Jongsma Marije A, van de Lagemaat Marieke, Busscher Henk J, Geertsema-Doornbusch Gesinda I, Atema-Smit Jelly, van der Mei Henny C, Ren Yijin
University of Groningen and University Medical Centre, Department of Orthodontics, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
University of Groningen and University Medical Centre, Department of Biomedical Engineering, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands.
J Dent. 2015 Dec;43(12):1580-6. doi: 10.1016/j.jdent.2015.08.001. Epub 2015 Aug 7.
Orthodontic, multi-strand retention-wires are used as a generalized model for oral retention sites to investigate whether biofilm left-behind after powered toothbrushing in-vivo enabled better penetration of antibacterials as compared with manual brushing.
2-cm multi-strand, stainless-steel retention-wires were placed in brackets bonded bilaterally in the upper arches of 10-volunteers. Volunteers used NaF-sodium-lauryl-sulphate-containing toothpaste and antibacterial, triclosan-containing toothpaste supplemented or not with an essential-oils containing mouthrinse. Opposite sides of the dentition including the retention-wires, were brushed manually or with a powered toothbrush. Health-care-regimens were maintained for 1-week, after which wires were removed and oral biofilm was collected.
When powered toothbrushing was applied, slightly less bacteria were collected than after manual brushing, regardless whether an antibacterial-regimen was used or not. Powered-toothbrushing combined with antibacterial-regimens yielded lower biofilm viability than manual brushing, indicating better antibacterial penetration into biofilm left-behind after powered brushing. Major shifts in biofilm composition, with a decrease in prevalence of both cariogenic species and periodontopathogens, were induced after powered brushing using an antibacterial-regimen.
Oral biofilm left-behind after powered brushing in-vivo enabled better penetration of antibacterials than after manual brushing.
Mechanical removal of oral biofilm is important for prevention of dental pathologies, but biofilm is always left-behind, such as in fissures, buccal pits, interproximal areas and gingival margins and around orthodontic appliances. Use of antibacterial toothpastes or mouthrinses can contribute to removal or killing of biofilm bacteria, but biofilm structure hampers antibacterial penetration. A synergy between brushing mode and antibacterial-regimen applied exists with clinically demonstrable effects.
正畸多股固位丝被用作口腔固位部位的通用模型，以研究与手动刷牙相比，电动牙刷在体内刷牙后残留的生物膜是否能使抗菌剂更好地渗透。
将2厘米长的多股不锈钢固位丝放置在10名志愿者上颌双侧粘结的托槽中。志愿者使用含氟化钠和月桂醇硫酸酯钠的牙膏以及含抗菌剂三氯生的牙膏，后者补充或不补充含精油的漱口水。牙列的相对侧包括固位丝，用手动或电动牙刷刷牙。维持保健方案1周，之后取出固位丝并收集口腔生物膜。
无论是否使用抗菌方案，使用电动牙刷时收集到的细菌略少于手动刷牙后。电动牙刷与抗菌方案相结合产生的生物膜活力低于手动刷牙，表明电动刷牙后残留的生物膜对抗菌剂的渗透更好。使用抗菌方案进行电动刷牙后，生物膜组成发生了重大变化，致龋菌和牙周病原体的患病率均降低。
与手动刷牙相比，电动牙刷在体内刷牙后残留的口腔生物膜对抗菌剂的渗透更好。
机械清除口腔生物膜对预防牙病很重要，但生物膜总是会残留，例如在裂隙、颊窝、邻面区域、牙龈边缘以及正畸矫治器周围。使用抗菌牙膏或漱口水有助于清除或杀死生物膜细菌，但生物膜结构阻碍抗菌剂渗透。刷牙方式与应用的抗菌方案之间存在协同作用，具有临床可证实的效果。
