title: Efficacy of plaque removal of the Sonicare Elite versus the Sonicare Advance from hard-to-reach sites.
abstract: OBJECTIVE
  To compare the Sonicare Elite with the Sonicare Advance in terms of the reduction in supragingival plaque in the posterior, hard-to-reach areas of the mouth.
  
  
  METHODS
  This was a single-cohort, 6-week, two-treatment, single-blind, cross-over clinical trial that recruited 45 subjects. Plaque scores were recorded throughout the study using a modification of the Quigley and Hein plaque index (PI). All subjects had a minimum pre-brushing PI of 1.8 at screening following 24 h abstention from tooth cleaning. Subjects then used a Sonicare Advance powered toothbrush at home for 4 weeks for familiarisation purposes. At the next visit (2), subjects were given either the Sonicare Elite or the Sonicare Advance powered toothbrush for a further 2 weeks of home use. Twenty-four hours prior to visit 3, subjects abstained again from tooth cleaning. At visit 3, the PI was recorded pre- and post-tooth brushing and then all remaining "mature" plaque was removed professionally with a dental prophylaxis. After a further period of 24 h (to accumulate new plaque) without tooth brushing the subjects returned for visit 4 at which PIs were again recorded pre- and post-tooth brushing. The subjects were then given the second toothbrush in the cross-over sequence and attended for visits 5 and 6 at which the protocol for visits 3 and 4 was repeated.
  
  
  RESULTS
  The Sonicare Elite powered toothbrush was more effective than the Sonicare Advance model in removing both mature and newly formed plaque. The magnitude of the differences between the toothbrushes for all posterior sites, interproximal and smooth surfaces, respectively, was 0.35 U (p<0.001), 0.39 U (p<0.001) and 0.32 U (p<0.001) of the modified Quigley and Hein PI. There was no evidence of a significant period effect comparing data from visits 5 and 6 against those from visits 3 and 4. There was, however, a significant visit effect with full-mouth (p<0.01), interproximal (p<0.001) and smooth surface (p<0.01) post-brushing plaque scores being significantly lower at visits 4 and 6 than at visits 3 and 5.
  
  
  CONCLUSIONS
  The data support the observation that the Sonicare Elite toothbrush is more effective than the Sonicare Advance model in removing both newly formed and mature plaque from all posterior, interproximal and smooth tooth surfaces.
authors.affiliation: School of Dental Sciences, University of Newcastle upon Tyne, UK. g.i.mccracken@newcastle.ac.uk
authors.forename: G I
authors.initials: GI
authors.lastname: McCracken
authors.forename: P M
authors.initials: PM
authors.lastname: Preshaw
authors.forename: L
authors.initials: L
authors.lastname: Heasman
authors.forename: F
authors.initials: F
authors.lastname: Stacey
authors.forename: N
authors.initials: N
authors.lastname: Steen
authors.forename: P A
authors.initials: PA
authors.lastname: Heasman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018592:Cross-Over Studies; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000628:therapy*; D003774:Dental Plaque Index; D004560:Electricity; D004869:Equipment Safety; D006801:Humans; D008875:Middle Aged; D016037:Single-Blind Method; D014099:Toothbrushing / Q000295:instrumentation*