In-Vitro Assessment of Novel Custom-Made Cleaning Devices

Objectives: Most elderly patients are rehabilitated with fixed or removable dental prostheses, but often demonstrate difficulties in performing adequate oral hygiene measures. The aim of this in-vitro study was to evaluate the efficacy of an innovative cleaning device for automated plaque removal (Seismodent©, patent pending).
Methods: A three-unit implant-supported fixed prosthesis (IFDP) was fitted on a resin teaching model. Plaque accumulation was modelled by applying a mixture of isopropyl alcohol and occlusal powder on the buccal and palatal sides of the model before each testing sequence. Two experimental Seismodent© devices (one-piece vibrating apparatuses individualized with Mucopren® or Erkoflex cleaning layers) were compared to manual brushing as well as to electric toothbrushes (sonic, rotation-oscillation). Each test comprised cleaning sequences of one, two or three minutes duration which were repeated five times. Standardized digital photographs served to evaluate the area of removed artificial plaque using image-substraction analysis ImageJ (outcome parameter). Statistical analysis comprised non-parametric Wilcoxon tests and ANOVA; 95%CI served to compare groups.
Results: Plaque free areas increased with cleaning time in all investigated groups, the Seismodent® devices, however, achieved a cleaning effect median>90% clean area already after one minute. All tested cleaning tools removed artificial plaque more effectively on the buccal than on the palatal surfaces (0.0001≤p≤0.03); except for the Erkoflex-coated appliance and the rotation-oscillation electric toothbrush (n.s.). The Mucopren®-coating cleaned significantly better than the control-devices in the first minute, beside the rotation-oscillation-subgroup (palatally). The least effective device was the manual toothbrush.
Conclusions: In the applied in-vitro model, the new device with Mucopren® coating removes plaque significantly better than manual- or electric toothbrushes; simultaneously brushing time can be reduced. The Seismodent device may be an alternative to patients with reduced dexterity, as it is easy to handle and does not depend on motor skills. Further development might comprise the use in implant-overdenture patients.