BackgroundMany adolescents have poor plaque control and sub-optimal toothbrushing behavior. Therefore, we compared the efficacy of an interactive power toothbrush (IPT) to a manual toothbrush (MT) for reducing dental plaque and improving toothbrushing compliance.MethodsIn this randomized, parallel single-blind clinical study, adolescents brushed twice daily with either a MT (Oral-B® Indicator soft manual toothbrush) or an IPT (Oral-B® ProfessionalCare 6000 with Bluetooth). Subjects brushed for 2 min, plus an additional 10 s for each ‘Focus Care Area’. At screening and Week 2, afternoon pre-brushing plaque was assessed via the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI), and supervised brushing duration was measured.ResultsSixty subjects were randomized; 98% completed. At Week 2, the mean reduction in whole mouth plaque relative to baseline was 34% (p < 0.001) for the IPT versus 1.7% (p = 0.231) for the MT. For Focus Care Areas, the IPT yielded a 38.1% mean TMQHPI reduction (p < 0.001) versus 6.2% for the MT (p < 0.001). Mean brushing time versus baseline increased 34 s in the IPT group (p < 0.001) while remaining flat in the MT group (p = 1.0).ConclusionsOver 2 weeks, adolescents using an IPT experienced superior plaque reduction and increased overall brushing time versus those using a MT.Trial registrationThis trial was retrospectively registered (ISRCTN10112852) on the 18th, June 2018.

Introduction: The objective of this 2-arm parallel trial was to determine the plaque removal efficacy (main outcome) and the motivation assessment (secondary outcome) comparing a manual versus an interactive power toothbrush in orthodontic patients. Methods: Sixty adolescents with fixed orthodontic appliances in both arches were randomized in a 1:1 ratio in this parallel, randomized, examiner-blind controlled clinical trial. Eligibility criteria included at least 16 natural teeth, 1-6 "focus care areas," plaque score of $1.75, no severe caries, gingivitis and periodontitis, no dental prophylaxis, no smoking, no antibiotics, and no chlorhexidine mouth rinse. Subjects were to brush unsupervised with either an interactive power toothbrush (Oral-B Professional Care 6000, D36/EB20) with Bluetooth technology or a regular manual toothbrush (Oral-B Indicator 35 soft). Focus care areas were each brushed for 10 additional seconds. Plaque removal was assessed with the use of the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI) to determine change from baseline at 2 and 6 weeks. Supervised brushing at screening and post-treatment visits recorded actual brushing times. Subject-reported motivational aspects were recorded at screening and week 6. Results: Fifty-nine subjects aged 13-17 years completed the study. The interactive power 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). Conclusions: An interactive power toothbrush generated increased brushing times and significantly greater plaque removal versus a manual brush. (Am J Orthod Dentofacial Orthop 2019;155:462-72)

To compare four plaque indices used in orthodontics. An objective, quantitative plaque index and three subjective conventional plaque indices were analyzed. The study included n = 50 photographs of n = 50 subjects with a multibracket appliance (MB) in the maxilla and mandible. Photographs were taken using Digital Plaque Imaging Analysis (DPIA) and the Percentage Plaque Index (PPI) was calculated. The conventional plaque indices, a modified version of the Turesky-modification of the Quigley & Hein Index (TQH index), Attin index, and modified bonded bracket index (mBB index) were collected from n = 14 evaluators using the DPIA photographs. The evaluators had different levels of orthodontic experience: n = 4 evaluators had little orthodontic experience, n = 5 evaluators had moderate orthodontic experience, and n = 5 evaluators had a lot of orthodontic experience. Plaque accumulation was assessed differently with the plaque indices. Thus, the plaque indices are not interchangeable. We recommend DPIA as an objective, quantitative and sensitive method for plaque determination in scientific studies. The simple statistical evaluation offers a great advantage over conventional plaque indices.

Background/Objectives: To compare the quantitative assessment methods, visual-tactile examination and fluorescence measurement, for the detection of white spot lesions (WSL) in adolescents with a multibracket appliance (MB).Material & Methods: The study included 28 subjects (14 ♂, 14 ♀) with MB in the maxilla and mandible. Data collection took place before (T0), half a year after (T1), and one year after the insertion of the MB (T2), using the Enamel Decalcification Index (EDI) developed by Banks & Richmond (1994, levels 0-3) and the quantitative light-induced fluorescence measurement (QLF).Results: At T0, n = 4 (14%) subjects were free of lesions. Six months after the onset of MB (T 1), n = 2 subjects (7%) were still free of lesions. One year after the onset of MB (T2), n = 2 subjects were free of lesions. The kappa coefficient value for measuring the degree of agreement between the two methods was 0.71 for all three study time points combined.Conclusion: Both the QLF and EDI methods demonstrated similar results, each presenting only a few discrepancies, which means that in order to determine the method most suitable for each individual case, the cost-benefit and time factors should be examined.