth surfaces in the area with orthodontic brackets. A computer-generated program randomly allocated the IDB sequence to the participants. Examiners (L.Z.-G. and Y.W.) assessing the outcomes were blinded to the intervention and the randomized allocation of participants to the different IDBs.
Both IDBs showed a plaque removal effect (CB, 0.68 [interquartile range, 0.63-0.77]; IB, 0.43 [interquartile range, 0.33-0.55]). The difference between the 2 IDB was statistically significant (P = 0.002). In particular, the CB yielded a higher plaque removal efficacy (CB effect, 0.68; IB effect, 0.21) at the main areas 1 and 8, which were difficult to reach. Ten participants were randomized to each sequence, and all 20 completed the study. No side effects or adverse events were reported or observed.
The waist-shaped brush head of the CB significantly enhanced plaque reduction in total and particularly in problem areas.
This trial was registered at the German Clinical Trials Registry (no. DRKS00014088; https://www.drks.de/drks_web/navigate.xxdo?navigationId=trial.HTML&TRIAL_ID=DRKS00014088)
The protocol was not published before trial commencement.
This study was supported by the manufacturer Top Caredent GmbH, Schönau, Germany, which provided all interdental brushes used in this study.
A randomized, 3-month, parallel-group clinical trial to compare the efficacy of electric 3-dimensional toothbrushes vs manual toothbrushes in maintaining oral health in patients with fixed orthodontic appliances
2021, American Journal of Orthodontics and Dentofacial Orthopedics
Citation Excerpt :
A modification of the plaque index, developed specifically for subjects with fixed orthodontic appliances, was used in the present study. It has been employed in other trials comparing electric and manual toothbrushes in fixed appliance orthodontic patients.8,17,19,38 In our study, plaque was assessed only on the buccal surfaces of teeth that were bonded but not banded (molars) because of difficulty in plaque assessment.
The aim of this single-blinded, parallel-group, randomized clinical trial was to compare the efficacy of electric 3-dimensional (3D) toothbrushes and manual toothbrushes in removing plaque and reducing gingival inflammation in orthodontic patients.
Eighty adolescents with fixed orthodontic appliances in both arches were randomized at a 1:1 ratio, with an equal number of both sexes, in this examiner blinded, parallel clinical trial. Eligibility criteria included subjects aged between 12 and 16 years, good general health, nonextraction orthodontic treatment, and plaque-induced gingivitis, excluding patients with active caries or periodontitis, tooth agenesis, syndromes, disabilities, and craniofacial deformities, ≥2 cervical and/or proximal fillings, dental prostheses or dental implants, and subjects smoking or using antibiotics or medication predisposing to gingival enlargement. Patients were assigned to use either an electric 3D orthodontic toothbrush (Oral-B Pro-1000 with Oral-B Ortho head; Procter & Gamble, Cincinnati, Ohio) or a manual toothbrush (Oral-B Orthodontic brush; Procter & Gamble) and instructed to brush twice daily for 2 minutes. The main outcomes were: (1) plaque removal, assessed with the Modified Silness and Löe plaque index and the Modified Full Mouth Plaque Score, and (2) gingival inflammation reduction, assessed with the Modified Silness and Löe Gingival Index and the Modified Simplified Gingival Index. Measurements were taken at baseline, 1, 2, and 3 months. Randomization was achieved with 2 random sequences, one for each brush, written and sealed in opaque numbered envelopes. Blinding was possible for outcome assessment only.
Considerable variability was observed among patients in the values of all dependent variables. There was no difference between interventions over time for any of the outcomes, and the main effects for treatment and time were also not statistically significant. For Modified Silness and Löe plaque index, the interaction was 0.001 (95% confidence interval, −0.011 to 0.013; P = 0.89).
No difference in plaque removal efficacy and gingival inflammation reduction was found between the electric 3D and manual toothbrushes in adolescents with fixed orthodontic appliances. Therefore, orthodontists should focus on enhancing their patients’ dental awareness and oral hygiene, along with professional prophylaxis and other oral hygiene aids, independently of the brush used.
This trial was registered at ClinicalTrials.gov (Identifier: NCT02699931).
The protocol was not published before trial commencement.
Electric and manual toothbrushes and toothpastes for all participants were provided by Procter & Gamble (Oral-B). Miscellaneous costs were covered by the participating departments.
The short-term effects of manual and interactive powered toothbrushes on the periodontal status of orthodontic patients: A randomized clinical trial
2021, Journal of the World Federation of Orthodontists
Citation Excerpt :
The main outcome measure in this study was change in plaque reduction. The sample size was calculated based on a previous study [13]. A power analysis (SPSS, 24.0; IBM, Armonk, NY) was performed based on a 1:1 ratio between groups.
To compare the effects of manual and interactive powered toothbrushes on periodontal status of patients during fixed orthodontic treatment.
Thirty-six patients aged 12 to 18 years were included in this parallel design randomized clinical trial. Patients were randomly divided into two groups: manual toothbrushes (MT group) and interactive powered toothbrushes (PT group). The plaque index (PI), gingival index (GI), and bleeding on probing (BOP) scores were obtained before brushing (T0), 4 weeks (T1), 2 months (T2), and 4 months (T3) after brushing initiation. Periodontal measurements were performed by the same researcher that blinded to the groups’ randomization. Data were analyzed with Mann-Whitney U and Friedman tests for the comparison of parameters between groups and times.
Significant differences were found in PI values at all time intervals (P < 0.001), with one exception (T2-T3 in the MT group). The GI changes between timepoints were parallel to the BOP findings of the PT group. Both groups had significantly lower bleeding scores in both T0-T2 and T0-T3 time intervals (P < 0.001). There was a significant reduction in the bleeding score of PT group between T1-T3 time interval (P < 0.05); however, there were no significant differences between the groups at any timepoint. PI and GI scores were statistically decreased in the PT group compared with the MT group from baseline to 4 months (P < 0.05).
All periodontal parameters decreased during the 4-month study period. The interactive powered toothbrushes may be an alternative to manual toothbrushes in terms of maintenance of periodontal health during fixed orthodontic treatment.
One type of powered toothbrush may be more effective than others in controlling plaque and gingivitis
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Different powered toothbrushes for plaque control and gingival health.
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To compare the relative efficacy of various types of powered toothbrushes in reducing plaque and gingivitis and to assess other performance factors such as stain removal, cost, reliability, and safety
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Plaque retention by self-ligating vs elastomeric orthodontic brackets: Quantitative comparison of oral bacteria and detection with adenosine triphosphate-driven bioluminescence
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Enamel decalcification is a common problem in orthodontics. The objectives of this randomized clinical study were to enumerate and compare plaque bacteria surrounding 2 bracket types, self-ligating (SL) vs elastomeric ligating (E), and to determine whether adenosine triphosphate (ATP)-driven bioluminescence could be used for rapid assessment of bacterial load in plaque.
Patients (ages, 11-17 years) were bonded with SL and E brackets in 14 maxillary and 12 mandibular arches by using a split-mouth design. Recall visits were at 1 week and 5 weeks after bonding. Plaque specimens were assayed for oral bacteria and subjected to ATP-driven bioluminescence determinations with a luciferin-based assay.
In most patients, teeth bonded with SL attachments had fewer bacteria in plaque than did teeth bonded with E brackets. At 1 and 5 weeks after bonding, the means for SL vs E brackets were statistically lower for total bacteria and oral streptococci (P <0.05). ATP bioluminescence values were statistically correlated to the total oral bacteria and oral streptococci, with correlation coefficients of 0.895 and 0.843, respectively.
SL appliances promote reduced retention of oral bacteria, and ATP bioluminescence might be a useful tool in the rapid quantification of bacterial load and the assessment of oral hygiene during orthodontic treatment.
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^*: ^aThird-year postgraduate student, Department of Orthodontics.

^**: ^bHead of the Department of Orthodontics.

^*: ^cDepartment of Medical Informatics and Statistics.

^**: Reprint requests to: Veronique Thienpont, Department of Orthodontics, University of Ghent Dental School, De Pintelaan 185, B-9000, Ghent, Belgium; e-mail, [email protected].

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Original ArticleComparative study of 2 electric and 2 manual toothbrushes in patients with fixed orthodontic appliances*,**,*,**

Abstract

Section snippets

Material and methods

Results

Discussion

Conclusion

Am J Orthod Dentofacial Orthop

Am J Orthod Dentofacial Orthop

Am J Orthod Dentofacial Orthop

Am J Orthod Dentofacial Orthop

J Dent

Am J Orthod Dentofacial Orthop

Am J Orthod Dentofacial Orthop

Am J Orthod Dentofacial Orthop

J Am Dent Assoc

Am J Orthod Dentofacial Orthop

Experimental gingivitis in man

J Periodontol

Plaque-induced periodontal disease in beagle dogs

J Periodontal Res

Oral hygiene and periodontal disease in an adult population in the United States

J Periodontol

Effect of oral hygiene instruction and professional toothcleaning on caries and gingivitis in schoolchildren

Community Dent Oral Epidemiol

Gingival enlargement coincident with orthodontic therapy

J Periodontol

Caries incidence and orthodontic treatment with fixed appliances

Scand J Dent Res

Caries incidence and oral hygiene during orthodontic treatment

Scand J Dent Res

Gingival condition associated with orthodontic treatment

Angle Orthod

The effect of a new electric toothbrush on supragingival plaque and gingivitis

J Periodontol

The effectiveness of a counter-rotary action powered toothbrush and conventional toothbrush on plaque removal and gingival bleeding: a short-term study

J Periodontol

A comparative clinical study of the safety and efficacy of three toothbrushes

J Periodontol

A comparison of the efficacy of 2 powered toothbrushes in affecting plaque accumulation, gingivitis, and gingival bleeding

J Periodontol

Two long-term clinical studies comparing the plaque removal and gingivitis reduction efficacy of the Oral-B Advantage Plaque Remover to five manual toothbrushes

J Clin Dent

Effectiveness of the Sonicare sonic toothbrush on reduction of plaque, gingivitis, probing pocket depth and subgingival bacteria in adolescent orthodontic patients

J Clin Dent

A comparative study of plaque removing efficiency using rotary electric and manual toothbrushes

Swed Dent J

Original Article
Comparative study of 2 electric and 2 manual toothbrushes in patients with fixed orthodontic appliances*,**,*,**