Dental Tribune United Kingdom Edition

April 15-21, 201320 United Kingdom EditionClinical page 19DTß Based on seven trials of up to three months duration, with no significant heterogeneity, os- cillating-rotating brushes were found to result in statistically significantly greater plaque re- ductions in the short term (one – three months) compared to side-to-side powered brushes. The standard mean difference (SMD) for plaque reduction was calculated to be SMD=0.24 (95 per cent CI; 0.02 to 0.46). Clini- cally, the relative superiority of the oscillating-rotating mode of action to the side to side mo- tion of action would equate to a seven per cent reduction in the Turesky modified Quig- ley & Hein plaque score. The short-term gingivitis reduction of SMD=0.35 (95 per cent CI; -0.04 to 0.74) missed being sta- tistically significant. As only one trial was available of more than three months duration, and with only a limited number of partic- ipants, no firm long-term con- clusions could be drawn. The safety of powered tooth- brushes A systematic review was re- cently conducted on the safety of oscillating-rotating brushes compared to manual brushes on hard and soft tissues (Van der Weijden et al, 2011). After searching several electronic databases, 35 original papers were appropriate for inclusion and were grouped by research design (randomised controlled trials with safety as the prima- ry outcome, trials where safety was a secondary outcome, stud- ies that used a surrogate marker of safety and, finally, laborato- ry-based studies). The review authors concluded that, “This systematic review of a large body of published research in the preceding two decades con- sistently showed oscillating- rotating toothbrushes to be safe when compared with manual brushes, and collectively indi- cated that they do not pose a clinically relevant concern to either hard or soft tissues.” The outcome is consistent with the observations of the Robinson et al, 2005 and Deacon et al, 2011 reviews supporting the safety of oscillating-rotating powered brushes. There are at present no systematic reviews on safety for any other powered brush. Other considerations Evidence-based dentistry is im- portant for decision making, however it has to be noted that clinical outcomes may not be the only decisive factor to come into play. For instance, the in- creased cost of powered tooth- brushes may play a role in a pa- tient’s toothbrush choice, while a powered toothbrush may offer ease-of-use and improve patient compliance with brushing. It is the toothbrush in the hands of the user that determines the ef- ficacy of plaque removal. The role of the dental professional is to coach and motivate the pa- tient. Features such as a timer and visual signals on a brush help to increase engagement of the user to perform an adequate job and have been found to re- sult in improved brushing and patient compliance. Conclusions Based on the available evidence, oscillating-rotating brushes have been shown to result in greater plaque and gingivitis reductions compared to the use of manual brushes. Additionally, based on short-term data, oscil- lating-rotating brushes compare favourably to powered brushes with a side-to-side mode-of-ac- tion, while insufficient evidence is available for other powered brushes. Systematic reviews also provide evidence for the safety of an oscillating-rotating brush. DT References Beals D, Ngo T, Feng Y, Cook D, Grau DG, Weber DA. Development and laboratory evaluation of a new toothbrush with a novel head design. Am J Dent. 2000; 13:5A-14A. Center for Evidence-Based Dentistry. http://ebd.ada.org/SystematicReviews. aspx Cochrane Handbook for Systematic Re- views. http://www.cochrane.org/training/ cochrane-handbook Heanue M, Deacon SA, Deery C, Robinson PG, Walmsley AD, Worthington HV, Shaw WC. Manual versus powered toothbrush- ing for oral health. Cochrane Database Syst Rev. 2003;(1):CD002281. Review. Update in: Cochrane Database Syst Rev. 2005;(2):CD002281. PubMed PMID: 12535436. Lindhe J, Wicén PO. The effects on the gingivae of chewing fibrous foods. J Perio Res. 1969;4(3):193-200. PubMed PMID: 4244252. Macgregor ID, Rugg-Gunn AJ. Tooth- brushing duration in 60 uninstructed young adults. Community Dent Oral Epidemiol. 1985 Jun;13(3):121-2. Quigley GA, Hein JW. Comparative cleans- ing efficiency of manual and power brush- ing. J Am Dent Assoc. 1962 Jul;65:26-9. PubMed PMID: 14489483. Robinson PG. The safety of oscillating- rotating powered toothbrushes. Evidence- Based Dentistry. 2011;12: 69. doi:10.1038/ sj.ebd.6400804 Robinson PG, Deacon SA, Deery C, Heanue M, Walmsley AD, Worthington HV, Glenny AM, Shaw WC. Manual versus powered toothbrushing for oral health. Cochrane Database Syst Rev. 2005;, Issue 2. Art. No.: CD002281.pub2. DOI: 10.1002/14651858. CD002281.pub2. Slot DE, Wiggelinkhuizen L, Rosema NAM, Van der Weijden GA. The efficacy of manual toothbrushes following a brush- ing exercise - a systematic review. Int J Dent Hyg. 2012. Accepted for publication. Smith JM. Evaluation of the Navy Plaque Index. US Navy Med. 1968 Dec;52(12):19- 20. PubMed PMID: 5255054. Socransky SS, Hafferjee AD, Cugini MA, Smith C, Kent RL. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25:134–44. Van der Weijden FA, Campbell SL, Dörfer CE, González-Cabezas C, Slot DE. Safety of oscillating-rotating powered brushes compared to manual toothbrushes: a systematic review. J Periodontol. 2011; 82:5-24. Van der Weijden F, Slot DE. Oral hygiene in the prevention of periodontal diseases: the evidence. Periodontol 2000. 2011 Feb;55(1):104-23. doi:10.1111/j.1600- 0757.2009.00337.x. Review. PubMed PMID: 21134231. Walters PA, Cugini M, Biesbrock AR, War- ren PR. A novel oscillating-rotating power toothbrush with SmartGuideTM: Designed for enhanced performance and compliance. J Contemp Dent Pract. 2007 May;8(4):1-9. Yacoob M, Deacon SA, Deery C, Glenny M, Walmsley AD, Worthington H, Robinson PG. Manual vs powered toothbrushes for oral health: Updated Cochrane Review. Abstract #106, British Society for Oral and Dental Research, Sheffield, England; September 2011. Call us on +44 (0)151 342 0410 Advanced Dental Education The Dawson Academy UK | Hilltop Court | Thornton Common Road | Thornton Hough | Wirral | CH63 4JT | UK www.bdseminars.cominfo@bdseminars.com +44 (0)151 342 0410 “I have developed a comprehensive system for each phase of dentistry and gained a new level of confidence in treating patients. Ian has given me the tools I need to be profitable, successful, happy in my work, which allows me to enjoy dentistry, my patients, my staff and my family.” Selar Francis Sofia Bulgaria “After20years,everythingfinallymakessense,and Ihaveasystematicapproachthatwillallowmeto solvejustaboutanydentalproblemIamfacedwith.” Steve Lomas CheshireIan Buckle (BDS) For further information on new courses, basic Core Curriculum of learning and team events, please contact: NEW COURSES FOR 2013 Full Mouth Rehabilitation: Over the Shoulder Live! Who: Dr. Ian Buckle | When: 21st-22nd June 2013 Where: Dawson Academy UK, Wirral Time: Fri 9am-5.30pm, Sat 9am-4.00pm | CPD: 14hrs Cost: £795+vat Live patient over the shoulder and hands on treatment planning Topics covered: > The records required for full mouth rehabilitation > The treatment planning process > Preparation Design > Exquisite provisional restorations > Placing and finishing the case On day one Dr. Buckle will place the lower anterior restorations. Delegates will be able to treatment plan the case according to Dawson principles before Dr Buckle unveils his approach. On day two you will watch live as he prepares the upper arch, takes all the necessary records and temporises the case showing you how to check the function and aesthetics. He will also demonstrate how to best communicate with the Lab to provide predictable definitive restorations. Core CurriculumCourse Description For Core Curriculum special offers of up to 40% off please visit www.bdseminars.com About the author Dr. Fridus van der Weijden gradu- ated in 1984 from the State Universi- ty Dental School in Utrecht, the Neth- erlands where he also received his training as a perio- dontist and was ac- credited by the Dutch Society of Peri- odontology in 1990. He defended his thesis entitled, ‘The use of models and indices in plaque and gingivitis trials’ in 1993 and received accreditation as a ‘senior investigator’ by the Nether- lands Institute for Dental Sciences in 2000. In 2005 he received accredita- tion as an ‘Implant-specialist’ by the Dutch Society of Oral Implantology. Since 1986 Fridus van der Weijden di- vides his time between the Clinic for Periodontology Utrecht and the Aca- demic Centre for Dentistry Amster- dam. Furthermore he works on regu- lar occasions as an implant dentist in a practice devoted to implantology in Drachten. He is a frequent lecturer in postgraduate courses and the au- thor of the book entitled, ‘The Power of Ultrasonics’ and the co-author and co-editor of the book ‘Preventive Den- tistry’. He has also authored and co- authored approximately 60 national and 130 international publications. The Ivory Cross, awarded him early 2009 with the Carl Witthaus Medal of honor for his work on prevention and propagation of oral health. Early 2010 he has been appointed a chair as pro- fessor at the University of Amsterdam with “Prevention and Therapy of peri- odontal infections” as main focus for his research. This chair has been an initiative of the Dutch Society of Peri- odontology