Microbiological and periodontal assessment of oral hygiene effectiveness of different types of brushes in patients with fixed orthodontic appliances

Objective: The purpose of this study was to compare the efficacy of manual and interactive power brushes in orthodontic patients by assessing periodontal indexes and bacterial content of saliva samples. Materials and Methods: Forty patients (20 females, 20 males; age range 12-18) with fixed orthodontic appliances were included in the study. The patients were randomly divided into two groups in a 1:1 ratio using sealed envelopes: group 1: Manual brush (Oral-B Ortho Brush), group 2: interactive power toothbrush (Oral-B Genius 8900). All participants were given the same toothpaste (Colgate Triple Action). The brushing procedure for each patient was described in detail, both orally and visually, utilizing a video demonstration. Plaque index, gingival index and bleeding on probing scores were recorded for both the lower and upper arches at the beginning of the study (T0), 6th week (T1), and 12th week (T2). In addition, the numbers of S. mutans, L. casei, and P. gingivalis bacteria were determined using a Real time PCR analysis in saliva samples collected at T0, T1, and T2 times. Mann-Whitney U test and Student's t test were used to compare data between the groups, and one-way ANOVA and Friedman tests were used to compare data from different time intervals for each group. Results: The plaque index values of Group 1's at T1 and T2 time points were higher than the the Group 2's values at the same time points. The gingival index and bleeding on probing scores of both groups were similar at T0, T1 and T2 times. While Group 2 had a larger number of salivary S. mutans at T0 and T2, there was no significant difference between the groups at T1. In all three time points, there was no significant difference in salivary L. casei levels between the groups. In Group 2, T1 and T2 time points had less number of L.casei compared to T0 time point. P. gingivalis levels of both groups were similar at T0 and T2 time points. Conclusions: The interactive power brush was more effective at removing plaque than the manual brush. The results of the gingival index, on the other hand, did not reflect the plaque scores. The number of certain salivary bacteria and brush type did not appear to have a clear relationship. Key words: Oral hygiene; Plaque reduction; Gingivitis; Orthodontic patients; Power toothbrush