title: Siwak as a oral hygiene aid in patients with fixed orthodontic appliances.
abstract: OBJECTIVE
  The aims of this study were to compare the mechanical efficacy of Siwak in plaque control and gingival health conditions in subjects wearing fixed orthodontic appliances compared with standard and orthodontic toothbrushes.
  
  
  METHODS
  Forty male patients with a mean age of 17.20+/-4.01 years, wearing fixed orthodontic appliances were included in this study. Following a session of scaling and polishing, which established a situation with minimal gingival inflammation and close to zero amounts of dental plaque, all patients were instructed to use a standard soft toothbrush for 1 week after which they were randomly and equally allocated to one of four groups: (i) a manual toothbrush group; (ii) an orthodontic toothbrush group; (iii) a Siwak group; and (iv) a combination of Siwak and an orthodontic toothbrush group. All patients were instructed to brush their teeth three times a day. All patients were scored for plaque and gingivitis 1 week after scaling and polishing and 2 weeks following group assignment.
  
  
  RESULTS
  A similar effect of Siwak to that of soft and orthodontic toothbrushes with respect to plaque control in patients with fixed orthodontic appliances was found. It was the combined use of Siwak and orthodontic toothbrush that provided the best plaque control in such patients. Gingival condition was better in the Siwak groups whether used solely or in combination with an orthodontic toothbrush.
  
  
  CONCLUSIONS
  The use of Siwak promotes gingival health in patients with orthodontic appliances.
authors.affiliation: Department of Preventive Dentistry, School of Dentistry, University of Science and Technology, Irbid, Jordan.
authors.forename: R M A
authors.initials: RM
authors.lastname: Al-Teen
authors.forename: K N
authors.initials: KN
authors.lastname: Said
authors.forename: E S J
authors.initials: ES
authors.lastname: Abu Alhaija
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000517:prevention & control*; D003774:Dental Plaque Index; D005891:Gingivitis / Q000517:prevention & control*; D006801:Humans; D007597:Jordan; D008297:Male; D009967:Orthodontic Appliances; D010512:Periodontal Index; D008517:Phytotherapy; D018547:Plant Stems; D032121:Salvadoraceae; D014099:Toothbrushing / Q000295:instrumentation*