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Manual vs. interactive power toothbrush on plaque removal and salivary Streptococcus mutans and Lactobacillus casei levels

Single-center, examiner-blinded, randomized clinical trial in orthodontic patients

Manuelle vs. interaktive elektrische Zahnbürste zur Plaqueentfernung und Konzentration von Streptococcus mutans und Lactobacillus casei im Speichel

Unizentrische, randomisierte, prüferverblindete klinische Studie mit kieferorthopädischen Patienten

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this study was to compare efficacy of a manual and an interactive power toothbrush in orthodontic patients by assessing periodontal indexes and bacterial content of saliva samples.

Methods

Forty patients (20 females, 20 males; age range 12–18 years) with fixed orthodontic appliances were included in the study. The patients were randomly divided into two groups in a 1:1 ratio using sealed envelopes: group 1: manual toothbrush (Oral‑B Ortho Brush, Procter&Gamble Company, Dublin, Ireland), group 2: interactive power toothbrush (Oral‑B Genius 8900, Procter&Gamble Company, Marktheidenfeld, Germany). All participants were given the same toothpaste (Colgate Triple Action, Colgate–Palmolive, New York, NY, USA). The brushing procedure for each patient was described in detail, both orally and visually, utilizing a video demonstration. Plaque and bleeding index scores were recorded for both the lower and upper arches at the beginning of the study (T0) and at weeks 6 (T1) and 12 (T2). In addition, the numbers of Streptococcus (S.) mutans, Lactobacillus (L.) casei, and Porphyromonas (P.) gingivalis bacteria were determined using a real-time polymerase chain reaction (PCR) analysis in saliva samples collected at T0, T1, and T2 times. Mann–Whitney U test and Student’s t test were used to compare data between the groups, and one-way analysis of variance (ANOVA) and Friedman tests were used to compare data from different time intervals for each group.

Results

Plaque index values were greater in group 1 at T1 and T2, although there was no difference between the groups at T0. The gingival index scores of both groups were similar at T0, T1, and T2. While group 2 had a larger number of salivary S. mutans at T0 and T2, there was no significant difference between the groups at T1. At all three time points, there was no significant difference in salivary L. casei levels between the groups.

Conclusions

Although the interactive power toothbrush was more effective at removing plaque than the manual toothbrush, the results of the gingival index did not reflect the plaque scores. The number of certain salivary bacteria and brush type did not appear to have a clear relationship.

Zusammenfassung

Einleitung

Ziel dieser Studie war es, die Wirksamkeit einer manuellen und einer interaktiven elektrischen Bürste bei kieferorthopädischen Patienten anhand von parodontalen Indizes und der Bakterienkonzentration in Speichelproben zu vergleichen.

Methoden

Vierzig Patienten (20 weibliche, 20 männliche; Altersbereich 12-18 Jahre) mit festsitzenden kieferorthopädischen Apparaturen wurden in die Studie aufgenommen. Die Patienten wurden randomisiert mithilfe versiegelter Umschläge im Verhältnis 1:1 in 2 Gruppen aufgeteilt: Gruppe 1: Handzahnbürste (Oral‑B Ortho Brush, Procter & Gamble, Dublin, Irland), Gruppe 2: interaktive elektrische Zahnbürste (Oral‑B Genius 8900, Procter & Gamble, Marktheidenfeld, Deutschland). Alle Teilnehmer bekamen die gleiche Zahnpasta (Colgate Triple Action, Colgate-Palmolive, New York, NY, USA). Die Putztechnik für jeden Patienten wurde sowohl mündlich als auch visuell mit Hilfe einer Videodemonstration ausführlich dargestellt. Zu Beginn der Studie (T0), in Woche 6 (T1) und in Woche 12 (T2) wurden die Plaque- und Blutungsindexwerte für den unteren und oberen Zahnbogen erfasst. Darüber hinaus wurde die Anzahl der Bakterien Streptococcus (S.) mutans, Lactobacillus (L.) casei und Porphyromonas (P.) gingivalis mit Hilfe einer Real-Time-PCR(Polymerasekettenreaktion)-Analyse in Speichelproben bestimmt, die zu den Zeitpunkten T0, T1 und T2 gesammelt wurden. Für den Vergleich der Daten zwischen den Gruppen wurden der Mann-Whitney-U-Test und der Student-t-Test verwendet, für den Vergleich der Daten aus verschiedenen Zeitintervallen für jede Gruppe die Einwegvarianzanalyse (ANOVA) und der Friedman-Test.

Ergebnisse

Die Plaqueindexwerte waren in Gruppe 1 bei T1 und T2 höher, obwohl es bei T0 keinen Unterschied zwischen den Gruppen gab. Die Gingivaindexwerte beider Gruppen waren bei T0, T1 und T2 ähnlich. Während Gruppe 2 zu T0 und T2 eine größere Anzahl von S. mutans im Speichel aufwies, gab es zu T1 keinen signifikanten Unterschied zwischen den Gruppen. Zu allen 3 Messzeitpunkten gab es keinen signifikanten Unterschied zwischen den Gruppen in Bezug auf die L.-casei-Konzentration im Speichel.

Schlussfolgerungen

Die interaktive elektrische Zahnbürste entfernte Plaque effektiver als die Handzahnbürste. Die Ergebnisse des Gingivaindex spiegeln dagegen nicht die Plaquewerte wider. Die Konzentration bestimmter Bakterien im Speichel und die Art der Zahnbürste schienen in keinem eindeutigen Zusammenhang zu stehen.

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Acknowledgements

We would like to thank Metin Erdoğan for the PCR analysis.

Funding

This research was supported by Afyonkarahisar Health Science University Scientific Research Project Committee (Project number: 21.DUS.007).

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Authors and Affiliations

  1. Department of Orthodontics, Afyonkarahisar Health Science University, Afyonkarahisar, Turkey

    Tuğba Erden & Hasan Camcı

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  1. Tuğba Erden
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  2. Hasan Camcı
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Contributions

Supervision: H.C., T.E.; Design: H.C., T.E.; Resources: T.E.; Materials: T.E.; Data Collection and/or processing: H.C., T.E.; Analysis and/or interpretation: H.C., T.E.; Literature research: T.E.; Writing manuscript: H.C., T.E.; Critical review: H.C., T.E.

Corresponding author

Correspondence to Hasan Camcı.

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Conflict of interest

T. Erden and H. Camcı declare that they have no competing interests.

Ethical standards

This study was approved by Afyonkarahisar Health Science University Clinical Research Ethics Committee (ID: 2020/488). Written consent for publication was obtained from each participant.

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Registration

The trial was not registered.

Protocol

The protocol was not published before trial commencement.

Availability of data and materials

Data and materials are available at the Orthodontic Department in the Faculty of Dentistry, Afyonkarahisar Health Science University

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Erden, T., Camcı, H. Manual vs. interactive power toothbrush on plaque removal and salivary Streptococcus mutans and Lactobacillus casei levels. J Orofac Orthop 85 (Suppl 1), 41–51 (2024). https://doi.org/10.1007/s00056-023-00470-6

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  • DOI: https://doi.org/10.1007/s00056-023-00470-6

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