Dental Care with Manual Toothbrushes during Fixed Orthodontic Treatment—a New Testing Procedure

Sander, Franz Martin; Sander, Christian; Sander, Franz Günter

doi:10.1007/s00056-005-0509-1

Cited by 5 publications

(10 citation statements)

References 10 publications

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“…The fi ndings ( Figure 4 ) confi rm the results of a previous in vitro study ( Sander et al , 2005 ) which showed that different bristle arrangements, such as lowered bristles in the middle of the brushfi eld, have improved cleaning effi cacy than planar bristle fi elds. Toothbrushes with a fl at profi le proved to be unsatisfactory for the cleaning of teeth with brackets.…”

Section: Discussionsupporting

confidence: 85%

In vitro tooth cleaning efficacy of manual toothbrushes around brackets

Schätzle¹,

Imfeld

Sener

et al. 2008

The European Journal of Orthodontics

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The purpose of this laboratory study was to assess the potential cleaning efficacy of nine different toothbrushes around brackets in vitro. Standard and Mini Diamond brackets were fixed on coloured teeth in a special model, coated with white titanium oxide, brushed in a machine with different manual toothbrushes (three different types: planar, staged, and v-shaped bristle field), and tested with a horizontal motion for 1 minute. After brushing, the teeth were scanned and the black surfaces were planimetrically assessed using a grey scale. Tooth areas which were black again after brushing indicated tooth surface contact of the filaments. The remaining white tooth areas around the brackets indicated 'plaque-retentive' niches. Statistical analysis was carried out using the Kruskal-Wallis one-way test of variance for individual comparison. Bonferroni adjustment was used for multiple testing, and comparison of bracket size with Wilcoxon signed rank test. In the most critical area of 2 mm around the brackets, there was no statistically significant difference between the different toothbrushes evaluated. The untouched area ranged from 11 to 26 per cent of the initially whitened tooth surface. By pooling the toothbrushes according to their design, the median cleaning efficacy of the v-shaped (73.1 per cent) and staged (75.6 per cent) toothbrushes resulted in significantly superior cleaning efficacy than planar toothbrushes (60.7 per cent) for standard brackets. For mini bracket type, staged toothbrushes showed a significantly better mean cleaning efficacy (77.8 per cent) than planar (65 per cent) and v-shaped (72.4 per cent) toothbrushes. Staged and v-shaped brush designs resulted in superior cleaning efficacy of teeth with fixed orthodontic attachments than toothbrushes with a planar bristle field. None of the tested toothbrushes showed a consistent, significantly higher cleaning efficacy than the others in this in vitro experiment.

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Section: Discussionsupporting

confidence: 85%

In vitro tooth cleaning efficacy of manual toothbrushes around brackets

Schätzle¹,

Imfeld

Sener

et al. 2008

The European Journal of Orthodontics

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“…At a high load, soft or fine bristles may become twisted resulting in a lower cleaning efficacy. With low force, interaction with the toothsurfaces increases since soft bristles allow penetration into the interproximal and interbracket area (Sander et al, 2005). To overcome this phenomenon and to assess the effect of various high contact forces, the pressure (load/brush field surface) in the present study was kept constant.…”

Section: Discussionmentioning

confidence: 99%

“…In an attempt to facilitate plaque control in orthodontic patients, specially designed manual and electric toothbrush heads have been marketed. For manual toothbrushes, experimental studies have shown that staged and V-shaped brush head designs outperformed planar brushes in the cleaning efficacy of teeth with fixed orthodontic attachments (Sander et al, 2005;Schätzle et al, 2009). Their effectiveness in clinically reducing gingivitis is, however, questionable (Williams et al, 1987).…”

Section: Discussionmentioning

confidence: 99%

“…Due to the fact that at high loads soft or fine bristles may become twisted resulting in a lower cleaning efficacy (Sander et al, 2005), the tracking force was varied in relation to the brush head area in order to achieve a constant force (Load/Area; Table 1). In a preliminary trial, it was observed that when the brush heads were placed in the centre of the brackets and in a perpendicular direction, there was only minimal filament-tooth surface contact and poor cleaning efficacy (data not shown).…”

Section: Methodsmentioning

confidence: 99%

“…Numerous types of toothbrushes have been designed and promoted for orthodontic patients. In recent in vitro studies, staged and V-shaped brush head designs outperformed planar brushes in cleaning efficacy of teeth with fixed orthodontic attachments (Sander et al, 2005;Schätzle et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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In vitro tooth cleaning efficacy of electric toothbrushes around brackets

Schätzle

Sener

Schmidlin

et al. 2010

The European Journal of Orthodontics

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This in vitro study assessed the cleaning efficacy of different electric toothbrushes around upper incisor brackets. Standard and Mini Diamond brackets were fixed on black-stained teeth. The teeth were coated with white titanium oxide and brushed in a machine twice for 1 minute each. Twelve different brush heads with either a wiping or an oscillating-rotating action were tested. After brushing, the teeth were scanned, the black surfaces were assessed planimetrically and a modified plaque index for orthodontic patients (PIOP) was introduced. Tooth areas, which were black again after brushing indicated tooth surface contact of the filaments and were expressed as a percentage of total area. The remaining white areas around the brackets indicated 'plaque-retentive' niches. Analysis of variance was used for individual comparison of the brush types. Bonferroni/Dunn adjustment was applied for multiple testing. The Sonicare toothbrush handle with the brush head 'Compact ProResults' (81.7 per cent) and the brush head 'Standard ProResults' (80.8 per cent), as well as the sonic Waterpik toothbrush SR 800E with the standard brush head (78.2 per cent), showed statistically significantly better cleaning efficacy than all others. The poorest cleaning efficacy was observed for the oscillating-rotating Braun Oral-B Professional Care with the brush head 'Ortho' (less than 50 per cent). The planimetric findings were in correspondence with the results of the PIOP assessment. Cleaning efficacy of electric toothbrushes around brackets on upper incisors was different between the tested brushes. The PIOP was practicable, effective, and easy to use, although it has to be verified in a clinical study.

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Cleaning performance of electric toothbrushes around brackets applying different brushing forces: an in-vitro study

Rominger,

Patcas,

Hamza

et al. 2024

Sci Rep

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Throughout treatment with fixed orthodontic appliances, effective plaque control is crucial to maintaining dental health. This in-vitro study evaluated the cleaning performance of eleven different brush heads of seven electric toothbrushes (oscillating-rotating and sonic motions) and varying brushing forces around orthodontic brackets. Six Mini Diamond® Twin brackets were placed on black-stained front teeth. Teeth were coated with white titanium oxide and brushed in a machine six times for one minute with two different brushing forces (1 N and 1.5 N). Eleven different brush heads were evaluated (either oscillating-rotating or sonic movements). The teeth were scanned and planimetrically evaluated after brushing. Three detailed plaque areas (DPAs) were created: proximal (< 1 mm to bracket), mid-tier (1–2 mm to bracket), and distant (> 2 mm to bracket). The proportion of contaminated proximal, mid-tier, and distant surfaces (white regions) in relation to the respective DPA was calculated. Independent of brushing forces, places with a higher distance (> 2 mm) to the orthodontic bracket had the least amount of residual contamination, followed by areas with a minor (1–2 mm) and proximal distance (< 1 mm). In all of the brushes tested and for both estimated brushing forces, the region with the highest residual contamination was the proximal area. The brush heads of the Paro® Sonic toothbrush left the least amount of residual contamination. The cleaning performance of electric toothbrushes around brackets on upper incisors varied across the brushes examined. The proximal area has the most residual contamination. Furthermore, 9 out of 11 toothbrushes cleaned more successfully with 1.5 N than with 1 N brushing force.

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Dental Care with Manual Toothbrushes during Fixed Orthodontic Treatment—a New Testing Procedure

Abstract: From testing five toothbrushes with four different weights, we have established profiles confirming the beneficial and less beneficial properties of certain toothbrushes involving various high contact forces.

Cited by 5 publications

References 10 publications

In vitro tooth cleaning efficacy of manual toothbrushes around brackets

In vitro tooth cleaning efficacy of manual toothbrushes around brackets

In vitro tooth cleaning efficacy of electric toothbrushes around brackets

Cleaning performance of electric toothbrushes around brackets applying different brushing forces: an in-vitro study

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