Periodontal Ehlers-Danlos syndrome in early childhood: A case report of loss of deciduous teeth.

The aim of the present study is to report a case of periodontal Ehlers-Danlos syndrome (pEDS) in early childhood. A 3-year-old child, complaining of severe tooth mobility, gingival bleeding, and early loss of deciduous teeth sought the dental clinics. The patient was diagnosed with pEDS, and no other systematic health impairments were diagnosed. It was implemented a strict supragingival biofilm control, using mechanical and chemical strategies. However, during the treatment, the patient had to receive multiple dental extractions. Scaling and root planing were performed in the remaining teeth, and the patient is included in the periodontal maintenance program to prevent recurrence of the disease. It was concluded that, although rare, severe cases of periodontitis may occur in deciduous teeth. Strict supragingival biofilm control and periodontal maintenance are strongly recommended in those patients, along with familial monitoring.

Female and Worst Academic Performance are Associated with Anxiety and Stress among Dental Students / Mulheres e Pior Desempenho Acadêmico Estão Associados com Ansiedade e Estresse em Estudantes de Odontologia

This study aimed to assess the levels and associated factors of stress and anxiety in dental students during the Covid-19 pandemic. This cross-sectional study involved both undergraduate and graduate dental students regularly enrolled in the first semester of 2020 of one University. An online structured questionnaire was applied, and demographical, behavioral, academic performance, fear and anxiety related to the Covid-19 pandemic were collected. The 21-item Depression Anxiety Stress Scale (DASS-21) was applied, but only the subscales of anxiety and stress were considered. Adjusted analyses were performed using Poisson regression with robust variance. To both anxiety and stress, independent analyses were performed considering the different levels of study (undergraduate and graduate dental students). At least moderate anxiety was detected in 42.9% and 24.7% of undergraduate and graduate students, respectively. Meanwhile, at least moderate stress was observed in 41.7% and 29.9% of undergraduate and graduate students, respectively. In the multivariate analyses, female undergraduate dental students presented significantly more anxiety (prevalence ratio [PR]: 1.57; 95% confidence interval [95%CI]: 1.11 ­ 2.22) and stress (PR: 1.54; 95%CI: 1.06 ­ 2.24) when compared to males. Conversely, undergraduate dental students with better academic performance demonstrated lower rates of anxiety (PR: 0.86; 95%CI: 0.75 ­ 0.98). Females undergraduate dental students demonstrate higher rates of anxiety and stress, and the academic performance may influence the levels of anxiety in these individuals. (AU)

O estudo objetivou avaliar os níveis e fatores associados de estresse e ansiedade em estudantes de Odontologia durante a pandemia de Covid-19. Esse estudo transversal envolveu alunos de graduação e pós-graduação em Odontologia regularmente matriculados no primeiro semestre de 2020 de uma Universidade. Um questionário estruturado online foi aplicado, e variáveis demográficas, comportamentais, performance acadêmica, medo e ansiedade relacionados à pandemia de Covid-19 foram coletadas. A "Depression Anxiety Stress Scale" (DASS-21) de 21 itens foi aplicada, mas somente os domínios de ansiedade estresse foram considerados. Análises ajustadas foram realizadas utilizando regressão de Poisson com variância robusta. Para ambos ansiedade e estresse, análises independentes foram realizadas considerando os diferentes níveis de estudo (estudantes de odontologia de graduação e pós-graduação). Pelo menos ansiedade moderada foi detectada em 42,9% e 24,7% dos alunos de graduação e pós-graduação, respectivamente. Já o estresse pelo menos moderado foi observado em 41,7% e 29,9% dos alunos de graduação e pós-graduação, respectivamente. Nas análises multivariadas, mulheres estudantes de graduação apresentaram significativamente mais ansiedade (razão de prevalência [RP]: 1,57; intervalo de confiança de 95% [IC95%]: 1,11 ­ 2,22) e maior estresse (RP: 1,54; IC95%: 1,06 ­ 2,24) quando comparados com homens. Contudo, estudantes de graduação com melhor performance acadêmica demonstraram menores taxas de ansiedade (RP: 0,86; IC95%: 0,75 ­ 0,98). Estudantes de graduação do sexo feminino demonstraram maiores taxas de ansiedade e estresse, e a performance acadêmica pode influenciar os níveis de ansiedade desses indivíduos. (AU)

Fontes de estresse, bem-estar psicológico e saúde entre estudantes de Odontologia: uma comparação entre fases pré-clínica e clínica e entre os sexos / Sources of stress, psychological well-being and health among dental students: a comparison between preclinical and clinical phases and between sexes

O objetivo do estudo foi avaliar bem-estar psicológico, saúde geral e fontes de estresse de estudantes de Odontologia de quatro cursos, comparando as fases pré-clínica e clínica e os sexos. Três instrumentos foram aplicados: Dental Environment Stress (DES), Psychological General Well-Being Index (PGWB) e Health Survey (SF-36), respondidos por 203 estudantes, sendo 75 (37%) em fase pré-clínica e 128 (63%) em clínica. Desses, 59 (29%) eram homens e 144 (71%) mulheres. As comparações foram realizadas pelo teste de Mann-Whitney, adotando um nível de significância de 5%. Nos domínios analisados pelo DES (performance acadêmica; dificuldades e inseguranças sobre o futuro profissional; responsabilidade com pacientes; fatores pessoais e institucionais; relações interpessoais), estudantes em fase pré-clínica demonstraram escores significativamente menores quando comparados a estudantes em fase clínica. No escore total de PGWB e em dois domínios (ansiedade e saúde geral), observou-se também escores menores em estudantes em fase pré-clínica. Quatro domínios do SF-36 (dor corporal, funcionamento físico, funcionamento social e papel físico), apresentaram significativa melhor saúde geral dos estudantes em fase pré-clínica. Entre os sexos, dois domínios do DES (performance acadêmica, dificuldade e insegurança sobre o futuro profissional) mostraram menores fatores estressores para o sexo masculino. O PGWB demonstrou diferença significativa em quatro domínios (estado deprimido; autocontrole; saúde geral; vitalidade), com melhor bem-estar psicológico para homens. O sexo masculino apresentou melhor vitalidade no domínio do SF-36. Concluiu-se que estudantes em fase pré-clínica e do sexo masculino demonstraram menores fontes de estresse, melhor bem-estar psicológico e percepção de saúde geral (AU).

The aim of this study was to evaluate psychological well-being, overall health, and sources of stress among dental students from four Doctor of Dental Surgery (DDS) programs, comparing the preclinical and clinical phases and sexes. Three instruments were applied: Dental Environment Stress (DES), Psychological General Well-Being Index (PGWB) and Health Survey (SF-36), answered by 203 students, with 75 (37%) in the preclinical phase and 128 (63%) in the clinical one. Among them, 59 were male (29%) and 144 were female (71%). Comparisons were performed using the Mann-Whitney test, adopting a significance level of 5%. In the domains analyzed using DES (academic performance, difficulties and insecurities about their professional future, responsibilities with patients, personal and institutional factors, interpersonal relationships), preclinical students showed significantly lower scores than students enrolled in the clinical phases. For PGWB total score and in two domains (anxiety and general health), lower scores were also observed in preclinical students. Four domains of SF-36 (bodily pain, physical functioning, social functioning and role-physical) showed significantly better overall health for preclinical students. Among the sexes, two DES domains (academic performance and difficulties and insecurities about their professional future) showed lower stressors for males. PGWB showed a significant difference in four domains (depressed mood, self-control, general health and vitality), with better psychological well-being for males. Males showed better vitality in the SF-36 domain. Concluding, preclinical and male students showed lower sources of stress, better psychological well-being and better perception of their overall health (AU).

Efficacy of an unwaxed dental floss impregnated with 2% chlorhexidine on control of supragingival biofilm: A randomized, clinical trial.

AIM: In the present study, we evaluated the antiplaque and antigingivitis efficacy of a dental floss impregnated with 2% chlorhexidine digluconate. METHODS: Thirty dental students were randomly divided into three groups (n=10): (a) negative control (NC) group, in which no interproximal cleaning was performed; (b) the positive control (PC) group, which used a standard unwaxed dental floss twice daily; and (c) and the test group, which used a unwaxed dental floss impregnated with 2% chlorhexidine twice daily. Six surfaces per tooth were evaluated by the Quigley-Hein plaque index (Turesky modification) at the last appointment (day 15), and testing for the presence of marginal bleeding was performed using the marginal bleeding index (MBI) at both the baseline and last appointments. RESULTS: At day 15, the test group had the lowest mean plaque index (1.04±0.67), showing a statistically-significant difference compared to the NC group (1.40±0.65, P<.001) and PC group (2.30±0.73, P<.001). The PC and test groups showed a mean reduction of 70.2% and 87.26%, respectively, with significant reduction compared to baseline (P<.05) for the MBI. No statistically-significant difference was found between the PC and test groups (P=.126). CONCLUSION: Unwaxed dental floss impregnated with 2% chlorhexidine showed additional reductions in supragingival interproximal biofilm compared with a conventional unwaxed dental floss, without additional improvement in marginal bleeding.

Use of antidepressive agents as a possibility in the management of periodontal diseases: A systematic review of experimental studies.

Antidepressant agents have anti-inflammatory functions that could be interesting as adjuvants in periodontal therapy. The aim of the present study was to analyze the effect of antidepressive drugs in the management of periodontal disease. The MEDLINE, Scopus, Embase, LILACS, and SciELO databases were searched. To be included, the studies had to be experimental studies; randomized, controlled; double-blinded; or blinded studies. A total of 565 articles were initially searched, of which five were selected for the systematic review. All studies used rats, and three different drugs were evaluated: tianeptine, venlafaxine, and fluoxetine. Two of these studies evaluated the effect of antidepressive agents in rats submitted to both ligature-induced periodontitis and depression models, showing that depressive rats had greater alveolar bone loss (ABL). Only the venlafaxine study was not able to find any significant ABL reduction in the group that used this antidepressive drug. The other four studies showed statistically-significant differences, favoring the group with the antidepressant agent. Treatments that are able to modulate the brain-neuroendocrine-immune system could be used as an adjuvant to periodontal disease management. However, studies on humans and animals are scarce, limiting the conclusion of a positive effect in the present systematic review.

Stressors, psychological well-being, and overall health amongst students from public and private dental schools

Aim: This study aimed to correlate stressors with psychological well-being and health factors in dental students from public and private schools. Methods: From February to May 2015, three different instruments (Dental Environment Stress ­ DES ­ Psychological General Well-Being ­ PGWB ­ and SF-36 Health Survey) were applied to students from two public and two private dental schools from the State of Ceará, Brazil. Mann-Whitney test or t test for independent samples were used in order to compare the stressors between private and public dental schools students. Correlations to each DES domain were performed using Kendall's Tau C test. Results: A total of 92 (45.32%) and 111 (56.68%) students from public and private schools, respectively, answered the questionnaire. Students from public schools demonstrated significantly higher scores in DES/academic performance and DES/personal and institutional factors (p<0.05). Significant negative correlations were detected between PGWB/anxiety and PGWB/general with all DES domains for both public and private schools (p<0.05). Additionally, DES/academic performance was significantly correlated with several SF-36 domains, such as physical function, vitality, and social functioning, to both public and private schools (p<0.05). However, DES/academic performance and SF-36/role physical was only significantly correlated in private school students (r=-0.171, p=0.039), while SF-36/bodily pain (r=-0.274, p<0.001), general health (r=-0.245, p=0.001), and mental health (r=-0.286, p<0.001) were significantly correlated with DES/academic performance only in public school students. Conclusion: Students from public and private dental schools presented different stressor patterns. Additionally, most of DES domains were significantly associated with PGWB and SF-36 to both public and private schools

Percepção e nível de conhecimento sobre halitose entre estudantes e pacientes / Perception and level of knowledge about halitosis among students and patients

O presente estudo analisou a percepção e o nível de conhecimento de estudantes e pacientes sobre halitose. Dois grupos de voluntários de ambos os gêneros, entre 18 e 60 anos, totalizando 225 participantes, responderam a um questionário que continha oito questões relativas à percepção, às causas e ao tratamento da halitose. O grupo de pacientes (P) consistiu-se de 150 indivíduos que procuraram os serviços odontológicos da Faculdade de Farmácia, Odontologia e Enfermagem da Universidade Federal do Ceará, Brasil, e o grupo de estudantes (S), de 75 alunos de Odontologia da mesma Universidade. No grupo P, 45,3% dos participantes acreditava ter halitose, já no grupo S, esse percentual foi de apenas 16,2%. Em relação às causas e aos tratamentos da halitose, encontrou-se que o grupo P assinalou mais opções relacionadas com o correto conhecimento sobre halitose quando comparados com o grupo S. É possível concluir que os pacientes relataram maior percepção da halitose do que os estudantes, bem como têm demonstrado maior conhecimento sobre a origem e tratamento da halitose.

This study aimed to assess individual perception and level of knowledge of students and patients about halitosis. Two groups of volunteers of both genders between 18 and 60 years old, totaling 225 subjects, answered a questionnaire containing eight questions relating to perception, causes, and treatment of halitosis. The group of patients (P) consisted of 150 individuals seeking dental services at the School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Brazil, and the Group of students (S) consisted of 75 students of Dentistry at the same University. In Group P, 45.3% of participants believed they had halitosis, while in Group S, this percentage was only 16.2%. In matters relating to the causes and treatment of halitosis, it was found that the Group P marked more options related to the correct knowledge about halitosis when compared to Group S. It is possible to conclude that patients reported greater halitosis perception than students, and also that they showed a better knowledge about the halitosis etiology and treatment.

The impact of antioxidant agents complimentary to periodontal therapy on oxidative stress and periodontal outcomes: A systematic review.

There is significant evidence linking chronic periodontitis (CP) and oxidative stress (OS). CP is a multifactorial infecto-inflammatory disease caused by the interaction of microbial agents present in the biofilm associated with host susceptibility and environmental factors. OS is a condition that arises when there is an imbalance between the levels of free radicals (FR) and its antioxidant defences. Antioxidants, defined as substances that are able to delay or prevent the oxidation of a substrate, exist in all bodily tissues and fluids, and their function is to protect against FR. This systematic review assessed the effects of the complimentary use of antioxidant agents to periodontal therapy in terms of oxidative stress/antioxidants. Only randomised, controlled, double-blind or blind studies were included. The majority of the included studies were performed in chronic periodontitis patients. Lycopene, vitamin C, vitamin E, capsules with fruits/vegetables/berry and dietary interventions were the antioxidant approaches employed. Only the studies that used lycopene and vitamin E demonstrated statistically significant improvement when compared to a control group in terms of periodontal parameters. However, oxidative stress outcomes did not follow the same pattern throughout the studies. It may be concluded that the use of some antioxidants has the potential to improve periodontal clinical parameters. The role of antioxidant/oxidative stress parameters needs further investigations.

Pleiotropic effects of statins on the treatment of chronic periodontitis--a systematic review.

AIM: Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase and are an important group of hypolipidaemic drugs, widely used in the treatment of hypercholesterolaemia and cardiovascular disease. Some studies have shown that statins are able to modulate inflammation and alveolar bone loss. METHODS: In order to evaluate whether statins could influence periodontal treatment, improving the clinical and radiographic parameters in chronic periodontitis, a systematic review was conducted in the databases PUBMED and BIREME, searching for articles in English and Portuguese, published between the years 2004 and 2014, using the combined keywords statin, periodontal disease, periodontitis and alveolar bone. Studies regarding the treatment of chronic periodontitis in humans, blind or double-blind, retrospective cohort or randomized controlled trials that used statins topically or systemically were selected. RESULTS: Statins have important anti-inflammatory and immune effects, reducing levels of C-reactive protein and matrix metalloproteinases and their intermediate products, such as tumour necrosis factor-α, and are also able to inhibit the adhesion and extravasation of leukocytes, which block the co-stimulation of T cells. Statins reduce bone resorption by inhibiting osteoclast formation and lead to increased apoptosis of these cells. The effect of statins on bone formation is related to the increased gene expression of bone morphogenetic protein in osteoblasts. CONCLUSION: Although we found biological mechanisms and clinical results that show lower alveolar bone loss and reduction of clinical signs of inflammation, further studies are needed to evaluate the clinical applicability of statins in the routine treatment of chronic periodontitis.

Vitamin E does not prevent bone loss and induced anxiety in rats with ligature-induced periodontitis.

OBJECTIVE: The purpose of this study was to investigate the effect of vitamin E on alveolar bone loss (ABL) and anxiety in rats with ligature-induced experimental periodontitis (EP). MATERIAL AND METHODS: Wistar rats were subjected to ligature-induced EP and treated with vitamin E (500mg/kg, orally) for 9 days. Then anxiety was tested using the elevated plus-maze (EPM) test. All of the animals were euthanised by cervical dislocation on day 11. ABL was analysed morphometrically and histopathologically. Lipid peroxidation quantification, activity of the enzyme superoxide dismutase and immunohistochemistry to tumour necrosis factor-alpha (TNF-α) and inducible isoform of nitric oxide synthases (iNOS) were also tested. RESULTS: EP induced a marked inflammatory process and intense ABL. Treatment with vitamin E decreased inflammatory reaction, prevented malondialdehyde formation and reduced the immunoreactivity to iNOS, but did not decrease ABL. Vitamin E had an anxiogenic effect on rats with or without EP. CONCLUSIONS: Vitamin E may have potential to reduce oxidative damage and inflammatory response in EP but does not prevent ABL. Attention should be given to indiscriminate use of vitamin E due to the risk of causing anxiety in patients.

Uso do laser GaAIAs e de agentes tópicos no tratamento da hipersensibilidade dentinária / The use of GaAlAs laser and topical agents in the treatment of dentin hypersensitivity

A hipersensibilidade dentinária mostra-se como uma condição dolorosa e de prevalência considerável na população em geral. Diversas alternativas já foram propostas visando o tratamento desta condição, porém, profissionais continuam buscando agentes dessensibilizantes que promovam um alívio mais rápido e duradouro. A terapia com o laser GaAlAs de baixa intensidade tem se mostrado como uma nova alternativa eficaz no tratamento da hipersensibilidade dentinária. O objetivo deste estudo foi comparar, por meio de revisão sistemática da literatura, a efetividade do laser GaAlAs de baixa intensidade em relação a outros agentes tópicos dessensibilizantes no tratamento da hipersensibilidade dentinária. Foram utilizadas as bases de dados Bireme e PubMed com os termos dentin hypersensitivity, dentine hypersensitivity, dentinal hypersensitivity, laser GaAlAs e diode laser. Realizando-se o refinamento da pesquisa bibliográfica, apenas quatro referências que envolviam ensaios clínicos em que se utilizou o laser GaAlAs e um agente tópico para tratamento desta condição enquadraram-se nos critérios de inclusão e exclusão e puderam ser selecionados. Todos os estudos selecionados mostraram que tanto o laser quanto o agente tópico foram eficazes na melhora do desconforto ocasionado pela hipersensibilidade dentinária, porém, a aplicação do laser pareceu ser mais confortável, tanto para o paciente quanto para o profissional. Pôde-se concluir que é necessária a realização de mais estudos clínicos para se delinear o protocolo de tratamento da hipersensibilidade dentinária com o uso do laser GaAlAs, e, além disso, avaliar a estabilidade dos resultados positivos a longo prazo

Uso do laser GaAIAs e de agentes tópicos no tratamento da hipersensibilidade dentinária / The use of GaAlAs laser and topical agents in the treatment of dentin hypersensitivity

A hipersensibilidade dentinária mostra-se como uma condição dolorosa e de prevalência considerável na população em geral. Diversas alternativas já foram propostas visando o tratamento desta condição, porém, profissionais continuam buscando agentes dessensibilizantes que promovam um alívio mais rápido e duradouro. A terapia com o laser GaAlAs de baixa intensidade tem se mostrado como uma nova alternativa eficaz no tratamento da hipersensibilidade dentinária. O objetivo deste estudo foi comparar, por meio de revisão sistemática da literatura, a efetividade do laser GaAlAs de baixa intensidade em relação a outros agentes tópicos dessensibilizantes no tratamento da hipersensibilidade dentinária. Foram utilizadas as bases de dados Bireme e PubMed com os termos dentin hypersensitivity, dentine hypersensitivity, dentinal hypersensitivity, laser GaAlAs e diode laser. Realizando-se o refinamento da pesquisa bibliográfica, apenas quatro referências que envolviam ensaios clínicos em que se utilizou o laser GaAlAs e um agente tópico para tratamento desta condição enquadraram-se nos critérios de inclusão e exclusão e puderam ser selecionados. Todos os estudos selecionados mostraram que tanto o laser quanto o agente tópico foram eficazes na melhora do desconforto ocasionado pela hipersensibilidade dentinária, porém, a aplicação do laser pareceu ser mais confortável, tanto para o paciente quanto para o profissional. Pôde-se concluir que é necessária a realização de mais estudos clínicos para se delinear o protocolo de tratamento da hipersensibilidade dentinária com o uso do laser GaAlAs, e, além disso, avaliar a estabilidade dos resultados positivos a longo prazo.

Composição, princípios ativos e indicações clínicas dos dentifrícios: uma revisão da literatura entre 1989 e 2011 / Composition, active ingredients and clinical indications of dentifrices: a literature review between1989 and 2011

Apesar do controle mecânico ser tido como o melhor método para remoção do biofilme das superfícies dentárias, a utilização de agentes antimicrobianos presentes em soluções para bochechos e em dentifrícios é, muitas vezes, requerida. O presente estudo teve como objetivo revisar a literatura acerca da composição dos dentifrícios atuais, seus princípios ativos e suas indicações clínicas. Para tanto, revisou-se a literatura compreendida entre o período de 1989 a 2011, utilizando-se a combinação das seguintes palavras-chaves: dentifrícios, composição química e flúor, nas línguas inglesa e portuguesa, nas bases de dados Pubmed, BVS, Bireme, SciELO e Portal da Capes. Foram incluídos também livros-texto de referência. Observou-se que os dentifrícios são utilizados para levar várias substâncias à cavidade bucal, objetivando a redução da cárie, das doenças gengivais e periodontais, do cálculo dentário, da hipersensibilidade dentinária e da halitose. Atualmente, os dentifrícios são compostos por: sistemas abrasivos, detergentes, flavorizantes, solventes, umectantes, aglutinantes, edulcorantes, conservantes e princípio ativo. A variedade de substâncias presentes nos dentifrícios é muito grande, sendo essa uma das razões para a grande dificuldade em identificar o dentifrício mais apropriado para cada situação clínica. No intuito de facilitar a aquisição desses produtos, é de suma importância que a composição química e a sua indicação sejam informadas adequadamente.

Although mechanical control is considered the best method to remove dental surfaces biofilm, the use of antimicrobial agents contained in mouthwashes and toothpaste is required. This study aimed to review the literature about the current composition of dentifrices, their active ingredients and clinical indications. Thus the literature between 1989 and 2011 was reviewed, using the following keyword combinations: dentifrice, chemical composition and fluoride, in English and Portuguese languages, in Pubmed, BVS, Bireme, SciELO, and Portal Capes databases. It was also included reference textbooks. It was observed that dentifrices are used to carry out a lot of substances to oral cavity, aiming to reduce caries, gingival and periodontal diseases, dental calculus, dentin hypersensitivity and also halitosis. Nowadays, dentifrices are composed of: abrasive systems, detergents, flavorings, solvents, humectants, binders, sweeteners, preservatives and active ingredient.The variety of substances found in dentifrices is huge, and this is one of the reasons that makes harder to identify the most appropriate dentifrice for each clinical situation. In order to facilitate the acquisition of these products, is quite important that the chemical composition and its indication are informed properly.

Comparative analysis between hard- and soft-filament toothbrushes related to plaque removal and gingival abrasion.

OBJECTIVE: The aim of this split-mouth, examiner-blind study was to compare the dental plaque removal and incidence of gingival abrasion associated with the use of hard- and soft-filament toothbrushes. METHODOLOGY: The test group consisted of 20 non-dental students, mean age 25 years. After a three-day period of plaque accumulation following the use of a disclosing solution, the Quigley-Hein Plaque Index was recorded, while the presence of gingival abrasion was measured from photographs. Pairs of quadrants 1-3 and 2-4 were allocated to supervised brushing with hard- or soft-filament toothbrushes for 30 seconds, limited to the buccal aspects of the teeth. Plaque levels and gingival abrasion were again assessed. Initial and final values of the plaque index and the mean number of abrasions were compared with the Friedman and Wilcoxon tests (p < or = 0.05). RESULTS: Plaque indices were reduced significantly from a baseline of 4.12 in both groups to 1.21 after the use of hard-filament toothbrushes, and to 1.67 after the use of soft-filament toothbrushes. The use of hard-filament toothbrushes resulted in a significantly higher mean number of lesions when compared to the soft-filament toothbrushes; 11.6 and 7.9, respectively (p = 0.018). CONCLUSION: Hard-filament toothbrushes remove more plaque than soft filament brushes, but also cause a higher number of gingival abrasions.