Plaque Removal by Sonicare and Manual Toothbrushes in Orthodontic Subjects

Objective: To compare plaque removal, gingivitis reduction and safety of Philips Sonicare FlexCare power toothbrush (PSF) and a manual toothbrush (MTB). Methods: A randomized, parallel, examiner-blinded study was conducted in a healthy orthodontic population of routine MTB users. At V1, subjects were screened for eligibility (Modified Bonded Bracket Index (BBI) >2.0; Pocket depth ≤ 4mm). At V2, subjects received a prophylaxis, were randomized and trained on the assigned product for home use; 2 minutes, twice daily. At Week 2 and 4 visits (12-24 plaque accumulation), safety, plaque and gingivitis were assessed. Comparisons to baseline were made for both groups, as were differences between groups over time and in single-use brushing events in the office. BBI was used to score bracketed surfaces and modified Turesky Quigley–Hein Plaque Index (TMQH) on non-bracketed surfaces. Gingivitis was assessed according to Löe and Silness criteria. ANOVA was used for statistical analysis. Results: Of 95 subjects enrolled (56 females, 39 males; mean age 17 years), 48 were randomized to PSF and 47 to MTB. Baseline demographics, plaque and gingivitis scores were comparable between groups. Post- minus pre-brushing BBI percent reduction for PSF and MTB at 2 and 4 weeks were 26%, 13% and 32%, 14% overall (p<0.0001) respectively. For non-bracketed surfaces, percent reductions were 31%, 19%, 31%, 18% for PSF and MTB at the same timepoints. Plaque reduction compared to baseline TMQH scores was significant only for PSF. Gingivitis reduction compared to baseline was statistically significant, however, clinically minor for both groups due to low population variation. Conclusions: PSF removed significantly more plaque than MTB in single- brushing episodes on bracketed and non-bracketed surfaces. Significant reductions of plaque over time compared to baseline were also observed on non-bracketed surfaces. Both PSF and MTB were safe for use on orthodontic subjects.

Supported by Philips Oral Healthcare.