Efficacy of manual and powered toothbrushes (I). Effect on clinical parameters

Background/aim: The purpose of the present investigation was to compare man ual (Crest Complete) and powered toothbrushing (Braun Oral-B 3D Plaque Remo ver) for their ability to affect clinical parameters of periodontal disease s. Methods: 48 periodontal maintenance subjects completed this single-blind 6- month longitudinal study. Subjects had a minimum of 20 natural teeth exclud ing third molars and > 10% of sites (approximately 17 sites) with pocket de pth greater than or equal to4 mm and/or > 10% sites with attachment level > 4 mm. At baseline, subjects received full mouth clinical measurements (168 sites) to determine mean Plaque Index, Gingival Index, pocket depth and att achment level and % of sites exhibiting BOP. Subjects were then randomly as signed to one of two groups. The control group (N=26) used a manual toothbr ush while the test group (N=22) used a powered toothbrush, Subjects receive d instruction in oral hygiene and used their assigned toothbrush twice dail y according to instruction. Follow-up clinical assessments were performed a t 3 and 6 months. Significance of differences in clinical measures over tim e was determined using the Quade test and between brushing groups at each t ime point using the Mann-Whitney test. Results: Mean pocket depth, mean plaque index and % of sites exhibiting BOP showed significant reductions from baseline to 3 and 6 months in both grou ps. Mean probing attachment level and mean Gingival Index were significantl y reduced in the powered brushing group only. There was a significant posit ive correlation between plaque reduction and reduction in other clinical pa rameters in both brushing groups. The majority of subjects showed improveme nts in clinical parameters at 6 months, although a greater proportion of su bjects in the powered group showed a reduction in Plaque Index (77% versus 65%) and in % sites exhibiting BOP (82% versus 69%). Mean pocket depth and mean attachment level showed significantly greater reductions between basel ine and 6 months in lingual and mandibular areas in the powered group. Conclusions: Both manual and powered toothbrushes reduced pocket depth, pla que index and BOP, The powered toothbrush significantly reduced mean gingiv al index and probing attachment level. The greatest benefit of the powered brush was at mandibular and lingual surfaces.