EVAULATION OF EFFECTS OF DIFFERENT TOOTHBRUSH TYPES ON PERIODONTAL STATUS IN ORTHODONTIC PATIENTS

Atatürk Üniv Diş Hek Fak Derg (J Dent Fac Atatürk Uni) Cilt:31, Sayı:3, Yıl: 2021, Sayfa: 433-8 YAVUZ, BÜYÜK, Araştırma/ Research Article TÜRKER, ALTUN EVAULATION OF EFFECTS OF DIFFERENT TOOTHBRUSH TYPES ON PERIODONTAL STATUS IN ORTHODONTIC PATIENTS Makale Kodu/Article code: 3998 Makale Gönderilme tarihi: 28.02.2019 Kabul Tarihi: ORTODONTİ 10.06.2019 FARKLI DİŞ FIRÇASI TİPLERİNİN HASTALARINDA PERİODONTAL DURUMA ETKİLERİNİN KARŞILAŞTIRILMASI Dr. Öğr. Üyesi Mustafa Cihan YAVUZ* Doç. Dr. Süleyman Kutalmış BÜYÜK** Dr. Öğr. Üyesi Gökhan TÜRKER*** Uzm. Dr. Meltem ALTUN**** Makale Kodu/Article code: 4961 Makale Gönderilme tarihi: 04.04.2021 Kabul Tarihi: 14.07.2021 DOI : 10.17567/ataunidfd.977586 Mustafa Cihan Yavuz: ORCID ID: 0000-0002-2861-8828 Suleyman Kutalmış Büyük: ORCID ID: 0000-0002-7885-9582 Gökhan Türker: ORCID ID: 0000-0001-5295-2722 Meltem Altun: ORCID ID: 0000-0003-4262-747x ABSTRACT Aim: The aim of this study was to evaluate the plaque removal efficacy of soft bristles toothbrushes (SBTB) compared with medium bristles toothbrushes (MBTB) using clinical periodontal parameters in orthodontic patients with self-ligating brackets. Methods: A total of 32 orthodontic patients scheduled for fixed orthodontic treatment were selected for this prospective study. Patients were divided into randomly two groups brushing with tooth brusher type as follow SBTB and MBTB. The bonded bracket plaque index (PI), and pocket depth values (PDV) were evaluated 1 week after bracket placement (T1), 2 weeks after bracket placement (T2); and 3 weeks after bracket placement (T3). The Friedman and Mann Whitney U tests were used to analyze the data based on the Bonferroni test. Results: There was no statistically significant difference between the groups regarding PI and PDV values (p > 0.05). In the MBTB group, PDV values revealed statistically significant changes between T2 and T3 (p < 0.05). Moreover, pain scores showed no significant difference between the toothbrush groups (p = 0.540). Conclusion: There were no differences in the periodontal parameters between the soft bristles toothbrushes and oft medium bristles toothbrushes in orthodontic patients with self-ligating brackets. Key words: Self-ligating brackets, Oral hygiene, Periodontal status ÖZ Amaç: Bu çalışmanın amacı yumuşak kıl formasyonuna sahip (SBTB) diş fırçası ile orta sertlikte kıl formasyonuna sahip (MBTB) diş fırçası tiplerinin kapaklı braketler ile tedavi edilen ortodonti hastalarında klinik periodontal parametreleri kaydedilerek plak kaldırma etkilerinin değerlendirilmesidir. Gereç ve Yöntem: Bu prospektif çalışma için sabit ortodontik tedavi gören 32 ortodonti hastası seçilmiştir. Hastalar randomize olarak kullandıkları diş fırçası tipine göre SBTB ve MBTB olarak iki gruba ayrılmıştır. Plak indeksi (PI) ve sondalama cep derinliği (PPDV) braketler yerleştirildikten 1 hafta sonra (T1), 2 hafta sonra (T2) ve 3 hafta sonra (T3) olmak üzere değerlendirilmiştir. Friedman ve Mann Whitney U testleri ile Bonferroni düzeltmesi kullanılarak veriler analiz edilmiştir. Bulgular: PI ve PPDV yönünden değerlendirildiğinde istatistiksel olarak anlamlı bir farklılık gözlenmemiştir (P> 0.05). MBTB grubunda, PDV değerleri T2 ve T3 tedavi zamanları arasında istatistiksel olarak anlamlı değişiklik göstermiştir (P <0.05). Ayrıca, ağrı skorları gruplar arasında bir hafta sonunda anlamlı farklılık göstermemiştir (P = 0.540). Sonuç: Yumuşak kıl formasyonuna sahip diş fırçası ile orta sertlikte kıl formasyonuna sahip diş fırçası tiplerinin kapaklı braket kullanılan ortodonti hastalarında periodontal parametreler açısından bir farklılığa sebep olmamıştır. * Department of Periodontology, Faculty of Dentistry, Istanbul Medeniyet University, İstanbul. Department of Orthodontics, Faculty of Dentistry, Ordu University, Ordu. *** Department of Orthodontics, Faculty of Dentistry, Mersin University, Mersin. **** Private Practice, İstanbul, Turkey. ** Kaynakça Bilgisi: Yavuz MC, Büyük SK, Türker G, Altun M. Farklı diş fırçası tiplerinin ortodonti hastalarında periodontal duruma etkilerinin karşılaştırılması. Atatürk Üniv Diş Hek Fak Derg 2021; 31: 433-8. Citation Information: Yavuz MC, Buyuk SK, Turker G, Altun M. Evaulation of effects of different toothbrush types on periodontal status in orthodontic patients. J Dent Fac Atatürk Uni 2021; 31: 433-8. INTRODUCTION Fixed orthodontic treatment can cause worsening of oral hygiene because a fixed orthodontic appliance increases the number of retentive sites for plaque accumulation on the tooth surface, particularly between the gingival margin and bracket.¹,² Along with increasing retention areas, brushing becomes difficult. This difficulty in brushing facilitates an increased risk of demineralization, caries, and periodontal diseases at the fixed appliance sites.³ 433 YAVUZ, BÜYÜK, TÜRKER, ALTUN After the application of fixed orthodontic appliances, an increase in pocket probe depth and bleeding on probing occurs.⁴ Tooth brushing efficacy can be clinically evaluated by gingival index, bleeding index, and plaque index.⁵ Chang et al.⁶ reported that there is a statistically significant increase in pH, plaque index scores, and the levels of Streptococcus mutans and lactobacilli after 3 months of active orthodontic treatment. Good oral hygiene is characterized by good periodontal and dental health during orthodontic treatment.⁷ If acceptable oral hygiene cannot be achieved, orthodontic treatment becomes complicated and develops side effects.⁸ Dental plaque causes most periodontal diseases and dental caries. Therefore, plaque control, including correct tooth brushing, must be provided to prevent periodontal problems during orthodontic treatment.⁹ There are many types of toothbrushes based on the size, length, hardness, and arrangement of bristles. There is a lack of evidence in the literature as to which toothbrush design is superior in terms of its efficacy in plaque removal.10 Actually, toothbrushes with soft bristles are appropriate for removing plaque efficiently.11 Toothbrush manufacturers aim to develop design features for better removal efficacy. There are different opinions in the literature concerning the effectiveness of manual and electric toothbrushes in terms of removing plaque.12,13 In a systematic review, Robinson et al.¹² discovered that an electric toothbrush with a rotation–oscillation action reduced plaque more than a manual tooth brush. On the other hand, Vibhute et al. reported no differences between electric and manual toothbrushes.¹³ To overcome the side effects of conventional brackets, self-ligating brackets (SLBs) were manufactured and gained popularity in recent years. SLBs are less complex than conventional brackets, reduce chair time, and have biomechanical advantages.¹⁴,¹⁵ SLBs have fewer retentive sites for plaque accumulation and do not require wire and elastomeric ligatures.¹⁵ Pellegrini et al.¹⁶ showed that SLBs are less likely to accumulate dental plaque compare (...truncated)