Abstract
Objectives
To investigate the impact of the lateral deflection of toothbrush bristles (amplitude) of three side-to-side toothbrushes for noncontact biofilm removal in an artificial interdental space model.
Materials and methods
A three-species biofilm (Porphyromonas gingivalis, Fusobacterium nucleatum, Streptococcus sanguinis) was formed in vitro on protein-coated titanium disks. A flow chamber system was combined with a static biofilm growth model. The amplitudes of three commercial side-to-side toothbrushes were evaluated by means of a dose response analysis. The amplitudes were decreased in steps (100%, 85%, 70%, 55%, and 40%). Subsequently, the biofilm-coated substrates were exposed to the toothbrushes. The biofilms were analyzed with confocal laser scanning microscope images and measured using volumetric analyses.
Results
The predictability of interdental biofilm reduction differed among the toothbrushes. A lower variety in the results of repeated experiments occurred in toothbrush C compared to toothbrushes A and B. Toothbrush C obtained highest percentage of biofilm reduction by 85% of amplitude power setting (median biofilm reduction 76%). Decreasing the amplitude from 85 to 40% resulted in reduced biofilm reduction (p = 0.029). In contrast, no significance could be observed for the differences of the tested amplitudes within toothbrushes A and B (p > 0.05). Between the toothbrushes, a significant difference in interdental biofilm reduction was found between C-A (p = 0.029) and C-B (p = 0.029) with amplitude of 85%.
Conclusions
The amplitude of one of the investigated side-to-side toothbrushes affected the biofilm reduction predictably in an interdental space model.
Clinical relevance
Within certain toothbrushes, a specific amplitude power setting may demonstrate beneficial effects on noncontact biofilm removal.
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References
Schmidt JC, Zaugg C, Weiger R, Walter C (2013) Brushing without brushing?--a review of the efficacy of powered toothbrushes in noncontact biofilm removal. Clin Oral Investig 17:687–709
Schmidt JC, Astasov-Frauenhoffer M, Hauser-Gerspach I, Schmidt JP, Waltimo T, Weiger R, Walter C (2014) Efficacy of various side-to-side toothbrushes for noncontact biofilm removal. Clin Oral Investig 18:793–800
Schmidt JC, Astasov-Frauenhoffer M, Waltimo T, Weiger R, Walter C (2017) Efficacy of various side-to-side toothbrushes and impact of brushing parameters on noncontact biofilm removal in an interdental space model. Clin Oral Investig 21:1565–1577
Schmidt JC, Astasov-Frauenhoffer M, Waltimo T, Weiger R, Walter C (2018) Influence of the oscillation frequency of different side-to-side toothbrushes on noncontact biofilm removal. Clin Oral Investig 22:2141–2147
Astasov-Frauenhoffer M, Braissant O, Hauser-Gerspach I, Weiger R, Walter C, Zitzmann NU, Waltimo T (2014) Microcalorimetric determination of the effects of amoxicillin, metronidazole, and their combination on in vitro biofilm. J Periodontol 85:349–357
Astasov-Frauenhoffer M, Braissant O, Hauser-Gerspach I, Daniels AU, Weiger R, Waltimo T (2012) Isothermal microcalorimetry provides new insights into biofilm variability and dynamics. FEMS Microbiol Lett 337:31–37
Weiger R, Decker EM, Krastl G, Brecx M (1999) Deposition and retention of vital and dead Streptococcus sanguinis cells on glass surfaces in a flow-chamber system. Arch Oral Biol 44:621–628
Decker EM, Maier G, Axmann D, Brecx M, von Ohle C (2008) Effect of xylitol/chlorhexidine versus xylitol or chlorhexidine as single rinses on initial biofilm formation of cariogenic streptococci. Quintessence Int 39:17–22
Decker EM, Weiger R, von Ohle C, Wiech I, Brecx M (2003) Susceptibility of planktonic versus attached Streptococcus sanguinis cells to chlorhexidine. Clin Oral Investig 7:98–102
Hauser-Gerspach I, Kulik EM, Weiger R, Decker EM, Von Ohle C, Meyer J (2007) Adhesion of Streptococcus sanguinis to dental implant and restorative materials in vitro. Dent Mater J 26:361–366
Egelberg J (1966) Permeability of the dento-gingival blood vessels. II Clinically healthy gingivae. J Periodontal Res 1:276–286
Egelberg J (1966) Permeability of the dento-gingival blood vessels. 1. Application of the vascular labelling method and gingival fluid measurements. J Periodontal Res 1:180–191
Busscher HJ, Jager D, Finger G, Schaefer N, van der Mei HC (2010) Energy transfer, volumetric expansion, and removal of oral biofilms by non-contact brushing. Eur J Oral Sci 118:177–182
Horiuchi S, Yumoto H, Kimura T, Sato M, Mitsui SN, Hiasa M, Nishikawa E, El-Bialy T, Tanaka E (2018) Effect of pulsed ultrasound toothbrush on Streptococcus mutans biofilm removal. Am J Dent 31:67–70
Hope CK, Petrie A, Wilson M (2003) In vitro assessment of the plaque-removing ability of hydrodynamic shear forces produced beyond the bristles by 2 electric toothbrushes. J Periodontol 74:1017–1022
Adams H, Winston MT, Heersink J, Buckingham-Meyer KA, Costerton JW, Stoodley P (2002) Development of a laboratory model to assess the removal of biofilm from interproximal spaces by powered tooth brushing. Am J Dent 15 Spec No:12B–17B
Parini MR, Eggett DL, Pitt WG (2005) Removal of Streptococcus mutans biofilm by bubbles. J Clin Periodontol 32:1151–1156
Parini MR, Pitt WG (2005) Removal of oral biofilms by bubbles: the effect of bubble impingement angle and sonic waves. J Am Dent Assoc 136:1688–1693
Parini MR, Pitt WG (2006) Dynamic removal of oral biofilms by bubbles. Colloids Surf B Biointerfaces 52:39–46
Lea SC, Khan A, Patanwala HS, Landini G, Walmsley AD (2007) The effects of load and toothpaste on powered toothbrush vibrations. J Dent 35:350–354
Aspiras MB, Barros SP, Moss KL, Barrow DA, Philips ST, Mendoza L, de Jager M, Ward M, Offenbacher S (2013) Clinical and subclinical effects of power brushing following experimental induction of biofilm overgrowth in subjects representing a spectrum of periodontal disease. J Clin Periodontol 40:1118–1125
Acknowledgements
We thank Elisabeth Filipuzzi-Jenny (Clinic of Preventive Dentistry and Oral Microbiology, University of Basel) for laboratory assistance; Dr. Oliver Biehlmaier (Image Core Facility, Biozentrum, University of Basel) for assistance with microscopic analyses; Ing. EurEta Sascha Martin (Department of Physics, University of Basel) for the construction of the toothbrush apparatus; and Dipl. El. Ing. HTL Michael Steinacher (Department of Physics, University of Basel) for the measurement and regulation of oscillation frequencies and amplitudes (Department of Physics, University of Basel).
Funding
This project was supported in part by an unrestricted grant from the DGPZM (German Society for Preventive Dentistry) CP-GABA research fund. The titanium disks were provided by Straumann AG (Basel, Switzerland).
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The authors Julia C. Schmidt, Monika Astasov-Frauenhoffer, Tuomas Waltimo, Roland Weiger, and Clemens Walter declare that they have no conflict of interest.
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The study was approved by the Research Ethics Committee of the University of Basel, Switzerland (EK:295/08).
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Informed consent was obtained by saliva providers.
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Schmidt, J.C., Astasov-Frauenhoffer, M., Waltimo, T. et al. Influence of the amplitude of different side-to-side toothbrushes on noncontact biofilm removal. Clin Oral Invest 23, 1951–1957 (2019). https://doi.org/10.1007/s00784-018-2633-5
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DOI: https://doi.org/10.1007/s00784-018-2633-5