Biomedical subjects

P R Warren

Publications and source records attributed to P R Warren.

At least 37 records · Page 2Linked to original sources

PubMed2001

Safety, efficacy and acceptability of a new power toothbrush: a 3-month comparative clinical investigation.

PURPOSE: To compare the safety and efficacy of a new power toothbrush (Braun Oral-B D17) with an ADA reference manual toothbrush. MATERIALS AND METHODS: 110 healthy subjects, 18-65 yrs of age, with a mean plaque index of > or = 1.80 and a gingival index of > or = 1.00, were enrolled in this 3-month, randomized, parallel-group, examiner-blind study. Oral soft and hard tissues were examined for safety, and plaque, gingivitis and bleeding were measured to evaluate efficacy. Measurements were made at baseline and after 1 and 3 months of product use. Following the baseline visit and randomization, subjects were instructed to brush twice daily for 2 mins with their assigned brush. RESULTS: 101 subjects completed the study with evaluable data for all time periods, 52 in the D17 group and 49 in the manual group. None of the nine withdrawals from the study were related to product use and no product-related adverse effects were reported. There was no clinically significant soft or hard tissue abrasion observed at any time point in either group. After 1 and 3 months, significant reductions from baseline in whole mouth and interproximal plaque, gingivitis and bleeding were observed in both groups. A comparison of the two groups revealed that the whole mouth and approximal plaque indices were reduced to a significantly greater extent in the D17 group after both 1 and 3 months. The whole mouth gingival index was also reduced to a greater extent in the D17 group at 1 and 3 months, but a difference in the approximal gingival index was only apparent after 3 months. With respect to the bleeding index, there was a significant difference between the two groups for the whole mouth at both 1 and 3 months, but the differences in favor of the D17 for approximal values did not achieve statistical significance. In conclusion, the D17 was found to be safe and had increased efficacy with respect to reduction of plaque and gingivitis, compared with a manual toothbrush.

Adolescent↗

PubMed2001

A 3-month clinical comparison of the safety and efficacy of two battery-operated toothbrushes: the Braun Oral-B Battery toothbrush and the Colgate Actibrush.

PURPOSE: To compare the safety and efficacy of two battery-operated, non-rechargeable power toothbrushes, the Braun Oral-B Battery toothbrush (D4) and the Colgate Actibrush. MATERIALS AND METHODS: This was a randomized, single-blind, parallel-group study carried out over a 3-month period. A total of 114 subjects from a general population, who met the inclusion criteria of the study and who had whole mouth plaque scores of > or = 1.5 and gingivitis scores of > or = 1.2, participated in the study. Subjects were given either the D4 or the Colgate Actibrush with the manufacturers' instructions, and were asked to brush their teeth at home twice each day. At baseline and after 1 and 3 months, subjects were examined for oral hard and soft tissue health, after which they were assessed for gingivitis (Modified Gingival Index), bleeding (Gingival Bleeding Index), and plaque (Modified Quigley-Hein Plaque Index). Prior to each assessment, subjects refrained from all oral hygiene procedures for a period of 12-18 hours. RESULTS: No evidence was found of significant oral soft or hard tissue trauma, and both brushes were considered to be safe when used according to the manufacturers' instructions. In the D4 group, whole mouth, marginal and approximal plaque scores were significantly reduced from baseline (P < 0.05) after both 1 and 3 months by 7-12%, whereas, in the Actibrush group, plaque scores remained relatively unchanged from baseline throughout the study. Furthermore, comparisons between the toothbrush groups showed that whole mouth, marginal and approximal plaque scores for the D4 were significantly lower than those for the Actibrush at both the 1- and 3-month assessments. Modified Gingival Index scores after 3 months were significantly reduced from baseline in both groups by 7-8%. Similarly, percentages of bleeding sites were significantly lower by 12-15%. There were no significant differences between the groups with respect to gingivitis scores.

Adolescent↗

PubMed2001

A single-use and 3-month clinical investigation of the comparative efficacy of a battery-operated power toothbrush and a manual toothbrush.

PURPOSE: To compare the safety and efficacy of a manual toothbrush and a battery-operated power toothbrush in two separate studies, one utilizing a single-use design and the other a 3-month parallel-group design. MATERIALS AND METHODS: The toothbrushes compared in the two studies were the Oral-B CrossAction manual toothbrush and the Colgate Actibrush battery-operated power toothbrush. The single-use study, which used a single-blind, cross-over design, involved 71 healthy subjects, who were instructed to abstain from oral hygiene for 23-25 hours prior to brushing with each of the two toothbrushes. Plaque was measured using the Proximal Marginal Index (PMI) pre- and post-brushing. The 3-month parallel-group study involved a total of 113 subjects who had plaque (PMI), gingivitis and bleeding (Loe and Silness) scored at baseline and after 1 and 3 months of product use. RESULTS: In both studies, the two toothbrushes were found to be safe. In the single-use study, significantly greater amounts of plaque were removed by the CrossAction manual toothbrush than by the Actibrush for the whole mouth as well as for marginal and approximal sites (P < 0.001). In the 3-month study, significantly greater plaque reduction was achieved with the CrossAction brush, the advantage being significant at 1 month for all sites except lingual sites (P < 0.05). At 3 months, there were consistent numerical advantages in favor of the CrossAction at all sites except lingual sites. Reductions in gingivitis were found to be similar with both toothbrushes.

Adolescent↗

PubMed2001

A laboratory comparison of the efficacy of battery-operated, non-rechargeable power toothbrushes.

PURPOSE: To evaluate the cleaning efficacy of three battery-operated, non-rechargeable, oscillating/rotating power toothbrushes, using a robot system to simulate normal clinical toothbrush use. MATERIALS AND METHODS: The study compared the cleaning efficacy of the new Braun Oral-B D4/EB4 with the Actibrush and the Dr. Best Powerclean in two independent experiments. Plaque substitute was applied to the artificial teeth of typodonts, which were cleaned by the robot system for a total of 2 minutes at a brushing force of 1.95 N. The remaining plaque substitute on buccal + lingual/palatal and occlusal surfaces, as well as gingival margin and interproximal sites, was measured using a computerized vision system. RESULTS: The new D4/EB4 was found to remove more plaque substitute than the Actibrush at all sites, and for all surfaces, lingual surfaces and occlusal surfaces the difference in favor of the D4/EB4 was statistically significant (P < 0.05). In comparison with the Powerclean toothbrush, the D4/EB4 was significantly more effective at all sites (P < 0.001). These results indicate that not all battery-operated oscillating/rotating power toothbrushes have equal efficacy with respect to plaque removal and that, in this series of laboratory experiments, the Braun Oral-B D4/EB4 was more effective than the Actibrush and the Dr. Best Powerclean.

Dental Plaque↗

PubMed2000

A practice-based study of a power toothbrush: assessment of effectiveness and acceptance.

BACKGROUND: The greater effectiveness of the power toothbrush compared with a manual toothbrush is well-documented. Despite this, acceptance by dental professionals is still low. METHODS: This general practice study evaluated the effectiveness of a power toothbrush (Braun Oral-B Ultra Plaque Remover, Braun GmbH) in 16,903 patients, based on the clinical opinions of dental professionals in regard to patients' changing oral health status. In addition, a survey assessed the attitudes of dental professionals and patients toward the power toothbrush. RESULTS: The power toothbrush was considered by dental professionals to have had a positive effect on the oral health of 80.5 percent of their patients; the noticeable benefits with respect to a number of clinical criteria included plaque removal and improved gingival condition. Most patients in the study (88.9 percent) reported that they would continue using the power toothbrush once the study was completed. At the end of the study, many more dentists and hygienists considered the power toothbrush to be the most effective way of brushing, and almost 70 percent said that they would now be more likely to recommend a power toothbrush to their patients. CONCLUSIONS: The power toothbrush improved the oral health of patients in this practice-based study, and the number of dental professionals who said they would recommend a power toothbrush increased markedly during the study. CLINICAL IMPLICATIONS: Enabling dental professionals to evaluate the effect of a power toothbrush reinforces the findings from controlled clinical studies and increases their awareness of its potential to improve oral hygiene.

Adolescent↗

PubMed2000

A comparison of the Braun Oral-B 3D plaque remover and the Sonicare plus electric toothbrush in removing naturally occurring extrinsic staining.

PURPOSE: To compare the extrinsic stain-removing properties and the safety of the Braun Oral-B 3D Plaque Remover and the Sonicare Plus electric toothbrush. MATERIALS AND METHODS: This randomized, parallel group, investigator-blinded study involved 67 subjects and was conducted over 6 weeks. After recruitment, the subjects received a baseline stain assessment (Lobene stain index) and a soft and hard tissue examination, and were then randomized to use either the Sonicare or the 3D device. All subjects were trained to use both devices, and instructed to brush twice daily with their assigned device for 2 min. The subjects' brushing technique was checked after 2 weeks. After a further 4 weeks, the subjects underwent a final stain assessment and soft and hard tissue examination. A questionnaire was also completed. RESULTS: At 6 weeks, oral hard and soft tissue examinations revealed no abrasion or damage in either group. Both brushes produced significant (P < 0.001) reductions from baseline in total stain score, stain area and intensity, but group comparisons showed that these reductions were significantly (P < 0.001) greater for the 3D device.

Adolescent↗

PubMed1999

Assessing the efficacy and safety of an electric interdental cleaning device.

BACKGROUND: Although routine interdental cleaning is important and recommended by dental professionals, compliance has been relatively low. To aid in improving compliance, an electrically powered device has been developed. METHODS: This six-month randomized, single-blinded, parallel-group study was conducted to compare the long-term efficacy and safety of a new interdental cleaning device (Braun Oral-B Interclean, model ID2) with those of an ADA-approved waxed dental floss in healthy adults. RESULTS: The authors found no statistically significant difference between the two products with respect to the gingival index or gingival bleeding index after three or six months of use. A one-time product use, at the six-month examination, confirmed the equivalency of the two methods with respect to removal of dental plaque. The oral soft-tissue status of both groups of subjects also remained comparable throughout the study. CONCLUSION: Use of the interdental cleaning device and dental floss resulted in comparable benefits with respect to gingival health and plaque removal. CLINICAL IMPLICATIONS: Although it was not shown to be an improvement over dental floss, the cleaning device was comparable in every respect. Since it can be used with one hand and does not require as much dexterity as floss, the device warrants consideration by those who lack the motivation or are unable to use dental floss.

Adult↗

PubMed1998

Electric toothbrush use. Attitudes and experience among dental practitioners in Germany.

PURPOSE: To evaluate the attitudes and experience of electric toothbrush use among dental practitioners in Germany. MATERIALS AND METHODS: A telephone survey of 399 dentists was conducted. RESULTS: Many dentists in Germany (41%) thought that between half and 70% of their patients do not clean their teeth correctly, and that this is the result of either poor brushing technique or insufficient brushing time coupled with insufficient visits to the dentist. Most dentists surveyed (61%) would recommend an electric toothbrush to their patients in order to improve oral hygiene control, and of these, 82% would recommend the Braun Oral-B Plaque Remover. When these dentists were asked if there had been any change in tooth and gum condition among those patients who switched from using a manual toothbrush to the Braun Oral-B Plaque Remover, 73% said that they had observed an improvement. None of the dentists interviewed had noted any deterioration. These views of German dentists are in agreement with laboratory and clinical studies that have shown an advantage for the Braun Oral-B Plaque Remover over a manual toothbrush. The results indicate that clinical trial results are a relevant way of assessing toothbrush performance, and that results may be extrapolated to normal home use.

Adult↗

PubMed1998

Cleaning efficacy of a new electric toothbrush.

PURPOSE: To evaluate the cleaning efficacy of a new electric toothbrush and new brush head design, using a robot system to simulate normal clinical toothbrush use. MATERIALS AND METHODS: The study compared the new oscillating/rotating/pulsating electric toothbrush (Braun Oral-B 3D Plaque Remover) comprised of the D15 handle and new EB15 brush head, with the clinically established oscillating/rotating electric toothbrush (Braun Oral-B Ultra Plaque Remover-D9) and brush head (EB9). Plaque substitute was applied to the artificial teeth of typodonts, which were cleaned by the robot system for 2 minutes. The remaining plaque substitute was measured for buccal + lingual/palatal and occlusal surfaces, as well as gumline and interproximal sites using a computerized vision system. RESULTS: The new D15/EB15 combination was found to be significantly more effective than the D9/EB9 combination in removing plaque substitute at all surfaces combined and all specific sites (P < 0.001). These results show that the new toothbrush which features an additional pulsating motion (D15), combined with the new brush head design (EB15), offer improved efficacy in comparison with the established oscillating/rotating combination (D9/EB9).

Dental Plaque↗

PubMed1998

Clinical plaque removing efficacy of a new power toothbrush.

PURPOSE: To evaluate the effect of adding a pulsating bristle action to the established oscillating/rotating action of the Braun Oral-B Ultra Plaque Remover (D9) on plaque removal. MATERIALS AND METHODS: Plaque removal was evaluated using the modified Quigley-Hein Plaque Index in a double blind randomized, crossover study involving 32 healthy volunteers without any dental training. After 2 weeks use of the D9 during which time subjects received training in its use, subjects abstained from oral hygiene for 48 hours. They were then assessed for plaque after which they brushed their teeth using an experimental toothbrush randomly set to either the D9 oscillating/rotating action or to the new 3D action with an additional pulsating movement of the brush head in the direction of the long axis of the bristles. After brushing, plaque was again evaluated. Following a further 2 weeks of normal home use of the D9, subjects returned and the procedure was repeated using the brush set in the second mode. RESULTS: Both toothbrush actions were found to be effective at removing plaque from all sites and surfaces in the mouth. The 3D action was consistently more effective than that of the D9, the difference being statistically significant for the whole mouth, the upper jaw, the lingual surfaces and for all interproximal sites, in particular in the upper jaw.

Adolescent↗

PubMed1998

A 3-month clinical investigation comparing the safety and efficacy of a novel electric toothbrush (Braun Oral-B 3D Plaque Remover) with a manual toothbrush.

PURPOSE: To compare the efficacy and safety of a novel electric toothbrush (Braun Oral-B 3D Plaque Remover) with a standard reference ADA manual toothbrush. MATERIALS AND METHODS: 114 subjects were included in a 3-month randomized, parallel group, examiner-blind study and divided into two groups: 3D users and manual toothbrush users. Subjects were instructed to brush twice daily for 2 minutes. Evaluation of oral soft and hard tissue for safety, plaque, gingivitis and bleeding was conducted prior to the start of product use (at baseline), at days 14 and 35, and at 3 months. RESULTS: 105 subjects (55 3D users and 50 manual toothbrush users) completed the study. At days 14, 35 and at 3 months both groups showed reductions from baseline in whole mouth plaque, gingivitis and bleeding that were statistically significant (P < 0.005), except in the case of plaque at day 35 in manual toothbrush users. At 3 months, reductions for whole mouth plaque, gingivitis and bleeding were 15%, 16% and 65%, for 3D users and 8%, 12% and 56%, for manual toothbrush users, respectively. Group differences were significant (P < 0.05) in favor of the 3D with respect to plaque reduction for the whole mouth and for interproximal and anterior lingual sites at all three time periods. With respect to gingivitis, reductions for the whole mouth and interproximal and posterior lingual sites at 3 months were significantly greater in the 3D group. There was no clinically significant soft or hard tissue abrasion in either group. In conclusion, the 3D electric toothbrush was found to be safe and had increased efficacy with respect to reduction of plaque and gingivitis compared to a manual toothbrush.

Adolescent↗

PubMed1998

A comparison of the efficacy of a novel electric toothbrush and a manual toothbrush in the treatment of gingivitis.

PURPOSE: To compare the efficiency of a new electric toothbrush featuring a novel three-dimensional brush head action, with a manual toothbrush, in resolving gingivitis which had been allowed to develop in a group of subjects prior to the treatment phase of the study. MATERIALS AND METHODS: This was a randomized split-mouth study. A total of 35 healthy non-dental students refrained from any oral hygiene on the lower jaw for a period of 21 days in order to develop gingivitis. They then brushed one quadrant of the lower jaw with the Braun Oral-B 3D Plaque Remover and the other with a manual toothbrush for a period of 4 weeks. Plaque and gingivitis were evaluated at the start of the study, after the 21 days of no oral hygiene, and after 1, 2, 3 and 4 weeks of brushing twice a day. RESULTS: At the end of the study, the 3D was found to be significantly more effective at reducing bleeding on probing (P < 0.05) for all sites combined and all individual sites. Plaque removal was also significantly more effective with the 3D. Subjects in the study reported that they preferred the 3D to the manual toothbrush and said that it would encourage them to brush for longer. It is concluded that the new Braun Oral-B 3D Plaque Remover offers advantages over a manual toothbrush in terms of plaque control and improvement of gingival condition.

Adolescent↗

PubMed1998

A comparison of electric toothbrushes in their potential to cause gingival abrasion of oral soft tissues.

PURPOSE: It has previously been established that gingival abrasion associated with the Braun Oral-B Ultra Plaque Remover (D9) is minimal and comparable to that observed with a manual toothbrush. The purpose of this single-use study was to compare gingival abrasion with the D9 and a novel electric toothbrush, the Braun Oral-B 3D Plaque Remover (3D). MATERIALS AND METHODS: 49 subjects (non-dental students) with at least 24 natural teeth and an absence of periodontal probing depths of 5 mm or greater were included in this study. Following a familiarization phase, all subjects received a single prophylaxis and were asked not to brush their teeth for 24 hours prior to their appointment. At this visit, the gums were disclosed by Mira-2-Tone solution and all gingival abrasion on the soft tissues was assessed and recorded. Subjects then brushed their teeth in a random split-mouth order with the two electric toothbrushes, using brush heads of the same design (EB9). The gums were then re-disclosed and gingival abrasions were recorded. They were recorded as either small sites of abrasion (< or = 5 mm) or large sites of abrasion (> 5 mm). RESULTS: The mean number of small traumas increased from 2.57 at baseline to 4.04 after brushing with the D9 and from 1.98 to 4.14 after brushing with the 3D. There was no statistically significant difference between the two groups. For both toothbrushes, more small traumas were found in the upper jaw compared with the lower jaw. No increase in number of large traumas was observed.

Adolescent↗

PubMed1998

A crossover clinical investigation of the safety and efficacy of a new oscillating/rotating electric toothbrush and a high frequency electric toothbrush.

PURPOSE: To compare the efficacy on plaque, gingivitis and calculus of an oscillating/rotating power toothbrush (Braun Oral-B Ultra Plaque Remover-D9) and a high frequency toothbrush (sonicare). MATERIALS AND METHODS: A 6-week, randomized crossover study was carried out. A total of 62 healthy adult subjects completed the study and were assessed for plaque control, gingival condition and calculus control. At the end of the study, subjects completed a questionnaire which assessed their preferences for the two devices. RESULTS: Both toothbrushes were found to be safe and effective, but a significantly lower gingival index (P = 0.002) and a lower calculus index (P = 0.022) was found in the D9 group. Assessment of patient preferences revealed that a significant majority of subjects in the study (65%) preferred the D9 to the high frequency toothbrush (27%). It is concluded that the D9 may offer greater potential for the maintenance of good gingival condition than the high frequency toothbrush, and that the greater preference for the D9 may be important with respect to long-term compliance. The implications of these findings are discussed.

Adult↗

PubMed1997

A robot system for evaluating plaque removal efficiency of toothbrushes in vitro.

A robot system simulating three-dimensional brushing motions as a function of time has been developed. In association with a typodont and either artificial plaque or chromogenic stain, the robot system can be used to assess the plaque removal efficiency or the cleaning effectiveness of toothbrushes. In particular, the influence of different brush head designs of powered toothbrushes was examined. The study compared the plaque removal efficiency of a cup-shaped brush head (Braun Oral-B EB 5) and a modified brush head (Braun Oral-B EB 9) that incorporates longer filaments on the outer ring, designed for additional interdental penetration. A specially designed artificial plaque was applied to the plastic teeth of typodonts. Artificial teeth were cleaned by the robot system for a 2-minute period with a wet brush head without a dentifrice. The remaining plaque was assessed visually by two independent examiners, with a modification of the global Plaque Index. In comparison to the EB 5, the new brush head significantly reduced artificial plaque overall. In vitro data demonstrated the ability of the robot system to reveal reproducible significant differences of the cleaning effectiveness of powered toothbrushes.

Dental Plaque↗

PubMed1996

The role of the electric toothbrush in the control of plaque and gingivitis: a review of 5 years clinical experience with the Braun Oral-B Plaque Remover [D7].

The Braun Oral-B Plaque Remover (D7) (previously known as D5) is a well established electric toothbrush available worldwide. It has a round brush head with a diameter of 13 mm, with bristle tufts arranged in three circular rings, and an oscillating/rotating action. Since its introduction in 1991, a significant number of well designed clinical investigations have been published comparing the D7 with manual toothbrushes, as well as with other electric devices. A review of the findings from these various studies indicates that while both the D7 and manual toothbrushes effectively remove plaque and improve gingival condition, the efficacy of the D7 is clearly greater than that of the manual toothbrush. It is suggested that this advantage is related in particular to greater efficiency in interproximal, vestibular and lingual sites. Compared to other electric toothbrushes, there is evidence that the D7 also offers greater efficacy, but this requires clarification in further clinical investigations. It is concluded that the greater efficacy of the D7 over that of a manual toothbrush, together with the motivational effect that has been shown to be associated with electric toothbrush use, should offer potential for improved oral hygiene control.

Dental Plaque↗

PubMed1996

The development of the Braun Oral-B Ultra Plaque Remover: an in vitro robot study.

PURPOSE: To assess the efficacy of a new brush head design and brushing action using a novel robot system which simulates normal clinical toothbrush use. The system allows developments in toothbrush design to be assessed prior to embarking on expensive and time consuming clinical trials. MATERIALS AND METHODS: Using this system, the efficacy of a new brush head design combined with a modified brushing speed, was compared with the clinically established Braun Oral-B Plaque Remover (D7 handle and EB5 brush head). RESULTS: A combination of a new brush head (EB9) with longer tufts of bristles designed to improve interdental penetration, and an increased frequency of bristle movement (63Hz, 3,800 strokes per minute - D9 handle) was associated with significantly greater removal of artificial plaque. Visual observation of typodonts suggested that this increased efficacy is related to greater removal of plaque from interdental surfaces and occlusal fissures. These results suggest that the D9/EB9 prototype electric toothbrush is suitable for further investigation and clinical evaluation.

Dental Plaque↗

PubMed1996

An overview of established interdental cleaning methods.

The removal of interproximal plaque is considered to be important for the maintenance of gingival health, prevention of periodontal disease and the reduction of caries. Unfortunately, the toothbrush is relatively ineffective at removing interproximal plaque, and therefore patients need to resort to additional techniques. Floss, woodsticks, rubber tips and interdental brushes currently represent the primary methods available for interproximal cleaning. No one method suits all patients and it is difficult for any of these methods to access the posterior dentition. Floss is the most widely used method of interdental cleaning and the American Dental Association reports that up to 80% of interdental plaque may be removed by this method, resulting in a significantly reduced incidence of caries and prevention of periodontal disease. The main problem with all interdental cleaning is, however, patient ability and motivation. Patients are known to find flossing difficult, especially where there are tight contact points, and therefore interdental cleaning does not readily become an established part of daily oral hygiene. As such, there is a need for new techniques/devices to be developed that will make interdental cleaning easier and improve patient motivation. Results of clinical and laboratory studies have indicated that the Braun Oral-B Interclean (ID2) is a safe and effective device for the reduction of interproximal plaque and the control of gingivitis. In addition, the ID2 was preferred by the majority of volunteers to conventional floss.

Dental Caries↗