The impact of toothbrush filament design on gingival health during healing. A randomized, controlled, investigator-blinded clinical trial

Abstract

Objectives. The primary objective of the study was to test toothbrushes with different types of filaments (conical vs. rounded) with respect to cause gingival abrasion after surgical intervention of wisdom teeth. A secondary objective was to evaluate the efficacy of plaque removal and the improvement of gingival conditions to alleviate wound healing and to avoid gingivitis. Methods. One hundred and seventy-three healthy subjects with surgical intervention of wisdom teeth participated in a randomized, single blind study and were randomly allocated to control group (standard ADA reference toothbrush) or test group (meridol® special toothbrush with conical filaments). Clinical examinations included gingival abrasion, plaque index and gingival index, and were conducted at baseline, 7 and 28 days. Results. For the gingival abrasion the mean number of lesions of all sizes was after 28 days significantly lower in the test group (p-value <0.001) compared to control group. Plaque index was not significantly different between the two groups in the last visit. At day 28 the gingival index was significantly lower in the test group (p=0.031) compared to control group. Conclusions. The toothbrush with conical filaments induced significantly less gingival abrasions than the standard ADA toothbrush and showed superior results in improving gingival health (gingival index). Both toothbrushes were comparable effective with respect to plaque removal. Clinical Relevance. Scientific rationale for study: Supra and sub-gingival biofilm leads to gingival inflammation. Post- surgical removal of the biofilm from gingival surfaces promotes healing after wisdom tooth extraction. Tooth brushing leads to gingival abrasion. Earlier investigations with toothbrushes having conical filaments suggest less gingival tissue damage. Principal findings: The results showed that the toothbrush with conical filaments caused significantly less gingival abrasions than the toothbrush with rounded filaments. Practical implications: : Toothbrush filament design should be considered when choosing toothbrush for oral hygiene after oral surgery.