title: Combined effects of repeated oral hygiene motivation and type of toothbrush on orthodontic patients: a blind randomized clinical trial.
abstract: OBJECTIVE
  To investigate the effects on plaque index (PI) scores of manual or electric toothbrush with or without repeated oral hygiene instructions (OHI) and motivation on patients wearing fixed orthodontic appliances.
  
  
  METHODS
  One month after the orthodontic fixed appliance bonding on both arches, 60 patients were randomly assigned to four groups; groups E1 (n  =  15) and E2 (n  =  15) received a powered rotating-oscillating toothbrush, and groups M1 (n  =  15) and M2 (n  =  15) received a manual toothbrush. Groups E1 and M1 received OHI and motivation at baseline (T0) and after 4, 8, 12, 16, and 20 weeks (T4, T8, T12, T16, and T20, respectively) by a Registered Dental Hygienist; groups E2 and M2 received OHI and motivation only at baseline. At each time point a blinded examiner scored plaque of all teeth using the modified Quigley-Hein PI.
  
  
  RESULTS
  In all groups the PI score decreased significantly over time, and there were differences among groups at T8, T12, T16, and T20. At T8, PI scores of group E1 were lower than those of group E2, and at T12, T16, and T20, PI scores of groups M1 and E1 were lower compared to those of groups M2 and E2. A linear mixed model showed that the effect of repeated OHI and motivation during time was statistically significant, independently from the use of manual or electric toothbrush.
  
  
  CONCLUSIONS
  The present results showed that repeated OHI and motivation are crucial in reducing PI score in orthodontic patients, independent of the type of toothbrush used.
authors.affiliation: a  Visiting Professor, Department of Biomedical and Neuromotor Sciences, Section of Orthodontics, University of Bologna, Bologna, Italy.
authors.forename: Ida
authors.initials: I
authors.lastname: Marini
authors.forename: Francesco
authors.initials: F
authors.lastname: Bortolotti
authors.forename: Serena Incerti
authors.initials: SI
authors.lastname: Parenti
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Gatto
authors.forename: Giulio Alessandri
authors.initials: GA
authors.lastname: Bonetti
mesh_terms: D000293:Adolescent; D002327:Cariostatic Agents / Q000627:therapeutic use; D002648:Child; D004396:Coloring Agents; D003731:Dental Caries / Q000517:prevention & control; D003773:Dental Plaque / Q000517:prevention & control; D003774:Dental Plaque Index; D004311:Double-Blind Method; D055615:Electrical Equipment and Supplies; D004867:Equipment Design; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D005500:Follow-Up Studies; D005891:Gingivitis / Q000517:prevention & control; D006801:Humans; D008297:Male; D009042:Motivation; D009910:Oral Hygiene / Q000193:education*; D009967:Orthodontic Appliances; D014099:Toothbrushing / Q000295:instrumentation*; D014100:Toothpastes / Q000627:therapeutic use
chemical_list: D002327:Cariostatic Agents; D004396:Coloring Agents; D014100:Toothpastes; D005459:Fluorides
keywords: Electric toothbrush; Manual toothbrush; Oral hygiene instructions; Oral hygiene motivation; Orthodontic appliances