Abstract
Aim: To evaluate the effect of manual (M), electric (E) and ultrasonic (US) toothbrushes on the removal of oral biofilm and control of gingivitis. Also, the roughness and tooth wear production were evaluated in vitro. Methods: For the in vitro analyses, thirty bovine dentin specimens were submitted to a 3-month brushing simulation (9 minutes) with the three types of toothbrushes (n = 10). Subsequently, a randomized controlled clinical trial was performed with 36 patients divided into 3 groups according to the toothbrushes used (n = 12). Gingival index, visible plaque index and the volume of crevicular fluid were evaluated at baseline and 3 months after the beginning of the toothbrush use. Furthermore, the performance of the biofilm removal per brushing cycle of 1 and 3 minutes with each toothbrush was made monthly until the end of the experiment. Results: The US group had the highest dentin wear. Clinically, the US group had a lower plaque index at 3 months than the M group. The M group also showed less biofilm removal efficiency from the second month of follow-up and more worn bristles at the end of the 3 month period than the E and US groups. Conclusion: The ultrasonic, electric and manual toothbrushes showed no differences in gingivitis control in the present study. The ultrasonic and electric toothbrushes had a more significant effect on biofilm removal than a manual toothbrush, but the ultrasonic toothbrush promoted greater dentin tissue wear.
Highlights
The dental biofilm represents a true complex biofilm that forms on the non-descamative surface of the teeth[1]
A random distribution of these specimens was performed in three Experimental Groups (n=10/group), according to the toothbrush used for the brushing simulation: 1) Ultrasonic toothbrush (US) (Ultrasonex Ultima Toothbrush®, Sonex International Corp, Brewster, New York, EUA ); 2) Electric toothbrush (E) (Braun Oral B 3D Plaque Remover, Braun GmbH, Kronberg, Alemanha); 3) Manual toothbrush (M) (Oral B Model 30, Gilette do Brasil, Manaus, Brazil)
The E and M groups presented a reduction in the gingival index at 3 months, a fact not observed in the US group (Figure 4B)
Summary
The dental biofilm represents a true complex biofilm that forms on the non-descamative surface of the teeth[1]. It is considered the major etiological factor of the most prevalent human oral diseases: dental caries and periodontal disease. Personal daily oral hygiene by brushing and using other hygiene aids is an accessible, effective, and economical method to maintain oral health[3]. It has been extensively demonstrated in clinical trials conducted in different geographical regions that the effective removal of dental biofilm is essential to maintain dental and periodontal health[4]. There are currently several toothbrush options on the market to increase motivation and facilitate brushing techniques, such as electric and ultrasonic brushes that have emerged as an alternative to conventional ones[5]
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