Clinical evaluations of plaque removal efficacy: an advanced rotating-oscillating power toothbrush versus a sonic toothbrush

OBJECTIVE: To evaluate the safety and plaque removal efficacy of an advanced rotating-oscillating power toothbrush relative to a sonic toothbrush with either a standard or compact brush head. METHODOLOGY: Two studies used a randomized, examiner-blind, two-treatment, crossover design. In Study 1, subjects were instructed to use their first randomly assigned toothbrush for five to seven days and then, after abstaining from all oral hygiene for 24 hours, were assessed with the Rustogi, et al. Modified Navy Plaque Index. They then brushed for two minutes and post-brushing plaque scores were recorded. Subjects were assigned to the alternate toothbrush and the procedures were repeated. In Study 2, subjects alternated using both brushes for approximately 10 days, then had four study visits three to four days apart (some variability based on patient scheduling). In Study 1, Oral-B Triumph with a FlossAction brush head and Sonicare Elite 7300 with a full-size, standard head were compared in a two-treatment, two-period crossover study. Study 2 compared Oral-B Triumph with a FlossAction brush head and Sonicare Elite 7300 with a compact head in a two-treatment, four-period crossover study. RESULTS: Fifty subjects completed Study 1 and 48 completed Study 2. All brushes were found to be safe and significantly reduced plaque after a single brushing. In Study 1, Oral-B Triumph was statistically significantly (p < 0.001) more effective in plaque removal than Sonicare Elite 7300 with the full-size brush head: whole mouth = 24% better, marginal = 31% better, approximal = 21% better. In Study 2, Oral-B Triumph was statistically significantly (p < 0.001) more effective than Sonicare Elite 7300 with the compact brush head: whole mouth = 12.2% better, marginal = 14.6% better, approximal = 12% better. CONCLUSION: Oral-B Triumph with its rotation-oscillation action was significantly more effective in single-use plaque removal than Sonicare Elite 7300 with its side-to-side sonic action when fitted with either a standard or a compact brush head.     

Comparison of a sonic and a manual toothbrush for efficacy in supragingival plaque removal and reduction of gingivitis

Abstract A new sonic electric toothbrush (Sonicare®) and a traditional manual toothbrush were compared for efficacy in removing supragingival plaque and reducing gingival inflammation in a 12-week, single-blind clinical trial. 60 subjects with a gingival index (GI) of >1.5 and no probing depths >5 mm were randomly assigned to use either the manual or sonic brush, instructed in its use, and asked to brush each morning and evening for 2 minutes. Plaque scores were taken at baseline and at 1.2, 4. and 12 weeks using the Turesky modification of the Quigley-Hein plaque index. Gingival inflammation was assessed by the GI. bleeding tendency score, presence or absence of bleeding on probing, volumetric measurements of gingival crevicular fluid (GCF). and aspartate aminotransferase (AST) levels in GCF. Repeated measures multivariate analyses of variance were used to delect time- and device-dependent differences for all clinical assessments between the 2 groups over the 5 visits. Both types of brush were effective in removing supragingival plaque. The sonic brush was statistically superior, on a percentage reduction basis, in removing supragingival plaque from the dentition taken as a whole (F-statistic; p=0.012) and was particularly better in hard-to-reach areas such as posterior teeth (F-statistic; p=0.003) and interproximal sites (F-statistic; p=0.004). Both devices were equally effective in reducing gingival inflammation. The sonic brush exhibited less tendency to cause gingival abrasion than the manual brush (1 incident with sonic, 5 incidents with manual), confirming the safely of this product as an oral hygiene device.     

Efficacy of plaque removal and learning effect of a powered and a manual toothbrush

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.     

Plaque removal efficacy of an advanced rotation-oscillation power toothbrush versus a new sonic toothbrush

PURPOSE: To evaluate the plaque removal efficacy and safety of an advanced rotation-oscillation power toothbrush relative to a newly-introduced sonic toothbrush. METHODS: This study used a randomized, examiner-blind, two-treatment, four-period, four-sequence crossover design. Subjects received both toothbrushes (Oral-B Triumph and Sonicare FlexCare) and a standard dentifrice from the study site and used each toothbrush at home during an acclimation phase prior to their plaque measurement visits. After abstaining from all oral hygiene for 24 hours, subjects returned to the study site and were assessed with the Rustogi Modified Navy Plaque Index. They then brushed for 2 minutes with their first randomly-assigned toothbrush and post-brushing plaque scores were recorded. This procedure was followed for three additional study visits, with subjects using their normal at-home toothbrush and dentifrice for the 2- to 5-day washout periods between visits. Subjects always abstained from all oral hygiene for 24 hours prior to their visits. RESULTS: 45 subjects completed the study. Both brushes were found to be safe and both significantly reduced plaque after a single brushing. Oral-B Triumph was statistically significantly (P < 0.0001) more effective in plaque removal than Sonicare FlexCare for whole mouth plaque scores, gingival marginal plaque scores and interproximal plaque scores. Compared to Sonicare FlexCare, the adjusted mean plaque reduction scores for Oral-B Triumph were 21%, 23% and 22% greater for whole mouth, marginal and interproximal areas, respectively.     

儿童使用声波震动牙刷清除牙菌斑的效果观察

目的:观察儿童使用声波震动牙刷清洁牙及控制菌斑的效果。方法:选择年龄6～7岁的儿童50例,实验组使用声波震动牙刷,对照组使用儿童保健牙刷。采用菌斑染色法记录刷牙前后的菌斑牙面数及菌斑指数(PLI),采用SPSS10.0统计软件包对相关组间数据进行t检验与χ2检验。结果:实验组菌斑清除率为70.22%,对照组为39.08%,声波震动牙刷去除舌面、近中颊面菌斑的能力是手动刷牙的2倍。刷牙前后菌斑指数和菌斑清除率在2组间有高度显著性差异(P<0.001)。结论:声波震动牙刷能有效帮助儿童清除牙面菌斑,是儿童口腔护理的有效工具。     

Clinical evaluation of plaque removal with a double-headed toothbrush

Abstract A blind, two-way, crossover clinical trial, completed by 44 adult subjects, instructed in specific oral hygiene techniques, was carried out to compare the effectiveness of plaque removal between a new Scandinavian double-headed toothbrush and a popular single-headed brush, each used for one week. The results showed that the double-headed brush was significantly more effective in removing plaque overall than a conventional brush. The effect was most evident on all lingual surfaces, especially in the lower arch and molar regions. It was also particularly pronounced when the double-headed toothbrush was allocated for use in the 2nd week of the study. There was no significant difference in the cleaning ability of the 2 brushes on the buccal surfaces of the teeth.     

One- and 3-minute plaque removal by a battery-powered versus a manual toothbrush

BACKGROUND: A new battery-powered toothbrush with a fundamentally different design than other powered toothbrushes has recently been introduced. The new toothbrush has a powered oscillating round head and a second powered head that translates back and forth. This study compared the plaque removal efficacy of a manual toothbrush to this new powered toothbrush. METHODS: This randomized, controlled, examiner-masked, four-period cross-over study examined plaque removal with the two toothbrushes following a single use in 40 subjects. Plaque was scored before brushing and after 1 and 3 minutes of brushing using the Turesky modification of the Quigley-Hein index. RESULTS: Baseline plaque scores were 2.98 prior to using the powered toothbrush and 2.99 prior to using the manual toothbrush. The powered toothbrush delivered a covariance-adjusted mean plaque score change from baseline of 0.61 after 1 minute of brushing and 0.93 after 3 minutes of brushing. The adjusted mean changes for the manual toothbrush were 0.43 and 0.62, respectively. The differences between treatment groups were statistically significant (P < 0.001) after both 1 and 3 minutes of brushing. The powered toothbrush had, on average, 42.1% and 49.6% greater plaque removal scores after 1 minute and 3 minutes of brushing, respectively. Both toothbrushes had statistically significantly greater plaque removal scores after 3 minutes than after 1 minute of brushing (P < 0.001). Plaque removal scores for each toothbrush after 3 minutes of brushing were about 50% higher than the scores after 1 minute of brushing. CONCLUSIONS: The powered toothbrush delivered statistically significantly superior plaque removal after both 1 and 3 minutes of brushing compared to the manual toothbrush. Both toothbrushes showed statistically significantly greater plaque removal following 3 minutes of brushing than following 1 minute of brushing, and the difference between the toothbrushes was greater following 3 minutes of brushing than following 1 minute of brushing.     

Relative effectiveness of a rotary and conventional toothbrush in plaque removal

Abstract The ability of a powered rotary toothbrush to remove 3- and 4-day-old microbial plaque deposits was evaluated in 10 young adults with healthy gingivae. Using a split mouth technique and a cross-over experimental design, the powered brush was compared with a conventional hand brush over a 14-day period. Statistical analysis of the results showed no significant differences between either method of brushing when the whole mouth, maxillary or mandibular arches were compared. Further analysis of the proximal scores again showed no significant differences between the powered brush or handbrush. The majority of the subjects preferred the conventional handbrush to the powered brush.     

Subgingival access and artificial plaque removal by a sonic cleaning device

A sonic subgingival cleaning device (soniPick Sonic Interdental Plaque Remover) has recently been marketed with three bristle tips varying in size lengths and bundle diameters. The purpose of this study was to evaluate the ability of these bristle tips to remove subgingival artificial plaque deposits in a laboratory method used for toothbrushes. The laboratory method has been modified for testing the sonic device, to simulate the directions for using the product at home. The dimensions (length x bundle width) of three tips tested were: 0.007" x 0.040"; 0.007" x 0.062"; and 0.009" x 0.062". The tips used with the sonic device were placed on the tooth surface at a 20 degrees angle according to directions, and inserted 3 mm under simulated gingivae. The device was turned on and the tip was moved in a maximum 10 mm stroke for 15 seconds with the brushing machine. For control purposes, a flat, multi-tufted, ADA-accepted manual toothbrush (Oral-B P35) was also tested. The manual toothbrush was tested using the standard methods for evaluating toothbrushes, i.e., with the bristle tips placed at the gingival margin, then brushed at a 45 degrees angle at 250 g weight, using 15 mm strokes for 60 seconds. The depth of subgingival deposit removal was recorded as the maximum depth of the artificial plaque deposit removed from the pressure-sensitive paper under the simulated gingivae over anterior- or posterior-shaped teeth. In the assays conducted, the three bristle tips on the sonic device removed artificial plaque deposits under the simulated gingival at depths of 1.9-2.7 mm. The manual toothbrush had a mean subgingival cleaning depth of 0.6 mm. Differences between the three bristle tips used with the sonic device and the manual toothbrush were significant (p < 0.001 ANOVA). In this laboratory assay, all 3 bristle tips provided with the sonic cleaning device maintained access into and subsequent removal of artificial plaque from the subgingival space.     

Comparative study of plaque removal efficacy of twin-motor sonic toothbrush with floating bristles and conventional powered toothbrushes in posterior teeth

PURPOSE: To compare twin-motor sonic toothbrushes (TST) with conventional sonic (CST) and electric (CET) toothbrushes in terms of plaque removal efficacy. METHODS: A single-blind, triple-treatment cross-over study was conducted involving 36 participants. Each subject refrained from brushing for 24 hours; subsequently, subjects were screened for dental plaque in premolars and molars with the Rustogi Modified Navy Plaque Index. Plaque removal efficacy was determined according to percentage of plaque score reduction in a single toothbrushing under supervision for 2 minutes at the base of whole tooth surfaces and approximal areas. RESULTS: 35 subjects completed this study. No meaningful difference in pre-brushing plaque score was observed among the three toothbrushes. In molars, TST (48.3+/-3.3%) was higher in plaque removal efficacy relative to CST (40.4+/-2.4%, P= 0.0064) and CET (36.7+/-2.8%, P= 0.0001). This trend was obvious in approximal areas of the lingual aspect of the mandible; 24.8% for TST versus 13.4% for CST (P= 0.0048) and 15.0% for CET (P= 0.0168). In premolars, TST displayed the greatest plaque removal efficacy, although the difference was significant exclusively for comparison with CET. These findings indicate that TST is more efficacious than CST and CET in terms of removal of plaque from molars, in particular, at approximal areas in the lingual aspect of the mandible, possibly due to new functions such as floating bristles and twin magnetic motors, which produce sonic vibration.     

Role of brushing technique and toothbrush design in plaque removal

Abstract – Twenty-four adults participated in an intraindividual crossover experimental study to compare the plaque removing ability of straight multitufted and V-shaped brushes. Twelve of the participants had loss of periodontal tissue resulting in open but healthy interdental areas while the other 12 displayed no periodontal breakdown. In part 1 the participants were asked to brush their teeth using their own brushing technique and length over two 12-day periods during which time they, at random, used one brush for the first and the other brush for the second period. In part 2 the participants were professionally brushed by two dental assistants using four brushing techniques (The Bass, The Roll, The Circular Scrub and The Horizontal Scrub) randomly assigned to the four quadrants of the mouth. Cleaning was performed once a day for two 5-day periods, during which time the participants refrained from brushing and interdental cleaning. Initial toothbrush assignment was randomized. At the beginning of the study and each test period no plaque or gingival inflammation was visible. At the end of each period the accumulated plaque was registered. The results showed that there was no difference between the two brushes tested in the unsupervised part. The plaque removing ability when using either of the brushes varied between participants. When professionally used the straight multitufted and V-shaped toothbrushes did not show any difference in plaque removal on buccal and lingual surfaces. Interproximally the V-shaped toothbrush was better at plaque removal than the straight one. However, plaque still remained after brushing with the V-shaped toothbrush, which indicates that toothbrushing always must be supplemented with interdental aids and that the shape of brushes as well as the techniques used are of little importance. Interproximal areas with tissue breakdown and loss of interdental papillae accumulated more plaque than those with no periodontal tissue breakdown.     

A clinical trial to evaluate plaque removal with a double-headed toothbrush

Fifty patients took part in a single blind study to test the plaque-removing efficacy of a new double-headed brush (Duodent 2000), compared with a conventional brush (Oral B 32). Twenty-seven patients were attending for an initial course of hygiene treatment, and 23 were recall patients with persistently inadequate plaque control. Plaque was assessed at baseline and at the end of the 2-week study period using the Turesky modification of the Quigley and Hine index for all buccal and lingual surfaces. All patients had plaque scores of more than 1 at baseline (maximum = 5). The reductions in mean plaque scores for combined lingual and palatal surfaces for subjects using the double-headed brush were significantly better than the corresponding reductions for the control groups. There were no significant differences between mean buccal plaque scores at the final examination for patients using either brush. The double-headed toothbrush helped to achieve better lingual and palatal plaque control, not only in the new patient group, but also in the group of patients who had not previously responded well to oral hygiene advice.     

Role of brushing technique and toothbrush design in plaque removal

Twenty-four adults participated in an intraindividual crossover experimental study to compare the plaque removing ability of straight multitufted and V-shaped brushes. Twelve of the participants had loss of periodontal tissue resulting in open but healthy interdental areas while the other 12 displayed no periodontal breakdown. In part 1 the participants were asked to brush their teeth using their own brushing technique and length over two 12-day periods during which time they, at random, used one brush for the first and the other brush for the second period. In part 2 the participants were professionally brushed by two dental assistants using four brushing techniques (The Bass, The Roll, The Circular Scrub and The Horizontal Scrub) randomly assigned to the four quadrants of the mouth. Cleaning was performed once a day for two 5-day periods, during which time the participants refrained from brushing and interdental cleaning. Initial toothbrush assignment was randomized. At the beginning of the study and each test period no plaque or gingival inflammation was visible. At the end of each period the accumulated plaque was registered. The results showed that there was no difference between the two brushes tested in the unsupervised part. The plaque removing ability when using either of the brushes varied between participants. When professionally used the straight multitufted and V-shaped toothbrushes did not show any difference in plaque removal on buccal and lingual surfaces. Interproximally the V-shaped toothbrush was better at plaque removal than the straight one.(ABSTRACT TRUNCATED AT 250 WORDS)