BACKGROUND: Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. OBJECTIVES: To compare manual and powered toothbrushes in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost. SEARCH STRATEGY: We searched the Cochrane Oral Health Group Trials Register (to 17/06/2004) and Central Register of Controlled Trials (The Cochrane Library Issue 2, 2004); MEDLINE (January 1966 to week 2 June 2004); EMBASE (January 1980 to week 2 2004) and CINAHL (January 1982 to week 2 June 2004). Manufacturers were contacted for additional data. SELECTION CRITERIA: Trials were selected for the following criteria: design-random allocation of participants; participants - general public with uncompromised manual dexterity; intervention - unsupervised manual and powered toothbrushing for at least 4 weeks. Primary outcomes were the change in plaque and gingivitis over that period. DATA COLLECTION AND ANALYSIS: Six authors independently extracted information. The effect measure for each meta-analysis was the standardised mean difference (SMD) with 95% confidence intervals (CI) using random-effects models. Potential sources of heterogeneity were examined, along with sensitivity analyses for quality and publication bias. For discussion purposes SMD was translated into percentage change. MAIN RESULTS: Forty-two trials, involving 3855 participants, provided data.Brushes with a rotation oscillation action removed plaque and reduced gingivitis more effectively than manual brushes in the short term and reduced gingivitis scores in studies over 3 months. For plaque at 1 to 3 months the SMD was -0.43 (95% CI: -0.72 to -0.14), for gingivitis SMD -0.62 (95% CI: -0.90 to -0.34) representing an 11% difference on the Quigley Hein plaque index and a 6% reduction on the Loe and Silness gingival index. At over 3 months the SMD for plaque was -1.29 (95% CI: -2.67 to 0.08) and for gingivitis was -0.51 (-0.76 to -0.25) representing a 17% reduction on the Ainamo Bay bleeding on probing index. There was heterogeneity between the trials for the short-term follow up. Sensitivity analyses revealed the results to be robust when selecting trials of high quality. There was no evidence of any publication bias.No other powered designs were as consistently superior to manual toothbrushes.Cost, reliability and side effects were inconsistently reported. Any reported side effects were localised and temporary. AUTHORS' CONCLUSIONS: Powered toothbrushes with a rotation oscillation action reduce plaque and gingivitis more than manual toothbrushing.Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.

/pdf/manual-versus-powered-toothbrushing-for-oral-health-4gczlank1i.pdf

Manual versus powered toothbrushing for oral health

:
Purpose: This review of the literature intends to evaluate the effect of brushes with high frequency motion when compared with manual toothbrushes regarding the indices of plaque and gingival bleeding. Methods: Patients presenting gingivitis and/or chronic periodontitis were evaluated in addition to patients having osseointegrated implants and fixed orthodontic appliances. Pertinent literature was reviewed to select articles according to previously defined inclusion criteria. Results: In the assessed studies results showed significant decreases in plaque and gingival indices by utilization of both types of brushes. However, in the selected studies where sonic brushes were tested in orthodontic and dental implant patients there was a more significant decrease in the indices. Furthermore, there was no indication of gingival recession attributed to product use. Conclusion: Future studies with a more homogeneous methodology and better experiment designs will be needed.

Comparison of manual versus sonic and ultrasonic toothbrushes: a review

Power toothbrushes (PTBs), in combination with abrasive dentifrices, may encourage wear of dental cements at crown margins. Purpose.The objective of this in vitro simulation was to control the clinical variables associated with PTB use and measure the potential side effects of PTBs with mild and abrasive dentifrices. Methods and Materials. Four PTBs (Braun-Oral-B-Professional Care at 150 g brushing force, Sonicare-Elite at 90 g, Colgate-Actibrush at 200 g and Crest-Spinbrush-Pro at 250 g) and 2 dentifrices mixed 1:1 with tap water (Mild= Colgate-Total, Colgate-Palmolive; Abrasive= Close-up, Chesebrough-Ponds) versus tap water alone (control) were used to abrade 2 cements (Fleck’s Mizzy Zinc Phosphate [ZP]; 3M-ESPE Unicem universal cement [UC]) using cement-filled slots (160 m wide) cut into wear-resistant ceramic blocks. A custom fixture controlled PTB/block alignment, PTB loads, and other testing variables. Wear was measured (3 profilometer traces/slot, 5 slots/block/group, baseline to 5-year differences) and analyzed (3-way ANOVA, p ≤ 0.05, Bonferroni) Results. Wear for ZP was much greater than UC (p Conclusions. Combinations of PTBs with mild and abrasive dentifrices produced significant wear with ZP but not UC; thus, resin-composite cements seem to represent a better choice for wear resistance.

https://jdh.adha.org/content/jdenthyg/81/4/79.full.pdf

Effect of power toothbrushing on simulated wear of dental cement margins.

This issue of the Journal of Dental Hygiene is especially exciting for ADHA and for me. The first news is that you will see the results of the first ever ADHA/Sigma Phi Alpha Journalism Award Competition. The award is intended to honor a student who has written a review or original research paper that contributes to the dental hygiene body of knowledge and is of the quality to be published in the Journal of Dental Hygiene. Students enrolled or within 6 months post-graduation from a baccalaureate, degree completion bachelor's program, master's, or doctoral-level program were eligible to apply. All of the papers were to be linked to the National Dental Hygiene Research Agenda. The recipient of the award received $1000 and had her paper published in the Journal of Dental Hygiene.

https://jdh.adha.org/content/jdenthyg/81/4/68.full.pdf

Moving Research Forward; Moving Dental Hygiene Forward

It was the objective of the present study to evaluate the efficacy of two new power toothbrushes (Braun Oral-B 3D Excel & Cybersonic 2) and one manual toothbrush (Elmex 29) in reducing plaque and preventing gingivitis. 120 subjects, whose dental hygiene was open to improvement, took part in the examiner-blind parallel study. Four weeks later, at baseline, two plaque indices (QHI, API) and one gingivitis index (PBI) were recorded. Thereafter the subjects used the assigned toothbrushes eight weeks two times a day for two minutes each. The level of dental hygiene was re-evaluated after four and eight weeks. Statistical analysis revealed that all indices showed statistically significant reductions for both power toothbrushes which were superior to the manual brush (p < 0,001). Braun Oral-B 3D Excel was superior to Cybersonic 2 with respect to reduction of approximal plaque after eight weeks (p < 0.05) and reduction of gingivitis after four and eight weeks (p < 0,01). One can conclude that Braun Oral-B 3D Excel and Cybersonic 2 may be more efficacious than a manual toothbrush in removing plaque and preventing gingivitis.

Klinische Effektivität zweier neuartiger elektrischer Zahnbürsten im Vergleich zu einer konventionellen Handzahnbürste

Statement of problem. Earlier studies on orthodontic brackets have shown a loss of bond strength after a sonic toothbrush was used. Purpose. This in vitro study evaluated the difference in bond strength of single complete veneer crowns after being subjected to the equivalent of 2 years of brushing with sonic and counterrotational toothbrushes. Material and methods. Complete gold crowns were fabricated with a conventional indirect technique for 30 extracted, intact, prepared human premolar teeth. Castings were then luted to the teeth with glass ionomer cement. Teeth were randomly divided into 3 groups of 10 teeth each, 1 group to be brushed with Sonicare sonic toothbrush, 1 group to be brushed with Interplak counterrotational mechanical toothbrush, and 1 group as the control. Groups 1 and 2 were then brushed for the equivalent of 2 years per tooth. A uniform force of 50 g for the sonic toothbrush and 120 g for the counterrotational toothbrush was used. Control specimens were not brushed. Brush heads and sample teeth in contact with the toothbrush were kept moist at all times. Tensile dislodgment force was determined with an Instron universal testing machine. Results. The castings brushed with a sonic toothbrush required a mean of 43.22 kg (±11.16) force to remove the crowns from the teeth, whereas the counterrotational group required a mean of 42.87 kg (±10.42) and the control group a mean of 42.12 kg (±6.61). Analysis of variance on the force data indicated no differences among the 3 groups in the force needed to remove the castings (F[2,24] = 0.031, P =.97). Conclusion. This in vitro study demonstrated no significant differences between groups in the amount of tensile dislodgment force required to remove cemented full veneer crowns from prepared teeth after brushing for the equivalent of 2 years time with a sonic toothbrush or a counterrotational toothbrush. (J Prosthet Dent 1998;80:429-33.)

Effect of brushing with sonic and counterrotational toothbrushes on the bond strength of full veneer crowns

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Effect of brushing with sonic and counterrotational toothbrushes on the bond strength of full veneer crowns