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This study aimed to compare the effectiveness of microcurrent-emitting toothbrushes (MCTs) and ordinary toothbrushes in reducing the dental plaque index (PI) and dental caries activity among orthodontic patients. The evaluation was performed using a crossover study design involving 22 orthodontic patients randomly assigned to the MCT or ordinary toothbrush groups. The participants used the designated toothbrush for 4 weeks and had a 1-week wash-out time before crossover to the other toothbrush. PI (Attin’s index) and dental caries activity were measured at baseline and at the end of each 4-week period. Additionally, patients completed questionnaires to assess patient satisfaction for “freshness in mouth” and “cleansing degree.” The results showed that the MCT group had a significant reduction in PI (p = 0.009), whereas the ordinary toothbrush group did not (p = 0.595). There was no significant difference in the dental caries activity between the two groups (p > 0.05). Patient satisfaction assessment revealed that 65% patients in the MCT group had more than “fair” experience of freshness, in contrast to 50% of patients in the ordinary toothbrush group. Satisfaction with cleansing degree was similar in both groups. Overall, these findings suggest that MCTs are more effective in reducing dental PI than ordinary toothbrushes.

The aim of this study was to evaluate the efficacy and patient satisfaction of lidocaine aerosol for pain management during periodontal scaling and root planning in patients with chronic periodontitis or dental plaque-induced gingivitis. This study specifically concentrated on comparing the effectiveness of lidocaine aerosol as a topical anesthetic against a placebo, assessing its impact on pain perception during the procedure. Additionally, the relationship between periodontal treatment and the reduction of oxidative stress markers in these patients was assessed. Eighty-six patients with chronic periodontitis or dental plaque-induced gingivitis were included. Notably, 5.6% lidocaine and placebo aerosols were randomly applied to the labial (buccal) and lingual (palatal) sides, approximately 3 mm from the gingival surface, with three sprays on each side, prior to supragingival ultrasonic scaling in these patients. In this controlled, double-blind study, the effectiveness of a 5.6% lidocaine aerosol in reducing pain during supragingival ultrasonic scaling was evaluated. The study involved 50 patients who divided into two groups: one receiving the lidocaine aerosol and the other a placebo. Pain was assessed using the Visual Analog Scale (VAS) and the Numeric Rating Scale (NRS). The results revealed a statistically significant reduction in pain scores in the lidocaine group compared with the placebo group. Specifically, the mean VAS score in the lidocaine group was 2.1 ± 1.3, compared with 5.6 ± 1.7 in the placebo group ( P  < 0.01). Similarly, the NRS scores were significantly lower in the lidocaine group (2.3 ± 1.2) compared with the placebo group (5.9 ± 1.8, P  < 0.01). No adverse reactions were found in none of the groups. 5.6% lidocaine aerosol holds promise as an effective anesthetic option for reducing pain during supragingival ultrasonic scaling procedures in patients with chronic periodontitis or dental plaque-induced gingivitis. Chinese Clinical Trial Registry (No. ChiCTR2000029831, date: 2020-02-15).

To assess feasibility, acceptability, and early efficacy of monetary incentive-based interventions on fostering oral hygiene in young children measured with a Bluetooth-enabled toothbrush and smartphone application. A stratified, parallel-group, three-arm individually randomized controlled pilot trial. Two Los Angeles area Early Head Start (EHS) sites. 36 parent-child dyads enrolled in an EHS home visit program for 0-3 year olds. Eligible dyads, within strata and permuted blocks, were randomized in equal allocation to one of three groups: waitlist (delayed monetary incentive) control group, fixed monetary incentive package, or lottery monetary incentive package. The intervention lasted 8 weeks. Primary outcomes were a) toothbrushing performance: mean number of Bluetooth-recorded half-day episodes per week when the child's teeth were brushed, and b) dental visit by the 2-month follow-up among children with no prior dental visit. The a priori milestone of 20% more frequent toothbrushing identified the intervention for a subsequent trial. Feasibility and acceptability measures were also assessed, including frequency of parents syncing the Bluetooth-enabled toothbrush to the smartphone application and plaque measurement from digital photographs. Digital monitoring of toothbrushing was feasible. Mean number of weekly toothbrushing episodes over 8 weeks was 3.9 in the control group, 4.1 in the fixed incentive group, and 6.0 in the lottery incentive group. The lottery group had 53% more frequent toothbrushing than the control group and 47% more frequent toothbrushing than the fixed group. Exploratory analyses showed effects concentrated among children ≤24 months. Follow-up dental visit attendance was similar across groups. iPhone 7 more reliably captured evaluable images than Photomed Cannon G16. Trial protocol and outcome measures were deemed feasible and acceptable. Results informed the study protocol for a fully powered trial of lottery incentives versus a delayed control using the smart toothbrush and remote digital incentive program administration. ClinicalTrials.gov identifier NCT03862443.

Objectives This randomized crossover trial involving adult participants with ≥ 10% plaque coverage on anterior teeth compared dental plaque regrowth dynamics between an oscillating‐rotating (O‐R) electric toothbrush and a manual toothbrush using Digital Plaque Imaging Analysis. Material and Methods Thirty‐four participants were randomized to one of 4 treatment sequences, each having four 8‐day treatment periods. Participants brushed twice daily with the assigned toothbrush. Morning and afternoon plaque were evaluated on Days 1, 3, and 8. The primary variable was afternoon percent plaque coverage, using repeated measures analysis from Days 1, 3, and 8. Results The O‐R toothbrush produced lower mean plaque levels versus the manual toothbrush for all endpoints (p ≤ 0.001). The benefit for the O‐R toothbrush increased over time, demonstrating 16.4% (p = 0.001) and 28.1% (p < 0.001) lower afternoon plaque levels on Days 1 and 8, respectively, compared to the manual brush. Trends were similar for morning plaque. Repeated measures analyses showed a 21.2% reduction in overall afternoon plaque and a 23.5% reduction in overall morning plaque for the O‐R brush versus the manual brush (p < 0.001). Conclusions The O‐R toothbrush controlled plaque regrowth better than a manual toothbrush and should be considered to reduce plaque‐related diseases as part of a generalized prophylaxis and treatment plan. Trial Registration ISRCTN Registry: ISRCTN 28649560.

Objective Dental plaque is a major contributor to oral diseases, particularly in children, but its impact can be significantly mitigated through targeted oral health education. This study aimed to evaluate the effectiveness of various tooth-brushing instructional methods in reducing dental plaque in children. Methods A total of 120 children, aged 6 to 8, attending the pediatric department of Alborz Dental School, were randomly selected for the study. Participants were divided into four groups of 30 children each (15 boys and 15 girls). Each group received a different instructional method: (1) demonstration of tooth brushing on a dental model, (2) self-brushing in front of a mirror, (3) brushing another child’s teeth in front of a mirror, and (4) instruction via a standardized video. Dental plaque levels were measured using a disclosing agent before and after training, with a two-week follow-up to assess the impact of instruction. Senior students provided group-specific brushing training. Data were analyzed using SPSS-22 with ANOVA and t-tests, with significance set at p  < 0.05. Results All four groups demonstrated significant reductions in plaque levels post-training and at the two-week follow-up compared to baseline, as measured by the O’Leary index. The group trained with dental models showed the most substantial plaque reduction ( p  < 0.001). Conclusion Instruction using dental models proved to be the most effective and sustainable method for reducing dental plaque in children, highlighting its potential for impactful and enduring oral hygiene education.

Objectives This study aimed to compare the cleansing efficacy of the Oral-B ® iO™ electric toothbrush incorporating oscillating-rotating technology with microvibrations - with a traditional oscillating-rotating toothbrush. Materials and methods Thirty adult participants were randomly assigned to use the iO™ electric toothbrush with the brush head iO™ Ultimate Clean or the traditional oscillating-rotating toothbrush Oral-B ® Genius ® with the Cross-Action brush head. Oral hygiene indices (Rustogi Modified Navy Plaque Index and Gingival Bleeding Index) were assessed before and after 28 days of home use of the assigned product. Participants were instructed to refrain from interdental hygiene during the study period. After a 2-week washout period, the clinical investigation was repeated in a crossover design. Results All 30 participants completed the study with no dropouts. After 28 days of use, the iO™ showed statistically significantly lower plaque levels than the conventional oscillating-rotating toothbrush (25.09% vs. 30.60%, p  = 0.029). This difference was particularly noticeable in marginal and approximal areas. There were no significant distinctions in gingival bleeding indices. Conclusions The Oral-B ® iO™ electric toothbrush displayed enhanced plaque removal efficiency compared to a conventional oscillating-rotating technology. Clinical relevance This study highlights the potential benefits of advanced toothbrush technologies for plaque reduction and encourages further research.

Objectives To compare the plaque reducing efficacy of oil pulling with sesame oil compared to distilled water in a randomized, controlled, examiner-blinded parallel group study. Materials and methods Forty probands without advanced periodontal disease of the University Hospital for Restorative Dentistry and Periodontology, Medical University of Innsbruck (Austria) were randomized allocated to test- (sesame oil) or control group (distilled water) and asked to pull daily in the morning for eight weeks with their allotted fluid for 15 min. Rustogi Modified Navy Plaque Index (RMNPI) and gingival bleeding index were assessed at baseline and after four and eight weeks. Plaque samples underwent microbiological analysis. Results Pulling with sesame oil was significantly more effective in reducing full mouth RMNPI compared to distilled water after eight weeks (median reduction 18.98% versus 10.49%; p  = 0.023), and was most pronounced in anterior, buccal, and lingual subscales. On approximal surfaces, significantly higher plaque reduction was found in the test group after four (24.07% versus 14.29%) and eight weeks (16.00% versus 5.36%) of intervention ( p  < 0.05). No significant changes in gingival index and mirobiological analysis could be detected. Conclusion Plaque reduction was statistically significantly higher with oil pulling than with distilled water, however, a study bias cannot be ruled out. Further high-quality trials are needed to understand the mechanisms and effectiveness of oil pulling, to finally clarify the evidence. Clinical relevance Oil pulling may be recommended as an adjuvant to mechanical dental cleaning. Individuals with keratosis may experience adverse effects. Trial registration ClinicalTrials.gov NCT06327841.

Experimental studies in animals and in vitro have shown the usefulness of photodynamic therapy (PDT) as an adjunct to periodontal treatment. The aim of this study was to evaluate the long-term clinical and microbiological effects of PDT associated with nonsurgical periodontal treatment. Three sites in each of 33 patients with chronic periodontitis were randomly allocated in a split-mouth design to a treatment group: (1) scaling and root planing (SRP group); (2) SRP and irrigation with toluidine blue O (TBO group); and (3) SRP, irrigation with TBO and low-level laser irradiation (PDT group). Clinical parameters including visible plaque index, bleeding gingival index, bleeding on probing, probing depth, gingival recession and clinical attachment level were measured at baseline, and after 60, 90 and 180 days. Additionally, subgingival plaque samples were collected for microbiological analysis by PCR. Intergroup and intragroup statistical analyses were performed. All treatment groups showed an improvement in all clinical parameters, and a significant reduction in the proportion of sites positive for periodontopathogens at 60, 90 and 180 days compared to baseline ( p  < 0.05). None of the periodontal parameters showed a significant difference among the groups ( p  > 0.05). At 180 days, PDT treatment led to a significant reduction in the percentage of sites positive for all bacteria compared to SRP alone ( p  < 0.05). Within the limits of this study it may be concluded that PDT as an adjunct to periodontal treatment produced statistically significant reductions in some of the key periodontal pathogens but produced no statistically significant benefit in terms of clinical outcome.

Background To evaluate the antiplaque effects of an alcohol-free mouthrinse containing essential oils—Listerine Zero (LZ)—and an alcohol-based essential oils mouthrinse (EO+) compared with a positive control of 0.20% chlorhexidine mouthrinse (CHX) and a negative control of a placebo solution (saline), using an in vivo plaque regrowth model of three days. Methods The study was designed as a double-masked, randomized, crossover clinical trial, involving 21 volunteers to compare four different mouthrinses, using a three-day plaque regrowth model. After receiving thorough professional prophylaxis at baseline, over the next three days each volunteer refrained from all oral hygiene measures and performed two daily rinses with 15 mL of the test mouthrinses. EO+ was compared with LZ. CHX rinse served as a positive control and a placebo solution as a negative control. At the end of each experimental period, the Plaque Index (PI) was assessed and a panelist completed through a visual analogue scale (VAS) questionnaire evaluating the organoleptic properties of each product. Each participant underwent a 14-day washout period and then there was another allocation. Results LZ showed the same inhibitory activity on plaque regrowth compared with EO+ in the whole mouth (PI = 1.72 versus 1.65, respectively), but there was less of an effect compared to the CHX (overall PI of 1.07) and a more efficient activity than the saline solution negative control (PI = 2.31). The difference of 0.07 between LZ and EO+ was not statistically significant. Conclusions LZ seems to have the same inhibiting effect on plaque regrowth as EO+ and a less inhibiting effect than the CHX control. Both LZ and EO+, as well as the CHX control, show a better inhibiting effect on plaque regrowth than the placebo solution. Trial registration ClinicalTrials.gov, NCT02894593 . Registered on 4 September 2016.

Dental plaque biofilms cause various dental diseases; therefore, inhibiting the growths of the dental plaque bacteria which produce biofilms can be a strategy for preventing dental disease. Certain sulfated polysaccharides from marine algae exert antimicrobial activities against human bacterial pathogens in addition to their physiological benefits. On the basis of these observations, the antimicrobial and antibiofilm activities of sulfated polysaccharides from different marine algae were evaluated against dental plaque bacteria. Among the sulfated polysaccharides, a fucoidan from Fucus vesiculosus showed notable antimicrobial activities against the selected dental plaque bacteria, including some foodborne pathogenic bacteria. The minimum inhibitory concentrations were of 125 to 1000 µg mL−1. Regarding the antibiofilm activity, the fucoidan at the concentrations of above 250 µg mL−1 completely suppressed the biofilm formations and planktonic cell growths of Streptococcus mutans and S. sobrinus. However, no eliminative effect on the completed biofilm was observed. The fucoidan consisted of almost fucose base polysaccharide containing approximately 14.0% sulfate content. The average molecular weight of the fucoidan was changed by heat treatment (121 °C for 15 min) and it affected the antimicrobial activity.