title: Efficacy of manual and powered toothbrushes (I). Effect on clinical parameters.
abstract: OBJECTIVE
  The purpose of the present investigation was to compare manual (Crest Complete) and powered toothbrushing (Braun Oral-B 3D Plaque Remover) for their ability to affect clinical parameters of periodontal diseases.
  
  
  METHODS
  48 periodontal maintenance subjects completed this single-blind 6-month longitudinal study. Subjects had a minimum of 20 natural teeth excluding third molars and >10% of sites (approximately 17 sites) with pocket depth > or =4 mm and/or >10% sites with attachment level >4 mm. At baseline, subjects received full mouth clinical measurements (168 sites) to determine mean Plaque Index, Gingival Index, pocket depth and attachment level and % of sites exhibiting BOP. Subjects were then randomly assigned to one of two groups. The control group (N=26) used a manual toothbrush while the test group (N=22) used a powered toothbrush. Subjects received instruction in oral hygiene and used their assigned toothbrush twice daily according to instruction. Follow-up clinical assessments were performed at 3 and 6 months. Significance of differences in clinical measures over time was determined using the Quade test and between brushing groups at each time point using the Mann-Whitney test.
  
  
  RESULTS
  Mean pocket depth, mean plaque index and % of sites exhibiting BOP showed significant reductions from baseline to 3 and 6 months in both groups. Mean probing attachment level and mean Gingival Index were significantly reduced in the powered brushing group only. There was a significant positive correlation between plaque reduction and reduction in other clinical parameters in both brushing groups. The majority of subjects showed improvements in clinical parameters at 6 months, although a greater proportion of subjects in the powered group showed a reduction in Plaque Index (77% versus 65%) and in % sites exhibiting BOP (82% versus 69%). Mean pocket depth and mean attachment level showed significantly greater reductions between baseline and 6 months in lingual and mandibular areas in the powered group.
  
  
  CONCLUSIONS
  Both manual and powered toothbrushes reduced pocket depth, plaque index and BOP. The powered toothbrush significantly reduced mean gingival index and probing attachment level. The greatest benefit of the powered brush was at mandibular and lingual surfaces.
authors.affiliation: Department of Periodontology,The Forsyth Institute, 140 The Fenway, Boston, MA 02115-3799, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Haffajee
authors.forename: M
authors.initials: M
authors.lastname: Thompson
authors.forename: G
authors.initials: G
authors.lastname: Torresyap
authors.forename: D
authors.initials: D
authors.lastname: Guerrero
authors.forename: S S
authors.initials: SS
authors.lastname: Socransky
mesh_terms: D000328:Adult; D003773:Dental Plaque / Q000628:therapy*; D003774:Dental Plaque Index; D004560:Electricity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000517:prevention & control*; D010512:Periodontal Index; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D014099:Toothbrushing / Q000295:instrumentation*