title: Relative effectiveness of powered and manual toothbrushes in elderly patients with implant-supported mandibular overdentures.
abstract: OBJECTIVE
  The aim of this study was to compare the clinical effectiveness of a powered toothbrush (Braun Oral-B Plaque Remover 3-D) and a manual soft toothbrush (Oral-B Squish-grip brush) for the control of supragingival plaque and soft tissue inflammation around implants supporting mandibular overdentures.
  
  
  METHODS
  The study sample involved 40 edentulous subjects, aged 55-80 years, having 2 unsplinted mandibular implants supporting a complete removable overdenture opposed by a maxillary complete denture. In this single-blinded, randomised, cross-over clinical trial, two 6-week experimental phases were separated by a 2-week wash-out period. 2 weeks prior to each experimental phase (pre-entry visits), implant abutments were polished to remove all plaque and a standardised instruction in the use of the toothbrush was given. Modified plaque and bleeding indices were recorded at the start and end of each experimental period. Mean index scores at each phase were analysed using paired t-test, and the mean number of sites showing a change in plaque or mucositis were compared using the Mann-Whitney U-test. Combined data from 2 different implant systems were considered after controlling for implant type.
  
  
  RESULTS
  Only minor changes in plaque and bleeding scores were observed following the two test periods. There were no statistically significant differences between the manual and powered toothbrushes.
  
  
  CONCLUSIONS
  Manual and powered brushes were found to be of comparable efficacy with regard to improvement in peri-implant bleeding and plaque indices.
authors.affiliation: Department of Oral Rehabilitation, School of Dentistry, Dunedin, New Zealand. andrew.tawse-smith@stonebow.otago.ac.nz
authors.forename: A
authors.initials: A
authors.lastname: Tawse-Smith
authors.forename: W J
authors.initials: WJ
authors.lastname: Duncan
authors.forename: A G T
authors.initials: AG
authors.lastname: Payne
authors.forename: W M
authors.initials: WM
authors.lastname: Thomson
authors.forename: J L
authors.initials: JL
authors.lastname: Wennström
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D000044:Dental Abutments; D003773:Dental Plaque / Q000517:prevention & control; D003774:Dental Plaque Index; D003777:Dental Prophylaxis; D019094:Dental Prosthesis, Implant-Supported; D003826:Denture, Complete, Lower; D003828:Denture, Overlay; D004560:Electricity; D004867:Equipment Design; D005884:Gingival Hemorrhage / Q000517:prevention & control; D005891:Gingivitis / Q000517:prevention & control; D006801:Humans; D016555:Matched-Pair Analysis; D008875:Middle Aged; D015999:Multivariate Analysis; D010512:Periodontal Index; D016037:Single-Blind Method; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D014099:Toothbrushing / Q000295:instrumentation* / Q000379:methods