Comparative evaluation of effects of manual and powered tooth brushing on biofilm formation on metal orthodontic brackets and on gingival and periodontal health- an in-vivo study

Abstract

To evaluate and compare the effects of manual tooth brushing and powered tooth brushing on biofilm formation on metal orthodontic brackets and on gingival and periodontal health of the patient undergoing orthodontic treatment.This randomized controlled clinical trial comprised a total of 36 patients in the age group 15-25 years, coming to Outpatient Department (OPD) of Orthodontics and Dentofacial Orthopedics and undergoing orthodontic treatment. Periodontal evaluation was performed for each patient at four intervals of time, before oral prophylaxis, 1 week after oral prophylaxis, after 3 months of bonding and after 6 months of bonding which constituted the readings at T, T, T and T, respectively. Patients were instructed to use manual toothbrushes for 3 months after bonding. Post 3 months, the patients were divided into two groups- Group I and II as Group I- patients using powered toothbrush and Group II- patients using manual toothbrush, for next 3 months. At both the intervals (T and T), two brackets were debonded from central incisors and second premolars from each patient and studied under scanning electron microscope for biofilm formation.Powered toothbrushing was more effective in reducing API and SBI scores, statistically high significant difference was seen in API score (P = .004) and SBI score (P < .001) between T & T time intervals on comparing both the groups. Both the manual and powered toothbrushing had equal effect on GI scores, no significant difference was seen in GI score (P = .540) between T & T time intervals on comparing both the groups. On inter group comparison of amount of biofilm formation between T2 & T3 time intervals in anterior and posterior region, higher amount of biofilm formation in both the anterior and posterior regions in group II patients (Anterior region= 12.05±6.90, P = .001, posterior region= 10.32±9.75, P = .001).Powered toothbrushes are more effective in removing plaque and thus reducing gingival inflammation in patients with fixed orthodontic appliances.