Long-term comparison of the efficacy of manual versus powered tooth brushing in adolescent orthodontic patients: a single-centre, parallel design randomized clinical trial.

BACKGROUND AND OBJECTIVES: To-date, there is no evidence comparing the long-term efficacy of powered and manual toothbrushes in adolescents undergoing fixed appliance treatment. The trial compared the efficacy of manual versus powered toothbrush in controlling plaque and gingival health in patients undergoing fixed treatment in respect of both the short- and long-term. TRIAL DESIGN: This was a randomized, parallel, controlled single-blind clinical trial, undertaken in a hospital setting, for which the consolidated standards of reporting trials guidelines were followed. METHODS: Ninety-two adolescent participants planned to undergo fixed appliance therapy, were randomly assigned to either a manual or powered toothbrush, with allocation concealment. The outcome measures were plaque and gingival indices and bleeding on probing, assessed at baseline (prior to fixed appliance), one-, six- and 12-months. RESULTS: The final sample included 84 participants, aged 12-18 (M=14.1, SD=1.93) years, with 40 (47%) were using a manual and 44 (52%) a powered toothbrush. The intervention (powered vs. manual toothbrush) itself appeared insignificant with regards to the gingival index (GI) (95%CI -0.1 - 0.03; P=0.26), plaque index (PI) (95%CI -0.13 - 0.14; P=0.93) and bleeding on probing (BoP) (95%CI -0.03 - 0.03; P=0.98) at any of the time points assessed. However, periodontal health indicators and plaque control significantly worsened (p<0.01), over the 12-month follow-up period, following placement of the fixed appliances placement. CONCLUSION: Whilst no differences were found between manual and powered toothbrushes in controlling plaque and gingival health, in participants undergoing fixed orthodontic treatment, both were suboptimal and highlighted the need for greater patient support and monitoring. TRIAL REGISTRATION DETAILS: https://doi.org/10.1186/ISRCTN74268923 Trial funding: Colgate-Palmolive (USA).

Influence of single-jaw surgery vs bimaxillary surgery on the outcome and duration of combined orthodontic-surgical treatment.

OBJECTIVE: To analyze the effects of single-jaw surgery (mandible or maxilla only) vs bimaxillary surgery on final peer assessment rating (PAR) score outcome and overall treatment duration. MATERIALS AND METHODS: Treatment records of 63 consecutively treated orthognathic patients were assessed; 41 underwent bimaxillary procedures, and the remainder single-jaw procedures. All treatment was undertaken at Kent and Canterbury Hospital in the United Kingdom. Demographic characteristics and clinical parameters, including treatment duration, number of visits required, initial and final PAR scores, and number of extractions undertaken, were recorded. RESULTS: The mean treatment time was 30.6 months; treatment time was shortest in the maxillary procedure only group. The mean reduction in percentage PAR score was 77%, with an average final score of 9. Linear regression analysis confirmed that procedure type had no influence on final PAR score (P = .62) or on overall treatment duration after adjustment for extractions and initial PAR score as confounders (P = .47). CONCLUSIONS: No significant difference was noted in treatment duration or in occlusal outcome between single- and double-jaw surgeries.