Grender Julie, Williams Karen, Walters Pat, Klukowska Malgorzata, Reick Hansjoerg
Procter & Gamble Health Care Research Center, 8700 Mason-Montgomery Road, Mason, OH 45040, USA.
Am J Dent. 2013 Apr;26(2):68-74.
This review of six clinical trials provides a comprehensive overview of the results of statistical analyses to explore between-brush differences, specifically in the lingual, gingival marginal, and approximal ("hard-to-clean") areas, in post-brushing plaque removal of oscillating-rotating (O-R) power toothbrushes compared to either a marketed sonic power toothbrush or a manual toothbrush control.
All studies were single-center, randomized and controlled, and examiner-blind. Four trials were four-period crossover design with replicate single-use brushing, while two studies were parallel group investigations (4 or 12 weeks) with multiple brushings and assessments at each visit. Generally healthy subjects were enrolled. Plaque evaluations were via the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI) or the Rustogi Modification of the Navy Plaque Index (RMNPI). At each evaluation visit, subjects brushed with either the randomly assigned O-R power brush [Oral-B Professional Care Series 4000 (Triumph) or Oral-B Vitality with Floss Action or Precision Clean brush head] or a control brush [Sonicare FlexCare with ProResults brush head (three trials) or an American Dental Association (ADA) reference manual toothbrush (three trials)]. ANCOVA and ANOVA analyses subsequently evaluated specifically the 'hard-to-clean' tooth surfaces for between-brush differences.
In total, 462 subjects completed the trials and were evaluable. While all toothbrushes provided significant post-brushing versus baseline plaque removal efficacy, the magnitude of the reduction was consistently superior for the O-R brush compared to either the sonic power or manual brush control in all the 'hard-to-clean" region-specific analyses. Adjusted mean RMNPI or TMQHPI benefits favoring the O-R brush relative to the sonic brush control were collectively 18% to 34% greater on lingual surfaces (P < or = 0.044), 32% to 49% greater on lingual approximal surfaces (P < 0.001), and 32% and 31% greater in lingual mandibular and lingual mandibular anterior regions, respectively (P < or = 0.005). Post-brushing whole mouth adjusted mean reduction RMNPI or TMQHPI benefits favoring the O-R brush compared to the manual brush control were collectively 31% to 206% greater on lingual surfaces (P < or = 0.001), 29% to 217% greater on lingual approximal surfaces (P < or = 0.001), and 67% to 526% greater in lingual gingival margin regions, respectively (P < or = 0.001). All study toothbrushes were well-tolerated.
本综述对六项临床试验进行了全面概述，以探讨统计分析结果，具体研究摆动旋转（O-R）电动牙刷与市售声波电动牙刷或手动牙刷对照相比，在刷牙后牙菌斑清除方面的刷间差异，特别是在舌侧、牙龈边缘和邻面（“难清洁”）区域。
所有研究均为单中心、随机对照且检查者盲法。四项试验采用四周期交叉设计，重复单次刷牙，而两项研究为平行组调查（4周或12周），每次就诊时进行多次刷牙和评估。纳入一般健康的受试者。通过Turesky对Quigley-Hein菌斑指数的改良版（TMQHPI）或Rustogi对海军菌斑指数的改良版（RMNPI）进行菌斑评估。在每次评估就诊时，受试者使用随机分配的O-R电动牙刷[欧乐-B专业护理系列4000（胜利款）或带有牙线功能或精准清洁刷头的欧乐-B活力款]或对照刷[带有专业效果刷头的飞利浦声波震动牙刷（三项试验）或美国牙科协会（ADA）参考手动牙刷（三项试验）]刷牙。随后，协方差分析（ANCOVA）和方差分析（ANOVA）专门评估了“难清洁”牙面的刷间差异。
共有462名受试者完成试验并可进行评估。虽然所有牙刷在刷牙后相对于基线的牙菌斑清除效果均显著，但在所有“难清洁”区域特异性分析中，与声波电动牙刷或手动牙刷对照相比，O-R电动牙刷的清除幅度始终更高。在舌侧表面，相对于声波电动牙刷对照，调整后的平均RMNPI或TMQHPI有利于O-R电动牙刷的益处总体上高出18%至34%（P≤0.044）；在舌侧邻面高出32%至49%（P<0.001）；在舌侧下颌区域和舌侧下颌前部区域分别高出32%和31%（P≤0.005）。与手动牙刷对照相比，刷牙后全口调整后的平均RMNPI或TMQHPI有利于O-R电动牙刷的降低幅度在舌侧表面总体高出31%至206%（P≤0.001）；在舌侧邻面高出29%至217%（P≤0.001）；在舌侧牙龈边缘区域分别高出67%至526%（P≤0.001）。所有研究用牙刷耐受性良好。
