Effects of ultrasonic, electric, and manual toothbrushes on subgingival plaque composition in orthodontically banded molars.

INTRODUCTION: Orthodontic appliances hinder mechanical plaque control. In this study, we evaluated the effect of self-performed supragingival plaque removal with ultrasonic, electric, and manual toothbrushes on subgingival plaque composition in orthodontically banded molars. METHODS: Twenty-one patients wearing fixed orthodontic appliances were assigned to this single-blind crossover study. Samples of subgingival plaque were collected from banded molars, before and after each toothbrush usage period, for quantification of 22 bacterial species by the checkerboard DNA-DNA hybridization method. For each crossover, patients used a toothbrush for 30 days, followed by a washout period of 14 days. RESULTS: The prevalence of Tannerella forsythia decreased significantly after a month of electric brush usage. In the manual brush group, the prevalences of Selenomonas noxia, Streptococcus sanguinis, and Prevotella melaninogenica also decreased significantly. However, there were no significant differences in the prevalences and levels of bacteria after usage of the ultrasonic brush. Intergroup comparisons showed no statistical differences among the 3 brushes for the microbiologic parameters. CONCLUSIONS: All 3 brushes generally reduced bacterial prevalences, and, although electric and manual toothbrushes showed some isolated significant variations, we found no superiority with any toothbrush type when used three times daily for 2 minutes on microbiologic parameters in orthodontically banded molars.

Efficacy of ultrasonic, electric and manual toothbrushes in patients with fixed orthodontic appliances.

OBJECTIVE: This crossover study compared the efficacy of an ultrasonic toothbrush for the reduction of plaque, gingival inflammation, and levels of Streptococcus mutans, in relation to an electric and a manual toothbrush. MATERIALS AND METHODS: Twenty-one patients with orthodontic appliances were divided into three groups. All patients were evaluated by a periodontist and samples of saliva were collected for quantification of S mutans. The patients received their first brushes with appropriate instructions. For each crossover leg, patients used each toothbrush for a period of 30 days. At the end of each washout period, participants received a periodontal evaluation and new samples of saliva were collected. After 15 days of using their own toothbrushes, patients received the next toothbrushes in the experimental sequence. RESULTS: The ultrasonic brush group presented significant improvement in the reduction of visible plaque on the buccal surfaces (-6.36%, P = .007). The counts of S mutans decreased in the electric (2.04 x 10(5) to 1.36 x 10(5) colony-forming units [CFU]/mL) and ultrasonic (2.98 x 10(5) to 1.84 x 10(5) CFU/mL) groups. There were no statistical differences among the three brushes for the clinical and microbiological parameters evaluated. CONCLUSIONS: This study did not demonstrate that the ultrasonic toothbrush was better in reducing gingival inflammation in adolescent orthodontic patients, but plaque scores were lowered on buccal surfaces of teeth with orthodontic brackets. In addition, S mutans counts were markedly decreased in the electric and ultrasonic groups, which should be related to a reduced risk of oral disease.

Effect of toothbrushing with different manual toothbrushes on the shear bond strength of orthodontic brackets.

The aim of this study was to evaluate the effect of brushing with a Colgate 360º or Oral B Indicator 35 toothbrush on the shear bond strength of orthodontic brackets bonded to extracted human teeth. The bristle wear and bristle tip morphology were also examined after simulated tooth-brushing. Orthodontic brackets (Roth-P/1st and 2nd premolar S/D- Slot 0.18") were bonded (Transbond XT) to the smoothest surface of each of 45 extracted human molar and premolar teeth. Test specimens were randomly divided into three groups: Group 1, control group with no brushing; Group 2, brushing with the Oral B Indicator 35; Group 3, brushing with the Colgate 360º. Samples were adapted to a machine that simulated tooth-brushing. The bond strength of each bracket to each tooth was assessed with a mechanical testing machine. The bristle wear and bristle tip morphology indices were also assessed. Statistically significant differences were defined for p < 0.05. The average bond strengths (range: 90.18-90.89 kgf/cm²) did not differ among the three groups. The Colgate 360º showed less bristle wear and a better bristle tip morphology than the Oral B Indicator 35 toothbrush. However, use of either toothbrush did not decrease the bond strength of the orthodontic brackets. Therefore, patients undergoing orthodontic therapy can safely use either toothbrush.

Orthodontic movement after periodontal regeneration of class II furcation: a pilot study in dogs.

PURPOSE: The effect of orthodontic movement on the periodontal tissues of maxillary second pre-molars, after regenerative treatment for class II furcations, was evaluated in four mongrel dogs. MATERIAL AND METHODS: Class II furcation lesions were created. After 75 days they were treated with bovine bone mineral matrix and guided tissue regeneration with absorbable membrane. After 2 months of daily plaque control, each of the dog's furcation pre-molars was randomly assigned to a test or control group. Orthodontic appliances were placed on both sides of the maxilla using third pre-molars and canines as anchorages. In the test group, bodily orthodontic movement of the second pre-molars was performed in the mesial direction for 3 months while control pre-molars remained unmoved. The dogs were sacrificed for histometric and histologic analyses. RESULTS: There were no statistically significant differences between the two groups in total bone and biomaterial areas or linear extension of periodontal regeneration on the radicular surfaces. In the test group, however, there was a tendency to a greater quantity of bone and a lesser quantity of biomaterial. CONCLUSION: The orthodontic movement was not pre-judicial to the results obtained with the regenerative periodontal treatment.

Effect of toothbrushing with different manual toothbrushes on the shear bond strength of orthodontic brackets

The aim of this study was to evaluate the effect of brushing with a Colgate 360º or Oral B Indicator 35 toothbrush on the shear bond strength of orthodontic brackets bonded to extracted human teeth. The bristle wear and bristle tip morphology were also examined after simulated tooth-brushing. Orthodontic brackets (Roth-P/1st and 2nd premolar S/D- Slot 0.18") were bonded (Transbond XT®) to the smoothest surface of each of 45 extracted human molar and premolar teeth. Test specimens were randomly divided into three groups: Group 1, control group with no brushing; Group 2, brushing with the Oral B Indicator 35; Group 3, brushing with the Colgate 360º. Samples were adapted to a machine that simulated tooth-brushing. The bond strength of each bracket to each tooth was assessed with a mechanical testing machine. The bristle wear and bristle tip morphology indices were also assessed. Statistically significant differences were defined for p < 0.05. The average bond strengths (range: 90.18-90.89 kgf/cm²) did not differ among the three groups. The Colgate 360º showed less bristle wear and a better bristle tip morphology than the Oral B Indicator 35 toothbrush. However, use of either toothbrush did not decrease the bond strength of the orthodontic brackets. Therefore, patients undergoing orthodontic therapy can safely use either toothbrush.

Periodontal conditions of teeth presenting pathologic migration.

The aim of the present study was to evaluate the periodontal conditions of anterior teeth that presented pathologic migration in patients with chronic periodontitis and to compare periodontal destruction in migrated versus non-migrated teeth. The sample included 32 patients of both sexes (mean age: 46.0 +/- 11.6 years) diagnosed with generalized chronic periodontitis and selected on the basis of the presence of pathologic migration in one or more anterior teeth. This migration was classified according to the following categories: facial flaring, diastema, proximal tilting, rotation or extrusion. The periodontal parameters recorded were clinical attachment loss (CAL) and percentage of radiographic bone loss (BL). Mean CAL of 5.50 +/- 2.20 mm and mean BL of 41.90 +/- 15.40% were found in 115 teeth assessed. The most frequent type of migration was facial flaring (34.80%), followed by diastema (27.00%). Extrusion was hardly observed in the sample (4.30%). However, greater severity of BL and CAL were observed in teeth with this type of migration (59.44% and 8.42 mm, respectively), and in teeth with facial flaring (45.17% of BL and 6.07 mm of CAL). Kruskal-Wallis test indicated that BL presented by teeth with extrusion or facial flaring was greater than that observed in rotated or tilted teeth (p < 0.05), while there was no difference between groups regarding CAL (p = 0.11). It was observed that anterior teeth with pathologic migration presented greater CAL and BL (5.1 mm and 40%) than non-migrated teeth (4.1 and 31%). The study indicated that the most prevalent kind of pathologic migration is facial flaring, which was associated to higher level of bone loss.

Periodontal conditions of teeth presenting pathologic migration

O objetivo deste estudo foi avaliar as condições clínicas periodontais de dentes anteriores com migração patológica (MDP) em pacientes com periodontite crônica generalizada e comparar a severidade de destruição periodontal entre dentes migrados e não-migrados. Foram selecionados 32 pacientes, de ambos os sexos, apresentando média de idade de 46,0 anos (± 11,6), com perda clínica de inserção em dentes anteriores e presença de algum tipo de MDP, a saber: vestibularização, diastema, inclinação proximal, giroversão ou extrusão. Os parâmetros avaliados foram a perda clínica de inserção (PIC) e o percentual de perda óssea radiográfica (PO). Os resultados mostraram, em média, uma PIC de 5,50 mm (± 2,20 mm) e uma PO de 41,90% (± 15,40%) do comprimento radicular, em 115 dentes selecionados. Os tipos mais freqüentes de migração foram vestibularização (34,80%) e presença de diastemas (27,00%). A extrusão foi a menos freqüente (4,30%). Maiores valores de PO e PIC foram registrados nos dentes com extrusão (59,44% e 8,42 mm) e vestibularização (45,17% e 6,07 mm). Esses valores de PO foram superiores aos observados nos dentes com giroversão ou inclinação proximal (p < 0,05 - Kruskal-Wallis). A PIC não apresentou diferenças significativas entre os diferentes tipos de migração (p = 0,11). Constatou-se que os dentes anteriores com MDP apresentaram maior PIC e PO (5,1 mm e 40%) quando comparados aos não-migrados (4,1 mm e 31%). Pôde-se concluir também que o tipo de MDP mais prevalente foi a vestibularização, que esteve relacionada a maiores níveis de perda óssea.

Avaliação de escova ultrassônica em pacientes sob terapia ortodôntica. Estudo in vitro, clínico e microbiológico / Use of an ultrasonic toothbrush in patients with fixed orthodontic appliances. A clinical, microbiological and in vitro evaluation

Objetivo: O objetivo do estudo foi avaliar o efeito de uma escova ultrassônica, comparada a uma elétrica e a uma manual, sobre os parâmetros clínicos periodontais e microbiológicos de adolescentes sob terapia ortodôntica com aparelhos fixos. Paralelamente, foi avaliada a diminuição da força adesiva de braquetes ortodônticos, fixados a dentes humanos extraídos, após o uso de uma escova dentária ultrassônica comparada a uma escova elétrica. Material e Método: Para o experimento in vivo, 21 indivíduos (15,2±1,7) que utilizavam aparelhos fixos há mais de um ano foram divididos em três grupos de acordo com a seqüência de uso das escovas (crossover). Os pacientes usaram cada escova por um período de 30 dias, com intervalos de 15 dias entre as mesmas (washout). Amostras de saliva e placa bacteriana foram coletadas para realização de cultura microbiológica de Streptococcus grupo mutans e técnica de Checkerboard DNA-DNA Hybridization, respectivamente. No experimento in vitro, braquetes ortodônticos foram colados a superfície mais plana de quarenta e cinco dentes humanos extraídos. Posteriormente, os corpos de prova foram divididos em grupos de acordo com a escova a ser utilizada. Após o procedimento de escovação, a resistência adesiva foi avaliada em uma maquina de ensaios mecânicos. Resultado: Uma diferença significante no índice de placa (p<0,05) foi observada após o uso de escova ultrassônica nas superfícies vestibulares (10,32% pré e 3,96% pós-escovação). Da mesma forma, após o uso das escovas ultrassônicas e elétricas, as contagens de Streptococcus grupo mutans diminuíram significativamente (técnica de cultura microbiana - p<0,05). A técnica Checkerboard DNA-DNA hybridization apontou uma redução nos níveis de T. forsythia após o uso da escova elétrica e das espécies S. noxia, S. sanguinis e P. melaninogenica após o uso da escova manual. Todavia, quando as três escovas foram comparadas entre si, não houve diferença estatisticamente significante nos parâmetros clínicos e microbiológicos (checkerboard) avaliados. Com relação ao estudo in vitro, o grupo ultrassônico apresentou uma força de resistência adesiva média de 59,21 kgf/cm2. Os valores para os grupos escova elétrica e controle foram de 53,79 kgf/cm2 e 59,71 kgf/cm2, respectivamente. Não foi encontrada diferença estatisticamente significante entre os grupos (p=0,68 ­ Kruskal-Wallis). Conclusão: o estudo não demonstrou uma superioridade evidente da escova ultrassônica quando comparada a uma elétrica e a uma manual. Também não foi encontrada uma relação entre o uso da escova ultrassônica e uma diminuição da resistência adesiva de braquetes ortodônticos

Objective: This study compared the efficacy of an ultrasonic toothbrush for the reduction of plaque, gingival inflammation, and levels of bacteria in relation to an electric and a manual toothbrush. In addition, it was evaluated the effect of brushing with both an ultrasonic and electric toothbrush on the bond strength of orthodontic brackets bonded to extracted human teeth. Material and method: Twenty-one patients (mean 15.2±1.7 years) with orthodontic appliances were randomly divided into three groups according to the sequence of brush usage (crossover study). The subjects used each assigned brush for a period of 30 days, followed by an interval of 15 days (washout) during which they returned to their regular toothbrushes and dental floss used in accordance with the monthly instructions of the orthodontist given prior to the study. During each visit, participants received a periodontal evaluation and samples of saliva and subgingival plaque were collected for microbiological tests (Streptococcus mutans culture and DNA-DNA Checkerboard Hybridization). For in vitro evaluation, individual orthodontic brackets were bonded to the smoothest surface of forty-five teeth. The test specimens were randomly distributed into three groups according to the toothbrush to be used. After completing the brushing stage, the test specimens were taken to the mechanical assay machine for a shearing test. Results: The ultrasonic brush group presented significant improvement in the reduction of visible plaque on the buccal surfaces (10.32% against 3.96%). The counts of S. mutans decreased in the electric and ultrasonic groups (culture test ­ p<0.05). The DNA-DNA Checkerboard hybridization technique showed that the counts of T. forsythia decreased significantly after a month of electric brush usage. Furthermore, in the manual group, S. noxia, S. sanguinis and P. melaninogenica counts also decreased significantly after a month. However, there were no statistical differences among the three brushes for the clinical and microbiological (checkerboard) parameters evaluated. For in vitro results, the ultrasonic group showed mean bond strength of 59.21 kgf/cm2 . The values for the electric toothbrush and control groups were of 53.79 kgf/cm2 and 59.71 kgf/cm2 , respectively. After the application of Kruskal-Wallis' test, no statistically significant difference was found among the groups (p=0.68). Conclusion: This study did not demonstrate superiority of any toothbrush type on clinical and microbiological parameters in adolescent orthodontic patients. In addition, the results suggest that the use of the toothbrushes evaluated does not lead to a decrease in the bond strength of orthodontic brackets

Uso de escovas dentárias de alta freqüência: revisão sistemática da literatura / Use af high frequency dental taathbrushes: systematic review

O objetivo do presente trabalho é, através de uma revisão sistemática da literatura, avaliar o efeito de escovas com movimentos de alta freqüência comparadas às manuais, com relação aos índices de placa e sangramento gengiva I, nos pacienortes com gengMte e/ou periodontite crônica. A literatura pertiornente ao tema foi consultada e os artigos foram selecionados de acordo com critérios de inclusão previamente estabelecidos. Os resultados dessa investigação demonstram reduções significantes nos índices de placa e gengival nos estudos avaliados com a utilização de ambos os tipos de escovas. Constata-se, porém, uma necessidade de estudos futuros com metodologias mais homogêneas.

Migração dentária patológica: revisão da literatura e relato de caso / Pathologic tooth migration: literature review and case report

A migração dentária patológica (MDP) tem sido definida como uma mudança de posição do dente que ocorre quando o equilíbrio entre os fatores que mantêm a posição fisiológica dos dentes é comprometido pela doença periodontal, ocasionado geralmente um problema estético. Tendo em vista a importância estética e funcional da MDP, busca-se por meio desta breve revisão abordar aspectos etiológicos, clínicos e terapêuticos que auxiliem os profissionais a compreender e indicar o correto tratamento.

Diagnóstico e tratamento de granuloma piogênico: relato de casos clínicos / Diagnostic and treatment of pyogenic granuloma: case reports

Granuloma piogênico representa um lesão benigna com proliferação de tecido de granulação vascular em resposta a irritação local. Este trabalho descreve os aspectos clínico e histopatológico e o tratamento do granuloma piogênico em dois relatos de caso