固定正畸青少年使用手动牙刷和互动式电动牙刷清除菌斑和提高动机的效果比较：一项单中心、 examiner 盲法随机对照试验。

Comparative assessment of plaque removal and motivation between a manual toothbrush and an interactive power toothbrush in adolescents with fixed orthodontic appliances: A single-center, examiner-blind randomized controlled trial.

机构信息

Department of Orthodontics and Dentofacial Orthopedics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.

出版信息

Am J Orthod Dentofacial Orthop. 2019 Apr;155(4):462-472. doi: 10.1016/j.ajodo.2018.12.013.

DOI:10.1016/j.ajodo.2018.12.013

PMID:30935601

Abstract

INTRODUCTION

The objective of this 2-arm parallel trial was to determine the plaque removal efficacy (main outcome) and the motivation assessment (secondary outcome) comparing a manual versus an interactive power toothbrush in orthodontic patients.

METHODS

Sixty adolescents with fixed orthodontic appliances in both arches were randomized in a 1:1 ratio in this parallel, randomized, examiner-blind controlled clinical trial. Eligibility criteria included at least 16 natural teeth, 1-6 "focus care areas," plaque score of ≥1.75, no severe caries, gingivitis and periodontitis, no dental prophylaxis, no smoking, no antibiotics, and no chlorhexidine mouth rinse. Subjects were to brush unsupervised with either an interactive power toothbrush (Oral-B Professional Care 6000, D36/EB20) with Bluetooth technology or a regular manual toothbrush (Oral-B Indicator 35 soft). Focus care areas were each brushed for 10 additional seconds. Plaque removal was assessed with the use of the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI) to determine change from baseline at 2 and 6 weeks. Supervised brushing at screening and post-treatment visits recorded actual brushing times. Subject-reported motivational aspects were recorded at screening and week 6.

RESULTS

Fifty-nine subjects aged 13-17 years completed the study. The interactive power toothbrush provided significantly (P <0.001) greater plaque reduction versus the manual toothbrush at 2 and 6 weeks according to the whole-mouth TMQHPI. The treatment difference in adjusted mean plaque change from baseline was 0.777 (95% CI 0.614-0.940) at week 2 and 0.834 (0.686-0.981) at week 6. Mean reductions in the number of focus care areas were also significantly greater (P <0.001) in the power brush group at weeks 2 and 6. Brushing times increased significantly at weeks 2 and 6 (P ≤0.013) versus baseline in the interactive power brush group only. Subject-reported motivation was significantly increased in the interactive power brush group at week 6 versus screening (P ≤0.005).

CONCLUSIONS

An interactive power toothbrush generated increased brushing times and significantly greater plaque removal versus a manual brush.

摘要

简介

本研究采用平行双臂随机临床试验，旨在比较手动和互动式动力牙刷在正畸患者中的菌斑清除效果（主要结局）和动机评估（次要结局）。

方法

本平行、随机、盲法对照临床试验纳入了 60 名固定正畸患者，按 1:1 的比例随机分组。纳入标准包括至少有 16 颗天然牙、1-6 个“重点护理区域”、菌斑指数≥1.75、无严重龋齿、牙龈炎和牙周炎、无洁牙、不吸烟、未服用抗生素和未使用洗必泰漱口液。受试者在无人监督的情况下分别使用带蓝牙技术的互动式动力牙刷（Oral-B Professional Care 6000，D36/EB20）和常规手动牙刷（Oral-B Indicator 35 soft）进行刷牙。每个重点护理区域额外刷 10 秒。使用改良的奎格利-海因菌斑指数（TMQHPI）评估菌斑清除效果，以确定治疗后 2 周和 6 周时与基线相比的变化。在筛查和治疗后随访时记录实际刷牙时间。在筛查和第 6 周记录受试者的动机报告。

结果

59 名年龄在 13-17 岁的受试者完成了研究。根据全口 TMQHPI，与手动牙刷相比，互动式动力牙刷在治疗后 2 周和 6 周时显著（P<0.001）降低了菌斑指数。从基线到第 2 周和第 6 周的调整平均菌斑变化的治疗差异分别为 0.777（95%CI 0.614-0.940）和 0.834（0.686-0.981）。在第 2 周和第 6 周，动力牙刷组重点护理区域的菌斑数量也显著减少（P<0.001）。仅在互动式动力牙刷组，治疗后 2 周和 6 周时的刷牙时间显著增加（P≤0.013）。与筛查时相比，第 6 周时互动式动力牙刷组的受试者报告的动机明显增加（P≤0.005）。