Clinical Significance
Better understanding how biological status can be altered to produce clinical and subclinical changes in persons with preexisting periodontal disease should lead to improved methods of managing
InquiryPower brushing
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Background
Power brushing is designed to remove as much plaque as possible, especially from areas that are relatively inaccessible. The brushing-induced turbulence produced during power brushing drives fluid dynamic forces into interproximal spaces, removing the biofilm from these areas. Power brushes offer anti-plaque and anti-gingivitis benefits and help in the management of gingivitis. Dental plaque biofilms are an important contributor to periodontal disease development, with bacteria in sub-gingival
BGI Categories
The BGI classifications are as follows: BGI-H, which is biofilm–gingival interface-healthy and represents a periodontally healthy group; BGI-G, which is BGI-gingivitis, representing naturally occurring gingivitis but without significant pocketing; P1, or mild periodontitis, which is treated and/or stable periodontitis; P2, or moderate periodontitis, which represents a common range of moderate to severe periodontitis; and P3, severe periodontitis, representing the most severe periodontal
Methods
The 175 healthy adults were divided into the five BGI groups, then underwent a prophylaxis treatment that did not include subgingival debridement. Subjects then received two acrylic stents to place over the right maxillary and mandibular posterior sextants and were told to abstain from brushing, flossing, or using interdental aids and mouthwash on these areas. The goal was to produce experimental biofilm overgrowth in the two sextants over a 3-week period. All subjects also received written and
Results
All groups showed significantly greater reductions in BOP, gingival index (GI), PD, and periodontal index (PI) with the power brush compared to the manual brush. The clinical signs of inflammation were reduced more effectively by the power brush than by the manual brush for shallow pockets and for patients with deep pockets. The BGI groups with deep PDs showed a significantly greater reduction in PI, GI, BOP, and PD compared to manual brushing, but no change in clinical attachment level (CAL).
Discussion
Power brushing for 4 weeks after creating a substantial subgingival biofilm was able to improve all clinical indices except CAL across a range of persons with periodontal disease. Significant changes were also noted in the levels of IL-1β, a marker of the body's inflammatory response.
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Aspiras MB, Barros SP, Moss KL, et al: Clinical and subclinical effects of power brushing following experimental induction of biofilm overgrowth in subjects representing a spectrum of periodontal disease. J Clin Periodontol 40:1118-1125, 2013
Reprints available from MB Aspiras, Philips Oral Healthcare – Dental & Scientific Affairs, 22100 Bothell Everett Hwy, MS 201, Bothell, Washington 98021; e-mail: [email protected]
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