ABSTRACT
Purpose: To evaluate the efficacy in dental biofilm (DB) removal between electric toothbrushes versus manual toothbrushes in primary dentition using an Image Analysis System (IAS) of digital photographs.
Methods: A prospective, randomized, controlled, blind, crossover clinical trial was conducted for 12 weeks with children between four to six years of age. The amount of DB was evaluated at zero, four, eight and 12 weeks. The degree of acceptance of the type of toothbrush used by the child was assessed at week 12.
Results: Twenty-two children participated and 176 photographs were taken, with 1,408 images of primary incisors being digitally analyzed by IAS. DB was significantly reduced by both types of toothbrushes on day zero (manual=7.44±1.83 percent; electric= 9.80±2.03 percent) and at week four (manual=8.57±2.23 percent; electric= 5.85±2.10 percent). However, there was no statistically significant difference in DB reduction when both types were compared. After week four, when compared prospectively, there was a statistically significant reduction (P <0.05) of DB for the electric toothbrush only. Electric toothbrushes had a significantly greater acceptance by the participants (P <0.01).
Conclusion: Electric toothbrushes eliminated DB better and were more accepted by the children than manual toothbrushes.
Subject(s)
Dental Plaque , Child , Humans , Prospective Studies , Toothbrushing , Cross-Over Studies , Tooth, Deciduous , Single-Blind MethodABSTRACT
BACKGROUND: The quantification of the dental plaque (DP) by indices has limitations: They depend on the subjective operator's evaluation and are measured in an ordinal scale. The purpose of this study was to develop and evaluate a method to measure DP in a proportional scale. MATERIALS AND METHODS: A portable photographic positioning device (PPPD) was designed and added to a photographic digital single-lens reflex camera. Seventeen subjects participated in this study, after DP disclosure with the erythrosine, their incisors, and a calibration scale ware photographed by two operators in duplicate, re-positioning the PPPD among each acquisition. A third operator registered the Quigley-Hein modified by Turesky DP index (Q-H/TPI). After tooth brushing, the same operators repeated the photographs and the Q-H/TPI. The image analysis system (IAS) technique allowed the measurement in mm(2) of the vestibular total tooth area and the area with DP. RESULTS: The reliability was determined with the intra-class correlation coefficient that was 0.9936 (P < 0.05) for the intra-operator repeatability and 0.9931 (P < 0.05) for inter-operator reproducibility. The validity was assessed using the Spearman's correlation coefficient that indicated a strong positive correlation with the Q-H/TPI r s = 0.84 (P < 0.01). The sensitivity of the IAS was evaluated with two sample sizes, only the IAS was able to detect significant differences (P < 0.05) with the sample of smaller size (n = 8). CONCLUSIONS: Image analysis system showed to be a reliable and valid method to measure the quantity of DP in a proportional scale, allowing a more powerful statistical analysis, thus facilitating trials with a smaller sample size.
