Sonic-powered toothbrushes and reversal of experimental gingivitis.

OBJECTIVE: To compare two sonic toothbrushes in relation to the reversal of experimental gingivitis. MATERIALS AND METHODS: Subjects refrained from brushing mandibular teeth for 21 days. During a 4-week treatment phase, the right or left side of the mouth was brushed with either the Sonic Complete (SC) or Sonicare Elite (SE) toothbrush as randomly allocated. Plaque and gingivitis were assessed on day 0, after 21 days of no oral hygiene and after 1, 2 and 4 weeks of brushing twice daily. RESULTS: Thirty-four subjects provided evaluable data. The experimentally induced gingivitis (EIG) resulted in higher bleeding and plaque scores compared with day 0. The mean plaque scores at day 21 changed from 3.09 to 1.30 for the SC, and from 3.02 to 1.21 for the SE. At the end of the treatment period, there was no significant difference between the two brushes. The mean bleeding scores changed from 1.87 (day 21) to 0.97 for the SC, and from 1.83 to 0.92 for the SE. For the assessments at 1, 2 and 4 weeks post-EIG, both brushes showed a significant decrease in bleeding scores. There were no statistically significant differences between brushes.

Development of an oscillating/rotating/pulsating toothbrush: The Oral-B professionalCaretrade mark series.

The Oral-B range of power toothbrushes are based on a clinically proven oscillating/rotating action. This review considers the extensive series of laboratory and clinical studies involved in the development of the Oral-B power toothbrushes with three-dimensional (3D) brush head action (i.e. oscillating/rotating/pulsating), now known as the Oral-B ProfessionalCaretrade mark Series. The unique, highly effective cleaning performance of the 3D action incorporated in the D15 and D17 models is proven in both the laboratory and clinical environments, thereby establishing an evidence-based platform for the development of the most recent ProfessionalCare 7000. In the early development phase, in-vitro studies indicated that the additional pulsating action and advancements in filament technology improved approximal penetration, where plaque removal is most difficult. In-vitro models provide a useful development tool for the rapid assessment of design modifications, while controlling many factors that confound in-vivo studies, but the relevance of their findings needs to be confirmed in the clinical situation by direct improvements in oral health. Results from well-controlled, randomised clinical studies in the development programme have demonstrated the superiority of the D15 and D17 models with 3D action over a manual toothbrush and other power toothbrushes of various actions and designs in the improvement of oral health outcomes such as plaque removal (especially from approximal sites), reduction of gingival inflammation, and control of calculus and stain formation, with no greater potential to cause oral tissue abrasion. Furthermore, user acceptance of the oscillating/rotating/pulsating toothbrush may encourage long-term compliance during normal use.

Single-use plaque removal efficacy of three power toothbrushes.

OBJECTIVES.: To compare the safety and plaque removal efficacy of two oscillating/rotating/pulsating toothbrushes (Oral-B ProfessionalCaretrade mark 7000 [PC 7000] and Oral-B 3D Excel [3DE]) and a high-frequency toothbrush (Sonicare(R) Advance, Philips Oral Healthcare; SA) in a single-use, examiner-blind, three period crossover study. METHODS.: After refraining from all oral hygiene procedures for 23-25 hours, subjects received an oral tissue examination and those with pre-brushing whole mouth mean plaque scores 0.6 based on the Rustogi et al. Modified Navy Plaque Index were randomly assigned to treatment sequence. After brushing with the assigned toothbrush and a commercially available dentifrice for 2 minutes, oral tissues were then re-examined and post-brushing plaque scores recorded. Following a brief washout period between two additional visits, the above procedures were repeated with the two alternate toothbrushes. One examiner, blinded to the treatment sequence, performed all clinical measurements. RESULTS.: A total of 79 subjects (28 males and 51 females) were enrolled and completed the study. Each toothbrush was found to be safe and significantly reduced plaque levels after a single brushing. The PC 7000 and 3DE were equally more effective in plaque removal than the SA, at all tooth areas, reducing plaque by 59.0%, 59.7% and 51.8%, respectively on whole mouth surfaces, and by 67.5%, 67.8% and 59.4%, respectively on approximal surfaces. CONCLUSIONS.: The action of the oscillating/rotating/pulsating toothbrushes (Oral-B ProfessionalCare 7000 and Oral-B 3D Excel) was more effective in plaque removal than the high-frequency toothbrush (Sonicare Advance).

Plaque removal efficacy of two electric toothbrushes with different brush head designs.

OBJECTIVES.: To compare the safety and plaque removal efficacy of two electric toothbrushes, one a rechargeable oscillating/pulsating toothbrush with a small round brush head (Oral-B ProfessionalCaretrade mark 7000; PC 7000), the other a battery-operated toothbrush with a dual moving brush head (Crest(R) SpinBrushtrade mark Pro; SBP). METHODS.: The study had a randomised, examiner-blind, two-arm crossover design. All subjects received an oral prophylaxis and used both toothbrushes on alternating days for a two-week practice period. After abstaining from all oral hygiene procedures for 23-25 hours, subjects received an oral tissue examination and those with pre-brushing whole mouth mean plaque scores >/=0.60 measured by the Rustogi et al. Modified Navy Plaque Index were randomly assigned to treatment sequence. Subjects brushed with their assigned toothbrush for 2 minutes using a commercially available dentifrice. Oral tissues were then re-examined and post-brushing plaque scores recorded. After a brief washout period, the above procedures were repeated with the alternate toothbrush. One examiner, blinded to the treatment sequence, performed all clinical measurements. RESULTS.: A total of 70 subjects (24 males and 46 females) were enrolled and completed the study. Each toothbrush was found to be safe and significantly reduced plaque levels after a single brushing. The PC 7000 was significantly more effective in plaque removal than the SBP at all tooth areas, reducing whole mouth plaque by 61% versus 58% and plaque from approximal surfaces by 69% versus 65%, respectively. CONCLUSIONS.: The action of the oscillating/pulsating toothbrush with a small round brush head, Oral-B ProfessionalCare 7000, is more effective in plaque removal than the battery-operated Crest SpinBrush Pro toothbrush with a larger dual moving brush head.

Three-month assessment of safety and efficacy of two electric toothbrushes.

OBJECTIVE.: This randomised, examiner-blind parallel group study was designed to evaluate the safety and efficacy of a rechargeable oscillating/pulsating toothbrush (Oral-B ProfessionalCaretrade mark 7000, Oral-B Laboratories; PC 7000) and a battery-operated toothbrush (Crest(R) SpinBrushtrade mark Pro, Procter & Gamble Company; SBP) in the reduction of gingivitis, bleeding and plaque over a 3-month period. METHODS.: After 12-18 hours of no oral hygiene, subjects had oral tissue examinations, and gingival and plaque assessments to determine eligibility in the study. Subjects were stratified and randomised into treatment groups based on initial whole mouth mean plaque (Turesky modification of Quigley Hein Plaque Index) and gingivitis (Löe & Silness Gingival Index) scores and gender. Subjects were instructed to brush twice daily with their assigned toothpaste and toothbrush. Clinical parameters were assessed at baseline, and after 1 and 3 months of use. Within treatment comparisons from baseline were analysed using t-test; between treatment comparisons were analysed using ANOVA. RESULTS.: Data were obtained from 92 subjects (PC 7000 n=45; SBP n=47). No significant differences were found in baseline plaque, gingivitis and bleeding between groups. Both treatment groups had significant reductions from baseline in plaque, gingivitis and bleeding scores. PC 7000 demonstrated significantly greater reductions compared to SBP in whole mouth plaque at 1 month: 0.39+/-0.43 vs. 0.16+/-0.42 and 3 months: 0.32+/-0.48 vs. 0.04+/-0.41. PC 7000 also demonstrated significant reductions compared to SBP in gingivitis at 3 months for whole mouth: 0.14+/-0.09 vs. 0.10+/-0.10 and approximal areas: 0.11+/-0.08 vs. 0.08+/-0.09. There were no significant differences between toothbrushes in bleeding at either time point. Safety examinations revealed no apparent difference in soft and hard tissue abnormalities between groups. CONCLUSION.: The PC 7000 toothbrush demonstrated significantly greater reductions in plaque and gingivitis compared to the SPB over a 3-month period.

Efficacy of a novel brush head in the comparison of two power toothbrushes on removal of plaque and naturally occurring extrinsic stain.

OBJECTIVES.: To compare the safety and efficacy of an oscillating/pulsating power toothbrush (Oral-B ProfessionalCaretrade mark 7000; PC 7000) fitted with either the standard FlexiSoft (PC 7000/EB17) brush head or the novel Pro Polisher (PC 7000/EB-Prophy) and a high-frequency toothbrush (Philips Sonicare(R) Elite(R); SE), in their relative ability to remove plaque and naturally occurring extrinsic dental stain over a six-week period. METHODS.: This randomised, examiner-blind, parallel group study involved 90 healthy subjects from a general population. All subjects received a baseline plaque (Turesky et al. modified Quigley-Hein Plaque Index), stain (Lobene Stain Index) and tooth shade (VITAPAN(R) Shade Guide) [Vita] assessment and an oral tissue examination. After training in the use of their randomly assigned device, subjects were instructed to brush twice daily for 2 min and returned after 3, 4 and 6 weeks of product use for a repeat of each clinical assessment. RESULTS.: Reductions from baseline in mean plaque and extrinsic dental stain scores were significant at Weeks 3, 4 and 6 in all three treatment groups. By Week 6, mean reductions from baseline in whole mouth plaque scores were 32%, 27% and 14% in the PC 7000/EB-Prophy, PC 7000/EB17 and SE groups, respectively. For the body of the tooth, mean reductions from baseline at Week 6 in total stain were 89%, 89% and 80%, respectively. Between treatment group comparisons consistently revealed that the PC 7000 toothbrush plus the EB-Prophy or EB17 brush head removed significantly more plaque and extrinsic stain (total stain, stain area and stain intensity) than the SE toothbrush at 3, 4 and 6 weeks. The EB-Prophy group had a greater proportion of subjects showing a 2-3+ change in Vita shade scores at each time point compared to the other two brushes; at Week 6 the proportions were 67% in the PC 7000/EB-Prophy group, 30% in the PC 7000/EB17 group, and 7% in the SE group. The PC 7000/EB17, PC 7000/EB-Prophy and the SE were found to be safe as used in the study. CONCLUSIONS.: The oscillating/rotating/pulsating PC 7000 (fitted with either the standard EB17 or novel EB-Prophy brush head) is more effective at removal of plaque and naturally occurring extrinsic tooth stain, and the PC 7000 plus EB-Prophy in the improvement of tooth shade, than the high-frequency SE toothbrush.

Development of an oscillating/rotating/pulsating toothbrush: the Oral-B ProfessionalCare Series.

The Oral-B range of power toothbrushes are based on a clinically proven oscillating/rotating action. This review considers the extensive series of laboratory and clinical studies involved in the development of the Oral-B power toothbrushes with three-dimensional (3D) brush head action (i.e. oscillating/rotating/pulsating), now known as the Oral-B ProfessionalCare Series. The unique, highly effective cleaning performance of the 3D action incorporated in the D15 and D17 models is proven in both the laboratory and clinical environments, thereby establishing an evidence-based platform for the development of the most recent ProfessionalCare 7000. In the early development phase, in-vitro studies indicated that the additional pulsating action and advancements in filament technology improved approximal penetration, where plaque removal is most difficult. In-vitro models provide a useful development tool for the rapid assessment of design modifications, while controlling many factors that confound in-vivo studies, but the relevance of their findings needs to be confirmed in the clinical situation by direct improvements in oral health. Results from well-controlled, randomised clinical studies in the development programme have demonstrated the superiority of the D15 and D17 models with 3D action over a manual toothbrush and other power toothbrushes of various actions and designs in the improvement of oral health outcomes such as plaque removal (especially from approximal sites), reduction of gingival inflammation, and control of calculus and stain formation, with no greater potential to cause oral tissue abrasion. Furthermore, user acceptance of the oscillating/rotating/pulsating toothbrush may encourage long-term compliance during normal use.

Single-use plaque removal efficacy of three power toothbrushes.

OBJECTIVES: To compare the safety and plaque removal efficacy of two oscillating/rotating/pulsating toothbrushes (Oral-B ProfessionalCare 7000 [PC 7000] and Oral-B 3D Excel [3DE]) and a high-frequency toothbrush (Sonicare Advance, Philips Oral Healthcare; SA) in a single-use, examiner-blind, three period crossover study. METHODS: After refraining from all oral hygiene procedures for 23-25 hours, subjects received an oral tissue examination and those with pre-brushing whole mouth mean plaque scores > or = 0.6 based on the Rustogi et al. Modified Navy Plaque Index were randomly assigned to treatment sequence. After brushing with the assigned toothbrush and a commercially available dentifrice for 2 minutes, oral tissues were then re-examined and post-brushing plaque scores recorded. Following a brief washout period between two additional visits, the above procedures were repeated with the two alternate toothbrushes. One examiner, blinded to the treatment sequence, performed all clinical measurements. RESULTS: A total of 79 subjects (28 males and 51 females) were enrolled and completed the study. Each toothbrush was found to be safe and significantly reduced plaque levels after a single brushing. The PC 7000 and 3DE were equally more effective in plaque removal than the SA, at all tooth areas, reducing plaque by 59.0%, 59.7% and 51.8%, respectively on whole mouth surfaces, and by 67.5%, 67.8% and 59.4%, respectively on approximal surfaces. CONCLUSIONS: The action of the oscillating/rotating/pulsating toothbrushes (Oral-B ProfessionalCare 7000 and Oral-B 3D Excel) was more effective in plaque removal than the high-frequency toothbrush (Sonicare Advance).

Plaque removal efficacy of two electric toothbrushes with different brush head designs.

OBJECTIVES: To compare the safety and plaque removal efficacy of two electric toothbrushes, one a rechargeable oscillating/pulsating toothbrush with a small round brush head (Oral-B ProfessionalCare 7000; PC 7000), the other a battery-operated toothbrush with a dual moving brush head (Crest SpinBrush Pro; SBP). METHODS: The study had a randomised, examiner-blind, two-arm crossover design. All subjects received an oral prophylaxis and used both toothbrushes on alternating days for a two-week practice period. After abstaining from all oral hygiene procedures for 23-25 hours, subjects received an oral tissue examination and those with pre-brushing whole mouth mean plaque scores > or = 0.60 measured by the Rustogi et al. Modified Navy Plaque Index were randomly assigned to treatment sequence. Subjects brushed with their assigned toothbrush for 2 minutes using a commercially available dentifrice. Oral tissues were then re-examined and post-brushing plaque scores recorded. After a brief washout period, the above procedures were repeated with the alternate toothbrush. One examiner, blinded to the treatment sequence, performed all clinical measurements. RESULTS: A total of 70 subjects (24 males and 46 females) were enrolled and completed the study. Each toothbrush was found to be safe and significantly reduced plaque levels after a single brushing. The PC 7000 was significantly more effective in plaque removal than the SBP at all tooth areas, reducing whole mouth plaque by 61% versus 58% and plaque from approximal surfaces by 69% versus 65%, respectively. CONCLUSIONS: The action of the oscillating/pulsating toothbrush with a small round brush head, Oral-B ProfessionalCare 7000, is more effective in plaque removal than the battery-operated Crest SpinBrush Pro toothbrush with a larger dual moving brush head.

An oscillating/pulsating electric toothbrush versus a high-frequency electric toothbrush in the treatment of gingivitis.

OBJECTIVES: The objective of this study was to compare the effect of an oscillating/pulsating power toothbrush (Oral-B ProfessionalCare 7000; PC 7000) and a high-frequency power toothbrush (Philips Sonicare Elite; SE) on the reversal of experimental gingivitis. METHODS: The study had a randomised, examiner-blind, split-mouth design. After dental prophylaxis, subjects refrained from brushing mandibular teeth for 21 days to allow development of gingivitis. During a 4-week treatment phase, the right or left side of the mouth was brushed with either the PC 7000 or the SE toothbrush as randomly allocated. Plaque and gingivitis were assessed at baseline (Day 0), after 21 days of no oral hygiene, and after 1, 2 and 4 weeks of brushing twice daily. Gingival abrasion was assessed at Day 0 and after 1, 2 and 4 weeks of product use. RESULTS: Of 38 enrolled subjects, 35 provided evaluable data. The experimentally induced gingivitis (EIG) phase resulted in higher bleeding and plaque scores as compared to Day 0. During the treatment phase, plaque and bleeding scores were significantly lower with the PC 7000 than the SE toothbrush. After 4 weeks of use, the mean plaque scores changed from 2.78 (Day 21 of EIG phase) to 0.70 for the PC 7000 and from 2.67 (Day 21) to 0.88 for the SE. The mean bleeding scores changed from 1.86 (Day 21) to 1.24 for the PC 7000 and from 1.88 (Day 21) to 1.42 for the SE. No major differences were found between brushes with regard to gingival abrasion. CONCLUSIONS: The oscillating/pulsating power toothbrush (Oral-B ProfessionalCare 7000) was more effective than the high-frequency power toothbrush (Philips Sonicare Elite) at plaque removal and improvement of gingival condition, with no greater potential for causing gingival abrasion.

Three-month assessment of safety and efficacy of two electric toothbrushes.

OBJECTIVE: This randomised, examiner-blind parallel group study was designed to evaluate the safety and efficacy of a rechargeable oscillating/pulsating toothbrush (Oral-B ProfessionalCare 7000, Oral-B Laboratories; PC 7000) and a battery-operated toothbrush (Crest SpinBrush Pro, Procter & Gamble Company; SBP) in the reduction of gingivitis, bleeding and plaque over a 3-month period. METHODS: After 12-18 hours of no oral hygiene, subjects had oral tissue examinations, and gingival and plaque assessments to determine eligibility in the study. Subjects were stratified and randomised into treatment groups based on initial whole mouth mean plaque (Turesky modification of Quigley Hein Plaque Index) and gingivitis (Löe & Silness Gingival Index) scores and gender. Subjects were instructed to brush twice daily with their assigned toothpaste and toothbrush. Clinical parameters were assessed at baseline, and after 1 and 3 months of use. Within treatment comparisons from baseline were analysed using t-test; between treatment comparisons were analysed using ANOVA. RESULTS: Data were obtained from 92 subjects (PC 7000 n=45; SBP n=47). No significant differences were found in baseline plaque, gingivitis and bleeding between groups. Both treatment groups had significant reductions from baseline in plaque, gingivitis and bleeding scores. PC 7000 demonstrated significantly greater reductions compared to SBP in whole mouth plaque at 1 month: 0.39 +/- 0.43 vs. 0.16 +/- 0.42 and 3 months: 0.32 +/- 0.48 vs. 0.04 +/- 0.41. PC 7000 also demonstrated significant reductions compared to SBP in gingivitis at 3 months for whole mouth: 0.14 +/- 0.09 vs. 0.10 +/- 0.10 and approximal areas: 0.11 +/- 0.08 vs. 0.08 +/- 0.09. There were no significant differences between toothbrushes in bleeding at either time point: Safety examinations revealed no apparent difference in soft and hard tissue abnormalities between groups. CONCLUSION: The PC 7000 toothbrush demonstrated significantly greater reductions in plaque and gingivitis compared to the SPB over a 3-month period.

Efficacy of a novel brush head in the comparison of two power toothbrushes on removal of plaque and naturally occurring extrinsic stain.

OBJECTIVES: To compare the safety and efficacy of an oscillating/pulsating power toothbrush (Oral-B ProfessionalCareTM 7000; PC 7000) fitted with either the standard FlexiSoft (PC 7000/EB17) brush head or the novel Pro Polisher (PC 7000/ EB-Prophy) and a high-frequency toothbrush (Philips Sonicare Elite; SE), in their relative ability to remove plaque and naturally occurring extrinsic dental stain over a six-week period. METHODS: This randomised, examiner-blind, parallel group study involved 90 healthy subjects from a general population. All subjects received a baseline plaque (Turesky et al. modified Quigley-Hein Plaque Index), stain (Lobene Stain Index) and tooth shade (VITAPAN Shade Guide) [Vita] assessment and an oral tissue examination. After training in the use of their randomly assigned device, subjects were instructed to brush twice daily for 2 min and returned after 3, 4 and 6 weeks of product use for a repeat of each clinical assessment. RESULTS: Reductions from baseline in mean plaque and extrinsic dental stain scores were significant at Weeks 3, 4 and 6 in all three treatment groups. By Week 6, mean reductions from baseline in whole mouth plaque scores were 32%, 27% and 14% in the PC 7000/EB-Prophy, PC 7000/EB17 and SE groups, respectivety. For the body of the tooth, mean reductions from baseline at Week 6 in total stain were 89%, 89% and 80%, respectively. Between treatment group comparisons consistently revealed that the PC 7000 toothbrush plus the EB-Prophy or EB17 brush head removed significantly more plaque and extrinsic stain (total stain, stain area and stain intensity) than the SE toothbrush at 3, 4 and 6 weeks. The EB-Prophy group had a greater proportion of subjects showing a 2-3+ change in Vita shade scores at each time point compared to the other two brushes; at Week 6 the proportions were 67% in the PC 7000/EB-Prophy group, 30% in the PC 7000/EB17 group, and 7% in the SE group. The PC 7000/EB17, PC 7000/EB-Prophy and the SE were found to be safe as used in the study. CONCLUSIONS: The oscillating/rotating/pulsating PC 7000 (fitted with either the standard EB17 or novel EB-Prophy brush head) is more effective at removal of plaque and naturally occurring extrinsic tooth stain, and the PC 7000 plus EB-Prophy in the improvement of tooth shade, than the high-frequency SE toothbrush.

A comparison of the plaque removal efficacy of two power toothbrushes: Oral-b Professional Care Series versus Sonicare Elite.

AIM: To compare the safety and plaque removal efficacy of an oscillating/ pulsating toothbrush (Professional Care Series, Oral-B Laboratories; PCS) and a high frequency toothbrush (Sonicare Elite, Philips Oral Healthcare; SE). METHODS: The study had a randomised, examiner-blind, crossover design. Sixty-one subjects aged 19-64 years were enrolled. After 23-25 hours of no oral hygiene, subjects received an oral tissue examination and those with pre-brushing whole mouth mean plaque scores > or = 0.60 measured by the Rustogi modified Navy Plaque Index were randomly assigned to treatment sequence. Subjects brushed with their assigned toothbrush for 2 minutes using a commercially available dentifrice. Oral tissues were then re-examined and post-brushing plaque scores recorded. After a brief washout period, the above procedures were repeated with the alternate toothbrush. One examiner blinded to the treatment sequence performed all clinical measurements. RESULTS: All 61 subjects completed the study. Both toothbrushes significantly reduced plaque levels after a single brushing (t-test, p < 0.0001). However, the PCS was significantly more effective than the SE in whole mouth plaque removal and in reducing plaque from marginal, buccal, lingual and approximal surfaces (ANOVA, p < 0.0001). Whole mouth plaque was reduced by 88% versus 61% and approximal plaque by 97% versus 73% for the PCS and SE toothbrushes, respectively. There was no evidence of hard or soft tissue trauma after a single-use of either toothbrush. CONCLUSION: Based on the findings of this single-use clinical evaluation, the action of the oscillating/ pulsating power toothbrush is more effective at plaque removal than a high frequency power toothbrush.

The safety and efficacy of a powered toothbrush on soft tissues in patients with implant-supported fixed prostheses.

The safety, efficacy and acceptability of an oscillating/rotating powered toothbrush was assessed in patients rehabilitated with fixed prostheses on implants. One hundred consecutive patients (aged 18-80; mean 56.3; 51 females), who met the inclusion/exclusion criteria and who participated in a regular annual recall scheme, were enrolled. They were instructed on how to use the powered toothbrush, as well as on classical interdental plaque control. The electric toothbrush had to be used twice daily for 2 min. The following periodontal parameters were measured at baseline and at 3 months, 6 months and 12 months: presence/absence of gingival and/or mucosal ulceration/desquamation; sulcus bleeding index; probing pocket depth; periodontal pocket-bleeding index and gingival recession. At 3 months and at the end of the study, patients completed a questionnaire concerning the overall acceptability and convenience of the powered toothbrush, as compared with their habitual manual toothbrush. A total of 80 patients completed the study. No dropouts were related to the use of the powered toothbrush. All parameters improved over the course of the study. The mean overall pocket depth decreased from 3.3 mm at baseline to 3.0 mm at 12 months, while the mean decrease in recession was 0.1 mm at 12 months. During the 1-year observation, there was a slight gain in periodontal attachment level. Gingival ulcerations were not observed at any point in the study. High scores for convenience and comfort of the powered toothbrush were reported, and the majority (95%) said that they would continue to use it for habitual oral hygiene. It is concluded that the powered toothbrush investigated is effective, safe and comfortable for patients rehabilitated by means of oral implant-supported prostheses.

A review of the clinical efficacy of the Oral-B oscillating/rotating power toothbrush and the Philips Sonicare toothbrush in normal subject populations.

Plaque removal by a toothbrush results from a physical scrubbing of bristles on the tooth surface that removes adherent plaque bacteria. Because of the frequency of brush head motion, some power toothbrushes generally remove plaque more effectively than a manual brush. One power toothbrush, Philips Sonicare, claims also to remove plaque as a result of dynamic fluid activity. This effect has been shown in laboratory studies but clinical evidence is currently lacking. This review evaluated the data from well-controlled clinical studies carried out in normal subjects from a general population comparing the Sonicare toothbrushes with the Oral-B oscillating/rotating power toothbrush technology. It focuses on plaque removal from approximal surfaces where it is difficult for toothbrush bristles to reach, as it is here that any dynamic fluid effect should be most apparent. Results from the review found no evidence to support a greater efficacy for the Sonicare toothbrushes either generally or at approximal surfaces. Data revealed that the oscillating/rotating toothbrush was more effective than the Sonicare toothbrushes with respect to plaque removal. It is possible that factors associated with the clinical situation such as damping resulting from bristle contact with the tooth surface and the high viscosity of saliva and dentifrice may counteract dynamic fluid activity in vivo. This review indicates that dynamic fluid activity beyond the reach of bristles as demonstrated in the laboratory is yet unproven in the clinical situation.

The safety and efficacy of a children's power toothbrush and a manual toothbrush in 6-11 year-olds.

PURPOSE: To evaluate and compare the oral hard and soft tissue safety and the plaque-removing efficacy of a children's power toothbrush (Braun Oral-B Kids' Power Toothbrush-D10) and a manual toothbrush in children from a general population. MATERIALS AND METHODS: Seventy children aged 6-11 yrs were enrolled into a single-blind, randomized, parallel-design study. At baseline, oral hard and soft tissues were evaluated and plaque was assessed on buccal and lingual surfaces of all fully erupted permanent and primary teeth using the Turesky Modification of the Quigley-Hein Plaque Index. Eligible subjects were randomized to use either a Braun Oral-B children's power toothbrush (D10) or a manual toothbrush for the duration of the study. Subjects were instructed to brush their teeth at home twice daily for 1 min each day for the 30-day study period. At baseline and after 15 and 30 days, plaque was assessed following 12-18 hrs of no oral hygiene. In addition, at each visit single-use plaque removal was evaluated after subjects had brushed their teeth for 1 min under supervision. Oral hard and soft tissues were assessed for safety before and after the supervised 1-min brushing at each visit. RESULTS: There were no pre-brushing oral hard and soft tissue abnormalities or post-brushing changes in oral tissues in either group. There were statistically significant reductions in mean plaque index for the whole mouth (P< 0.006), buccal surfaces (P < 0.0001) and anterior teeth (P< 0.008) from day 0 to day 30 in the D10 group, but not in the manual group. Greater mean changes in whole mouth plaque reduction were seen for the D10 group as compared to the manual group at days 15 and 30 (P< 0.05). Results from the single-use supervised brushing at each visit revealed that reductions in mean whole mouth plaque were statistically significant in both groups at each visit (P< 0.0001). There was statistically significantly greater plaque removal after a single brushing at day 0 in the D10 group compared with the manual group (P< 0.002), but the difference was not significant at days 15 and 30.

A comparative 3-month clinical investigation of the safety and efficacy of a battery-operated and a rechargeable oscillating-rotating power toothbrush.

PURPOSE: To compare the safety and efficacy of two oscillating-rotating power toothbrushes, the rechargeable Braun Oral-B D8 and the battery-powered Colgate Actibrush. MATERIALS AND METHODS: This was a randomized, examiner-blind, parallel-group study, carried out over 3 months of product use, involving a total of 113 healthy subjects with a plaque score of > or = 1.5 and a gingivitis score of > or = 1.1. Subjects were given written and verbal instructions in the use of their respective power brushes and were told to brush twice per day. At baseline, hard and soft tissues were examined, and plaque scores and gingival scores were recorded after 12-18 hrs of no oral hygiene. Subjects returned after 3 months, at which time soft and hard tissues were re-examined and plaque and gingivitis scores were recorded. RESULTS: No evidence was found of soft or hard tissue trauma and both brushes were considered to be safe when used according to the manufacturers' instructions. After 3 months, whole mouth plaque scores had decreased by 7% in the D8 group but had increased by 4.3% in the Actibrush group. The decrease from baseline in the D8 group was statistically significant, but the increase in the Actibrush group was not. The difference between the two groups was statistically significant both for the whole mouth and all individual sites. Whole mouth gingivitis scores were also reduced significantly from baseline in both groups, by 22.5% in the D8 group and by 17.5% in the Actibrush group. For whole mouth scores and all individual sites (interproximal, buccal and lingual), the D8 was significantly more effective than the Actibrush.

A comparative single-use clinical study of the efficacy of two manual toothbrushes with angled bristles.

PURPOSE: To compare the safety and plaque removal efficacy of two angled-bristled toothbrushes. MATERIALS AND METHODS: The brushes were compared using a single-use, cross-over designed study, where healthy subjects from a normal population brushed their teeth with their assigned toothbrush for a timed 60 seconds. Pre- and post-brushing plaque levels were evaluated after disclosing, using the Proximal/Marginal Plaque Index. At the first visit, 100 subjects with a plaque index of > or = 2.20 after 23-25 hours of no oral hygiene were enrolled in the study. At the end of the study, data from 91 subjects were suitable for analysis. The two treatment sequence groups, X-Aktiv/CrossAction and CrossAction/X-Aktiv, were balanced for age and gender and, at each visit, pre-brushing plaque scores did not differ significantly between the two groups. Data from the two visits were pooled, after which plaque removal efficacies were compared. RESULTS: Both toothbrushes were found to be safe and both significantly reduced plaque levels (P< or = 0.0001), but the CrossAction was significantly more effective than the X-Aktiv for whole mouth and marginal sites, as well as the difficult-to-access approximal areas (P< or = 0.0008). For the whole mouth, the CrossAction was 11.8% more effective; for marginal sites the difference was 12.6%, and for approximal sites the difference was 11.4%. It is concluded that the Oral-B CrossAction toothbrush is significantly more effective with respect to plaque removal than the Dr. Best X-Aktiv.

Safety, efficacy and acceptability of a new power toothbrush: a 3-month comparative clinical investigation.

PURPOSE: To compare the safety and efficacy of a new power toothbrush (Braun Oral-B D17) with an ADA reference manual toothbrush. MATERIALS AND METHODS: 110 healthy subjects, 18-65 yrs of age, with a mean plaque index of > or = 1.80 and a gingival index of > or = 1.00, were enrolled in this 3-month, randomized, parallel-group, examiner-blind study. Oral soft and hard tissues were examined for safety, and plaque, gingivitis and bleeding were measured to evaluate efficacy. Measurements were made at baseline and after 1 and 3 months of product use. Following the baseline visit and randomization, subjects were instructed to brush twice daily for 2 mins with their assigned brush. RESULTS: 101 subjects completed the study with evaluable data for all time periods, 52 in the D17 group and 49 in the manual group. None of the nine withdrawals from the study were related to product use and no product-related adverse effects were reported. There was no clinically significant soft or hard tissue abrasion observed at any time point in either group. After 1 and 3 months, significant reductions from baseline in whole mouth and interproximal plaque, gingivitis and bleeding were observed in both groups. A comparison of the two groups revealed that the whole mouth and approximal plaque indices were reduced to a significantly greater extent in the D17 group after both 1 and 3 months. The whole mouth gingival index was also reduced to a greater extent in the D17 group at 1 and 3 months, but a difference in the approximal gingival index was only apparent after 3 months. With respect to the bleeding index, there was a significant difference between the two groups for the whole mouth at both 1 and 3 months, but the differences in favor of the D17 for approximal values did not achieve statistical significance. In conclusion, the D17 was found to be safe and had increased efficacy with respect to reduction of plaque and gingivitis, compared with a manual toothbrush.

A 3-month clinical comparison of the safety and efficacy of two battery-operated toothbrushes: the Braun Oral-B Battery toothbrush and the Colgate Actibrush.

PURPOSE: To compare the safety and efficacy of two battery-operated, non-rechargeable power toothbrushes, the Braun Oral-B Battery toothbrush (D4) and the Colgate Actibrush. MATERIALS AND METHODS: This was a randomized, single-blind, parallel-group study carried out over a 3-month period. A total of 114 subjects from a general population, who met the inclusion criteria of the study and who had whole mouth plaque scores of > or = 1.5 and gingivitis scores of > or = 1.2, participated in the study. Subjects were given either the D4 or the Colgate Actibrush with the manufacturers' instructions, and were asked to brush their teeth at home twice each day. At baseline and after 1 and 3 months, subjects were examined for oral hard and soft tissue health, after which they were assessed for gingivitis (Modified Gingival Index), bleeding (Gingival Bleeding Index), and plaque (Modified Quigley-Hein Plaque Index). Prior to each assessment, subjects refrained from all oral hygiene procedures for a period of 12-18 hours. RESULTS: No evidence was found of significant oral soft or hard tissue trauma, and both brushes were considered to be safe when used according to the manufacturers' instructions. In the D4 group, whole mouth, marginal and approximal plaque scores were significantly reduced from baseline (P < 0.05) after both 1 and 3 months by 7-12%, whereas, in the Actibrush group, plaque scores remained relatively unchanged from baseline throughout the study. Furthermore, comparisons between the toothbrush groups showed that whole mouth, marginal and approximal plaque scores for the D4 were significantly lower than those for the Actibrush at both the 1- and 3-month assessments. Modified Gingival Index scores after 3 months were significantly reduced from baseline in both groups by 7-8%. Similarly, percentages of bleeding sites were significantly lower by 12-15%. There were no significant differences between the groups with respect to gingivitis scores.