Performance of a New Toothbrush for Orthodontic Patients: Pilot Study

Objectives: Better toothbrushes are needed to improve plaque control during orthodontic treatment since the attachments used complicate adequate hygiene which may lead to gingivitis and/or white-spot-lesions. Objective: evaluate plaque removal with a newly designed toothbrush for orthodontic patients(OP) and compare it to a “v”-shaped toothbrush commonly recommended for OP.
Methods: A pilot randomized clinical trial was performed on 51 OP (from a university clinic) with metal attachments. After acceptance, subjects were randomly assigned to either Oral-B-Orthodontic® (with a central v-shape groove) or Orthofit®, Ortho-Classic (recently designed, short central tufts, outer tufts bent inwards 120°). Subjects watched a short video of the technique for the assigned toothbrush, then ate a snack (cookie and small juice). A blinded periodontist stained(Tri-Plaque ID Gel®, GC) and evaluated plaque (Modified Silness/Loe Index, score0-3) on the distal, mesial, incisal and cervical surfaces of each tooth from the bracket. They then brushed (two minutes) following the video-instructions and plaque was re-evaluated. Plaque removal was calculated as the difference between both measurements. Differences were added for the mesial/distal and for the incisal/cervical areas and divided by the number of teeth with brackets/tubes for each subject. Non-parametric-tests were used to compare plaque removal between toothbrushes and areas. Statistical significance was set at 0.05.
Results: There was no difference in plaque removal between the toothbrushes in the mesial/distal surfaces; plaque removal increased 14%(median 1.979,iq.98 vs 1.7083,iq.61) in the incisal/cervical surfaces with the Orthofit® although the difference did not reach statistical significance(Mann-Whitney). Oral B® removed the same amount of plaque on all surfaces; Orthofit® removed more plaque on the incisal/cervical than on the mesial/distal(Wilcoxon-sign-rank-tests).
Conclusions: Orthofit® seems to be more efficient in removing plaque from the incisal/cervical surfaces in orthodontic patients. The experience and results will be used to plan the full study (e.g. the difference found will be used to calculate sample size).