title: Efficacy of various side-to-side toothbrushes for noncontact biofilm removal.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of four different powered toothbrushes with side-to-side action for noncontact biofilm removal in vitro.
  
  
  METHODS
  A three-species biofilm was formed in vitro on protein-coated titanium disks using a flow chamber combined with a static biofilm growth model. Subsequently, the biofilm-coated substrates were exposed to four different side-to-side toothbrushes (A, B, C, and D) with various brushing times (2, 4, and 6 s) and brushing (bristle-to-disk) distances (0, 2, and 4 mm). The biofilm volumes were measured using volumetric analyses with confocal laser scanning microscope images and Imaris version 7.5.2 software.
  
  
  RESULTS
  The median percentages of biofilm reduction by the analyzed toothbrushes ranged from 9 % to 80 %. The abilities of the tested toothbrushes to remove the in vitro biofilm differed significantly (p < 0.05). Two of the tested toothbrushes (C and D) were capable of significant biofilm reduction by noncontact brushing.
  
  
  CONCLUSIONS
  It was possible to reduce a three-species in vitro biofilm by noncontact brushing with two out of four side-to-side toothbrushes.
  
  
  CONCLUSIONS
  Toothbrushes C and D show in vitro a high efficacy in biofilm removal without bristle contact.
authors.affiliation: Department of Periodontology, Cariology and Endodontology, School of Dental Medicine, University of Basel, Hebelstrasse 3, 4056, Basel, Switzerland.
authors.forename: Julia C
authors.initials: JC
authors.lastname: Schmidt
authors.forename: Monika
authors.initials: M
authors.lastname: Astasov-Frauenhoffer
authors.forename: Irmgard
authors.initials: I
authors.lastname: Hauser-Gerspach
authors.forename: Jan-Philipp
authors.initials: JP
authors.lastname: Schmidt
authors.forename: Tuomas
authors.initials: T
authors.lastname: Waltimo
authors.forename: Roland
authors.initials: R
authors.lastname: Weiger
authors.forename: Clemens
authors.initials: C
authors.lastname: Walter
mesh_terms: D018441:Biofilms; D004867:Equipment Design; D006801:Humans; D014099:Toothbrushing