Clinically controlled study of plaque reduction
and inflammation control of the gingiva
with the ultrasonic toothbrush emmi ® -dent
Executive Summary
Witten 2011
ORMED Institute for Oral Medicine at the University of Witten/Herdecke
Study director: Prof. Dr. Dr. hc P. Gängler
Dr. Tomas Lang
Investigator: Sigrun Charlotte Denda
on behalf of: EMAG AG, 64546 Mörfelden-Walldorf
Tooth decay and periodontal disease are the two main bacterial diseases of the oral cavity and are still extremely widespread. In addition to microbiological, immunological and genetic factors in the fight against infections, personal oral hygiene with toothbrushes and fluoride-containing dentifrices is the mainstay of prevention. However, long-term use of abrasive brushes and pastes carries the risk of mechanical damage to teeth and gums. The testing of alternative biophysical methods for the abrasion-free removal of bacterial plaque is therefore a high priority. The generation of ultrasound at a selected frequency is a plausible approach.
Therefore, in a clinically controlled cross-over study, the effectiveness of plaque control with the ultrasonic toothbrush Emmi ® -dental Professional (EMAG AG, Mörfelden-Walldorf) was compared on 16 subjects aged 20 to 34 years. The reduction of dental plaque on all surfaces of the teeth was documented intraorally photographically and evaluated planimetrically in a blinded manner using the modified Navy Plaque Index.
The health status of the gingiva was also clinically assessed on all surfaces of all teeth using the gingival index. The study was approved by the responsible ethics committee of the University of Witten/Herdecke and the subjects' consent was given.
The study period comprised 28 days for each toothbrush tested after a previous professional tooth cleaning, divided into a 4-day training phase with the assigned toothbrush, 3 days of oral hygiene abstinence to allow plaque accumulation (3-day plaque regrowth) and subsequent index surveys after 7 and 21 days. According to the manufacturer, the Emmi ® -dental toothbrush is activated exclusively by ultrasound. This study is therefore the first investigation of this biophysical principle. All previous investigations have so far concerned combined sonic/ultrasonic toothbrushes. The ultrasonic test toothbrush Emmi ® -dental Professional showed a significant reduction in dental plaque with the planimetry of the plaque index, which was the same in 16 subjects with a crossover protocol after 4 days of training and a further 3 days of oral hygiene abstinence.
The plaque reduction across all tooth surfaces after a single application was over 20% in each case, measured on unbrushed teeth. In the further course of the study, after 7 and 21 days, over 45% plaque freedom was achieved.
Plaque reduction was more pronounced on the front teeth than on the side teeth. The upper teeth, however, were cleaned just as well as the lower teeth.
The individual examination of plaque control at the gum line and in the interdental spaces showed a significant reduction in these areas of the teeth that are at risk for caries or gingivitis.
The parallel assessment of gum health using the Gingiva Index resulted in extremely low values over the entire study period, so that the vast majority of all sites examined on all teeth remained free of inflammation. Consequently, the toothbrush contributes to maintaining healthy gingiva.
Studies on ultrasonic toothbrushes included in meta-analyses have so far only considered combined sound/ultrasound models (Cochrane Review 2005, 2010). Therefore, the present clinically controlled test of the effectiveness of a purely ultrasound-activated toothbrush is the only one of its kind. It demonstrates clinically effective dental plaque control.
The particular advantage is that the brush can be guided over the individual groups of teeth in a completely abrasion-free manner, which means that brushing-related damage to the tooth structure can be ruled out with permanent use.
This represents a new biophysical dimension of effective tooth cleaning with the control of bacterial biofilm formation, which fundamentally avoids brushing movements with mechanical abrasion.
Clinical Conclusion
The tested, ultrasonic-activated toothbrush safely removes plaque. It guarantees the maintenance of healthy gums and completely prevents abrasive brushing movements. This eliminates the risk of abrasive damage to teeth and gums.
The original PDF can be found here You can find the scientific study here
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