title: Synergy of brushing mode and antibacterial use on in vivo biofilm formation.
abstract: OBJECTIVE
  Orthodontic, multi-strand retention-wires are used as a generalized model for oral retention sites to investigate whether biofilm left-behind after powered toothbrushing in-vivo enabled better penetration of antibacterials as compared with manual brushing.
  
  
  METHODS
  2-cm multi-strand, stainless-steel retention-wires were placed in brackets bonded bilaterally in the upper arches of 10-volunteers. Volunteers used NaF-sodium-lauryl-sulphate-containing toothpaste and antibacterial, triclosan-containing toothpaste supplemented or not with an essential-oils containing mouthrinse. Opposite sides of the dentition including the retention-wires, were brushed manually or with a powered toothbrush. Health-care-regimens were maintained for 1-week, after which wires were removed and oral biofilm was collected.
  
  
  RESULTS
  When powered toothbrushing was applied, slightly less bacteria were collected than after manual brushing, regardless whether an antibacterial-regimen was used or not. Powered-toothbrushing combined with antibacterial-regimens yielded lower biofilm viability than manual brushing, indicating better antibacterial penetration into biofilm left-behind after powered brushing. Major shifts in biofilm composition, with a decrease in prevalence of both cariogenic species and periodontopathogens, were induced after powered brushing using an antibacterial-regimen.
  
  
  CONCLUSIONS
  Oral biofilm left-behind after powered brushing in-vivo enabled better penetration of antibacterials than after manual brushing.
  
  
  CONCLUSIONS
  Mechanical removal of oral biofilm is important for prevention of dental pathologies, but biofilm is always left-behind, such as in fissures, buccal pits, interproximal areas and gingival margins and around orthodontic appliances. Use of antibacterial toothpastes or mouthrinses can contribute to removal or killing of biofilm bacteria, but biofilm structure hampers antibacterial penetration. A synergy between brushing mode and antibacterial-regimen applied exists with clinically demonstrable effects.
authors.affiliation: University of Groningen and University Medical Centre, Department of Orthodontics, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
authors.forename: Marije A
authors.initials: MA
authors.lastname: Jongsma
authors.affiliation: University of Groningen and University Medical Centre, Department of Orthodontics, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: van de Lagemaat
authors.affiliation: University of Groningen and University Medical Centre, Department of Biomedical Engineering, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands.
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Busscher
authors.affiliation: University of Groningen and University Medical Centre, Department of Biomedical Engineering, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands.
authors.forename: Gesinda I
authors.initials: GI
authors.lastname: Geertsema-Doornbusch
authors.affiliation: University of Groningen and University Medical Centre, Department of Biomedical Engineering, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands.
authors.forename: Jelly
authors.initials: J
authors.lastname: Atema-Smit
authors.affiliation: University of Groningen and University Medical Centre, Department of Biomedical Engineering, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands.
authors.forename: Henny C
authors.initials: HC
authors.lastname: van der Mei
authors.affiliation: University of Groningen and University Medical Centre, Department of Orthodontics, Hanzeplein 1, 9700 RB Groningen, The Netherlands. Electronic address: y.ren@umcg.nl.
authors.forename: Yijin
authors.initials: Y
authors.lastname: Ren
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D018441:Biofilms / Q000187:drug effects*; D003750:Dental Fissures / Q000382:microbiology; D003773:Dental Plaque / Q000188:drug therapy / Q000382:microbiology; D004357:Drug Synergism; D005260:Female; D005459:Fluorides / Q000494:pharmacology; D006801:Humans; D008297:Male; D009067:Mouthwashes / Q000737:chemistry / Q000494:pharmacology; D009822:Oils, Volatile / Q000494:pharmacology; D009969:Orthodontic Wires / Q000382:microbiology*; D011209:Power, Psychological; D012967:Sodium Dodecyl Sulfate / Q000008:administration & dosage; D013193:Stainless Steel; D014099:Toothbrushing / Q000379:methods*; D014100:Toothpastes / Q000008:administration & dosage / Q000737:chemistry; D014260:Triclosan / Q000494:pharmacology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D009067:Mouthwashes; D009822:Oils, Volatile; D014100:Toothpastes; D013193:Stainless Steel; D012967:Sodium Dodecyl Sulfate; D014260:Triclosan; D005459:Fluorides
keywords: Antibacterials; Biofilm; Manual brushing; Powered brushing