Australasian Dentist Magazine March April 2021

Category 50 Australasian Dentist and Ivoclar Vivadent Plaque Test was used for disclosing plaque [Pizzo et al., 2010]. Using a micro-brush the fluid was applied to 3 teeth at a time in the upper and lower arches, both for buccal and lingual surfaces. Under a polymerisation light, plaque appears fluorescent yellow. Plaque’s scoring was performed and recorded using the Turesky modification of the original index of Quigley and Hein [Biesbrock et al., 2007; Quigley and Hein, 1962] (Fig. 2). Plaque examinations were performed by a single trained, experienced dentist who had previously demonstrated the ability to differentiate between score levels [Creeth et al., 2009]. After this assessment, a manual toothbrush or a Sonicare device was randomly delivered to the patient. Subjects were addressed to the brushing session; brushing time was divided evenly between the 4 dental quadrants and set to 2 minutes (total time). The brushing was supervised by a single investigator who did not make the plaque assessment: to avoid impartiality, subjects brushed out of the examiner’s view; the toothbrushes were collected immediately after brushing. Dental plaque remaining on the subject’s teeth was disclosed again and the level evaluated and recorded as before. The last control at one week was scheduled. The patient was asked not to brush teeth for 23–25 hours prior to the appointment and to refrain from eating, drinking or smoking in the preceding 4 hours, as previously instructed [Pizzo et al., 2010]. Week 2 (T2) For the third session once again, an initial assessment of the plaque was carried out. The second toothbrush was provided and tested. A new plaque score was recorded following the same procedures as above. Data analysis For each completed plaque evaluation an entire mouth index was calculated using the following formula: index = total score / number of examined surfaces. For each patient, reductions in whole mouth plaque scores were obtained (pre- brushing minus post-brushing values) for the two tested toothbrushes. Analysis of variance (ANOVA) was used to: 1. Detect differences in baseline pre- brushing mean plaque levels between T1 and T2 appointments; 2. Compare plaque levels between male and female subjects at baseline and post-brushing, regardless the type of toothbrush; 3. Compare mean reductions in whole mouth plaque scores according to the type of toothbrush (manual versus sonic). The level of significance was set at p=0.05 for all statistical tests The study population was subjected to descriptive statistical analysis using a professional software (SPSS Statistics 19, IBM Corp.). The potential relationships between specific categorical socio- demographic variables and obtained plaque scores were analysed using the Mann-Whitney U test (dummy variables) and Kruskal-Wallis (multiple variables). Results All 40 enrolled patients completed the scheduled appointments and were included in the final data analysis; no subject dropped the study because of adverse effects related to treatment. Table 2 shows demographic characteristics, habits and collected financial information of the investigated population. Results are presented diagrammatically as box plots (Fig. 3, 4). The efficacy of brushing action, regardless the tested device (manual or sonic), was confirmed: in fact, mean full mouth plaque levels were lower at post- brushing than at baseline sessions (by approximately 62%; p<0.0001). Average baseline plaque scores ranged from 0.5 to 3.35 (mean: 1.82 ± 0.57); a statistically significant difference was found between male and female subjects (p=0.0011). At post brushing sessions the difference among gender was confirmed with average plaque scores from 0.1 to 2.23 (mean: 0.7 ± 0.46; p=0.0109). The calculated mean plaque index reductions for manual and sonic toothbrush were of 1.05 ± 0.22 and 1.19 ± 0.37, respectively. A statistically significant difference was found between the two devices (p=0.0342) (Fig. 4). The powered sonic toothbrush removed 10% more plaque than the manual one. The population showed an overall positive attitude towards regular dental check-ups (85% of patients reported to attend a clinical examination at least once per year, or even more frequently: 2 or more visits/year). The most common tool used for daily home dental cleaningwas the conventional manual toothbrush, while a restricted TABLE 2 Descriptive statistics for the studied population. Fig 2 Plaque’s scoring according to Quigley-Hein index, Turesky modification. Total Index = Total score/ Number surfaces examined. Demographic data (N=40) Gender (n) Male: 18 Female: 22 Age (mean) Male: 23.78 Female: 24.23 Age (range) < 20 yrs: 3 20-25 yrs: 27 >25 yrs: 10 Habits Mouthwash (n) Yes: 21 No: 19 Dental Floss (n) Yes: 18 No: 22 Current toothbrush (n) Manual: 37 Power Rotating: 3 Shopping (n) Store: 15 Dentist: 10 Pharmacy: 13 Internet: 2 Dental Checkup (range) <1/year: 6 1/year: 20 2/year or more: 14 In-office Hygiene (range) <1/year: 21 1/year: 15 2/year or more: 4 Financial WTP* for toothbrush ( € ) Manual (Mean ± SD): 4,83 ± 3,86 Sonic (Mean ± SD): 54,75 ± 36 WTP* for professional Male (Mean ± SD): 76,39 ± 30 Female (Mean ± SD): 78,64 ± 22 hygiene session ( € ) * Willingness To Pay Score 0 Score 1 Score 2 Score 3 Score 4 Score 5 No plaque Flecks Up to 1mm 1mm – 1/3 tooth 1/3 – 2/3 tooth > 2/3 tooth clinical