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Dental Tribune United Kingdom Edition

April 15-21, 201318 United Kingdom EditionClinical page 17DTß Evolve Supplies Ltd Unit 12, Crynant Business Park Crynant, Neath SA10 8PX United Kingdom Reg. In The UK. 7266118 VAT No. 103 7158 43 T: 00 +44 (0) 844 504 7016 F: 00 +44 (0) 844 686 1797 E: £650.00  Auto Stop & Auto Reverse  20 - 2,900 RPM  Torque of 9.9Ncm  Large Clear Colour Screen ENDO ‘E’ CLASS + FREE 1:1 or 16:1 CONTRAANGLE ENDO ‘A’ CLASS + FREE 16:1 CONTRAANGLE  Auto Stop & Auto Reverse  120 - 2,000 RPM  Torque of 3.0Ncm  15 Free Set Programmes  LCD Screen  Weight of 138g  Extremely Quiet £729.00 INTRA ORAL CAMERA ENHANCES PATIENT TREATMENT ACCEPTANCE!  5” HD LCD screen  45° Adjustment For Crisp View  Complete With Memory Card  USB Connection / TV Output  6 White LED’s With Anti-Fog Lens £650.00 8” Intra Oral Camera also available £799.00 decisive for interpretation of the results of the review. After the research protocol is written, an objective literature search is undertaken to find the relevant literature while minimising the chance of missing any research. The parameters used to evalu- ate the results are also impor- tant for the conclusions that will be drawn. An example of parameters used would be the reductions in plaque and gingi- vitis associated with the use of different types of toothbrushes. Toothbrushing The use of mechanical devic- es for the routine cleaning of teeth dates back to the ancient Egyptians, who made a brush by chewing on the end of a twig to fray it. Today, there are liter- ally hundreds of manual tooth- brush designs, including bristle patterns that are designed to enhance plaque removal from hard-to-reach areas of the den- tition, particularly proximal ar- eas. Much emphasis has also been placed on new ergonomic designs, for example handle siz- es appropriate for the hand size of the prospective user. None- theless, even adults, despite their apparent efforts, appear not to be as effective in their plaque removal as might be ex- pected. The effectiveness of manual toothbrushes in a systematic review Brushing exercise studies are commonly used for toothbrush evaluations, serve as a useful indication of the plaque removal ability of a toothbrush and facil- itate the control of confounding variables such as compliance. A recent systematic review evalu- ated the efficacy of manual toothbrushing with respect to toothbrush design and brush- ing duration following such exercises (Slot et al, 2012). The literature search yielded 2079 titles and abstracts, of which 59 papers with 212 brushing exer- cises as separate legs of the ex- periments, and including 10,806 participants, met the eligibil- ity criteria for inclusion. The mean pre- and post-brushing plaque scores found in the pa- pers were used to calculate an overall weighted mean percent- age plaque score reduction. The sheer magnitude of the number of participants and the hetero- geneity observed in the various study designs gives the results particular value, because they reflect what may be gener- ally expected from routine oral hygiene. For the studies with data assessed according to the Quigley & Hein plaque index, the weighted mean reduction in plaque scores was 30 per cent (95 per cent CI: 27 per cent to 33 per cent), while in the stud- ies using the Navy plaque index a weighted mean plaque score reduction of 53 per cent (95 per cent CI: 50 per cent to 56 per cent) was observed. Sub-analy- sis between the different bristle tuft configurations illustrated variation in plaque removal ability (24 per cent to 61 per cent), with the angled bristle design demonstrating the high- est mean plaque reduction with either index. A sub-analysis on the influence of the duration of brushing revealed a mean plaque reduction of 27 per cent after one minute of brushing and 41 per cent after two min- utes. Therefore it was concluded that the efficacy of plaque re- moval resulted in an average plaque score reduction from baseline of 50 per cent, with a range of 30 per cent to 53 per cent depending on the plaque index used. The available evi- dence indicates that bristle tuft arrangement (flat-trim, multi- level, angled) and brushing du- ration are variables contribut- ing to efficacy. Irrespective of the index used, it appears that there is room for improvement for the efficacy of manual tooth- brushes. Powered (electric) tooth- brushes The first successful electric toothbrush (the Broxo SA) was ‘The use of mechan- ical devices for the routine cleaning of teeth dates back to the ancient Egyp- tians, who made a brush by chewing on the end of a twig to fray it’