Publications by authors named "Aaron R Biesbrock"

70 Publications

Randomized clinical trial assessing anti-gingivitis efficacy of two stannous fluoride dentifrices and zinc/arginine dentifrice.

Am J Dent 2021 Apr;34(2):110-115

Faculty of Dental Medicine of the Hebrew University and Hadassah University Medical Center, Jerusalem, Israel.

Purpose: To evaluate the anti-gingivitis efficacy of two bioavailable stannous fluoride (SnF2) dentifrices versus a zinc/arginine dentifrice and a negative control dentifrice, and to compare the plaque control benefits.

Methods: This was a single-center, randomized, controlled, four-treatment, parallel-group, double-blind, 3-month clinical trial. Healthy adult subjects with gingivitis were randomly assigned to one of four different dentifrice treatment groups: SnF2 dentifrice A, SnF2 (1,100 ppm F) + sodium fluoride (350 ppm F) + sodium hexametaphosphate (Procter & Gamble); SnF2 dentifrice B, SnF2 (1,100 ppm F) + sodium fluoride (350 ppm F) + citrate (Procter & Gamble); Zn/Arg dentifrice, zinc/arginine + sodium fluoride (1,450 ppm F) (Colgate-Palmolive); negative control dentifrice, sodium monofluoro-phosphate (1,000 ppm F) + sodium fluoride (450 ppm F) (Colgate-Palmolive). Subjects brushed with their assigned treatment dentifrice and an assigned manual toothbrush (Oral-B Indicator) for 1 minute, twice daily, for the duration of the study. Gingivitis was assessed at Baseline and at Weeks 2, 4 and 12 by calculating the total number of gingival bleeding sites using the Gingival Bleeding Index, and plaque was assessed at Baseline and at Week 12 using the Turesky Modified Quigley-Hein Index. A repeated measures model was carried out across Weeks 2, 4, and 12 to determine bleeding efficacy (total number of bleeding sites). An ANCOVA with baseline plaque as the covariate was used to evaluate plaque efficacy at Week 12.

Results: 161 subjects were randomized (mean age= 38.8 years). 154 subjects completed the study and 153 had evaluable data at Week 12. The mean (SD) number of Baseline bleeding sites overall was 78.74 (31.16) with no significant difference between groups (P= 0.537). SnF2 dentifrice A significantly reduced the number of bleeding sites relative to the negative control dentifrice at Weeks 2, 4 and 12 by 15.4%, 13.7% and 17.2%, respectively. SnF2 dentifrice B significantly reduced the number of bleeding sites relative to the negative control dentifrice at Week 4 by 13.9% (P= 0.041). Relative to the Zn/Arg dentifrice, SnF2 dentifrice A produced significantly greater reductions in gingival bleeding sites at Weeks 2, 4 and 12 by 23.4%, 17.2% and 20.9%, respectively (P≤ 0.007). SnF2 dentifrice B produced significantly greater bleeding reductions versus the Zn/Arg dentifrice at Weeks 4 and 12 by 17.4% and 14.4%, respectively (P≤ 0.035). The Zn/Arg dentifrice did not differ significantly in the number of bleeding sites (P≥ 0.127) or plaque (P= 0.175) relative to the negative control dentifrice. Both SnF2 dentifrices significantly reduced plaque levels (P≤ 0.029) relative to both negative control dentifrice and Zn/Arg dentifrice at Week 12. All dentifrices were well tolerated.

Clinical Significance: Two different SnF2 dentifrices showed significantly reduced gingival bleeding and plaque levels relative to a Zn/arginine dentifrice.
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April 2021

The relative clinical efficacy of three 0.454% stannous fluoride dentifrices for the treatment of gingivitis over 3 months.

Am J Dent 2020 Aug;33(4):218-224

The Procter & Gamble Company, Mason, OH, USA.

Purpose: To assess the safety and efficacy of three stannous fluoride (SnF2) dentifrices in the reduction of gingivitis versus a negative control dentifrice.

Methods: This was a randomized, controlled, double-blind, four-treatment parallel group study. 120 healthy adult volunteers with established gingivitis were enrolled and randomly assigned to one of four dentifrice treatment groups (30/group): 0.454% SnF2 + citrate dentifrice A; 0.454% SnF2 + sodium hexametaphosphate dentifrice B; 0.454% SnF2 + pyrophosphate dentifrice C; or 0.76% sodium monofluorophosphate negative control group. Subjects brushed with their assigned dentifrice and an assigned regular manual toothbrush (Oral-B Indicator) for 1 minute twice daily for 12 weeks. Number of gingival bleeding sites and Löe-Silness Gingival Index (LSGI) scores were assessed at baseline and at Weeks 2, 4 and 12.

Results: 120 subjects were enrolled and 112 completed the trial. Subjects had an average age (SD) of 39.31 (14.5) years; 67% of subjects were female. Overall baseline means (SD) were 81.2 (25.6) for number of bleeding sites and 1.51 (0.197) for mean LSGI score. Baseline disease levels were balanced across all treatment groups. At Week 2, SnF2 dentifrices A and B demonstrated a significant reduction in gingival bleeding sites versus the negative control; however, SnF2 dentifrice C was not significantly different from the negative control (P= 0.15). At Weeks 4 and 12, all SnF2 dentifrices demonstrated a significant gingival bleeding site reduction versus the negative control (P< 0.001). At Weeks 2, 4 and 12, the SnF2 dentifrices were rank ordered dentifrice A > dentifrice B > dentifrice C for reduction in gingival bleeding sites (P< 0.001). The same trends were seen for LSGI scores.

Clinical Significance: In this 12-week clinical study, all 0.454% SnF2 dentifrices delivered statistically significant reductions in the number of gingival bleeding sites relative to the negative control. Importantly, statistically significant efficacy differences were observed among the three 0.454% SnF2 dentifrices, demonstrating the important role that differences in formulation have on clinical efficacy.
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August 2020

A clinical study to assess the effect of a stabilized stannous fluoride dentifrice on hypersensitivity relative to a marketed sodium fluoride/triclosan control.

J Clin Dent 2014 ;25(2):13-8

Objective: To evaluate the efficacy of a marketed stabilized stannous fluoride (SnF2) dentifrice in reducing dentinal hypersensitivity as compared to a marketed sodium fluoride (NaF)/triclosan dentifrice over an eight-week period.

Methods: Adults with confirmed dentinal hypersensitivity were enrolled in this randomized and controlled, parallel group, double blind, eight-week, single-center clinical trial. Random assignment to one of two dentifrice test groups via age, gender, and thermal sensitivity of enrolled test teeth was performed at baseline, with subjects assigned to twice-daily unsupervised brushing with either the marketed SnF2 dentifrice (Oral-B Pro-Expert, 0.454% SnF2 plus 0.077% NaF) or the marketed 0.32% NaF with 0.3% triclosan/copolymer dentifrice control (Colgate Total Advanced). Tactile sensitivity (Yeaple Probe) and thermal sensitivity (airblast/Schiff Air Index) evaluations of the selected test teeth were performed at baseline pre-treatment, and again at Weeks 2 and 8 of product use to compare the dentifrices' relative hypersensitivity protection effectiveness.

Results: Ninety-seven (97) of the 100 enrolled subjects completed the trial and were fully evaluable. At both Week 2 and Week 8, for both the thermal and tactile evaluation measurements, subjects brushing with the marketed SnF2 dentifrice experienced statistically significantly (p < 0.0001) superior average dentinal hypersensitivity improvement versus subjects assigned to the NaF/triclosan control dentifrice. Between groups, superior relative mean reduction in thermal Schiff Air Index favored SnF2 by 24% at Week 2 and 68% at Week 8, while greater relative mean tactile Yeaple Probe benefits were observed for SnF2 relative to the control by 114% after Week 2 and 184% at Week 8. The dentifrices were well-tolerated.

Conclusion: Twice-daily brushing with a marketed SnF2 dentifrice provided superior dentinal hypersensitivity improvement versus a commercially available NaF/triclosan dentifrice, with significantly (p < 0.0001) greater relief after two weeks, and even larger relative benefits at eight weeks.
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September 2014

Digital plaque imaging evaluation of a stabilized stannous fluoride dentifrice compared with a triclosan/copolymer dentifrice.

Am J Dent 2013 Dec;26(6):303-6

Purpose: To compare the relative plaque control efficacy of a marketed 0.454% stabilized stannous fluoride (SnF2) dentifrice relative to a triclosan/copolymer dentifrice using digital plaque imaging analysis (DPIA).

Methods: This was a randomized, two-treatment, double-blind, parallel group design study that compared SnF2 and triclosan/copolymer dentifrices over a period of 3 weeks. DPIA was used to capture a digital image of the maxillary and mandibular anterior facial surfaces of 12 teeth and to calculate plaque area coverage. Overnight DPIA images were taken at a baseline visit after which subjects were randomly assigned to one of the two treatment groups and were required to brush with their assigned dentifrice according to each manufacturer's instructions. Subjects had DPIA assessments on two separate days at the end of Week 3.

Results: 96 subjects were randomized to treatment. Plaque area data for 47 subjects per treatment group were compared at Week 3 using ANCOVA. The SnF2 group demonstrated a statistically significant reduction in overnight plaque at Week 3 compared to baseline (P= 0.002). The reduction for the triclosan group at Week 3 compared to baseline was not statistically significant (P= 0.24). At Week 3, the SnF2 group demonstrated a 17% lower adjusted mean for overnight plaque relative to the triclosan group with a mean difference that was statistically significant (P< 0.05). The Week 3 adjusted mean change from baseline in overnight plaque for the SnF2 group was 3 times greater versus that of the triclosan group (P< 0.05).
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December 2013

8-week evaluation of anti-plaque and anti-gingivitis benefits of a unique multi-directional power toothbrush versus a sonic control toothbrush.

Am J Dent 2012 Sep;25 Spec No A(A):27A-32A

Procter & Gamble Health Care Research Center, 8700 Mason-Montgomery Road, Mason, OH 45040, USA.

Purpose: To assess the ability of a novel multi-directional power toothbrush to control plaque and gingivitis when compared to a marketed sonic power toothbrush control.

Methods: This was a randomized and controlled, examiner-blinded, parallel group, 8-week study at a single center, in adult subjects with mild-to-moderate gingivitis. Pre-treatment gingivitis levels and plaque coverage were evaluated at baseline using the Lobene Modified Gingival Index (MGI), the Gingival Bleeding Index (GBI), and the Rustogi Modified Navy Plaque Index (RMNPI). Qualified subjects were randomly assigned to either a novel multi-directional power toothbrush with a wireless display (Oral-B Professional Deep Sweep + SmartGuide TRICLEAN 5000, also marketed as Oral-B TriZone) or the marketed control sonic toothbrush (Philips Sonicare FlexCare). After a supervised brushing at the clinical site at baseline, subjects brushed unsupervised at home twice daily according to manufacturer instructions with the assigned test brush and standard sodium fluoride dentifrice. After 8 weeks, subjects were recalled to assess toothbrush efficacy via the MGI and GBI gingivitis and RMNPI plaque evaluations.

Results: A total of 128 evaluable subjects completed the study. After 8 weeks of brushing, both test toothbrushes provided statistically significant reductions compared to baseline in mean whole mouth MGI and GBI, and in RMNPI whole mouth and interproximal (approximal) sites (P < 0.001). The novel multi-directional power brush consistently produced significantly superior anti-gingivitis and anti-plaque reductions relative to pre-treatment versus the sonic control brush: the Week 8 adjusted mean relative reductions were 30% and 29% greater for whole mouth MGI and GBI, respectively (P < 0.001); and were 44% and 77% greater for the RMNPI whole mouth and interproximal regions, respectively (P < or = 0.003). Both toothbrushes were well-tolerated.
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September 2012

12-week clinical evaluation of a rotation/oscillation power toothbrush versus a new sonic power toothbrush in reducing gingivitis and plaque.

Am J Dent 2012 Oct;25(5):287-92

Procter & Gamble Health Care Research Center, 8700 Mason-Montgomery Road, Mason, OH 45040, USA.

Purpose: To evaluate the efficacy of an advanced rotation/oscillation power toothbrush (Oral-B Triumph with SmartGuide) relative to a new sonic power toothbrush (Sonicare DiamondClean) in the reduction of gingivitis and plaque over a period of 12 weeks.

Methods: This was a single-center, open-label, examiner-blind, two-treatment, parallel group, randomized study in which subjects brushed with their assigned toothbrush and a marketed dentifrice for 2 minutes twice daily at home for 12 weeks. Gingivitis and plaque were evaluated at baseline, Week 6 and Week 12 using the Modified Gingival Index (MGI), Number of Bleeding Sites, and Rustogi Modification of the Navy Plaque Index (RMNPI). Safety was also assessed at every visit. At the end of the study, subjects completed a consumer questionnaire to evaluate their brushing experience.

Results: In total, 130 subjects were randomized to treatment and completed the study (65 per group). The rotation/oscillation group had higher gingivitis reductions from baseline at Weeks 6 and 12 by 31.9% and 32.3%, respectively, for MGI and by 43.4% and 34.9%, respectively, for number of bleeding sites than the sonic group. Group differences at both Weeks 6 and 12 were highly significant (P < 0.001) for both MGI and number of bleeding sites. The rotation/oscillation group had higher RMNPI plaque reductions from baseline at Weeks 6 and 12 by 15.8% and 19.3%, respectively, for whole mouth; by 24.1% and 30.4% at the gumline; and by 22.9% and 24.4% in the approximal regions, than the sonic group. Comparisons between groups at Week 12 were highly significant (P < or = 0.002) for all three mouth areas; group differences at Week 6 were significant (P < 0.05) for whole mouth and approximal RMNPI. Analysis of the questionnaire data showed that subjects using the rotation/oscillation brush rated it higher for several key attributes than subjects in the sonic group. There were no safety concerns with either brush.
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October 2012

Anti-gingivitis effects of a novel 0.454% stabilized stannous fluoride dentifrice relative to a positive control.

Am J Dent 2012 Jun;25(3):136-40

Procter & Gamble Health Care Research Center, 8700 Mason-Montgomery Road, Mason, OH 45040, USA.

Purpose: To compare the anti-gingivitis efficacy of a novel 0.454% stannous fluoride dentifrice to a commercially available positive control triclosan-containing dentifrice in a population of adults with gingivitis.

Methods: This single-center, randomized and controlled, double-blind, parallel group, 2-month trial enrolled 200 adults with mild-to-moderate gingivitis. At baseline, pre-treatment gingivitis levels were assessed with both the Lobene Modified Gingival Index (MGI) and the Gingival Bleeding Index (GBI). Subjects were randomly assigned to one of two test dentifrices: either 0.454% highly bioavailable stannous fluoride or the 0.30% triclosan positive control. Following at-home, unsupervised toothbrushing according to manufacturer's instructions with their assigned test dentifrice for 2 months, subjects were re-evaluated for gingivitis again via the MGI and GBI examinations.

Results: A total of 196 subjects completed the trial and were evaluable. At Month 2, both test dentifrices produced statistically significant reductions in number of bleeding sites, GBI, and MGI on average relative to pre-treatment (P< 0.0001). The Month 2 adjusted mean improvement from baseline for the stannous fluoride dentifrice group was 62% greater for number of bleeding sites, 60% greater for GBI, and 45% greater for MGI versus the triclosan/copolymer positive control group; groups differed significantly (P<0.0001) for each gingivitis measure at Month 2. Both dentifrices were well-tolerated.
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June 2012

Clinical evaluation of the fast onset and sustained sensitivity relief of a 0.454% stannous fluoride dentifrice compared to an 8.0% arginine-calcium carbonate-sodium monofluorophosphate dentifrice.

Am J Dent 2011 Dec;24(6):336-40

Procter & Gamble Health Care Research Center, 8700 Mason-Montgomery Road, Mason, OH 45040, USA.

Purpose: To evaluate the efficacy of a dentifrice containing 0.454% stannous fluoride (SnF2) in the reduction of dentin hypersensitivity immediately after use, after 3 days and after a 2-week use period as compared to a positive control dentifrice containing 8.0% arginine, calcium carbonate and 1450 ppm fluoride as sodium monofluorophosphate.

Methods: 80 healthy adult subjects with moderate dentin hypersensitivity were enrolled in this clinical study, which had a controlled, randomized, examiner-blind, two-treatment (40 subjects per treatment group), parallel group design. For each subject, two sensitive bicuspid or cuspid teeth in different quadrants demonstrating reproducible sensitivity to thermal stimuli (Schiff air sensitivity score of > 1) were chosen for evaluation. Subjects were randomized to treatment with either the SnF2 dentifrice or the positive control dentifrice. At the baseline visit, subjects were assessed for sensitivity to thermal stimuli, received an oral soft tissue examination, and were instructed to brush with their assigned dentifrice according to manufacturers' usage instructions. Immediately after brushing, sensitivity to thermal stimuli for each enrolled tooth was assessed by an experienced dental examiner using the Schiff air sensitivity index and by study subjects based on air visual analog scale (VAS). After using their assigned dentifrice for 3 days and for 2 weeks, thermal sensitivity was re-assessed by both examiner and subject, and each subject received an oral soft tissue examination.

Results: 40 subjects in the SnF2 dentifrice group and 38 subjects in the control group completed all study procedures. Both dentifrice groups showed significant sensitivity relief relative to baseline (P < 0.01). The SnF2 dentifrice provided a statistically significant (P = 0.005) 7.4% reduction in sensitivity relative to the positive control dentifrice immediately after first use and an even more significant (P = 0.001) 20% reduction at Week 2 based on the Schiff air sensitivity scale. Based on the VAS, the SnF2 dentifrice provided statistically significant (P < 0.0001) reduction in sensitivity relative to the positive control dentifrice immediately after first use, at Day 3, and Week 2, with percent reductions of 7.2%, 15.8% and 28.2%, respectively. No adverse events were reported with either dentifrice.
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December 2011

Rapid desensitizing efficacy of a stannous-containing sodium fluoride dentifrice.

J Clin Dent 2011 ;22(2):40-5

The Procter & Gamble Company Mason, Ohio, USA.

Objective: To evaluate the efficacy of an experimental stannous-containing sodium fluoride dentifrice (1450 ppm fluoride) in the reduction of dentinal hypersensitivity over a three-day period as compared to a positive control dentifrice containing 8% arginine, calcium carbonate, and 1450 ppm fluoride as sodium monofluorophosphate.

Methods: This study, conducted in China, had a controlled, randomized, examiner-blind, two-treatment, parallel-group design. Eighy-one healthy adult subjects with moderate dentinal hypersensitivity were enrolled, two bicuspid or cuspid teeth in different quadrants demonstrating reproducible thermal (cold air) sensitivity with a score of > 1 on the SchiffAir Sensitivity Scale were chosen for each subject. Subjects also assessed their own level of pain on a Visual Analog Scale (VAS). Subjects were randomized to treatment with either the experimental or positive control dentifrice. At the baseline visit, sensitivity to thermal stimuli was assessed by both the examiner (Schiff Air Sensitivity) and the subject (pain VAS), and subjects were instructed to brush with their assigned study dentifrice according to the manufacturer's instructions provided. Immediately after brushing, thermal sensitivity for each enrolled tooth was reassessed by both examiner and subject. Subjects used their assigned dentifrices at home for three days, after which thermal sensitivity was reassessed by both examiner and subject. Subjects received an oral soft tissue examination at baseline and on Day 3.

Results: Forty subjects in the experimental group and 41 subjects in the positive control group completed all study procedures. On the Schiff Air Sensitivity Scale, the experimental dentifrice provided statistically significant (p < 0.001) reductions of 14.8% and 54.1% in sensitivity relative to the positive control dentifrice immediately after first use and at Day 3, respectively. On the pain VAS, the experimental dentifrice provided statistically significant (p < 0.001) reductions of 22.3% and 74.1% in sensitivity relative to the positive control dentifrice immediately after first use and at Day 3, respectively. No adverse events were reported for any subject.

Conclusion: An experimental stannous-containing sodium fluoride dentifrice provided significantly better dentin hypersensitivity relief relative to a positive control dentifrice both immediately and after three days of product use.
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July 2011

Plaque and gingivitis reduction efficacy of an advanced pulsonic toothbrush: a 4-week randomized and controlled clinical trial.

Am J Dent 2010 Dec;23(6):305-10

BioSci Research Canada, Ltd, Mississauga, Ontario, Canada.

Purpose: To compare the safety and efficacy of a novel sonic power toothbrush and a manual toothbrush in the reduction of gingivitis and plaque over a 4-week period.

Methods: This study employed a randomized two treatment, examiner-blinded, parallel group design. Subjects with evidence of gingivitis were randomly assigned to 4 weeks' twice daily home use of either the Oral-B Pulsonic sonic toothbrush or an ADA reference manual toothbrush. At baseline (Visit 1) and again after product use at Week 4, subjects received gingivitis evaluations with the Modified Gingival Index (MGI) and Gingival Bleeding Index (GBI) examinations, followed by plaque assessment using the Rustogi Modified Navy Plaque Index (RMNPI). For 12 hours before both visits, subjects abstained from all oral hygiene, and ceased eating, drinking and smoking 4 hours prior.

Results: Both brushes significantly reduced gingivitis, gingival bleeding and plaque compared with baseline, and were well-tolerated by the 129 subjects completing the study. The sonic toothbrush was statistically significantly (P < 0.0001) more effective than the manual brush, with greater relative mean reductions in MGI, GBI and RMNPI of 11.9%, 62.3% and 46.5%, respectively.
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December 2010

Innovations in global dentifrice technology: an advanced stannous-containing sodium fluoride dentifrice.

Am J Dent 2010 Sep;23 Spec No B:3B-10B

Procter & Gamble Health Care Research Center, 8700 Mason-Montgomery Road, Mason, OH 45040, USA.

Purpose: Despite oral health improvements in many geographies, the prevalence of oral concerns, including caries, gingivitis, dentin hypersensitivity, breath malodor, calculus, and extrinsic staining remains unacceptably high across the globe. Dentifrice offers a convenient and accessible vehicle to deliver ingredients--such as antimicrobials, fluoride, and esthetic-enhancing agents--to treat a broad range of common oral conditions. Recently, a novel stannous-containing sodium fluoride (1450 ppm F-) dentifrice was introduced that has been tested in the lab and/or clinically in diverse geographic regions for its impact on major oral conditions.

Methods: This next-generation dentifrice, marketed as Crest Pro-Health in China and blend-a-med Pro-Expert in parts of Europe, has been extensively clinically tested in the lab and/or clinically on multiple continents in a broad range of subject populations with varying levels of disease and/or cosmetic concerns. This special issue features a few of the many laboratory and clinical investigations conducted on this formulation.

Results: The findings reported here demonstrate the product's anticaries potential as well as its ability to reduce plaque, improve dentin hypersensitivity, inhibit extrinsic stain, and improve breath malodor.
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September 2010

Benefit of the power component of sonic and rotation-oscillation modes of action for plaque removal using power toothbrushes.

Am J Dent 2010 Apr;23(2):60-4

University of Missouri at Kansas City, Kansas City, Missouri, USA.

Purpose: To assess the benefit of the power component of two power toothbrushes, with sonic and rotation-oscillation mechanisms, on plaque removal efficacy.

Methods: Two independent studies with identical designs were used to assess the benefit of the power component of two power toothbrushes, with sonic and rotation-oscillation mechanisms, on plaque removal efficacy. Each brush was tested with the power 'On' relative to a control of the same brush with the power 'Off' used like a manual toothbrush. The studies were carried out independently at different sites, and each employed a replicate use, single brushing, two-treatment, four-period, examiner-blind, randomized, crossover design for assessing plaque removal. Study 1 compared rotation-oscillation action (Oral-B Triumph with FlossAction brush head), and Study 2 compared sonic action (Sonicare FlexCare with ProResults standard brush head) with power on versus off. The two treatments in each study consisted of (1) brushing teeth per manufacturer's instructions of the power toothbrush and (2) brushing without power by using the power toothbrush like a manual toothbrush. Prior to the treatment phase of each study, subjects exclusively used the assigned study toothbrush for 2 minutes twice per day according to the manufacturer's instructions (power on) during an acclimation period. Plaque was scored at prebrushing (baseline) and post-brushing on Visits 2, 3, 4 and 5 using the Turesky Modified Quigley-Hein Plaque Index (TMQHPI). A 2-day washout period separated each treatment period.

Results: 32 subjects were enrolled in each study; 28 subjects provided complete data for Study 1 and 32 subjects provided complete data for Study 2. The adjusted mean TMQHPI plaque removal scores for Study 1 were 0.793 for the rotation-oscillation 'On' regimen and 0.675 for the rotation-oscillation 'Off' regimen. This represents a statistically significantly (P<0.0001) greater plaque score reduction for the rotation-oscillation 'On' versus rotation-oscillation 'Off' treatment. The adjusted mean TMQHPI plaque removal scores for Study 2 were 1.042 for the sonic 'On' regimen and 1.007 for the sonic 'Off' regimen. This represents a nonsignificant (P=0.426) greater plaque score reduction for the difference between sonic 'On' versus sonic 'Off' regimen.
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April 2010

Comparison of rotation/oscillation and sonic power toothbrushes on plaque and gingivitis for 10 weeks.

Am J Dent 2009 Dec;22(6):345-9

University of Missouri at Kansas City, Kansas City, Missouri, USA.

Purpose: Although power toothbrushes provide valuable tools toward improving oral health, contrasting results are discerned in their efficiency. This 10-week study was conducted to compare the safety and efficacy of rotation/oscillation and sonic power toothbrushes in the reduction of plaque and gingivitis.

Methods: This two-treatment, parallel group, examiner-blind, randomized study had the subjects brush twice daily at home with their assigned rotation/oscillation or sonic toothbrush following manufacturer's instructions with center visits at baseline, and at 4 and 10 weeks following the baseline visit, for assessment of oral safety (all visits), plaque (baseline, Weeks 4 and 10), and gingivitis (baseline and Week 10). Gingivitis and number of bleeding sites were measured using the Löe-Silness Gingivitis Index, and plaque was measured using the Turesky Modification of the Quigley-Hein Plaque Index.

Results: At Week 10, 171 subjects were evaluable for plaque assessment (85 in Sonic group, 86 in rotation/oscillation group) and 165 subjects were evaluable for gingivitis and bleeding sites assessment (84 in sonic group, 81 in rotation/oscillation group). The rotation/oscillation group had statistically significantly lower gingivitis scores (by 3.5%) and statistically significantly fewer bleeding sites than the sonic group (by 16.1%) with P = 0.038 and 0.028, respectively, at Week 10. Compared to baseline, only the rotation/oscillation group showed a statistically significant improvement in gingivitis (P = 0.003) and bleeding (P < 0.001) at Week 10. At both Weeks 4 and 10, the rotation/oscillation group had directionally lower plaque scores than the sonic group (by approximately 3%), but treatment group differences were not statistically significant (P > 0.1) at either time point. Both groups showed statistically significantly lower plaque scores at Weeks 4 and 10 relative to baseline.
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December 2009

Gingival transcriptome patterns during induction and resolution of experimental gingivitis in humans.

J Periodontol 2009 Dec;80(12):1963-82

Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27709, USA.

Background: To our knowledge, changes in the patterns of whole-transcriptome gene expression that occur during the induction and resolution of experimental gingivitis in humans were not previously explored using bioinformatic tools.

Methods: Gingival biopsy samples collected from 14 subjects during a 28-day stent-induced experimental gingivitis model, followed by treatment, and resolution at days 28 through 35 were analyzed using gene-expression arrays. Biopsy samples were collected at different sites within each subject at baseline (day 0), at the peak of gingivitis (day 28), and at resolution (day 35) and processed using whole-transcriptome gene-expression arrays. Gene-expression data were analyzed to identify biologic themes and pathways associated with changes in gene-expression profiles that occur during the induction and resolution of experimental gingivitis using bioinformatic tools.

Results: During disease induction and resolution, the dominant expression pathway was the immune response, with 131 immune response genes significantly up- or downregulated during induction, during resolution, or during both at P <0.05. During induction, there was significant transient increase in the expression of inflammatory and oxidative stress mediators, including interleukin (IL)-1 alpha (IL1A), IL-1 beta (IL1B), IL8, RANTES, colony stimulating factor 3 (CSF3), and superoxide dismutase 2 (SOD2), and a decreased expression of IP10, interferon inducible T-cell alpha chemoattractant (ITAC), matrix metalloproteinase 10 (MMP10), and beta 4 defensin (DEFB4). These genes reversed expression patterns upon resolution in parallel with the reversal of gingival inflammation.

Conclusions: A relatively small subset (11.9%) of the immune response genes analyzed by array was transiently activated in response to biofilm overgrowth, suggesting a degree of specificity in the transcriptome-expression response. The fact that this same subset demonstrates a reversal in expression patterns during clinical resolution implicates these genes as being critical for maintaining tissue homeostasis at the biofilm-gingival interface. In addition to the immune response pathway as the dominant response theme, new candidate genes and pathways were identified as being selectively modulated in experimental gingivitis, including neural processes, epithelial defenses, angiogenesis, and wound healing.
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http://dx.doi.org/10.1902/jop.2009.080645DOI Listing
December 2009

A randomized 12-week study to compare the gingivitis and plaque reduction benefits of a rotation-oscillation power toothbrush and a sonic power toothbrush.

J Clin Dent 2009 ;20(3):93-8

BioSci Research Canada, LTD Mississauga, Ontario, Canada.

Objective: Sonic and rotation-oscillation power toothbrushes are popular and effective, but have been shown to differ in relative benefits. The objective of this 12-week investigation was to compare the efficacy of a rotation-oscillation powered toothbrush and a newly introduced sonic toothbrush in the reduction of gingivitis and dental plaque.

Methods: This was a randomized, controlled, examiner-blind, two-treatment, parallel-group study to assess gingivitis reduction and plaque reductions after twice-daily brushing with either the rotation-oscillation brush or the sonic toothbrush over 12 weeks. The Modified Gingival Index (MGI) and Gingival Bleeding Index (GBI) were used to determine gingivitis benefits at Week 6 and Week 12, and plaque was scored at these visits before and after supervised brushing using the Rustogi Modified Navy Plaque Index (RMNPI).

Results: In 171 evaluable subjects, gingivitis reduction benefits were significantly greater for the rotation-oscillation brush group than for those using the sonic toothbrush, with relative mean benefits favoring the rotation-oscillation brush of 29.4% for GBI and 8.2% for MGI at 12 weeks (p < or = 0.01). The rotation-oscillation brush produced significantly lower RMNPI plaque by 33.3% compared to the sonic toothbrush (p < 0.001) at Week 12.

Conclusion: The rotation-oscillation power toothbrush was significantly more efficacious than the sonic toothbrush in removing plaque, in reducing gingivitis, and lowering the number of bleeding sites after 12 weeks of twice-daily brushing.
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December 2009

Clinical assessment of extrinsic stain removal efficacy with a new Pulsonic toothbrush.

J Clin Dent 2009 ;20(3):71-4

The University of Texas Health Science Center at San Antonio, TX, USA.

Objective: To assess the extrinsic stain removal benefit of two different power toothbrushes: an experimental Oral-B Pulsonic rechargeable toothbrush and a positive control Sonicare FlexCare toothbrush.

Methods: This was a randomized, positive-controlled, examiner-blind, two-treatment, parallel group, two-week study. A Lobene stain index was performed at baseline on the facial surfaces of the anterior teeth. Subjects were randomized to one of two treatment groups: Pulsonic or FlexCare. Both groups were assigned the same fluoride dentifrice, and were instructed to brush their teeth twice per day for two minutes with the assigned toothbrush and dentifrice in front of a mirror. A further Lobene stain index was performed following two weeks of brushing.

Results: A highly significant reduction (p < 0.001) in mean Lobene composite scores after two weeks was found for both the Pulsonic treatment group and the FlexCare treatment group (median reduction of 94.4% and 90.7%, respectively). Both treatment groups also showed a highly significant (p < 0.001) reduction in extent and intensity scores. No significant treatment group differences were seen in the reduction in mean Lobene scores (p > 0.1).

Conclusion: Both the experimental Pulsonic and the positive control FlexCare power toothbrushes showed highly effective stain removal efficacy relative to baseline following two weeks of brushing. Stain removal efficacy did not differ significantly between brushes.
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December 2009

Replicate single-use comparative study of plaque removal with two contemporary manual toothbrushes.

Am J Dent 2009 Jun;22(3):189-92

University of Texas Health Science Center, San Antonio Dental School, USA.

Purpose: To compare the plaque removing efficacy of Oral-B Advantage 123 and Colgate 360 degrees manual toothbrushes on a single brushing after a 24-hour void in oral hygiene.

Methods: This study had a two-treatment (Advantage 123 versus Colgate 360 degrees), examiner-blind, randomized, four-period (visit) crossover design. At the first (baseline) visit, subjects received a plaque examination using the Rustogi Modified Navy Plaque Index (RMNPI) after which they were instructed to brush for 1 minute in their normal manner with their assigned toothbrush and a marketed dentifrice and unaided by access to a mirror. Post-brushing plaque was then assessed. At three further visits, each separated by a period of 3-8 days, brushes were assigned to subjects according to their treatment sequence and the same brushing and plaque grading procedure as at baseline was followed.

Results: 50 subjects were enrolled in the replicate single-use study; all were included in the analysis. Oral-B Advantage 123 was significantly better than Colgate 360 degrees at reducing whole mouth (P = 0.006), gingival margin (P = 0.010) and approximal (P = 0.040) plaque scores.
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June 2009

Impact of a novel power toothbrush with SmartGuide technology on brushing pressure and thoroughness.

J Contemp Dent Pract 2008 Nov 1;9(7):1-8. Epub 2008 Nov 1.

University of Michigan Dental School, USA.

Aim: Toothbrushing effectiveness can be improved with at-home reinforcement of proper technique. This study evaluated the ability of a power brush with a wireless remote display (Oral-B Triumph with SmartGuide) to improve brushing force and thoroughness.

Methods And Materials: At baseline, 61 pre-screened subjects were videotaped while brushing. The wireless display was also videotaped. Subjects were then randomized to the power brush alone or the power brush with the wireless display. After 30 days of home use, subjects returned and brushed for two minutes using a two-way mirror. Brushing behavior and the wireless display were videotaped.

Results: Fifty-eight subjects were included in the pressure sensor analysis. The reduction in pressure sensor activation time at day 30 versus baseline was 88.5% for the power brush with wireless display and 53.4% for the power brush alone. The difference between groups was statistically significant in favor of the power brush with display (p=0.034). Forty-six subjects were included in the brushing thoroughness assessment. Subjects using the power brush with the wireless display showed statistically significantly more thorough brushing across the dentition and lingual/buccal surfaces relative to baseline. The power brush alone did not show a significant difference relative to baseline.

Conclusion: Subjects using the power brush with the wireless display brushed with less force than subjects using the power brush alone after 30 days of home use.

Clinical Significance: The power brush with the wireless display can be incorporated in patients' home care routine to improve brushing technique, including brushing pressure and thoroughness.
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November 2008

Plaque removal efficacy of an advanced rotation-oscillation power toothbrush versus a new sonic toothbrush.

Am J Dent 2008 Jun;21(3):185-8

Procter & Gamble Company, Mason, OH 45040-9462, USA.

Purpose: To evaluate the plaque removal efficacy and safety of an advanced rotation-oscillation power toothbrush relative to a newly-introduced sonic toothbrush.

Methods: This study used a randomized, examiner-blind, two-treatment, four-period, four-sequence crossover design. Subjects received both toothbrushes (Oral-B Triumph and Sonicare FlexCare) and a standard dentifrice from the study site and used each toothbrush at home during an acclimation phase prior to their plaque measurement visits. After abstaining from all oral hygiene for 24 hours, subjects returned to the study site and were assessed with the Rustogi Modified Navy Plaque Index. They then brushed for 2 minutes with their first randomly-assigned toothbrush and post-brushing plaque scores were recorded. This procedure was followed for three additional study visits, with subjects using their normal at-home toothbrush and dentifrice for the 2- to 5-day washout periods between visits. Subjects always abstained from all oral hygiene for 24 hours prior to their visits.

Results: 45 subjects completed the study. Both brushes were found to be safe and both significantly reduced plaque after a single brushing. Oral-B Triumph was statistically significantly (P < 0.0001) more effective in plaque removal than Sonicare FlexCare for whole mouth plaque scores, gingival marginal plaque scores and interproximal plaque scores. Compared to Sonicare FlexCare, the adjusted mean plaque reduction scores for Oral-B Triumph were 21%, 23% and 22% greater for whole mouth, marginal and interproximal areas, respectively.
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June 2008

A clinical evaluation of extrinsic stain removal: a rotation-oscillation power toothbrush versus a dental prophylaxis.

J Contemp Dent Pract 2008 Jul 1;9(5):1-8. Epub 2008 Jul 1.

University of Texas, Health Science Center, San Antonio School of Dentistry, San Antonio, TX, USA.

Aim: To assess extrinsic stain removal efficacy of a power toothbrush and a dental prophylaxis followed by the use of a standardized American Dental Association (ADA) reference manual toothbrush.

Methods And Materials: This was a randomized, positive-controlled, examiner-blind, parallel group, two-week study. A Lobene stain examination was performed at baseline. Subjects were randomized to one of two treatment groups: Group 1: Oral-B Vitality Pro White power toothbrush or Group 2: Subjects receiving a dental prophylaxis then using a standardized ADA reference manual toothbrush. Subjects were instructed to brush their teeth with the assigned toothbrush and a fluoride dentifrice in front of a mirror twice per day for 2 minutes. Stain was reassessed following 2 weeks of brushing.

Results: A significant reduction (p <0.001) in mean Lobene composite scores after 2 weeks was found for Group 1 (90.6%) and Group 2 (94.4%). Both groups also showed a significant reduction (p <0.001) in extent and intensity scores. There was no significant group difference in reduction in mean Lobene composite scores (p>0.1).

Conclusions: The Oral-B Vitality Pro White power toothbrush showed effective stain removal at a level similar to receiving an oral prophylaxis followed by the use of an ADA reference manual toothbrush.

Clinical Significance: In this small study the Oral-B Vitality Pro White power toothbrush achieved statistically significant stain removal between dental visits.
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July 2008

Clinical evaluation of the effects of a sonic toothbrush with ultrasound waveguide in disrupting plaque with and without bristle contact.

Am J Dent 2008 Apr;21(2):83-7

Procter & Gamble Company, Mason, OH 45040, USA.

Purpose: To assess the in vivo plaque removal efficacy of the newly marketed sonic/ultrasonic toothbrush. Plaque removal resulting from the toothbrush being held approximately 3 mm from the tooth surface was compared versus a no brushing control. Also, plaque removal resulting from the brush being used according to the manufacturer's instructions was compared versus a control of using the brush (with power turned off) like a manual toothbrush would be used.

Methods: This was a replicate use, four-treatment, examiner-blind, randomized, eight-period crossover design single brushing plaque study involving 31 subjects. The four treatment regimens consisted of (1) brushing for 2 minutes with the Ultreo powered toothbrush according to manufacturer's instructions, (2) brushing for 2 minutes with the Ultreo toothbrush (power turned off) using the brush like a manual toothbrush, (3) having a trained dental hygienist hold the Ultreo toothbrush head 3 mm from tooth surfaces for a total of 2 minutes, or (4) swishing with a dentifrice slurry for 1 minute in the absence of toothbrushing. For each subject, an experienced, calibrated plaque examiner performed the Turesky Modified Quigley-Hein Plaque Index prior to brushing and following brushing. The difference (baseline minus post-regimen) in average scores was calculated for each subject. The difference scores were analyzed for treatment regimen differences using a mixed model ANCOVA (with baseline whole-mouth average score as the covariate and subjects considered random) for a crossover design.

Results: Adjusted mean plaque removal scores (baseline plaque score minus post-brushing plaque score) were 0.052 for swishing with a dentifrice slurry, 0.058 for the dental hygienist holding the Ultreo toothbrush approximately 3 mm from tooth surfaces, 0.536 for the Ultreo toothbrush used according to manufacturer's instructions and 0.666 for the Ultreo toothbrush (power turned off) used like a manual toothbrush. The difference between the Ultreo toothbrush held approximately 3 mm from tooth surfaces and swishing with a dentifrice slurry was not statistically significant (P = 0.808). The adjusted mean plaque removal score for the Ultreo toothbrush (power turned off) used like a manual toothbrush was statistically significantly (P < 0.001) greater than the corresponding score for the Ultreo toothbrush used per manufacturer's instructions. Ultreo used like a manual toothbrush had an adjusted mean plaque removal score that was 12.4% greater than that for Ultreo used per manufacturer's instructions. Finally, plaque removal scores for the Ultreo toothbrush used per manufacturer's instructions and used like a manual toothbrush were statistically significantly (P < 0.001) greater than plaque removal scores for the non-brushing treatment regimens.
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April 2008

Improved plaque removal efficacy with a new manual toothbrush.

J Contemp Dent Pract 2008 May 1;9(4):1-8. Epub 2008 May 1.

Procter & Gamble Company Health Care Research Center in Cincinnati, OH, USA.

Aim: To compare the safety and efficacy of two manual toothbrushes, Oral-B Exceed and Asian Colgate 360 masculine, in removing plaque.

Methods And Materials: The study used an examiner-blind, two-treatment, randomized, four-period (visits) crossover design. At the first visit, subjects received a baseline plaque examination; plaque was scored using the Rustogi et al. Modified Navy Plaque Index (RMNPI) and the Turesky et al. Modified Quigley-Hein Plaque Index (TQHPI). Subjects used their assigned toothbrush for one minute. Post-brushing plaque was assessed. The following three visits were separated by an interval of two to six days. At each visit, subjects were assigned brushes according to their treatment sequence and plaque was scored per the first visit.

Results: Forty-eight subjects were enrolled in the study; 47 were included in the analysis. Both brushes were found to be safe and both significantly reduced plaque after a single brushing. The Oral-B Exceed was significantly (p<0.001) better than the Asian Colgate 360 masculine at removing whole mouth plaque (18.1% using TQHPI; 9% using RMNPI). The Oral-B Exceed was also significantly better at removing marginal (p=0.001) and approximal (p=0.022) plaque.

Conclusion: The Oral-B Exceed brush removed significantly more whole mouth, approximal, and gingival margin plaque than the Asian Colgate 360 masculine in a four-period crossover clinical comparison.
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May 2008

Clinical evaluations of plaque removal efficacy: an advanced rotating-oscillating power toothbrush versus a sonic toothbrush.

J Clin Dent 2007 ;18(4):106-11

Procter & Gamble Company Mason, OH, USA.

Objective: To evaluate the safety and plaque removal efficacy of an advanced rotating-oscillating power toothbrush relative to a sonic toothbrush with either a standard or compact brush head.

Methodology: Two studies used a randomized, examiner-blind, two-treatment, crossover design. In Study 1, subjects were instructed to use their first randomly assigned toothbrush for five to seven days and then, after abstaining from all oral hygiene for 24 hours, were assessed with the Rustogi, et al. Modified Navy Plaque Index. They then brushed for two minutes and post-brushing plaque scores were recorded. Subjects were assigned to the alternate toothbrush and the procedures were repeated. In Study 2, subjects alternated using both brushes for approximately 10 days, then had four study visits three to four days apart (some variability based on patient scheduling). In Study 1, Oral-B Triumph with a FlossAction brush head and Sonicare Elite 7300 with a full-size, standard head were compared in a two-treatment, two-period crossover study. Study 2 compared Oral-B Triumph with a FlossAction brush head and Sonicare Elite 7300 with a compact head in a two-treatment, four-period crossover study.

Results: Fifty subjects completed Study 1 and 48 completed Study 2. All brushes were found to be safe and significantly reduced plaque after a single brushing. In Study 1, Oral-B Triumph was statistically significantly (p < 0.001) more effective in plaque removal than Sonicare Elite 7300 with the full-size brush head: whole mouth = 24% better, marginal = 31% better, approximal = 21% better. In Study 2, Oral-B Triumph was statistically significantly (p < 0.001) more effective than Sonicare Elite 7300 with the compact brush head: whole mouth = 12.2% better, marginal = 14.6% better, approximal = 12% better.

Conclusion: Oral-B Triumph with its rotation-oscillation action was significantly more effective in single-use plaque removal than Sonicare Elite 7300 with its side-to-side sonic action when fitted with either a standard or a compact brush head.
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April 2008

Oral hygiene regimens, plaque control, and gingival health: a two-month clinical trial with antimicrobial agents.

J Clin Dent 2007 ;18(4):101-5

The Procter & Gamble Company, Health Care Research Center, Mason, OH, USA.

Objective: The purpose of this study was to examine the effects of various product combinations involving brush, paste, rinse, and floss on the prevention of plaque regrowth and gingivitis.

Methodology: In this randomized, parallel-group, examiner-blind, eight-week study, 179 subjects with gingivitis had a dental prophylaxis and were randomly assigned to one of six product combinations: 1) Colgate Wave manual toothbrush + Colgate Total dentifrice (0.3% triclosan/copolymer dentifrice); 2) Wave + Total + Listerine (essential oils rinse); 3) Oral-B CrossAction manual toothbrush + Crest Pro-Health dentifrice (0.454% stannous fluoride/sodium hexametaphosphate); 4) CrossAction + Pro-Health dentifrice + Crest Pro-Health Rinse (0.07% cetylpyridinium chloride rinse); 5) Oral-B ProfessionalCare Series 8000 power toothbrush + Pro-Health dentifrice; or 6) ProfessionalCare power brush + Pro-Health dentifrice + Oral-B Hummingbird power flosser. Subjects used their test products for the duration of the study. Whole mouth plaque, gingivitis, and product-related adverse events were assessed. Treatments were compared at a 0.05 level of significance.

Results: One-hundred and seventy-four subjects completed the study and were included in the data analysis. At Week 8, the overnight adjusted whole mouth plaque scores were statistically significantly lower in all other groups relative to the Wave + Total group (p < or = 0.030). Plaque scores were also statistically significantly lower (approximately 20%) in both groups where a therapeutic rinse was added to a manual brush and therapeutic paste relative to scores for the brush plus paste without a rinse (p < or = 0.034). All groups showed a reduction in gingivitis at Week 4, and mean scores remained stable or increased slightly at Week 8. The power toothbrush groups were directionally better at preventing gingivitis than the manual groups at Weeks 4 and 8.

Conclusion: Reductions in overnight plaque were seen when therapeutic rinses were added to manual brush plus therapeutic dentifrice regimens above that observed with a manual brush and therapeutic dentifrice alone.
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April 2008

Plaque-removal efficacy of four types of dental floss.

J Periodontol 2008 Feb;79(2):245-51

University of Texas Health Science Center at San Antonio Dental School, San Antonio, TX, USA.

Background: Effective plaque removal is essential for gingival health, and dental floss is used to augment plaque removal achieved with a toothbrush.

Methods: This randomized, controlled, examiner-masked, five-period crossover study examined plaque removal in 25 subjects following single use with an American Dental Association reference manual toothbrush alone and in combination with four floss products: three traditional (unwaxed, woven, and shred-resistant) and one powered flosser. Plaque was scored before and after brushing for 1 minute. The Rustogi modified Navy plaque index was used to focus scores on tooth areas contacted during the proper use of dental floss.

Results: Mean plaque reductions (baseline minus postbrushing) in floss contact areas were as follows: 0.181 with the toothbrush alone; 0.228, 0.217, and 0.210 for the toothbrush in combination with the three traditional flosses, unwaxed, woven, and shred-resistant, respectively; and 0.252 for the toothbrush plus powered flosser. No statistically significant differences were found between the three traditional floss treatments. All four floss treatments showed greater (P <0.05) mean plaque removal than the toothbrush alone. Mean plaque removal with the powered flosser combination was greater than for the woven combination and shred-resistant combination (both P < or =0.006) and fell just short of significance compared to the unwaxed combination (P = 0.051).

Conclusions: All four floss products in combination with a manual toothbrush removed plaque significantly better than the toothbrush alone. Among floss types, there was evidence of superiority for the powered flosser, but there were no significant treatment differences between the three traditional floss products.
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http://dx.doi.org/10.1902/jop.2008.070345DOI Listing
February 2008

A study comparing the plaque removal efficacy of an advanced rotation-oscillation power toothbrush to a new sonic toothbrush.

J Clin Dent 2008 ;19(4):154-8

University of Missouri at Kansas City, Kansas City, MO, USA.

Objective: Recently, a new sonic power toothbrush has been marketed. The purpose of this study was to compare the plaque removal efficacy of a control rotation-oscillation power toothbrush (Oral-B Triumph) to this new sonic-powered toothbrush (Sonicare FlexCare) following a single brushing.

Methods: This study was a randomized, controlled, examiner-blind, two-treatment, four-period crossover design, which examined plaque removal with the two toothbrushes following replicate single uses in 48 subjects. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI).

Results: Baseline plaque scores were 2.87 for the sonic toothbrush and 2.85 for the rotation-oscillation toothbrush treatment groups. With respect to all surfaces examined, the sonic toothbrush delivered an adjusted (via Analysis of Covariance) mean difference between baseline and post-brushing plaque scores of 0.95, while the rotation-oscillation toothbrush delivered an adjusted mean difference of 1.06. The difference between treatment groups was statistically significant (p = 0.003).

Conclusion: The rotation-oscillation toothbrush delivered superior plaque removal by reducing plaque scores, on average, 12.1% more than the new sonic toothbrush.
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May 2009

A comparative clinical study of the plaque removal efficacy of an oscillating/rotating power toothbrush and an ultrasonic toothbrush.

J Clin Dent 2008 ;19(4):138-42

Procter & Gamble Health Care Research Center, Mason, OH, USA.

Objective: To evaluate the safety and efficacy of two power toothbrushes in the removal of dental plaque following a single brushing.

Methods: The study employed a two-treatment, examiner-blind, randomized, four-period crossover design. A total of 25 generally healthy adult subjects were enrolled into the study. Test products were an oscillating/rotating power toothbrush (Oral-B Triumph Professional Care 9000) and a newly marketed sonic toothbrush with an ultrasound waveguide (Ultreo). Subjects used each power toothbrush twice during the study following each manufacturer's usage instructions. Clinical examinations using the Turesky Modified Quigley-Hein Plaque Index (TMQHPI) as the primary variable and the Rustogi Modification of the Navy Plaque Index (RMNPI) were performed by calibrated and experienced clinical examiners prior to and following brushing. The difference (baseline minus post-regimen) in average plaque scores was calculated for each subject. The different scores were analyzed for treatment regimen differences using a mixed model analysis of covariance (with baseline whole-mouth average score as the covariate and subjects considered random) for a crossover design.

Results: Baseline whole-mouth TMQHPI and RMNPI plaque scores were well balanced between the two treatment groups. Adjusted mean whole-mouth TMQHPI plaque removal (baseline minus post-brushing) scores were 0.604 for the Triumph toothbrush and 0.488 for the Ultreo toothbrush. The Triumph toothbrush provided statistically significantly more plaque reduction that was 23.9% greater than the Ultreo toothbrush (p = 0.0001). The RMNPI examiner detected similar treatment differences in favor of the Triumph toothbrush, with a 16.3% greater plaque reduction than the Ultreo toothbrush (p < 0.0001). Both products were well tolerated with no adverse events reported in the study.

Conclusion: The results demonstrate superior plaque removal efficacy of the oscillating/rotating Triumph toothbrush versus the Ultreo ultrasonic toothbrush.
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May 2009

Tooth whitening through the removal of extrinsic stain with two sodium hexametaphosphate-containing whitening dentifrices.

Am J Dent 2007 Oct;20(5):309-14

University of Texas Health Science Center, San Antonio Dental School, TX, USA.

Purpose: To evaluate the tooth whitening benefit through stain removal delivered by a marketed whitening dentifrice (Crest Vivid White) used twice a day or a combination regimen of two marketed dentifrices (Crest Vivid White Night used at night and Crest Cavity Protection used in the morning) relative to a positive control over a 2-week period.

Methods: Both studies were randomized, two treatment, parallel group, examiner-blind, 2-week clinical trials involving 22 and 30 healthy adults with longstanding visible extrinsic stain on the facial surfaces of at least six anterior teeth. In each study, subjects were randomized to one of two treatments: a sodium fluoride/sodium hexametaphosphate whitening dentifrice used alone (Study 1) or in combination with a cavity protection dentifrice (Study 2) with an ADA reference manual toothbrush versus a control power toothbrush with a cavity protection dentifrice (both studies).

Results: In both studies, all treatment groups statistically significantly (P < 0.001) reduced baseline stain scores following 1 and 2 weeks of brushing. After 2 weeks, the whitening dentifrice used twice daily had a median percent stain removal of 90% and the night-time whitening dentifrice (used once a day) in combination with the cavity protection dentifrice had a median percent stain removal of 85% while powered toothbrush groups showed median percent stain removal of 88-89% in both studies. Stain removal scores after 1 and 2 weeks of brushing did not differ significantly between the two treatment groups in either study.
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October 2007

Comparative efficacy of stabilized stannous fluoride/sodium hexametaphosphate dentifrice and sodium fluoride/triclosan/copolymer dentifrice for the prevention of periodontitis in xerostomic patients: a 2-year randomized clinical trial.

J Periodontol 2007 Aug;78(8):1505-14

School of Dental Medicine, Tufts University, Boston, MA, USA.

Background: The primary objective of this study was to compare the efficacy of a stannous fluoride (SnF2) dentifrice relative to a positive control triclosan dentifrice for prevention of clinical attachment loss (CAL) in xerostomic patients. A secondary objective was to compare the dentifrices for root caries remineralization.

Methods: This was a 2-year, randomized, double-masked, parallel-group study. A 0.454% SnF2/sodium hexametaphosphate dentifrice was tested versus a positive control dentifrice (sodium fluoride/0.30% triclosan/copolymer) in 440 medication-induced xerostomic adults identified in a 1-year, run-in phase (no treatment) as high risk for periodontitis and root caries. During the study phase, subjects were stratified based on gender and attachment level into two groups. Subjects brushed twice a day for 60 seconds using their assigned product. Clinical examinations including probing depth, attachment level, bleeding on probing, and root caries remineralization were performed at baseline and 1 and 2 years.

Results: A total of 334 subjects were evaluable. During run-in, average CAL relative to initial examination was 1.33 mm. Probing depth increased 0.95 mm. At year 2 in the treatment phase, attachment gain was 0.77 mm for the test group and 0.79 mm for the control group versus baseline. Probing depth decreased 0.57 mm for the test group, similar to the control group (0.53 mm). These changes versus baseline were statistically significant (P <0.01) for each group. Products were not statistically significantly different from each other. Both treatments resulted in similar remineralization for root caries lesions at study completion (P = 0.40).

Conclusion: The results establish comparable benefits for the SnF2 dentifrice in preventing CAL and root caries versus the sodium fluoride/triclosan/copolymer control in xerostomic patients.
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http://dx.doi.org/10.1902/jop.2007.060479DOI Listing
August 2007

A novel oscillating-rotating power toothbrush with SmartGuide: designed for enhanced performance and compliance.

J Contemp Dent Pract 2007 May 1;8(4):1-9. Epub 2007 May 1.

Procter & Gamble Health Care Research Center, Cincinnati, OH, USA.

Aim: The aim of this article is to provide a review of common power toothbrush technologies with a focus on the oscillating-rotating motion used in a novel toothbrush; describe features to drive compliance such as the "SmartGuide" innovation; and finally recommend steps to motivate patients to adopt a power toothbrush as part of their home care regimen.

Background: Contemporary power toothbrushes are available with various modes of actions, bristle designs, and features. Clinical research shows these factors can impact the effectiveness of a toothbrush by altering its ability to remove plaque, particularly in areas that are difficult to access. An independent systematic review of power toothbrush technologies showed toothbrushes with a rotation-oscillation motion provided significant advantages over manual toothbrushes for plaque removal and gingivitis reduction. No other powered toothbrush technology showed results as consistently superior to manual toothbrushes.

Conclusions: Recently, an advanced oscillating-rotating toothbrush was introduced, the Oral-B Triumph with SmartGuide (Procter & Gamble, Cincinnati, OH, USA), using clinically proven oscillating-rotating technology and incorporating a unique wireless remote display to drive good brushing technique and increase brushing time. This type of innovation in power toothbrush technology provides dental professionals and consumers with additional home care tools to help improve oral health. In recommending any power toothbrush, dental professionals should reinforce the benefits to patients in a way that addresses their values, use experiential learning tools to ensure they understand how to use the brush, explain the desired outcomes, and gain their commitment to comply with the recommendation.
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May 2007