Cleaning Efficacy of Regular, Orthodontic and Electric Toothbrushes around Orthodontic Brackets: An In-vitro Study

Abstract

Introduction: Plaque formation increases when mechanical disruption occurs in the oral cavity’s self-cleaning systems during fixed orthodontic therapy. Hence, it is imperative that oral prophylaxis must be performed with more care in orthodontic patients. This can be efficiently done with the help of toothbrushes. There are various types of toothbrushes such as regular, orthodontic and electric toothbrushes which are most commonly used by patients to maintain proper oral hygiene and prevent plaque accumulation. Aim: To identify which toothbrush has the best cleaning efficiency, when used around orthodontic brackets. Materials and Methods: This in-vitro study was conducted in the laboratory set-up at Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India. The study was conducted for a period of two weeks from 17th January 2022 to 30th January 2022, and used 24 permanent premolars extracted for orthodontic purposes which were divided into three groups: regular, orthodontic and electric toothbrushes. There were eight tooth samples in each group. Following premolar bracket bonding, a biofilm was formed around the teeth using E.faecalis culture in-vitro for three days. The samples were then carefully removed and treated with a disclosing agent before being put through a brushing simulation. The “Plaque index for Orthodontic Patients” (PIOP) index was used to estimate plaque scores before and after brushing based on how much biofilm was remaining on the tooth surfaces. Oneway Analysis of Variance (ANOVA) and Tukey's Post-hoc tests were used to determine the statistical significance. Results: The mean plaque scores after simulation in the toothbrush groups were 3±0.75 (regular), 1.75±0.70 (orthodontic) and 2.37±0.74 (electric). There was a statistically significant difference in mean plaque scores between groups as determined by one-way ANOVA {F(p=0.008)}. A Tukey's Post-hoc test revealed that the cleaning efficacy of orthodontic toothbrushes was statistically significant compared to the other two groups. Conclusion: The orthodontic toothbrushes produced a statistically greater level of tooth-cleaning effectiveness.