COMPARATIVE-STUDY OF ELECTRIC AND MANUAL TOOTHBRUSHES IN PATIENTS WITH FIXED ORTHODONTIC APPLIANCES

The objective of this three treatment, three period, single blind, cro ss-over trial was to evaluate the efficacy of three toothbrushes in a cohort of children undergoing fixed appliance orthodontic therapy. The brushes used were: (1) Dental Logic HP550 with regular brush head HP5 924 (Philips, U.K.); (2) Braun Oral B Plaque Remover (D7) with dedicat ed orthodontic brush head OD5-1 (Braun AG, Germany); and (3) a manual dedicated orthodontic toothbrush (P35, Oral B Laboratories, Calif.). S ixty orthodontic patients, aged 10 to 16 years and wearing upper and l ower fixed appliances, were screened and recruited with parental conse nt. After an oral soft tissue examination at baseline, the percentage of plaque-covered tooth surfaces and gingival bleeding sites were reco rded using visible plaque and gingival bleeding indexes. Each subject was randomly allocated to one of three groups (n = 20) with brushing s equences 1-2-3, 2-1-3, 3-2-1.The first brush was given 2 weeks after b aseline (visit 1). The time interval for using each brush was 4 weeks at the end of which visible plaque and gingival bleeding indexes were recorded and a further prophylaxis given. Statistical analysis was und ertaken with analysis of variance. Data were analyzed on a site-specif ic basis; buccal smooth and interproximal surfaces, lingual smooth and interproximal surfaces. At baseline the mean visible plaque index for all subjects were; buccal smooth, 52.5% (+/- 22.5%); buccal interprox imal, 70.5% (+/- 18.5%); lingual smooth, 68.5% (+/- 21%); lingual inte rproximal, 76% (+/- 16%). At visit 1,the plaque scores at all surfaces had reduced significantly compared to baseline, but there had been no active treatment. This was attributed to a Hawthorne effect. Subseque ntly, there were no significant effects on visible plaque (or gingival bleeding) indexes with any toothbrush at any tooth surfaces. This sug gests that the new HP550 is equally effective as specifically designed orthodontic toothbrushes in removing plaque from patients with fixed orthodontic appliances.