A randomized clinical trial to evaluate the plaque removal efficacy of an oscillating-rotating toothbrush versus a sonic toothbrush in orthodontic patients using digital imaging analysis of the anterior dentition

ABSTRACT Objective: To compare the plaque removal efficacy of an oscillating-rotating electric toothbrush with an orthodontic brush head versus a sonic toothbrush in adolescent patients with fixed orthodontic appliances. Materials and Methods: This was a randomized, examiner-blind, replicate single-use, two-treatment, four-period, crossover study with a washout period between visits of approximately 24 hours. Forty-four adolescent patients with fixed orthodontic appliances in both arches were randomized based on a computer-generated randomization schedule to one of four toothbrush treatment sequences. The primary outcome was plaque score change from baseline, measured using digital plaque imaging analysis. Results: Baseline plaque levels for both brush treatments were high, covering more than 50% of the tooth area. Effective plaque removal was observed with both brush treatments (P < .001); however, the reduction in plaque with the oscillating-rotating toothbrush was statistically significantly greater (P = .017) compared with the sonic toothbrush. Conclusions: The study provides evidence for more effective plaque-removing efficacy of the oscillating-rotating toothbrush versus the sonic toothbrush among orthodontic patients.

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Dental plaque removal and motivation of a manual toothbrush versus an interactive power toothbrush in young people with ﬁxed orthodontic appliances: a single examiner-blind randomized controlled clinical trial

International Journal of Development Research ◽

10.37118/ijdr.20816.01.2021 ◽

2021 ◽

pp. 43828-43831

Keyword(s):

Clinical Trial ◽

Controlled Clinical Trial ◽

Orthodontic Appliances ◽

Auxiliary Result ◽

Plaque Score ◽

Plaque Removal ◽

Fixed Orthodontic Appliances ◽

Manual Toothbrush ◽

Treatment Contrast ◽

Mouth Wash

Introduction: The goal of this 2-arm equal preliminary clinical trial was to decide the plaque expulsion efﬁcacy (primary result) and the motivation assessment (auxiliary result) looking at a manual versus an interactive power toothbrush in orthodontic patients. Methods: Sixty teenagers with ﬁxed orthodontic appliances who reported to the Department of Periodontics for routine oral prophylaxis in the both arches were randomized in a 1:1 proportion parallel, randomized, examiner-blindcontrolled clinical preliminary. Qualification criteria included in any event 16 characteristic teeth, 1-6 "center consideration zones," plaque score of ≥1.75, no serious caries, gingivits and periodontitis, no dental prophylaxis, no smoking, no anti-microbials, and no chlorhexidine mouth wash. Subjects were to brush solo with either an interactive power toothbrush (Oral-B Professional Care 6000, D36/EB20) with Bluetooth innovation or a customary manual toothbrush (Oral-B Indicator 35 delicate). Center consideration regions were each brushed for 10 extra seconds like inter-proximal spaces. Plaque removal was surveyed with the utilization of the Turesky Modiﬁcation of the Quigley-Hein Plaque Index (TMQHPI) to decide change from standard at 2 weeks followed by 6 weeks. Supervised brushing at screening and post-treatment visits recorded real brushing times. Subject-revealed motivational viewpoints were recorded at screening and week 6. Results: Fifty-nine subjects between 13-17 years finished the investigation. The interactive power toothbrush gave signiﬁcantly (P\0.001) more noteworthy plaque decrease versus the manual toothbrush at 2 and 6 week as indicated by the entire mouth TMQHPI. The treatment contrast in balanced mean plaque change from standard was 0.777 (95% CI 0.614-0.940) at week 2 and 0.834 (0.686-0.981) at week 6. Mean decreases in the quantity of center consideration regions were likewise signiﬁcantly more noteworthy (P \0.001) in the power brush bunch at weeks 2 and 6. Brushing times increased signiﬁcantly at weeks 2 and 6 (P #0.013) versus standard baseline in the interactive powertoothbrush group only.Subject-revealed motivation was signiﬁcantly increased in the interactive power tooth brush group at week 6 as opposed to screening (P #0.005). Conclusions: An interactive power toothbrush produced increased brushing times and signiﬁcantly more prominent plaque removal versus a manual brush.

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A visual evaluation of oral plaque removal utilizing an adjunct enzyme pre-rinse in orthodontic subjects

The Angle Orthodontist ◽

10.2319/120819-776.1 ◽

2020 ◽

Vol 90 (6) ◽

pp. 844-850

Author(s):

Jennifer Rose ◽

Ahmed Ghoneima ◽

Frank Lippert ◽

Lisa Maxwell ◽

George Eckert ◽

...

Keyword(s):

Clinical Trial ◽

Repeated Measures ◽

Orthodontic Appliances ◽

Visual Evaluation ◽

Double Blind ◽

Plaque Score ◽

Significance Level ◽

Plaque Removal ◽

Repeated Measures Analysis ◽

Fixed Orthodontic Appliances

ABSTRACT Objective To determine if an adjunct proteolytic pre-rinse along with contemporary methods of dental cleaning may more effectively remove visual plaque in subjects with fixed orthodontic appliances. Materials and Methods Forty-three orthodontic subjects, ages 10 to 25, completed this single site, double-blind, crossover clinical trial. Subjects randomly received bromelain enzyme or a powdered-sugar placebo pre-rinse, followed by manual tooth brushing and use of a Waterpik. Subjects received the alternate pre-rinse during the subsequent visit. Baseline and residual plaque accumulation were recorded via disclosing tablet and digital photography. A single, blinded examiner scored visual plaque scores from randomized photographs. Treatment effects on composite plaque score were evaluated using repeated-measures analysis of variance. A 5% significance level was used for all tests. Results No significant differences in plaque scores were noted at baseline or post-rinse between the enzyme and placebo. The changes from baseline to post-rinse (P = .190), post-brushing (P = .764), and post-Waterpik (P = .882) were not significantly different between interventions. Significant reduction in plaque scores were observed in both arms of the study after brushing (P < .01) and waterjet use (P < .01). Neither age (P = .220) nor gender (P = .449) impacted plaque scores. Conclusions Use of a bromelain enzyme pre-rinse alone did not significantly enhance plaque removal. A significant reduction in retained plaque was observed with the application of brushing and or Waterpik.

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Effect of fixed orthodontic appliances on nonmicrobial salivary parameters

The Angle Orthodontist ◽

10.2319/111317-773.1 ◽

2018 ◽

Vol 88 (6) ◽

pp. 806-811 ◽

Cited By ~ 1

Author(s):

Ioannis P. Zogakis ◽

Erez Koren ◽

Shlomit Gorelik ◽

Isaac Ginsburg ◽

Miriam Shalish

Keyword(s):

Orthodontic Treatment ◽

Statistical Significance ◽

Orthodontic Appliances ◽

Inclusion Criteria ◽

Reactive Protein ◽

Fixed Orthodontic Appliances ◽

Salivary Ph ◽

Orthodontic Patients ◽

The Difference ◽

Ph Decrease

ABSTRACT Objectives: To examine possible changes in the levels of salivary antioxidants, C-reactive protein (CRP), cortisol, pH, proteins, and blood in patients treated with fixed orthodontic appliances. Materials and Methods: Salivary samples from 21 orthodontic patients who met specific inclusion criteria were collected before the beginning of orthodontic treatment (T0; baseline), 1 hour after bonding (T1), and 4–6 weeks after bonding (T2). Oxidant-scavenging ability (OSA) was quantified using a luminol-dependent chemiluminescence assay. Cortisol and CRP levels were measured using immunoassay kits. pH levels and presence of proteins and blood in the samples were quantified using strip-based tests. Results: A significant decrease in salivary pH was observed after bonding (P = .013). An increase in oxidant-scavenging abilities during orthodontic treatment was detected, but the change was not statistically significant. Cortisol and CRP levels slightly increased after bonding, but the difference was small without statistical significance. Changes in the presence of proteins and blood were also insignificant. Conclusions: Exposure to fixed orthodontic appliances did not show a significant effect on salivary parameters related to inflammation or stress, with the exception of a significant but transient pH decrease after bonding.

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Gingival Bleeding Index Status Among Orthodontic Patients Treated with Fixed Orthodontic Appliances in a Tertiary Level Hospital

KYAMC Journal ◽

10.3329/kyamcj.v9i3.38785 ◽

2018 ◽

Vol 9 (3) ◽

pp. 129-132

Author(s):

Md Ali Kawsar ◽

Mohammad Rafiqul Islam ◽

Rifat Rezwana ◽

Md Rubayet Alam Prodhan ◽

Md Ahsan Habib ◽

...

Keyword(s):

Oral Hygiene ◽

Mean Value ◽

Orthodontic Appliances ◽

Tertiary Level ◽

Dental Floss ◽

Gingival Bleeding ◽

Fixed Orthodontic Appliances ◽

Orthodontic Patients ◽

Mouth Wash ◽

Medical University

Background: Oral hygiene maintenance becomes difficult during fixed orthodontic treatment.Objective: The aim of this study was to assess Gingival Bleeding Index among patients treated with fixed orthodontic appliances in a tertiary level hospital.Metanitil and Methody: This study was conducted on 100 patients treated with fixed orthodontic appliances for more than six months in the OPD of Orthodontics Department at Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2013 to July 2014. All the information related to oral hygiene maintenance like brushing, dental floss use, use of mout hwash during treatment in the OPD were recorded. The Gingival Bleeding Index (GBI) was calculated and recorded. Apart from this, frequency of brushing, type of tooth brush, technique of brushing and inter dental brush were also considered.Result: Over all mean value of GBI was 23.44±17.00. Mean value of GBI was 26.44 ± 15.23 among patients who brushed their teeth once a day but it was decreased gradually as the patients increased frequency of toot hbrush use per day and became 11.55±4.71 among the patients who brushed their teeth thrice a day. Mean value of GBI was 23.46±17.18 who did not use dental floss and 22.85 (12.64) who used dental floss once a day. Mean value of GBI was 25.30±17.73 who used inter dental brush irregularly but 2.75±0.35 who used it thrice a day. Mean value of GBI was25.17±17.69 who did not use mouth wash whereas it reduced to 8.00±0.00 among them who used mouth wash thrice a day.Conclusion: The Gingival Bleeding Index (GBI) is increased in patients treated with fixed orthodontic appliances.KYAMC Journal Vol. 9, No.-3, October 2018, Page 129-132

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Efficacy of a U-Shaped Automatic Electric Toothbrush in Dental Plaque Removal: A Cross-Over Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17134649 ◽

2020 ◽

Vol 17 (13) ◽

pp. 4649

Author(s):

Michele Nieri ◽

Veronica Giuntini ◽

Umberto Pagliaro ◽

Monica Giani ◽

Lorenzo Franchi ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Dental Plaque ◽

Controlled Trial ◽

Secondary Outcome ◽

Outcome Variable ◽

Plaque Score ◽

Plaque Removal ◽

Randomized Controlled ◽

Significant Difference ◽

Electric Toothbrush

Background: The aim of this single-use, four-treatment, four-period (visit), cross-over, mono-centered, examiner-blind, cross-over randomized controlled trial (RCT) was to evaluate the efficacy in dental plaque removal of a U-shaped automatic electric toothbrush (U) compared to a conventional powered toothbrush (P), a habitual toothbrushing procedure (H), and no brushing (N). Methods: Eligible participants were volunteer students. Primary outcome measure was the reduction in full-mouth plaque score (FMPS) after brushing. The secondary outcome variable was a visual analogic scale (VAS) on subjective clean mouth sensation. Mixed models were performed for difference in FMPS and VAS. Results: Twenty-two participants were randomized to the treatments in the four periods of the study. The differences between treatments in FMPS reduction after brushing were statistically significant (p < 0.0001). The differences were statistically significant between the U and P groups (difference −48; 95% CI from −54 to −41) favoring the P group, and between the U and H groups (difference −45; 95% CI from −52 to −39) favoring the H group. On the contrary, the difference between the U and N groups was not significant (difference 5; 95% CI from −2 to 12) favoring the U group. The differences between treatments in clean mouth VAS was statistically significant (p < 0.0001) favoring the P and H groups. Conclusions: The U-shaped automatic electric toothbrush tested in this study proved to be not effective in removing dental plaque.

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Microbiologic Changes in Subgingival Plaque After Removal of Fixed Orthodontic Appliances

The Angle Orthodontist ◽

10.2319/111808-593r.1 ◽

2009 ◽

Vol 79 (6) ◽

pp. 1149-1155 ◽

Cited By ~ 9

Author(s):

Dong-Soon Choi ◽

Bong-Kuen Cha ◽

Paul-Georg Jost-Brinkmann ◽

Si-Young Lee ◽

Beom-Seok Chang ◽

...

Keyword(s):

Detection Method ◽

Orthodontic Appliances ◽

Treponema Denticola ◽

Subgingival Plaque ◽

Campylobacter Rectus ◽

Prevotella Nigrescens ◽

Fixed Orthodontic Appliances ◽

Orthodontic Patients ◽

Polymerase Chain ◽

Subgingival Microbiota

Abstract Objective: To evaluate changes that occur in the subgingival microbiota after removal of fixed orthodontic appliances using polymerase chain reaction (PCR). Materials and Methods: Thirty orthodontic patients (11 males and 19 females; aged 20 ± 7.3 yr) were included in this study. Subgingival plaque samplings were gathered from the disto-buccal gingival crevice of the left upper central incisors and the left lower central incisors, and from the mesio-buccal gingival crevice of the left upper first molars and the left lower first molars, at two different times: 2 weeks before appliance removal (T1), and 3 months after appliance removal (T2). DNA was extracted from the samples and the 16S rRNA-based PCR detection method was used to determine the prevalence of Actinobacillus actinomycetemcomitans, Tannerella forsythia, Campylobacter rectus, Eikenella corrodens, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, and Treponema denticola, which are considered as putative periodontopathogens. Results: The frequency of positive sites at T1 and T2 was 65% and 43.3% for C. rectus, and 53.3% and 30.8% for E. corrodens, respectively. For the other bacteria, the frequency tended to be reduced between times. Conclusion: Periodontopathogens during orthodontic treatment were significantly reduced within 3 months of appliance removal. However, how long it takes to return to the preorthodontic composition of the subgingival microbiota and whether it happens at all remain to be seen.

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Correlations Between Two Plaque Indices in Assessment of Toothbrush Effectiveness

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-7-5-1 ◽

2006 ◽

Vol 7 (5) ◽

pp. 1-9 ◽

Cited By ~ 19

Author(s):

MaryAnn Cugini ◽

Maureen Thompson ◽

Paul R. Warren

Keyword(s):

Pearson Correlation ◽

Correlation Coefficients ◽

Plaque Score ◽

Plaque Removal ◽

Minimum Score ◽

Single Use ◽

Positive Correlations ◽

Using Data ◽

Clinical Measurements ◽

Study Designs

Abstract Background The Rustogi et al. Modified Navy (RMNPI) and Turesky et al Modification of the Quigley Hein (TQHPI) plaque indices are commonly used to measure plaque removal. This study evaluated the possible correlations of both indices using data relative to a single use assessment of plaque removal using commercially available toothbrushes. Methods Single use crossover study designs have been previously reported. Disclosed plaque was scored pre- and post-brushing using both the RMNPI and the TQHPI. Sixty subjects, with an initial mean RMNPI score of 0.6 or greater, were enrolled and completed the study. No minimum score was required for TQHPI. After the initial scoring, the order for each index was randomized so that each subject was scored with either RMNPI followed by TQHPI or vice versa. Two manual toothbrushes [Oral-B® CrossAction® (CA) and Colgate® Navigator. (NA)] and one battery-powered brush (Crest® SpinBrush. Pro) (SBP) were evaluated in the trial. One examiner performed all clinical measurements. Pearson correlations were performed on whole mouth, buccal, and lingual plaque scores for the CA toothbrush. Results Strong positive correlations were found between the two plaque indices for pre- and post-brushing scores for the whole mouth and on lingual and buccal surfaces, where Pearson correlation coefficients ranged between 0.963 and 0.995. There was no correlation between the pre-brushing plaque score and the amount of plaque removed by brushing indicating that higher plaque levels before brushing do not necessarily predict that greater amounts of plaque will be removed during toothbrushing. Each toothbrush was found to be safe and significantly reduced plaque levels after a single brushing (t-test, p=0.0001). Significantly greater plaque reductions were found with the CA than the NA and SBP toothbrushes at whole mouth, lingual, and approximal surfaces for both indices (analysis of variance (ANOVA), p . 0.0002 for all comparisons). Conclusions Strong positive correlations were found between two plaque indices (the RMNPI and TQHPI) for pre- and post-brushing scores at whole mouth, lingual, and buccal surfaces as assessed using data from a single use assessment of plaque removal. Efficacy data from this study demonstrated the CA toothbrush provided superior cleaning when compared to the NA manual toothbrush and SBP battery toothbrush. Clinical Implications Two commonly used indices for assessing plaque removal in clinical studies are RMNPI and TQHPI. However, each index differs in the way plaque is scored. This study used both indices to assess comparative toothbrush efficacy and showed a strong correlation between indices for both pre- and postbrushing plaque scores. The result suggests that both indices demonstrate sufficient sensitivity to differentiate toothbrush efficacy. Citation Cugini M, Thompson M, Warren PR. Correlations Between Two Plaque Indices in Assessment of Toothbrush Effectiveness. J Contemp Dent Pract 2006 November;(7)5:001-009.

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Caries-Preventive Effects of Fluoride-Releasing Materials

Advances in Dental Research ◽

10.1177/08959374950090040601 ◽

1995 ◽

Vol 9 (4) ◽

pp. 377-383 ◽

Cited By ~ 19

Author(s):

T. Büyükyilmaz ◽

B. Øgaard

Keyword(s):

Clinical Studies ◽

Antimicrobial Agents ◽

Orthodontic Appliances ◽

Clinical Effects ◽

Bonding Agents ◽

Model Studies ◽

Fixed Orthodontic Appliances ◽

Caries Model ◽

Orthodontic Patients ◽

Caries Lesions

The plaque-retentive properties of fixed orthodontic appliances result in a severe challenge on surfaces generally not susceptible to caries. Lesions may develop within a month in the absence of fluoride, and clinical studies have shown that from 50 to 75% of orthodontic patients develop decalcifications on labial surfaces during treatment. Fluoride mouthrinses reduce the occurrence, although compliance is often poor. Orthodontic bonding agents and cements releasing fluoride, which reduce the need for cooperation, have been introduced. Few clinical studies have been done to prove the cariostatic properties of fluoride-releasing materials in orthodontics. In short-term caries model studies, glass ionomers and a glass filler containing light-cured adhesive that releases relatively large amounts of fluoride have shown cariostatic properties. However, during severe challenges such as occur with orthodontic appliances, fluoride alone has limited cariostatic properties. The combination of fluoride with antimicrobial agents, and the use of acidic fluoride solutions depositing acid-resistant coatings of calcium fluoride and titanium have shown to give better clinical effects than fluoride alone during extreme conditions. Fluoride-releasing materials may therefore be considered as useful supplements to these procedures.

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Microbiological Evaluation of Octenidine Dihydrochloride Mouth Rinse after 5 Days' Use in Orthodontic Patients

The Angle Orthodontist ◽

10.2319/062008-322.1 ◽

2009 ◽

Vol 79 (4) ◽

pp. 766-772 ◽

Cited By ~ 13

Author(s):

Alev Aksoy Dogan ◽

Emel Sesli Cetin ◽

Emad Hüssein ◽

Ali Kudret Adiloglu

Keyword(s):

Inhibitory Effect ◽

Oral Bacteria ◽

Lactobacillus Species ◽

Orthodontic Appliances ◽

Cariogenic Bacteria ◽

Fixed Orthodontic Appliances ◽

Octenidine Dihydrochloride ◽

Orthodontic Patients ◽

Fixed Appliances

Abstract Objective: To determine the absolute and relative antibacterial activity of octenidine dihydrochloride (OCT) against total and cariogenic bacteria in saliva samples of patients with fixed orthodontic appliances during 5 days of usage. Materials and Methods: The study group consisted of 5 male and 13 female subjects who were selected from patients in the Clinic of Orthodontics. Each patient was given physiologic saline (PS), chlorhexidine gluconate (CHX), polyvinylpyrrolidone-iodine complex (PVP-I), and OCT every morning for 5 days, each separated by a 2-week interval. Total and cariogenic bacteria in saliva samples of orthodontically treated patients with fixed appliances were collected during 5 days of usage. Unstimulated saliva was collected as a baseline sample. Saliva samples were collected at 15 minutes, and on the second, third, and fifth day after rinsing the mouth with any of the solutions for 30 seconds, and bacterial counts were detected. Results: OCT showed an ultimate reduction of total viable oral bacteria, Lactobacillus species, and Streptococcus mutans in vivo. OCT also had a significantly greater inhibitory effect than 0.2% CHX and 7.5% PVP-I, from the beginning of the study until the fifth day after the orthodontic appliances were bonded (P < .1). Conclusions: OCT compared favorably with respect to CHX and PVP-I complex in orthodontically treated patients with fixed appliances (P ≤ .1).

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Online Oral Hygiene Instructions for Orthodontic Patients in Malaysian Population

Medicine & Health ◽

10.17576/mh.2021.1601.18 ◽

2021 ◽

Vol 16 (1) ◽

pp. 223-236

Author(s):

Nurul Asyikin Yahya ◽

Keyword(s):

Oral Hygiene ◽

Oral Care ◽

Knowledge Retention ◽

High Rate ◽

Orthodontic Appliances ◽

Massive Open Online Course ◽

Learning Content ◽

Fixed Orthodontic Appliances ◽

Orthodontic Patients ◽

Oral Hygiene Instructions

Fixed orthodontic appliances causes plaque accumulation, which leads to the formation of dental caries and gingivitis. Therefore, concise oral hygiene instructions (OHI) is necessary to avoid the occurrence of these diseases. Massive Open Online Course (MOOC) ensures interactive learning to improve knowledge retention. MOOC transfers the responsibility of learning OHI to the patients with remote guidance from the clinician, thus reduces clinical time. This research aimed to develop the MOOC learning content on OHI in orthodontic practice. The secondary aim was to assess the overall analytics data among learners enrolled for the completion rate and time taken to complete the MOOC. The ADDIE principles which were, "Analyse, Design, Develop, Implement and Evaluate", were used to develop the MOOC. The contents were based on a published pamphlet of OHI from the Ministry of Health, Malaysia. The MOOC was pre-tested, and content was improved based on the feedback from users and experts. The MOOC named “Penjagaan Kebersihan Pendakap Gigi” utilises the Bahasa Melayu language to educate learners regarding oral care with orthodontic appliances. Sixty-two learners joined the MOOC, with 77.4% achieving a high rate of completion of the MOOC learning content. There were forty-six female learners (74.2%), while male learners comprised sixteen (25.8%). The median (interquartile range) time taken to complete MOOC learning content were 31.50 minutes, (13.00 minutes to 55.50 minutes). This shows that MOOC could be an alternative platform to instruct patients on OHI with fixed appliances. MOOC can potentially reduce clinical time to teach OHI to patients.

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