User perception of fluoride mouthwashes for daily use: A randomized clinical trial.

AIM: To assess user perceptions of different commercially available fluoride mouthwashes (FL-MWs). METHODS: A single-blind, randomized clinical trial was conducted. Participants were randomly assigned to a sequence of six different FL-MWs, one of which contained alcohol. For each visit, participants rinsed with one specific mouthwash (15 mL) for 30 s. After rinsing, participants completed a questionnaire with a visual analogue scale. Questions focused on overall taste, mild/pungent feeling, taste duration, foaming effect, burning sensation, sensitivity, numbness, dryness, rinsing time, smell, and colour of the mouthwashes. Descriptive analyses and statistical tests regarding differences among and between the mouthwashes were performed. RESULTS: Overall, 53 participants completed the study protocol, including nine who did, however, not rinse with the alcohol-containing mouthwash due to religious reasons. Among the mouthwashes, significant differences were found for foaming effect, sensitivity, rinsing time, smell, and colour (p < 0.05). Pairwise comparison for smell did not reveal a difference, and foaming was within the acceptance range (low to medium foaming). Coloured mouthwashes were more appreciated than transparent solutions (p = 0.00). The mouthwash containing essential oils and alcohol produced significantly more sensitivity (p = 0.00) and, in general, participants experienced the rinsing time significantly longer (p < 0.05) compared to the non-alcohol-containing mouthwashes. CONCLUSION: There is heterogeneity in user perceptions and preferences for FL-MWs, with a significant difference in foaming effect, sensitivity, rinsing time, smell, and colour. Coloured mouthwashes are preferred. The mouthwash containing essential oils and alcohol was less acceptable in relation to sensitivity and rinsing time.

[Long-term results of periodontal therapy]. / Langetermijnresultaten van parodontale behandeling.

Treatment of periodontitis plays an important role in preventing tooth loss. Over the years, various treatment modalities have been proposed, researched and applied in the dental practice. The non-surgical periodontal therapy of cleaning the root surfaces is still the golden standard in treatment of periodontitis. If pockets of ≥ 6 mm remain after the non-surgical therapy, surgical periodontal therapy could be considered. People with periodontal disease should agree with lifelong periodontal therapy, because after the 'active' (non-surgical and surgical) periodontal therapy, lifelong periodontal maintenance is the most important thing to guarantee periodontal health and stability. The ultimate goal of periodontal therapy is preservation of the natural dentition. Many studies have shown that this goal can be achieved, providing the following circumstances are met: a good oral hygiene and high patient motivation, optimal periodontal treatment, and smoking cessation.

In vitro evaluation of temperature changes in the root canal induced by ultrasonic scalers.

OBJECTIVE: To evaluate in vitro the thermal effects induced by four different ultrasonic scalers on the temperature in the root canal during ultrasonic scaling. METHODS: An extracted lower central incisor provided with a thermocouple in the root canal and a tube, entering the tooth incisally and exiting it apically to simulate an artificial bloodstream, was placed in a model of the lower jaw with soft artificial gingiva. Tested ultrasonic scaler systems included: EMS PM-600, Satelec P-max, Dürr Vector and Dentsply Cavitron. The tooth was scaled with each system at full water supply of 21°C. Furthermore, the amount of water supply was determined to maintain during scaling a constant temperature in the root canal. Finally, thermal changes due to scaling without water were assessed. RESULTS: Except for the Vector all scaler systems showed a temperature decrease in the root canal. The Vector with water/polish suspension showed a trend towards an increase in temperature. To maintain a constant temperature in the root canal the Cavitron needed twice the amount of water compared with PM-600 and P-max. Without water, all scaling systems induced a temperature increase. CONCLUSION: For safe ultrasonic scaling, care should be taken that the cooling water has room temperature and that, dependent on the scaler system, the proper amount of water is supplied.

Fluoride, pH Value, and Titratable Acidity of Commercially Available Mouthwashes.

AIM: The primary objective of this work was to assess total soluble fluoride (TSF), pH values, and titratable acidity (TA) of various mouthwashes "in vitro," and the second was to compare fluoride content on labels with measured TSF. METHODS: Commercial mouthwashes were collected and analysed. Company, type, manufacturer data, and active ingredients (essential oils [EO], cetylpyridinium chloride [CPC], chlorhexidine [CHX], and fluoride) were described. TSF, pH, and TA capacity were measured. Descriptive quantitative analysis were performed per mouthwash. RESULTS: In total, 54 mouthwashes from 20 brands were included. These included mouthwashes with the active ingredients EO (n = 11), CPC (n = 17), CHX (n = 18), and fluoride (n = 32); 27 mouthwashes with more than 1 of these active ingredients; and 4 with none of the above-mentioned ingredients. Fluoride was present in different formulations; most contained sodium fluoride (NaF), and a few had sodium monofluorophosphate and amine fluoride + NaF. The pH values of all evaluated mouthwashes ranged from 4.1 to 7.9. Twenty mouthwashes presented pHs below 5.5, of which 10 contained fluoride. TA ranged from 0 to 48. According to the manufacturer data, mouthwashes with fluoride had concentrations from 217 to 450 ppm, with 90% in the range from 217 to 254 ppm. Laboratory data revealed that TSF ranged from 229 to 500 ppm, with 90% in the range from 229 to 337 ppm. A statistically significant difference was observed between measured TSF and the labelled fluoride content on the packaging of the fluoride mouthwashes (mean difference, 43.92 ± 34.34; P < .001). Most of these mouthwashes contained at least the amount of fluoride as mentioned on the packaging (93%). CONCLUSION: The pH values and TA of commercially available mouthwashes showed a large variation. TSF levels of the fluoride mouthwashes were found to be at least the amount of fluoride as labelled. Dental care professionals should be aware of the pH, TA, fluoride content, and other active ingredients of different mouthwashes to better understand their potential impact on oral health.

Safety and efficacy of two manual toothbrushes.

OBJECTIVE: The purpose of this study was to test the efficacy and safety of a newly designed multi-level manual toothbrush (Profit-Haije-Brush) compared with a control flat-trimmed manual reference toothbrush from the American Dental Association (ADA). MATERIAL AND METHODS: For this study, 36 healthy subjects without previous experience in the use of the Profit-Haije-Brush (PHB) were selected. Subjects were given a period of 2 weeks to become familiar with both types of brushes and were instructed to use them on alternate days for 2 min twice daily. Prior to their visit, subjects refrained from all oral hygiene procedures for 48 h. Prebrushing plaque and gingival abrasion scores were assessed. Subsequently, two randomly chosen contra-lateral quadrants were brushed with one of both brushes and the other two quadrants with the alternate brush. Subjects were supervised during their 2-min brushing exercise. After brushing, plaque and gingival abrasion were re-assessed. A questionnaire was filled out to investigate the subjects' attitudes towards both brushes. RESULTS: The overall mean prebrushing PI was 2.47 for the PHB and 2.44 for the ADA. The reduction in PI was 1.32 and 1.23 respectively (P < 0.05). With regard to gingival abrasion the overall mean prebrushing scores were 4.57 (PHB) and 5.34 (ADA). Post-brushing scores were 13.49 and 13.77 for the PHB and ADA respectively. CONCLUSION: Statistically, the multi-level PHB was significantly more efficacious than the flat-trimmed ADA. However, the difference is clinically considered small and the amount of remaining plaque was not significantly different between brushes. No greater potential to cause gingival abrasion to the oral tissues was observed.

The influence of a hydrogen peroxide and glycerol containing mouthrinse on plaque accumulation: a 3-day non-brushing model.

AIM: To evaluate the inhibition of plaque growth by an experimental mouthrinse (BioXyl) based on hydrogen peroxide/glycerol. DESIGN: It was a double-blind, randomized study involving 40 volunteers in good general health. At the start of the trial, all participants received a dental prophylaxis to remove all plaque deposits. During the next 3 days subjects refrained from any mechanical oral hygiene procedure, except for the allocated mouthrinse being either the hydrogen peroxide (H(2)O(2); 0.013% H(2)O(2)/0.004% glycerol) or the placebo without H(2)O(2). At the third day of appointment, plaque levels were assessed at six sites per tooth. RESULTS: The test group had a mean overall plaque score of 2.66 and the placebo group of 2.70. The difference in plaque scores between the two groups was not statistically significant. CONCLUSIONS: The results of this pilot study showed that there was no statistically significant difference between the H(2)O(2)/glycerol group and the placebo group with respect to plaque inhibition within this study design.

Evaluation of two soft manual toothbrushes with different filament designs in relation to gingival abrasion and plaque removing efficacy.

OBJECTIVES: To evaluate the effect of two soft manual toothbrushes with different filament and brush head designs in relation to gingival abrasion and plaque removing efficacy to the in relation flat trimmed manual reference toothbrush of the American Dental Association (ADA). METHODS: The study had a randomized single use cross-over model (n = 76) with three sessions whereby all brushes were used by each subject. Subjects were asked to abstain from all oral hygiene procedures for 48 h. They brushed according to split-mouth design. Pre- and post-brushing plaque and gingival abrasion were assessed. RESULTS: The Sensodyne Sensitive (SENS) was more abrasive than the ADA (P < 0.001) while the Oral-B Sensitive Advantage (OBSA) was less abrasive than the SENS (P < 0.001). There was no statistically significant difference between the OBSA and the ADA (P = 0.319). All three brushes showed statistically significant reductions (49-56%) in plaque versus baseline. Compared to the ADA and the SENS, the OBSA had a smaller percentage of plaque removal (56% versus 49%, P

Tapered toothbrush filaments in relation to gingival abrasion, removal of plaque and treatment of gingivitis.

OBJECTIVES: To compare a tapered filament toothbrush (TFTB) to a control toothbrush (ADA) in their potential to cause gingival abrasion and improve the gingival condition following a period of experimental gingivitis. METHODS: Thirty-two subjects refrained from brushing mandibular teeth for 21 days. During a subsequent 4-week treatment phase, the left or right side of the mouth was brushed with either the TFTB or ADA as randomly allocated. Gingival abrasion, plaque and gingival bleeding were assessed. RESULTS: During the treatment phase gingival abrasion showed a trend to be lower with the TFTB than the ADA, which was significant at the 2-week assessment. The mean plaque scores changed from 2.98 (day 21) to 1.59 for the TFTB and from 3.00 (day 21) to 1.31 for the ADA. The mean bleeding scores changed from 1.86 (day 21) to 1.35 for the TFTB and from 1.85 (day 21) to 1.20 for the ADA. Plaque and bleeding scores were significantly lower with the ADA. CONCLUSIONS: Both toothbrushes improved gingival health and effectively removed plaque. Although there was a tendency towards fewer sites with gingival abrasion with the TFTB brush, it was less effective than the ADA in the removal of plaque biofilm and reduction of bleeding. Subjects considered the TFTB to be more pleasant to use.

[Post-academic dental specialties 19. The effect of periodontal treatment on the degree of de novo plaque formation]. / Beroepsdifferentiatie in de tandheelkunde 19. Het effect van parodontale behandeling op de mate van de novo plaquevorming.

In order to determine whether the quantity of bacteria in saliva and the degree of periodontal infection influence the speed of de novo plaque formation in periodontitis patients, 23 patients rinsed with 10 ml sterile saline. All teeth were then supragingivally and professionally cleaned, after which the patients were not allowed to undertake any form of oral hygiene for 24 hours. After this period, the rinsing procedure was repeated and the amount of de novo plaque was assessed. Three months after the initial periodontal therapy was completed the experiment was repeated. Both before and after treatment, the periodontal parameters were evaluated. The results showed that the quantity of the de novo plaque in healthy areas was less than in infected areas. In order to determine the influence of the quantity of bacteria in the saliva, only the areas which were already healthy before the treatment and the same areas after treatment were inspected. It was concluded that the degree of periodontal infection was the most important parameter for the degree of de novo plaque formation, but that the number of bacteria in the saliva also played a role.

Inhibition of "de novo" plaque formation with 0.12% chlorhexidine spray compared to 0.2% spray and 0.2% chlorhexidine mouthwash.

BACKGROUND: Chlorhexidine (CHX) is widely accepted as the most effective product in the control of supragingival plaque. It is available in different delivery devices. The aim of this study was to test whether 0.12% CHX spray was as effective as 0.2% CHX spray and 0.2% CHX mouthwash in a 3-day "de novo" plaque formation model. METHODS: Ninety volunteers were enrolled into a single-blind, randomized, three-group parallel study. They received a thorough dental prophylaxis prior to the test period. Subjects were divided randomly into three equal groups. They were requested to refrain from all forms of mechanical oral hygiene and instructed to use only their assigned product during the 3-day experimental period. After 3 days, the plaque growth was assessed using the Quigley and Hein plaque index (Q&H PI) at six sites per tooth. RESULTS: After 3 days, the CHX mouthwash group had a mean Q&H PI of 1.17 compared to 1.41 for the 0.2% CHX spray and 1.49 for the 0.12% CHX spray. The difference between the mouthwash and the two sprays was statistically significant, whereas the two sprays did not differ significantly from each other. CONCLUSIONS: Within the limitations of this 3-day "de novo" plaque formation study, the two sprays were not as effective as the mouthwash in plaque inhibition. No significant difference was found between the two sprays. To achieve the same effectiveness as a mouthwash, a higher dose (number of puffs) of CHX spray may be necessary.

The additional effect of a dentifrice on the instant efficacy of toothbrushing: a crossover study.

BACKGROUND: Inconclusive evidence exists in the literature with regard to the additional (beneficial) mechanical effect of a dentifrice on plaque removal. A previous split-mouth study found that a dentifrice did not contribute to plaque removal. Because of limitations of the split-mouth model, a crossover design was used to evaluate whether a commercially available dentifrice had an additional effect on mechanical plaque removal during manual toothbrushing. METHODS: Thirty-six subjects were given a manual toothbrush and a standard dentifrice. After a 48-hour plaque accumulation, subjects brushed under supervision with or without a dentifrice (total time of 2 minutes) in a 2 x 2 crossover design. RESULTS: Plaque reductions were 50% with and 56% without the use of dentifrice. This 6% difference was statistically significant (P = 0.034). Explorative analysis showed that brushing without a dentifrice was more effective in removing plaque on the approximal surfaces. CONCLUSIONS: The use of a dentifrice did not contribute to mechanical plaque removal during manual toothbrushing. It seemed that the mechanical action provided by the toothbrush was the main factor in the plaque-removing process.

Additional effect of dentifrices on the instant efficacy of toothbrushing.

BACKGROUND: Inconclusive evidence exists in the literature with regard to the additional effect of the use of dentifrice on plaque removal. The present study was undertaken to test whether the use of dentifrice during toothbrushing contributes to the instant cleaning efficacy of the brushing procedure. METHODS: Three groups of patients, 40 subjects each, were randomly assigned to one of three dentifrices that differed with respect to the relative dentin abrasivity (RDA) value. After a 48-hour plaque accumulation, subjects brushed under supervision in a split-mouth order with or without the use of dentifrice (total time=2 minutes). RESULTS: Plaque reductions varied between 51% and 58% for the three dentifrices. The overall analysis showed a mean difference of 3% in plaque reduction in favor of brushing without dentifrice (P=0.017). The type of dentifrice did not influence this observed difference (P=0.506). Also, the order of the brushing procedure (starting the brushing procedure with or without dentifrice) had no interaction with the effect of dentifrice on the brushing (P=0.187). CONCLUSIONS: The use of dentifrice does not contribute to the instant mechanical plaque removal during manual toothbrushing. A higher dentifrice abrasivity does not seem to contribute to increased plaque removal with a manual toothbrush. It appears that the mechanical action provided by the use of a toothbrush is the main factor in the plaque-removing process.

[Tooth brushing and gingival abrasion]. / Tandenpoetsen en gingivalaesies.

It has been known for some time that tooth brushing can have unwanted effects on the gingiva and hard dental tissues. The aim of this study is to evaluate two factors that may be of influence on the incidence of gingival abrasion during tooth brushing. The first factor being the possible influence of feedback through oral sensory perception and the second the possible abrasive effects of dentifrice. From the sensory feedback experiment it became clear that a significantly greater number of abrasions occurred when the test subjects would brush their own teeth than when they would have their teeth brushed by a dental hygienist. From the dentifrice experiment it became clear that the use of dentifrice has no significant effect on the occurrence of gingival lesions.

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.

The effect of periodontal treatment on periodontal bacteria on the oral mucous membranes.

The aim of this study was to investigate the effect of conventional periodontal treatment on the prevalence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia on oral mucous membranes in patients with periodontitis. Fifteen patients were selected with moderate to severe periodontitis (mean age: 39.8 years, range: 26 to 58). From each patient the 4 deepest sites with bleeding on probing were selected for clinical and microbiological evaluation. At baseline, 6 weeks after oral hygiene instruction and extensive scaling and root planing, and 3 months after periodontal surgery, clinical parameters and microbiological samples including saliva, oral mucous membranes, and supra- and subgingival plaque were evaluated for the presence of the 3 test bacteria using indirect immunofluorescence. All clinical variables, except redness, showed a significant improvement after surgery. After treatment, the subgingival prevalence of the 3 putative periodontal pathogens had decreased significantly. However, almost no concomitant reduction in the prevalence of the bacteria was seen on the oral mucous membranes. This suggests that the oral mucous membranes may serve as a source for reinfection of the periodontium after treatment.

Comparison of different approaches of interdental oral hygiene: interdental brushes versus dental floss.

The purpose of the present study was to compare in untreated patients suffering from moderate to severe periodontitis the efficacy of dental floss (DF) and interdental brushes (IDB) in the reduction of plaque, gingival inflammation, and probing depth in a 6-week period prior to subgingival debridement. Twenty-six patients (12 female, 14 male; mean age 37.4 years; range 27 to 72 years) were instructed to use DF for one side of the dentition and IDB for the other side as an adjunct to the daily toothbrushing for 6 weeks. Oral hygiene instructions for toothbrushing and the use of the two devices were given at baseline and at week 3. Measurements were carried out at baseline and at 6 weeks including plaque scores, probing depth, and 2 bleeding scores (periodontal pocket bleeding index and angulated bleeding index). With the IDB, the approximal plaque score at baseline of 3.09 reduced to 2.15 at 6 weeks and with DF from 3.10 to 2.47, respectively. IDB proved to remove significantly more plaque than DF. Baseline probing depth of 5.84 mm for IDB sites and 5.59 mm for DF sites was reduced to 5.01 mm at 6 weeks for both regimens. Analysis showed that the use of IDB resulted in a greater pocket reduction. Both bleeding indices were slightly reduced with IDB and DF, but no differences between devices were found. In relation to patient acceptance, more problems were observed with DF, and IDB were felt to be more efficacious. In conclusion, the results of the present study indicate that in combination with a manual toothbrush, the use of interdental brushes is more effective in removal of plaque and results in a larger reduction of probing depth than the use of dental floss. Although the differences were small, they indicate, in combination with patient preferences, that interdental brushes are to be considered preferable to floss for interdental plaque removal in patients suffering from moderate to severe periodontitis.

Effect of periodontal treatment on the protein composition of whole and parotid saliva.

Cystatins are physiological inhibitors of cysteine proteinases and widely distributed in human tissues and fluids including saliva. Cystatins S, SA, SN, and D are only found in glandular saliva and tear fluid whereas cystatin C has been detected in all tested biological fluids. Previous studies demonstrated that total cystatin activity and cystatin C concentration were highest in whole and parotid saliva of periodontitis patients compared to healthy subjects suggesting a response of the salivary glands to an inflammatory condition of the oral cavity. Based on these results we studied a possible change in the concentration of cystatin S, cystatin C, albumin, IgA, amylase activity, and cystatin activity in a whole and parotid saliva of 20 periodontitis patients as a consequence of periodontal treatment. Saliva samples were quantified for cystatins S and C, albumin, and IgA by enzyme-linked immunosorbent assay. Amylase was determined in an activity assay and total cystatin activity was measured towards pa-pain. The clinical condition of the subjects improved significantly after 6 months of periodontal therapy whereas biochemical analyses of whole and parotid saliva indicated that significant changes in salivary protein composition occurred only in whole saliva. Total cystatin activity (P < 0.05) and cystatin C concentration (P < 0.05) of whole saliva samples collected after periodontal treatment decreased to normal healthy control values. Further, concentrations of cystatin S were unchanged during the periodontal treatment process. These results suggest that other sources of cystatins than the parotid gland i.e.; other salivary glands or crevicular fluid, are involved in the decrease of total cystatin activity in whole saliva after periodontal treatment.

A 15-month evaluation of the effects of repeated subgingival minocycline in chronic adult periodontitis.

BACKGROUND: A double-blind, randomized, parallel, comparative study was designed to evaluate the long-term safety and efficacy of subgingivally administered minocycline ointment versus a vehicle control. METHODS: One hundred four patients (104) with moderate to severe adult periodontitis (34 to 64 years of age; mean 46 years) were enrolled in the study. Following scaling and root planing, patients were randomized to receive either 2% minocycline ointment or a matched vehicle control. Study medication was administered directly into the periodontal pocket with a specially designed, graduated, disposable applicator at baseline; week 2; and at months 1, 3, 6, 9, and 12. Scaling and root planing was repeated at months 6 and 12. Standard clinical variables (including probing depth and attachment level) were evaluated at baseline and at months 1, 3, 6, 9, 12, and 15. Microbiological sampling using DNA probes was done at baseline; at week 2; and at months 1, 3, 6, 9, 12, and 15. RESULTS: Both treatment groups showed significant and clinically relevant reductions in the numbers of each of the 7 microorganisms measured during the entire 15-month study period. When differences were detected, sites treated with minocycline ointment always produced statistically significantly greater reductions than sites which received the vehicle control. For initial pockets > or =5 mm, a mean reduction in probing depth of 1.9 mm was seen in the test sites, versus 1.2 mm in the control sites. Sites with a baseline probing depth > or =7 mm and bleeding index >2 showed an average of 2.5 mm reduction with minocycline versus 1.5 mm with the vehicle. Gains in attachment (0.9 mm and 1.1 mm) were observed in minocycline-treated sites, with baseline probing depth > or =5 mm and > or =7 mm, respectively, compared with 0.5 mm and 0.7 mm gain at control sites. Subgingival administration of minocycline ointment was well tolerated. CONCLUSIONS: Overall, the results demonstrate that repeated subgingival administration of minocycline ointment in the treatment of adult periodontitis is safe and leads to significant adjunctive improvement after subgingival instrumentation in both clinical and microbiologic variables over a 15-month period.

Toothbrushing duration and plaque removing efficacy of electric toothbrushes.

PURPOSE: To test the plaque removing efficacy of three different toothbrushes in relation to duration of toothbrushing. MATERIALS AND METHODS: The brushes studied were the Sonicare, the Braun Plak Remover (D7), and a modified Plak Control with increased speed (D9). Part 1 of the study was divided into four experiments which differed only in respect to the brushing time. The available times were 15, 30, 45, 60 seconds per quadrant. After 48 hours plaque accumulation, all subjects (n = 22) were brushed professionally using at random a brush in one quadrant (without toothpaste). Part 2 was a 3-way cross-over design in which the same three brushes were tested. In total 49, subjects participated. They were given a brief instruction on the use of each toothbrush and were allowed to get familiarized with each brush during a 2-week period. After 48 hours plaque accumulation, they brushed in a random order the four quadrants, each with a different brushing time (15, 30, 45, 60 seconds). The amount of dental plaque was evaluated pre- and post-brushing by means of the Silness & Löe plaque index at six sites around each tooth investigated. RESULTS: The results of Part 1 and 2 showed an increase in efficacy for all brushes varying from 1 minute per quadrant to 4 minutes per quadrant. In Part 1, the D7 was more effective than the Sonicare brush at 15, 20, 45 seconds whereas the D9 was more effective at all four brushing times. In Part 2, both the D7 and D9 were more effective than the Sonicare at the 2-minute brushing time. These differences were mainly caused by a greater plaque removal from the approximal areas.

A comparison of the efficacy of a novel electric toothbrush and a manual toothbrush in the treatment of gingivitis.

PURPOSE: To compare the efficiency of a new electric toothbrush featuring a novel three-dimensional brush head action, with a manual toothbrush, in resolving gingivitis which had been allowed to develop in a group of subjects prior to the treatment phase of the study. MATERIALS AND METHODS: This was a randomized split-mouth study. A total of 35 healthy non-dental students refrained from any oral hygiene on the lower jaw for a period of 21 days in order to develop gingivitis. They then brushed one quadrant of the lower jaw with the Braun Oral-B 3D Plaque Remover and the other with a manual toothbrush for a period of 4 weeks. Plaque and gingivitis were evaluated at the start of the study, after the 21 days of no oral hygiene, and after 1, 2, 3 and 4 weeks of brushing twice a day. RESULTS: At the end of the study, the 3D was found to be significantly more effective at reducing bleeding on probing (P < 0.05) for all sites combined and all individual sites. Plaque removal was also significantly more effective with the 3D. Subjects in the study reported that they preferred the 3D to the manual toothbrush and said that it would encourage them to brush for longer. It is concluded that the new Braun Oral-B 3D Plaque Remover offers advantages over a manual toothbrush in terms of plaque control and improvement of gingival condition.