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Purpose: To compare the cleaning efficacy of a battery-powered toothbrush with an oscillating/rotating action (Dr. Best Powerclean) and a standard flat-trimmed manual toothbrush (Elmex super 39) in a single-blind, cross-over clinical study., Materials and Methods: 78 healthy subjects took part in the study. Subjects were asked to abstain from all oral hygiene procedures for 48 hours, after which hard and soft oral tissues were examined. Plaque was then scored using the Turesky modification of the Quigley-Hein Index, and subjects were instructed to brush their teeth for a total time of 1 minute with either one or the other brush, according to a predetermined randomization schedule. Immediately after brushing, plaque was scored again and hard and soft tissues were re-examined. All plaque scoring was carried out by the same investigator who was blind with respect to the brushes used. Subjects were instructed to continue with their usual oral care routine throughout the study period. They were scheduled to return after 12-14 days, having again abstained from all oral hygiene for 48 hours prior to the visit, in order to repeat the evaluation sequence but brushing with the alternative brush. Prior to analysis of the results, data from the two phases of the study were combined., Results: Both toothbrushes were found to be safe as used in the study. Using the non-parametric Wilcoxon test for paired samples, whole mouth plaque scores were found to be reduced significantly from 2.04 +/- 0.60 to 1.57 +/- 0.51 by the Powerclean toothbrush (P < 0.001), and from 1.99 +/- 0.65 to 1.27 +/- 0.52 by the manual toothbrush (P < 0.001). At approximal surfaces, the plaque scores were also significantly reduced from 2.14 +/- 0.0.59 to 1.69 +/- 0.50 for the Powerclean (P < 0.001), and from 2.08 +/- 0.64 to 1.40 +/- 0.57 for the manual toothbrush (P < 0.001). A comparison of the two brushes revealed that the manual toothbrush removed significantly more plaque than the Powerclean, both for the whole mouth and approximal surfaces (P < 0.001). The Powerclean reduced whole mouth plaque by 23.2 +/- 11.5% compared to 37.8 +/- 14.0% for the manual toothbrush and approximal plaque by 20.9 +/- 10.6% and 34.9 +/- 14.0%, respectively. It is concluded that the Dr. Best Powerclean toothbrush is not as effective as a standard flat-trimmed manual toothbrush.

Purpose: To test the hypothesis that simulation of an intrapulpal pressure during the application of dentin bonding systems influences hybrid layer formation in vitro., Materials and Methods: 180 teeth and three different bonding agents were used for shear bond strength measurements and for confocal laser scanning microscopy studies on the dentin-composite interface. The bonding agents (30 teeth each material) were applied without (90 teeth, Group A) and with intrapulpal pressure simulation of 34 cm H20 with water (90 teeth, Group B). 45 specimens from each group were sheared in a testing machine, and 45 teeth from each group were used for CLSM studies after labeling the primer components of the bonding agents with a fluorescent dye., Results: After simulation of pulpal pressure the bond strengths decreased significantly in all groups (Syntac [without/with]: 16.0 +/- 4.5/8.0 +/- 3.7, P= 0.001; Gluma: 13.3 +/- 4.6/8.4 +/- 4.4, P= 0.008; Prime & Bond NT: 14.8 +/- 5.8/8.7 +/- 5.7, P= 0.007; n = 15 each; U-tests). There were no significant differences between the hybrid layer thickness without/with simulation of pulpal pressure (Syntac: 3.6 +/- 0.6/4.1 + 1.2, P= 0.35; Gluma: 3.5 +/- 0.6/3.7 + 0.9, P= 0.49; Prime & Bond NT: 3.5 +/- 0.9/3.8 + 0.8, P= 0.44; n = 15 each; U-tests). In the case of simulation of an intrapulpal pressure, CLSM examination revealed a distinctly shallower penetration of the adhesives into dentin compared to the samples treated without intrapulpal pressure.

Purpose: To compare the clinical efficacy with respect to plaque removal of a battery-operated power toothbrush (Dr. Johns Spin Brush Classic) with two manual toothbrushes, a standard ADA flat trim reference brush and the Oral-B CrossAction toothbrush., Materials and Methods: Efficacy was evaluated in two independent studies using a randomized, single-use, cross-over design. Healthy adult subjects from a general population brushed their teeth for a timed 1 min and plaque was scored before and after brushing was completed. In Study 1 (Spin Brush vs. ADA toothbrush), plaque was scored using the modified Quigley and Hein Plaque Index, while in Study 2 (Spin Brush vs. CrossAction) plaque was scored using the Modified Navy Plaque Index. In addition, a hard and soft tissue examination was carried out before and after brushing to allow evaluation of safety., Results: In Study 1, both the ADA toothbrush and the Spin Brush significantly reduced levels of whole mouth and approximal plaque (P < 0.0005); however, the Spin Brush was not significantly more effective than the manual brush. Relative plaque reduction for the whole mouth was 35.6 +/- 16.0% for the Spin Brush compared to 38.9 +/- 14.9% for the manual toothbrush (P < 0.047), and, for the approximal surfaces, 32.7 +/- 14.6% and 36.3 +/- 13.7%, respectively (P = 0.024). In Study 2, both toothbrushes significantly reduced plaque levels (P < 0.0001), but, as for Study 1, the CrossAction manual toothbrush was more effective than the Spin Brush. For whole mouth, marginal and approximal sites, respectively, the Spin Brush reduced plaque by 54.3%, 43.5% and 62.0%, compared with 58.6%, 47.5% and 67.1% for the CrossAction toothbrush. The difference in favor of the CrossAction brush was statistically significant (P < 0.0005) for all areas.