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Article

Effectiveness of Oscillating and Rotating versus High-Frequency Sonic Powered Toothbrush in Dental Hygiene University Students: A Proof-of-Concept Study

by
Martina Ferrillo
1,*,
Paola Mariani
2,
Vittorio Gallo
3,
Silvia Leone
4,
Federica Pezzotti
4,
Leonzio Fortunato
1,
Amerigo Giudice
1 and
Mario Migliario
4,5
1
Dentistry Unit, Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
2
Private Practice, Calvizzano, 80012 Naples, Italy
3
CIR Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
4
Dentistry Unit, University Hospital “Maggiore della Carità”, 28100 Novara, Italy
5
Dentistry Unit, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
*
Author to whom correspondence should be addressed.
Appl. Sci. 2023, 13(1), 18; https://doi.org/10.3390/app13010018
Submission received: 28 November 2022 / Revised: 13 December 2022 / Accepted: 15 December 2022 / Published: 20 December 2022
(This article belongs to the Section Applied Dentistry and Oral Sciences)
Versions Notes

Abstract

:
Plaque biofilm is considered one of the etiological factors involved in the onset of caries and gingivitis, and is associated with the progression of periodontitis and peri-implant inflammation. There is no agreement in the literature on the effectiveness of the oscillating-rotating (OR) powered toothbrush (PTB) and high-frequency sonic (HFS) PTB in improving oral health. Thus, using the present proof-of-concept study we aimed to evaluate the effectiveness of OR PTB versus HFS PTB in terms of the improvement in plaque, gingival inflammation, and lingual patina indexes in dental hygiene university students. Dental hygiene students from the University of Eastern Piedmont “A. Avogadro” of Novara, Italy from November 2019 to October 2021 were recruited. Based on the type of toothbrush previously used for at-home plaque removal, the study participants were divided into two groups: Group 1 (subjects that used MTB prior to the study beginning, asked to use OR PTB for 2 times/day for a minimum of 3 months) and Group 2 (subjects that used HFS PTB prior to the study beginning). All the participants were instructed to avoid floss aids during the study (i.e., pipe cleaners, dental floss, and mouthwash). The outcome measures were: New Method of Plaque Scoring (NMPS), simplified Oral Disease Index (OHI-S), Plaque Control Record (PCR), Gingival Bleeding Index, and Winkel Tongue Coating Index (WTCI). All the outcomes were assessed at baseline (T0) in both groups and after 3 months (T1) in Group 1. Fifty-seven subjects (44 females and 13 males) were included and allocated to the study group (n = 30, 22 females and 8 males) and control group (n = 27, 22 females and 5 males). At T0, all the indexes were significantly higher in Group 2 (p < 0.0001). At T1, NMPS, OHI-S, PCR, GBI, and WTCI were statistically improved in Group 1 (p < 0.0001). Lastly, there was a statistically significant difference between Group 1 at T1 and Group 2 at T0 in terms of NMPS (p = 0.043), OHI-S (p = 0.032), and PCR (p < 0.001). Taken together, the findings of this proof-of-concept study showed the effectiveness over a 3-month period of both oscillating-rotating and sonic PTB in terms of oral health status in a sample of dental hygiene students.

1. Introduction

Plaque-biofilm is a three-dimensional structure in which complex polymicrobial communities live in a symbiotic state of co-aggregation [1]. If dental plaque is not removed, the colonization of pathogenic Gram-negative bacteria, such as Prevotella spp., Selenomonas spp., and F. nucleatum ss. polymorphum, can occur [1]. Biofilm is considered one of the etiological factors involved in the onset of caries and gingivitis, and is associated with the progression of periodontitis and peri-implant inflammation [2,3]. The accumulation of abundant Gram-negative species (e.g., Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Actinomyces actinomycetemcomitans) below the gingival margin may cause a detrimental host inflammatory-immune response, representing the most important risk factor for periodontitis [4]. So, the mechanical control of supra-gingival plaque represents one of the main goals of preventive dentistry and oral hygiene motivation and the efficacy of therapeutic instruments plays a key role in the daily domiciliary mechanical plaque control [4,5,6,7,8].
During the last decades, great progress has been made in the design of instruments used for the disorganization, disintegration, and removal of plaque, and among the different chemical and mechanical methods, tooth brushing is still the primary and most widely accepted method of plaque removal [9]. However, in the scientific literature it was reported that most people do not brush for long enough, leaving an abundant amount of plaque on teeth surfaces [10]; moreover, manual tooth brushing is dependent on technique and it was shown that about 60% of plaque was not removed [11]. Thus, most people consider the practice of brushing to be time-consuming and boring, so they do not perform adequate daily home hygiene, especially subjects with decreased manual dexterity [12,13]. The toothbrush design and tooth brushing methods, time, and frequency may affect the clinical effectiveness of tooth brushing, which is also greatly dependent on the skills and motivation of the individual [14]. In the effort to improve oral hygiene, over the years, more effective manual toothbrushes (MTBs) to remove plaque have been introduced, and currently toothbrushes come in a wide range of sizes, shapes, and materials [15,16].
In this context, powered toothbrushes (PTB) were introduced in order to simplify patients’ daily oral care, without requiring specific tooth brushing techniques [17].
In this context, several systematic reviews explored the efficacy of PTBs compared with MTB in terms of both plaque and inflammation control [2,18,19]. In the scientific literature, several authors [9,17,20,21] have emphasized the benefits of PTBs, albeit they showed to not always be significantly more effective in reducing plaque [19,22,23]. However, other authors supported that PTB showed the same or less efficacy of MTB in plaque and gingivitis reduction when compared to MTB [2,24,25].
The scientific literature has focused its attention on different types of PTB, including oscillating-rotating (OR) and high-frequency sonic (HFS) technology, considered as the most common commercially available products in the last years [26].
In 2010, a Cochrane systematic review by Deacon et al. [10] evaluated the plaque score reduction comparing different modes of powered tooth brushing against each other. The authors included 17 trials with a total of 1369 participants and no definitive conclusions were drawn regarding the superiority of a particular type of PTB. In 2021, a review by Preda et al. [27] showed no great differences between OR and HFS PTB, supporting that both could provide great improvements in plaque removal and gingival inflammation reduction. However, the authors highlighted that further studies were necessary to outline more accurate conclusions. In 2021, Thomassen et al. [26] conducted a systematic review to compare the efficacy of PTB (both OR and HFS) and MTB. The authors included 28 RCT to evaluate the plaque score reduction after a single brushing action. The results of the network meta-analysis showed a significant difference in plaque score reduction in favor of both OR and HFS compared to MTB. In addition, a very small benefit for the use of an OR PTB mode of action over an HFS PTB appeared.
To date, there is still no agreement in the scientific literature on the superiority of a particular type of PTB despite the key role of tooth brushing in the prevention of gum disease and tooth decay. In this scenario, using the present study we aimed to evaluate the effectiveness of OR PTB versus HFS PTB in terms of the improvement in plaque, gingival inflammation, and lingual patina indexes in dental hygiene university students.

2. Materials and Methods

2.1. Participants

In the present proof-of-concept study, we recruited students attending the 2nd and 3rd year of the Dental Hygiene Degree Course at the University of Eastern Piedmont “A. Avogadro” of Novara, Italy from November 2019 to October 2021. Inclusion criteria were: (a) at least 18 years of age; (b) able to provide written informed consent; (c) minimum of 20 natural teeth; and (d) using manual or sonic toothbrush. We excluded subjects with: (a) evidence of periodontitis or presence of probing depths > 4 mm; (b) gingival recession > 3 mm; (c) use of antibiotics or anti-inflammatory drugs within the previous 2 weeks; (d) ongoing fixed orthodontic appliances; (e) pregnancy or lactation; (f) uncontrolled diabetes mellitus, infectious diseases including HIV/AIDS or any diseases or conditions that could interfere with the study protocol. The study was approved by the Local Ethics Committee (CE 61/10, prot.392 CE). All the participants were asked to carefully read and sign an informed consent, and researchers were provided to protect the privacy and study procedures according to the Declaration of Helsinki, with pertinent National and International regulatory requirements.

2.2. Intervention

The study participants were divided into two groups based on the type of toothbrush used for at-home plaque removal: MTB and HFS PTB.
-
Group 1 (subjects that used MTB prior to the study beginning, asked to use OR PTB for 3 months):
These subjects were instructed to use an OR PTB (Oral B GENIUS 9000N, Kronberg, Germany) in “Daily Clean mode” (9900 roto-oscillations and 45,000 pulsations per minute) for teeth and “Tongue Clean mode” for the tongue. These subjects received a toothpaste containing: Glycerin, PEG-8, Hydrated Silica, Pentasodium Triphosphate, Aroma, Sodium Lauryl Sulfate, Titanium Dioxide, Carbomer, Sodium Saccharin, Stannous Fluoride, Cocamidopropyl Betaine, Sodium Flouride, and Limonene (GSK Consumer Healthcare—GMTD, Clocherane, Youghal Road, Dungarvan, Co., Waterford, Ireland). Group 1 participants were instructed to use the OR PTB 2 times/day for a minimum of 2 min for a 3-month period. These subjects were instructed to avoid floss aids during the study (i.e., pipe cleaners, dental floss, and mouthwash).
-
Group 2 (subjects that used HFS PTB prior to the study beginning):
These subjects used HFS PTB (Philips Sonicare DiamondClean, Philips S.p.A., Milan, Italy) without any instruction from a dentist.

2.3. Outcome Measures

At the baseline, each participant completed a questionnaire to collect their demographic characteristics and oral health behavior, such as the type of toothbrushes used to perform daily home oral hygiene, time spent on brushing, and frequency of brushing per day.
All the study participants underwent an oral examination at the Dentistry Unit of the University Hospital “Maggiore della Carità” of Novara, Italy, including the use of a plaque-disclosing agent (GUM® REDCOTE® Tablets, Sunstar, Osaka, Japan).
The examination included the assessment of the following outcomes:
-
New Method of Plaque Scoring (NMPS), for evaluating the presence and amount of bacterial plaque at the level of tooth surfaces. The scoring system was based on a numerical range from 0 to 10 representing the total stained plaque on the facial and lingual tooth surfaces, according to the method proposed by Dababneh et al. [28]. The buccal surface of the tooth element was divided into 1/3 gingival (zone A) and 2/3 coronal area. The 2/3 coronal area was further divided into zone B (1/3 mesial), Zone C (1/3 distal), and zone D (1/3 central). The zones A, B and C were assigned a value between 0 and 3 (Grade 0: No plaque; Grade 1: Presence of plaque for no more than 1/3 of the area; Grade 2: Presence of plaque for more than 1/3 but not more than 2/3 of the zone; Grade 3: Presence of plaque for more than 2/3 of the zone). The evaluation of the middle third (zone D) was carried out by assigning value 0 (no plaque) or value 1 (plaque presence). The average index value was the sum of the values assigned to each individual tooth divided by the number of teeth considered.
-
Oral Hygiene Index (OHI) [29], for the presence of debris/stain and calculus on the dental elements. The values of debris and calculus were determined by examining the buccal surface of the teeth. The following data were recorded for debris: Grade 0: Absence of debris or stains; Grade 1: Soft residues or pigmentations covering less than 1/3 of the tooth surface; Grade 2: Soft residues and stains covering from 1/3 to 2/3 of the tooth surface; Grade 3: Soft residues and stains covering more than 2/3 of the tooth surface). The following data were recorded for calculus: Grade 0: Absence of calculus; Grade 1: Presence of supragingival calculus covering no more than 1/3 of the tooth surface; Grade 2: Presence of supragingival calculus covering between 1/3 and 2/3 of the tooth surface, or presence of subgingival calculus around the cervical area of the tooth; Grade 3: Presence of supragingival calculus covering more than 2/3 of the exposed tooth surface, or continuous band of subgingival calculus around the cervical area of the tooth. The facial surface of teeth 11, 16, 26, and 31 and the lingual surface of teeth 36 and 46 were evaluated. The average index value was the sum of the values assigned to each individual tooth divided by the number of teeth considered.
-
Plaque Control Record (PCR) [30], to record the presence of plaque on the buccal, lingual, mesial, and distal surfaces. The average index value was the sum of areas with plaque divided by the number of surfaces examined.
-
Gingival Bleeding Index (GBI) [31], to assess gingival inflammation. Each tooth surface was divided into four areas (mesiobuccal, buccal, distobuccal, and lingual) and the assessment was based on color, texture, and bleeding (Grade 0: Normal gingiva; Grade 1: Slight erythema, mild edema, no bleeding on probing; Grade 2: Redness, edema, and shiny appearance of marginal gingiva; bleeding on probing; Grade 3: Severe erythema; tendency for spontaneous bleeding, possible ulceration). The average index value was the sum of the values assigned to individual areas divided by the areas considered.
-
Winkel Tongue Coating Index (WTCI) [32]. The dorsum of the tongue was divided into six areas to evaluate the amount of tongue coating (Grade 0: No coating; Grade 1: Presence of light coating; Grade 2: Presence of severe coating). The average index value was the sum of the values assigned to individual areas divided by the areas considered.
We evaluated all the outcome measures at the baseline (T0) and after 3 months (T1) in Group 1 (MTB + OR PTB) and Group 2 (HFS PTB) to evaluate:
(i)
the difference between the two groups at T0;
(ii)
the intra-group difference (T0-T1) in Group 1 after using an OR PTB for 3 months;
(iii)
the difference between the values of Group 1 (MTB + OR PTB) at T1 and Group 2 (HFS PTB) at T0.

2.4. Statistical Analysis

The statistical results were obtained through a statistical analysis using STATA 14 statistical software (StataCorp LLC, College Station, TX, USA). The Mann–Whitney test was used to determine the difference in oral hygiene indices between the two groups. The intra-group difference between the values of the oral hygiene indices at T0 and T1 was calculated through the Wilcoxon signed-rank test. Pearson’s chi-square proportions test (χ2) was applied to the qualitative variables (presence or absence of a certain characteristic), which allows us to compare proportions observed in different samples and verify the presence of statistically significant differences between them. In cases where the sample size in at least one cell of the double entry table was less than 5, Fisher’s exact test was applied. Values of p < 0.05 were considered statistically significant.

3. Results

Fifty-seven subjects (44 females and 13 males) were included and allocated to Group 1 (MTB + OR PTB) (n = 30, 22 females and 8 males) and Group 2 (HFS PTB) (n = 27, 22 females and 5 males). At T0, there were no between-group differences in socio-demographic and clinical characteristics, except for statistically significant higher values in Group 1 (MTB + OR PTB) in terms of number of smokers (p = 0.043) and in Group 2 (HFS PTB) in terms of tooth brushing timing (p = 0.006). Moreover, there were no statistically significant differences between the two groups according to the data on dental formula (see Table 1 for further details).
At the baseline, the indexes of oral hygiene, gingival inflammation, and lingual patina were significantly higher in Group 1 (MTB + OR PTB) than in Group 2 (HFS PTB) (p < 0.0001), as depicted by Table 2.
NMPS, OHI-S, PCR, GBI, and WTCI revealed a high statistically significant improvement in Group 1, after using the OR PTB for 3 months (T1), (p < 0.0001) (as depicted in Table 3).
Lastly, we found a statistically significant difference between Group 1 after using the OR PTB for 3 months (at T1) and Group 2 (HFS PTB) at T0 in terms of NMPS (p = 0.043), OHI-S (p = 0.032), and PCR (p < 0.001); moreover, there was a positive trend, although not significant, in the other oral hygiene indexes (GBI and WTCI), as reported by Table 4.

4. Discussion

The oral cavity is one of the most complex ecosystems in the body, affected not only by the overall health condition of the host but also by environmental and behavioral factors including oral hygiene, nutrients, smoking, and mechanical stress [33,34]. Among the about 700 bacterial species that coexist in the oral cavity, some oral pathogens (e.g., Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola, Fusobacterium nucleatum, and Tannerella forsyth) could lead to a dysbiotic biofilm deposition on the teeth surface and in the periodontal pocket [35]. The local inflammatory response seems to be promoted by several inflammatory pathways, and it may lead to microbial products spreading in the systemic circulation and reaching distant organs. Indeed, periodontal diseases have been related to low-grade systemic inflammation driven by several inflammatory mediators [36]. In this scenario, our research group has recently shown that poor oral hygiene might increase the risk of progressive periodontal disease and dental decay in pregnant women and patients affected by chronic diseases [37,38,39].
To improve toothbrushes’ adaptability and efficiency, several types of manual and powered toothbrushes have been introduced. Both MTB and PTB could lead to optimum oral hygiene through the disorganization, breakdown and removal of bacterial plaque that is adhered to both soft tissue and teeth [40,41].
The present study aimed at comparing the effects of two different powered toothbrushes on plaque and calculus accumulation, gingival bleeding and inflammation, and the amount of tongue coating.
To the best of our knowledge, this is the first study comparing the effectiveness of oscillating-rotating and sonic-powered toothbrushes among dental hygiene students, well-educated and motivated to perform good home oral hygiene.
The results of our study showed that oral hygiene status was better in the group using HFS PTB than in the group using MTB at baseline. Indeed, all the investigated parameters (NMPS, OHI-S, PCR, GBI, and WTCI) revealed a significantly healthier oral status in Group 2 (p < 0.0001).
Our results are in line with Mensi et al. [42], who compared the efficacy of sonic versus manual tooth brushing in terms of plaque reduction after a session of professional mechanical plaque removal. In this randomized controlled trial, the authors showed that sonic brushing was significantly more effective than manual, both at the statistical and clinical level, for Plaque Index, Bleeding on Probing, and Gingival Index.
After 3 months of using the OR PTB, Group 1 showed a significant improvement in all the investigated indexes (NMPS, OHI-S, PCR, GBI, and WTCI). These results are in line with the scientific literature [2,9,19,21,43]; indeed, different authors showed that powered toothbrushes were more effective than manual ones. Moreover, Cochrane systematic reviews showed that oscillating-powered toothbrushes could remove plaque and reduce gingivitis more than manual brushes in both the long and short term [2,21], reporting minor and transient injuries to the gums. Moreover, it is interesting to note that although Group 1 subjects reported a higher number of smokers and shorter tooth brushing timing before the study began, at T1 the Group 1 subjects improved their periodontal indexes compared to Group 2 subjects at T0. These results could be related to the positive influence of the information and instructions on oral hygiene provided to Group 1 subjects. In this context, in 2022, Arnett et al. [43] showed the efficacy of both brief motivational interviewing and hygiene instruction in improving periodontal health, showing better periodontal outcomes in terms of plaque score, bleeding on probing, and gingival index over a 12-month period.
After 3 months of OR PTB, the main oral hygiene indexes (NMPS, OHI-S, and PCR) improved so much that they resulted in being significantly better than those detected at T0 in Group 2, albeit from a clinical point of view, this statistically significant difference was not relevant. In the scientific literature, there is still no agreement on this topic, considering that a meta-analysis performed by van der Sluijs et al. [44] showed a small but significant difference between the oscillating-rotating power toothbrush and high-frequency sonic toothbrush, confirming a clinically more relevant advantage of oscillating-rotating than using HFS PTB. Moreover, a review of randomized clinical trials by Preda et al. [27], taking into account the quality assessment, resulted in being in favor of sonic toothbrushes, reporting greater long-term results for both the gingival and bleeding indices. Clark Perry and Levin [45] conducted a meta-analysis of RCTs to analyze the efficacy of OR PTB compared with other PTB (specifically HFS), assessing plaque removal and gingival inflammation indexes. The authors showed that OR PTB reported statistically significant improvement for the full-mouth plaque reduction (p < 0.01) and the number of bleeding sites (p < 0.001), but not for the modified gingival index (p > 0.05).
The study had several limitations: first, the inclusion of students attending the 2nd and 3rd year of the Dental Hygiene Degree Course that should be more observant in performing adequate oral hygiene, thus precluding an external validity; second, the small number of study participants, albeit it should be considered the proof-of-concept study design; third, there is a lack of a complete periodontal chart (with full-mouth plaque and full-mouth bleeding values) and the periodontal phenotype assessment, which might have provided additional information for this study.
The findings from the present study might suggest clinical recommendations to transit from MTB to PTB and provide oral hygiene instructions, aimed to improve plaque removal and achieve better periodontal indexes. A very small effect appeared for the use of an OR PTB mode of action over an HFS PTB; thus, results from the present study may suggest choosing OR over HFS PTB. The powered brush head motion may help to establish and maintain oral health, reducing the periodontal inflammatory response. Future clinical trials are expected to provide dentists with more adequate evidence-based decision-making.

5. Conclusions

Taken together, the findings of this proof-of-concept study showed the effectiveness of OR PTB in terms of oral health status in a sample of subjects educated and motivated in proper oral hygiene that previously used MTB. At the same time, adequate use of HFS PTB could be considered in patients with fewer pathogenic factors. In this scenario, we recommend using OR PTB, whilst considering the need for periodic instructions and motivational refreshers to standardize oral home care.

Author Contributions

Conceptualization, M.F. and M.M.; methodology, M.F. and M.M.; formal analysis, M.F., P.M. and V.G.; investigation, S.L., F.P. and M.M.; resources, M.F.; data curation, L.F., A.G. and M.M.; writing—original draft preparation, M.F., P.M. and V.G.; writing—review and editing, A.G. and M.M.; visualization: S.L., F.P. and L.F.; supervision, M.M. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was approved by the Ethics Committee of the University of Eastern Piedmont, Novara, Italy (number: 61/10, prot.392).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The dataset is available upon request.

Conflicts of Interest

The authors declare no conflict of interest.

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Table
Table 1. Study population baseline characteristics (n = 57).
Table 1. Study population baseline characteristics (n = 57).
Group 1 (MTB + OR PTB) (n = 30)Group 2 (HFS PTB) (n = 27)
Sex (male/female)8/225/22
Mean age (years)23.17 ± 1.9123.27 ± 2.07
Right-handed/left-handed29/126/1
Smokers (n. %)12 (40.00%) *4 (14.80%)
Tooth brushing frequency
2/die10 (33.33%)15 (55.56%)
3/die19 (63.33%)11 (40.74%)
>3/die1 (3.33%)1 (3.70%)
Tooth brushing timing
<60 sec10 (33.33%)1 (3.70%)
>60 sec20 (66.67%)26 (96.30%) *
Pipe cleaners17 (56.61%)20 (74.6%)
Dental floss10 (33.33%)6 (22.38%)
Mouthwash14 (46.67%)8 (29.63%)
Tongue cleaning
Toothbrush30 (90%)26 (96.30%)
Tongue cleaner1(3.33%)1 (3.70%)
Number of teeth28.73 ± 1.3128.46 ± 1.10
Subjects with decayed teeth2 (6.67%)1 (3.70%)
Subjects with filled teeth15 (50%)22 (81.48%)
Subjects with sealed teeth10 (33.33%)9 (33.33%)
Subjects with cervical wear2 (6.67%)2 (7.40%)
Subjects with vestibular recession7 (23.30%)4 (14.81%)
Subjects with demineralization8 (26.67%)7 (25.93%)
Subjects with fixed prosthesis6 (20%)2 (7.40%)
Subjects with orthodontic fixed appliance2 (6.67%)2 (7.40%)
Subjects with orthodontic splint8 (26.67%)4 (14.81%)
Continuous variables are expressed as means ± standard deviations or median and IQR; categorical variables are expressed as counts/percentages; ratios are expressed as x/y. Abbreviations: HFS = high-frequency sonic; MTB = manual toothbrush; OR = oscillating-rotating; PTB = powered toothbrush. * = p < 0.05.
Table
Table 2. Differences between the two groups in terms of oral hygiene indexes at the baseline (T0).
Table 2. Differences between the two groups in terms of oral hygiene indexes at the baseline (T0).
Group 1 (MTB + OR PTB) T0Group 2 (HFS PTB) T0p Value
NMPS2.17 ± 0.850.27 ± 0.37<0.0001
OHI-S1.07 ± 0.650.25 ± 0.28<0.0001
PCR53.84 ± 16.477.87 ± 9.76<0.0001
GBI3.04 ± 3.170.72 ± 0.74<0.0001
WTCI0.46 ± 0.200.20 ± 0.23<0.0001
Continuous variables are expressed as means ± standard deviations. Wilcoxon rank sum test was performed as statistical analysis. Abbreviations: HFS = high-frequency sonic; MTB = manual toothbrush; OR= oscillating-rotating; PTB = powered toothbrush; NMPS = New Method of Plaque Scoring; OHI-S = Oral Hygiene Index Simplified; PCR = Plaque Control Record; GBI = Gingival Bleeding Index; WTCI = Winkel Tongue Coating Index.
Table
Table 3. Comparison between oral hygiene status in Group 1 after using the rotating and oscillating powered toothbrush for three months (from T0 to T1).
Table 3. Comparison between oral hygiene status in Group 1 after using the rotating and oscillating powered toothbrush for three months (from T0 to T1).
Group 1 (MTB + OR PTB) T0Group 1 (MTB + OR PTB) T1p Value
NMPS2.17 ± 0.850.18 ± 0.32<0.0001
OHI-S1.07 ± 0.650.12 ± 0.17<0.0001
PCR53.84 ± 16.475.56 ± 9.76<0.0001
GBI3.04 ± 3.170.58 ± 1.100.0002
WTCI0.46 ± 0.200.19 ± 0.23<0.0001
Continuous variables are expressed as means ± standard deviations. Wilcoxon signed-rank test was performed as statistical analysis. Abbreviations: MTB = manual toothbrush; OR= oscillating-rotating; PTB = powered toothbrush; NMPS = New Method of Plaque Scoring; OHI-S = Oral Hygiene Index Simplified; PCR = Plaque Control Record; GBI = Gingival Bleeding Index; WTCI = Winkel Tongue Coating Index; T0 = baseline; T1 = 3 months.
Table
Table 4. Difference in oral hygiene indexes between Group 1 after using the rotating and oscillating powered toothbrush for three months (at T1) and Group 2 at T0.
Table 4. Difference in oral hygiene indexes between Group 1 after using the rotating and oscillating powered toothbrush for three months (at T1) and Group 2 at T0.
Group 1 (MTB + OR PTB) T1Group 2 (HFS PTB) T0p Value
NMPS0.18 ± 0.320.27 ± 0.370.043
OHI-S0.12 ± 0.170.25 ± 0.280.032
PCR5.56 ± 9.767.87 ± 9.76<0.001
GBI0.58 ± 1.100.72 ± 0.740.080
WTCI0.19 ± 0.230.20 ± 0.230.187
Continuous variables are expressed as means ± standard deviations. Wilcoxon rank sum test was performed as statistical analysis. Abbreviations: HFS = high-frequency sonic; MTB = manual toothbrush; OR = oscillating-rotating; PTB = powered toothbrush; NMPS = New Method of Plaque Scoring; OHI-S = Oral Hygiene Index Simplified; PCR = Plaque Control Record; GBI = Gingival Bleeding Index; WTCI = Winkel Tongue Coating Index.
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Ferrillo, M.; Mariani, P.; Gallo, V.; Leone, S.; Pezzotti, F.; Fortunato, L.; Giudice, A.; Migliario, M. Effectiveness of Oscillating and Rotating versus High-Frequency Sonic Powered Toothbrush in Dental Hygiene University Students: A Proof-of-Concept Study. Appl. Sci. 2023, 13, 18. https://doi.org/10.3390/app13010018

AMA Style

Ferrillo M, Mariani P, Gallo V, Leone S, Pezzotti F, Fortunato L, Giudice A, Migliario M. Effectiveness of Oscillating and Rotating versus High-Frequency Sonic Powered Toothbrush in Dental Hygiene University Students: A Proof-of-Concept Study. Applied Sciences. 2023; 13(1):18. https://doi.org/10.3390/app13010018

Chicago/Turabian Style

Ferrillo, Martina, Paola Mariani, Vittorio Gallo, Silvia Leone, Federica Pezzotti, Leonzio Fortunato, Amerigo Giudice, and Mario Migliario. 2023. "Effectiveness of Oscillating and Rotating versus High-Frequency Sonic Powered Toothbrush in Dental Hygiene University Students: A Proof-of-Concept Study" Applied Sciences 13, no. 1: 18. https://doi.org/10.3390/app13010018

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