title: Comparison of the clinical effects and gingival abrasion aspects of manual and electric toothbrushes.
abstract: OBJECTIVE
  The clinical effects and gingival abrasion aspects of 2 electrical tooth-brushes (Braun Oral-B Plak Control Ultra and the novel development Braun Oral-B Plak Control 3D) were to be compared with conventional manual tooth-brushing.
  
  
  METHODS
  In a cross-over study, 26 dental student volunteers participated and were assigned to 1 of 3 groups. Following instruction in the use of the electric as well as manual toothbrushes, the volunteers were timed for 2 min each day to apply one electric or the manual toothbrush, respectively, during 3 experimental phases of 2 weeks. No other methods of tooth cleaning were to be performed except the one specified for the respective test period. When brushing manually, the Bass toothbrushing technique was applied. Between each test period, a recovery period of 1 week was allowed during which no oral hygiene was performed at all. At the start and the end of each of the experimental periods, the extension of plaque deposits from the gingival margin in coronal direction was assessed using the Turesky et al. modification of the Quigley and Hein plaque index. Presence or absence of gingival inflammation was evaluated by bleeding and probing (BOP). The extent and severity of gingival abrasions were assessed by use of a modified method of Breitenmoser et al. and adapted by Danser et al.
  
  
  RESULTS
  The plaque-reducing effect was similar in all groups with the same cleaning regime. For that reason, the result of the different experimental phases with the respective cleaning modalities were collapsed. Cleaning with the Braun Oral-B Plak Control Ultra electric toothbrush resulted consistently in the lowest plaque scores when compared to both the Braun Oral-B Plak Control 3D and the manual toothbrush. Although the differences in plaque reduction were statistically significant between cleaning with Braun Oral-B Plak Control Ultra and 3D, they were small and of questionable clinical relevance. No significant differences in plaque reductions were found between manual brushing and any of the 2 electric brushes. Gingival abrasions were least pronounced following brushing with the Braun Oral-B Plak Control 3D electric toothbrush. However, no significant differences in gingival abrasion were encountered following brushing with the Braun Oral-B Plak Control Ultra electric in comparison with the manual toothbrush.
  
  
  CONCLUSIONS
  The results of the present study have shown that in a group of dental students trained in manual brushing technique, where efficacy was similar with the 3 toothbrushes tested, there is no evidence of greater gingival abrasion with either Braun Oral-B Plak Control Ultra or 3D when compared with a manual brush.
authors.affiliation: University of Berne School of Dental Medicine, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Mantokoudis
authors.forename: A
authors.initials: A
authors.lastname: Joss
authors.forename: M M
authors.initials: MM
authors.lastname: Christensen
authors.forename: H X
authors.initials: HX
authors.lastname: Meng
authors.forename: J E
authors.initials: JE
authors.lastname: Suvan
authors.forename: N P
authors.initials: NP
authors.lastname: Lang
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D018592:Cross-Over Studies; D003773:Dental Plaque / Q000517:prevention & control*; D005260:Female; D005881:Gingiva / Q000293:injuries*; D005882:Gingival Diseases / Q000209:etiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D010512:Periodontal Index; D023861:Photography, Dental; D014099:Toothbrushing / Q000009:adverse effects* / Q000295:instrumentation*