No difference between manual and different power toothbrushes with and without specific instructions in young, oral healthy adults—results of a randomized clinical trial
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The aim of this randomized clinical study was to detect the effect of an instruction within a group using oscillating-rotating (OR), sonic-active (SA), or manual toothbrushes (MTB) in young, oral healthy adults.
One hundred fifty participants were randomly assigned into six groups (n = 25): with (OR-I, SA-I, MTB-I) and without instruction (OR-NI, SA-NI, MTB-NI). Participants in I subgroups received one standardized instruction of the toothbrush system. At baseline (t0), after 2 (t1), 4 (t2), and 12 weeks (t3), plaque indices including modified Quigley–Hein Index (QHI) and Marginal Plaque Index (MPI) as well as inflammation indices including Papilla Bleeding Index (PBI) and Gingival Index (GI) were assessed. Kruskal–Wallis test, Friedman test, and chi-square or Fisher’s exact test (p < 0.05) were used for statistical analysis.
One hundred thirty-one participants completed the follow-up and were analyzed: OR-I = 21, OR-NI = 22, SA-I = 22, SA-NI = 22, MTB-I = 22, and MTB-NI = 22. Within groups between t0 and t3, OR and SA systems showed a significant plaque reduction, irrespective of instruction (p i < 0.05). In MTB-I and in SA-NI subgroups, a reduction of GI was detected, while an improvement in PBI within SA-I was found (p i < 0.05). Thereby, after 12 weeks, gingival inflammation and plaque indices were comparable between all subgroups (p i > 0.05). Irrespective of the toothbrush system used, only QHI was positively influenced by instruction (p < 0.01).
The used toothbrush as well as the presence or absence of a single brush-specific instruction has no influence on plaque removal and reduction of gingival inflammation in young, oral healthy adults in an observation period of 12 weeks.
A single instruction might bring no benefit in this patient group, independently of the used toothbrush system.
KeywordsClinical trial Toothbrushing Dental plaque Sonic-active Oscillating-rotating Manual toothbrush Oral hygiene instruction
We would like to thank Dr. Tanja Kottmann (Clinical Research Organization, Hamm) for the statistical analysis. Furthermore, the authors thank Philips GmbH (Hamburg, Germany), CP GABA (GmbH, Hamburg, Germany), and GlaxoSmithKline Oral Health Care GmbH (Brühl, Germany) for providing materials for the study. Moreover, we would like to thank Mrs. M. Mühle and A. Oehme for conducting the professional tooth cleaning of all study participants.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study was reviewed and approved by the Ethics Committee of the University Medical Center in Leipzig, Germany (No. 217-15-01062015). This RCT was registered in the “WHO International Clinical Trials Registry Platform” in the German Clinical Trials Register (DRKS; No. DRKS00011422) and conducted in accordance with the CONSORT guidelines.
Patients were informed verbally and in writing about the study and gave written informed consent.
- 4.Chapple IL, Van der Weijden F, Doerfer C, Herrera D, Shapira L, Polak D, Madianos P, Louropoulou A, Machtei E, Donos N, Greenwell H, Van Winkelhoff AJ, Eren Kuru B, Arweiler N, Teughels W, Aimetti M, Molina A, Montero E, Graziani F (2015) Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol 42(Suppl 16):S71–S76CrossRefPubMedGoogle Scholar
- 5.Tonetti MS, Eickholz P, Loos BG, Papapanou P, van der Velden U, Armitage G, Bouchard P, Deinzer R, Dietrich T, Hughes F, Kocher T, Lang NP, Lopez R, Needleman I, Newton T, Nibali L, Pretzl B, Ramseier C, Sanz-Sanchez I, Schlagenhauf U, Suvan JE (2015) Principles in prevention of periodontal diseases: consensus report of group 1 of the 11th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases. J Clin Periodontol 42(Suppl 16):S5–11CrossRefPubMedGoogle Scholar
- 6.Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, Glenny AM (2014) Powered versus manual toothbrushing for oral health. Cochrane Database Syst Rev 6:CD002281Google Scholar
- 16.Schulz KF, Altman DG, Moher D (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Open Med 4:60–68Google Scholar
- 18.Schmickler J, Wurbs S, Wurbs S, Lange K, Rinke S, Hornecker E, Mausberg RF, Ziebolz D (2014) Influence of the utilization time of different manual toothbrushes on oral hygiene assessed during a 6-month observation period: a randomized clinical trial. J Periodontol 85:1050–1058CrossRefPubMedGoogle Scholar
- 19.Schmickler J, Wurbs S, Wurbs S, Kramer K, Rinke S, Hornecker E, Mausberg RF, Ziebolz D (2016). The influence of the utilization time of brush heads from different types of power toothbrushes on oral hygiene assessed over a 6-month observation period: a randomized clinical trial. Am J Dent (in press)Google Scholar
- 20.Schmalz G, Müller M, Schmickler J, Rinke S, Haak R, Mausberg RF, Ziebolz D (2017) Influence of manual and power toothbrush on clinical and microbiological findings in initial treatment of periodontitis—a randomized clinical study. Am J Dent (in press)Google Scholar
- 21.Lange DE, Plagmann HC, Eenboom A, Promesberger A (1977) Clinical methods for the objective evaluation of oral hygiene. Deutsch Zahnärztl Zeitschr 32:44–47 [in German]Google Scholar
- 26.Deacon SA, Glenny AM, Deery C, Robinson PG, Heanue M, Walmsley AD, Shaw WC (2010) Different powered toothbrushes for plaque control and gingival health. Cochrane Database Syst Rev 8:CD004971Google Scholar
- 29.Dentino AR, Derderian G, Wolf M, Cugini M, Johnson R, Van Swol RL, King D, Marks P, Warren P (2002) Six-month comparison of powered versus manual toothbrushing for safety and efficacy in the absence of professional instruction in mechanical plaque control. J Periodontol 73:770–778CrossRefPubMedGoogle Scholar