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VOLUME 6 , ISSUE 3 ( August, 2005 ) > List of Articles

RESEARCH ARTICLE

Plaque Removal Efficacy of a Prototype Manual Toothbrush versus an ADA Reference Manual Toothbrush with and without Dental Floss

Aaron R. Biesbrock, Robert D. Bartizek, Samer A. Bsoul, Geza T. Terezhalmy

Citation Information : Biesbrock AR, Bartizek RD, Bsoul SA, Terezhalmy GT. Plaque Removal Efficacy of a Prototype Manual Toothbrush versus an ADA Reference Manual Toothbrush with and without Dental Floss. J Contemp Dent Pract 2005; 6 (3):1-13.

DOI: 10.5005/jcdp-6-3-1

License: CC BY-NC 3.0

Published Online: 01-08-2005

Copyright Statement:  Copyright © 2005; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective

The objective of this study was to compare the plaque removal efficacy of a prototype manual Deep Clean toothbrush versus an American Dental Association (ADA) manual toothbrush and the ADA manual toothbrush in conjunction with floss.

Methods

This study was a randomized, examiner-blind, six-period cross-over, single-center study conducted in 60 adult subjects that examined plaque removal with a prototype Deep Clean manual toothbrush, an ADA reference manual toothbrush, and an ADA reference manual toothbrush followed by floss. During the course of this study, subjects used each treatment two times. Plaque was scored before and after brushing using the Rustogi Modification of the Navy Plaque Index. A mixed model analysis of covariance (ANCOVA) for a crossover design with baseline plaque score as the covariate was applied to the baseline minus one-minute post-brushing differences in average whole-mouth plaque scores. Supplemental analyses were also performed using the ANCOVA model separately for average gingival margin scores and for average interproximal scores, using the appropriate baseline score as the covariate. All comparisons were two-sided at the 0.05 level of significance.

Results

The prototype Deep Clean manual toothbrush delivered an adjusted (via ANCOVA) mean difference between baseline and post-brushing plaque scores of 0.245, while the ADA manual toothbrush plus floss delivered an adjusted mean difference of 0.207 versus 0.196 for the ADA manual toothbrush alone. The prototype Deep Clean manual toothbrush demonstrated a statistically significantly greater reduction in plaque than the ADA manual toothbrush plus floss (p<0.001), which in turn had a statistically significantly greater reduction in plaque than the ADA manual toothbrush alone (p<0.001). The prototype Deep Clean manual toothbrush group had, on average, 25.2% and 18.3% greater plaque removal scores than the ADA manual toothbrush alone and the ADA manual toothbrush plus floss groups, respectively. Results for the interproximal and gingival margin regions also demonstrated statistically significantly (p<0.001) greater plaque removal for the prototype Deep Clean manual toothbrush group relative to the other groups.

Conclusions

The prototype manual Deep Clean toothbrush was found to deliver greater plaque removal by 25.2% and 18.3% compared to the control manual toothbrush group (ADA reference manual toothbrush) and ADA manual toothbrush plus floss group.

Citation

Terézhalmy GT, Bsoul SA, Bartizek RD, Biesbrock AR. Plaque Removal Efficacy of a Prototype Manual Toothbrush versus an ADA Reference Manual Toothbrush with and without Dental Floss. J Contemp Dent Pract 2005 August;(6)3:001-013.


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  1. Periodontal diseases in the United States population. J Periodontol 1998;69(2):269-78.
  2. Periodontal diseases in Europe. Periodontol 2000 2002;29:104-21.
  3. Oral health and dental care in modern-day China. Community Dent Oral Epidemiol 2001;29(5):319-28.
  4. Epidemiology of gingivitis. J Clin Periodontol 1986;13:360-370.
  5. Periodontal health and disease in children and adolescents. Pediatr Clin North Am. 1991 Oct;38(5):1183-207.
  6. What is the relationship between bacterial plaque and calculus formation? Periodontal Abstr. 1967 Jun;15(2):53-6.
  7. The relationship between gingivitis and plaque levels. J Periodontol. 1989 Apr;60(4):172-5.
  8. Implantation of Bacteroides gingivalis in nonhuman primates initiates progression of periodontitis. Science. 1988 Jan 1;239(4835):55-7.
  9. Anti-plaque agents in the prevention of biofilm-associated oral diseases. Oral Dis. 2003;9 Suppl 1:23-9.
  10. Microbiology and management of periodontal infections. Gen Dent 2003;51(5):424-8.
  11. The role of electric toothbrushes: advantages and limitations. Proceedings of the European Workshop on Mechanical Plaque Control; 1998. p. 138-55.
  12. Toothbrushing frequency as it relates to plaque accumulation and gingival health. Journal of Periodontology 44 (1973), pp. 396-405.
  13. The toothbrush and other mechanical devices in Oral Hygiene Products and Practice. Marcel Dekker, New York, pp. 141-194, 1988.
  14. Preventive behaviors as correlates of periodontal health status. J Public Health Dent. 1995 Winter;55(1):10-7.
  15. Evaluating the efficacy of a new flossing aid. J Clin Periodontol. 1993 Aug;20(7):490-7.
  16. A new in vivo interdental sampling method comparing a daily flossing regime versus a manual brush control. J Clin Dent. 2004;15(3):59-65.
  17. Interproximal plaque mass and fluoride retention after brushing and flossing╌a comparative study of powered toothbrushing, manual toothbrushing and flossing. Oral Health Prev Dent. 2004;2(2):119-24.
  18. Cleaning efficacy of a manual toothbrush with tapered filaments. Oral Health Prev Dent. 2003;1(2):111-8.
  19. Plaque removal efficacy and safety of the next generation of manual toothbrush with angled bristle technology: results from three comparative clinical studies. Am J Dent. 2005 Feb;18(1):3-7.
  20. Home oral hygiene revisited. Options and evidence. Oral Health Prev Dent. 2003;1 Suppl 1:407-22.
  21. An overview of established interdental cleaning methods. J Clin Dent. 1996;7(3 Spec No):65-9.
  22. Refinement of the modified navy plaque index to increase plaque scoring efficiency in gumline and interproximal tooth areas. J Clin Dent 3(Suppl C):C9-C12, 1992.
  23. Applied Mixed Models in Medicine. John Wiley & Sons, Ltd., New York, 1999;261-294.
  24. A comparison of estimated versus actual brushing time. Pharmacol Ther Dent. 1981;6(3-4):93-8.
  25. New studies on estimated and actual toothbrushing times and dentifrice use. J Clin Dent. 1998;9(2):49-51.
  26. Oral Self Care: Strategies for Preventive Dentistry. Virginia, Reston Press, pp. 1-3. 1985.
  27. Impact of improved toothbrushes on dental diseases. I. Quintessence Int. 1997 Aug;28(8):513-25.
  28. Impact of improved toothbrushes on dental diseases. II. Quintessence Int. 1997 Sep;28(9):573-93.
  29. A new in vivo interdental sampling method comparing a daily flossing regime versus a manual brush control. J Clin Dent. 2004;15(3):59-65.
  30. Preventive behaviors as correlates of periodontal health status. J Public Health Dent. 1995 Winter;55(1):10-7.
  31. A survey of floss frequency, habit and technique in a hospital dental clinic & private periodontal practice. N Y State Dent J. 2004 May-Jun;70(5):28-33.
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