The online version of this article (doi:10.1186/s12903-015-0079-6) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
Dr. Tawakoli conceived this research and was the main investigator in this study. Mrs. Sauer and Mr. Becker helped with the performance of the study and with methodological issues. Dr. Buchalla and Dr. Attin supervised the study and critically revised the manuscript. All authors read and approved the final manuscript.
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.
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.
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.
Cleaning of interproximal regions achieved better success with an oral irrigator as compared to the use of a sonic toothbrush. (350/ 350 words)
Additional file 1: Validation of the alamarBlue assay. (DOCX 194 kb)12903_2015_79_MOESM1_ESM.docx
Adams H, Winston MT, Heersink J, Buckingham-Meyer KA, Costerton JW, Stoodley P. Development of a laboratory model to assess the removal of biofilm from interproximal spaces by powered tooth brushing. Am J Dent. 2002;15 Spec No:12B–7B. PubMed
Hope CK, Wilson M. Comparison of the interproximal plaque removal efficacy of two powered toothbrushes using in vitro oral biofilms. Am J Dent. 2002;15 Spec No:7B–11B. PubMed
Brambilla E, Cagetti MG, Belluomo G, Fadini L, Garcia-Godoy F. Effects of sonic energy on monospecific biofilms of cariogenic microorganisms. Am J Dent. 2006;19:3–6. PubMed
Heersink J, Costerton WJ, Stoodley P. Influence of the Sonicare toothbrush on the structure and thickness of laboratory grown Streptococcus mutans biofilms. Am J Dent. 2003;16:79–83. PubMed
Stanford CM, Srikantha R, Kirchner HL, Wu CD. Removal of supragingival plaque in an intraoral model by use of the Sonicare toothbrush. J Int Acad Periodontol. 2000;2:115–9. PubMed
Frey S. Characterization of the inter-proximal flow generated by sonic toothbrushes measured experimentally by a shear-stress sensor. Institute of Fluid Dynamics ETH Zürich. 2012.
Gorur A, Lyle DM, Schaudinn C, Costerton JW. Biofilm removal with a dental water jet. Compend Contin Educ Dent. 2009;30 Spec No 1:1–6. PubMed
Barnes CM, Russell CM, Reinhardt RA, Payne JB, Lyle DM. Comparison of irrigation to floss as an adjunct to tooth brushing: effect on bleeding, gingivitis, and supragingival plaque. J Clin Dent. 2005;16:71–7. PubMed
- Interproximal biofilm removal by intervallic use of a sonic toothbrush compared to an oral irrigation system
Pune N Tawakoli
- BioMed Central
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