Oscillating-rotating Toothbrush Research Articles

Cleansing efficacy of the electric toothbrush Oral-B® iO™ compared to conventional oscillating-rotating technology: a randomized-controlled study

ObjectivesThis study aimed to compare the cleansing efficacy of the Oral-B® iO™ electric toothbrush incorporating oscillating-rotating technology with microvibrations - with a traditional oscillating-rotating toothbrush.Materials and methodsThirty adult participants were randomly assigned to use the iO™ electric toothbrush with the brush head iO™ Ultimate Clean or the traditional oscillating-rotating toothbrush Oral-B® Genius® with the Cross-Action brush head. Oral hygiene indices (Rustogi Modified Navy Plaque Index and Gingival Bleeding Index) were assessed before and after 28 days of home use of the assigned product. Participants were instructed to refrain from interdental hygiene during the study period. After a 2-week washout period, the clinical investigation was repeated in a crossover design.ResultsAll 30 participants completed the study with no dropouts. After 28 days of use, the iO™ showed statistically significantly lower plaque levels than the conventional oscillating-rotating toothbrush (25.09% vs. 30.60%, p = 0.029). This difference was particularly noticeable in marginal and approximal areas. There were no significant distinctions in gingival bleeding indices.ConclusionsThe Oral-B® iO™ electric toothbrush displayed enhanced plaque removal efficiency compared to a conventional oscillating-rotating technology.Clinical relevanceThis study highlights the potential benefits of advanced toothbrush technologies for plaque reduction and encourages further research.

The Effect of Different Electric Toothbrush Technologies on Interdental Plaque Removal: A Systematic Review with a Meta-Analysis.

The removal of dental plaque from the gingival margins of the teeth is essential to maintaining periodontal health. Whilst it has been established that electric toothbrushes demonstrate a greater ability to remove plaque, no systematic review has specifically investigated which technology is better for removing plaque from the interdental tooth surfaces, where plaque control may be more difficult. Three databases were searched until October 2023: MEDLINE and DOSSS via EBSCOhost and Embase. Data extraction was carried out on studies which met the inclusion criteria, and a risk of bias assessment was completed. The study findings were combined via a narrative synthesis and a meta-analysis where appropriate. A total of 77 studies were found, out of which 14 were selected and included in the analysis. The mean difference in interproximal plaque reduction, measured using the Rustogi Modified Naval Plaque Index (RMNPI) at 8 weeks, was 0.09 (p < 0.00001) in favor of the oscillating-rotating toothbrush. At 6 and 12 weeks, the mean difference in plaque reduction (RMNPI) was 0.05 (p = 0.0008) and 0.04 (p = 0.0001) in favor of the oscillating-rotating toothbrush, respectively. The studies show a tendency for oscillating-rotating toothbrushes to remove more interproximal plaque than oscillating toothbrushes, especially in a short time (8 weeks).

Droplet Sizes Emitted from Demonstration Electric Toothbrushes.

The COVID-19 pandemic has drawn attention to microbial transmission risk via aerosols in dental practice. Demonstration electric toothbrushes are used intra-orally for education. The aim of this investigation was to measure the size of droplets emitted by the brush head of two demonstration oscillating-rotating electric toothbrushes. Measurement of droplet production and size was recorded in vitro using three methods: (1) Malvern Spraytec (LASER particle size measurement device with detectable particle size of 0.1–2500 µm) and brushes mounted on a 3D-printed, two-shell form-fit fixture with a supply of tap water; (2) a DustTrak aerosol measurement device and toothpaste slurry, with brushing simulated in the oral cavity of a phantom head; (3) high-speed visualization in a simulated-use situation in the oral cavity of a phantom head, with individual evaluation of tap water, water with detergent, 70% ethanol, glycerin and toothpaste slurry. Both brushes showed the size of emitted droplets was consistently between 200 and 1200 µm, categorized as splatter (dental aerosols are <50 µm diameter). No significant incremental aerosol-sized matter was detected during toothbrush operation. The high-speed video visualization confirmed only splatter-sized droplets during operation. These findings indicate that oscillating-rotating toothbrushes do not produce aerosol-sized particles during simulated use.

Accidental Oral Injuries by Electric Toothbrush: A Report of Three Cases

In recent years, electric toothbrushes have become widespread. However, injuries caused by electric toothbrushes have rarely been reported. We describe three cases of oral penetrating injuries caused by electric toothbrushes. Case 1 occurred in a disabled boy while brushing due to unexpected movement. In Case 2, a mother using an electric toothbrush had fallen when bumped by her child. Case 3 involved a man using the toothbrush while taking a bath, who slipped in the bathtub. Cases 1 and 3 were using sonic toothbrushes, and Case 2 was using an oscillating-rotating toothbrush. Electric toothbrushes can cause oral penetrating injuries and infections in the same manner as manual toothbrushes. Prevention of oral trauma requires familiarity with the form and function of electric toothbrushes. Some room for improvement remains in optimizing the form of electric toothbrushes.

Evaluation of an oscillating-rotating toothbrush with micro-vibrations versus a sonic toothbrush for the reduction of plaque and gingivitis: results from a randomized controlled trial

To compare a novel oscillating-rotating (O-R) electric rechargeable toothbrush with micro-vibrations to a marketed premium sonic toothbrush for reduction of gingivitis and plaque in an 8-week randomized controlled trial. Adult subjects with evidence of gingivitis and plaque were randomized to use either the novel O-R brush (Oral-B iO) or the sonic brush with sodium fluoride dentifrice twice daily. Assessments at baseline and week 8 included the Rustogi Modification of the Navy Plaque Index (RMNPI), Modified Gingival Index (MGI), and Gingival Bleeding Index (GBI). Gingivitis status ('healthy'/'not healthy') was classified per the American Academy of Periodontology/European Federation of Periodontology criteria. Ninety subjects were randomized to treatment and completed the study. Subjects had a mean age of 49.2years; 68 were females. At baseline, the mean number (standard deviation [SD]) of bleeding sites for all subjects was 32.8 (16.43). At week 8, the O-R brush group had a higher percentage of 'healthy' gingiva subjects than the sonic brush group (84% vs. 53% P=0.003). In the between-group comparisons at week 8, the O-R brush group showed statistically significantly greater reductions (P<0.001) compared to the sonic group for MGI, GBI, and number of bleeding sites. The O-R brush group also had statistically significantly greater plaque removal (P≤0.011) than the sonic brush group for whole mouth plaque as well as plaque in the proximal regions and along the gingival margin. The novel O-R electric toothbrush with micro-vibrations provided greater plaque and gingivitis reductions than the marketed premium sonic toothbrush over 8weeks.

An 8-week randomized controlled trial comparing the effect of a novel oscillating-rotating toothbrush versus a manual toothbrush on plaque and gingivitis

To compare a novel oscillating-rotating (O-R) electric rechargeable toothbrush with micro-vibrations (Oral-B iO) to a manual brush for gingivitis and plaque reduction. Adult subjects with gingivitis and plaque were randomized to use either the O-R or the manual toothbrush with standard fluoride dentifrice twice daily. Efficacy was assessed at baseline, week 1, and week 8 using the Rustogi Modification of the Navy Plaque Index (RMNPI), Modified Gingival Index (MGI), and Gingival Bleeding Index (GBI). Gingivitis status ('healthy'/'not healthy') was also assessed, per the American Academy of Periodontology/European Federation of Periodontology criteria. One hundred and ten subjects were enrolled and completed the randomized controlled trial. The baseline mean number (SD) of bleeding sites for all subjects was 32.11 (16.703). At week 8, 82% of subjects using the O-R toothbrush were categorized as 'healthy' (<10% bleeding sites), versus 24% of subjects using the manual brush (P<0.001). Subjects using the O-R toothbrush showed statistically significantly greater reductions (P<0.001) in the number of bleeding sites, GBI scores and MGI scores versus those using a manual toothbrush as early as 1week and throughout the 8-week study. The O-R toothbrush also provided statistically significantly greater reductions (P<0.001) in all plaque measures, including sub-regions, versus the manual toothbrush after a single brushing and at weeks 1 and 8. The novel O-R electric toothbrush with micro-vibrations provided statistically significantly greater plaque and gingivitis reductions versus a manual toothbrush, with performance benefits demonstrated after a single brushing and continuing throughout the 8-week study.

The Effects of Oscillating-Rotating Electric Toothbrushes on Plaque and Gingival Health

The Effects of Oscillating-Rotating Electric Toothbrushes on Plaque and Gingival Health

A randomized clinical trial to evaluate the plaque removal efficacy of an oscillating-rotating toothbrush versus a sonic toothbrush in orthodontic patients using digital imaging analysis of the anterior dentition.

To compare the plaque removal efficacy of an oscillating-rotating electric toothbrush with an orthodontic brush head versus a sonic toothbrush in adolescent patients with fixed orthodontic appliances. This was a randomized, examiner-blind, replicate single-use, two-treatment, four-period, crossover study with a washout period between visits of approximately 24 hours. Forty-four adolescent patients with fixed orthodontic appliances in both arches were randomized based on a computer-generated randomization schedule to one of four toothbrush treatment sequences. The primary outcome was plaque score change from baseline, measured using digital plaque imaging analysis. Baseline plaque levels for both brush treatments were high, covering more than 50% of the tooth area. Effective plaque removal was observed with both brush treatments (P < .001); however, the reduction in plaque with the oscillating-rotating toothbrush was statistically significantly greater (P = .017) compared with the sonic toothbrush. The study provides evidence for more effective plaque-removing efficacy of the oscillating-rotating toothbrush versus the sonic toothbrush among orthodontic patients.

Effectiveness and compliance of an oscillating-rotating toothbrush in patients with dental implants: a randomized clinical trial

BackgroundThe aim of this randomized clinical trial was to assess the efficacy of an oscillating-rotating toothbrush in reducing plaque and inflammation around dental implants.MethodsEighty patients presenting dental implants were enrolled in this study and assigned randomly to two different groups: 40 patients in the test group and 40 in the control one. Each patient in the test group received an oscillating-rotating toothbrush while in the control group patients kept using the manual toothbrush. Furthermore, the test group received a special toothbrush head designed for dental implants and another one for natural teeth. Domiciliary oral hygiene instructions were given to both groups. Periodontal parameters like plaque index (PI), bleeding on probing (BoP), and probing pocket depth (PPD) were recorded at the baseline and after 1 and 3 months.ResultsAt the end of the study, the difference of plaque and bleeding indices with the baseline was statistically significant for both test and control groups (P < 0.0001). Implant sites showed higher values of both BoP and PI when compared to the natural teeth. In the second part of the study, comparing the 1–3-month period, the oscillating-rotating toothbrush was effective in reducing new plaque formation (P < 0.0001) and bleeding (P < 0.0001) both at the implant sites and the dental sites comparing to manual ones (P > 0.05). No significant differences were appreciated concerning the PPD.ConclusionsThe oscillating-rotating toothbrush can be successfully used for the plaque and bleeding control of the peri-implant tissues.

A new tooth brushing approach supported by an innovative hybrid toothbrush-compared reduction of dental plaque after a single use versus an oscillating-rotating powered toothbrush

BackgroundAn innovative hybrid toothbrush was designed functioning either in manual mode, in powered mode (sonic) or in combined mode (manual and powered). The primary aim of this study was to evaluate and compare the clinical efficacy of this first hybrid toothbrush (Elgydium Clinic/Inava Hybrid) used in combined mode to a marketed oscillating-rotating powered toothbrush (Oral-B Vitality) in the reduction of dental plaque after a single use. The secondary aims were to evaluate the tolerance and acceptability of each device.MethodsIt was a randomized, examiner-blind, single-center study performed on two parallel groups: hybrid toothbrush (n = 33) versus oscillating-rotating toothbrush (n = 33). A brushing exercise was conducted for two minutes on subjects presenting a “Silness and Löe Plaque Index” (PI) between 1.0 and 2.0 and a “Modified Gingival Index” between 1.0 and 2.0. They were not to have ever used an electric toothbrush. To assess the device effect after brushing, a paired t-test was applied on the change outcome (After-Before brushing). An unpaired t-test was used to compare the efficacy of both devices. A global tolerance assessment of each powered toothbrush was done on all the subjects. The number and percentage of reactions related to each toothbrush was collected and the final tolerance assessment was estimated.ResultsAfter a single use, the hybrid toothbrush used in combined mode presented a global anti-plaque efficacy characterized by a significant decrease of the global PI of 45% on average (p < 0.0001; paired t-test). It was as effective as the oscillating rotating toothbrush in plaque removal (p > 0.05; unpaired t-test). The global tolerance of both toothbrushes was judged as “Good” and they were equally appreciated by the users.ConclusionThe results of this one-time use trial demonstrate the efficacy of the hybrid toothbrush used in combined mode for plaque removal. The hybrid toothbrush design allows each user to adapt tooth brushing to his preference (manual / sonic / combined), his skills or his mouth condition. We hypothesize that such an individualized approach can favor long term compliance with oral health recommendations and improve global oral wellness.Trial RegistrationISRCTN12394494, 20/02/2018 - Retrospectively registered.

Toothbrush abrasivity in a long-term simulation on human dentin depends on brushing mode and bristle arrangement.

ObjectiveThe aim of this study was to evaluate the susceptibility of dentin to brushing abrasion using four different toothbrushes (rotating-oscillating, sonic and two types of manual toothbrushes) with the same brushing forces.MethodsDentin samples (n = 72) were selected from 72 impacted third molars. Half of the surface of dentin samples was covered with an adhesive tape, creating a protected and a freely exposed area in the same specimen. Brushing was performed with either a: sonic (Sonicare PowerUp, Philips GmbH, Hamburg, Germany), b: oscillating-rotating (Oral B Vitality Precisions Clean, Procter & Gamble, Schwalbach am Taunus, Germany) or two different manual toothbrushes c: flat trim brush head toothbrush (Dr. Best: Original, Glaxo-Smith-Kline, Bühl, Germany) and d: rippled-shaped brush head toothbrush (Blend-a-Dent, Complete V-Interdental, Blend-a-med, Schwalbach, Germany) in a custom made automatic brushing machine. The brushing force was set to 2 N and a whitening toothpaste (RDA = 150) was used. The simulation period was performed over a calculated period to mimic a brushing behavior of two times a day brushing for eight years and six months. Dentin loss was quantitatively determined by profilometry and statistically analyzed by Wilcoxon and Mann-Whitney-U Test (p < 0.05).ResultsThe mean (standard deviation) surface loss was 21.03 (±1.26) μm for the sonic toothbrush, 15.71 (±0.85) μm for the oscillating-rotating toothbrush, 6.13 (±1.24) μm for the manual toothbrush with flat trim brush head and 2.50 (±0.43) μm for the manual toothbrush with rippled-shaped brush head. Differences between all groups were statistically significant at p<0.05.ConclusionUsing the same brushing force and a highly abrasive toothpaste, manual toothbrushes are significantly less abrasive compared to power toothbrushes for an 8.5—year simulation.

Gingival Margin Stability After Mucogingival Plastic Surgery. The Effect of Manual Versus Powered Toothbrushing: A Randomized Clinical Trial.

Oscillating-rotating power toothbrushes have been proven to be clinically efficacious. To the best of the authors' knowledge, a clinical evaluation of the safety of these toothbrushes after surgical root coverage procedures has not been published. The aim of this study is to evaluate the gingival margin (GM) stability with the use of an oscillating-rotating toothbrush compared with a manual toothbrush. Sixty healthy individuals with at least one Miller Class I or II gingival recession underwent a surgical root coverage procedure. Soft-bristle manual and powered toothbrushes were given to participants randomly assigned to control and test groups, respectively. Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), and recession depth (RD) were recorded at baseline and 1, 3, and 6 months after completion of the surgical procedure. Data analyses were performed using linear random-intercept models to take into account within-participant correlations over time. Temporal trend differences across treatments by including treatment-time interaction terms were then tested using a global Wald test. Use of a powered toothbrush resulted in a significantly greater reduction of recorded periodontal clinical indices compared with a manual device (FMPS, P = 0.05; FMBS, P = 0.005; RD, P = 0.004). No significant differences were noticed between the two experimental groups both for PD (P = 0.03) and clinical attachment level (P = 0.11). Complete root coverage was significantly higher in participants who used the powered toothbrush compared with the manual toothbrush at 6 months (control, 66.67%; test, 96.67%; P = 0.002). Use of an oscillating-rotating powered toothbrush with a soft-bristle head resulted in higher GM stability after root coverage procedures compared with the use of a manual soft-bristled toothbrush.

Comparison of Vertical and Inclined Toothbrush Filaments: Impact on Shear Force and Penetration Depth

This paper presents a semi-analytical model to describe the action of vertical and 16°-inclined toothbrush filaments onto flat tooth surfaces and into approximal areas. The theory is based on the analytical solution of the beam equation about normal and transversal (shear) forces that deform the filaments. A 15% increase of penetration depth (approximal area model) and a 60% increase of transversal force (tooth surface model) for an inclination angle of 16° compared to a vertical filament were determined. Furthermore, that 16°-inclined filaments are able to transfer higher shear forces to the tooth compared to vertical ones was shown experimentally, which could account for the higher efficiency of plaque removal by inclined filaments compared to vertical filaments. The theoretical findings for manual and oscillating-rotating toothbrushes are discussed, and implications for their design are drawn.

The safety of oscillating-rotating powered toothbrushes

PubMed-Medline, the Cochrane Central Register of Controlled Trials (Cochrane-CENTRAL), Embase, together with the reference lists of selected studies were searched. Both in vitro and in vivo studies were included with selection being undertaken by two reviewers with a third as arbiter if required. Human randomised clinical trials (RCT) or controlled clinical trials conducted in healthy subjects were included where, the intervention included a rechargeable, oscillating-rotating power toothbrush compared with a manual toothbrush control and a safety assessment was included. Similar criteria were used for in vitro studies. Two independent reviewers extracted the data with any discrepancies being decided by a third reviewer. Missing data were calculated and designated accordingly. Meta-analysis was performed where possible using a random-effects model. Thirty-five publications met the criteria. The mean change in gingival recession was not significantly different among toothbrush groups in the two selected trials with safety as a primary outcome (weighted mean difference: 0.03). A meta-analysis of the five trials that evaluated safety with a surrogate parameter was not possible; however, there were no significant between-group differences at the study end in any trial. A descriptive analysis of the 24 selected studies assessing safety as a secondary outcome revealed few brushing-related adverse events. The heterogeneity in objectives and methodology of the four in vitro trials that met the eligibility criteria precluded generalisation of the results. A large body of published research in the preceding two decades has consistently shown oscillating-rotating toothbrushes to be safe compared to manual toothbrushes, demonstrating that these power toothbrushes do not pose a clinically relevant concern to hard or soft tissues.

Safety of Oscillating‐Rotating Powered Brushes Compared to Manual Toothbrushes: A Systematic Review

Oscillating-rotating power toothbrushes have been proven clinically efficacious. To our knowledge, a comprehensive review of all clinical and laboratory investigations solely comparing the safety of these toothbrushes to the standard of care (i.e., manual toothbrushes) has not been published. The aim of this systematic review is to examine the literature concerning the relative soft and/or hard tissue safety outcomes with the use of oscillating-rotating toothbrushes compared to manual toothbrushes. With the use of electronic databases of the National Library of Medicine (PubMed-MEDLINE), the Cochrane Central Register of Controlled Trials (Cochrane-CENTRAL), and the Excerpta Medical Database (EMBASE), a search of in vivo and in vitro trials through May 2010 was conducted to identify appropriate studies that evaluated the effects of an oscillating-rotating power toothbrush compared to a manual toothbrush with respect to soft and/or hard tissue safety. Eligible trials incorporated a safety evaluation as a primary or secondary outcome parameter (i.e., gingival recession, observed/reported adverse events, and hard tissue effects) or used a surrogate parameter (i.e., stained gingival abrasion and brushing force) to assess safety. Data extraction for the primary- and surrogate-measure safety studies, which included mean values and SDs when available, and a meta-analysis of the gingival recession data were performed. Independent screening of the titles and abstracts of 697 PubMed-MEDLINE, 436 Cochrane-CENTRAL, and 664 EMBASE papers resulted in 35 publications that met the eligibility criteria. The mean change in gingival recession was not significantly different among toothbrush groups in the two selected trials with safety as a primary outcome (weighted mean difference: 0.03). A meta-analysis of the five trials that evaluated safety with a surrogate parameter was not possible; however, there were no significant between-group differences at the study end in any trial. A descriptive analysis of the 24 selected studies assessing safety as a secondary outcome revealed few brushing-related adverse events. The heterogeneity in objectives and methodology of the four in vitro trials that met the eligibility criteria precluded generalization of the results. A large body of published research in the preceding 2 decades has consistently shown oscillating-rotating toothbrushes to be safe compared to manual toothbrushes, demonstrating that these power toothbrushes do not pose a clinically relevant concern to hard or soft tissues.

A Prospective Clinical Study to Evaluate the Effect of Manual and Power Toothbrushes on Pre-existing Gingival Recessions

To evaluate gingival recession changes after six months of brushing with an oscillating-rotating power toothbrush (PT) or an ADA reference manual toothbrush (MT). Healthy subjects with pre-existing recession were assigned to brush with either a PT (n=55) or an ADA reference MT (n=54) according to a prospective randomized, controlled, single-blind, parallel group design. Participants were asked to brush their teeth twice daily for two minutes each with the same fluoride toothpaste. Clinical attachment loss and probing pocket depths (PPDs) were measured at six sites per tooth to the nearest mm by one calibrated examiner at baseline and after six months. Gingival recession was calculated as the differences between clinical attachment loss and PPDs overall and separately at individual sites. As compared with baseline, overall recession at six months was reduced from 2.35 +/- 0.35 mm to 1.98 +/- 0.55 mm (p<0.001) in the PT group and from 2.26 +/- 0.31 mm to 1.90 +/- 0.45 mm (p<0.001) in the MT group. The data showed 40% (power) and 38% (manual) of all recession sites improved by at least 0.5 mm while 51% and 54% remained unchanged. Eight percent and 7% recessions increased over time. Differences between groups were not statistically significant at either timepoint. Both the PT and the MT significantly reduced pre-existing gingival recession after six months of brushing. This may have been due to improved brushing technique (i.e., Hawthorne effect). Based on these six-month data, concern that power tooth brushing results in a higher risk for gingival recession is not warranted.