A clinical comparison of an oscillating/rotating powered toothbrush and a manual toothbrush in patients with chronic periodontitis

Primary objective: To compare the relative efficacy of an oscillating/rotating powered toothbrush to that of a conventional manual toothbrush in a group of periodontal patients over a 16-month period with respect to plaque control. Secondary objective: To compare differences in pocket depth (PD) and bleeding index (BI) between the two groups over a 16-month period. Material and Methods: Forty patients were recruited to a 16-month, single-blind, two-group, randomised, parallel group clinical trial to compare the effects of manual and oscillating/rotating powered toothbrushes in a cohort of patients with chronic periodontitis. None of the patients had previous experience of using an oscillating/rotating brush and had a mean plaque index (PI) of >2.0 (modified Quigley and Hein index) at baseline. Patients were stratified by gender, age and smoking status then randomised to using a manual or an oscillating/rotating brush for the duration of the study. Conventional non-surgical periodontal therapy was undertaken within the first month after baseline. PI was the primary outcome measure with PDs and BI also recorded at baseline and months 3, 6, 10 and 16. Results: Mean full-mouth (FM) scores at baseline for oscillating/rotating brushing and manual brushing groups were as foolows: PI, 3.4 and 3.5; BI, 1.7 and 1.5; and PD, 3.4 and 3.3. The mean reduction in FM scores from baseline to 16 months were: PI, 0.72 and 0.75; PD, 0.43 and 0.57; and BI, 0.74 and 0.83, respectively. Repeated measures <smallcapitals>anova</smallcapitals> were used to compare differences between groups (adjusted for baseline levels) at months 3, 6, 10 and 16 and showed no statistically significant difference between groups for PI and PD (p>0.05). A difference of 0.2 BI units was detected in favour of the manual brushing group (p=0.04). Conclusion: Over a 16-month period, there were no differences in PI reduction or PD reduction between patients who underwent non-surgical management of chronic periodontal disease and used either an oscillating/rotating powered toothbrush or a conventional manual toothbrush. A difference in gingival bleeding reduction was detected in favour of the patients allocated the manual brush.