Comparative assessment of plaque removal and motivation between a manual toothbrush and an interactive power toothbrush in adolescents with fixed orthodontic appliances: A single-center, examiner-blind randomized controlled trial

Abstract

Introduction: The objective of this 2-arm parallel trial was to determine the plaque removal efficacy (main outcome) and the motivation assessment (secondary outcome) comparing a manual versus an interactive power toothbrush in orthodontic patients. Methods: Sixty adolescents with fixed orthodontic appliances in both arches were randomized in a 1:1 ratio in this parallel, randomized, examiner-blind controlled clinical trial. Eligibility criteria included at least 16 natural teeth, 1-6 "focus care areas," plaque score of $1.75, no severe caries, gingivitis and periodontitis, no dental prophylaxis, no smoking, no antibiotics, and no chlorhexidine mouth rinse. Subjects were to brush unsupervised with either an interactive power toothbrush (Oral-B Professional Care 6000, D36/EB20) with Bluetooth technology or a regular manual toothbrush (Oral-B Indicator 35 soft). Focus care areas were each brushed for 10 additional seconds. Plaque removal was assessed with the use of the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI) to determine change from baseline at 2 and 6 weeks. Supervised brushing at screening and post-treatment visits recorded actual brushing times. Subject-reported motivational aspects were recorded at screening and week 6. Results: Fifty-nine subjects aged 13-17 years completed the study. The interactive power toothbrush provided significantly (P\0.001) greater plaque reduction versus the manual toothbrush at 2 and 6 weeks according to the whole-mouth TMQHPI. The treatment difference in adjusted mean plaque change from baseline was 0.777 (95% CI 0.614-0.940) at week 2 and 0.834 (0.686-0.981) at week 6. Mean reductions in the number of focus care areas were also significantly greater (P \0.001) in the power brush group at weeks 2 and 6. Brushing times increased significantly at weeks 2 and 6 (P #0.013) versus baseline in the interactive power brush group only. Subject-reported motivation was significantly increased in the interactive power brush group at week 6 versus screening (P #0.005). Conclusions: An interactive power toothbrush generated increased brushing times and significantly greater plaque removal versus a manual brush. (Am J Orthod Dentofacial Orthop 2019;155:462-72)

An 8-week randomized controlled trial comparing the effect of a novel oscillating-rotating toothbrush versus a manual toothbrush on plaque and gingivitis

“…In addition, research among specific populations, such as studies done with earlier O‐R models among orthodontic patients and implant patients 33‐35 , would provide additional insights to the plaque removal efficacy and gingival health benefits of the toothbrush when compared to use of control brushes. Finally, the role of interactive features with use of the novel O‐R electric toothbrush will be evaluated in future research to understand if they provide improvements in brushing behavior seen with other interactive O‐R toothbrushes 36,37 .…”

Randomized controlled trial assessing plaque removal of an oscillating-rotating electric toothbrush with micro-vibrations

“…Interactive features have also been introduced to share real‐time feedback to the user, initially via a wireless display and more recently using a Smartphone with app, by communicating information such as brushing force, time, and thoroughness. Research has demonstrated these features generate increased patient compliance and improved brushing habits 10‐12 .…”

Prioritization of risk factors of gingival hyperplasia during orthodontic treatment: the role of biofilm.

“…Inevitably, placement of a fixed orthodontic appliance creates plaque retention areas that make cleaning difficult [31]. However, the constant presence of bacterial plaque is inevitably accompanied by numerous undesirable effects such as gingivitis, gingival overgrowth, demineralization of enamel (leading to precarious leucomas and even to caries) and, possibly in extreme cases, attachment loss [32], [33].…”