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Background Very few studies have investigated the effect of patient and site factors on periodontal progression and long-term tooth loss in populations with minimal dental care. The aim of this retrospective study was to assess tooth loss and radiographic bone loss over at least 5 years in patients attending a national-health service primary care practice in Sicily and undergoing no regular care. Methods Records of two hundred consecutive patients with at least 5 years follow-up were screened and demographic, clinical and radiographic data were retrieved. Analyses of associations between patient and site factors and tooth loss were performed. Results After excluding not suitable patients, a total of 159 patient records with clinical and radiographic data with average 8.6 years follow-up were included. One hundred of these patients had no professional mechanical plaque removal (PMPR) carried out throughout the study follow-up. Nearly 65% of patients lost at least 1 tooth during the follow-up period, with a total of 400 extracted teeth (for periodontal and non-periodontal reasons). The annual tooth loss rate was slightly higher for 'no PMPR' (untreated) patients (0.30 teeth/patient/year) compared with patients who had PMPR (0.27 teeth/patient/year). On a patient-level, only reduced frequency of daily tooth brushing was associated with tooth loss at logistic regression, while staging, grading and diagnosis of caries were associated with rates of tooth loss/year. At multilevel analysis including patient- and tooth- factors, age, diagnosis of caries and endodontic disease and percentage of bone loss at baseline were associated with tooth loss. Conclusion This study confirms the importance of tooth brushing, initial bone loss, caries and endodontic disease in predicting tooth survival in a primary care setting. This article is protected by copyright. All rights reserved.

Background: The best and the most reliable methods to manage the dental plaque are still mechanical procedures. It has been traditionally recommended that a firm fruit such as an apple be eaten to minimize caries and control plaque at the end of a meal. However, several studies have reported contradictory findings about the microbial plaque function of the apples. Some studies, for instance, have found that apples contain sugar and, therefore, can cause plaque growth; some other researches, on the other hand, have shown that they have the potential to decrease plaque due to their mechanical plaque removal function. This study, therefore, aimed to compare the effects of apple-chewing method and that of tooth-brushing one on plaque removal. Methods: The study group included 48 healthy dental students with good oral health status, who were randomly selected to participate in this comparative, crossover clinical study. First, they were asked to brush their teeth or eat an apple. After 2 weeks, the experiment was repeated with the order reversed. Plaque indexes (PIs) were determined as before brushing/apple eating (baseline, B), immediately afterward (A), and 24 hours afterward (24). Results: Over time, there was a significant shift in the plaque index pattern between the groups (P value

Objective: The objective was to compare water flosser and regular floss in the efficacy of plaque removal in patients after single use. Materials and Methods: A randomized controlled clinical trial was conducted to compare the plaque removal efficacy of water flosser and regular floss. Eighty three subjects who met the inclusion criteria were recruited from dental clinic. Silness and Löe plaque index was measured for all the subjects prior to and after the intervention by an examiner who was blind to the type of aid used. The type of floss used was randomly assigned to each side of the oral cavity; unflavored waxed regular floss (oral B) used on one side, while a water flosser (Waterpik® Cordless Plus Water Flosser) was used on the other side. A trained investigator used either unflavored waxed regular floss or water flosser as assigned. Paired t-test was used to compare between the two groups. Results: The mean plaque scores at baseline were 1.10(±0.38) and 0.94(±0.38) respectively for regular floss and water flosser. The mean plaque scores were 0.12(±0.13) and 0.12(±0.15) respectively for regular floss and water flosser. There was no statistically significant difference in the plaque scores (p = 0.58) between the groups after the use of respective interdental aids. There was a statistically significant difference in the plaque scores before and after use of interdental aids for both the groups (p

Objective: To clinically evaluate the efficacy of chewing stick as alternative to tooth brushing for plaque removal in subject with clinically healthy gingival status. Material and methods: This randomized trial was conducted on a total of 80 participants, randomly allocated into two groups of 40 each at Department of Periodontology, Sardar Begum Dental College, Gandhara University, Peshawar, Pakistan. Group A were guided to use toothbrush, while group B was miswak users. Both groups were advised to use the respective group technique twice daily for four weeks. Pre and Post intervention examinations were planned by using Modified Quigley-Hein Plaque Index (QHPI), which measures the plaque levels. Data was recorded on the first day (baseline) and after 4 weeks. Obtained data was analyzed using SPSS v.24.0 Results: Mean age of the study participants was 25.54±6.004 years. Plaque was measured using QHPI, at baseline group A presented mean of 5.001±1.50, while group B had mean of 4.923±0.63 (p=

Background and objectives The efficiency of mechanical plaque control in children not only depends on the type of oral aids they use but also on the instructions, training, and motivation given to them. To compare the efficiency of different methods of personal supervision of toothbrushing in reducing the dental plaque levels in 7–9-year-old schoolchildren. Materials and methods A parallel designed double-blinded randomized study was conducted in a private school in Jeddah, Saudi Arabia from September 2018 to December 2018. The children were allocated randomly into two groups based on the type of supervision given. Plaque scores examination was carried out at four intervals as baseline, 7th day, 14th day, and 90th day. Results Plaque scores reduced after 7 days in all groups, even though there was no statistically significant difference observed. At the final examination of plaque scores (90th day), there was a highly statistically significant reduction observed in group I and II compared to group III where the reduction was less evident. Conclusion Supervision of toothbrushing in the correct way was effective in reducing the plaque scores. Our study benefited both parents and children in understanding the correct method of brushing and the importance of plaque control. How to cite this article Pullishery F, Abuzenada BM, Alrushnudi NM, et al. Comparison of Efficacy of Different Supervision Methods of Toothbrushing on Dental Plaque Scores in 7–9-year-old Children. Int J Clin Pediatr Dent 2021;14(2):263–268.

Objectives Pain is affecting acceptance of supportive periodontal therapy and primary periodontitis prevention. Our objective was to evaluate the efficacy of a 1-week pre-treatment use of dentinal-hypersensitivity-reducing mouth-rinses (DHM) in periodontal maintenance (SPT) or dental prophylaxis patients. Material and methods One hundred fifty-five participants attending for professional mechanical plaque removal (PMPR) were randomly assigned to use a mouth-rinse twice daily for 1 week prior to their next PMPR. Rinses were containing either potassium oxalate (n = 52), arginine (n = 52), or herbal extracts (n = 51). At baseline and reassessment, procedural pain was assessed by visual analogue scale (VAS) and verbal rating scale (VRS). Self-reported efficacy was documented. Results No inter-group differences were estimated between both test groups and the control for baseline and reassessment means (VAS, VRS). In the SPT group, VAS reduction and self-reported efficacy were found (p < 0.05). Conclusion The 1-week use of DHM failed to show a predictable effect on discomfort during PMPR overall. Around 20% of the patients showed a quantifiable benefit from both test mouth-rinses, whereas more than 50% reported a subjective pain reduction. Focusing patients undergoing supportive periodontal therapy, quantifiable effects were found for both test groups. From a patient’s point of view, DHM might be a suitable adjunct to enhance procedural comfort, especially in patients with a history of periodontitis. Clinical relevance The 1-week use of the dentinal-hypersensitivity-reducing mouth-rinses prior to professional-mechanical-plaque-removal showed to be a suitable adjunct to enhance procedural comfort during instrumentation, especially in patients undergoing supportive periodontal therapy. Registration number: DRKS00010811

Bacterial plaque control is critical in maintenance of oral health because dental plaque is the primary etiological factor for both caries and periodontal disease. Toothbrush and dentifrices play an integral part in accomplishing plaque removal. The aim of the study was to assess the enamel surface abrasion caused by three different dentifrices using automated brushing simulator and profilometer. A total of 24 samples (N=24) which are extracted for orthodontic purposes were divided into three groups based on the dentifrices used. They are Group 1-Colgate Swarnavedsakthi (n=8), Group 2-Dabur Herbal(n=8),Group 3-Ayush(n=8). Samples were subjected to take pre profilometric readings and brushing was done by an automated brushing simulator. A Laser 3D profilometer was used to detect the wear in the enamel surface. Pre and Post profilometric readings were compared. Statistically significant differences (p

Background and Objectives: Dental professionals often recommend changing toothbrushes every three months due to their wear and decreased plaque removal efficacy. This study aimed to assess the correlation of duration of use of a toothbrush and its wear and then the relationship of wear of toothbrush and Plaque Index (PI) of users and tapering of toothbrush filaments after three months of use was evaluated as well. Materials and Methods: In this study, 60 female students were enrolled according to the eligibility criteria and received a new set of toothbrush and toothpaste. They were requested to brush their teeth using the Bass technique twice a day for 2 minutes and the Ramfjord PI was measured at baseline and after 3 months. The wear of 47 toothbrushes after three months of use was evaluated using the Rawls index. Of collected 47 toothbrushes, 30 were randomly chosen and inspected under an electron microscope to determine the degree of tapering of bristles. Data were analyzed using SPSS version 20 via Spearman’s correlation coefficient, paired t-test and Pearson’s correlation coefficient (alpha=0.05). Results: After 3 months, the mean PI score significantly decreased (paired t-test, P=0.034). The PI at 3 months after use had no significant correlation with the toothbrush wear score (Spearman’s correlation coefficient, P=0.61) but the toothbrush wear score had a significant correlation with tapering of bristles (Spearman’s correlation coefficient, P=0.04). No significant association existed between PI at 3 months after use and tapering of bristles (Pearson’s correlation coefficient, P=0.69). Conclusion: The duration of use and wear of toothbrush alone do not affect the quality of plaque removal. Practicing Oral hygiene can affect the quality of plaque removal.

espanolIntroduccion: Existe una alta prevalencia de caries del esmalte alrededor de los brackets debido a la corta edad de la mayoria de los pacientes de ortodoncia y a la dificultad de remocion de la placa en presencia de aparatos de ortodoncia. Recientemente, se introdujeron agentes protectores como los vidrios bioactivos (VB) para mejorar la remineralizacion y prevenir la desmineralizacion de las estructuras dentales. Este estudio tuvo como objetivo evaluar la resistencia al cizallamiento (RC) del cemento de ionomero de vidrio modificado con resina (CIVMR) con la adicion de 45S5 BG para mejorar su potencial remineralizante utilizando dos metodos convencionales. Material y Metodos: Este estudio expe-rimental in vitro evaluo tres grupos (n = 20) de brackets de ortodoncia adheridos al esmalte usando Transbond XT (grupo 1), CIVMR fotopolimerizable (grupo 2) y CIVMR con VB agregado (grupo 3). Las muestras se sometieron a 7000 ciclos termicos y se midio su RC. Tambien se determino la puntuacion del indice de restos de adhesivo (IRA). Los datos cuantitativos se analizaron mediante ANOVA de una via, mientras que los datos cualitativos se analizaron mediante una prueba de chi-cuadrado. Discusion: Los resultados no mostraron diferencias significativas en la RC entre los grupos de estudio, sin embargo, los puntajes IRA fueron significativamente diferentes entre los grupos. El grupo CIVMR mostro el ARI mas alto mientras que CIVMR dopado con VB mostro el puntaje IRA mas bajo. Conclusion: La adicion de un 30% p/v de 45S5 VB a CIVMR no causa un cambio significativo en la RC de los brackets de ortodoncia adheridos al esmalte, mientras que resulta en una menor cantidad de remanentes de agente de fijacion en la superficie del esmalte despues del desprendimiento. Resistencia al Corte. EnglishIntroduction: There is a high prevalence of enamel caries around brackets due to the young age of the majority of orthodontic patients, and to the difficulty of plaque removal in presence of orthodontic appliances. Recently, protective agents such as bioactive glasses (BGs) were introduced to enhance remineralization and prevent demineralization of tooth structures. This study aimed to assess the shear bond strength (SBS) of resin-modified glass ionomer cement (RMGIC) with addition of 45S5 BG to enhance its remineralizing potential using two conventional methods. Material and methods: This in-vitro experimental study evaluated three groups (n=20) of orthodontic brackets bonded to enamel using Transbond XT (group 1), light-cure RMGIC (group 2) and RMGIC with BG added (group 3). Samples underwent 7000 thermal cycles and their SBS was measured. The adhesive remnant index (ARI) score was also determined. Quantitative data were analyzed using one-way ANOVA while qualitative data were analyzed using a chi-square test. Discussion: The results showed no significant difference in SBS between study groups, however the ARI scores were significantly different among the groups. The RMGIC group showed the highest ARI while RMGIC doped with BG showed the lowest ARI score. Conclusion: Addition of 30% w/v 45S5 BG to RMGIC does not cause a significant change in SBS of orthodontic brackets bonded to enamel, while resulting in less amount of luting agent remnants on the enamel surface after debonding.

Background: Frenum that encroaches on the margin of the gingiva may interfere with plaque removal and can lead to gingival recession and midline diastema. Thus, to maintain proper oral hygiene and prevent gingival recession, frenectomy is done. Frenectomy can be accomplished by conventional frenectomy technique, which has certain disadvantages. To overcome those drawbacks, paralleling technique of frenectomy has been introduced. Both the techniques can be performed by using various treatment modalities. Aim: The purpose of this clinical study was to compare the bleeding during surgery, post-operative wound healing and patient's perception towards the conventional frenectomy technique with scalpel, paralleling frenectomy technique with scalpel and paralleling technique with electrocautery. Materials and method: A total of 30 subjects with gingival or papillary frenal attachment were selected and equally divided into three groups. Group 1 was treated by conventional technique with scalpel, Group 2 by paralleling technique with scalpel and Group 3 by paralleling technique with electrocautery. Various parameters such as bleeding during surgery, patient's perception towards the various techniques and post-operative wound healing were evaluated. Results: The results showed that bleeding during surgery was minimum in group 3 as compared to other two groups. Patient's perception towards paralleling technique with scalpel, was found better than the other groups. At 7th day, though there was a difference in the healing but at 21st day wound healing was almost similar in all the three groups. Conclusion: Based on our findings and clinical outcome, paralleling technique with scalpel provided better patient's perception and an efficient and satisfactory option for frenectomy.

Purpose An innovative hybrid toothbrush was designed to function either in manual sonic mode or combined mode (manual and sonic). The primary objective was to assess the efficacy of a new hybrid powered toothbrush (PTB) used in combined mode versus a comparative manual toothbrush (MTB) for plaque removal, after 14 days of twice-daily use under normal conditions. The secondary objectives were to evaluate the gingival state, to evaluate the tolerance of the hybrid PTB and to evaluate its acceptability. Materials and Methods This study was a monocentric, block-randomized, dual treatment, parallel group, and examiner-blinded trial with before and after evaluation. It was conducted on two groups of 55 subjects presenting a visible plaque accumulation (score ≥2 as measured by the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI)). On Day 1/Day 8/Day 15, the same investigator conducted blind clinical examinations on each subject and evaluated TMQHPI and Papillary Bleeding Score (PBS). On Day 1, the subjects received either the hybrid PTB or the comparative MTB and used it twice daily under normal conditions of use. Results The hybrid PTB used in its combined mode eliminates dental plaque more efficiently than the comparative MTB, especially in difficult-to-access areas such as posterior and interproximal dental surfaces, while remaining gentle on the gingivae. The PBS was significantly lower with the hybrid toothbrush compared with the reference manual one. Conclusion The new device confirmed previous findings and should improve oral hygiene following the manufacturer's instructions. Moreover, the specific design of the toothbrush means that it can be used according to the oral environment conditions and personal feeling.

Purpose Surface sealants are widely used as a prevention strategy and are indicated for young patients with insufficient oral hygiene who also need plaque removal by professional tooth cleaning. The aim of this study was to evaluate discoloration of surface sealants by plaque disclosing solutions and to test to what extent this discoloration can be reduced again by professional tooth cleaning. Methods In all, 96 extracted lesion-free human teeth were randomly assigned to treatment with either Pro Seal® (PS; Opal Orthodontics, South Jordan, UT, USA) or Opal®Seal™ (OS; Reliance Orthodontic Products, Itasca, IL, USA). Color evaluations after application of the plaque disclosing solution Mira-2-Ton® (Hager & Werken, Duisburg, Germany) were performed using a clinical spectrophotometer. Staining and polishing were repeated once. Color differences (∆E) above 3.77 were regarded as clinically relevant. Results All sealants showed high, clinically relevant ∆E values after the first staining. Polishing led to significantly decreased ∆E values on PS-treated teeth; however, the median ∆E value remained above the clinically relevant threshold. Polishing on OS-treated teeth only slightly reduced ∆E values. After professional tooth cleaning both PS and OS showed clinically relevant ∆E values. Conclusion Surface sealants show clinically relevant discoloration after exposure to plaque disclosing solution under in vitro conditions. Such discolorations could not be removed by professional tooth cleaning. Thus, in clinical practice, plaque disclosing solutions might cause esthetic deficits in surface sealant-treated teeth. The impact of plaque disclosing solutions under clinical conditions (e.g., in the presence of saliva and by various aspects of a person’s nutrition) should be investigated in clinical studies.

Elderly patients often find it challenging to remove plaque accumulated on the attachments of implant overdentures (IODs) using conventional cleaning instruments. Further, excessive plaque accumulation can lead to peri-implant diseases and occasionally to respiratory diseases. Therefore, here, we aimed to compare the effectiveness of waist-shaped interdental brushes (WIBs) with that of straight-shaped interdental brushes (SIBs) in plaque removal from the locator attachments of IODs. Twenty participants with 2 locator attachments retaining mandibular IODs participated in this study. After the baseline cleaning, the participants refrained from oral hygiene maintenance for 3 days. A dentist cleaned 1 of the attachments using the WIB and the other attachment using the SIB. The pre- and post-cleaning modified plaque index (mPLI) scores were recorded. After another 3 days free from oral hygiene maintenance, the trained participants repeated the same cleaning procedure using the WIB and SIB. Pre- and post-cleaning mPLI scores were recorded. Regardless of the type of brush used, the post-cleaning mPLI scores were lower than the pre-cleaning scores. After the cleaning procedure, the overall mean mPLI score was lower in the WIB group than in the SIB group. The post-cleaning mPLI scores at the line angles and on the axial surfaces of the attachments were also lower in the WIB group than in the SIB group. There was no difference in the cleaning effectiveness between the dentist and participants when they used the same type of interdental brush. The WIB was significantly more efficient in plaque removal than the SIB, especially at the line-angle sites.

Objective: The objective was to assess plaque removal potential of a newly designed oscillating-rotating (O-R) electric rechargeable toothbrush with micro-vibrations compared to a manual toothbrush. Methods: This was a randomized single-brushing, two-treatment, examiner-blind, replicate-use, four-period crossover design study, conducted with three cohorts of nine subjects each, with all subjects using each toothbrush twice. Test toothbrushes included a new O-R rechargeable electric toothbrush with micro-vibrations (Oral-B iO prototype) and a manual American Dental Association (ADA) reference toothbrush. On each of the four study visits, subjects refrained from oral hygiene for 12 hours prior. At each visit, subjects received a pre-brushing plaque examination, brushed with their assigned toothbrush and a marketed fluoride dentifrice and then received a post-brushing plaque examination. Plaque was assessed using the expanded Turesky Modified Quigley-Hein Plaque Index. Treatment comparison analyses were two-sided and carried out at the 5% significance level. Results: All 27 randomized subjects (mean age = 42.0 years) completed the trial. Both brushes produced significant plaque reductions versus baseline (P < 0.001). The O-R electric brush provided statistically significantly greater plaque reductions in all regions compared to the regular manual toothbrush, with a between-treatment difference of 0.929 for whole mouth plaque, 0.965 for proximal plaque, 1.029 for lingual plaque and 0.815 for facial plaque (P < 0.001 for all comparisons). Additionally, use of the novel O-R brush yielded greater brushing evenness/consistency when comparing the facial and lingual mean plaque removal differences relative to manual brushing (P = 0.001). Both brushes were well-tolerated. Conclusion: The novel O-R toothbrush with micro-vibrations produced significantly greater plaque reductions compared to the manual toothbrush.

Objectives: In adult participants, what is, following a single brushing exercise, the efficacy of a powered toothbrush (PTB) as compared to a manual toothbrush (MTB) on plaque removal?. Methods: MEDLINE-PubMed and Cochrane-CENTRAL were searched from inception to February 2019. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects ≥18 years of age, in good general health and without periodontitis, orthodontic treatment, implants and/or removable prosthesis. Papers evaluating a PTB compared with a MTB in a single brushing exercise were included. When plaque scores were assessed according to the Quigley-Hein plaque index (Q&HPI) or the Rustogi modified Navy plaque index (RMNPI). From the eligible studies, data were extracted. A meta-analysis and subanalysis for brands and mode of action being oscillating-rotating (OR) and side-to-side (SS) were performed when feasible. Results: Independent screening of 3450 unique papers resulted in 17 eligible publications presenting 36 comparisons. In total, 28 comparisons assessed toothbrushing efficacy according to the Q&HPI and eight comparisons used the RMNPI. Results showed a significant effect in favour of the PTB. The difference of Means (DiffM) was −0.14 (P

Background: At present, different designs of tooth brushes are available, each one is being claimed to be the best by their manufacturers. There is a need to compare the plaque removal efficacy of the most popular designs. Aim: The aim of the present study was to compare the degree ofplaque removal obtained with the use of two commercially available tooth brushes with round ended and thinner tip bristles. Materials and Methods: The study involved 60 subjects within age range 18–40 years, randomly distributed into 2 groups, 30 in each: Group A- round ended bristle, Group B– thinner tip bristle. Turesky, Gilmore, Glickman Modification of Quigley-Hein Plaque Index, (1970), (PI) was assessed at baseline, 2 weeks, 4 weeks, and 6 weeks; and Muhlemann and Son, (1971), Sulcus bleeding index (SBI) at baseline and 2 weeks were assessed in each subject. Scaling was done at 2nd week, 4th week, and 6th week after assessment of parameter. At 4th week the subjects were switched over to another type of brush for crossover evaluation. Results: Over 2 weeks, both the groups showed significant (P < 0.05) reduction in plaque score, better reduction in Group A with mean differences of 0.48 than 0.41 in Group B, though it was insignificant on intergroup comparison (P = 0.09). There was reduction in SBI in both groups with mean difference of 0.50 in Group A and 0.11 in Group B and this was statically insignificant. But on comparison, between the two groups at 2 weeks, statically significant reduction was there in Group A. Brushing with specified brush, after scaling, at 4th week Group A had significantly better plaque control (P < 0.01). Upon crossover analysis, better efficiency of round ended bristles was observed but it did not reach the significance level (P = 0.126). Conclusion: Within the limitations of the study, the data derived from the study show that both the toothbrushes had shown decrease in plaque scores. Round ended bristles were more efficient.

OBJECTIVE: The mechanical plaque removal methods for removable orthodontic appliances (ROAs) may damage the surface of the appliance and may not effectively eliminate the entire microbial plaque. This study aimed to compare the efficacy of brushing+denture cleansing tablets, brushing+propolis mouthwash, and brushing only, for plaque removal from the surface of each orthodontic appliance. METHODS: This crossover randomized clinical trial evaluated 32 patients aged 7-15 years with ROAs. The patients were randomly assigned to 3 groups of brushing (control), brushing + denture cleansing tablets (intervention group 1), and brushing + propolis mouthwash (intervention group 2). The plaque removal methods were switched among the groups during 3 periods, each of 1-month duration. One month after practicing a certain protocol, the plaque disclosing agent was applied on the surface of the appliance. The photographs of the appliances were analyzed by Image J software to calculate the surface area occupied by the residual microbial plaque. RESULTS: The ratio difference between the surface area of residual plaque to the surface area of the entire appliance was significant between the intervention group 1 and the control group (P

OBJECTIVE: The aim of this study was to investigate the effects of using plaque-disclosing tablets (PDTs) on the plaque and gingival index scores of patients wearing fixed orthodontic appliances. METHODS: In group A (n=16), the subjects were motivated by conventional oral hygiene instructions, including verbal information about tooth brushing. The patients in group B (n=17) were motivated using PDTs used in the dentists’ office to show the locations of biofilms in addition to the instructions given to group A. Both the chairside demonstration performed in group B and the at-home use of disclosing tablets were undertaken by those in group C (n=15). The periodontal parameters were recorded before applying the fixed appliance (T0) and after the first (T1) and third (T2) months. RESULTS: The plaque index (PI) scores of group C were significantly lower (p0.05) were found between groups A and B. The gingival status of group C did not change significantly (p>0.05) over the three months and was statistically lower when compared to groups A and B. CONCLUSION: The use of PDTs at home may enhance the plaque removal efficiency and gingival health stability, by facilitating self-examination.

Background/purpose Few papers were available on the interproximal cleaning efficiency by manual toothbrushes when used alone. The aim was to investigate the efficiency of commercially available toothbrushes on interproximal cleaning and determine the key properties that would make the differences. Materials and methods Artificial-teeth were coated with manicure type experimental dental plaque covering mainly the interproximal surface and fixed in the jaw model of a dental simulator. A modified scrubbing technique was employed to brush out the plaque conducted by one trained dentist using 26 different toothbrushes from the equal number of separate interproximal conditions. The rate of the plaque removal (%) was calculated by measuring the plaque free areas on the post-brush images. Results The data analysis using mixed effect modelling showed that stiffness, number of tufts and total length have effect on the rate of the plaque removable from the interproximal surfaces. Conclusion This study indicated consideration should be given to toothbrush properties to enhance plaque removal from the interproximal surfaces.

Summary Objective The objective of this trial was to compare the plaque removal ability of a triple-headed toothbrush to a conventional manual toothbrush in adolescents with fixed orthodontic appliances. Materials and methods Sixty adolescent patients undergoing orthodontic treatment were randomly assigned to brush one time with either a conventional manual toothbrush or a triple-headed toothbrush. The main outcome was the post-brushing plaque index as measured by the Silness-Loe plaque index. Results Sixty patients (mean age, 14.2; standard deviation, 1.65) were randomized in a 1:1 ratio to either a manual toothbrush group or a triple-headed toothbrush group. Baseline characteristics were similar between the two groups. There were no dropouts. The mean post-brushing plaque index was 0.84 (95% CI, 0.67–1.02; SD, 0.60) for the conventional manual toothbrush group, and 0.31 (95% CI, 0.13–0.49; SD, 0.48) for the triple-headed toothbrush group. There was a statistically significant difference in the mean plaque index of 0.53 (95% CI, 0.28–0.78; P Conclusion The results of this study indicate strong evidence that the triple-headed toothbrush leads to a significantly lower plaque index compared to the conventional manual toothbrush post-brushing.

Aim and objective To compare dental plaque removal efficacy with a manual and powered toothbrush in 10-14 years old visually and auditory impaired children. Material and methods The proposed study was a randomized controlled study. The ethical approval was obtained from the institutional ethical board. The written informed consent for the study was taken from the parents. The 60 participants were categorized into group I: visually impaired (30) and group II: speech and hearing impaired (30) which were again divided into I1 (manual toothbrush) and I2 (powered toothbrush); II1 (manual toothbrush) and II2 (powered toothbrush), respectively. The baseline score was recorded using Turesky-Gilmor-Glickman Modification of The Quigley-Hein plaque Index. The oral prophylaxis was performed and then randomization of the toothbrush group was done with concealed allocation method. The plaque-removal efficacy was evaluated at the end of the 15 days in the visually and hearing-impaired children. Results The mean score of dental plaque at baseline was 1.44 for the manual toothbrush group and 1.65 for the powered toothbrush group in visually impaired children, respectively. In blind children with a manual toothbrush, the mean score difference was 0.14 while the powered toothbrush showed the mean score difference of 0.30 which is significant. The mean score of dental plaque at baseline was 1.74 for the manual toothbrush group and 1.80 for the powered toothbrush group in auditory impaired children. In auditory impaired children with manual toothbrushes, the mean score difference was 0.15 while the powered toothbrush showed the mean score of 0.32 which was significant. Conclusion Dental plaque reduction was significantly better with the powered toothbrush as compared to a manual toothbrush in visually and auditory impaired children. How to cite this article Patel NG, Bargale S, Shah S, et al. Comparison of Plaque Removal Efficacy with Powered and Manual Toothbrushes in 10-14-year-old Visually and Auditory Impaired Children: A Randomized Controlled Study. Int J Clin Pediatr Dent 2021;14(3):364-368.

For patients with fixed orthodontic appliances, adequate daily dental plaque removal is more difficult. As a result, dental plaque accumulates more quickly and gingivitis and white spots develop more often. In non-orthodontic patients, electric toothbrushing is more effective in dental plaque removal than a manual toothbrush. This structured literature review shows that there is limited evidence that electric toothbrushes are more effective in plaque removal than a manual toothbrush in patients with fixed orthodontic appliances.Bij patiënten met vaste orthodontische apparatuur is adequate dagelijkse plaqueverwijdering moeilijker dan zonder deze apparatuur, waardoor plaque sneller accumuleert en vaker gingivitis en witte vlekken ontstaan. Bij niet-orthodontische patiënten is elektrisch tandenpoetsen effectiever in plaqueverwijdering dan met een handtandenborstel. Uit dit gestructureerde literatuuronderzoek blijkt dat er beperkte evidentie is dat elektrische tandenborstels effectiever zijn in plaqueverwijdering dan een handtandenborstel bij patiënten met een vaste orthodontische apparatuur.

Dental biofilm is often found to be the source of bacteria that releases toxins, peptides, lipopolysaccharides as well as organic acids, which lead to gingival inflammation and tooth caries. Further, the persistent plaque may result in the continued destruction of the surrounding soft and hard tissues. During fixed orthodontic therapy, arch-wires, brackets, and elastic modules have been shown to be sites of significant plaque accumulation, making it difficult for a patient to maintain proper oral hygiene. The problem most dentists face is that they cannot visualize this biofilm completely to be able to carry out efficient plaque removal. Visual assessment is, to date, the most common method for plaque visualization, and various indexes have been demonstrated to be sufficient for quantification of the amount of plaque present. However, the problem is that visual assessments are inconsistent, operator dependent and often subjective, which can lead to inconsistency in results. Fluorescence is one such method that can be explored for its use in effective plaque identification and removal. Literature has it that dentists and patients find it particularly useful for monitoring oral hygiene status during treatment. Fluorescence has the capability of offering clinical orthodontists and researchers a new method of detection of demineralization during orthodontic treatment, furthermore, for efficient removal of orthodontic adhesive cements, fluorescent light may be used in conjunction with high-speed burs to deliver fast, less time consuming, and safer results. The benefit of direct visual treatment using fluorescence enhanced theragnosis is that the patient receives controlled and guided therapy. It has multiple benefits, such as early diagnosis of caries, biofilm identification, and even helps to achieve improved treatment outcomes by better resin selection for esthetic procedures.

This study evaluated the effectiveness of a microcurrent toothbrush (approved by the US Food and Drug Administration [FDA]), which employs a superimposed alternating and direct electric current, named as a Proxywave® technology, similar to the intensity of the biocurrent, in plaque removal and reducing gingivitis by biofilm removal through the bioelectric effect. This study enrolled 40 volunteers with gingivitis. Dental observations were made every two weeks, before and after the use of each toothbrush. We randomly assigned participants into two groups: one group used the Proxywave® toothbrush (PB) for two weeks followed by the control toothbrush (CB) for two weeks, while the other group used the CB for two weeks followed by the PB. The participants had a two-week washout period. If the toothbrush used earlier has had an effect on the bacterial flora in the oral cavity, this is to remove this effect and return it to its previous state. During each dental visit, we recorded plaque index (PI) and gingival index (GI) scores. The PI and GI scores were significantly lower in both the PB and the CB (p &lt, 0.05). Considering the PI, there was no significant difference between the toothbrushes on all the surfaces. Considering the GI, the PB showed a significant decrease in the interproximal surface, compared to the CB (p &lt, 0.05). The PB showed a significant decrease in the interproximal GI and had a beneficial effect in the interproximal area where the bristles could not reach. No adverse events were observed in the participants during the clinical trial. The microcurrent toothbrush is a device that can be safely used for plaque removal.

Summary Early detection of limb ischemia, strokes, and heart attacks may be enabled via long-term monitoring of arterial health. Early stenosis, decreased blood flow, and clots are common after surgical vascular bypass or plaque removal from a diseased vessel and can lead to the above diseases. Continuous arterial monitoring for the early diagnosis of such complications is possible by implanting a sensor during surgery that is wirelessly monitored by patients after surgery. Here, we report the design of a wireless capacitive sensor wrapped around the artery during surgery for continuous post-operative monitoring of arterial health. The sensor responds to diverse artery sizes and extents of occlusion in vitro to at least 20 cm upstream and downstream of the sensor. It demonstrated strong capability to monitor progression of arterial occlusion in human cadaver and small animal models. This technology is promising for wireless monitoring of arterial health for pre-symptomatic disease detection and prevention.

OBJECTIVES This study aimed to evaluate plaque removal efficacy of toothbrushes to guide clinical model development. METHODS This single-centre, randomised, controlled, examiner-blind, method development study included 80 healthy participants. Over 28 days, participants brushed twice-daily using a fluoride toothpaste and one of four marketed toothbrushes: Toothbrushes A (compact head) and B (regular head): medium-hard; flat trim; end-rounded bristles; Toothbrush C: medium-hard; end-rounded bristles; silky, tapered filaments; compact head; Toothbrush D: soft; tapered filaments; compact head. Supra-gingival plaque removal was evaluated immediately after single brushing events (Days 0, 7, 28, at study centre) and following 7- and 28-days' home use via Rustogi modified Navy Plaque Index (RPI) and Turesky modified Quigley Hein Plaque Index (TPI). RESULTS All toothbrushes provided significant plaque removal after single-brushing events with change from Day 0 pre-brushing scores on RPI ranging from -0.10 to -0.16 (p

Head and neck reconstructive microsurgery in patients with calcified vessels (atherosclerosis or radiotherapy) is challenging. Preoperative reconstruction planning should meticulously evaluate the pedicle length and caliber aiming to select the most adapted free flap type and to plan the need for harvesting two free flaps or a venous graft. During surgery, end-to-end microanastomosis should be preferred, without artery clamps on calcified vessels and using open-loop sutures, a limited number of microsutures and a round needle with inside-outside directed bites (no atherosclerotic plaque removal). Before declamping, fibrin sealants are used to prevent minor leakage around the anastomosis as well as before wound closure to fix the optimal position of the pedicle avoiding pressure on the vessels or pedicle kinking. Calcified vessels are not a barrier to microsurgery and do not constitute a contraindication. Several options are useful to safely perform microsurgical head and neck reconstruction.

Background In elite sport, the protection of an athlete's health is a priority. However, research indicates a substantial prevalence of oral disease in elite and professional athletes. The challenges to oral health from participation in sport require investigation to identify effective strategies and mitigate risk.Aim To explore athlete-reported oral health behaviours, risks and potential for behaviour change in a representative sample of elite athletes based in the UK.Method This was a cross-sectional study. We provided oral health screening for 352 elite and professional athletes from June 2015 to September 2016; 344 athletes also completed a questionnaire.Results The median age was 25 years (range 18-39) and 236 (67%) were male; 323 (94.2%) said they brush twice daily while 136 (40%) said their most recent dental attendance was within the previous six months. Ninety-seven (28%) would be assessed as high consumers of sugar in their regular diet. The use of sports nutrition products was common with 288 (80%) reporting the use of sports drinks during training or competition but were positive about behaviour changes.Conclusion Despite reporting positive oral health-related behaviours, athletes have substantial amounts of oral disease. Athletes are willing to consider behaviour change related to daily plaque removal, increased fluoride availability and regular dental visits to improve oral health.

Objective: The present study aimed to evaluate the biofilm removal capacity according to sex and age. Material and methods: Seventy individuals aged between 21 and 70 years were included. Modified Navy Board Index (MNBI) was performed by a calibrated examiner. Individuals brushed their teeth with a brush for a minute, and the MNBI was applied again. The volunteers were asked to use the brush for seven days, twice a day, with standardized toothpaste. On day 7, the same procedures of the first visit were made. The percentages of removal of supragingival biofilm (whole-mouth, interproximal and gingival margin line) were calculated for each of the experimental periods. Comparisons were performed between genders and age using the t-test for independent samples. The significance level adopted was 5%. Results: At baseline and after 7 days, women presented more dental plaque in whole mouth than men (p 37 years or older (p

Objective: To test the efficacy of a dentifrice containing baking soda (BS), compared with dentifrice without BS for controlling plaque and gingivitis.Materials and methods: MEDLINE‐PubMed and Cochrane‐CENTRAL were searched. The inclusion criteria were randomized controlled clinical trials including healthy participants aged 18 years or older. Studies were selected that compared the effect of toothbrushing with a dentifrice with and without BS on the clinical parameters of plaque and gingivitis. Data were extracted from the selected studies, and a meta‐analysis was performed.Results: The search retrieved 21 eligible publications. Among these papers, 43 comparisons were provided, with 23 involving a single‐use design and 20 being evaluations with a follow‐up. Negative controls were found, or positive controls for which various active ingredients had been used. The included studies showed a moderate overall potential risk of bias and considerable heterogeneity. The meta‐analysis of plaque scores from the single‐brushing experiments showed that BS dentifrice (BS‐DF) was associated with significantly better outcomes than the negative control dentifrices (DiffM −0.20; P < 0.0001; 95% CI: [−0.27; −0.12]) or the positive control dentifrices (DiffM −0.18; P < 0.0001; 95% CI: [−0.24; −0.12]). This finding was only confirmed in studies that used a follow‐up design as compared to a negative control (DiffM −0.19; P = 0.01; 95% CI: [−0.34; −0.04]). The indices of gingival bleeding also improved when the comparison was a negative control (DiffM −0.08; P = 0.02; 95% CI: [−0.16; −0.01] and (DiffM −0.13; P < 0.001; 95% CI: [−0.18; −0.08]. However, for the gingival index scores, the meta‐analysis did not reveal any significant differences.Conclusion: BS‐DF showed promising results with respect to plaque removal in single‐use studies. However, the finding was partially substantiated in follow‐up studies. Studies that assessed bleeding scores indicated that a small reduction can be expected from BS, relative to a control product.

Background: Molars and premolars are considered as the most vulnerable teeth of caries attack, which is related to the morphology of their occlusal surfaces along with the difficulty of plaque removal. different methods were used for early caries detection that provide sensitive, accurate preoperative diagnosis of caries depths to establish adequate preventive measures and avoid premature tooth treatment by restoration. The aim of the present study was to evaluate the clinical sensitivity and specificity rates of DIAGNOdent and visual inspection as opposed to the ICDAS for the detection of initial occlusal caries in noncavitated first permanent molars. Materials and Methods: This study examined 139 occlusal surface of the first permanent molar pooled from fifty patients aged 8-9 years by three methods. The selected criteria include one occlusal site per tooth (first permanent molars) with carious lesions range from 0 to 3 according to ICDASII (gold standard) visual criteria then the clinical sensitivity and specificity of visual inspection according to Ekstrand et al.in 1997 and DIAGNOdent were performed. . Results: the highest correlation was found between the ICDASII and DIAGNOdent. The sensitivity of the DIAGNOdent for the enamel caries detection (D1) was better than that of visual inspection. The sensitivity and the specificity for the DIAGNOdent at D3 threshold were better than the D1 threshold and the visual inspection method. Conclusion: DIAGNOden pen can be used as a tool for early caries detection in cases of difficult diagnosis that provide good additional sensitivity to the visual inspection.

OBJECTIVE The aim of this study was to investigate the characteristics of bacteremia caused by professional mechanical plaque removal (PMPR) in two groups of patients with generalized moderate chronic periodontitis. MATERIALS AND METHODS Venous blood samples were taken at multiple time points for one hour following PMPR in fifty patients with generalized moderate chronic periodontitis. Subjects consisted of two groups, one group was receiving supportive periodontal therapy (SPT, n = 25) and the other group was receiving initial periodontal therapy (IPT, n = 25). Blood samples were processed and analyzed for cultivable microflora. Pertinent clinical parameters were recorded for each patient in both groups. RESULTS Bacteremia was detected in 10 of 25 SPT and 8 of 25 IPT patients (p = 0.796). In both groups, the prevalence of bacteremia was dependent on the time of blood sampling and varied in magnitude between

Aim and objective This study aimed to compare the plaque removal efficacy of different toothbrushes and to ascertain the most efficient mechanical mean for daily plaque removal so as to maintain oral health in a preeminent way. Study design It was a randomized controlled clinical trial consisting of 60 subjects divided into three groups (group I ultrasonic and sonic toothbrush, group II multidirectional toothbrush, and group III manual toothbrush) with 20 in each group. Prebrushing and postbrushing plaque scores were recorded at weekly intervals for four weeks using Turesky modification of Quigley and Hein plaque index. Results Statistically significant differences (p < 0.001) existed in mean percent reduction of pre-day 1 to pre-day 28 mean percent reduction in plaque values of the ultrasonic toothbrush group (111.92 ± 25.20), the multidirectional toothbrush group (189.06 ± 52.70), and the manual toothbrush group (42.34 ± 14.77). Similar results were found in post-day 1 to post-day 28 mean percent reduction in plaque values. Conclusion Group II (i.e., multidirectional toothbrush) showed maximum mean percent reduction in prebrushing and postbrushing plaque scores at the end of four weeks when compared with the baseline values followed by ultrasonic toothbrush and manual toothbrush. How to cite this article Aggarwal N, Gupta S, Grover R, et al. Plaque Removal Efficacy of Different Toothbrushes: A Comparative Study. Int J Clin Pediatr Dent 2019;12(5):385–390.

Introduction The foundation for healthy permanent teeth in children and teenagers is laid during the first few years of life. Toothbrushing should be presented as a habit. A wide array of toothbrushes is available in the market, which differ in size, design, length, hardness, arrangement of bristles. This present clinical study is undertaken to evaluate the effectiveness of ionic toothbrush on oral hygiene status and plaque removal. Materials and methods A total of 30 children aged 6 years to 12 years were selected in this study. The children were divided into two groups, 15 children were given HyG ionic toothbrush, were instructed how to use product according to manufacturer's instructions, 15 children were assigned to use manual toothbrush, instructed to brush their teeth in usual manner. All subjects used the same commercially available dentifrice throughout the study. Results The results were evaluated at each visit day 0, day 15 and day 30 following 12–18 hours of no oral hygiene. The subjects brushed their teeth twice daily for 1 minute under supervision. The result showed that there was significant difference in all the mean values in all the parameters. It may be concluded from the present study that though the ionic toothbrush was insignificantly superior to the manual toothbrush, both the toothbrushes are clinically effective in removing plaque and improving the gingival conditions. How to cite this article Chandra S, Jain N, Garg R, et al. Ionic vs Manual Toothbrushes: Effect on Plaque and Oral Hygiene Status in Children. Int J Clin Pediatr Dent 2019;12(5):375–378.

Aim To compare plaque removal and wear between charcoal infused bristle toothbrushes (T1) and nylon bristle toothbrushes (T2) in a randomized clinical crossover study. Materials and methods A cross-over study was conducted in 2 phases of 6 weeks duration each with an intervening 2-week washout. Twenty-five participants meeting inclusion criteria were randomly allocated into groups A (13) and B (12). In phase 1: group A was assigned T1 and group B was assigned T2. Toothbrushing was advised twice daily for 2 minutes by modified bass technique after meals. At baseline, 3 weeks and 6 weeks the wear index (WI), plaque index (PI) and gingival index (GI) were recorded. Following washout in phase 2 group A was assigned T2 and group B was assigned T1 and the same study protocol was followed. Results Intra-group comparison between baseline, 3 and 6 weeks by the paired t-test resulted in significant reduction in PI, GI and increase in WI (p 0.05). Conclusion Charcoal infused bristles demonstrated less wear and more plaque removal compared to nylon bristles. Clinical significance Charcoal infused bristles demonstrate less wear compared to nylon bristles.

Supportive periodontal therapy (SPT) is an important factor in maintaining the results of active treatment of periodontal disease. Selection of effective personal hygienic tools is very important in addition to the formation of sustainable hygienic skills in patients. The aim of the study is a comparative assessment of the quality of mechanical removal of a native microbial biofilm with toothbrushes with different types of head rotation and a manual toothbrush. Objects and methods. The extracted teeth were fixed in plaster models, and the vestibular surface of the three teeth was processed for 10 seconds without the use of toothpaste. Tooth № 1 was a control (biofilm was not removed), tooth № 2 was cleaned with a manual toothbrush with an imitation of the Brass method, tooth № 3 was cleaned with a brush with oscillating-rotating movements of bristles. Tooth №4 was brushed with a toothbrush with vibrating types of bristles motion. The enamel-cementum junction of the tooth was taken strictly from the vestibular surface along the central axis of the tooth for studying in a scanning electron microscope. Conclusions. A complete cleaning of the tooth enamel surface from microbial biofilms is not achieved after using a manual toothbrush. Toothbrushes with oscillating-rotating movements of bristles create the phenomenon of “sweeping” of the biofilm fragments into the area of the cementum-enamel junction. The vibrating types of bristles motion maximally clean the cervical area of the tooth.

Objective: Aim of this study was to compare the plaque-reducing effectiveness of powered and manual tooth brushing in a small group of children.Materials and Methods: Ten children aged between 7 to 10 years old were included the study. Each child firstly used manual tooth brush (ORAL B Stages for children). After two weeks children were asked to use powered tooth brush (ORAL-B TRIUMPH 5000 SMART GUIDE) for two weeks. Turesky modification of the Quigley and Hein Plaque Index (TQHPI) and Approximal Plaque Index (API) scores were recorded every two weeks. Friedman test and Wilcoxon signed rank test were used for comparison the jaws and powered brush /manual brush. Significance at p

Background: Atherosclerotic disease of the internal carotid artery (ICA) is a common reason for ischemic stroke. Computed tomography angiography (CTA) is a common tool for evaluation of internal carotid artery (ICA) stenosis. However, blooming artifacts caused by calcified plaques might lead to overestimation of the stenosis grade. Furthermore, the intracranial ICA is more vulnerable to calcification than other ICA segments. The proposed technique, dual-energy computed tomography (DECT) with a modified three-material decomposition algorithm may facilitate the removal of calcified plaques and thus increase diagnostic accuracy.Objectives: The objective of the study is to assess the accuracy of the modified three-material decomposition algorithm for grading intracranial ICA stenosis after calcified plaque removal, with digital subtraction angiography (DSA) used as a reference standard.Materials and Methods: In total, 41 patients underwent DECT angiography and DSA. The three-material decomposition DECT algorithm for calcium removal was applied. We evaluated 64 instances of calcified stenosis using conventional CTA, the previous non-modified calcium removal DECT technique, the modified DECT algorithm, and DSA. The correlation coefficient (r2) between the results generated by the modified algorithm and DSA was also calculated.Results: The virtual non-calcium images (VNCa) produced by the previous non-modified calcium removal algorithm were named VNCa 1, and those produced by the modified algorithm were named VNCa 2. The assigned degree of stenosis of VNCa 1 (mean stenosis: 39.33 ± 19.76%) differed significantly from that of conventional CTA images (mean stenosis: 59.03 ± 25.96%; P = 0.001), DSA (13.19 ± 17.12%, P < 0.001). VNCa 1 also significantly differed from VNCa 2 (mean stenosis: 15.35 ± 18.70%, P < 0.001). In addition, there was a significant difference between the degree of stenosis of VNCa 2 and conventional CTA images (P < 0.001). No significant differences were observed between VNCa 2 and DSA (P = 0.076). The correlation coefficient (r2) between the stenosis degree of the VNCa 2 and DSA images was 0.991.Conclusions: The proposed DECT with a modified three-material decomposition algorithm for calcium removal has high sensitivity for the detection of relevant stenoses, and its results were more strongly correlated with DSA than with those of conventional CTA or the previous non-modified algorithm. Further, it overcomes CTA's previous problem of overestimating the degree of stenosis because of blooming artifacts caused by calcified plaques. It is useful to account for calcified plaques while evaluating carotid stenosis.

AIM The aim of this study was to compare the efficacy of two brushing methods (manual vs. sonic) in terms of plaque control after a session of professional mechanical plaque removal (PMPR). METHODS Subjects with gingivitis underwent a session of PMPR and were randomly assigned to sonic (SB) or manual brushing (MB). Oral hygiene instructions were provided at baseline (BL), 2 (T0a), 4 (T0b) and 6 weeks (T1) and 6 months (T2). Plaque Index (PI), Gingival Index (GI) and bleeding on probing (BoP) were measured at BL, T1 and T2. The proportion of sites with PI, GI and BoP was modelled at site level using a negative binomial regression fitted via generalized linear mixed model accounting for intra-patient correlation. RESULTS Thirty-two subjects were selected, 16 assigned to each group and 31 completed the study. PI, BoP and GI were comparable at BL. At T1, PI was successfully maintained at 6.21% for SB and 22.81% for MB, while at T2 reached 11.34% for SB and 28% for MB, favouring the SB group (p

Purpose The aim of this randomized clinical trial was to assess whether chemical cleansing using a sulfonic/sulfuric acid gel solution (HBX) as an adjunct to scaling and root planing (SRP) resulted in a decrease in residual plaque and calculus in deep periodontal pockets compared to SRP alone. Methods Fifty-six patients with 56 hopeless posterior teeth, scheduled for extraction due to severe periodontitis, were enrolled in this study. Each tooth was randomly assigned to 1 of the 2 experimental procedures. The test teeth were subjected to the irrigation of the subgingival area with HBX for 2 minutes, followed by SRP with hand and ultrasonic instruments for 14 minutes, and then extracted. The control teeth received only mechanical instrumentation before extraction. Residual biofilm was evaluated on photographs and measured as total area and percentage of root surface covered by remaining plaque (RP) or calculus (RC) after treatment. Results The initial pocket depth (PD) and total subgingival root surface area were similar between the 2 treatment groups. After treatment, the total subgingival root area covered by RP and RC was statistically significantly larger (P, Graphical Abstract

Background and Aims: Dental plaque as the main etiological factor for caries and periodontal disease is transparent, colorless and not easily visible. Visualized dental plaque can be an aid for patients to develop an efficient system of plaque removal. Several disclosing agents have been developed and applied to clinical and home-care use, yet people are still searching for a natural coloring agent which could be considered safe for long term use. Methods: In this study, various concentrations of Pitaya flesh extract were tested to stain dental plaque taken from 30 volunteers. A disclosing agent of basic-fuchsin already marketed was used as a positive control. The dental plaque specimens were divided into 5 groups and each group was randomly stained either with 0.05 mL of basic fuchsin as a positive control, or 25%, 50%, 75%, or 100% Pitaya flesh extract. The specimens were then analyzed using a spectrophotometer. Results: The results showed that Pitaya flesh extract exhibited dental plaque staining ability. The concentration of 75% Pitaya was similar to the staining ability of basic-fuchsin, while 100% was superior to that of basic-fuchsin. Conclusion: Under the limitations of this study, 75% and 100% extract of pitaya flesh exhibited dental plaque staining in vitro as assessed by a spectrophotometer.

Previous findings from the positron emission tomography (PET) substudy of the SCarlet RoAD and Marguerite RoAD open-label extension (OLE) showed gantenerumab doses up to 1200 mg every 4 weeks administered subcutaneously resulted in robust beta-amyloid (Aβ) plaque removal over 24 months in people with prodromal-to-moderate Alzheimer’s disease (AD). In this 36-month update, we demonstrate continued reduction, with mean (standard error) centiloid values at 36 months of -4.3 (7.5), 0.8 (6.7), and 4.7 (8.0) in the SCarlet RoAD (double-blind pooled placebo and active groups), Marguerite RoAD double-blind placebo, and Marguerite RoAD double-blind active groups respectively, representing a change of -57.0 (10.3), -90.3 (9.0), and -74.9 (10.5) centiloids respectively. These results demonstrate that prolonged gantenerumab treatment, at doses up to 1200 mg, reduces amyloid plaque levels below the amyloid positivity threshold. The ongoing GRADUATE Phase III trials will evaluate potential clinical benefits associated with gantenerumab-induced amyloid-lowering in people with early (prodromal-to-mild) AD.

During orthodontic treatment, plaque tends to form around fixed orthodontic appliances, which increases the risk of dental caries. It has been reported that ultarafine bubble with a diameter

Background Clinical investigations of electric toothbrushes in young children are limited. Aim To assess plaque reduction efficacy of an oscillating-rotating electric versus manual toothbrush in a paediatric population in primary and mixed dentitions. Design In this randomised, single-brushing, 2-treatment, 4-period, replicate-use crossover study, subjects were divided into 2 age groups (3-6 years; 7-9 years) and assigned to a treatment sequence involving an Oral-B Kids electric brush and a manual brush control. Plaque was assessed pre- and post-brushing (Turesky Modified Quigley-Hein Plaque Index). Parents brushed the teeth of their children aged 3-6 years, whereas children aged 7-9 years brushed their own teeth under supervision. Plaque removal scores were analysed for brush differences in each age group separately using an analysis of covariance for crossover design. Results Forty-one children (n = 20, 3-6 years; n = 21, 7-9 years) completed the study. For the primary dentition in children 3-6 years, the electric brush reduced 32.3% more plaque than the manual brush (P = .005). For the mixed dentition in children 7-9 years, the electric brush reduced 51.9% more plaque than the manual brush (P Conclusions An electric toothbrush reduced significantly more plaque than a manual toothbrush in 2 paediatric age groups.

Objective: Air polishing is a safe tooth polishing technique used by dental professionals for stain and plaque removal and as a preventive procedure for dental health. We previously reported the antibacterial properties of cannabinoids against dental plaque bacteria. The objective of this study was to analyze the possibilities to improvise the existing air-polishing technique by supplementing cannabinoid powder into the classic polishing powder for effective removal of supragingival and subgingival plaque and for inhibition of plaque-forming bacteria. Materials and Methods: The cannabidiol (CBD) powder was added to the tooth polishing powder (AIR-N-GO, classic) at a 1% (wt/wt) ratio. The study was conducted on 12 patients, of whom six received regular polishing treatment and six received CBD-supplemented polishing treatment. The dental plaque samples were collected before and after each treatment and subjected to in vitro microbiological analysis, and the colony forming units (CFU) were analyzed by using an automated colony counter. Results: Based on in vitro microbiological analysis, the average CFU of interdental space samples collected from post-CBD-supplemented polishing treatment was significantly reduced (linear fold change between 3.9 and 18.4) compared with that of postregular polishing (linear fold change between 1.0 and 2.6) treatment. Conclusions: The CBD-supplemented polishing powder can help in effective removal and killing of dental plaque bacteria during the polishing treatment; it can also be added as an enhancing supplement to the existing polishing powders.

Aim: This systematic review synthesizes the available clinical evidence concerning efficacy of mechanical oral hygiene devices in periodontal maintenance patients. Material and Methods: Three databases were searched up to October 2019 for clinical trials conducted in adult patients in periodontal maintenance which evaluated the effect of toothbrushes or an interdental device on plaque removal and parameters of periodontal diseases. Descriptive analysis and network meta-analysis (NMA) were performed. Results: Sixteen eligible publications, including 17 relevant comparisons, were retrieved. Four out of five comparisons found no clinical difference between a manual and power toothbrush. Of the interdental cleaning devices, the interdental brushes (IDBs) reduced plaque scores more effectively than a manual toothbrush alone. For the oral irrigator, two out of three comparisons indicated a positive effect on gingivitis scores, and probing pocket depth. The NMA demonstrated that for plaque removal the adjuvant use of IDBs was significantly more effective than the manual toothbrush alone. For the reduction of gingival inflammation, no product ranked higher than the manual toothbrush. Conclusion: Due to the scarcity of studies that met the inclusion criteria for each of the oral hygiene devices and the low certainty of the resultant evidence, no strong “evidence-based” conclusion can be drawn concerning any specific oral hygiene device for patient self-care in periodontal maintenance.

We previously reported that polybutylene terephthalate (PBT) toothbrushes become less effective for plaque removal after two months of use. However, it remains unknown how the bristle stiffness of PBT toothbrushes changes after several months of use. We performed a single-center randomized controlled trial to evaluate the bristle stiffness and bristle splaying of soft and medium manual toothbrushes among dental and medical students of Hiroshima University. Subjects were 80 participants who met the criteria. Participants were randomly assigned to the soft toothbrush group (n = 40) or the medium toothbrush group (n = 40). We collected toothbrushes immediately after first use (T0), after one month of use (T1), after two months of use (T2), and after three months of use (T3). Bristle stiffness was measured according to the International Organization for Standardization (ISO) 22254. The mean bristle stiffness (N/cm2) of soft and medium toothbrushes was significantly lower at T2 and T3 than at T0 (T2 vs. T0, soft, 3.63 vs. 3.89, P &lt, 0.01 and medium, 4.33 vs. 4.52, P &lt, 0.05, respectively, and T3 vs. T0, 3.62 vs. 3.89, p &lt, 0.01 and 4.18 vs. 4.52, p &lt, 0.001, respectively). Bristle stiffness was significantly reduced in soft and medium PBT toothbrushes after two months of use.