title: Computer-based intraoral image analysis of the clinical plaque removing capacity of 3 manual toothbrushes.
abstract: BACKGROUND
  (I) Introducing an intraoral camera system with a special positioner to allow computer-based analysis of reproducible images on lingual tooth surfaces and (II) comparing plaque removal by three manual toothbrushes with different brushhead designs (convex, multilevel and flat trimmed) on lingual mandibular tooth surfaces.
  
  
  METHODS
  In a clinical single-blind, crossover, 24-h plaque-regrowth study on 25 subjects, a computer-based index (PPI) was used to evaluate pre- and postbrushing plaque on lingual surfaces of mandibular premolars and molars. Subjects brushed their teeth under standardized conditions at three visits, each time with a different, randomly assigned toothbrush.
  
  
  RESULTS
  The intraoral camera system allowed a reproducible and relatively convenient access to the lingual surfaces of the mandibular teeth and provided an increase in objectivity. Overall, each brush achieved statistically significant plaque removal, however, none reached clinical relevance. The multilevel brush was superior at specific sites, but failed to show statistically significant superiority in terms of overall plaque reduction. Without regard of the toothbrush used, the right handed subjects were less efficient in removing plaque from the right side compared to the left.
  
  
  CONCLUSIONS
  The method is able to detect even small differences in plaque reduction. None of the different brushhead designs was able to compensate an insufficient brushing techniques.
authors.affiliation: Department of Operative Dentistry and Periodontology, School of Dental Medicine, University of Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany.
authors.forename: C B
authors.initials: CB
authors.lastname: Staudt
authors.forename: S
authors.initials: S
authors.lastname: Kinzel
authors.forename: S
authors.initials: S
authors.lastname: Hassfeld
authors.forename: W
authors.initials: W
authors.lastname: Stein
authors.forename: H J
authors.initials: HJ
authors.lastname: Staehle
authors.forename: C E
authors.initials: CE
authors.lastname: Dörfer
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D018592:Cross-Over Studies; D003773:Dental Plaque / Q000517:prevention & control*; D003774:Dental Plaque Index; D004867:Equipment Design; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D016037:Single-Blind Method; D014099:Toothbrushing / Q000295:instrumentation* / Q000379:methods