Electric Toothbrush Research Articles

A Versatile Integrated Microfluidic Chip Based on Sonic Toothbrush-Assisted Mixing for Analyses of Diverse Biomolecules.

Usually, different assays and instrumentation are required for different types of targets, e.g., nucleic acids, proteins, small molecules, etc., because of significant differences in their structures and sizes. To increase efficiency and reduce costs, a desirable solution is to develop a versatile platform suitable for diverse objectives. Here, we established a versatile detection technique: first, target separation and enrichment were carried out using magnetic beads (MBs); then, different targets were converted to same barcoded DNA strands (BDs) released from gold nanoparticles; finally, sensitive detection of three different targets (miRNA-21, digoxigenin antibody, and aflatoxin B1) was achieved through exonuclease III (Exo III) cyclic cleavage-assisted signal amplification. To simplify the operation, we integrated this technique into a microfluidic chip with multiple chambers in which the requisite reagents were prestored. Just by moving the MBs through different chambers with a magnet, multiple steps can be completed. Due to the limited space in microfluidic chips, the full mixing of MBs and solution is a key point to improve reaction efficiency. The mixing can be achieved by acoustic vibration generated by a small, portable sonic toothbrush. Based on the microfluidic chip, the detection limits of the above three targets were 0.76 pM, 0.16 ng/mL, and 0.56 nM, respectively. Furthermore, miRNA-21 and Digoxigenin antibody (Dig-Ab) in serum and AFB1 in corn powder were also used to demonstrate the performance of this chip. Our versatile platform is easy to operate and is expected to develop into an automatic "sample-to-answer" device.

Liquid Metal Droplets-Based Elastomers from Electric Toothbrush-Inspired Revolving Microfluidics.

Liquid metal (LM)-based elastomers have a demonstrated value in flexible electronics. Attempts in this area include the development of multifunctional LM-based elastomers with controllable morphology, superior mechanical performances, and great stability. Herein, inspired by the working principle of electric toothbrushes, a revolving microfluidic system is presented for the generation of LM droplets and construction of desired elastomers. The system involves revolving modules assembled by a needles array and 3D microfluidic channels. LM droplets can be generated with controllable size in a high-throughput manner due to the revolving motion-derived drag force. It is demonstrated that by employing a poly(dimethylsiloxane) (PDMS) matrix as the collection phase, the generated LM droplets can act as conductive fillers for the construction of flexible electronics directly. The resultant LM droplets-based elastomers exhibit high mechanical strength, stable electrical performance, as well as superior self-healing property benefiting from the dynamic exchangeable urea bond of the polymer matrix. Notably, due to the flexible programmable feature of the LM droplets embedded within the elastomers, various patterned LM droplets-based elastomers can be easily achieved. These results indicate that the proposed microfluidic LM droplets-based elastomers have a great potential for promoting the development of flexible electronics.

Combined Effect of Electric Toothbrush and Oral Irrigator- “Aqua Brush”

The efficacy and effectiveness of electric toothbrushes in comparison to manual toothbrushes lead to superior full-mouth and interproximal plaque removal and reduction of gingivitis, periodontitis and dental caries. Additionally, the use of an irrigator has been shown to improve the overall oral health. The aim of this study was to design and develop a utility model for the combined effect of the oral irrigator and tooth brush for maintaining oral health. The design of the modified toothbrushing unit comprises of an electric toothbrush and an oral irrigator. This was achieved by removing the electric toothbrush head to place a drill in the centre of the brush head for the insertion of irrigator head. The irrigator which was attached to a 50 ml water container with a detachable irrigator head powered by a 12 V external battery source was used to pump the water. The outcome was that a multifunctional working model combining the electric tooth brush and oral irrigator is designed successfully. Aqua Brush can be incorporated into the regular oral hygiene regimen making it convenient for the patient as it can be used as a single brushing unit and/or with the added irrigation enhancing the maintenance of oral hygiene.

Comparison of Oral Hygiene Practices between Dental, Medical and Allied Health Sciences Undergraduate Students of Lahore

Aim: To determine how dental education affects the oral hygiene practices in Pakistan. Study design: Descriptive cross-sectional study. Place: FMH College of Medicine and Dentistry, Lahore, Pakistan. Duration: One month. Methodology: A self-administered questionnaire was circulated amongst BDS, MBBS, and AHS students of FMH College of Medicine and Dentistry, Lahore, Pakistan. The responses were analyzed using SPSS version 20.0. Results: Dental students were superior to MBBS and AHS students in brushing frequency, electric toothbrush and water flosser use. Manual toothbrushes are more commonly used than electric toothbrushes in all three groups. More MBBS students believed that electric toothbrushes were better. Flossing proved unpopular. Toothpicks were the preferred interdental aid. Few students use water flossers. Mouthwashes are only used when needed. Most respondents were nonsmokers, but more BDS students smoked. Conclusion: Conclusion: Dental education in Pakistan impacts oral hygiene habits since dental students reported to have superior oral hygiene habits. More MBBS students believed electronic toothbrushes are superior to manual ones, indicating that BDS and AHS students require knowledge of electric toothbrushes. Keywords: Allied Health Sciences, Dental education; Dental students; Medical students; Oral hygiene practices.

Digital imaging and qPCR analysis and comparison of short-term plaque removal effects of tooth brushing

PurposeDigital image technology and a real-time fluorescent quantitative polymerase chain reaction (RQ-PCR) were used to determine the changes in dental plaque caused by different toothbrushing tools.MethodsA total of 120 subjects were selected and divided into four groups: a manual toothbrush group, a manual toothbrush combined with an oral irrigator group, an electric toothbrush combined with an oral irrigator group, and an electric toothbrush group. We compared the changes in plaque count, plaque area, and colony colonization of the four groups after different cleaning tools had been used for a period of time.ResultsDental plaque count and plaque area decreased in all four groups. The decreases in plaque count and Streptococcus mutans in the electric toothbrush combined with an oral irrigator group were significantly higher than those in other groups.ConclusionElectric toothbrush combined with an oral irrigator shows a good result for plaque removal effect. Digital image analysis combined with biological methods can be used to evaluate dental plaque.

Effect of A Fluoride Toothpaste Containing Enzymes and Salivary Proteins on Periodontal Pathogens in Subjects with Black Stain: A Pilot Study.

Black stain (BS) is an extrinsic dental discoloration particularly difficult to treat. Although its etiology is not fully clear yet, chromogenic bacteria inside the oral cavity seem to be involved. In this pilot study, we evaluated whether a toothpaste containing enzymes and salivary proteins could improve oral health and reduce the presence of periodontal pathogens in subjects predisposed to BS discoloration. Twenty-six subjects were enrolled in the study: 10 subjects without BS; 16 subjects with BS, randomly assigned in two groups: test (n = 8) and control (n = 8). The test group used a toothpaste containing sodium fluoride, enzymes, and salivary proteins. The control group used a toothpaste with amine fluoride. At enrollment and after 14 weeks, participants were subjected to professional oral hygiene, evaluation of BS (through Shourie index) and oral health status, collection of saliva and dental plaque samples. The presence of periodontal pathogens in plaque and saliva of all subjects was investigated by molecular analysis (PCR). The prevalence of investigated microbial species in patients with/without BS was performed by Chi-squared test. The variation in the prevalence of the investigated species after treatment in test and control group was analyzed by t-test. Clinical evaluation showed that 86% of participants with BS had a reduction in the Shourie index, independently from the toothpaste used. In particular, a greater reduction in the Shourie index was observed in subjects using an electric toothbrush. We did not observe an effect of the fluoride toothpaste containing enzymes and salivary proteins on the composition of the oral microbiota of the test subjects in comparison with controls. When comparing all subjects with BS (n = 16) and without BS (n = 10), P. gingivalis detection was significantly higher in saliva samples collected from subjects with BS (p = 0.0129). We verified that the use of an enzyme-containing toothpaste alone is not sufficient to prevent the formation of BS dental pigmentation in subjects predisposed to this discoloration. Mechanical cleaning, especially using electrical toothbrushes, seems to be useful to counteract BS formation. Moreover, our results suggest a possible association between BS and the presence of P. gingivalis at the salivary level.

Systematic Review and Meta Analysis of the Relative Effect on Plaque Index among Pediatric Patients Using Powered (Electric) versus Manual Toothbrushes.

Although many randomized controlled trials (RCT) have evaluated the efficacy of powered or electric toothbrushes compared with manual or traditional toothbrushes to remove biofilm and plaque, only one systematic review has been published for pediatric patients. The primary objective of this study was to perform a systematic review and meta analysis for this population. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, N = 321 studies were initially identified. Three independent, blinded abstract reviews were completed resulting in a total of n = 38/322 or 11.8% for the final analysis (n = 27 non-orthodontic, n = 11 orthodontic studies). Meta analysis of these outcome data have revealed a strong reduction in plaque index scores among pediatric patients using electric toothbrushes of approximately 17.2% for non-orthodontic patients and 13.9% for orthodontic patients. These results provide strong clinical evidence for recommending electric toothbrushing to pediatric patients, as well as those patients undergoing orthodontic therapy and treatment.

Experimental and numerical responses of fibroblast and epithelial cells to the frequency of electric toothbrush

In the oral environment, fibroblast and gingival epithelial cells undergo distinct forces. Chewing, brushing, or force interactions with dental materials like implants can produce these forces. The behavior and response of these cells to forces are determined by their stiffness. Additionally, this behavior can be crucial in mechanosensory and tissue development. In this study, after being cultured using nanomagnet materials, fibroblast and epithelial cells were subjected to magnetic tweezers cytometry testing, and the viscoelastic model was used to determine their stiffness. The reaction of single gingival cells was modeled by determining the stiffness of cells at Gel Point frequencies and the operating frequency of electric toothbrushes and employing the Finite Element Method (FEM). Epithelial cell and fibroblast gel points took place at frequencies of 5Hz and 3Hz, respectively. At these frequencies, the behavior of cells is both quasi-solid and fluid. In addition, the findings of the finite element analysis demonstrated that the cells undergo a greater degree of deformation at the Gel point frequency compared to the operating frequency of toothbrushes. This quantity was approximately 331 times greater in epithelial cells, which reached a maximum of 7.114 μm. Additionally, the maximal fibroblast cell deformation at 3Hz frequency was determined to be 2.981 μm, which is roughly 117 times that at 150Hz frequency.

A review and comparison of control charts for ordinal samples

Qualitative, more specifically, ordinal data generating processes are common in real-world process control implementations. In this study, a survey of control charts for the sample-based monitoring of independent and identically distributed ordinal data is provided together with critical comparisons of the control statistics, for memory-less Shewhart-type and for memory-utilizing exponentially weighted moving average (EWMA) and cumulative-sum types of control charts. New results and proposals are also provided for process monitoring. Using some real-world quality scenarios from the literature, a simulation study for performance comparisons is conducted, covering sixteen different types of control chart. It is shown that demerit-type charts used in combination with EWMA smoothing generally perform better than the other charts, which may rely on quite sophisticated derivations. A real-world data example for monitoring flashes in electric toothbrush manufacturing is discussed to illustrate the application and interpretation of the control charts in the study.

Dentronics: Tooth cleaning with a tactile, collaborative robot. An in vitro proof of concept.

The aim was to compare the performance of a collaborative tactile robot programmed by a dental professional (DP) with the performance of a DP in removal of surrogate plaque In vitro. Six teeth of typodonts in articulated jaws were covered with surrogate plaque and cleaned by a DP with help of a manual toothbrush (DP/manual) and an electric toothbrush (DP/electric). The experiment was repeated with the help of a collaborative seven-axis tactile robot programmed by a DP handling a manual toothbrush (robot/manual) and an electric toothbrush (robot/electric). All experiment were repeated five times resulting in a total of N= 30 teeth in each group. Cleaning results were reported as the percentage of surface area with residual plaque. The cleaning results of the robot and the DP showed no significant differences. However, electric toothbrushing was significantly less effective compared to manual toothbrushing (p<0.05). This In vitro study indicates that current robot technology may perform removal of surrogate plaque as efficient as a DP. In future this may be helpful to release nursing staff from this time-demanding and possibly contagious task or support humans with reduced motor skills or impaired vision in performing daily oral hygiene.

Modular Product Architecture for Sustainable Flexible Manufacturing in Industry 4.0: The Case of 3D Printer and Electric Toothbrush

Integrating sustainability, a flexible manufacturing system, and Industry 4.0 resolves the issues of fluctuating market demand arising from customization requirements. Modular products allow flexibility to adapt to changing requirements and optimize resource utilization. In this study, a method was proposed and applied to two products, i.e., a 3D printer and an electric toothbrush featuring modular architecture, multiple product versions, and customization, to contribute to the development of sustainable flexible manufacturing systems. From the results of the two case studies nine modules were identified that contain specific functions and related interface information. From these modules, one platform was developed that comprises common entities used in all variants of the products. This platform was further extended to product families. From the modules, product architecture was developed that supports the product and process relationships. These relationships can be developed concurrently, enabling product features to be linked to the manufacturing setup. Thus, when a modular architecture is developed, the factory has to be reorganized accordingly, or reconfiguration is possible. Hence, the main aim of the research was to develop modular product architecture to identify product and process relationships for a sustainable flexible manufacturing system.

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

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.

Portable detection of multiple mycotoxins based on a sonic toothbrush, microfluidic chip and smartphone.

A portable method for on-site detection of three mycotoxins was developed based on a sonic toothbrush, microfluidic chip and smartphone. Our method could complete all procedures, including sample pretreatment, signal conversion and processing, without any sophisticated instruments. The limits of detection for these mycotoxins were lower than the limit values in cereals in the standards of China and the European Union.

Effectiveness of subgingival irrigation and powered toothbrush as home care maintenance protocol in type 2 diabetic patients with active periodontal disease: A 4-month randomized controlled trial.

There is a bidirectional link between diabetes and periodontal disease. Control of active periodontal infection is an essential requisite to maintain optimal oral and systemic health in diabetic patients. The purpose of this study was to evaluate the efficacy of subgingival irrigation and powered toothbrush as home care maintenance protocol in type 2 diabetic patients with active periodontal disease compared to routine oral hygiene. Forty (n = 40) diabetic (HbA1c >7%) patients were enrolled in this parallel, examiner-blind, interventional clinical trial. Patients were randomized into two groups: Group A (sonic toothbrush and irrigation with water twice daily) or Group B (manual toothbrush and mouth rinsing with 0.12% Chlorhexidine gluconate (CHX) twice daily)). All patients received Phase I therapybefore the start of the study. Clinical parameters (plaque index [PI], gingival index [GI], oral hygiene index [OHI], pocket depth [PD], clinical attachment level [CAL], and bleeding index [BI]) were assessed at baseline, 1, 2, and 4 months. Levels of C-reactive protein (CRP), HbA1c, and interleukin (IL)-1 β were assessed at baseline and 4 months only. Verbal and written instructions were provided to each subject specific to their intervention allocation. Descriptive, parametric, and nonparametric analyses were used where appropriate. Sixteen (n = 16) patients in Group A and fifteen (n = 15) patients in Group B completed the 4-month study. Both groups showed a significant difference in BI, PD, CAL, and HbA1c from baseline to 4 months. There were no differences within groups for OHI, GI, or PI and CRP, IL-1 β. The results are based on an underpowered study due to the drop out of 9 patients reducing the number below the needed 19 patients per group based on the power analysis. Results from this study provide information for future studies on self-care regimens for individuals living with Type 2 diabetes.

Impact of Oral Health on Rheumatoid Arthritis

This is a narrative review describing how oral infections and diseases associate with rheumatoid arthritis. From the voluminous oral microbiom, bacteria can get access to circulation through inflamed periodontal tissue, oral mucosa, and carious teeth. This results in upregulation of a number of chemokines and cytokines that often cause chronic, subclinical systemic inflammation with consequent organ pathology. The periodontal pathogen Porphyromonas gingivalis was observed to cause citrullination of proteins that play a role in the development of arthritis by generating of specific autoantibodies such as anti-citrullinated peptide antibody. These migrate and form immune complexes at the synovial membrane of joints. In general, patients with rheumatoid arthritis should have a healthy mouth. Dry mouth is a symptom seen among many patients with rheumatic diseases, also rheumatoid arthritis. Because saliva is one of the principal defense factors of the mouth, hyposalivation renders the patient liable to oral diseases. Consequently, the patients must drink enough daily and use saliva substitutes when necessary, and, above all, maintain good oral hygiene daily. In rheumatoid arthritis, manual dexterity may be impaired, however, causing cleaning the teeth difficult. Hence, patients with rheumatic diseases like rheumatoid arthritis need counseling and individual oral health care instructions by oral health care professionals for implementation at home. An electric toothbrush should be recommended. Regular oral health examinations by dentists are needed more often than among the healthy.

Roughness assessment of colored compomers: Results after an erosive-abrasive in vitro cycling test.

The present in vitro study aimed to evaluate and compare the surface roughness of a colored compomer and a composite resin, after 15 days of erosive-abrasive cycling. The sample included ninety circular specimens, randomly divided (n = 10): G1 Berry, G2 Gold, G3 Pink, G4 Lemon, G5 Blue, G6 Silver, G7 Orange and G8 Green, referring to the different colors of compomer (Twinky Star®, VOCO, Germany) and G9 for composite resin (Z250®, 3M ESPE). The specimens were submerged in artificial saliva and stored at 37°C for 24 hours. After polishing and finishing, the specimens were submitted to initial roughness (R1). Then, the specimens were submerged in an acidic cola-based drink for 1 minute and then exposed to electric toothbrushing for 2 minutes for 15 days. After this period, the final roughness (R2) and the ΔRa were performed. Data were submitted to ANOVA and Tukey's test for intergroup comparison and paired T-test for intragroup comparison (p<0.05). Among compomers, the green color presented the higher/lower initial and final roughness values (0.94 ± 0.44, 1.35 ± 0.55) with lemon color presenting the most prominent real roughness increase (ΔRa = 0,74) whereas composite resin showed the lower values (0,17 ± 0.06, 0,31 ± 0.15; ΔRa = 0,14). All compomers, after the erosive-abrasive challenge, presented an increase in roughness values when compared to composite resin with a highlight to green tones. Key words:Compomers, composite resins, surface properties.

The contribution of the combined use of an electric toothbrush and specialized toothpaste for electric brushes to the dental health of young people aged 18—25 years

The contribution of the combined use of an electric toothbrush and specialized toothpaste for electric brushes to the dental health of young people aged 18—25 years

Beyazlatıcı Diş Macunlarının Kompozit Rezinlerin Mikrosertliğine ve Yüzey Pürüzlülüğüne Etkisi: Bir İn Vitro Çalışma

Objective: This study aimed to assess the effect of different types of whitening toothpastes on the microhardness and surface roughness of composite resins. Material and Methods: 120 discshaped samples each of Clearfil Majesty Esthetic and Gradia Direct Anterior composite resins were randomly assigned to 4 groups, based on the toothpaste used [three whitening toothpastes: Signal White Now (SWN), Colgate Optic White (COW), Ipana 3D White Luxe (IWL), and one non-whitening toothpaste: Sensodyne Promine (SP)]. The samples were brushed using an electrical toothbrush for 4 minutes. Before and after toothbrushing surface roughness (n=15) and Vickers microhardness (n=15) values were measured and the topography of the composite resins was observed using scanning electron microscopy. Data were analyzed using repeated measures analysis of variance and Bonferroni correction (p˂0.05). Results: The surface roughness was significantly affected by the toothpastes (p=0.013) and there was a significant interaction between toothpastes and composite resins (p˂0.001). The surface roughness of composite resins significantly increased after toothbrushing with all toothpastes. SWN and IWL showed significantly higher surface roughness values than SP (p=0.024 and p=0.028, respectively). There was a significant increase in the microhardness values for Gradia Direct Anterior after toothbrushing with SWN, IWL and SP (p=0.003, p˂0.001 and p=0.029, respectively). Conclusion: In this study, it was determined that all toothpastes increased the surface roughness values of Clearfil Majesty Esthetic and Gradia Direct Anterior, and all toothpastes (except COW) increased the microhardness values of Gradia Direct Anterior. Clinicians should notify patients of the abrasive capacity of all toothpastes, especially those that are whitening.

ПРОТОКОЛЫ ИНДИВИДУАЛЬНОЙ ГИГИЕНЫ РТА ПРИ ДЕНТАЛЬНОЙ ИМПЛАНТАЦИИ

Aim. Improving the quality of treatment of patients with defects in the dentition using orthopedic structures based on dental implants with development of individual oral hygiene protocols. Materials and methods. A survey of 82 patients using prostheses fixed on intraosseous dental implants was carried out. The results of treatment 5 years after the installation of implants were analyzed according to the criteria: the quality of oral hygiene and the presence of inflammation in the tissues surrounding the implant. Results. After fixation of prostheses based on dental implants, 73.2% of patients do not follow the recommendations on the oral care. Satisfactory level of oral hygiene in 57.3%, unsatisfactory - in 28.0% of patients using a manual toothbrush. The number of "successful" implants after 5 years is 41.5%, removed - 7.3%. Tissue inflammation was found in 36.5% of implants. Protocols for individual oral hygiene of patients using a toothbrush have been developed: before implantation; after surgery implantation early period; after implantation surgery late period; after completion of implant-supported prosthetics. Conclusions. The use of the toothbrush in the treatment of patients before and after dental implantation is a promising direction in improving its immediate and long-term results. The interactive functions of electric toothbrushes are considered as a tool for motivation and control of oral hygiene. The functionality of the toothbrush greatly simplifies hygienic care in hard-to-reach areas of dentures. The presence of seven modes and two nozzles helps to provide individual approach to oral hygiene, depending on the condition of the tissues.

Efficacy of a new sonic powered toothbrush versus a manual toothbrush in a young population. A randomized cross-over clinical trial.

To compare the effectiveness of dental plaque removal between a new sonic toothbrush and a manual toothbrush. In total, 75 healthy dental students participated in this randomized double-blind crossover clinical trial. Subjects were randomly assigned to one of the two groups (manual or sonic toothbrush) and underwent a single toothbrushing exercise. Seven days after, patients were asked to repeat the same procedure with the other toothbrush. Plaque scores were recorded before and after brushing. A significant mean reduction in the full-mouth plaque index was observed after the use of both type of brushes: 46.2% ± 0.28% (p=0.000) and 50.5% ± 0.24% (p=0.000) for the manual and sonic toothbrush, respectively. However, there were no statistically significant differences between the two types of brushes (p=0.277). Regarding plaque reduction on the distinct tooth surfaces, differences between the groups reached statistical significance in favour of the sonic toothbrush only on the buccal sites (p=0.003). Both devices lead to similar plaque score reduction after a single tooth brushing.