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Interproximal biofilm removal by intervallic use of a sonic toothbrush compared to an oral irrigation system.

Tawakoli PN, Sauer B, Becker K, Buchalla W, Attin T - BMC Oral Health (2015)

Bottom Line: Highest reduction in metabolic activity was recorded significantly for the oral irrigator used for 10 s (residual activity per day d1: WF 17.9 %, WPa 58.8 %, WPi 82.5 %, CO 89.6 %; d2: WF 36.8 %, WPa 85.2 %, WPi 82.5 %, CO 90.0 %; d3: WF 17.2.%, WPa 79.6 %, WPi 96.3 %, CO 116.3 %).CFU data confirmed the graduations between the groups.Cleaning of interproximal regions achieved better success with an oral irrigator as compared to the use of a sonic toothbrush. (350/350 words).

View Article: PubMed Central - PubMed

Affiliation: Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Center of Dental Medicine, 8032, Zurich, Switzerland. nina.tawakoli@zzm.uzh.ch.

ABSTRACT

Background: The purpose of this in-vitro study was to investigate the potential of biofilm removal in interproximal tooth regions using intervallic cleaning with an oral irrigator or a sonic toothbrush.

Methods: Three-species biofilms (Streptococcus mutans (OMZ 918), Streptococcus oralis SK 248 (OMZ 60), Actinomyces naeslundii (OMZ 745)) were grown on hydroxyapatite discs for 3 days in culture media. Every 24 h, specimens were incubated for 15 min in resazurin solution (i.e., culture medium and 10 % v/v alamarBlue®) to measure the metabolic activity with a fluorescence spectrophotometer in relative fluorescence units (rfu) at baseline. Then, specimens were fixed in interproximal holding devices and underwent treatment with an oral irrigator (WF; Waterpik® Sensonic WP-100E), an active sonic toothbrush (WPa), or an inactive sonic toothbrush (WPi; Waterpik® Sensonic SR-3000E) for 10 s (n = 18/group). Untreated biofilms served as controls (CO). After treatment, bacterial activity was re-measured, and specimens were re-grown in fresh medium for 24 h until next cleaning procedure. Altogether, cleaning was repeated in intervals of three treatment days (d1, d2, d3). After d3, SEM images were taken (n = 8) and CFU was measured (n = 3). Metabolic activity was analyzed for each disc separately, rfu values were averaged for d1 to compare initial biofilm stability, and ratios of baseline and post-treatment values were compared. Results were analyzed using ANOVA with the post-hoc Scheffé test, or Kruskal-Wallis with post-hoc Mann-Whitney test.

Results: Median baseline rfu-values of d1 resulted in 7821.8 rfu (interquartile range = 5114.5). Highest reduction in metabolic activity was recorded significantly for the oral irrigator used for 10 s (residual activity per day d1: WF 17.9 %, WPa 58.8 %, WPi 82.5 %, CO 89.6 %; d2: WF 36.8 %, WPa 85.2 %, WPi 82.5 %, CO 90.0 %; d3: WF 17.2.%, WPa 79.6 %, WPi 96.3 %, CO 116.3 %). SEM images of untreated specimens (CO) and specimens treated with the sonic toothbrush (WPa and WPi) showed huge amounts of biofilm, while oral irrigator-treated specimens (WF) revealed barely any bacteria. CFU data confirmed the graduations between the groups.

Conclusions: Cleaning of interproximal regions achieved better success with an oral irrigator as compared to the use of a sonic toothbrush. (350/350 words).

No MeSH data available.


Related in: MedlinePlus

SEM images of all groups after the last treatment (d3). Specimens after treatment with the oral irrigator WF (a,b), the active sonic toothbrush WPa (c,d), the inactive sonic toothbrush WPi (e,f), the control group CO without treatment (g,h) and specimens without bacteria (i,j). Areas with shorn-off biofilm are shown in a) and b). Magnifications of 45x (a,c,g,e,I; scale bar = 100 μm) and 500x (b,d,f,h,j; scale bar = 10 μm) were used
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Fig3: SEM images of all groups after the last treatment (d3). Specimens after treatment with the oral irrigator WF (a,b), the active sonic toothbrush WPa (c,d), the inactive sonic toothbrush WPi (e,f), the control group CO without treatment (g,h) and specimens without bacteria (i,j). Areas with shorn-off biofilm are shown in a) and b). Magnifications of 45x (a,c,g,e,I; scale bar = 100 μm) and 500x (b,d,f,h,j; scale bar = 10 μm) were used

Mentions: Median baseline rfu-values of d1 (all groups) resulted in 7821.8 rfu (interquartile range = 5114.5). Baseline rfu-values of d2 (pre-treatment rfu) showed higher metabolic activity than d1, irrespective of the treatment group (mean ± SD, WF: 12045 ± 4414, WPa: 11832 ± 4331, WPi: 10600 ± 3362, CO: 10508 ± 3153). Baseline rfu-values of d3 revealed reduced metabolic activity compared to d1 and d2 (mean ± SD, WF: 5864 ± 3974, WPa: 6768 ± 3753, WPi: 6531 ± 4490, CO: 6878 ± 4093; Table 1). Post-treatment rfu-values were related to baseline rfu-values to calculate the residual metabolic activity in percentage. Significantly highest reduction in metabolic activity with regard to baseline was shown for the WF-group (oral irrigator) for 10 s for all treatment cycles (d1: 17.9 %, d2: 36.8 % and d3: 17.2 %). The WPa-group (active sonic toothbrush) showed significantly reduced metabolic activity on d1, whereas no significant reduction was measured on treatment cycle d2 and d3 (d1: 58.8 %, d2: 85.2 %, d3: 79.6 %). Specimens treated with the inactive sonic toothbrush (Wpi) and untreated specimens (CO) showed no significant reduction in biofilm activity at all (d1: WPi 82.5 %, CO 89.6 %; d2: WPi 82.5 %, CO 90.0 %; d3: WPi 96.3 %, CO 116.3 %; Fig. 2). Scanning electron microscopic images of the WF-group revealed almost biofilm-free surfaces with residual bacteria and partially shorn-off matrix on the outer areas (Fig. 3 a and b). Images of the WPa-, WPi- and CO-group showed huge amounts of biofilm with peaks of bacterial islands and aggregates (Fig. 3). Median CFU data resulted in 1.0 × 10^6 (WF), 2.2 × 10^9 (WPa), 1.1 × 10^11 (WPi) and 1.8 × 10^11 (CO). Two specimens of the CO-group were uncountable (>10^11; Fig. 4).Table 1


Interproximal biofilm removal by intervallic use of a sonic toothbrush compared to an oral irrigation system.

Tawakoli PN, Sauer B, Becker K, Buchalla W, Attin T - BMC Oral Health (2015)

SEM images of all groups after the last treatment (d3). Specimens after treatment with the oral irrigator WF (a,b), the active sonic toothbrush WPa (c,d), the inactive sonic toothbrush WPi (e,f), the control group CO without treatment (g,h) and specimens without bacteria (i,j). Areas with shorn-off biofilm are shown in a) and b). Magnifications of 45x (a,c,g,e,I; scale bar = 100 μm) and 500x (b,d,f,h,j; scale bar = 10 μm) were used
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Related In: Results  -  Collection

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Fig3: SEM images of all groups after the last treatment (d3). Specimens after treatment with the oral irrigator WF (a,b), the active sonic toothbrush WPa (c,d), the inactive sonic toothbrush WPi (e,f), the control group CO without treatment (g,h) and specimens without bacteria (i,j). Areas with shorn-off biofilm are shown in a) and b). Magnifications of 45x (a,c,g,e,I; scale bar = 100 μm) and 500x (b,d,f,h,j; scale bar = 10 μm) were used
Mentions: Median baseline rfu-values of d1 (all groups) resulted in 7821.8 rfu (interquartile range = 5114.5). Baseline rfu-values of d2 (pre-treatment rfu) showed higher metabolic activity than d1, irrespective of the treatment group (mean ± SD, WF: 12045 ± 4414, WPa: 11832 ± 4331, WPi: 10600 ± 3362, CO: 10508 ± 3153). Baseline rfu-values of d3 revealed reduced metabolic activity compared to d1 and d2 (mean ± SD, WF: 5864 ± 3974, WPa: 6768 ± 3753, WPi: 6531 ± 4490, CO: 6878 ± 4093; Table 1). Post-treatment rfu-values were related to baseline rfu-values to calculate the residual metabolic activity in percentage. Significantly highest reduction in metabolic activity with regard to baseline was shown for the WF-group (oral irrigator) for 10 s for all treatment cycles (d1: 17.9 %, d2: 36.8 % and d3: 17.2 %). The WPa-group (active sonic toothbrush) showed significantly reduced metabolic activity on d1, whereas no significant reduction was measured on treatment cycle d2 and d3 (d1: 58.8 %, d2: 85.2 %, d3: 79.6 %). Specimens treated with the inactive sonic toothbrush (Wpi) and untreated specimens (CO) showed no significant reduction in biofilm activity at all (d1: WPi 82.5 %, CO 89.6 %; d2: WPi 82.5 %, CO 90.0 %; d3: WPi 96.3 %, CO 116.3 %; Fig. 2). Scanning electron microscopic images of the WF-group revealed almost biofilm-free surfaces with residual bacteria and partially shorn-off matrix on the outer areas (Fig. 3 a and b). Images of the WPa-, WPi- and CO-group showed huge amounts of biofilm with peaks of bacterial islands and aggregates (Fig. 3). Median CFU data resulted in 1.0 × 10^6 (WF), 2.2 × 10^9 (WPa), 1.1 × 10^11 (WPi) and 1.8 × 10^11 (CO). Two specimens of the CO-group were uncountable (>10^11; Fig. 4).Table 1

Bottom Line: Highest reduction in metabolic activity was recorded significantly for the oral irrigator used for 10 s (residual activity per day d1: WF 17.9 %, WPa 58.8 %, WPi 82.5 %, CO 89.6 %; d2: WF 36.8 %, WPa 85.2 %, WPi 82.5 %, CO 90.0 %; d3: WF 17.2.%, WPa 79.6 %, WPi 96.3 %, CO 116.3 %).CFU data confirmed the graduations between the groups.Cleaning of interproximal regions achieved better success with an oral irrigator as compared to the use of a sonic toothbrush. (350/350 words).

View Article: PubMed Central - PubMed

Affiliation: Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Center of Dental Medicine, 8032, Zurich, Switzerland. nina.tawakoli@zzm.uzh.ch.

ABSTRACT

Background: The purpose of this in-vitro study was to investigate the potential of biofilm removal in interproximal tooth regions using intervallic cleaning with an oral irrigator or a sonic toothbrush.

Methods: Three-species biofilms (Streptococcus mutans (OMZ 918), Streptococcus oralis SK 248 (OMZ 60), Actinomyces naeslundii (OMZ 745)) were grown on hydroxyapatite discs for 3 days in culture media. Every 24 h, specimens were incubated for 15 min in resazurin solution (i.e., culture medium and 10 % v/v alamarBlue®) to measure the metabolic activity with a fluorescence spectrophotometer in relative fluorescence units (rfu) at baseline. Then, specimens were fixed in interproximal holding devices and underwent treatment with an oral irrigator (WF; Waterpik® Sensonic WP-100E), an active sonic toothbrush (WPa), or an inactive sonic toothbrush (WPi; Waterpik® Sensonic SR-3000E) for 10 s (n = 18/group). Untreated biofilms served as controls (CO). After treatment, bacterial activity was re-measured, and specimens were re-grown in fresh medium for 24 h until next cleaning procedure. Altogether, cleaning was repeated in intervals of three treatment days (d1, d2, d3). After d3, SEM images were taken (n = 8) and CFU was measured (n = 3). Metabolic activity was analyzed for each disc separately, rfu values were averaged for d1 to compare initial biofilm stability, and ratios of baseline and post-treatment values were compared. Results were analyzed using ANOVA with the post-hoc Scheffé test, or Kruskal-Wallis with post-hoc Mann-Whitney test.

Results: Median baseline rfu-values of d1 resulted in 7821.8 rfu (interquartile range = 5114.5). Highest reduction in metabolic activity was recorded significantly for the oral irrigator used for 10 s (residual activity per day d1: WF 17.9 %, WPa 58.8 %, WPi 82.5 %, CO 89.6 %; d2: WF 36.8 %, WPa 85.2 %, WPi 82.5 %, CO 90.0 %; d3: WF 17.2.%, WPa 79.6 %, WPi 96.3 %, CO 116.3 %). SEM images of untreated specimens (CO) and specimens treated with the sonic toothbrush (WPa and WPi) showed huge amounts of biofilm, while oral irrigator-treated specimens (WF) revealed barely any bacteria. CFU data confirmed the graduations between the groups.

Conclusions: Cleaning of interproximal regions achieved better success with an oral irrigator as compared to the use of a sonic toothbrush. (350/350 words).

No MeSH data available.


Related in: MedlinePlus