Efficacy of an electric toothbrush on plaque control compared to two manual toothbrushes

Objectives: This study aimed to compare an electric toothbrush with two manual toothbrushes, in their relative efficacy to control plaque. Design: Randomised clinical trial. Setting: Kerman Dental School, Iran. Participants: Forty‐five volunteer dental students were randomly assigned to one of three groups. All subjects received a baseline plaque assessment using O’Leary plaque index, and then a prophylaxis to achieve the plaque index of zero. Subjects were trained to brush twice daily, with their assigned device and return after 1 week and then after 2 weeks for plaque assessment. Chi‐squared and ANOVA were mainly used. Main outcome measure: Plaque assessment using O’Leary plaque index. Results: Although Jordan toothbrush consistently resulted in lower plaque indices compared to both manual toothbrushes, those differences were not statistically significant, F(2, 42) = 2.45, P = 0.10. Plaque reduction from week 1 to week 2 was significant in Jordan Power group (60%, from 13.46 to 5.44, P = 0.010) and Panbehriz Classic group (53%, from 20.92 to 9.91, P = 0.007). Conclusion: The results of this study shows no evidence of statistically significant difference in respect to plaque control, between Jordan Power electric toothbrush and either of Oral‐B Advantage or Panbehriz Classic manual brushes in a group of dental students after 2 weeks.     

Effects of supervised daily dental plaque removal by children after 3 years

The benefits of a school-based plaque removal program are presented. Children in grades 5-8 were included in a study which was designed to determine the effect on oral hygiene, gingival inflammation and dental caries of removing dental plaque through supervised daily flossing and toothbrushing in school. A fluoride-free dentifrice was used. Controls did not receive instruction in plaque removal procedures nor did they engage in plaque removal activities at school. For three school years the students in the treatment group practiced daily plaque removal, supervised by trained personnel. All participants were examined initially for plaque (PHP), gingival inflammation (DHC) and dental caries (DMFS). Girls in the treatment group showed a significant reduction (28%) in mean plaque scores and, for girls and boys, the mean changes in gingivitis scores were significantly reduced (40% and 17%, respectively). Adjusted mean incremental DMF surface scores were 13 % lower in the treatment group than in the control group. The difference between groups was not statistically significant and was accounted for entirely by the findings in mesial and distal surfaces (26%). This difference approached statistical significance (P= 0.07).     

不同部位菌斑pH的动态变化及其与唾液的关系

目的：测定口腔不同部位菌斑在进食后pH的动态变化，探讨不同部位菌斑产酸力的差异及唾液在产酸代谢过程中的作用。方法：采用微型pH电极接触法原位测试患龋状况不同者上、下颌，健康部位与龋坏部位菌斑及唾液pH在含漱糖液前后1h内的变化。结果：不同部位菌斑pH在漱糖后均呈先下降后上升的趋势；患龋状况不同者健康部位菌斑pH在用糖后的变化无统计学差异；上颌菌斑pH变化幅度均较下颌明显；龋洞内菌斑pH变化幅度均较健康部位明显；唾液与菌斑pH间无明显相关性。结论：口腔不同部位菌斑内的产酸代谢活动存在差异，这可能主要与不同部位唾液对糖的清除有关；而唾液的缓冲作用对菌斑的产酸代谢无明显影响。     

不同性别刷牙效果的临床对比研究

目的 对不同性别人群刷牙效果进行对比研究。方法 实验对象按性别分组，均使用波浪型牙刷，刷牙前后各做一次菌斑检查，用O′Leaiy卡记录菌斑在牙面的分布。结果 女性比男性刷牙更彻底（P＜0．01），菌斑清除率相差10．42％。结论 性别对刷牙后菌斑清除效果有一定影响。     

Testing the efficacy of 2 prototype brush heads for a powered toothbrush: refining the model

OBJECTIVES: To compare 2 prototype powered toothbrush (PTB) heads (A, B) to a marketed head (Sensiflex 2000) for plaque removing efficacy on the Philips/Jordan HX2550 PTB. MATERIALS AND METHODS: A 2-week, 3-group, single-blind trial recruited 78 volunteers (18-25). Plaque indices (PIs) were recorded at screening and 14 days later at baseline. Subjects were stratified (gender and PI) and then asked to abstain from oral hygiene measures for 48 h. A supervised episode of brushing with the allocated PTB head followed. Subjects then used the PTBs at home for the next 12 days before being asked to abstain from all oral hygiene measures for another 48 h prior to a second supervised brushing episode. Plaque was scored using a new modification of the Quigley & Hein Index (PI) at full mouth (FM), interproximal (IP) and smooth surfaces (SS). PIs were recorded before and after the supervised brushing episodes to enable the means of the within subject differences (pre- to post-brushing) to be compared between groups (ANOVA/t-tests). RESULTS: There were no significant differences in PI between groups at baseline or prior to the supervised brushings (p>0.05). Highly significant, mean reductions in PIs (approximately 1/2 of one PI unit) were observed for design B compared with the Sensiflex 2000 at FM and IP sites (p<0.0001) for both supervised brushing episodes. A significant reduction in PI at SS was seen only after the first brushing episode (p=0.0004). For design A, PI reductions were consistently greater than those for the Sensiflex 2000 but differences were only significant at the p<0.05 level. CONCLUSION: It is concluded that this model of clinical trial has sufficient power to demonstrate clinical superiority with respect to plaque removal for PTBs and can be used for testing one or more prototype designs of brush heads.     

Is there a relationship between juvenile idiopathic arthritis and periodontitis?

AIM: The aim was to compare the prevalence of periodontal conditions in patients with juvenile idiopathic arthritis (JIA) (n=78, age 14.4 years) with those revealed in a healthy control group (n=75, age 15.5 years). MATERIAL AND METHODS: In both groups, the approximal plaque index (API), the modified sulcular bleeding index (SBI), and the clinical attachment loss (CAL) were determined. Laboratory parameters for JIA activity included the capsule-reactive protein (CRP) and the immunoglobulins A, G, M. RESULTS: JIA patients had a significantly higher API (64.6%versus 49.9%, p=0.004) and slightly higher mean percentages of sites with CAL>3.5 mm (0.58%versus 0.22%, p=0.041). There was no significant difference in the prevalence of patients and controls who had sites with CAL >3.5 mm (25.6%versus 17.3%, p=0.212). The mean CAL was slightly greater (0.2 mm; p=0.030) in patients with CRP> or =5.0 mg/l compared with patients with CRP<5.0 mg/l. Patients who took non-steroidal anti-inflammatory drugs (NSAIDs) had a significantly decreased SBI (26.2%versus 51.1%, p=0.019). CONCLUSION: After adjustment for microbial plaque, JIA is not a risk factor for periodontitis.     

Oral pharmacology of chlorhexidine

Abstract The paper concerns factors which affect the binding and plaque-inhibiting effect of chlorhexidine-digluconate (CH) in the human oral cavity. About one-third of the administered dose was retained after mouth rinses (0.05-0.40 % w/v) and after toothbrushing with a CH gel (1 % w/w) measured by [¹⁴C]-chlorhexidine. The following CH concentration in saliva showed an almost logarithmic fall during the first 4-8 h, followed by a more steady low concentration, with CH still present after 24 h. The amount retained after mouth rinses increased almost linearly with the increase in the concentration. Time studies showed that about 55 % of the amount retained after 60 sec was retained after the first 15 sec. Lowering the pH of the rinsing solution reduced the retention, and increase in ionic strength of after-rinses increased the release of CH. Calcium in a 250 mM concentration significantly reduced the retention and increased the release when present in after-rinses. The detergent sodium dodecyl (lauryl) sulphate greatly reduced both the retention and the plaque-inhibiting effect. Comparative studies between CH and quaternary ammonium compounds showed that 60-65 % of the quaternaries was retained, compared to 32 % of CH. When used four times daily, the plaque-inhibiting effect of the quaternaries approached that of CH. Their concentration in saliva fell more rapidly than that of CH.     

Effect of triclosan/copolymer-containing toothpaste on the association between plaque and gingival bleeding: a randomized controlled clinical trial

AIM: To study longitudinal associations between plaque and gingival bleeding and multilevel variance/covariance structures after introducing triclosan-containing toothpaste. MATERIAL AND METHODS: A 10-week, randomized, two-arm, double-masked, controlled clinical trial was conducted in 34 healthy, non-smoking females with plaque-induced gingivitis. Clinical periodontal examinations were repeated every other week. At week 4, test toothpaste containing 0.24% sodium monofluorophosphate, 0.3% triclosan, and 2% polyvinyl-methyl ether maleic acid; or control toothpaste containing 0.76% sodium monofluorophosphate and 0.1% sodium fluoride, were randomly distributed. RESULTS: Multivariate multilevel models indicated that, after introducing experimental toothpastes, subject random error was reduced from 0.6 to below 0.2. The odds ratio (OR) of bleeding on probing (BOP) was about 30% less in the test than in the control group (p<0.01). At the end of the experiment, ORs for BOP and plaque index scores 1-3 (reference 0) were 2.1-2.4 in the control group, but 1.1-1.9 in the test group (p<0.05). No effects on plaque levels and calculus were observed. CONCLUSIONS: Multivariate multilevel modelling allows the study of fixed and random effects of experimental toothpastes on gingival inflammation in small sample. Triclosan appears to attenuate the causal association between supragingival plaque and gingival bleeding in gingivitis.     

Antibiotic resistance of subgingival species during and after antibiotic therapy

AIM: The purpose of the present investigation was to determine the percentage and identity of antibiotic-resistant species in subgingival plaque and saliva samples from chronic periodontitis patients treated by scaling and root planing followed by orally administered amoxicillin or metronidazole. METHOD: In all, 20 chronic periodontitis patients were selected for study. After clinical and microbiological monitoring, subjects were randomly assigned to receive either orally administered amoxicillin at the dosage of 500 mg, 3 times daily for 14 days or orally administered metronidazole at the dosage of 250 mg, 3 times daily for 14 days. For the antibiotic resistance determinations, subgingival plaque samples were taken from six posterior teeth at baseline, and 90 days; and from two randomly selected teeth at 3, 7 and 14 days during and after antibiotic administration. Samples were plated on enriched blood agar plates with or without either 2 micro g/mL metronidazole or 2 micro g/mL amoxicillin. Colonies were counted at 7 days. Significant differences in percentage of resistant organisms over time were determined by the Quade test. Microbial growth was washed from antibiotic-containing media and the identity of species determined using checkerboard DNA-DNA hybridization. Data were compared with those obtained in a previous study from subjects receiving SRP only or SRP followed by 14 days of orally administered doxycycline. The level of doxycycline used to determine antibiotic resistance in that study was 4 micro g/mL. RESULTS: The mean percentage of resistant isolates increased during antibiotic administration and returned to baseline levels by 90 days post therapy. The mean percentages (+/- SEM) of isolates resistant to 2 micro g/mL metronidazole were 53 +/- 9, 65 +/- 9, 79 +/- 4 and 69 +/- 7 at baseline, 3, 7 and 14 days during antibiotic administration, and 57 +/- 4, 64 +/- 5, 62 +/- 7 and 47 +/- 6 at 3, 7, 14 and 90 days after antibiotic administration. At the same time points, the percentage of resistant isolates to amoxicillin was 0.5 +/- 0.2, 22 +/- 12, 14 +/- 5 and 37 +/- 11 during, and 31 +/- 11, 8 +/- 3, 3 +/- 2 and 3 +/- 0.6 after, administration. Antibiotic-resistant isolates of resistant species detected during or after therapy were also detected prior to therapy. The most prevalent resistant species in the metronidazole-treated group were: A. naeslundii 1, S. constellatus, A. naeslundii 2, S. mitis, S. oralis, A. odontolyticus, S. sanguis, and in the amoxicillin-treated group: S. constellatus, P. nigrescens, E. saburreum, A. naeslundii 1, S. oralis, P. melaninogenica and P. intermedia. CONCLUSIONS: Systemic antibiotic administration transiently increased the percentage of resistant subgingival species, but a major component of subgingival plaque remained sensitive to the agents during their administration. Antibiotic-resistant isolates of resistant species could be detected in samples both prior to and after therapy. However, % antibiotic-resistant isolates returned to baseline levels 90 days after antibiotic administration.