Efficacy of ultrasonic, electric and manual toothbrushes in patients with fixed orthodontic appliances.
OBJECTIVE
This crossover study compared the efficacy of an ultrasonic toothbrush for the reduction of plaque, gingival inflammation, and levels of Streptococcus mutans, in relation to an electric and a manual toothbrush.


METHODS
Twenty-one patients with orthodontic appliances were divided into three groups. All patients were evaluated by a periodontist and samples of saliva were collected for quantification of S mutans. The patients received their first brushes with appropriate instructions. For each crossover leg, patients used each toothbrush for a period of 30 days. At the end of each washout period, participants received a periodontal evaluation and new samples of saliva were collected. After 15 days of using their own toothbrushes, patients received the next toothbrushes in the experimental sequence.


RESULTS
The ultrasonic brush group presented significant improvement in the reduction of visible plaque on the buccal surfaces (-6.36%, P = .007). The counts of S mutans decreased in the electric (2.04 x 10(5) to 1.36 x 10(5) colony-forming units [CFU]/mL) and ultrasonic (2.98 x 10(5) to 1.84 x 10(5) CFU/mL) groups. There were no statistical differences among the three brushes for the clinical and microbiological parameters evaluated.


CONCLUSIONS
This study did not demonstrate that the ultrasonic toothbrush was better in reducing gingival inflammation in adolescent orthodontic patients, but plaque scores were lowered on buccal surfaces of teeth with orthodontic brackets. In addition, S mutans counts were markedly decreased in the electric and ultrasonic groups, which should be related to a reduced risk of oral disease.
Costa
Mauricio Ribeiro
MR
São Paulo State University-Araraquara Dental School, Brazil.
Silva
Vanessa Camila
VC
Miqui
Miriam Nakatani
MN
Sakima
Tatsuko
T
Spolidorio
Denise Madalena Palomari
DM
Cirelli
Joni Augusto
JA
D000293:Adolescent; D002648:Child; D015169:Colony Count, Microbial; D003773:Dental Plaque / Q000628:therapy*; D004560:Electricity; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D009967:Orthodontic Appliances; D012463:Saliva / Q000382:microbiology*; D013295:Streptococcus mutans; D014099:Toothbrushing / Q000295:instrumentation*; D014464:Ultrasonic Therapy / Q000295:instrumentation