Dental Tribune United Kingdom Edition

19ClinicalApril 15-21, 2013United Kingdom EditionUnited Kingdom Edition * Source: GfK and SDM market data 2010 for LuxaCore The Nr.1 in Germany and USA!* No other core build-up material comes closer to the natural properties of dentine than the new LuxaCore Z-Dual: This premium composite for core build-ups and post cementations cuts like dentine. LuxaCore Z-Dual is the first material of its category that combines true DMG-patented nano technology and zirconium dioxide. With LuxaPost, the new glass fiber reinforced and pre- silanized composite post, DMG offers the perfect partner for LuxaCore Z-Dual. www.dmg-dental.com Yet even closer to nature – LuxaCore Z. AZ_LxCZ_DEP_1201.indd 1 24.07.12 17:07 conceived in Switzerland in 1954 by Dr. Philippe-Guy Woog, and the first generation of elec- tric toothbrushes had a brush head designed as a manual toothbrush that made a (com- bined) horizontal and vertical motion. Since the 1980s, tre- mendous advances have been made and various electric tooth- brushes have been developed to improve the efficiency of plaque removal. Powered brushes cur- rently available vary in their mode-of-action. Oscillating- rotating brushes are designed with a round head that moves back and forth, with alternating turns clockwise and counter- clockwise. In contrast, brushes with a circular mode-of-action rotate in one direction only, counter-oscillation brushes have tufts of bristles that rotate back and forth independent of the directions of other tufts, and other brushes move from side- to-side (including sonic brush- es). At different times, individu- al studies have been conducted on the efficacy and safety of these powered brush categories and the collective evidence has been summarised in systematic reviews. Powered brushes versus manual toothbrushes An early dental systematic re- view, performed in collabora- tion with the Cochrane Oral Health Group, compared man- ual and powered toothbrushes in everyday use, principally in relation to plaque removal and gingival health (Heanue et al, 2002). Five electronic databases were searched to identify ran- domised controlled trials com- paring powered and manual toothbrushes (up to the middle of 2002) where the participants were members of the public with uncompromised manual dexterity who brushed unsu- pervised for at least four weeks. The review was first updated by Robinson et al. in 2005 and the most recent update of this review was published by Ya- coob et al. in 2011. In total, 50 eligible trials involving 4326 participants, with no evidence of publication bias, were in- cluded in the review. Oscillat- ing-rotating powered brushes resulted in greater plaque and gingivitis reductions compared to manual brushes, with stand- ard mean differences (SMD) for plaque and gingivitis reduc- tions of SMD=0.53 (95 per cent CI; -0.74 to -0.31) and SMD=0.49 (95 per cent CI; -0.73 to -0.26) respectively in the short-term (one– three months). Signifi- cantly greater plaque and gingi- vitis reductions were also found in the long-term beyond three months, with approximately 27 per cent fewer sites with bleed- ing-on-probing. The conclusion from this last systematic review was that only for oscillating-rotating brushes is there consistent evidence to consider them clinically supe- rior to manual brushes and to offer greater plaque and gingi- vitis reductions. These results confirm the findings and con- clusions from the earlier re- views comparing manual and powered brushes. Comparison of different pow- ered toothbrushes The most recent Cochrane re- view assessed the comparative efficacy of powered brushes with different modes of action and their effect on oral health (Deacon et al, 2011). Five elec- tronic databases were searched up to July 2010, resulting in a total of 17 eligible trials, with more than 1,300 total partici- pants. The criteria for selec- tion were that the studies were randomised, compared at least two powered brushes with dif- ferent modes of action, involved at least four weeks of unsuper- vised brushing and where the participants had no impairment of manual dexterity. The tooth- brush modes-of-action rep- resented by these trials were: oscillating-rotating, counter- oscillating, side-to-side, circular ultrasonic, multidimensional and ionic (electrically active). page 20DTà ‘Evidence-based dentistry is impor- tant for decision making, however it has to be noted that clinical outcomes may not be the only decisive factor to come into play’