Plaque Removal Efficacy of Two Power Brushes in Orthodontic Patients

For patients with multibracket appliances the maintenance of proper oral hygiene is difficult and therefore may lead to increased plaque accumulation, which enhances the risk of caries and gingivitis. These patients require special and efficient oral hygiene aids. Objective: The aim of this study was to assess the plaque removal efficacy of two power brushes in orthodontic population. Methods: This study was a replicate single-use, two treatment, examiner-blind, randomized, four period crossover design. 44 Patients (14.7±2.48 years old) with multibracket appliances in upper and lower jaw were enrolled. After the acclimation period, the patients were randomly assigned to one of the four treatment sequences. Thus, each subject brushed two times with either a oscillation-rotation power toothbrush (Oral-B® Professional Care SmartSeries 4000TM with an Ortho brush head) or with a sonic toothbrush (Sonicare® FlexCareTM 900 series with a ProResults standard brushhead HX6011). The pre and post brushing plaque levels (measured in %) were assessed by Digital Plaque Image Analysis (DPIA). The plaque reductions were analyzed for treatment group differences using a mixed model ANCOVA for a crossover. Results: Both brushes provided statistically significant reductions from baseline (p<0.001). The % plaque reduction was 66% for oscillation-rotation toothbrush and 61% for sonic toothbrush. Treatment effect test found that the oscillation-rotation brush was statistically superior (by 8.1%) in terms of plaque reduction than the sonic toothbrush (p<0.017). Conclusions: The oscillation-rotation power brush provided significantly better plaque removal than the sonic toothbrush in subjects with orthodontics. Both brushes were well tolerated.