Electric Toothbrush Research Articles

Biomimetic Mechanism of Action of Fluoridated Toothpaste Containing Proprietary REFIX Technology on the Remineralization and Repair of Demineralized Dental Tissues: An In Vitro Study.

Objectives This in vitro study aimed to characterize the mineral content and surface and cross-sectional morphology of enamel and dentin tissues treated with a 1450 ppm fluoride-containing toothpaste with REFIX technology. Materials and Methods Bovine enamel blocks ( n = 5) were obtained (4 × 4 × 6 mm), demineralized (artificial caries lesion), and treated (pH cycling and brushing with the toothpaste). During the pH cycling, which lasted for 7 days (demineralization and remineralization took 6 and 18 hours, respectively), the enamel was brushed for 5 minutes using an electric toothbrush before being immersed in a remineralizing solution. The dentin blocks were acid-etched for 2 minutes (0.05 M citric acid, pH 1.8) to expose the dentinal tubules ( n = 5). Morphological analysis of the dentin was performed immediately and after 7 days of brushing with the dentifrice, and compared with the control group. The specimens were then cross-sectioned. The surface and cross-sectional micromorphology were assessed using scanning electron microscopy (SEM). The elemental analyses (weight%) were determined with an energy-dispersive X-ray spectroscopy (EDS). Results The toothpaste with REFIX technology remineralized and repaired the surface enamel effectively. The elemental analysis also demonstrated that treating the enamel with the toothpaste formed a silicon-enriched mineral layer on the enamel surface. Elemental analysis of the enamel cross-sections showed that the toothpaste induced a mineral change. The results were also consistent in the dentin, where the dentinal tubules were progressively occluded until there was complete occlusion after 7 days. Conclusions We prove the biomimetic mechanism of action of fluoridated toothpaste containing proprietary REFIX technology for obtaining silicon-enriched, remineralized and repaired dental tissues.

Appliance-based solar certificates: A new way of going green

In recent years, an increasing amount of solar energy has been produced around the globe, but too few consumers actually buy it. Three studies now show how this purchase can be promoted with an approach similar to the carbon offset program in aviation. After a fictitious purchase of differently priced appliances (e.g. electric toothbrush or TV set) in an online store, participants could buy a solar certificate for this appliance, whereby its price depended on the appliance's energy consumption as well as the selected term (e.g. 1 or 3 years) of the certificate. By purchasing such a certificate, the amount of solar energy consumed by this appliance for the selected term would be fed into the Swiss electricity grid. Study 1 showed that participants were willing to buy such a certificate, especially certificates with longer terms. That willingness, however, depended on the “solar certificate price/appliance price” ratio. While Study 2 showed that this purchase is influenced by promotions (e.g., a specific reduction in price), Study 3 showed that this purchase did not lead to a less environmentally friendly behavior afterwards. Appliance-based solar certificates easily available at the point of sale can encourage consumers to buy more solar energy.

Oral neuromuscular training in patients with dysphagia after stroke: a prospective, randomized, open-label study with blinded evaluators

BackgroundOral and pharyngeal swallowing dysfunction are common complications in acute stroke patients. This primary aim of this study was to determine whether oral neuromuscular training improves swallowing function in participants with swallowing dysfunction after stroke. A secondary aim was to assess how well results of the timed water-swallow test (TWST) correspond with swallowing dysfunction diagnosed by videofluoroscopy (VFS).MethodsThis was an intention-to-treat two-centre prospective randomized open-label study with blinded-evaluators (PROBE) design. At 4 weeks after stroke onset, participants with swallowing dysfunction were randomized to 5 weeks of continued orofacial sensory-vibration stimulation with an electric toothbrush or additional oral neuromuscular training with an oral device (Muppy®). Participants were examined with TWST, a lip-force test, and VFS before (baseline), after 5 weeks’ treatment (the end-of-treatment), and 12 months after treatment (follow-up). The baseline VFS results were compared with the TWST results. The primary endpoint was changes in swallowing rate assessed using TWST, from baseline to the end of training and from baseline to follow-up based on intention-to-treat analyses. The secondary endpoint was the corresponding changes in lip-force between baseline, the end of treatment, and follow-up.ResultsThe participants were randomly assigned as controls (n = 20) or for intervention with oral neuromuscular training (n = 20). After treatment, both groups had improved significantly (intervention, P < 0.001; controls, P = 0.001) in TWST but there was no significant between-group difference in swallowing rate. At the 12-month follow-up, the intervention group had improved further whereas the controls had deteriorated, and there were significant between-group differences in swallowing rate (P = 0.032) and lip force (P = 0.001). A TWST < 10 mL/sec at baseline corresponded to VFS-verified swallowing dysfunction in all assessed participants.ConclusionThe 5-week oral neuromuscular training improved swallowing function in participants with post-stroke dysphagia compared with the controls 12 months after intervention, but there was no between-group difference in improvement immediately after treatment. TWST results corresponded with VFS results, making TWST a feasible method for identifying persons with swallowing dysfunction after stroke. Larger randomized controlled trials are required to confirm our preliminary positive long-term results.Trial registrationRetrospectively registered at ClinicalTrials.gov: NCT04164420. Registered on 15 November 2019.

Comparative Assessment of Three Toothpastes and Prophylactic Polishing Paste as A Method of Iron Stain Removal in Primary Teeth: An in-Vitro Study

Aim: To compare and assess the efficacy of three toothpastes compared to prophylactic polishing paste as iron stain removal method in extracted primary teeth. Method: Sixty extracted primary anterior teeth were decoronated at cementoenamel junction, followed by filling the pulp chamber with flowable composite. The teeth were then immersed in ferrous sulphate solution and digital images were obtained. The teeth were subjected to electric tooth brushing using Colgate® Visible White (Group A), Himalaya® Sparkling White (Group B) and Biomed ® Superwhite (Group C) toothpastes. Prophylactic polishing paste (Group D) was used as control for stain removal. Post-intervention digital images were obtained and color parameter differences (L*, a*, b *, hue, chroma and ΔE) were evaluated using image color summarizer software. The data was then statistically analysed using one way ANOVA test. Intergroup analysis was done using bon ferroni multiple comparison test. Results: Significant differences in L* and b* colour parameters were obtained for Group A, B and D (p &lt; 0.05); however, a* parameter did not show a significant change in values for any group. A significant difference was observed in terms of chroma in groups A, C and D. No significant difference was observed in hue parameter values for all four groups. Intergroup comparison of ΔE revealed significant differences between groups D (p &lt; 0.05) and group A, B and C respectively.

Clinical comparison of an electric-powered ionic toothbrush and a manual toothbrush in plaque reduction: A randomized clinical trial.

This study aimed to evaluate the plaque removal efficacy of a newly developed electric-powered ionic toothbrush vs. a manual toothbrush. Manual or electric-powered ionic toothbrushes were randomly assigned to 30 healthy volunteers divided into two groups (Phase I). After 2min of brushing, all tooth surfaces were stained with a plaque staining solution, and blinded examiners performed scoring using the Rustogi Modification of the Navy Plaque Index. Plaque removal rate was calculated at the central incisors, first premolar and first molar, as representative teeth, in the maxilla and mandibula. One week following Phase I, the same examinations were repeated in all subjects using another toothbrush (Phase II), as a crossover design. Electric ionic toothbrushes demonstrated a significantly higher plaque removal rate than manual toothbrushes in the premolar and molar areas (p<.05). However, in the central incisor area, no statistically significant difference was observed. Compared with manual toothbrushes, electric-powered ionic ones were significantly efficient in removing plaque in the premolar and molar areas.

Factors Associated with Dental Plaque, Gingivitis, and Caries in a Pediatric Population: A Records-Based Cross-Sectional Study.

This retrospective, cross-sectional study evaluated dental records of 1000 healthy children to determine factors associated with plaque, gingivitis, and caries. A logistic model for plaque and gingivitis (mild versus moderate/severe) and caries (yes/no) was carried out separately for each variable using the following potential factors: Age, Gender, Brush Type, Starting Age of Brushing, Brushing Frequency, and Bite Type. Data from 998 children (median age: 4 years, 10 months (range: 2.5–7 years)) were analyzed. Sixty-four percent were manual toothbrush users; 36% were oscillating-rotating electric toothbrush users. For plaque and gingivitis, but not caries, Brush Type was more impactful than Brushing Frequency. Age influenced the severity of plaque and gingivitis, with increases in the odds of having moderate/severe plaque or gingivitis associated with increasing age. The probability of caries increased until approximately age 5 and then decreased until age 7. Oscillating-rotating brush users were more likely to present with less plaque, gingivitis, and caries, with 6.0, 5.1, and 1.4 times greater odds of having mild (versus moderate/severe) plaque, less severe gingivitis, and being caries-free, respectively, than manual brush users. Similarly, brushing twice daily and starting brushing at an earlier age were associated with better oral health outcomes. Children with anterior bite abnormalities had increased odds of developing moderate/severe plaque and gingivitis than children with normal anterior bites. Gender was not a statistically significant factor associated with plaque, gingivitis, or caries. Children’s oral health is influenced by toothbrush type, starting age of brushing, compliance with twice-daily brushing, and bite abnormalities.

Powered toothbrushes for plaque control in fixed orthodontic patients: a network meta-analysis.

Orthodontic patients are at greater risk due to the inability to clean around the components directly bonded to teeth. Hence, the aim of the present network meta-analysis is to compare the utility of powered toothbrushes in plaque control in patients with orthodontic brackets compared with manual tooth brushing. Necessary data were extracted and analysed for Risk of Bias. Heterogeneity was assessed using Chi-square and I2 tests. Random effects model was used for both direct and mixed treatment comparisons. Standardized mean difference with 95% confidence interval was the effect estimate for plaque and bleeding scores and mean difference for pocket depth. Inconsistencies between the direct and indirect estimates were evaluated by H-statistics. GRADE approach was used to assess the quality of evidence. Pooled results from 14 studies showed significantly higher plaque scores in patients using manual toothbrushes. Pooled results from 13 studies showed significant higher bleeding scores as well with manual brushes. There was a significant reduction in pocket depth with electric toothbrushes. Powered toothbrushes are a promising alternative for plaque control in patients with fixed orthodontic brackets. Stronger evidence can be established with addition of long-term clinical trials based on the recommendations.

Knowledge About Brushing Simulator Among Dentists - A Survey

Brushing is an important activity in a day to day life. It helps to keep our oral cavity healthy. A brushing simulator is a machine that holds the toothbrush and helps to check various activities done with it. Brushing helps to clean the teeth, tongue, gums, and place a major role in maintaining dental hygiene. Dental plaque is removed by this process. This is a computer program mission where everything is done using the software. The aim of the survey was to assess the knowledge about the brushing simulator among dentists in Chennai. A questionnaire regarding simulator was created and circulated to dentists in Chennai, a total of 13 questions were created and a total of 135 responses were received. The data obtained was with SPSS and represented with the help of pie charts and graphs. When comparing the awareness of brushing simulator with gender, it was shown that females had a higher level of awareness about the brushing simulator when compared with males (p = 0.029), which was statistically significant. When comparing the knowledge about the uses of brushing simulators with gender, it was shown that females had a higher level of knowledge about the uses of brushing simulators when compared with males. p = 0.013), which was statistically significant. When comparing the knowledge about the types of brushing simulator movements with gender, it was shown that females had a higher level of knowledge when compared with males.(p= 0.034), which was statistically significant. The knowledge and view varied for each question. Brushing force is usually higher for sonic toothbrush and with manual toothbrush dentin face the highest abrasion when compared to the enamel. People are aware of the simulation of brushing, but not about the brushing simulator machine.

Features of spatial localization of dental plaque during orthodontic treatment on braces

The aim of the study was to evaluate the features of spatial localization of dental plaque in patients with braces, depending on the type of toothbrush used. We enrolled 63 patients from 11 to 18 years old, needing orthodontic treatment on a bracket system due to the tight position of the teeth in unilateral cleft palate and lip (Q37.1 according to ICD-10) after reconstructive surgery, in combination with mesial occlusion (K07.2 according to ICD-10).&#x0D; Material and methods: We evenly divided all participants into three groups depending on the type of brush used. Group 1 (n = 21) patients used an orthodontic manual toothbrush (Professor persin, Spazzolificio Piave S. p.A, Italy). Group 2 (n = 22) patients used an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n = 20) used an electric toothbrush (Oral-B Pro-Expert, Procter Gamble, USA). To assess the level of hygiene and determine the spatial accumulation of plaque, we used the Silness Loe index in the modification of Williams P. et al. (1991) at various stages. These included one week after professional hygiene after fixing both arcs. Then, six, and twelve months of wearing them.&#x0D; Material and methods: Group I contained the most pronounced deterioration in the hygienic state of the oral cavity during orthodontic treatment using a manual brush. Predominantly, the plaque accumulated in pricesavvy region. Uneven distribution of dental plaque relative to orthodontic techniques in group 1 was found in all quadrants of the upper and lower jaw.Conclusion: When assessing the spatial distribution of dental plaque relative to the bracket systems, it was possible to identify an additional advantage of using an ultrasonic brush. In comparison with an electric brush, we observed slight expressions in plaque accumulation on the four surfaces of the tooth., In the posterior area, plaque accumulated without pronounced deviations from the other areas of the tooth.

Bristle Motion, Forces, and Related Vertical Translation for a Novel Electric Toothbrush Design

This paper presents a combination of theoretical and experimental techniques applied to characterize the bristle motion, forces, and related vertical translation for a novel electric toothbrush design with a linear drive system. Results of the theoretical description, based on a single filament, were successfully compared with laboratory-based investigations: force measurements and high-speed video analysis, and tracking the toothbrush motion. This work describes the vertical translation induced in the toothbrush head, of up to 250 μm, when the toothbrush bristles are applied against a contact surface at brushing loads of approximately 1 N to 2.5 N. Using these techniques, including Fast-Fourier transform analysis, it is shown that the vertical motion of the head is composed of the driving frequency and its harmonics.

Socio-hygienic aspects of the dental caries in adults and its prevention

Relevance . A significant group is occupied by risk factors that completely depend directly on the socio-hygienic aspects of the patient's lifestyle. Purpose. To study the impact of the nature of nutrition and oral hygiene on the dental health of adults in modern conditions. Materials and methods. To identify and assess the risk factors for dental caries, a questionnaire was developed and 121 patients from dental clinics in Kazan were interviewed. A discriminant analysis of a group of risk factors for dental caries was performed. We also conducted a comparative analysis of oral hygiene in 36 people using a manual toothbrush and the new device (toothbrush) for cleaning all surfaces of the teeth. Results. The majority of the respondents (95,0%) brush their teeth 2 times a day with a cleaning time of 2 minutes (64,5%), and equally use both electric and manual toothbrushes. However, the frequency of brushing does not correspond to the mode and frequency of consumption of foods with easily fermentable carbohydrates in the diet, sugar-containing beverages, which has a direct impact on the occurrence of dental caries and periodontal diseases. The nature of nutrition significantly affects the development of caries of all teeth, except for the incisors of the maxilla. Brushing your teeth with a frequency of less than 2 times a day also contributes to the development of caries (except for premolars and molars of the maxilla). To improve the level of dental health of the population and prevent the development of dental caries and periodontal diseases in adults a new device (toothbrush) for cleaning all surfaces of teeth has been proposed. Conclusion. The results of the study emphasize the practical importance of analyzing the risk factors for the development of dental caries in the adult population with the possibility of conducting reasonable, targeted correction methods to minimize the risk of further disease progression.

Treatment Success and User-Friendliness of An Electric Toothbrush App: A Pilot Study.

Electronic and mobile health (eHealth/mHealth) are rapidly growing areas in medicine and digital technologies are gaining importance. In dentistry, digitalization is also an emerging topic, whereby more and more applications are being offered. As an example, using real-time feedback, digital application software (an app) was designed to help users brush their teeth more accurately. However, there is no data on the effectiveness and haptic of such apps. Therefore, a single-blinded, randomized controlled clinical trial was designed: twenty volunteers received an electric toothbrush with an associated app to assess whether the app-assisted toothbrushing is better than without. After a short period of familiarization with the electric toothbrush, plaque index (O‘Leary et al. 1972) was recorded and subjects were assigned to the test (with app; n = 10) or the control group (no app; n = 10). At the end of the 2-week pilot study period, plaque was again assessed and participants in the test group completed a questionnaire about the app’s user-friendliness. Statistical analysis revealed no significant differences between the test and control groups. The plaque index improved on average by 8.5% points in the test and 4.7% points in the control group. Fifty percent of the test group participants were of the opinion that they had achieved better cleaning results and would recommend the app to others, although the app contributed only marginally to increased plaque removal. However, such apps may nevertheless be helpful as motivational tools, especially when tracking and monitoring cleaning data. Therefore, more development and research on this topic is indicated.

Combining evidence-based healthcare with environmental sustainability: using the toothbrush as a model.

Introduction Healthcare professionals should consider environmental sustainability when recommending medical devices to patients, although there is currently little quantitative data available. The toothbrush is a widely recommended healthcare device worldwide. The aim of this study was to compare the sustainability of different types of toothbrush.Materials and methods Four types of toothbrush were studied: a traditional plastic and electric toothbrush, as well as a plastic manual toothbrush with replaceable heads and a bamboo manual toothbrush. Life cycle assessment (LCA) methodology was applied to quantify the environmental impact of these toothbrushes over five years.Results The electric toothbrush performed consistently poorly compared to the three manual toothbrush types and had the greatest impact in 15 out of 16 environmental categories. The bamboo and replaceable-head plastic toothbrushes had the lowest impact in all categories. The climate change potential of the electric toothbrush was 11 times greater than the bamboo toothbrush.Discussion Switching toothbrushes from the traditional toothbrushes to bamboo or replaceable-head plastic is more environmentally sustainable. These results could be used to inform individual consumer choice, oral health recommendations, procurement of toothbrushes for public health programmes and toothbrush manufacturers. LCA methodology can be used to make healthcare more sustainable.

Anti-erosive effect of rinsing before or after toothbrushing with a Fluoride/Stannous Ions solution: an in situ investigation: Application order of Fluoride/Tin products for erosive tooth wear

Objective: To evaluate the impact of the application of a F-/Sn2+-containing mouthrinse before or after toothbrushing with a F-/Sn2+/chitosan toothpaste on the progression of erosion/abrasion on enamel and dentin. Methods: This crossover in situ study had five arms: Control (toothbrushing without toothpaste), Brushing (toothbrushing with toothpaste), Brushing + Rinsing, Rinsing + Brushing, and Rinsing (without toothbrushing). Fifteen subjects used removable mandibular appliances containing 3 enamel and 3 dentin specimens, which were subjected to erosion-abrasion cycling of 60 min salivary pellicle formation followed by 5 min extra-oral erosion with 1% citric acid (4x/day for 5 days). Treatments were performed in situ after first and last erosive challenges with rinse (10 ml; 30 s) and/or toothbrushing with/without toothpaste (with electric toothbrush; 5 s per specimen; total 2 min contact with slurry). Surface loss (SL) was evaluated with an optical profilometer. Data were analyzed by two-way repeated measures ANOVA and Tukey tests (α = 0.05). Results: The Control showed the highest SL (mean ± SD for enamel: 24.58 ± 11.32; dentin: 32.32 ± 10.10; all μm). Rinsing alone resulted in significantly lower SL value (enamel: 8.30 ± 4.96; dentin: 16.15 ± 8.29) compared with arms that applied toothpaste, except Brushing + Rinsing. None of the arms that underwent toothbrushing with the toothpaste differed from each other (p > 0.05). Dentin specimens showed significantly higher SL values than enamel (p < 0.001). Conclusion: The order of treatment applications had no influence on their anti-erosive effect; however, toothbrushing with F-/Sn2+/chitosan toothpaste reduced enamel surface loss. Additional rinsing with F-/Sn2+ mouthrinse did not offer improved protection.Clinical significance: The use of fluoride- and stannous- containing toothpastes and mouthrinses is an important approach in the prevention of erosive tooth wear. Further evidence is needed to support the benefit of combining these products against this condition.

IOT Power Theft Identification and Monitoring

Now a days we can’t imagine today’s life without electricity, almost all the things, equipment and appliances we are using in day to day life are using ELECTRIC power to run smoothly. Ever since the advent of electricity it has become an integral part of our life. Solar energy is the alternative but is has some limitations like environmental changes, high initial cost etc. In todays present world every little appliance works on electricity from the electric toothbrush to huge motors. So from rural to urban and from domestic to industrial areas the use of electricity is increased but with the power theft hand in hand. Using IOT based power theft identification and monitoring a system can find the dishonest user by identifying the status of energy meter at the back end of power office.

Efficacy of a U-Shaped Automatic Electric Toothbrush in Dental Plaque Removal: A Cross-Over Randomized Controlled Trial.

Background: The aim of this single-use, four-treatment, four-period (visit), cross-over, mono-centered, examiner-blind, cross-over randomized controlled trial (RCT) was to evaluate the efficacy in dental plaque removal of a U-shaped automatic electric toothbrush (U) compared to a conventional powered toothbrush (P), a habitual toothbrushing procedure (H), and no brushing (N). Methods: Eligible participants were volunteer students. Primary outcome measure was the reduction in full-mouth plaque score (FMPS) after brushing. The secondary outcome variable was a visual analogic scale (VAS) on subjective clean mouth sensation. Mixed models were performed for difference in FMPS and VAS. Results: Twenty-two participants were randomized to the treatments in the four periods of the study. The differences between treatments in FMPS reduction after brushing were statistically significant (p < 0.0001). The differences were statistically significant between the U and P groups (difference −48; 95% CI from −54 to −41) favoring the P group, and between the U and H groups (difference −45; 95% CI from −52 to −39) favoring the H group. On the contrary, the difference between the U and N groups was not significant (difference 5; 95% CI from −2 to 12) favoring the U group. The differences between treatments in clean mouth VAS was statistically significant (p < 0.0001) favoring the P and H groups. Conclusions: The U-shaped automatic electric toothbrush tested in this study proved to be not effective in removing dental plaque.

Adjunct use of mouth rinses with a sonic toothbrush accelerates the detachment of a Streptococcus mutans biofilm: an in vitro study

BackgroundThe aim of this in vitro study was to examine the possible enhancement of the biofilm peeling effect of a sonic toothbrush following the use of an antimicrobial mouth rinse.MethodsThe biofilm at a noncontact site in the interdental area was treated by sound wave convection with the test solution or by immersion in the solution. The biofilm peeling effect was evaluated by determining the bacterial counts and performing morphological observations. A Streptococcus mutans biofilm was allowed to develop on composite resin discs by cultivation with stirring at 50 rpm for 72 h. The specimens were then placed in recesses located between plastic teeth and divided into an immersion group and a combination group. The immersion group was treated with phosphate buffer, chlorhexidine digluconate Peridex™ (CHX) mouth rinse or Listerine® Fresh Mint (EO) mouth rinse. The combination group was treated with CHX or EO and a sonic toothbrush.ResultsThe biofilm thickness was reduced by approximately one-half compared with the control group. The combination treatment produced a 1 log reduction in the number of bacteria compared to the EO immersion treatment. No significant difference was observed in the biofilm peeling effect of the immersion group compared to the control group.ConclusionsThe combined use of a sonic toothbrush and a mouth rinse enhanced the peeling of the biofilm that proliferates in places that are difficult to reach using mechanical stress.

Incidence of Periodontal Disease among Adolescents

Abstract Background: Despite the scarcity of studies regarding periodontal disease in young patients (teenagers and young adults), it seems that this disorder is also affecting the young population. Risk factors for periodontal disease include older age, chronic tobacco use, male gender, habits regarding oral hygiene, educational status, ethnicity, and financial status. Aim: This study aimed to evaluate the periodontal health among adolescents in two high schools in Târgu Mureș that had dental practices. Material and Methods: An online questionnaire consisting of 16 questions was distributed among high schoolers of Târgu Mureș. Data about personal characteristics, oral hygiene habits, family history of periodontal disease, risk factors for periodontal disease, and symptoms of periodontal disease observed by the respondents were collected and analyzed. Results: Out of the 501 teenagers who responded to the online questionnaire, 114 (22.8%) were 18 years old and were mostly females (88.2%). Regarding oral hygiene habits, 75.8% prefer a manual toothbrush over an electric toothbrush, 66.7% brush their teeth twice a day, and 54.1% practice a horizontal method of toothbrushing. Mouthwash was the most used oral hygiene aid (58.3%). Family history of periodontal disease was observed in 21.9% of respondents. As favoring factors, nicotine addiction (23.8%), bruxism (24.4%), interposition of various objects between teeth (48.3%), past or present orthodontic treatments (38.7%) were recorded. Symptoms of gingivitis and periodontitis, such as gingival bleeding (81.4%), redness of gingiva (39.3%), increased gingival volume (44.5%), gingival retraction (22.8%), and halitosis (81%), were present in the responding teenagers. Conclusions: In this study, periodontal disease was affecting mostly adolescent females who are practicing inappropriate methods of toothbrushing with inadequate frequency.

Measurement of eroded dentine tubule patency and roughness following novel dab-on or brushing abrasion

ObjectivesTo investigate the effect of dab-on or brushing of stannous-fluoride SnF2 or sodium-fluoride NaF dentifrice on eroded dentine tubule patency, surface and inter-tubular dentine roughness, using Confocal-Laser-Scanning-Microscopy (CLSM), Atomic-Force-Microscopy (AFM), Energy-Dispersive-X-ray-Spectroscopy (EDX), Scanning-Electron-Microscopy (SEM) and Contact-Profilometry (CP). Methods75-polished human dentine samples were prepared and eroded in agitated 6% citric acid to expose patent tubules and ‘initiate’ DH. Samples were randomly allocated into 5 intervention groups; artificial saliva control (1); electric tooth-brushing with NaF (2) or SnF2 (3), and dab-on application of NaF (4) or SnF2 (5). Samples underwent three cycles of intervention followed by further acid challenge. Patent tubules, likely to cause DH clinically, were measured using validated biocomputational methods with CLSM images of dentine surfaces taken baseline and post-intervention. Randomised samples (n = 15, 20 %) were investigated using AFM, EDX and SEM to study surface and sub-surface tubular occlusion. Dentine surface and inter-tubular roughness were measured using CP and AFM respectively. ResultsAt baseline, mean tubule patency in all samples was 216 (SD 58) with no significant inter-group differences. Post-intervention, the mean patency was 220 (40) and 208 (35) in groups 1 and 2 respectively (p ≥ 0.06), but decreased to 62 (41), 62 (21) and 63 (19) in groups 3, 4 and 5 respectively (p < 0.0001). Patency was confirmed using AFM, SEM and EDX. SnF2 interventions created greater sub-surface occlusion (p < 0.01), and increased CP surface roughness (p = 0.015). Significant negative correlation (-0.6) existed between CP surface roughness and tubule patency (p = 0.009). ConclusionsDab-on with NaF and SnF2 or brushing with SnF2 reduces DH in eroded dentine with ongoing acid challenges. Contacting surface roughness measures indicate risk of DH. Clinical significanceDab-on is a convenient supplementary method of dentifrice application to reduce DH; it beneficially avoids brushing post-erosion or overzealous brushing, enables re-establishment of an appropriate brushing regime post-DH and supports oral health. Significant modes of action of SnF2 in reducing DH are revealed. Finally, CP roughness measures provide indication of dentine lesions that may cause DH clinically.

Randomized in situ trial on the efficacy of Carbopol in enhancing fluoride / stannous anti-erosive properties

ObjectiveTo evaluate if the bioadhesive polymer (Carbopol 980) could potentiate the protective effect of sodium fluoride with stannous chloride (FS) solution on the control of enamel erosive wear. MethodsCylindrical bovine enamel specimens were polished and randomly allocated into three groups (n = 60): FS (500 ppm F- +800 ppm Sn2+ - positive control), FS + Carbopol (0.1% Carbopol), and ultrapure water (negative control). A randomized double-blind cross-over in situ model with three phases was used. In each phase, volunteers (n = 15) used a palatal appliance containing 4 specimens: two were submitted to an erosion model (2 h of pellicle formation; immersion in 1% citric acid, pH 2.3, for 5 min, 4x/day; 1 h intervals of saliva exposure; and treatment with the test solutions for 1 min, 2x/day). Besides erosion, the other two specimens were also subjected to abrasion (2x/day, 15 s) with active electric toothbrush, before the treatment with the solutions. After 5 days, enamel surface loss (μm) was evaluated by profilometry. Data were analyzed by two-way RM-ANOVA and Tukey tests (5%). ResultsThere were significant differences for both challenge and treatment factors. Erosion/abrasion challenge resulted in significantly higher enamel loss than erosion only (p < 0.05). The surface loss values for the erosion/remineralization model were (means ± SL): C = 14.7 ± 5.8b; FS = 9.0 ± 7.5ab; FS + Carbopol = 5.9 ± 3.8a; and for erosion/abrasion: C = 26.6 ± 10.1c; FS = 15.0 ± 8.8b; FS + Carbopol = 12.3 ± 7.9ab. ConclusionThe association of Carbopol to the FS solution significantly protected the enamel against erosive wear, but it was not significantly superior to FS only. Clinical SignificanceUnder highly erosive and abrasive conditions, rinsing with solutions containing sodium fluoride plus stannous chloride, associated or not with the Carbopol polymer, is an effective approach to control enamel erosive wear.