Parallel-group, randomized, active- controlled trial with a 1:1 allocation ratio.
Oral-B Professional Care 6000, D36/EB20 (oscillating/ rotating) males: 15; females: 15; no smokers; age: 13-17 years
Oral-B Indicator 35 soft; males: 15; females: 15; no smokers; age: 13-17 years
Good health and undergoing full upper and lower arch orthodontic appliance therapy
Twice daily for at least 2 minutes
Turesky-modified Quigley and Hein Plaque Index (TMQHPI) Modified Quigley and Hein Index (MQH)
Baseline, 2, and 6 weeks
Fifty-nine subjects aged 13-17 years completed the study. The interactive powered toothbrush provided significantly (p < 0.001) greater plaque reduction versus the manual toothbrush at 2 and 6 weeks according to the whole-mouth TMQHPI. The treatment difference in adjusted mean plaque change from baseline was 0.777 (95% CI, 0.614-0.940) at week 2 and 0.834 (0.686-0.981) at week 6. Mean reductions in the number of focus care areas were also significantly greater (p < 0.001) in the power brush group at weeks 2 and 6. Brushing times increased significantly at weeks 2 and 6 (p ≤ 0.013) versus baseline in the interactive power brush group only. Subject-reported motivation was significantly increased in the interactive power brush group at week 6 versus screening (p ≤ 0.005).
Oscillating-rotating powered toothbrush with a specially designed orthodontic brush head (Oral-B Triumph, OD17; Procter & Gamble, Cincinnati, Ohio); males: 29 females: 17; smokers: not reported; age: 12-25 years (mean: 14.6)
The same powered toothbrush handle with a regular brush head (EB25; Procter & Gamble); and a regular ADA manual toothbrush
Good health and undergoing full upper and lower arch orthodontic appliance therapy
6-period crossover study with washout periods of approximately 24 hours between visits
Turesky modified Quigley and Hein Plaque Index (TMQHPI)
Baseline w/DPIA, and postbrushing w/DPIA
The powered toothbrush, with either brush head, demonstrated significantly greater plaque removal over the manual brush. The orthodontic brush head was superior to the regular head
Powered brush (Braun Oral B 3D Plaque Remover, Braun GmbH, Kronberg, Germany)Manual brush (Oral B Model 30, Gillete do Brasil, Manaus, Brazil)The participants were randomly divided into 3 sequences of brush use: (1) ultrasonic, powered, and manual; (2) manual, ultrasonic, and powered; and (3) powered, manual, and ultrasonic.
Good health and undergoing full upper and lower arch orthodontic appliance therapy
The subjects were asked to use their assigned toothbrush 3 times daily for 2 minutes with a designated toothpaste
Silness-Löe Plaque Index
For each crossover, patients used a toothbrush for 30 days, followed by a washout period of 14 days
Although counts and prevalences of some taxa examined decreased in the 3 groups, no toothbrush demonstrated superiority, when used three times daily for 2 minutes, on microbiologic parameters in banded molars of adolescent orthodontic patients. Furthermore, more comprehensive studies with other experimental designs are needed to determine whether these results can be sustained.
Braun Oral-B 3D Plaque Remover (Kronberg, Germany) Philips-Jordan HP 510 (Philips Domestic Appliances, Groningen, The Netherlands); males: 18; females: 18; reported age: 11-24 years (mean: 13.6 years)
Lactona orthodontic toothbrush (Bergen op Zoom, The Netherlands) Oral-B Advantage Control Grip (Braun)
Good health and undergoing full upper and lower arch orthodontic appliance therapy
All 33 patients used each of the 4 brush types for 1 month in a randomly designed sequence over the course of a year.
Modified Gingival Index (GI); Bleeding on Probing Index (BOPI); Plaque Index, tooth (PIT); and brackets (PIB)
Baseline and after every 4-week test period
No statistically significant differences were found for any of the parameters measured after analysing scores for the upper and lower jaws. This indicates that no brush was less efficient than the others for either the upper or the lower jaw. For the left and right sides, the 4 brushes were also found equally efficient for all parameters, except for the PIT on the left side. For this index, the Philips-Jordan toothbrush had the best score.
Dental Logic HP550 with regular brush head HP5924 (Philips, U.K.) Braun Oral B Plaque Remover (D7) with dedicated orthodontic brush head OD5-1 (Braun AG, Germany); N = 6021 males; 39 females; age 10-16 years (mean: 13.6, SD 1.2 years)
Manual dedicated orthodontic toothbrush (P35, Oral B Laboratories, Calif.)
Good health and undergoing full upper and lower arch orthodontic appliance therapy
The first brush was given 2 weeks after baseline (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
Visible Plaque Index (VPI); GBI, Gingival Bleeding Index
The time interval for using each brush was 4 weeks from baseline
This 4-week, cross-over study demonstrated that the Philips HP550, the dedicated powered Braun D7, and the manual (Oral B) orthodontic brushes were equally effective in removing plaque and reducing gingival inflammation as indicated by bleeding on probing in patients undergoing fixed orthodontic treatment.
Interplak (Bausch& Lomb) Philips (Philips) 36 orthodontic subjects; age: 11 years and 5 months to 15 years and 2 months (mean: 12 years and 10 months); 19 girls (mean age:12 years and 7 months); 17 boys (mean age: 13 years and 1 month)
36 systemically healthy patients with orthodontic fixed appliances
3 minutes
Gingival Index; Bleeding Index; Plaque Index (PI); Plaque Index brackets (PIb).
At baseline and after 1 and 2 months, all clinical parameters were measured.
Manual toothbrushes presented significantly better effect than powered toothbrushes. Of the three powered toothbrushes tested, the Philips toothbrush seemed to give slightly better results than the Interplak toothbrush, whereas Rota-dent very clearly gave results inferior to all others.
Interplak (Bausch & Lomb, Berlin, Germany), Rota-dent (Rota-dent, Küsnacht, Switzerland), Braun Oral-B Plaque Remover (Braun/Oral-B, Kronberg, Germany). N=38; median age 15.3 years
Elmex 29, Wybert GmbH, Lörrach, Germany A manual technique
Healthy subjects using fixed orthodontic appliances
Twice per day, 2-minute brushing
O'Leary Plaque Index (PI) and Ainamo Gingival Bleeding Index (GBI),
Patients were randomly allocated to groups who, within the test period, alternately used the toothbrushes. Before getting a new toothbrush that was to be used for a period of 4 weeks, each patient received video and written instructions. For another 4 weeks, the patient returned to the usual oral hygiene procedures before receiving the next new toothbrush.
Under home conditions, Rota-dent, without additional devices, can contribute to the improvement of oral hygiene in orthodontic patients compared with a manual technique with a hand toothbrush, interdental brush, and dental floss. The same holds true for the Braun Oral-B Plaque Remover with the orthodontic head, but only for patients with poor oral hygiene. Powered toothbrushes can improve patient motivation, which is very valuable over a treatment time of 2 years or more. Orthodontists are well advised to not rely solely on new powered devices but rather focus on enhancing the patient's dental awareness of oral hygiene.
Rota-dent, Prodentec Corp., Batesville, Ark.) 30 subjects; ninety consecutive adolescent patients who were to receive orthodontic treatment. There were 22 female and 13 male patients in the control group, 19 female and 11 male patients in the first treatment group, and 15 female and 10 male patients in second treatment group.
Manual toothbrushing only (control group); 25 subjects; once-daily use of a 0.05% NaF, 0.05% sodium fluoride rinse 20 subjects
Healthy subjects using fixed orthodontic appliances
Twice per day, 2-minute brushing
Plaque lndex; Gingival Index; Bleeding Index
All subjects in both treatment groups, but not the control group, were also instructed to use a 0.05% NaF mint-flavored mouth rinse (Flurigard, Colgate) once a day at bedtime. They were told to keep half ounce of the rinse in their mouth for 1 minute and then to expectorate, but not rinse with water, after using the rinse. These instructions also were reinforced at each monthly visit.
The results showed that although there were no significant differences between the three groups at baseline, the Rota-dent group showed significantly () less post-treatment decalcification than either the control or rinse groups. In a separate analysis of first molars, the Rota-dent group again showed the least decalcification and the control group showed the most.
