To review and evaluate the literature with respect to the effect of cross angled bristle tuft (CAbt) configurations in manual toothbrushes as compared to flat trim (FTbt) toothbrushes on plaque scores and parameters of gingival health in adult patients.
Methods:
Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched up to September 2012 to identify eligible studies. Included were randomized controlled clinical trials comparing CAbt to FTbt toothbrushes. Only studies regarding self performed brushing by adult subjects without periodontitis were included. The primary outcome parameters were plaque and gingivitis scores. Secondary outcomes were side effects. Study selection, quality assessment and data extraction were carried out by two independent reviewers.
Results:
Independent screening by two investigators of the unique titles and abstracts of the respectively PubMed 105, Cochrane 69 and EMBASE 158 papers resulted in 5 publications. These provide 6 experiments that met the eligibility criteria of which 4 had a single-use design and 2 were longer term (30 days) studies. Due to heterogeneity of the indices used and the data presentation it was not possible to perform a meta-analysis. Therefore, a descriptive analysis was carried out. Regarding plaque scores, 3 out of the 4 single-use experiments and both longer term studies provided a significant positive effect in favor of CAbt over FTbt toothbrushes. Data regarding bleeding scores and gingival indices were rather scarce and inconclusive. No product related side effects were described in the selected studies.
Conclusion:
Based on limited but rather consistent evidence positive significant effects on plaque scores can be obtained when cross angled bristle tuft configurations toothbrushes are compared to flat trim toothbrush configuration.