Malgorzata Klukowska

Plaque levels of patients with fixed orthodontic appliances measured by digital plaque image analysis.

INTRODUCTION A digital plaque image analysis system was developed to objectively assess dental plaque formation and coverage in patients treated with fixed orthodontic appliances. METHODS The technique was used to assess plaque levels of 52 patients undergoing treatment with fixed appliances in the Department of Orthodontics at Johannes Gutenberg University in Mainz, Germany. RESULTS Plaque levels ranged from 5.1% to 85.3% of the analyzed tooth areas. About 37% of the patients had plaque levels over 50% of the dentition, but only 10% exhibited plaque levels below 15% of tooth coverage. The mean plaque coverage was 41.9% ± 18.8%. Plaque was mostly present along the gum line and around the orthodontic brackets and wires. CONCLUSIONS The digital plaque image analysis system might provide a convenient quantitative technique to assess oral hygiene in orthodontic patients with multi-bracket appliances. Plaque coverage in orthodontic patients is extremely high and is 2 to 3 times higher than levels observed in high plaque-forming adults without appliances participating in clinical studies of the digital plaque image analysis system. Improved hygiene, chemotherapeutic regimens, and compliance are necessary in these patients.

The effect of strip, tray and office peroxide bleaching systems on enamel surfaces in vitro

UNLABELLED Improvement of the appearance of teeth by whitening systems is one of the goals of modern esthetic dentistry. Vital tooth bleaching is administered in a variety of forms including trays, strips and paint-on gels. The concentrations and conditions of bleaching systems vary considerably between these treatment forms. OBJECTIVES This study compared surface changes associated with exposure of human premolar teeth to topical cycling treatments with three different bleaching systems: Opalescence X-Tra Boost (OPXB), Opalescence 20% PF (OP20PF) and Crest Whitestrips Supreme (CWSS), respectively. METHODS Extracted human premolars were prepared in Durabase blocks and measured for tooth color, surface microhardness and roughness. Teeth were cycled in a regimen including a pre-test period, test bleaching treatment and 7 days post-bleach period. Bleaching was segmented to 0 h for untreated control group (UC); 42 h for CWSS, 42 h for OP20PF and 45 min with OPXB. Following treatment specimens were re-measured as before. RESULTS Bleaching treatments produced significant tooth lightening (yellow reduction). Hardness of enamel specimens from control and bleaching groups were unchanged during cycling: Delta Vickers hardness number (VHN): UC (18+/-11S.D.) a; CWSS (7.0+/-29nsd) a; OP20PF (19+/-15S.D.) a; OPXB (25+/-13S.D.) a (nsd = non-significant difference post-cycle-treat vs. initial Students t; ANOVA p<0.05 a not equal b between group comparison post-treat). With respect to surface roughness, two-dimensional analysis showed no changes with bleaching: DeltaR(a) (roughness) 2D = UC (0.06+/-0.06nsd) a; CWSS (0.02+/-0.07nsd) a; OP20PF (-0.14+/-0.08nsd) a; OPXB (0.00+/-0.12nsd) a. CONCLUSION Office administered, prescribed and OTC/prescribed bleaching systems were demonstrated as similarly safe to enamel surfaces including maintenance of both hardness and roughness in vitro.

Efficacy of 3 toothbrush treatments on plaque removal in orthodontic patients assessed with digital plaque imaging: A randomized controlled trial

INTRODUCTION Good oral hygiene is a challenge for orthodontic patients because food readily becomes trapped around the brackets and under the archwires, and appliances are an obstruction to mechanical brushing. The purpose of this study was to compare plaque removal efficacy of 3 toothbrush treatments in orthodontic subjects. METHODS This was a replicate-use, single-brushing, 3-treatment, examiner-blind, randomized, 6-period crossover study with washout periods of approximately 24 hours between visits. Forty-six adolescent and young adult patients with fixed orthodontics from a university clinic in Germany were randomized, based on computer-generated randomization, to 1 of 3 treatments: (1) oscillating-rotating electric toothbrush with a specially designed orthodontic brush head (Oral-B Triumph, OD17; Procter & Gamble, Cincinnati, Ohio); (2) the same electric toothbrush handle with a regular brush head (EB25; Procter & Gamble); and (3) a regular manual toothbrush (American Dental Association, Chicago, Ill). The primary outcome was the plaque score change from baseline, which we determined using digital plaque image analysis. RESULTS Forty-five subjects completed the study. The differences in mean plaque removal (95% confidence interval) between the electric toothbrush with an orthodontic brush head (6% [4.4%-7.6%]) or a regular brush head (3.8% [2.2%-5.3%]) and the manual toothbrush were significant (P <0.001). Plaque removal with the electric toothbrush with the orthodontic brush head was superior (2.2%; P = 0.007) to the regular brush head. No adverse events were seen. CONCLUSIONS The electric toothbrush, with either brush head, demonstrated significantly greater plaque removal over the manual brush. The orthodontic brush head was superior to the regular head.

Effect of a Multidirectional Power Toothbrush and a Manual Toothbrush in Individuals Susceptible to Gingival Recession: A 12-Month Randomized Controlled Clinical Study.

BACKGROUND Clinical studies have explored the relationship between toothbrushing and development of gingival recession (GR), but relevant GR data for the multidirectional power toothbrush (PT) are lacking. The aim of this study is to evaluate the effect of brushing with either a multidirectional PT or American Dental Association reference manual toothbrush (MT) on mid-buccal preexisting GR (PreGR) during 12 months. METHODS This was a 12-month prospective, single-masked, parallel-group, randomized, controlled clinical study. Healthy participants without periodontitis with at least two teeth showing PreGR ≥2 mm were randomized to a group brushing with either an MT or PT. The primary outcome parameter was change at sites with PreGR ≥2 mm. All clinically based GR measurements were performed by one calibrated examiner at baseline, 6, and 12 months. Secondary outcomes were changes of GR at all mid-buccal sites (with or without PreGR), changes in percentage of GR sites demonstrating a change of ≥1 mm, and changes in probing depths. RESULTS A total of 107 participants completed the study (PT: 55, MT: 52). During the 12-month study period the mean recession at sites with PreGR ≥2 mm decreased significantly from 2.2 to 2.1 mm in both groups (P <0.05). The extent of GR parameters did not differ between MT and PT groups at any time point. GR evaluated clinically and on stone casts was well correlated. CONCLUSION Neither the PT nor MT led to an increase in PreGR during 12 months of daily use.

Using Electromagnetic Articulography to Measure Denture Micromovement during Chewing with and without Denture Adhesive: Measuring Denture Micromovement during Chewing

Abstract Purpose To study the effects of denture adhesive upon denture micromovements in three dimensions during the chewing of hard, sticky, and tough food items observed using a novel method involving an electromagnetic articulograph (EMA) speech research system. Materials and Methods Ten volunteers (mean age 60.9 ± 10.4 years) with fair‐ or poor‐fitting complete maxillary dentures were enrolled. Chewing experiments were conducted using two treatments (adhesive or no‐adhesive control) and three foods: carrots (hard), raisins (sticky), and processed meat stick (tough). Denture micromovement was measured through a novel application of a Northern Digital Wave EMA System. Three‐dimensional denture position was captured during mastication using three sensors embedded into a replica denture for each subject. Following individual characterization of a “home” reference position, the Euclidean Distances from Home (DfH) were calculated for each recorded sample of the chewing experiments. The DfH at each sample represented the denture movement for that 1/100th of a second of the activity. The DfH data were then summarized as the mean DfH, the maximum DfH, and total distance traveled by the denture. Several thresholds were also analyzed, including the percent of time that the DfH ≥1.5 mm, ≥2.0 mm, and ≥2.5 mm. Results With adhesive treatment, the mean DfH of dentures during chewing was reduced by 26.8% for carrot, 30.3% for raisin, and 31.0% for meat stick, when compared with no‐adhesive treatment (p < 0.001 for all comparisons). Similar results were also seen for the maximum DfH and total distance travelled endpoints across foods. For the threshold endpoints, adhesive treatment was associated with a statistically significant reduction in denture micromovements at all three thresholds across foods. At the threshold of DfH ≥ 1.5 mm, adhesive treatment was associated with a reduction in micromovement by 61.6%, 56.2%, and 70.0% with carrot, raisin, and meat stick, respectively (p ≤ 0.004 for all comparisons). Conclusions Observations of denture movement using the Wave EMA System were able to differentiate systematically between adhesive treatment and no‐adhesive treatment for denture micromovements during different chewing challenges. Use of adhesive was associated with statistically significant reductions in denture micromovements for hard, sticky, and tough foods as measured with both distance and threshold endpoints.