Efficacy of various side-to-side toothbrushes for noncontact biofilm removal

Abstract

The aim of this study was to evaluate the efficacy of four different powered toothbrushes with side-to-side action for noncontact biofilm removal in vitro. A three-species biofilm was formed in vitro on protein-coated titanium disks using a flow chamber combined with a static biofilm growth model. Subsequently, the biofilm-coated substrates were exposed to four different side-to-side toothbrushes (A, B, C, and D) with various brushing times (2, 4, and 6 s) and brushing (bristle-to-disk) distances (0, 2, and 4 mm). The biofilm volumes were measured using volumetric analyses with confocal laser scanning microscope images and Imaris version 7.5.2 software. The median percentages of biofilm reduction by the analyzed toothbrushes ranged from 9 % to 80 %. The abilities of the tested toothbrushes to remove the in vitro biofilm differed significantly (p < 0.05). Two of the tested toothbrushes (C and D) were capable of significant biofilm reduction by noncontact brushing. It was possible to reduce a three-species in vitro biofilm by noncontact brushing with two out of four side-to-side toothbrushes. Toothbrushes C and D show in vitro a high efficacy in biofilm removal without bristle contact.