Effects of Rinsing with Povidone-Iodine during Step II Periodontal Therapy: A Systematic Review and Meta-Analysis.

Background and Objectives: Antiseptics have been suggested to enhance the outcomes of non-surgical periodontal treatment (NSPT). Among these, povidone-iodine (PVP-iodine) was reported to significantly reduce periodontal pocket depths (PPDs). The aim of this study was to systematically re-assess the existing literature regarding the potential benefit of using PVP-iodine in step II periodontal therapy. Material and Methods: The scientific literature was systematically searched across electronic libraries for randomized controlled trials employing PVP-iodine during NSPT through to September 2023, using search items related to PVP-iodine and periodontitis. The selection process was performed by two independent reviewers. The primary outcomes were reductions in periodontal probing depth (PPD) and clinical attachment level (CAL). When reasonable, a meta-analysis of the included studies was performed. Results: Initially, 799 records were identified. After abstract and title screening and fulltext revision, 15 RCTs were included. The data from eight studies were merged in meta-analyses. The use of PVP-iodine had no significant effect on PPD reduction at 6 months (means [standard deviation]: -0.12 mm [-0.33; 0.09]) but it did at 12 months (-0.29 mm [-0.56; -0.02]). CAL was significantly better at 6 (-0.42 mm [-0.64; -0.20]) and 12 months (-0.39 mm [-0.66; -0.11]). Conclusions: PVP-iodine rinsing during NSPT may slightly improve patients' PPD and CAL.

Effect of Toothbrush Bristle Stiffness and Brushing Force on Cleaning Efficacy.

PURPOSE: This study investigated the effect of toothbrush bristle stiffness and brushing force on the cleaning efficacy in vitro. MATERIALS AND METHODS: Eighty bovine dentin samples were allocated to eight groups (n=10). Two custom-made toothbrushes of different bristle stiffness (soft and medium) were tested at four different brushing forces (1, 2, 3 and 4 N). Dentin samples were stained in black tea and brushed (60 strokes/min) for a total of 25 min in a brushing machine with an abrasive solution (RDA 67). Photographs were taken after 2 and 25 min of brushing time. Cleaning efficacy was measured planimetrically. RESULTS: After 2 min of brushing, the soft-bristle toothbrush did not cause statistically significantly different cleaning efficacy at different brushing forces, while the medium-bristle toothbrush cleaned statistically significantly less efficaceously only at 1 N. Comparing the two different toothbrushes, higher cleaning efficacy was observed only at 1 N for the soft-bristle brush. At 25 min brushing time, the soft-bristle cleaned statistically significantly better at 4 N compared to 1 N and 2 N and at 3 N compared to 1 N. Using the medium-bristle, cleaning efficacy increased with increasing brushing force. After 25 min of brushing, no statistically significant difference was observed between the two different toothbrushes. CONCLUSION: Irrespective the brushing force, the use of a soft or medium toothbrush results in comparable cleaning efficacy. At 2 min brushing time, increasing the brushing force does not increase the cleaning efficacy.

Effect of toothbrush bristle stiffness and toothbrushing force on the abrasive dentine wear.

OBJECTIVE: To investigate the influence of toothbrush bristle stiffness and applied brushing force on the resulting abrasive dentine wear in vitro. METHODS: One hundred sixty bovine dentine samples were randomly allocated in eight groups (n = 20). Groups one to four were brushed with a soft-bristle toothbrush with soft bristles applying 1, 2, 3 and 4 N brushing force, respectively. Groups five to eight were brushed with a medium-bristle toothbrush applying the same aforementioned brushing forces (120 strokes/min, abrasive slurry (RDA = 121), 25 min). Profiles were recorded before and after the brushing sequence, and the median and interquartile range of abrasive dentine wear were calculated and compared using two-way ANOVA and pairwise tests corrected after Tukey (α = 0.05). RESULTS: At 1, 2 and 3 N brushing force, the tested toothbrushes caused no significantly different abrasive dentine wear. At 4 N brushing force, the medium-bristle toothbrush caused statistically significantly higher abrasive force than the soft-bristle toothbrush. Using the medium-bristle toothbrush, abrasive dentine wear statistically significantly increased with increasing brushing force from 1 to 3 N. However, increasing the brushing force to 4 N did not result in statistically significantly higher wear. Using the soft-bristle toothbrush, abrasive dentine wear statistically significantly increased with increasing brushing force from 1 to 2 N. However, increasing the brushing force to 3 or 4 N did not result in statistically significantly higher wear. CONCLUSION: The soft-bristle toothbrush tends to cause less abrasive wear with increasing brushing force than the medium-bristle toothbrush.

Dentin Abrasivity and Cleaning Efficacy of Novel/Alternative Toothpastes.

PURPOSE: To investigate dentin abrasivity and cleaning efficacy of novel/alternative toothpastes containing diamond particles, active carbon, sea salt or organic oils. MATERIALS AND METHODS: Seventy-two bovine dentin samples (for measuring abrasivity) and 60 human dentin samples (for assessing cleaning efficacy) were used in this study. Samples were divided into six groups as follows: group 1: Elmex Kariesschutz (hydrated silica); group 2: Lavera Neutral Zahngel (sea salt); group 3: Curaprox Black is White (active carbon); group 4: Swiss Smile Diamond Glow (diamond powder); group 5: Ringana Fresh Tooth Oil (hydrated silica); and group 6: artificial saliva. Samples were brushed for a total of 26 min at 120 strokes/min, replacing slurries (1 part respective toothpaste and 2 parts artificial saliva) every 2 min. Finally, abrasive dentin wear was measured profilometrically and cleaning efficacy planimetrically. RESULTS: The highest abrasivity values were observed for Lavera Neutral Zahngel (sea salt 9.2 µm) and Elmex Kariesschutz group (hydrated silica 6.0 µm). The lowest abrasivity value was observed for Ringana Fresh Tooth Oil group (hydrated silica 1.3 µm). The highest cleaning efficacy was observed for Elmex Kariesschutz group (86.7%) and the lowest cleaning efficacy was observed for Ringana Fresh Tooth Oil group (31.3%). CONCLUSION: The addition of diamond powder or active carbon to toothpastes could offer high cleaning efficacy with low dentin abrasivity. The addition of sea salt to traditional abrasives might cause high abrasive dentin wear without adding further cleaning benefit.