title: Cleaning Efficacy of Manual Toothbrushes Around Brackets - A Pilot Randomised Control Trial.
abstract: OBJECTIVE
  To test the cleaning efficacy of different manual toothbrushes in orthodontic patients in a single-blind randomised clinical trial. The brushes tested were selected based on previous in vitro tests.
  
  
  METHODS
  Thirty-five regular orthodontic patients with a minimum of six bonded brackets on the maxillary anterior teeth were randomly assigned to three experimental groups: staged (2-level) (Candida Parodin, 12 patients) and V-shaped (Oral-B Ortho, 12 patients) toothbrush head designs were compared in a two-phase study to planar control brushes (Paro M 43, 11 patients). First, all participants were advised to brush their teeth twice daily for 2 min for 3 weeks. Prior to the start and at the end of the study, the gingival index was assessed to evaluate the level of oral hygiene. Afterwards, cleaning efficacy was assessed planimetrically by disclosing the respective teeth after two days of not performing any oral hygiene measures.
  
  
  RESULTS
  Of the initial 35 participants, two did not attend after 3 weeks and had to be excluded. After 3 weeks, the control (5 out of 180 sites or -2.8% with GI ≥ 2) and staged groups (16 out of 216 sites or 7.5% with GI ≥ 2) showed minor improvement in the oral hygiene level. In contrast, the V-shaped group (29 out of 198 sites or 14.6 % with GI ≥ 2) showed a statistically significant improvement of the oral hygiene level. Planimetric evaluation, however, showed no superior cleaning efficacy of any of the tested head designs.
  
  
  CONCLUSIONS
  The use of V-shaped and staged toothbrush head designs might be beneficial in patients with inadequate oral hygiene undergoing orthodontic treatment with a fixed appliance. Further large-scale investigations are, however, necessary to validate the presented results.
authors.forename: Marc
authors.initials: M
authors.lastname: Schätzle
authors.forename: Luca
authors.initials: L
authors.lastname: Golland
authors.forename: Raphael
authors.initials: R
authors.lastname: Patcas
authors.forename: Valerie
authors.initials: V
authors.lastname: Ronay
authors.forename: Beatrice
authors.initials: B
authors.lastname: Sener
authors.forename: Thomas
authors.initials: T
authors.lastname: Attin
authors.forename: Timo
authors.initials: T
authors.lastname: Peltomäki
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Schmidlin
mesh_terms: D000293:Adolescent; D002648:Child; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D016910:Orthodontic Brackets; D010865:Pilot Projects; D016037:Single-Blind Method; D014099:Toothbrushing / Q000295:instrumentation*; D055815:Young Adult