Commercial oral hygiene products and implant collar surfaces: Scanning electron microscopy observations.

Background: The use of medicated mouthwashes and gels in the home care maintenance of dental implants is controversial due to the possibility of residue deposition on the implant collar. The aim of this in vitro study was to analyse, by means of scanning electron microscopy (SEM), the amount of residues on dental implant collars treated with various commercial home dental care products. Methods: Gel and mouthwash products were tested on 10 implants. The gels included sodium fluoride, amine fluoride, and sodium hyaluronate products. The mouthwashes tested contained triclosan, nimesulide, stannous fluoride, amine fluoride, and hexetidine-chlorobutanol. The SEM observations were performed at different magnifications in double modality SE (secondary electrons) and BSE (backscattered electrons) to qualitatively assess any residual products. The image quantitative analysis was performed by Image J® software to assess areas occupied by residuals. All results were analysed by the same researcher with experience in electron microscopy. Results: The fluoride-based gel products left wider areas occupied by residuals than the mouthwash products. In particular the fluoride-based and hyaluronate products left the highest amount of residues. Among mouthwashes, fluoride-based and triclosan products showed the highest amount of residuals deposition. Discussion: Oral hygiene procedures and related professional products are fundamental to the prevention, treatment, and control of microorganisms. In the case of implants, mechanical and chemical plaque control strategies are even more important since the potentially harmful biofilm covers abiotic titanium surfaces. In situ fixture maintenance is crucial for dental implant therapy success. Correct recommendation of home care products for bacterial control is fundamental to the health of implants and their surrounding tissues. Conclusions: Data from this experimental study showed that home care commercial products in gel formulation, especially those containing fluoride, leave more residuals on titanium smooth surfaces than mouthwash products. The longer permanence of the products may lead to a more effective plaque control than other products.

Contexte: L'utilisation de bains de bouche et de gels médicamentés lors des soins d'entretien à domicile des implants dentaires porte à controverse en raison de la possibilité de dépôts de résidus sur le collet de l'implant. La présente étude in vitro visait à analyser par microscopie électronique à balayage (MÉB) la quantité de résidus sur les collets d'implants dentaires traités in vitro avec divers produits commerciaux de soins dentaires à domicile. Méthodologie: Les produits de gels et de bains de bouche ont été testés sur 10 implants. Les gels comprenaient les produits de fluorure de sodium, de fluorure d'amine et de hyaluronate de sodium. Les bains de bouche évalués contenaient du triclosan, de la nimésulide, du fluorure d'étain et du hexétidine-chlorobutanol. Les observations par MÉB ont été effectuées à diverses amplifications en modalité double SE (électrons secondaires) et BSE (électrons rétrodiffusés) pour évaluer de manière qualitative tout produit résiduel. L'analyse quantitative de l'image a été effectuée à l'aide du logiciel Image J® pour évaluer les zones ayant des résidus. Tous les résultats ont été analysés par le même chercheur expérimenté dans le domaine de la microscopie électronique. Résultats: Les produits de gels à base de fluorure ont laissé des résidus sur de plus vastes zones que les produits de bains de bouche. En particulier, les produits à base de fluorure et le hyaluronate ont laissé la plus grande quantité de résidus. Parmi les bains de bouche, les produits à base de fluorure et de triclosan ont révélé la plus grande quantité de dépôts de résidus. Discussion: Les procédures d'hygiène buccodentaire et les produits professionnels qui y sont liés sont essentiels à la prévention, au traitement et au contrôle des microorganismes. En matière d'implants, les stratégies de contrôle mécanique et chimique de la plaque sont encore plus importantes puisque le biofilm potentiellement nocif couvre les surfaces abiotiques du titane. L'entretien in situ du montage est primordial au succès de la thérapie de l'implant dentaire. La bonne recommandation de produits de soins à domicile pour le contrôle des bactéries est essentielle à la santé des implants et des tissus environnants. Conclusions: Les données de cette étude expérimentale ont montré que les produits commerciaux de soins à domicile en formule de gels, surtout ceux contenant du fluorure, laissent une plus grande quantité de résidus sur les surfaces lisses du titane que les produits de bains de bouche. La permanence plus longue des produits peut mener à un contrôle plus efficace de la plaque que d'autres produits.

Oral cleanliness in daily users of powered vs. manual toothbrushes - a cross-sectional study.

BACKGROUND: Toothbrushing is a daily routine. Still, when adults are asked to manually perform oral hygiene to the best of their abilities, a considerable amount of plaque persists. Little is known about the performance of people who use a powered toothbrush. The present study thus analysed whether the capability to achieve oral cleanliness is better in people for whom powered toothbrushing is a daily routine. METHODS: University students, who either performed powered (N = 55) or manual (N = 60) toothbrushing for more than 6 months on a daily basis were asked to clean their teeth to the best of their abilities by their own device. Plaque was assessed prior to and immediately after brushing. Furthermore, gingival bleeding, recessions, periodontal pocket depths and dental status were assessed. Oral hygiene performance was video-taped and analyzed with respect to brushing duration, sites of brushing and application of interproximal cleaning devices. RESULTS: No differences between groups were found with respect to plaque before and after brushing, clinical parameters and overall brushing duration (all p > 0.05, all d < 0.156). After brushing, plaque persisted at approximately 40% of the sections adjacent to the gingival margin in both groups. CONCLUSIONS: No advantage of daily powered toothbrushing as compared to daily manual toothbrushing was seen with respect to oral hygiene or clinical parameters. The capability to achieve oral cleanliness was low, irrespective of the type of toothbrush under consideration. Additional effort is thus needed to improve this capability.

Efficacy of Two Different Toothbrushes on Plaque Control: A Randomized Clinical Study

Objective: This parallel, randomized, examiner-blind clinical trial aimed to evaluate the efficacy of two different toothbrushes (manual and sonic) on plaque control in adolescents. Material and Methods: This study enrolled 56 volunteers, randomly allocated to two different groups: group A (n = 28) for the manual toothbrush (Curaprox 5460 Ultra Soft®) and group B (n = 28) for the sonic toothbrush (Edel White®). Mean age was 17.2 ± 1.1 years. A calibrated periodontist performed a periodontal evaluation to assess the presence of plaque with the Turesky Modification of the Quigley Hein Plaque Index (PI) and the gingival inflammation with the Silness & Löe Gingival Index (GI). Adolescents received instructions about the mechanical control of plaque at baseline (T0), with a reexamination after 3 months (T1) and 6 months (T2). Non-parametric Mann Whitney test was used to compare the differences between the two toothbrush groups and the Friedman test was used for the comparisons between times. Results: There has been PI reduction concerning the study times (T0, T1 and T2, p<0.05), but not between the groups A and B (p>0.05). As for GI there has been no significant difference between the groups and between the study times (p>0.05). Conclusion: Both toothbrushes were efficient in the control of supragingival plaque (visible biofilm).

The Effectiveness of the Use of "Special Grip Toothbrushes" on Dental Hygiene for Indonesian Patients with Ischemic Stroke

Objective: To find out the effectiveness of specially made brushes with special grips for use by groups of ischemic stroke sufferers for oral hygiene. Material and Methods: A sample of 30 stroke patients were taken at the Makassar Stroke Center, Indonesia, with criteria for extreme hemisphere ischemic stroke patients and willing to participate in the study and fill out informed consent. Brush making with a special grip design (modified brush) with Clay mixed material. The oral hygiene assessment procedure of the sample using a modified toothbrush was done in 3 stages before the brush, after brush and on the seventh day. Oral and oral hygiene was measured using the index of Oral Hygiene Index Simplified (OHI-S). The oral hygiene assessment procedure was done in 3 stages before the brush, after brush and on the seventh day. To find out the difference in effectiveness before and after the intervention was analyzed using the paired t test. The level of significance was set at 5%. Results: The highest percentage of stroke patients were female (53.3%), aged 40-60 years (66.7%) with an education level below junior high school (56.7%). There is a difference in the average OHIS score before and after using a special grip toothbrush (p<0.01). Conclusion: A special grip toothbrush that is used for Stroke sufferers can help to clean his teeth and mouth.

Effect of environmental and socioeconomic factors on the use of dental floss among children: a hierarchical approach

Abstract The aim of this study was to evaluate the association of environmental and socioeconomic characteristics with the use of dental floss in preschool children. This cross-sectional study was conducted with a sample of 402 preschool children aged 1-5 years, from Santa Cruz do Sul, a Southern city in Brazil. Mothers answered questions about environmental, demographic, and socioeconomic characteristics. Behavior variables as use of dental floss (study outcome) and dental attendance were also evaluated. Poisson regression analysis with robust variance through a hierarchical approach was used to investigate the association of explanatory variables for use of dental floss. Prevalence ratio (PR) and 95% confidence intervals (95%CI) were estimated. The mean sample age was 3.32 years (standard deviation [SD] 1.10). Of the included children, 291 (73.12%) did not use dental floss. The environmental model indicated that children who attended daycare (PR 2.53; 95%CI 1.39-4.60) and those whose parents were members of volunteer networks (RP 1.58; 95%CI 1.02-2.46) were more likely to use dental floss. Children from families with higher income (PR 1.55; 95%CI 1.07-2.24) and maternal schooling (PR 2.21; 95%CI 1.31-3.74) presented a higher prevalence of dental floss use. Older children and those who attended dental services were also related to higher dental floss use. Our findings suggest that children who live in a supporting environment and those with a higher socioeconomic status are more likely to use dental floss.

Efficiency of the Ocluch©MAD in the treatment of patients with OSAS and its association with craniofacial morphology.

OBJECTIVE: This study uses polysomnography and the Epworth sleepiness scale to assess the efficiency of the Ocluch©MAD in patients with Obstructive sleep apnea-hypopnea syndrome (OSAS), on overall respiratory disturbance indices (RDI), supine respiratory disturbance index (SRDI), minimum oxygen saturation, microarousals, CT90 (or ID90), sleep efficacy and snoring. These data are associated with skeletal class and facial biotype in order to establish predictive parameters for its effectiveness according to craniofacial morphology. METHODS: 22 adult patients (between 38 and 60 years of age) of both sexes (7 women, 15 men) diagnosed with OSAS in the Hospital de Carabineros de Chile (HOSCAR) Neurology Unit were recruited and given the Ocluch© MAD in the hospital's dental clinic, for its use during a three-month period. Patients were assess at the beginning and in the end of this period. RESULTS: 87.5% of patients with mild OSAS achieved the success criterion and normalization; 71.5% of patients with moderate OSAS achieved the success criterion and 33.3% achieved normalization; 85.7% of patients with severe OSAS achieved the success criterion and 57.1% achieved normalization. All class I and mesofacial patients achieved normalization, but class II patients had the greatest proportional improvement. CONCLUSIONS: The Ocluch MAD is an efficient low-cost alternative that should be considered among the therapeutic arsenal for a multidisciplinary approach to treating this disease.

"Everybody brush!": protocol for a parallel-group randomized controlled trial of a family-focused primary prevention program with distribution of oral hygiene products and education to increase frequency of toothbrushing.

BACKGROUND: Twice daily toothbrushing with fluoridated toothpaste is the most widely advocated preventive strategy for dental caries (tooth decay) and is recommended by professional dental associations. Not all parents, children, or adolescents follow this recommendation. This protocol describes the methods for the implementation and evaluation of a quality improvement health promotion program. OBJECTIVE: The objective of the study is to show a theory-informed, evidence-based program to improve twice daily toothbrushing and oral health-related quality of life that may reduce dental caries, dental treatment need, and costs. METHODS: The design is a parallel-group, pragmatic randomized controlled trial. Families of Medicaid-insured children and adolescents within a large dental care organization in central Oregon will participate in the trial (n=21,743). Families will be assigned to one of three groups: a test intervention, an active control, or a passive control condition. The intervention aims to address barriers and support for twice-daily toothbrushing. Families in the test condition will receive toothpaste and toothbrushes by mail for all family members every three months. In addition, they will receive education and social support to encourage toothbrushing via postcards, recorded telephone messages, and an optional participant-initiated telephone helpline. Families in the active control condition will receive the kit of supplies by mail, but no additional instructional information or telephone support. Families assigned to the passive control will be on a waiting list. The primary outcomes are restorative dental care received and, only for children younger than 36 months old at baseline, the frequency of twice-daily toothbrushing. Data will be collected through dental claims records and, for children younger than 36 months old at baseline, parent interviews and clinical exams. RESULTS: Enrollment of participants and baseline interviews have been completed. Final results are expected in early summer, 2017. CONCLUSIONS: If proven effective, this simple intervention can be sustained by the dental care organization and replicated by other organizations and government. TRIAL REGISTRATION: ClinicalTrials.gov NCT02327507; http://clinicaltrials.gov/ct2/show/NCT02327507 (Archived by WebCite at http://www.webcitation.org/6YCIxJSor).

Influence of the utilization time of different manual toothbrushes on oral hygiene assessed during a 6-month observation period: a randomized clinical trial.

BACKGROUND: The aim of this randomized clinical trial (RCT) was to investigate whether 6-month continuous use of different manual toothbrushes (TBs) influences plaque removal and the degree of gingival inflammation compared to short utilization periods of 4 weeks each. METHODS: In total, 96 participants were randomly allocated into two groups: continuous use during 6 months (non-renewal group) or a change in TB every 4 weeks during 6 months (renewal group). Each group was subdivided into four subgroups (groups A to H; n = 12 each) according to the head size (normal or short) and bristle hardness (medium or soft) of the TB used. The modified Quigley-Hein plaque index (QHI), papilla bleeding index (PBI), and gingival index (GI) were recorded at baseline and 2, 8, 12, 16, and 24 weeks after baseline. After 24 weeks, each participant received a new TB, and at week 26, the final QHI, PBI, and GI were determined. The statistical evaluation consisted of analysis of covariance (P <0.05). RESULTS: With time, QHI, PBI, and GI were significantly different between the renewal and the non-renewal groups (QHI: P = 0.02; PBI: P = 0.04; GI: P <0.01), independent of subgroup. In the renewal group, QHI showed a significant decrease between baseline and each follow-up visit (P <0.01). In the non-renewal group, there was a significant decrease compared to baseline up to and including week 16 (P <0.01). PBI in the renewal group showed no significant differences between baseline and each follow-up visit (P >0.05). In the non-renewal group, only the normal head/soft subgroup exhibited a significant increase at week 24 (P = 0.02). The GI in the renewal group showed no difference between baseline and all follow-up visits, whereas in the non-renewal group, there was a significant decrease up to and including week 12 (P <0.05). CONCLUSIONS: Six-month continuous use reduced the effectiveness of the TB with respect to plaque removal, and gingival inflammation appeared to increase.

Social determinants and use of dental floss by 35-44-year-old adults / Determinantes sociais e o uso de fio dental por adultos de 35 a 44 anos de idade

Objective: To analyze social, economic and demographic variables associated with the use of dental floss by 35-44-year-old adults living in the district of Embu, 2008. Methods: A cross-sectional type study in which an inquiry was applied and oral conditions were examined. The sample delineation was conglomeration probabilistic in two stages of random selection (censor sectors and eligible homes). The dependent variable was the use of dental floss in daily oral hygiene practices. The independent variables were social economic and demographic conditions, access to health services, habits and presence of caries and periodontal diseases. EPIINFO 06 and STATA 10 programs were used for Poisson regression analysis with adjustment for conglomeration sample.Results: Of persons interviewed 52.1% stated that they did not use dental floss. In the multivariate model there was an association of non use of dental floss for men (PR=1,61 p=0,00), with those who declared having smoking habit (PR=1.24 p=0.04); with family income equal to or less than one minimum salary (PR=1.62 p=0.00); who had up to 8 years of schooling (PR=1.42 p=0.01); who did not receive information from the dentist about cleaning the teeth and gums (PR=1.27 p=0.02), and who presented severe periodontal diseases with clinical attachment loss >3.5mm (PR=1.05 p=0.00). Conclusion: The research showed that the lack of dental floss use is a socially related behavior. Therefore, fair social policies is needed in order to minimize social inequalities, and ensure adult oral health educational programs.

Objetivo: Analisar as variáveis sócio econômicas e demográficas associadas ao uso do fio dental em adultos de 35 a 44 anos no município de Embu, 2008. Métodos: Estudo do tipo transversal no qual foi aplicado um inquérito e realizado um exame das condições bucais. O delineamento da amostra foi probabilístico por conglomerado em dois estágios de sorteio (setores censitários e domicílios elegíveis). A variável dependente foi o uso do fio dental nas práticas diárias de higiene bucal. As variáveis independentes: condições sócio demográficas, sócio econômicas, acesso aos serviços, hábitos, presença de cárie dentária e doença periodontal. Empregou-se o programa EPIINFO 06 e o STATA 10, foi usado o modelo de regressão de Poisson com ajuste para amostragem complexas. Resultados: A percentagem de pessoas relatando que não utilizavam o fio dental foi de 52,1%. No modelo de análise multivariável demonstrou que houve associação para o não uso do fio dental entre os homens (RP=1,61 p=0,00), que relataram o hábito de fumar (RP=1,24 p=0,04), com renda familiar menor ou igual a um salário mínimo (RP=1,62 p=0,00), que apresentavam até 8 anos de estudo (RP=1,42 p=0,01), que não receberam informação do cirurgião-dentista sobre higiene bucal (RP=1,27 p=0,02), e apresentam perda de inserção periodontal superior a 3,5mm (RP=1,05 p=0,00). Conclusão: A pesquisa demonstrou que não usar o fio dental de maneira regular é um comportamento socialmente determinado, verifica-se a necessidade de elaboração de políticas socialmente mais justas que minimizem as iniquidades sociais, com ações de educação de saúde bucal voltadas para adultos

Saúde bucal e educação infantil: avaliação do desgaste e do acondicionamento de escovas dentárias utilizadas por pré-escolares / Oral health and early childhood education: evaluation of the wear andstorage of toothbrushes used by preschoolers

Introdução: A infância é uma fase da vida de importância primordial para o futuro da saúde bucal. O elo entre os setores da educação e da saúde pode oportunizar a incorporação de práticas educativas e preventivas em saúde bucal no cotidiano pré-escolar. A principal medida é a escovação dentária manual ? método mais acessível para a maioria da população. Objetivo: Avaliar macroscopicamente o desgaste das cerdas, a forma de acondicionamento e a identificação das escovas dentárias. Material e método: Foram avaliadas 345 escovas utilizadas por crianças de 2 a 5 anos, em quatro escolas de educação infantil, sendo duas participantes do programa de promoção de saúde bucal. Empregou-se o índice de Rawls et al. para avaliar as cerdas. Resultado: Diferenças estatisticamente significantes (p = 0,020 - teste U de Mann-Whitney) foram comprovadas entre as frequências de escovas, sendo a maior (n = 205) verificada em escola participante do programa; e, entre escovas adequadas e inadequadas (p< 0,05 - teste X2), em que 31,7 e 60% das escovas das escolas participantes e não participantes do programa, respectivamente, foram classificadas como impróprias para a escovação. Dos porta-escovas avaliados, 100% eram de uso coletivo. Quanto à identificação, 18% das escovas não estavam identificadas nas escolas participantes e 37% nas demais. Conclusão: A maioria das escovas apresentou desgastes acentuados e o acondicionamento das mesmas era inadequado; entretanto, as escolas participantes do programa apresentaram escovas com cerdas menos desgastadas. Sugere-se que haja a capacitação do educador quanto ao correto acondicionamento e à avaliação das escovas em relação ao desgaste das cerdas em todas as escolas de educação infantil.

Introduction: Early childhood is an essential phase of life for the future of oral health. The link between educational and health sectors can facilitate incorporating educational and preventive oral health practices in daily teaching in pre-schools. The main measure is manual tooth-brushing, which is the most accessible method for most of the population. Objective: The objective of this study is to evaluate macroscopically the wear on the bristles, form of storage, and identification of tooth brushes. Material and method: 345 toothbrushes used by children between the ages of 2 and 5 were evaluated in 4 pre-schools, by 2 participants from the oral health program. The Rawls et al. index was used to evaluate the bristles. Result: There were statistically significant differences (p = 0.020 - Mann-Whitney U test) between the frequency of toothbrushes, with the highest being (n = 205) stored at participating school; and, between adequate and inadequate brushes (p < 0.05 - X2 test) with 31.7 and 60%, respectively, classified as unfit for tooth-brushing. Of the toothbrush holders evaluated 100% were used collectively. Regarding identification, 18% of the toothbrushes were not identified in participating schools, and 37% in the others. Conclusion: The toothbrushes exhibited marked wear, and storage was inadequate; however, the schools participating in the oral health program showed toothbrushes with bristles less worn. It is suggested that training of educators regarding correct storage and evaluation of toothbrushes for wear of the bristles should be undertaken in all early childhood schools.

Critérios adotados para a escolha da escova dental: estudo com consumidores de Florianópolis, Santa Catarina (Brasil) / Criteria adopted for the toothbrush choice: a study among consumers in Florianópolis, Santa Catarina (Brazil)

Introdução e objetivo: Buscou-se conhecer os critérios adotadospor sujeitos adultos para a aquisição da escova dental e identificar ainfluência do cirurgião-dentista nessa escolha. Material e métodos:Trata-se de um estudo descritivo, transversal, feito por intermédio dolevantamento de dados primários. A população-alvo foi formada porconsumidores de um supermercado da região central de Florianópolis(SC, Brasil). Para o cálculo da amostra considerou-se uma população infinita e erro de 5%. A seleção dos sujeitos aconteceu de modoacidental. O critério de inclusão foi idade igual ou superior a 18 anos.Foi aplicado um questionário, estruturado em duas partes, comquestões fechadas e abertas. A análise estatística descritiva ocorreupor meio da distribuição de frequência relativa. Resultados: Ao todoparticiparam da pesquisa 409 sujeitos (54,65% homens) com idadede 19 a 72 anos, e a maioria era da faixa etária de 41 a 51 anos. Pelomenos uma vez ao ano 41,1% realizam consulta odontológica e 52%afirmaram trocar sua escova a cada três ou quatro meses, em funçãodo desgaste das cerdas. Um baixo percentual (25,6% homens, 25,5%mulheres) recebeu orientação do cirurgião-dentista sobre a escovadental. O critério mais adotado para a aquisição da escova é o preço(43,6%), e a participação do dentista foi citada por 10,5%, a qual foimais evidenciada por sujeitos de classe socioeconômica mais elevada.Conclusão: Para o grupo pesquisado, o critério mais adotado paraaquisição de escovas dentais é o preço, e a influência do cirurgiãodentistanesse procedimento é reduzida.

Introduction and objective: To identify the criteria adopted by adultconsumers when buying a toothbrush and to determine whetherdentists influence on this choice. Material and methods: It was atransversal descriptive study through primary data collection. Thetarget population consisted of consumers in a supermarket in thedowntown of Florianópolis (SC, Brazil). An infinite population and anerror of 5% were considered to the sample calculation. The selectionof people was random. The inclusion criterion was being above 18years old. A questionnaire structured in two parts with closed andopen questions was applied. Data was submitted to statistical analysisthrough distribution of relative frequency. Results: Altogether, 409people (54.65% male) participated in the survey, aged from 19 to 72years, and the majority (28%) aged between 41 and 51 years. 41.1% visitthe dentist at least once a year, and 52% change their toothbrushes everythree months due to the wear of the bristles. A low percentage of people(25.6% male and 25.5% female) received orientation of the dentist onthe toothbrush. The most adopted criterion for the acquisition of thetoothbrush was the price (43.6%), and the participation of the dentistwas cited by 10.5%, being more common for people of the highersocioeconomic class. Conclusion: For this group, price is the mostadopted criterion for the acquisition of toothbrushes, and the influenceof the dentist on this procedure is reduced.

Clinical study on the auxiliary effectiveness of dental floss or interdental brush in severe chronic periodontitis / 中国基层医药

Objective To study the auxiliary effectiveness of dental floss or interdental brush in treating severe chronic periodontitis.Methods Thirty-five patients with severe chronic periodontitis were selected.The subjects were randomly divided into two groups.Right methods of brushing teeth,scaling,root planning and dental floss or interdental brush were performed in the experimental group,and the same therapy was used in the control group except using dental floss and interdental brush.The following indexes and measurements were compared:plaque index(PLI),probing depth(PD),bleeding index(BI) and mobility degree(MD).Results PLI,PD and BI demonstrated a significant improvement(P

A Comparison of the Efficacy of 2 Powered Accumulation, Gingivitis, and Gingival Bleeding Toothbrushes in Affecting Plaque.

BACKGROUND: The purpose of this 30-day blinded, parallel-design study was to compare the effect of 2 powered toothbrushes, the Rowenta MH700 and the Braun Plak Control Ultra, on reducing plaque accumulation, gingivitis, and gingival bleeding in a cohort of 60 healthy adults. METHODS: After baseline evaluation of plaque, gingivitis, and gingival bleeding, subjects were randomly assigned to one of the experimental groups, provided written and verbal toothbrushing instructions, and had their teeth polished. At 2 weeks (follow-up 1) and 4 weeks (follow-up 2) all clinical parameters were again evaluated. RESULTS: The Braun group demonstrated a nearly significant reduction in gingival index (Gl) and a significant reduction in GI at follow-up 2. The Rowenta group demonstrated significant reductions in GI, plaque index (PI), and bleeding index (GBI) at both follow-up 1 and 2 examinations. At follow-up 1, the Braun group demonstrated a nearly significant reduction in GI, a significant reduction in PI, and a non-significant reduction in GBI. At follow-up 2, the Braun group demonstrated a significant reduction in GBI, but not a significant reduction in PI. The reduction in GI for the Rowenta group was significantly greater (P values of 0.0001 and 0.0001, respectively) than that demonstrated in the Braun group. However, the Rowenta group did not demonstrate a significantly greater reduction in PI (P values of 0.7135 and 0.3184 for follow-up 1 and follow-up 2, respectively) or GBI than the Braun group at either examination (P values of 0.0663 and 0.3397 for followup 1 and 2, respectively). CONCLUSIONS: The results of this study support the findings of numerous other studies that powered toothbrushes have great potential to remove plaque and improve gingival health and that the improvement can be demonstrated in a relatively short period of time. J Periodontol 1999;70:840-847.