Stimuli-responsive piezoelectric orthodontic adhesives for smart biofilm control.

Purpose: Comparative evaluation of manual, electric, sonic and ultrasonic toothbrush effectiveness on children's gingival status. Material and methods: The study involved 106 children aged 11 to 13 years, divided into four groups according to the type of toothbrush used. A group based preventive program for motivation and training was developed for each type of toothbrush. The program was assessed over four visits, during which the gingival status was recorded at each visit using the Full Mouth Bleeding Score (FMBS) index with the aid of an electronic periodontal probe. Results: Values of bleeding on probing were reduced by half (baseline FMBS -26-29% to 14% at the end of study) at the end of the study in all study groups. Conclusion: The establishment of effective oral hygiene behaviors through comprehensive instruction in the appropriate use of various toothbrush modalities is fundamental to the maintenance of gingival health in children.

The aim of the study was to analyze the adhesion of microorganisms to the surface of removable plastic dentures, depending on the method of their cleaning, in order to determine the optimal method of hygienic care for the prosthesis. Blocks of basic plastic were made and the operating and cleaning conditions of removable dentures were modeled in various ways. Among the hygiene items considered was a manual toothbrush, an electric one, and an ultrasonic one. Soap, hygienic toothpaste, whitening toothpaste, as well as tablets for cleaning removable dentures were used with each hygiene item. Next, the degree of adhesion of a number of microorganisms to the surface of the prepared plastic blocks was investigated, the number of microorganisms was counted and the statistical processing of the results was carried out. Among the hygiene items, an ultrasonic toothbrush is the best option, and among the hygiene products, the best result was recorded when using tablets for cleaning removable dentures. In cases of chronic infectious diseases of the denture-bearing area, the hygiene method should be selected individually.

BackgroundThe low-level laser therapy (LLLT) and low-intensity pulsed ultrasound (LIPUS) have been recently applied to control pain during orthodontic treatment.ObjectiveTo evaluate and compare the effectiveness of LLLT and LIPUS in reducing pain induced by orthodontic separation.Study designA single-blinded randomized controlled trial.MethodsOne hundred and fifty patients were randomly assigned into three groups; LLLT group, LIPUS group, and control group. After 5 min from the separators’ placement, the first dose of the laser or the ultrasound was applied, the second dose was applied after 24 h, and the third dose was applied after 48 h on both maxillary and mandibular first molars. The exposure of laser was for 20 s at each point (maxillary and mandibular first molars), with an 810-nm aluminum-gallium-arsenide (AlGaAs) diode laser on continuous mode. The output power set at 150 mW, the energy density of 4 J/cm2, and a laser spot diameter of 7 mm were applied. Whereas the frequency of ultrasonic toothbrush was 1.6 MHz; and average output intensity was 0.2 W/cm2. The application was for 20 min (5 min on each first molar). The control group received the separators without another intervention. A Visual Analog Scale (VAS 100 mm) was used to assess pain intensity at several time intervals during the first four days after the separators’ placement.ResultsA total of 145 patients were assessed. There was a significant difference in pain perception among the three groups after 5 min (P = .002). The maximum pain level was reached after 24 h. However, the laser group and the ultrasound group showed a statistically significant decrease in pain scores compared to the control group at all the assessment time points (P < .001). Whereas there was no difference between the laser group and the ultrasound group in reducing the pain scores (P > .05).ConclusionsThe LLLT and the LIPUS effectively reduce the separation pain when applied in multiple doses without differences between them.Trial registrationThis trial was registered with the German Clinical Trials Register (DRKS). (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID= DRKS00029991). Date of registration: 26/08/2022.

Abstract Biofilms are the chief culprits of most intractable infections and pose great threat to human health. Developing effective strategies to sweep away the detrimental microbe and stubborn biofilm still remains a challenge. Here, an ultrasound (US) activated microbomb is constructed by encapsulating perfluorohexane (PFH) and iron‐tannin modified calcium peroxide (CaO2‐TA‐Fe) in poly(lactide‐co‐glycolide) (PLGA) vesicles as the reactive oxygen species (ROS) generating reactors for dental biofilm elimination. Upon the US irradiation by ultrasonic toothbrush, the swiftly vaporized PFH can not only promptly explode the PLGA shell to facilitate the generation of H2O2 from CaO2, but also blast the tight biofilm for effective delivery of the lethal hydroxyl free radicals (•OH) caused by degradative Fe3+ from iron‐tannin network, thereby proceeding cascade catalysis eradication of biofilm. As a proof‐of‐concept, this study demonstrates the proposed synergetic paradigm that integrates the US‐triggered explosion with ROS‐induced sterilization for stubborn biofilm elimination, and is a promising tactic for the costly and prevalent caries prevention as well as the biofilm‐associated diseases treatments.

Introduction: The bacteria present in dental plaque are the main cause of caries, gum disease, and periodontal disease. Regular brushing will remove plaque build up and maintain the oral health. An ultrasonic toothbrush is an electric toothbrush which is designed for daily home use which operates by generating ultrasound waves to help in removing plaque and rendering plaque bacteria harmless.&#x0D; Aim: The aim of the present study is to assess the effect of sonic toothbrush in reducing the plaque pathogens in comparison with the normal brushing.&#x0D; Materials and Methods: Volunteers who use sonic toothbrushes were selected as a study population. The swab samples were collected before and after brushing. The collected swabs were inoculated on BHI agar and the total CFU count was checked.&#x0D; Results and Discussion: The percentage reduction in case of ultrasonic toothbrush was more (86.82%) when compared to the manual brushing making it efficient in reducing plaque pathogens.&#x0D; Conclusion: The present study concludes that the ultrasonic or the sonic toothbrush is efficient on plaque pathogens on the tooth surface.

Simple SummaryPoor oral health is a common problem in dogs and can cause them pain and impaired welfare. In this study, four different devices used for active dental home care were examined: two toothbrushes, manual and ultrasonic; and two textile products, a nylon glove and a microfiber finger cloth. These pieces of equipment were evaluated for efficacy against gingivitis, plaque, and tartar, using twenty-one beagle dogs. The dogs had their teeth cleaned once a day during five weeks. Each dog received two treatments (toothbrushes or textiles) but on separate sides of the mouth, right and left, respectively. The dogs’ oral health was assessed before and after the five-week period, by a veterinarian not aware of treatment. Each device improved the oral health in the dogs, reducing plaque and gingivitis. Furthermore, the amount of calculus also decreased in some individuals. The study also assessed the dogs’ stress, fear and anxiety levels during treatment using a (fear, anxiety, stress (FAS) protocol. The assessment of the stress levels in the dogs showed that adaptation occurs in the dogs subjected to daily dental care. These results can be used by veterinary staff who want to inspire and encourage dog owners to start brushing their dog’s teeth.Poor oral health is a common problem in dogs causing pain and impaired welfare. The gold standard to maintain good oral health and prevent periodontitis is daily tooth brushing. However, many dog owners find it difficult, and dogs often show aversive behavior. There are several different tools available, and in this intra-subject study, four different active dental home care treatment options were examined: manual and ultrasonic toothbrush, a nylon glove, and a microfiber finger cloth. The treatments were evaluated for efficacy against gingivitis, plaque, and calculus in beagle dogs. Each dog received two treatments on the buccal sides of the teeth once daily, either two types of toothbrushes (N = 10) or two types of textiles (N = 11), on separate sides of the mouth. The dogs’ teeth were assessed before and after the five-week treatment period, with the assessor blinded by additional, similar dogs (N = 7). The study also assessed the dogs’ stress levels during treatment using a fear, anxiety, stress (FAS) protocol. All four treatments improved dog oral health, reducing gingivitis and plaque. Furthermore, the amount of calculus also decreased in some individuals. Adaptation to dental care occurred in the dogs over time. This information can be used to encourage dog owners to brush their dogs’ teeth.

Aim: To evaluate the effect of manual (M), electric (E) and ultrasonic (US) toothbrushes on the removal of oral biofilm and control of gingivitis. Also, the roughness and tooth wear production were evaluated in vitro. Methods: For the in vitro analyses, thirty bovine dentin specimens were submitted to a 3-month brushing simulation (9 minutes) with the three types of toothbrushes (n = 10). Subsequently, a randomized controlled clinical trial was performed with 36 patients divided into 3 groups according to the toothbrushes used (n = 12). Gingival index, visible plaque index and the volume of crevicular fluid were evaluated at baseline and 3 months after the beginning of the toothbrush use. Furthermore, the performance of the biofilm removal per brushing cycle of 1 and 3 minutes with each toothbrush was made monthly until the end of the experiment. Results: The US group had the highest dentin wear. Clinically, the US group had a lower plaque index at 3 months than the M group. The M group also showed less biofilm removal efficiency from the second month of follow-up and more worn bristles at the end of the 3 month period than the E and US groups. Conclusion: The ultrasonic, electric and manual toothbrushes showed no differences in gingivitis control in the present study. The ultrasonic and electric toothbrushes had a more significant effect on biofilm removal than a manual toothbrush, but the ultrasonic toothbrush promoted greater dentin tissue wear.

Background:Adequate plaque control facilitates good gingival and periodontal health, prevents tooth decay, and preserves oral health. Toothbrushing is the primary method of removing plaque and can be classified into powered and manual toothbrushes.Aim:The primary objective was to compare the abrasiveness and surface roughness caused by four different power-driven toothbrushes with a different mode of action, on tooth surfaces in vitro.Materials and Methods:An in vitro experiment was conducted on eighty freshly extracted tooth specimens which were equally divided into four groups. Each group was brushed with the specifically assigned electric toothbrush to that group, but keeping parameters such as force applied during brushing, storage of tooth before and after brushing, and toothbrushing time same. A total of the 2-month study was done on each tooth specimen. Tooth surface roughness was recorded before and after the toothbrushing experiment to check the difference between surface roughness readings. Scanning electron microscopic (SEM) analysis was done afterward to analyse the surface topography of each group specimens.Statistical Analysis Used:Paired t-test used for intergroup analysis and intragroup analysis was done using Kruskal–Wallis test.Results:After comparing the baseline and final readings of each group, it has been found that the mean difference between values is highly significant in Group 1 (rotary/oscillatory). The mean rank of Group 1 was least in all four groups, which showed the highest tooth surface abrasion in that group. SEM analysis also revealed that Group 1 tooth specimens had deeper scratches/lines comparatively to other groups.Conclusion:Rotary/oscillatory toothbrush caused the highest tooth surface abrasion when compared with other electronic toothbrushes.

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.

To study the effect of toothbrushes of various types on the accumulation of plaque and the proteolytic potential of gingival fluid as a pathogenic factors in long-term orthodontic treatment of patients with a distal permanent bite. We examined 63 patients of both sexes aged 11-18 years. Orthodontic treatment was carried out for the close position of the teeth with a distal permanent bite (K07.2) and cleft palate and lips (Q37.1). Patients were divided into three groups depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, «Spazzolificio Piave», Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush ("Oral-B Pro-Expert, «Procter & Gamble», USA). The amount of soft plaque was assessed by the Silness-Loe hygiene index in the subgingival region. The activity of proteolytic enzymes - elastase, collagenase, and a α-inhibitor of proteinases was determined by the enzymatic method using a XL 200 biochemical analyzer («Erba Lachema», Czech Republic). The accumulation of plaque in the gingival region on both jaws during the entire period of orthodontic treatment is most pronounced when using a manual brush compared to ultrasonic and electric brushes. An increase in proteolytic activity in the gingival fluid with a simultaneous decrease in antiprotease potential with long-term orthodontic treatment of patients was observed when using a manual orthodontic brush, which can be regarded as an increase in the activity of the pathogenic factors for the development of local inflammatory and destructive changes. To prevent inflammatory and destructive changes during prolonged orthodontic treatment of patients, the use of ultrasonic and electric toothbrushes in daily oral hygiene is justified.

The aim of the study was to determine the likelihood and frequency of complications, the impact of the use of various types of toothbrushes in the dynamics of orthodontic treatment with fixed appliances in patients with a distal permanent bite. The clinical study was conducted on 63 patients of both sexes, aged 11-18 years. Patients received long-term orthodontic treatment for a close tooth position with a distal permanent bite (K07.2) and cleft palate and lip (Q37.1). Three groups were conditionally distinguished depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, Spazzolificio Piave S.p.A, Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush (Oral-B Pro-Expert, Procter & Gamble, USA). According to the Kaplan-Meier method, the probability of developing complications of orthodontic treatment was calculated as patients wear braces, and the impact on the effectiveness of orthodontic treatment of using toothbrushes of various types was evaluated. A frequency analysis of the complications of orthodontic treatment for the entire period of wearing fixed orthodontic structures revealed a difference only in respect to enamel demineralization. In group 1, enamel demineralization was more common (42.9%) compared with 2 (9.1%) and 3 (25%) groups (p=0.039). The likelihood of developing gingivitis was higher in group 1, the timing of the development of inflammatory processes in periodontium was also shortened in group 1 compared with groups 2 and 3. The frequency and timing of the development of gingivitis and enamel demineralization depended on the type of toothbrush used in daily oral hygiene. A marked deterioration in the oral hygiene during orthodontic treatment using a manual brush was accompanied by a more frequent development of gingivitis and enamel demineralization.

ABSTRACTAim and objectiveThis study aimed to compare the plaque removal efficacy of different toothbrushes and to ascertain the most efficient mechanical mean for daily plaque removal so as to maintain oral health in a preeminent way.Study designIt was a randomized controlled clinical trial consisting of 60 subjects divided into three groups (group I ultrasonic and sonic toothbrush, group II multidirectional toothbrush, and group III manual toothbrush) with 20 in each group. Prebrushing and postbrushing plaque scores were recorded at weekly intervals for four weeks using Turesky modification of Quigley and Hein plaque index.ResultsStatistically significant differences (p < 0.001) existed in mean percent reduction of pre-day 1 to pre-day 28 mean percent reduction in plaque values of the ultrasonic toothbrush group (111.92 ± 25.20), the multidirectional toothbrush group (189.06 ± 52.70), and the manual toothbrush group (42.34 ± 14.77). Similar results were found in post-day 1 to post-day 28 mean percent reduction in plaque values.ConclusionGroup II (i.e., multidirectional toothbrush) showed maximum mean percent reduction in prebrushing and postbrushing plaque scores at the end of four weeks when compared with the baseline values followed by ultrasonic toothbrush and manual toothbrush.How to cite this articleAggarwal N, Gupta S, Grover R, et al. Plaque Removal Efficacy of Different Toothbrushes: A Comparative Study. Int J Clin Pediatr Dent 2019;12(5):385–390.

A Single-Brushing Study to Compare Plaque Removal Efficacy of a Manual Toothbrush, an Electric Toothbrush and an Ultrasonic Toothbrush

本研究は, 患者が超音波歯ブラシを購入し, 歯科衛生士などから口腔清掃指導を受けることなく独自に使用することを想定し, 超音波歯ブラシに添付された説明書を一読しただけで, どの程度のプラーク除去効果が得られるかを手用歯ブラシのプラーク除去効果と比較検討した。被験者は日本大学歯学部付属歯科病院の事務職員, 男性10名, 女性20名で, 過去に口腔清掃指導を受けたことがない者とした。研究開始より1週目は手用歯ブラシを, 2週目は超音波歯ブラシを使用した。両歯ブラシを使用した際のO'Learyらのプラークコントロールレコード(PCR)は, 手用歯ブラシ(47.2±10.9%)と超音波歯ブラシ(45.0±13.5%)との間で統計学的有意差は認められなかった。部位別のPCRも両歯ブラシ間に有意差は認められなかった。超音波歯ブラシにおいてPCRの低い人は, 手用歯ブラシにおいてもPCRは低く, 超音波歯ブラシにおいてPCRの高い人は手用歯ブラシでもPCRが高いという結果が得られ, 手用歯ブラシと超音波歯ブラシのPCRに統計学的に有意な相関関係が認められた(P<0.01)。本結果から, 手用歯ブラシから超音波歯ブラシに変更する際に説明書を一読しただけでは, 有意な口腔清掃効果の改善はみられず, 口腔清掃用具の選択よりもブラッシング手技の向上が, 口腔清掃の改善に重要であることが示唆された。日本歯周病学会会誌(日歯周誌)53(3) : 191-196, 2011

An ultrasonic toothbrush for daily oral hygiene application is disclosed, having an ultrasound transducer in direct contact with the fluids in the oral cavity, without ultrasound energy attenuation between the transducer and the fluids in the oral cavity. Maximum level of ultrasound energy coupled to the fluids within the oral cavity and to the teeth and gums and periodontal pockets, achieving maximum loosening of soft plaque. Toothbrush configurations of ultrasonically enhanced manually operated toothbrushes and motorized toothbrushes having lateral direction sonic frequency vibrating brush heads emitting ultrasonic energy are disclosed. To generate the sonic frequency lateral vibration of the brush head, a motion transducer is utilized. Removable and user replaceable brush heads are described. In the various configurations low voltage DC energy supplied by a battery is converted to ultrasonic frequency DC current to activate the ultrasonic transducer. All configurations are utilizing bristle tufts to effectively dislodge plaque loosened by the ultrasonic waves from the surfaces of teeth and gums.

Clinical Effects of Ultrasonic Toothbrush for Patients with Chronic Periodontitis

Aim: This was to compare the incidence of bacteraemia following toothbrushing using ultrasonic, powered or conventional manual children’s toothbrushes. Methods: Healthy subjects (11), aged 18 to 45 years, attending the Leeds Dental Institute were recruited. Subjects attended three separate appointments, during which they had their teeth brushed with a conventional manual toothbrush (CMT), a powered Braun-Oral B toothbrush (PBT) or a Sonicare Optima ultrasonic toothbrush (STB). Venous blood samples were taken immediately before, 30 secs and 2 mins after brushing. Blood and saliva samples collected prior to tooth brushing, all samples were immediately processed for microbiological analysis. Results: An increase in the incidence of bacteria in blood samples followed the use of all types of toothbrush. The highest incidence of bacteraemia (8/11 subjects) was following brushing with powered toothbrushes, which was significantly (p<.025) greater than that following brushing with ultrasonic (5/11) or manual (5/11) toothbrushes. There was no significant difference in salivary total bacterial counts comparing all individuals, so this had little bearing on subsequent development of bacteraemia. Conclusion: Brushing with a powered toothbrush resulted in a transient bacteraemia more frequently than brushing with a manual or ultrasonic toothbrush and may affect children with congenital heart defects at risk of bacterial endocarditis.

This review of the literature intends to evaluate the effect of brushes with high frequency motion when compared with manual toothbrushes regarding the indices of plaque and gingival bleeding. Patients presenting gingivitis and/or chronic periodontitis were evaluated in addition to patients having osseointegrated implants and fixed orthodontic appliances. Pertinent literature was reviewed to select articles according to previously defined inclusion criteria. In the assessed studies results showed significant decreases in plaque and gingival indices by utilization of both types of brushes. However, in the selected studies where sonic brushes were tested in orthodontic and dental implant patients there was a more significant decrease in the indices. Furthermore, there was no indication of gingival recession attributed to product use. Future studies with a more homogeneous methodology and better experiment designs will be needed.

This crossover study compared the efficacy of an ultrasonic toothbrush for the reduction of plaque, gingival inflammation, and levels of Streptococcus mutans, in relation to an electric and a manual toothbrush. Twenty-one patients with orthodontic appliances were divided into three groups. All patients were evaluated by a periodontist and samples of saliva were collected for quantification of S mutans. The patients received their first brushes with appropriate instructions. For each crossover leg, patients used each toothbrush for a period of 30 days. At the end of each washout period, participants received a periodontal evaluation and new samples of saliva were collected. After 15 days of using their own toothbrushes, patients received the next toothbrushes in the experimental sequence. The ultrasonic brush group presented significant improvement in the reduction of visible plaque on the buccal surfaces (-6.36%, P = .007). The counts of S mutans decreased in the electric (2.04 x 10(5) to 1.36 x 10(5) colony-forming units [CFU]/mL) and ultrasonic (2.98 x 10(5) to 1.84 x 10(5) CFU/mL) groups. There were no statistical differences among the three brushes for the clinical and microbiological parameters evaluated. This study did not demonstrate that the ultrasonic toothbrush was better in reducing gingival inflammation in adolescent orthodontic patients, but plaque scores were lowered on buccal surfaces of teeth with orthodontic brackets. In addition, S mutans counts were markedly decreased in the electric and ultrasonic groups, which should be related to a reduced risk of oral disease.