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PubMed2002

The effect of duration and force of mechanical toothbrushing stimulation on proliferative activity of the junctional epithelium.

BACKGROUND: Gingival bleeding is frequently accompanied by an ulcerated epithelium, with repair depending on the proliferative activity of the epithelial cells. The present study examined the proliferative activity of the junctional epithelium (JE) under several different methods of toothbrushing stimulation. METHODS: Twelve dogs were used in this 3-week experiment. Prior to the experiment, all teeth underwent daily removal of plaque and calculus using a scaler. Teeth were then divided into quadrants: 9 teeth in 3 quadrants (test, 3 per quadrant) were mechanically stimulated by toothbrushing for various time intervals (10, 20, or 40 seconds) and at various forces (100, 200, or 250 gf). The 3 teeth in the fourth quadrant served as controls. The proliferative activity of the basal cells of the junctional epithelium was evaluated for expression of proliferating cell nuclear antigen (PCNA). The numbers of PCNA-positive basal cells and total basal cells were counted, and the width of the junctional epithelium was measured. RESULTS: Toothbrushing force significantly affected the PCNA-positive basal cell ratio (P < 0.05). The 200 g toothbrushing force produced the highest PCNA-positive basal cell ratio, which was significantly higher than that using the 100 g force (P < 0.05). CONCLUSION: In junctional epithelium stimulated with a toothbrush, the PCNA-positive basal cell ratio is more sensitive to toothbrushing force than to duration.

Analysis of Variance↗
PubMed2006

Quality of trials in a systematic review of powered toothbrushes: suggestions for future clinical trials.

BACKGROUND: This study aimed to assess the quality of reports of randomized controlled trials (RCTs) comparing manual and powered toothbrushes and provide advice on how future trials might be improved. METHODS: Studies were identified in the Cochrane systematic review of RCTs comparing powered versus manual toothbrushes. Reports were assessed against predefined criteria on the design of the studies to determine the effectiveness of the brushes in everyday home use and on their methodological quality. RESULTS: Only 42 of 297 identified studies satisfied the inclusion criteria and were eligible for inclusion in the review. Many studies were excluded for more than one reason. Fifteen studies employed split-mouth designs that may have changed toothbrushing behavior. Of 42 included RCTs, the generation of randomization sequence was adequate in 15 trials and concealment of allocation was adequate in 16 trials. Intention-to-treat analysis was reported in only five studies. Plaque data were reported using 10 different indices and gingivitis with nine indices. Only 12 trials lasted 3 months or longer, and there were no data on the benefits of powered toothbrushes for periodontal attachment. CONCLUSIONS: Some designs created an artificial research environment that may have undermined the findings. Authors of toothbrush trials should consider the Consolidated Standards of Reporting Trials statement. Greater standardization of the indices used is required. Trials of longer duration would enhance the evaluation of powered toothbrushes. Data on thresholds for clinically significant differences in plaque and gingivitis levels would help to determine whether oral hygiene aids provide important health benefits.

Dental Devices, Home Care↗
PubMed2003

Wear test combining simulated occlusal wear and toothbrush wear.

A new wear testing system, which carries out toothbrush wear and simulated occlusal wear tests alternately, was developed. Differences in wear behavior among three modes of wears, combined wear, toothbrush wear and simulated occlusal wear, were investigated using polymethylmethacrylate (PMMA) and two commercial resin composites (Z100, APX). The area of the material loss after each test was measured on the worn surfaces to evaluate the different modes of wears. On PMMA and Z100, the toothbrush wear corresponded to the combined wear, suggesting that toothbrush wear was dominant in the combined wear for these materials. On the other hand, the occlusal wear was dominant corresponding to the combined wear on APX. Both the simulated occlusal wear and toothbrush wear tests are essential to evaluate the wear behavior of restorative materials, and the combined wear test is effective to analyze the wear behavior of restorative materials under different wear processes which consist of toothbrush wear and simulated occlusal wear.

Analysis of Variance↗
PubMed2000

Usefulness of a toothbrush as a source of evidential DNA for typing.

We investigated the usefulness of a toothbrush as a source of DNA for an unidentified cadaver. Ten toothbrushes were obtained from ten individuals along with their peripheral blood. We recovered from 10 to 430 ng of DNA from all but one of the toothbrushes. All ten toothbrushes, including the one containing no detectable DNA by fluorometry, were typed correctly at all of the loci tested, including nine STRs. Three toothbrushes obtained in two actual deaths also identified two victims and one suspect. Therefore, toothbrushes seem to be useful as a source of evidential DNA for personal identification.

Cadaver↗
PubMed2000

A comparative clinical investigation of a novel toothbrush designed to enhance plaque removal efficacy.

PURPOSE: To investigate the safety and efficacy of a new toothbrush with a novel brush head design (Oral-B CrossAction) in comparison with seven leading manual brushes. MATERIALS AND METHODS: Seven independent clinical studies, each involving approximately 100 healthy subjects from a general population, were carried out using a crossover design. In each study, the Oral-B CrossAction toothbrush was compared with an alternative brush for plaque removal efficacy. Plaque was evaluated before and after brushing for 60 s using the Proximal/Marginal Plaque Index. Subjects were randomly assigned to the two brushes in each study and after brushing at visit 1 they returned after a further 2 weeks to repeat the procedure with the second brush. RESULTS: All toothbrushes in the seven studies significantly reduced levels of plaque from their pre-brushing values and were found to be safe with no evidence of oral soft tissue trauma. In each of the studies, the CrossAction was found to be significantly (P < 0.05) more effective than the comparison brush for whole mouth plaque scores, as well as for plaque scores at the gingival margin and proximal surfaces. Advantages in favor of the CrossAction ranged from 9.8% to 23.2% for whole mouth plaque, from 5.3% to 20.6% for the gingival margin and from 12.8% to 24.5% for proximal surfaces. It was concluded that the novel brush head design of the CrossAction toothbrush provides enhanced plaque removal, especially from proximal surfaces, and that this toothbrush is significantly more effective than all seven toothbrushes tested.

Adolescent↗
PubMed2002

A clinical study of plaque removal with an advanced rechargeable power toothbrush and a battery-operated device.

PURPOSE: To compare the safety and efficacy of two recently introduced modern power toothbrushes with different characteristics. MATERIALS AND METHODS: This was a single-blind, randomized, crossover study which compared the ability of two power toothbrushes to remove plaque during a 2-minute brushing period. The two brushes were the Braun Oral-B 3D Excel (D17), a rechargeable toothbrush with an oscillating/rotating/pulsating action and the Colgate Actibrush, a battery-operated device with an oscillating/rotating action. Seventy-four healthy subjects from a general population who met the inclusion/exclusion criteria used the two brushes on alternate days for a period of familiarization before returning to the test facility. At this visit, subjects with a whole mouth mean Proximal/Marginal Plaque Index of > or = 2.20 after 23-25 hours of no oral hygiene were randomly assigned to one of two treatment sequences, D17/Actibrush and Actibrush/D17, balanced for age and gender. Subjects brushed with their assigned toothbrush after which post-brushing plaque scores were recorded. After a 2-week washout phase subjects returned to the test facility and brushed with the alternate toothbrush as described. Data from the two visits were pooled, after which plaque removal efficacies were compared. Change from prebrushing treatment means were compared using ANOVA with models appropriate for the crossover design. RESULTS: Both toothbrushes were found to be safe and both significantly reduced plaque levels (P < or = 0.0001), but the D17 was significantly more effective than the Actibrush for the whole mouth and for approximal sites. Plaque reductions for the D17 were 46.5%, 55.2% and 42.9% for whole mouth, marginal and approximal sites, respectively while reductions for the Actibrush for the whole mouth, marginal, and approximal sites, were 41.5%, 52.5% and 36.8% respectively. It is concluded that the Braun Oral-B D17 may offer advantages in terms of plaque removal over the battery-powered Actibrush, particularly at hard to reach approximal sites.

Adult↗
PubMed2002

Impact of the sonicare toothbrush on plaque and gingivitis.

The sonicare toothbrush has been shown to be 40% more effective in removing plaque than a manual toothbrush, 82% better in removing plaque from interproximal areas, and to reverse gingivitis. In vitro studies have examined the ability of the sonicare toothbrush to remove plaque bacteria beyond the reach of the bristles. The sonicare toothbrush has also been shown to produce significantly less dentin wear in vitro than another leading power toothbrush. This article reviews both in vivo and in vitro studies that illustrate the efficacy of the sonicare toothbrush in improving oral health.

Adult↗
PubMed1992

Comparative plaque removal efficacy of three toothbrushes in two independent clinical studies.

Two independent studies were conducted to evaluate and compare the clinical performance of three toothbrushes on plaque removal. Both studies were carried out under the same protocol. A total of 73 adult male and female subjects who met the inclusion/exclusion criteria completed Study I and 78 different subjects completed Study II. Subjects were initially screened for dental plaque eligibility. After plaque was scored on the facial and lingual surfaces of all natural teeth using the Rustogi, et al. index, qualifying subjects were randomly assigned to one of three groups on the basis of initial plaque scores and number of teeth. Subjects were then dismissed and scheduled to return for Visit 1 a week later, having abstained from all oral hygiene procedures for a prior 24-hour period. At Visit 1, each group was evaluated for plaque before brushing with their assigned toothbrush for sixty seconds. They were again scored for plaque after brushing. Subjects were dismissed and instructed to resume their normal routine and return to the clinical site for two more weekly visits. At each visit, a different test toothbrush was assigned to each group in a cross-over design. Plaque evaluations and brushing procedures were performed as in Visit 1 of the study. In both studies, the Colgate Precision toothbrush was significantly more effective (p < 0.01) than both the Oral-B 40 and Reach Full-Head soft toothbrushes in reducing the whole mouth plaque scores, as well as plaque at the gumline and at interproximal areas. The Oral-B 40 and Reach toothbrushes were not significantly different from each other with regard to plaque removal.

Adolescent↗
PubMedDate not supplied

A clinical study on the control of dental plaque using an electronic toothbrush with piezo-electric element.

A double-blind clinical study was conducted to compare the plaque-removing efficiency of a newly designed electronic toothbrush to that of a placebo, conventional toothbrush. Twenty-six students were selected at Asahi University, School of Dentistry in Japan. The subjects were divided into two groups, one which used the electronic toothbrush and the other which used the placebo toothbrush. The subjects served as their own control by brushing manually for 3 minutes. The plaque elimination ratio, however, showed no significant difference between the testing and the control group. The main conclusion of this study is that an electronic toothbrush is not superior to the conventional toothbrush.

Adult↗
PubMed2004

Wedged cervical lesions produced by toothbrushing.

PURPOSE: To compare the morphology of experimentally induced cervical toothbrush abrasion lesions to teeth demonstrating non-carious cervical lesions in vivo. METHODS: Eighteen premolars extracted for orthodontic reasons were each subjected to 80 hours (1.4 million strokes) of horizontal brushing in a custom fabricated toothbrushing machine. Toothpaste slurry was applied continuously and specimens were subjected to 300 gms of toothbrushing force. Denture base resin was used to simulate gingival recession of 1 mm and a sulcus width of 0.1 mm. Cervical abrasions were analyzed by optical and scanning electron microscopy and classified as either V-shape/wedged vs. U-shape/rounded lesions. When lesions exhibited both shapes, they were classified as mixed. Shapes of experimentally induced lesions then were compared to naturally occurring ones found on extracted premolars. RESULTSts: Experimentally induced toothbrush abrasion duplicated the classical clinical shapes. Half (9/18) of the experimentally induced toothbrush abrasions exhibited wedged lesions, 28% (5/18) showed a mixed wedged/rounded lesion, and 22% (4/18) showed rounded lesions. Serial photography showed progression of the morphology of the lesions. Toothbrush abrasion apparently begins apical to the cemento-enamel junction, progresses to dentin, and then undermines enamel with loss of the original cemento-enamel junction. Wedged lesions may appear with the apex oriented coronal or apical, or may be symmetrical.

Bicuspid↗
PubMed2004

Classification system for toothbrushing habits.

AIM: For orthodontic patients, optimal oral prophylaxis is essential. In this article, a classification system for toothbrushing habits, according to three criteria that can indicate the direction of guidance for primary school children, is discussed. METHODS: Toothbrushing habits of children are evaluated according to three criteria (frequency of toothbrushing, attitude toward voluntary toothbrushing, and thoroughness of toothbrushing). Computer-generated classification graphs, performance tables, and component tables were obtained based on the responses to 26 questions. RESULTS: The children can be classified into different types, according to the three criteria, on the graphs. Performance tables indicate the items that require guidance, while component tables indicate the priority of the items that require guidance. CONCLUSION: The quantitative assessment of toothbrushing habits for children is possible, using this new classification system.

Attitude to Health↗
PubMed2003

Cleaning efficacy of a manual toothbrush with tapered filaments.

PURPOSE: To compare the cleaning efficacy of (A): a newly developed manual toothbrush with tapered filaments (meridol, GABA International, CH-Münchenstein) with (B): a standard flat trim manual toothbrush (ADA reference toothbrush) in vivo. MATERIALS AND METHODS: 87 healthy participants took part in this study. Subjects were asked to abstain from all oral hygiene procedures for 48 hours. After plaque was scored (Turesky modification of the Quigley Hein Index), the subjects brushed their teeth under supervision with the two manual toothbrushes according to a split-mouth design. In total, a cleaning time of two minutes was given for the whole procedure with an alert after every 30 seconds. Immediately after brushing, plaque was scored again by the same investigator, who was blind with respect to the toothbrush used. RESULTS: Using the non-parametric Wilcoxon test for paired samples (p<0.05) the overall plaque scores were reduced for (A) from 1.95+/-0.48 to 1.02+/-0.41 (p<0.001), and (B) from 1.93+/-0.52 to 1.09+/-0.44 (p<0.001). At proximal surfaces the plaque scores were reduced (A) from 2.02+/-0.49 to 1.11+/-0.43 (p<0.001) and (B) from 2.01+/-0.52 to 1.20+/-0.45 (p<0.001). The relative plaque reductions overall were (A) 47.4+/-18.0% and (B) 44.1+/-15.6% (p=0.039), at proximal surfaces (A) 44.2+/-18.8% and (B) 40.5+/-15.9% (p=0.015), and at lingual surfaces (A) 30.6+/-28.1% and (B) 24.0+/-27.1% (p=0.016). CONCLUSION: Both brushes removed a significant amount of plaque. Overall and in areas difficult to reach, the meridol toothbrush was superior to the ADA reference brush.

Adolescent↗
PubMed2006

[The efficacy of dental plaque removed by using sonic electric toothbrush in children].

PURPOSE: To evaluate the efficacy of using sonic electric toothbrush to clean the teeth and control dental plaque in children. METHODS: 50 children aged 6 to 7 years old were selected and divided into 2 groups according to the use of sonic electric toothbrush and traditional manual toothbrush (control group). The numbers of dental plaque surface and PLI before and after tooth brushing were recorded. The data of the two groups were analyzed with SPSS10.0 software package for student's t test and chi(2) test. RESULTS: The ratio of dental plaque removal was 70.22% by using sonic electric toothbrush and 39.08% in the control group. The efficacy of dental plaque removal on the lingual and mesial buccal surface by using sonic electric toothbrush was 2 times greater than the control group. The PLI and the ratio of dental plaque removal were significantly different between the 2 groups (P<0.001). CONCLUSIONS: Sonic electric toothbrush can help children effectively remove dental plaque. It's an efficient instrument for oral care of children.

Child↗
PubMed1989

[Elasticity and deviation angle of toothbrush in Korean adults].

The purpose of this experiment was to establish a simple and general recommendation criteria to evaluate the toothbrush whether it was usable or not. We gave 94 adults the same toothbrushes and required them to use only those toothbrushes and recollected them after 4 weeks' use. Then, we determined elasticity loss, deformation degree and deviation angle of the used toothbrushes. From the above data, we compared and analyzed the correlation between loss of elasticity loss and deviation angle. The obtained results were as follows: 1. In Korean adults, there was no statistical difference between elasticity loss and deviation angle according to both age and sex group (p greater than 0.05). 2. There was no statistical correlationship between elasticity loss and deviation angle (r = 0.15, p greater than 0.05). 3. It was regarded that the determination of deviation angle was more simple method than that of elasticity loss for the evaluation of useful period of toothbrush. 4. In Korean adults, the average usable period of toothbrush was estimated about 1 month.

Adult↗
PubMed1989

[Distribution of dental plaque and time analysis of toothbrushing without instruction in school children and students].

The purpose of this study is to evaluate oral hygiene before and after individual method toothbrushing without instruction and to analyze toothbrushing times for school children from 6 to 13 years of age. Subjects were 150 pupils from primary to junior high school affiliated with the faculty of education of an university located in Setagaya, Tokyo: 38 first-grade pupils aged 6, 36 fourth-grade pupils aged 9, 37 sixth-grade pupils aged 11, and 39 second-year junior high school pupils aged 13. Assessments of dental plaque were made by two dentists using the PHP plaque score (Podshadely and Haley, 1968) for primary school pupils and OHI-S (only DI-S; Greene and Vermillion, 1964) for junior high school pupils. Plaque distribution disclosed by an Erythrosine solution was examined before and after toothbrushing, and the performance of toothbrushing by subjects was recorded on video-tape through a one-way mirror so that the children were unaware. Toothbrushing time was measured by 2 or 3 examiners using a time counter of video-monitor. Average scores for dental plaque before and after toothbrushing were almost the same for first and fourth-grade primary school pupils; but scores decreased with a statistically significant difference (p less than 0.01) for sixth-grade pupils. Distribution patterns of plaque scores for fourth-grade pupils showed characteristically narrow ranges (2-5 before brushing and 1-4 after brushing). The majority of subjects (69.4%) had scores of 2-3 after brushing, Whereas only 8.3% showed a range of 2-3 before brushing.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

The curved-bristle toothbrush: an aid for the handicapped population.

This study was undertaken to assess the comparative effectiveness of two toothbrushes in the removal of plaque in an institutionalized, handicapped population. The two methods were: a conventional toothbrush using the Modified Stillman Method; and a curved-bristle toothbrush using the scrubbing technique recommended by the manufacturer. Subjects selected were profoundly retarded individuals, incapable of self-brushing skills. According to random selection, subjects' teeth were brushed by trained personnel with either the curved bristle or the conventional toothbrush. Results demonstrated that the curved-bristle toothbrush was as effective as the conventional toothbrush when used by trained personnel.

Adolescent↗
PubMed1994

Laboratory interproximal access efficacy comparison of bi-level and flat bristled toothbrushes.

A laboratory method for testing interproximal access efficacy (IAE) differentiates between different toothbrush designs and has been correlated with clinical plaque removal efficacy. The purpose of this study was to compare the bi-level trim Advanced Design Research (ADR) toothbrush with two flat-trim toothbrushes, Oral-B 40 (OB) and Colgate Plus Full Size (CPFS) toothbrushes, all in soft texture, for IAE using this laboratory method. Vertical and horizontal motions were used on simulated anterior and posterior tooth shapes at 250, 500, and 750 g brushing weights. Brushing times were 60 seconds. IAE is a measurement of the maximum width of the brushing stroke around the simulated teeth. Sixteen brushes of each design were tested for each parameter monitored. For both brushing motions and tooth shapes tested, at the 250 g brushing weight, ADR had significantly higher IAE (p < 0.01 by ANOVA) compared to OB and CPFS. The IAE values at 500 g for ADR were consistently higher than the other two brushes, while not always significantly different. At 750 g the three brushes approximated each other on IAE and were equally effective. When total IAE (means of all weights tested) were evaluated, the ADR was superior (p < 0.05 by the Student's t-test) to the OB and CPFS products. In this laboratory study, the Advanced Design Research toothbrush had consistently and significantly higher interproximal access efficacy compared to the Oral-B and Colgate Plus toothbrushes. These results were predictive of a recent clinical plaque removal study.

Analysis of Variance↗
PubMed1995

A review of current toothbrush bristle endo-rounding studies.

Rounded toothbrush bristle tips are desirable because they are less likely to abrade hard and soft tissue and restorative materials than sharp-pointed bristles. Studies evaluating different types of toothbrushes have compared the degree of the end-roundness of different brands of toothbrushes, but have yielded conflicting results. Nine studies and three methods of evaluating end-rounding are reviewed in this article. Within the limits of the review, it appears that visual inspection of a bristle tip by scanning electron microscopy or a stereomicroscope at a 45-degree angle is the technique of choice for evaluating end-roundness. Of the 9 studies reviewed, 3 studies that used the 45-degree microscopic techniques provide the most useful information of toothbrush bristle end-roundness to date. Of the brushes compared in these three studies, Crest Complete and Improved Crest Complete toothbrushes were shown to have the highest degree of end-roundness. Future research should include longitudinal studies to clarify the relationship of the degree of end-rounding of toothbrush bristles and soft-and hard-tissue abrasion.

Equipment Design↗