scholarly journals Efficacy of a sonic toothbrush on plaque removal—A video-controlled explorative clinical trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261496
Author(s):  
Nadine Schlueter ◽  
Sarah Fiedler ◽  
Maxi Mueller ◽  
Clemens Walter ◽  
Julia C. Difloe-Geisert ◽  
...  

Clinical studies on the efficacy of sonic toothbrushes show inconsistent results, most studies have been conducted without sufficient supervision of appropriate toothbrush usage. Aims of the explorative clinical trial were therefore to investigate whether the usage of an activated sonic toothbrush reduces plaque more effectively than an inactivated one used as a manual toothbrush, and to which extent the correct use of such toothbrush plays a role in its efficacy. The clinical trial was designed as a video-controlled interventional study. Thirty participants (mean (±SD) age 22.9 (±2.5) years) were included, areas of interest were the buccal surfaces of the upper premolars and the first molar (partial mouth recording). Toothbrushing was performed without toothpaste in a single brushing exercise under four different conditions: switched off, habitually used as manual toothbrush, no instruction; switched on, habitually used as powered toothbrush, no instruction; switched off, used as manual toothbrush, instruction in the Modified Bass Technique; switched on, used as powered toothbrush, instruction in a specific technique for sonic toothbrushes. Brushing performance was controlled by videotaping, plaque was assessed at baseline (after 4 days without toothbrushing) using the Rustogi modified Navy-Plaque-Index and planimetry. Main study results were that plaque decreased distinctly after habitual brushing regardless of using the sonic brush in ON or OFF mode (p for all comparisons < 0.001). After instruction, participants were able to use the sonic brush in ON mode as intended, with only minor impact on efficacy. Using the toothbrush in OFF mode with the Modified Bass Technique was significantly less effective than all other conditions (p for all comparisons < 0.001). Under the conditions used, the sonic toothbrush was not more effective when switched on than when switched off, and there was no evidence that the correct use of the toothbrush was more effective than the habitual use.

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041458
Author(s):  
Vicki Anderson ◽  
Vanessa C Rausa ◽  
Nicholas Anderson ◽  
Georgia Parkin ◽  
Cathriona Clarke ◽  
...  

IntroductionWhile most children recover from a concussion shortly after injury, approximately 30% experience persistent postconcussive symptoms (pPCS) beyond 1-month postinjury. Existing research into the treatment of pPCS have evaluated unimodal approaches, despite evidence suggesting that pPCS likely represent an interaction across various symptom clusters. The primary aim of this study is to evaluate the effectiveness of a multimodal, symptom-tailored intervention to accelerate symptom recovery and increase the proportion of children with resolved symptoms at 3 months postconcussion.Methods and analysisIn this open-label, assessor-blinded, randomised clinical trial, children with concussion aged 8–18 years will be recruited from The Royal Children’s Hospital (The RCH) emergency department, or referred by a clinician, within 17 days of initial injury. Based on parent ratings of their child’s PCS at ~10 days postinjury, symptomatic children (≥2 symptoms at least 1-point above those endorsed preinjury) will undergo a baseline assessment at 3 weeks postinjury and randomised into either Concussion Essentials (CE, n=108), a multimodal, interdisciplinary delivered, symptom-tailored treatment involving physiotherapy, psychology and education, or usual care (UC, n=108) study arms. CE participants will receive 1 hour of intervention each week, for up to 8 weeks or until pPCS resolve. A postprogramme assessment will be conducted at 3 months postinjury for all participants. Effectiveness of the CE intervention will be determined by the proportion of participants for whom pPCS have resolved at the postprogramme assessment (primary outcome) relative to the UC group. Secondary outcome analyses will examine whether children receiving CE are more likely to demonstrate resolution of pPCS, earlier return to normal activity, higher quality of life and a lower rate of utilisation of health services, compared with the UC group.Ethics and disseminationEthics were approved by The RCH Human Research Ethics Committee (HREC: 37100). Parent, and for mature minors, participant consent, will be obtained prior to commencement of the trial. Study results will be disseminated at international conferences and international peer-reviewed journals.Trial registration numberACTRN12617000418370; pre-results.


2020 ◽  
Vol 4 (1) ◽  
pp. 50-58
Author(s):  
Matthias  Tietsch ◽  
Amir Muaremi ◽  
Ieuan Clay ◽  
Felix Kluge ◽  
Holger Hoefling ◽  
...  

Analyzing human gait with inertial sensors provides valuable insights into a wide range of health impairments, including many musculoskeletal and neurological diseases. A representative and reliable assessment of gait requires continuous monitoring over long periods and ideally takes place in the subjects’ habitual environment (real-world). An inconsistent sensor wearing position can affect gait characterization and influence clinical study results, thus clinical study protocols are typically highly proscriptive, instructing all participants to wear the sensor in a uniform manner. This restrictive approach improves data quality but reduces overall adherence. In this work, we analyze the impact of altering the sensor wearing position around the waist on sensor signal and step detection. We demonstrate that an asymmetrically worn sensor leads to additional odd-harmonic frequency components in the frequency spectrum. We propose a robust solution for step detection based on autocorrelation to overcome sensor position variation (sensitivity = 0.99, precision = 0.99). The proposed solution reduces the impact of inconsistent sensor positioning on gait characterization in clinical studies, thus providing more flexibility to protocol implementation and more freedom to participants to wear the sensor in the position most comfortable to them. This work is a first step towards truly position-agnostic gait assessment in clinical settings.


2018 ◽  
Vol 38 (5) ◽  
pp. 749-754 ◽  
Author(s):  
Olivia Kiwanuka ◽  
Bo-Michael Bellander ◽  
Anders Hånell

When evaluating the design of pre-clinical studies in the field of traumatic brain injury, we found substantial differences compared to phase III clinical trials, which in part may explain the difficulties in translating promising experimental drugs into approved treatments. By using network analysis, we also found cases where a large proportion of the studies evaluating a pre-clinical treatment was performed by inter-related researchers, which is potentially problematic. Subjecting all pre-clinical trials to the rigor of a phase III clinical trial is, however, likely not practically achievable. Instead, we repeat the call for a distinction to be made between exploratory and confirmatory pre-clinical studies.


2020 ◽  
Author(s):  
Eric-Jan Wagenmakers ◽  
Alexander Ly

In a recent randomized clinical trial, Wennerholm and colleagues compared induction of labour at 41 weeks with expectant management and induction at 42 weeks. The trial was stopped early, because six perinatal deaths occurred in the expectant management group, whereas none occurred in the induction group. Our Bayesian reanalysis finds that the SWEPIS data indeed support the hypothesis that induction of labour at 41 weeks of pregnancy is associated with a lower rate of stillbirths. However, the degree of this support is moderate at best, and arguably provides insufficient ground for terminating the study. In general, it seems hazardous to terminate clinical studies on the basis of a single P&lt;0.05 result, without converging support of a Bayesian analysis.


2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Alina Danet ◽  
Joan Carles March Cerdá ◽  
Manuel Romero Vallecillos

Objetivo. Los ensayos clínicos con heroína (diacetilmorfina-DAM) han aportado al arsenal terapeútico disponible una alternativa en la atención a drogodependientes. El objetivo del presente artículo es conocer las experiencias y resultados clínicos de los estudios sobre el uso terapéutico de la heroina.Metodo. Revisión bibliográfica de los diferentes estudios y ensayos clínicos realizados hasta el presente a nivel mundial, sobre la intervención con pacientes dependientes de opioides. Se han consultado las bases de datos: EMBASE, ScienceDirect, Wiley-Blackwell, PubMed, Bio-Med Central, Medline, Ovid, y los descriptores «heroin», «diacetylmorphine», «clinical trial», «survey».Resultados. Se detectan 42 referencias, 16 presentan los resultados de ensayos clínicos de Suiza, Holanda, Alemania, Canadá, España y Reino Unido, comenzando con 1994. El resto de estudios se refieren a: captación y participación de los drogodependientes, mortalidad, calidad de vida, efectos secundarios y necesidad de nuevas investigaciones y ensayos clínicos.Conclusiones. Los estudios clínicos llevados a cabo hasta la actualidad muestran heterogeneidad en los métodos y variables empleadas, pero los objetivos son comunes (parten de evaluar los efectos del uso terapéutico de la heroina) y los resultados constatan la seguridad y efectividad de la prescripción médica de la diacetilmorfina. AbstractObjective. Clinical trials with heroin (diacetylmorphine) bring an alternative to the available therapeutic possibilities for addict people. The purpose of this article is to describe the experiences and results of clinical studies centered on the therapeutic use of heroin.Method. Literature review of studies and clinical trials, centered on the intervention with opiois- dependent patients. The databases consulted were : EMBASE, ScienceDirect, Wiley-Blackwell, PubMed, Bio-Med Central, Medline, Ovid. The descriptors : «heroin», «diacetylmorphine», «clinical trial», «survey».Results. The literature review revealed the existence of 42 references, of which 16 presented the results of clinical trials in Switzerland, Holland, Germany, Canada, Spain and United Kingdom, starting with 1994. Other references are centered on uptake and involvement of the drug, mortality quality of life/ side effects and need for further research and clinical trials.Conclusions. Clinical studies carried out until the present show heterogeneity in the methods and variables used, but the objectives are the same (based on assessing the effects of the therapeutic use of heroin) and the results confirm the safety and effectiveness of medical prescription of diacetylmorphine.


2020 ◽  
Vol 11 (1) ◽  
pp. 22-25
Author(s):  
Nucharee Juntarachot ◽  
Bhagavathi Sundaram Sivamaruthi ◽  
Sasithorn Sirilun ◽  
Piyachat Tongpong ◽  
Phakkharawat Sittiprapaporn ◽  
...  

Background: Dextran is a branched polysaccharide and one of the polymers, present in the biofilm matrix. The dextran plays a perilous role in dental plaque formation, which is involved in the development of some common oral diseases like dental caries. The dextran-hydrolyzing enzymes are under investigation to treat and manage the dental plaques. Aims and Objective: The present study reporting the preliminary observations on the effect of the use of dextranase-containing mouthwash (DMW) on dental plaque and oral health. Materials and Methods: DMW was prepared with food-grade dextranase, preservatives, gellingagents, and water as detailed. Four weeks of experimental design was employed in fourteen healthy volunteers. The selected volunteers were recommended to use DMW for at least twice a day. The plaque index (PI), probing depth (PD), gingival index (GI) and bleeding on probing (BOP) of the volunteer's teeth have been assessed before and after four weeks of DMW use. Results:The volunteers were insisted to use a DMW solution twice a day for four weeks. The PI, PD, GI, and BOP was measured before and after the treatment. The plaque index of the subject at baseline and after treatment was 2.22 ± 0.48, and 1.88 ± 0.50, respectively. PI was significantly reduced after the use of DMW solution for four weeks. The value of PD was 2.00 and 2.00 at baseline and after the use of DMW, respectively. The value of PD was not changed when compared to the baseline values. The sensory evaluation of DMW was performed using questionnaires. Conclusion: The preliminary study results suggested that the use of DMW solution for four weeks (twice a day) notably reduced the PI without any change in PD. However, GI and BOP values were not affected after the use of DMW. The participants, based on the sensory evaluation, accepted the prepared DMW solution. Additional detailed research on the impact of DMW on oral hygiene is needed to confirm the beneficial effects of DMW.


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