Claydon N, Addy M, Scratcher C, Ley F, Newcombe R
Division of Restorative Dentistry, Dental School, Bristol, UK.
J Clin Periodontol. 2002 Apr;29(4):310-6. doi: 10.1034/j.1600-051x.2002.290406.x.
Considerable interest has been shown in the plaque removal properties of modern toothbrush designs. The primary aim of the study was to compare the plaque removal properties of 8 relatively recent designs of manual toothbrush using a professional tooth brusher and within a commonly used time frame. A secondary aim was established to utilise the data to observationally appraise plaque accumulation together with the patterns of removal as a consequence of using the timed professional tooth brusher.
The method was an 8-period, single-examiner, randomized, blind cross-over study involving 24 healthy volunteers, balanced for residual effects. Subjects accumulated plaque over a 4 day no oral hygiene period. On day 4, the accumulated plaque was scored by plaque index at the mesial, mid and distal sites of each of the buccal and lingual surfaces of the assessed teeth. Subjects were then removed from the assessment area where they received a professional brushing timed to last 48 s. Brushing was completed according to pre-study training without toothpaste and was followed by a re-scoring of the remaining plaque. A washout period of 3 days was then allowed prior to the next period during which normal oral hygiene was resumed.
Similar quantities of plaque accumulated in each arch, although the difference between the buccal and lingual surfaces was of the order of 30%. The professional toothbrusher removed approximately 40% of the accumulated plaque in the 48 s allocated. The buccal surfaces were most effectively cleaned (approximately 45%) compared with the lingual (approximately 25%), with the plaque removal in the mesial and mid sections approaching 40% and 60% respectively. The difference in performance between the test brushes corresponded to 5% of the residual plaque values with none being significantly more efficient overall. Pair wise site comparisons did produce differences of the order of 10% (p=0.004) at the mesio-buccal, and 8% (p=0.030) at the mid-buccal sites respectively in favour of 2 brushes compared to one other brush.
These data derived from a standardized brushing method support the contention of many researchers that there is no one superior design of manual toothbrush. The minor and few site differences in favour of some brushes are unlikely to be of clinical significance to gingival health. This leaves uncontested the conclusion that the user is by far the most significant variable. Perhaps methods such as used in the present study could be more gainly employed to set a minimum standard of toothbrush efficacy.
现代牙刷设计的牙菌斑清除特性已引发了相当大的关注。本研究的主要目的是在常用的时间范围内，比较8种相对较新的手动牙刷设计在专业刷牙者使用时的牙菌斑清除特性。次要目的是利用这些数据，观察评估牙菌斑的积聚情况以及使用定时专业刷牙方法后的清除模式。
该方法是一项为期8个阶段、由单一检查者操作的随机、盲法交叉研究，涉及24名健康志愿者，并对残留效应进行了平衡处理。受试者在4天不进行口腔卫生护理的时间段内积聚牙菌斑。在第4天，通过菌斑指数对被评估牙齿的每个颊面和舌面的近中、中间和远中部位的积聚牙菌斑进行评分。然后让受试者离开评估区域，在那里他们接受一次持续48秒的专业刷牙。刷牙按照研究前的培训进行，不使用牙膏，之后再次对残留牙菌斑进行评分。在下一阶段之前允许有3天的洗脱期，在此期间恢复正常口腔卫生护理。
每个牙弓中积聚的牙菌斑量相似，尽管颊面和舌面之间的差异约为30%。专业牙刷在分配的48秒内清除了约40%的积聚牙菌斑。与舌面（约25%）相比，颊面的清洁效果最显著（约45%），近中部位和中间部位的牙菌斑清除率分别接近40%和60%。测试牙刷之间的性能差异相当于残留牙菌斑值的5%，总体上没有一种牙刷明显更有效。成对的部位比较在近中颊面产生了约10%（p = 0.004）的差异，在中间颊面产生了约8%（p = 0.030）的差异，分别表明有2种牙刷比另一种牙刷更具优势。
这些来自标准化刷牙方法的数据支持了许多研究人员的观点，即不存在一种 superior 的手动牙刷设计。有利于某些牙刷的微小且少数部位差异对牙龈健康不太可能具有临床意义。这使得使用者是迄今为止最重要的变量这一结论无可争议。也许本研究中使用的方法可以更有效地用于设定牙刷功效的最低标准。
