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Objective: To compare the effectiveness of dental plaque removal between a new sonic toothbrush and a manual toothbrush., Methods: In total, 75 healthy dental students participated in this randomized double-blind crossover clinical trial. Subjects were randomly assigned to one of the two groups (manual or sonic toothbrush) and underwent a single toothbrushing exercise. Seven days after, patients were asked to repeat the same procedure with the other toothbrush. Plaque scores were recorded before and after brushing., Results: A significant mean reduction in the full-mouth plaque index was observed after the use of both type of brushes: 46.2% ± 0.28% (p = 0.000) and 50.5% ± 0.24% (p = 0.000) for the manual and sonic toothbrush, respectively. However, there were no statistically significant differences between the two types of brushes (p = 0.277). Regarding plaque reduction on the distinct tooth surfaces, differences between the groups reached statistical significance in favour of the sonic toothbrush only on the buccal sites (p = 0.003)., Conclusions: Both devices lead to similar plaque score reduction after a single tooth brushing., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: To establish the efficacy of oscillating-rotating power toothbrush (OR-PTB) compared to high-frequency sonic power toothbrush (HFS-PTB) on improving parameters of plaque and gingival inflammation. Safety and participants' preference were secondary interests., Materials and Methods: MEDLINE-PubMed and Cochrane-CENTRAL databases were searched, up to April 2021. Inclusion criteria were (randomized)controlled clinical trials that evaluated healthy humans brushing with an OR-PTB compared to a HFS-PTB. Evaluation for a minimum of 4 weeks, of one or more of the following parameters: plaque index scores (PI), bleeding scores (BS), number of bleeding sites (NoB) and gingival index scores (GI)., Results: Thirty two publications involving 38 comparisons were included after the independent screening. The descriptive analysis showed that in 54% of the comparisons, a significant difference in favour of the OR-PTB was found for PI, BS and GI scores. The Quigley and Hein index showed a significant difference of means (DiffM) between the end scores (DiffM 0.13, 95% CI [0.05;0.21] p < 0.001), as well as for the Rustogi-modified Navy index (DiffM 0.01, 95% CI [0.01;0.03] p = 0.002). This is in line with the meta-analysis for BS (DiffM 0.09, 95% CI [0.03;0.14] p = 0.003), for which the results were in favour of the OR-PTB and considered potentially clinically relevant. NoB showed a significant difference in favour of the OR-PTB for the end scores (DiffM 3.61, 95% CI [2.63;4.58] p < 0.00001). No difference in safety was indicated, 78% of participants preferred the OR-PTB., Conclusion: For patients to maintain good plaque control and improve gingival health, there is a small but significant difference based on longer-term studies between OR-PTB and HFS-PTB. This difference is potentially clinically relevant., (© 2022 The Authors. International Journal of Dental Hygiene published by John Wiley & Sons Ltd.)

Objective: To investigate the effect of a new powered toothbrush with tapered bristles on the brush head for the reduction of dental plaque and gingivitis., Methods: This was a single-centre, single-group, longitudinal clinical trial. Thirty-two participants who were typical manual toothbrush users were recruited and assigned the sonic-powered brush. Interviews were arranged on the 1 st , 4 th , and 15 th days which represented the baseline (T 1 ), middle (T 2 ) and final (T 3 ) time points, respectively. At each visit, the plaque index (PlI), gingival index (GI), bleeding on probing (BOP) and probing depth (PD) were recorded for the Ramfjord index teeth, gingival crevicular fluid(GCF) samples were collected and the proportions of eight periodontal pathogenic bacteria were analysed. Repeated-measures analysis of variance (ANOVA) was used for comparisons at different time points., Results: PlI was significantly reduced by 41.67% from T 1 to T 2 (p<0.001) and decreased by 18.57% from T 2 to T 3 (p=0.003). GI also varied significantly from T 1 to T 2 (p=0.018) and T 1 to T 3 (p=0.037). A 35.86% reduction in the BOP percentage occurred after using the sonic-powered toothbrush for 3 days (p=0.001). However, no significant difference was observed in the mean values of PD at different examination intervals (p=0.529). There was no significant difference in the proportions of bacteria between T 1 and T 3 (p>0.05)., Conclusion: This research demonstrated the efficacy of the sonic-powered brush handle together with tapered bristles on the brush in reducing plaque and gingivitis within a short time period., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: To establish the effect of a single-brushing exercise on dental plaque removal using an oscillating-rotating power toothbrush (OR-PTB) as compared to a high-frequency sonic power toothbrush (HFS-PTB)., Materials and Methods: The MEDLINE-PubMed and Cochrane-CENTRAL databases were searched up to September 2019. The inclusion criteria contained (randomized) controlled clinical trials involving healthy adult participants brushing with an OR-PTB as compared to an HFS-PTB. Plaque index (PI) scores were evaluated after a single-brushing exercise., Results: A total of 15 publications were included, representing 34 comparisons, of which 8 were professional brushing exercises and 26 participant brushing exercises. The potential risk of bias was estimated to be low. In the overall descriptive analysis of 34 comparisons, 19 comparisons showed a statistically significant difference in favour of the OR-PTB and 4 in favour of the HFS-PTB. The meta-analysis using the professional brushing study design showed a significant difference of means (DiffM) in favour of the OR-PTB (PI score) (DiffM 0.19; P < .0001) (95% CI [013; 0.25]). In those studies where the participants brushed themselves, the data were inconclusive. PI scores showed no difference between the two brushes (P = .15), while one plaque index (the Rustogi Modified Navy plaque index) indicated significant favour for the OR-PTB (DiffM 0.06; P = .002) (95% CI [0.02; 0.09])., Conclusion: Based on the estimated evidence profile, there is moderate certainty of evidence of a very small but significant beneficial effect on plaque removal after a single-brushing exercise with the OR-PTB over the HFS-PTB., (© 2020 The Authors. International Journal of Dental Hygiene published by John Wiley & Sons Ltd.)

Background: An innovative hybrid toothbrush was designed functioning either in manual mode, in powered mode (sonic) or in combined mode (manual and powered). The primary aim of this study was to evaluate and compare the clinical efficacy of this first hybrid toothbrush (Elgydium Clinic/Inava Hybrid) used in combined mode to a marketed oscillating-rotating powered toothbrush (Oral-B Vitality) in the reduction of dental plaque after a single use. The secondary aims were to evaluate the tolerance and acceptability of each device., Methods: It was a randomized, examiner-blind, single-center study performed on two parallel groups: hybrid toothbrush (n = 33) versus oscillating-rotating toothbrush (n = 33). A brushing exercise was conducted for two minutes on subjects presenting a "Silness and Löe Plaque Index" (PI) between 1.0 and 2.0 and a "Modified Gingival Index" between 1.0 and 2.0. They were not to have ever used an electric toothbrush. To assess the device effect after brushing, a paired t-test was applied on the change outcome (After-Before brushing). An unpaired t-test was used to compare the efficacy of both devices. A global tolerance assessment of each powered toothbrush was done on all the subjects. The number and percentage of reactions related to each toothbrush was collected and the final tolerance assessment was estimated., Results: After a single use, the hybrid toothbrush used in combined mode presented a global anti-plaque efficacy characterized by a significant decrease of the global PI of 45% on average (p < 0.0001; paired t-test). It was as effective as the oscillating rotating toothbrush in plaque removal (p > 0.05; unpaired t-test). The global tolerance of both toothbrushes was judged as "Good" and they were equally appreciated by the users., Conclusion: The results of this one-time use trial demonstrate the efficacy of the hybrid toothbrush used in combined mode for plaque removal. The hybrid toothbrush design allows each user to adapt tooth brushing to his preference (manual / sonic / combined), his skills or his mouth condition. We hypothesize that such an individualized approach can favor long term compliance with oral health recommendations and improve global oral wellness., Trial Registration: ISRCTN12394494 , 20/02/2018 - Retrospectively registered.

Objectives: To evaluate and compare the efficacy of a marketed oscillating-rotating electric rechargeable toothbrush to a marketed sonic toothbrush in the reduction of gingivitis and plaque over an 8-week period., Methods: This was a randomized, examiner-blind, parallel group, eight-week study. Subjects with presence of mild-to-moderate plaque and gingivitis received an oral examination and were evaluated for baseline gingivitis (Modified Gingival Index; MGI), gingival bleeding (Gingival Bleeding Index; GBI), and plaque (Rustogi Modified Navy Plaque Index). Qualified subjects were randomly assigned to an entry-level oscillating-rotating electric rechargeable brush handle (Oral-B® PRO 1000, D16U) with a round brush head with angled bristles (Oral-B® CrossAction, EB50) or a premium sonic brush (Philips Sonicare® Diamond Clean Toothbrush with AdaptiveClean brush head). One hundred and fifty subjects were instructed to brush twice daily with their assigned brush and a fluoride dentifrice for eight weeks before returning for an oral examination and gingivitis and plaque evaluations. The same methods were used at baseline and Week 8 for all evaluations., Results: One hundred and forty-eight subjects completed the study, 74 in each group. After eight weeks of use, both brushes reduced MGI, GBI, total number of bleeding sites, whole mouth plaque, gingival margin plaque, and proximal plaque (p < 0.001 for each). The oscillating-rotating brush provided statistically significantly greater reductions than the sonic brush for all gingivitis measures, with a 34.8%, 48.4%, and 42.6% greater reduction for MGI, GBI, and number of bleeding sites, respectively, after eight weeks of use (p < 0.001 for each). Significantly greater whole mouth (26.2%) and proximal (38.5%) plaque reductions were also demonstrated at Week 8 for the oscillating-rotating brush versus the sonic brush (p < 0.001)., Conclusions: The entry-level oscillating-rotating brush performed better than the premium sonic brush in the reduction of plaque and gingivitis in this eight-week randomized and examiner-blind study., Competing Interests: Dr. Ccahuana-Vasquez, Ms. Conde, Ms. Cunningham, and Dr. Grender are employees of Procter & Gamble. Dr. Goyal and Mr. Qaqish have no conflicts to disclose. The research was funded by Procter & Gamble., (Copyright© by the YES Group, Inc.)

The effective cleaning of interdental spaces using toothbrushes is a challenge. The aim of the present in vitro study was to evaluate on the one hand the interdental cleaning efficiency and on the other hand the gingival injury potential of an electric single-headed sonic toothbrush (Water-pik) and two single-tufted manual toothbrushes (Curaprox 1009; Lactona Interdental Brush). Brushes were evaluated using a brushing device. Test dental casts (maxillary sextants) consisting of black teeth coated with white paint were brushed using standardized horizontal movements. Thereafter, black (i.e. cleaned) areas were measured planimetrically. The soft tissue injury potential was evaluated using front segments of porcine mandibles. In the same brushing device, test brushes were moved over the gingiva. Before and after each treatment, the porcine mucosa was stained with a plaque disclosing agent to visualize injured areas, which could then be measured planimetrically as well. These evaluations were each made after 15, 30, 60, and 120 seconds of brushing. The statistical analysis was performed using non-parametric Mann-Whitney tests, and the level of significance was set at 5%. The best cleaning performance of 46% across all interdental spaces assessed was found with the electric sonic toothbrush (Waterpik), while the performances of the manual brushes from Lactona and Curaprox were 14.8% and 5%, respectively. At each point of evaluation, the gingiva was injured most markedly by the powered sonic toothbrush (Waterpik), followed by the manual Curaprox brush. The smallest damage of the porcine gingiva was produced by the manual Lactona brush. When comparing the manual toothbrushes, the Lactona product revealed a better cleaning performance combined with a smaller injury potential than the Curaprox brush. Thus, the prophylactic goal to achieve high degrees of cleaning while producing minimal damage is important and should have priority when evaluating and selecting toothbrushes.

Objective: The aim of this research was to assess how the application of an oral irrigator modifies the subgingival bacterial flora in patients undergoing periodontal maintenance therapy. We used a qualitative microbiological analysis with a phase contrast microscope that can differentiate a non-pathogenic (immobile) bacterial flora from a pathogenic (mobile). Methods: In this study, 60 patients with a diagnosis of moderate periodontitis were enrolled. They were treated with non-surgical laser-assisted causal therapy and after one month a re-evaluation was performed that established the stabilization of the periodontal pathology. They were instructed in the home oral hygiene protocol with sonic toothbrush, interdental brushes and oral irrigator, and were included in the periodontal maintenance therapy program with a phase contrast microscope control every 6 months. At T0 phase contrast–phase microscopic examinations, the existence of non-pathogenic bacterial flora was displayed in all patients. They were then randomly divided into two groups, A and B. After professional oral hygiene treatment, group B suspended the usage of oral irrigator. Patients of group A, after the professional oral hygiene treatment, were motivated to continue their oral hygiene protocol at home. After three months, the patients underwent microscopic analysis of the bacterial plaque. Results: At T1 in Group B, 90% of patients had undergone a pathogenic bacterial flora change. In group A, in which patients kept using the oral irrigator for the three months, 100% of them showed immobile plaque on phase contrast microscopic analysis. Conclusions: This research showed that oral irrigator in the practice of home hygiene protocols plays a role in the long-term maintenance of a non-pathogenic bacterial flora in periodontal patients. [ABSTRACT FROM AUTHOR]

Stéphanie Favrel,1 Anna Urbaniak,2 Izabela Chabowska,3 Anne Sirvent,4 Jean-Philippe Gatignol5 1Innovation Unit, Clinical Department, Pierre Fabre Consumer Health Care, Castres, France; 2Dental Clinic, Gdansk, Poland; 3Dermscan Poland, Gdansk, Poland; 4Eurofins Dermscan, Villeurbanne, France; 5Innovation Unit, Medical Department, Pierre Fabre Consumer Health Care, Castres, FranceCorrespondence: Jean-Philippe GatignolInnovation Unit, Medical Department, Pierre Fabre Consumer Health Care, Péraudel, 17, Avenue Jean Moulin, Castres 81106, FranceTel +33 563 516 804Email jean.philippe.gatignol@pierre-fabre.comPurpose: An innovative hybrid toothbrush was designed to function either in manual sonic mode or combined mode (manual and sonic). The primary objective was to assess the efficacy of a new hybrid powered toothbrush (PTB) used in combined mode versus a comparative manual toothbrush (MTB) for plaque removal, after 14 days of twice-daily use under normal conditions. The secondary objectives were to evaluate the gingival state, to evaluate the tolerance of the hybrid PTB and to evaluate its acceptability.Materials and Methods: This study was a monocentric, block-randomized, dual treatment, parallel group, and examiner-blinded trial with before and after evaluation. It was conducted on two groups of 55 subjects presenting a visible plaque accumulation (score ≥ 2 as measured by the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI)). On Day 1/Day 8/Day 15, the same investigator conducted blind clinical examinations on each subject and evaluated TMQHPI and Papillary Bleeding Score (PBS). On Day 1, the subjects received either the hybrid PTB or the comparative MTB and used it twice daily under normal conditions of use.Results: The hybrid PTB used in its combined mode eliminates dental plaque more efficiently than the comparative MTB, especially in difficult-to-access areas such as posterior and interproximal dental surfaces, while remaining gentle on the gingivae. The PBS was significantly lower with the hybrid toothbrush compared with the reference manual one.Conclusion: The new device confirmed previous findings and should improve oral hygiene following the manufacturer’s instructions. Moreover, the specific design of the toothbrush means that it can be used according to the oral environment conditions and personal feeling.Keywords: powered toothbrush, sonic toothbrush, dental plaque, oral health

Abstract Background An innovative hybrid toothbrush was designed functioning either in manual mode, in powered mode (sonic) or in combined mode (manual and powered). The primary aim of this study was to evaluate and compare the clinical efficacy of this first hybrid toothbrush (Elgydium Clinic/Inava Hybrid) used in combined mode to a marketed oscillating-rotating powered toothbrush (Oral-B Vitality) in the reduction of dental plaque after a single use. The secondary aims were to evaluate the tolerance and acceptability of each device. Methods It was a randomized, examiner-blind, single-center study performed on two parallel groups: hybrid toothbrush (n = 33) versus oscillating-rotating toothbrush (n = 33). A brushing exercise was conducted for two minutes on subjects presenting a “Silness and Löe Plaque Index” (PI) between 1.0 and 2.0 and a “Modified Gingival Index” between 1.0 and 2.0. They were not to have ever used an electric toothbrush. To assess the device effect after brushing, a paired t-test was applied on the change outcome (After-Before brushing). An unpaired t-test was used to compare the efficacy of both devices. A global tolerance assessment of each powered toothbrush was done on all the subjects. The number and percentage of reactions related to each toothbrush was collected and the final tolerance assessment was estimated. Results After a single use, the hybrid toothbrush used in combined mode presented a global anti-plaque efficacy characterized by a significant decrease of the global PI of 45% on average (p 0.05; unpaired t-test). The global tolerance of both toothbrushes was judged as “Good” and they were equally appreciated by the users. Conclusion The results of this one-time use trial demonstrate the efficacy of the hybrid toothbrush used in combined mode for plaque removal. The hybrid toothbrush design allows each user to adapt tooth brushing to his preference (manual / sonic / combined), his skills or his mouth condition. We hypothesize that such an individualized approach can favor long term compliance with oral health recommendations and improve global oral wellness. Trial Registration ISRCTN12394494, 20/02/2018 - Retrospectively registered.

Purpose: To determine differences in interproximal plaque mass and fluoride retention with different modes of toothbrushing and flossing.Materials and Methods: Forty-seven subjects in good health used four treatments in a four-period, randomized, crossover design: 1) manual brushing only; 2) manual brushing and daily flossing; 3) electric brushing using a rotational oscillation toothbrush; and 4) electric brushing using a sonic toothbrush. Subjects used a standard sodium fluoride dentifrice during the eight-day experimental periods and a fluoride-free dentifrice during the seven-day washout periods between treatments. Interproximal plaque samples were taken on Day 1 and on Day 8, weighed, and analyzed for fluoride content.Results: The amount of interproximal plaque was lowest with sonic brushing, which left 43-65% less plaque than all other treatments. Manual brushing and flossing yielded less plaque than manual brushing alone and rotational oscillation brushing. Differences were statistically significant (p < 0.05) for treatment; there was no time effect on plaque mass. For fluoride retention, at Day 1 sonic brushing gave at least 54% more fluoride in the interproximal plaque than all other treatments, which was significant. All treatments demonstrated a significant increase in fluoride concentration with time except manual brushing and flossing, which showed a significant decrease. At Day 8, the fluoride concentration was significantly higher for sonic brushing than for manual brushing or rotational oscillation brushing by over 40%, and all treatments exhibited significantly greater fluoride than the manual brushing and flossing combination.Conclusion: The mode of toothbrushing may impact the amount of plaque retained interproximally and its fluoride concentration. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this RCT study was to compare early wound healing and gingival crevicular fluid cytokine levels of patients treated with two different post‐surgical cleansing protocols. Methods: A total of 30 chronic periodontitis patients scheduled for osseous resective surgery with fibre retention technique were randomly assigned to follow one of two post‐surgical protocols. Patients assigned to the test protocol (n = 15) were instructed to brush the surgical area with a sonic toothbrush starting the day after surgery in addition to 0.12% chlorhexidine (CHX) rinsing, while patients following the control protocol (n = 15) rinsed only with 0.12% CHX solution and resumed mechanical cleansing with a manual toothbrush on day 14 after surgery. Interleukin (IL)‐1β and IL‐8 levels were assessed before and 14 days post‐operatively in gingival crevicular fluid. Patients were recalled on day 7, 14, 21 and 28 after surgery for clinical assessment. Pain was self‐reported by a visual analogue scale. Results: Lower early wound healing scores, higher bacterial plaque reduction and milder inflammatory response were observed at the surgical sites in the test group on day 7, 14 and 28 when compared to the control group (P < 0.01). The faster wound healing process was modulated by a statistically significant decrease in IL‐1β and IL‐8 levels on day 14 in the sonic group. The intensity of pain was similar between groups. Conclusions: The introduction of sonic toothbrush on the first post‐operative day as an adjunct of daily CHX rinsing would seem to accelerate early wound healing. [ABSTRACT FROM AUTHOR]

Abstract Objectives: To determine the plaque-removing ability of a Sonicare Plus® electric toothbrush in an in vitro model. Material and Methods: Multispecies oral biofilms derived from human saliva were grown on hydroxyapatite discs in a constant-depth film fermenter. The biofilms were placed in a typodont model so that they mimicked the interproximal plaque between teeth 46 and 47 and were then treated with an electric toothbrush, both activated and inactivated. The distance from the bristle tips to the edge of the disc was 2.65 mm. Brushing action was controlled by a specially constructed brushing machine. After brushing, the number of viable bacteria removed from, and remaining in, the biofilms were determined. Results: In all, 73.70% of viable bacteria in the biofilms were dislodged from the discs using the activated toothbrush. An inactivated toothbrush removed only 3.66%. Scanning electron microscopy and confocal microscopy revealed differences between untreated and treated biofilms. Conclusion: The fluid shear forces generated by the electric toothbrush penetrated at least 2.65 mm beyond the reach of the bristles and these forces contributed to the toothbrush's plaque-removal ability (p <0.001). [ABSTRACT FROM AUTHOR]