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1.
Monogr Oral Sci ; 29: 74-79, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33427231

RESUMO

The intraoral biofilm requires mechanical removal due to its physical properties. When exposed to the biofilm, interdental areas need special devices to be used. The most effective ones and the first choice are interdental brushes. However, they may not be adequate in the case of very narrow interdental spaces. Despite the difficulties in handling, dental floss may have some advantage in subgingival cleaning. Data are present for gingivitis and periodontitis, but almost no information has been published on gingivally healthy individuals. With respect to interdental caries there is evidence that floss only has a protective value when used professionally and without sufficient fluoridation. There are no such data available on interdental brushes.


Assuntos
Placa Dentária , Gengivite , Biofilmes , Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Humanos , Escovação Dentária
2.
Quintessence Int ; 52(2): 176-186, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33433083

RESUMO

At present, the most important criterion for the size selection of interdental brushes is the PHD-value (passage hole diameter) according to the ISO standard for interdental brushes ISO 16409:2016. The PHD size range of commercially available products currently lies between 0.6 and 5.2 mm. With the exceptions of special situations, a range between 0.7 and 2.9 mm is sufficient for clinical routine. As most products have longer filaments nowadays, one brush can often be applied for two PHD intervals. Consequently, adequate patient counseling and the individual selection of the appropriate interdental brushes can generally be achieved with an assortment of 12 systematically arranged interdental brush sizes. An application example is the "Heidelberg set" described herein. It is crucial that the correct choice of size is based upon continuously rising PHD-values, and not upon parameters such as stem size, outer diameter of filaments, or similar, as these do not allow for a reliable conclusion regarding the interdental passage. The usage of ISO sizes is also not recommendable due to their insufficient size differentiation. (Quintessence Int 2021;52: 176-186; doi: 10.3290/j.qi.b872241; Revised from an article originally published (in German) in Parodontologie 2020;31(1)37-49)

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Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária , Índice de Placa Dentária , Humanos , Higiene Bucal , Escovação Dentária
3.
Swiss Dent J ; 130(11): 899-905, 2020 Nov 09.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-33161692

RESUMO

Studies on interdental cleaning have shown an advantage of interdental brushes (IDB) over other interdental care products. Sticks (STK) made of rubber are often recommended as an alternative, as they are considered user-friendly, gentle but nevertheless effective. This laboratory study aimed to compare the cleaning efficiency with the same application force between IDB and STK. Brushes with different geometries and diameters were tested. Two conical STK from two manufacturers of the sizes "XS/S" (0.7-2.6 mm) and "L" (0.9-3.4 mm) were tested. For the IDB, one conical (2.7-3.4 mm), two cylindrical (1.9 and 2.5 mm) and one waisted brush (4-2-4 mm) were assessed. A geometric model with parallel-walled metal blocks (black and coated with titanium oxide) was used. The brushes were tested with one and five cleaning cycles each in horizontal direction. The test surfaces were measured planimetrically for cleaning efficiency by calculating the areas freed from titanium oxide in relation to the maximum cleanable total area. The maximum cleaning efficiency of the IDB was 45% at 1 mm distance with one cleaning cycle and 95% with five cycles. For the sticks, the cleaning efficiency with one cleaning cycle was 30% and 67% with five cycles. At a distance of 2 mm, the maximum cleaning efficiency was 50% with one cleaning cycle and 87% with five cycles for the IDBs and only 10% for the STKs. Taking into account the limitations of this study, the IDBs showed an overall better cleaning efficiency with the same application force, compared to STKs, with the waisted IDB achieving better cleaning efficiency than the conical IDB. In conclusion, STKs can be used in narrow interdental spaces where app opriate, but overall IDBs are more preferable in narrow and wider contact point conditions.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária , Humanos , Escovação Dentária
4.
Medicine (Baltimore) ; 99(36): e21622, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32898997

RESUMO

The objective of the study was to characterize self-reported oral hygiene practices among Mexican older adults aged ≥60 years, and to measure the association between frequency of tooth brushing and a set of sociodemographic, socioeconomic, and dental variables.We conducted a cross-sectional study of 139 older adults aged ≥60 years in Pachuca, Mexico. A questionnaire and a clinical dental examination were administered to identify specific variables. We determined frequency of tooth brushing (or cleaning of dentures or prostheses) and use of toothpaste, mouthwash, and dental floss among respondents. Non-parametric testing was performed for statistical analysis and a multivariate logistic regression model was generated with Stata 11 software to determine frequency of tooth brushing.In our study sample, 53.2% of participants reported brushing their teeth at least once a day, 50.4% always using toothpaste, 16.5% using mouthwash and 3.6% using floss for their oral hygiene. In general, younger and female respondents used oral hygiene aids more than the others. Our multivariate model yielded an association (P < .05) between tooth brushing at least once daily and the following variables: having functional dentition (OR = 12.60), lacking health insurance (OR = 3.72), being retired/pensioned (OR = 4.50), and suffering from a chronic disease (OR = 0.43).The older adults in our sample exhibited deficient oral hygiene behaviors. The results suggest certain socioeconomic inequalities in oral health. The findings of this study should be considered when designing dental care instructions for older adults.


Assuntos
Escovação Dentária/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Dispositivos para o Cuidado Bucal Domiciliar , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Antissépticos Bucais/administração & dosagem , Autorrelato , Fatores Socioeconômicos , Cremes Dentais/administração & dosagem
5.
Periodontol 2000 ; 84(1): 35-44, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32844413

RESUMO

It is well established that dental plaque on teeth leads to gingivitis and periodontitis, and that several mechanical and chemical methods of plaque control can prevent gingivitis. The aim of the current review is to summarize and synthesize the available scientific evidence supporting practices for mechanical oral hygiene to prevent periodontal diseases. Evidence for contemporary practices of mechanical oral hygiene to prevent periodontal disease relies on studies of gingivitis patients. General recommendations concerning the ideal oral hygiene devices and procedures are still inconclusive. However, toothbrushing and interdental cleaning remain the mainstays of prevention of periodontal diseases. The primary approach requires individually tailored instruction for implementation of a systematic oral hygiene regimen.


Assuntos
Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Doenças Periodontais/prevenção & controle , Dispositivos para o Cuidado Bucal Domiciliar , Humanos , Higiene Bucal , Escovação Dentária
7.
J Dent Hyg ; 94(4): 29-38, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32753522

RESUMO

Purpose: The purpose of this study was to evaluate the effects of using mobile text messages and a novel floss holder as compared to finger flossing or the novel floss holder alone, on the psychological, behavioral, and clinical parameters of patients with gingivitis.Methods: A total 165 adults were assessed for eligibility and 144 met the criteria for randomization into three groups: Finger Floss (FF, n=43), Novel Floss Holder (NFH, n= 40), and Novel Floss Holder plus Text Messages (NFH+TM, n= 61) following a dental hygiene consultation appointment. Gingival bleeding points were measured on probing (BOMP) at baseline and four months later by a calibrated dental hygienist, blinded to the experimental groups. Participants also self-reported their oral hygiene behaviors, and indicated psychological determinants of behavior change prior to the dental hygiene consultation and at four months. Descriptive statistics and repeated measures analysis of variance (ANOVA) were used to compare groups over time.Results: Two subjects dropped out of the study making the total number of participants 142. At the four month follow-up, the NFH group and the NFH+TM groups demonstrated significantly higher levels of self-reported flossing, action self-efficacy, intention, action planning, and action control. The NFH+TM group showed lower levels of bleeding and higher levels of oral hygiene and recovery self-efficacy than the other groups, in addition to higher levels of maintenance self-efficacy as compared to the FF group.Conclusions: The use of a novel floss holder, NFH, was shown to improve the behavioral and psychological determinants of periodontal health four months after introduction of the device. However the clinical measures of BOMP only improved significantly when used in conjunction with text messages (NFH+TM). The use of a consciousness awareness technique,TMs, in combination with a novel device, may help patients to reach therapeutic objectives and contribute to the management of periodontal pathologies such as gingivitis.


Assuntos
Placa Dentária , Gengivite , Higiene Bucal , Envio de Mensagens de Texto , Adulto , Dispositivos para o Cuidado Bucal Domiciliar , Índice de Placa Dentária , Humanos , Escovação Dentária
8.
Oral Health Prev Dent ; 18(1): 343-354, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32618458

RESUMO

PURPOSE: Preventive dentistry aims to improve oral hygiene, including the use of interdental cleansing aids. Clear and simple classifications may positively impact patient communication and motivate oral health behaviour. To date, there is no comparative analysis of interdental brush classifications and sizes. MATERIALS AND METHODS: A total of 2320 interdental brush samples by 24 manufacturers was examined regarding their passage hole diameter (PHD) according to the ISO standard for interdental brushes (ISO16409:2016), and their current classifications were evaluated. Inter- and intrarater reliability of the ISO size classification were determined based on 20 raters and 10 interdental brushes. The insertion force for these interdental brushes was analysed in vitro. RESULTS: Excellent intra- and interrater reliability was achieved (intraclass correlation coefficient (ICC) ≥ 0.973) overall, although greater variance was observed for bigger brush sizes. Insertion forces varied depending on size and form of the brushes, amounting to 1.58 N (SD = 1.27 N) for cylindric and tapered brushes, and to 2.31 N (SD = 0.81 N) for waist-shaped brushes. The size range of commercially available products was 0.6-5.2 mm PHD, 90% presenting with a PHD ≤ 2.0 mm. Size intervals were unsystematic. The ISO size was indicated by 33% of all manufacturers, the exact PHD by 25%. CONCLUSIONS: The determination of the PHD is a reproducible instrument for most brushes currently on the market. In vitro, forces developed based on this classification are mostly moderate, thus unlikely to cause periodontal trauma. Given the discontinuous range and unclear labelling of available products, the development of a simplified classification system by usage of the PHD may benefit the practitioner and patient alike by contributing to improve oral hygiene behaviours.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária , Humanos , Higiene Bucal , Reprodutibilidade dos Testes , Escovação Dentária
10.
PLoS One ; 15(7): e0236259, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32702010

RESUMO

The aim of this prospective cohort study was to examine whether oral hygiene knowledge, and the source of that knowledge, affect oral hygiene behavior in university students in Japan. An oral exam and questionnaire survey developed to evaluate oral hygiene knowledge, the source of that knowledge, and oral hygiene behavior, such as the frequency of tooth brushing and regular dental checkups and the use of dental floss, was conducted on university student volunteers. In total, 310 students with poor tooth brushing behavior (frequency of tooth brushing per day [≤ once]), 1,963 who did not use dental floss, and 1,882 who did not receive regular dental checkup during the past year were selected. Among these students, 50, 364, and 343 in each respective category were analyzed in over the 3-year study period (follow-up rates: 16.1%, 18.5%, and 18.2%, respectively). The odds ratios (ORs) and 95% confidence intervals (CIs) for oral hygiene behavior were calculated based on oral hygiene knowledge and the source of that knowledge using logistic regression models. The results showed that dental clinics were the most common (> 50%) source of oral hygiene knowledge, and that a more frequent use of dental floss was significantly associated with dental clinics being a source of oral hygiene knowledge (OR, 4.11; 95%CI, 1.871-9.029; p < 0.001). In addition, a significant association was seen between dental clinics being a source of oral hygiene knowledge and more frequent regular dental checkups (OR, 13.626; 95%CI, 5.971-31.095; p < 0.001). These findings suggest the existence of a relationship between dental clinics being the most common source of oral hygiene knowledge and improved oral hygiene behavior in Japanese university students.


Assuntos
Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Higiene Bucal , Estudantes , Universidades , Adolescente , Estudos de Coortes , Dispositivos para o Cuidado Bucal Domiciliar , Feminino , Seguimentos , Humanos , Japão , Masculino , Razão de Chances , Escovação Dentária
11.
Braz Oral Res ; 34: e057, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32578800

RESUMO

Poor oral hygiene seems to be the norm in children and teenagers with Down Syndrome (DS). Advances in design and types of toothbrushes may improve biofilm control. This randomized, single-blind, crossover clinical trial evaluated the effectiveness of electric toothbrushes regarding mechanical control of biofilm in children and teenagers with DS and their cooperation. Twenty-nine participants with DS, aged 6 to 14 years, used both types of toothbrushes: electric (ET) and manual (MT). The order of use of the different types of toothbrushes was randomly defined, including a 7-day period with each type with 7-day washout period in between. The Turesky-Quigley-Hein biofilm index was used before and after brushing to assess the effectiveness of the technique. Frankl's behavioral scale was used during toothbrushing to assess the participants' cooperation. Paired T-test, Mann Whitney, Chi-square, and Fisher's Exact tests were applied, with a significance level of 5%. The quantity of dental biofilm was significantly reduced after both brushing techniques (p < 0.001). However, no significant difference was found in total biofilm (ET: 0.73 ± 0.36; MT: 0.73 ± 0.34; p = 0.985) or % biofilm reduction (ET: 72.22%; MT: 70.96%; p = 0.762) after brushing between techniques or in % biofilm reduction between toothbrushes of age groups (6 -9 years, p = 0.919; 10-14 years, p = 0.671). Participants showed similar cooperation level with the two types of toothbrush (p = 1.000). The use of electric or manual toothbrush had no effect on the quantity of dental biofilm removed in children and teenagers with DS, nor did it influence their cooperation during the procedure.


Assuntos
Biofilmes , Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/prevenção & controle , Síndrome de Down/fisiopatologia , Escovação Dentária/instrumentação , Adolescente , Comportamento do Adolescente , Cuidadores , Criança , Comportamento Infantil , Estudos Cross-Over , Cárie Dentária/prevenção & controle , Desenho de Equipamento , Feminino , Humanos , Masculino , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento
12.
Oral Health Prev Dent ; 18(1): 427-432, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32515412

RESUMO

PURPOSE: To analyse the effect of information technologies on improving the frequency of the use of dental floss among adolescents. MATERIALS AND METHODS: A randomised, controlled clinical trial was conducted with 291 adolescents (mean age: 16.1 years) in three phases. Phase I involved the application of a questionnaire and clinical examinations using the simplified Oral Hygiene Index and gingival bleeding index. In phase II, the adolescents were randomly allocated to four groups: oral counseling (OR) and the use of an application (App) for smartphones; OR without the app; video (VD) and app; and VD without app. Messages were set through the app for 30 days. Phase III involved the second administration of the questionnaire and clinical examination. The frequency of dental floss use was evaluated in phases I and III. The groups were categorised into the use of technology (VD and/or App) and non-use of technology (OR alone). RESULTS: Statistically significant reductions in the clinical indices were found with all educational methods (p < 0.005) and improvements were found in the use of dental floss (p < 0.001). Moreover, information technologies were associated with an improvement in the frequency of dental floss use (p < 0.033). CONCLUSION: All methods were effective at improving clinical indicators. The use of information technologies can be considered an effective tool for improving dental floss use among adolescents.


Assuntos
Placa Dentária , Gengivite , Tecnologia da Informação , Adolescente , Dispositivos para o Cuidado Bucal Domiciliar , Índice de Placa Dentária , Humanos , Índice de Higiene Oral
13.
Aust Dent J ; 65 Suppl 1: S79-S84, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32583594

RESUMO

BACKGROUND: This paper examines oral hygiene behaviours (tooth brushing, mouthwash use and dental floss) by a range of explanatory variables. METHODS: Explanatory variables included age, sex, region, income, area-based SES, dental insurance and visiting pattern. The data reported were collected in the interview survey in NSAOH 2017-18. RESULTS: A higher percentage of females brushed with toothpaste at least daily (98.0%) and used floss in the last week (62.6%) than males (94.6% and 48.5% respectively). There was an income gradient in tooth brushing. Higher percentages brushed in the high income (96.8%) than middle (96.2%) and low-income tertiles (93.6%). A higher percentage of the high-income tertile (58.2%) flossed than the lower tertile (53.3%). Those with unfavourable visit patterns had lower percentages who brushed daily (92.7%) than the intermediate (96.7%) or favourable (98.2%) groups. There was a gradient in flossing by visiting, with a lower percentage flossing for the unfavourable visiting group (38.5%) than for the intermediate (52.8%) or favourable groups (67.6%). CONCLUSIONS: Oral hygiene behaviours were associated with gender, socioeconomic status and dental visiting. A higher percentage of women brushed and flossed than men. Lower socioeconomic status and those with unfavourable visiting patterns had lower frequencies of brushing and flossing.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Higiene Bucal , Adulto , Austrália , Feminino , Humanos , Masculino , Saúde Bucal , Escovação Dentária
14.
J Evid Based Dent Pract ; 20(1): 101403, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32381410

RESUMO

OBJECTIVES: Dental research typically targets multiple outcomes. Interdental cleaning devices such as interdental brushes (IB) and water jet devices (WJ) share a sizable portion of the medical device market. However, recommendations for device selection are limited by the conflicting evidence from multiple outcomes in available studies and the lack of an appropriate synthesis approach to summarize evidences taken from multiple outcomes. In particular, both pairwise meta-analyses and single-outcome network meta-analyses can give discordant results. The purpose of this multioutcome, Bayesian network meta-analysis is to introduce this innovative method to the dental research community using data from interdental cleaning device studies for illustrative purposes. METHODS: We reanalyzed a network meta-analysis of interproximal oral hygiene methods in the reduction of clinical indices of inflammation, which included 22 trials assessing 10 interproximal oral hygiene aids. We focused on the primary outcome of gingival inflammation, which was measured by 2 correlated outcome variables, the Gingival Index (GI) and bleeding on probing (BOP). RESULTS: In our previous single-outcome analysis, we concluded that IB and WJ rank high for reducing gingival inflammation while toothpick and flossing rank last. In this multioutcome Bayesian network meta-analysis with equal weight on GI and BOP, the surface under the cumulative ranking curve was 0.87 for WJ and 0.85 for IB. WJ and IB remained ranked as the 2 best devices across different sets of weightings for the GI and BOP. CONCLUSION: In conclusion, multioutcome Bayesian network meta-analysis naturally takes the correlations among multiple outcomes into account, which in turn can provide more comprehensive evidence.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária , Teorema de Bayes , Pesquisa em Odontologia , Humanos , Metanálise em Rede , Escovação Dentária
15.
BMC Oral Health ; 20(1): 136, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32384897

RESUMO

BACKGROUND: Interdental rubber picks (IRP) have become a frequent and convenient alternative for interdental cleaning. However, only little evidence exists supporting the effectiveness of newer designs available on the market. Therefore, a new in vitro model was evaluated to measure the experimental cleaning efficacy (ECE), as well as the force needed for insertion and during the use of IRP, with high reproducibility. METHODS: Five different sizes of commercially marketed IRP with elastomeric fingers (IRP-F) (GUM SOFT-PICKS® Advanced, Sunstar Deutschland GmbH, Schönau, Germany) or slats (IRP-S) (TePe EasyPick™, TePe D-A-CH GmbH, Hamburg, Germany) were tested. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre-/post brushing situations at interdental areas (standardized cleaning, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. Forces were registered with a load cell [N]. RESULTS: IRP-F have to be inserted with significant higher forces of 3.2 ± 1.8 N compared to IRP-S (2.0 ± 1.6 N; p < 0.001) independent of the size and type of artificial interdental area. During cleaning process IRP-S showed significantly lower values for pushing/pulling (1.0 ± 0.8 N/0.5 ± 0.4 N) compared to IRP-F (1.6 ± 0.8 N/0.7 ± 0.3 N; p < 0.001) concomitant to significantly lower ECE (19.1 ± 9.8 vs. 21.7 ± 10.0%, p = 0.002). Highest ECE was measured with largest size of IRP-F/IRP-S independent the morphology of interdental area. CONCLUSIONS: New interdental cleaning aids can be tested by the new experimental setup supported by 3D printing technology. Within the limitations of an in vitro study, IRP-F cleaned more effectively at higher forces compared to IRP-S.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/prevenção & controle , Escovação Dentária/instrumentação , Alemanha , Humanos , Fotografia Dentária , Pressão , Reprodutibilidade dos Testes , Escovação Dentária/métodos
16.
Clin Oral Investig ; 24(6): 2121-2127, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32430775

RESUMO

OBJECTIVES: The aim of this split-mouth, prospective controlled study was to compare the effects of two different interdental devices on clinical plaque elimination, gingival bleeding and patient acceptance and comfort. MATERIALS AND METHODS: Thirty participants who had been diagnosed with gingivitis were included in the study. After professional oral prophylaxis and a 3-day washout period, patients were advised to use two test devices (TePe Interdental Brushes Original and TePe EasyPick™, Malmö, Sweden) according to instructions. The plaque index (Turesky modification of the Quigley and Hein Index) and bleeding index (Papillary Bleeding Index) were recorded at baseline and after 2 weeks. Patient satisfaction and comfort were assessed with a questionnaire. RESULTS: Both of the tested devices improved the plaque and bleeding index scores. There were no differences between the two sides in terms of time-dependent changes. The patients felt more satisfied with the cleansing capacity and more comfortable with the use of SCIP compared with IDB (p = 0.001). Pain sensation with the use of SCIP was significantly lower than with IDB (p = 0.002). CONCLUSION: The clinical efficiency of the tested interdental devices was similar in terms of removing plaque and decreasing bleeding. However, SCIP were found to be more comfortable and preferable to IDB. CLINICAL RELEVANCE: The silicone coated interdental picks showed similar effects on plaque removal as interdental brushes and superiority in terms of ease to use than interdental brushes.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Gengivite , Silicones , Índice de Placa Dentária , Gengivite/prevenção & controle , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Estudos Prospectivos , Método Simples-Cego , Suécia , Escovação Dentária , Resultado do Tratamento
18.
Acta Odontol Scand ; 78(4): 265-274, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32285744

RESUMO

Objective: Power toothbrushes is considered an effective tool for maintaining oral health; however, its efficacy as compared to manual toothbrushes is still not completely clarified. This article aims to evaluate the efficacy of power toothbrushes compared with the manual toothbrushes in terms of plaque, gingivitis and bleeding reduction.Methods: An electronic search was performed on PUBMED, Web of Science, Wiley and Research Gate. Studies comparing the effectiveness of plaque, gingivitis and bleeding reduction between power and manual toothbrushes were included. Results and effect sizes analysis are presented as standard mean difference (SMD), and subgroup analysis stratified by mode of action of the power toothbrush was performed. Study quality and risk of bias were assessed using the Cochrane assessment tool.Results: A total of 21 randomized clinical studies were included. Power toothbrushes were significantly more effective in reducing plaque index (26 trials: SMD = 0.86, 95% CI: 0.58 to 1.14, I2 = 91.5%, p < .0001), gingival index (14 trials: SMD = 0.47, 95% CI: 0.12 to 0.82, I2 = 88.7%, p < .0001), and bleeding index (11 trials: SMD = 0.92, 95% CI: 0.43 to 1.40, I2 = 91.8%, p < .0001) compared with the manual toothbrushes, except that there was no significant differences between the oscillating-rotating toothbrushes and manual toothbrushes regarding gingivitis reduction (7 trials: SMD = 0.07, 95% CI: -0.20 to 0.33, I2 = 57.2%, p = .03).Conclusions: Power toothbrushes is more effective in reducing dental plaque, gingivitis and bleeding compared with the manual toothbrush.


Assuntos
Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Saúde Bucal , Escovação Dentária/instrumentação , Dispositivos para o Cuidado Bucal Domiciliar , Índice de Placa Dentária , Desenho de Equipamento , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Escovação Dentária/métodos
20.
World Neurosurg ; 138: 253-256, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32194265

RESUMO

BACKGROUND: Intracranial pneumocephalus, the accumulation of air, occurs most frequently from trauma, tumor, cranial surgeries, or infection. Intraparenchymal otogenic pneumocephalus is a rare but well-documented development. We describe a patient who developed pneumocephalus in the context of eardrum perforation secondary to toothpick use for ear wax. CASE DESCRIPTION: An 86-year-old female presented to the emergency room with a 1-day history of dysarthria and a few days of cough and sneezing. History revealed she had recently been advised to avoid Q-Tips to clean her ears and instead was using toothpicks. She denied otalgia or otorrhea and had no signs of infection near the ear. On otoscopic examination, the right tympanic membrane was perforated. On head computed tomography, she was found to have a large right temporal pneumocephalus extending from the petrous bone. Magnetic resonance imaging of the brain revealed a defect in the right tegmen. She was started on empiric antibiotics and subsequently taken to the operating room for craniotomy and repair of bony and dural defects. CONCLUSIONS: Otogenic pneumocephalus is a rare occurrence. This is the first reported case of pneumocephalus related to self-induced middle ear trauma with a toothpick that ultimately required craniotomy for repair.


Assuntos
Pneumocefalia/etiologia , Pneumocefalia/cirurgia , Membrana Timpânica/lesões , Idoso de 80 Anos ou mais , Dispositivos para o Cuidado Bucal Domiciliar , Feminino , Humanos , Pneumocefalia/diagnóstico por imagem
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