Clinical assessment of dental plaque accumulation and periodontal status in patients using different types of tootbrushes undergoing fixed orthodontic treatment

The purposes of this study were to evaluate the effects of different types of toothbrushes on oral hygiene in patients having fixed orthodontic treatment and to compare cleaning efficiency of these toothbrushes in patients wearing conventional and self ligating brackets. This was a single blind, randomised, prospective, single center and parallel clinical trial. The study was conducted on parameters measured on 12 teeth of 92 individuals receiving orthodontic treatment. Self-ligating brackets were used in 41 subjects and conventional brackets in the other 51. Each bracket group was assigned into 3 subgroups who used different types of toothbrushes (manual, oscillating-pulsating, rotating). Dental plaque accumulation and periodontal status was assessed by Modified Gingival Index, Modified Quigley Hein Plaque Index, Bleeding on Probing Index and the Accumulated Plaque in the Bracket Slot. All measurements of the patients were performed: at baseline (T0), at 4 weeks after oral hygiene education and necessary profilaxis (T1), and at the end of the 8 weeks (T2). The statistical calculations were performed by using NCSS software for Windows.Oral hygiene education improved individuals? motivation and toothbrushing efficiency. In the group with conventional brackets, rotary toothbrush had less cleaning efficiency than manual and oscillating-pulsating toothbrush; in the group with self-ligating brackets, oscillating toothbrush had superiority over the other groups. In both bracket groups patients using the rotary toothbrush had significantly increased bleeding on probing index than the other toothbrush groups. In the group with conventional brackets, patients using rotary toothbrush had increased accumulated plaque scores in the bracket slot than the manual and oscillating groups. In the self-ligating group, no significant differences in intra and inter-group comparisons were observed relative to accumulated plaque in the bracket slot scores.When conventional and self-ligating bracket groups were compared, patients using manual toothbrushes showed significantly greater modified gingival index, plaque index and bleeding on probing index values in the self-ligating bracket groups. There were no significant effects of different bracket designs on clinical indexes when battery-powered toothbrushes were used. Accumulated plaque scores in the bracket slot had significantly increased values in all clinical measurement time points and all toothbrush groups in self-ligating bracket groups than in the conventional bracket groups.Key words: fixed orthodontic treatment, toothbrushes, self-ligating brackets, dental plaque,gingivitis