Effectiveness of a motionless ultrasonic toothbrush in reducing plaque and gingival inflammation in patients with fixed orthodontic appliances

Angle Orthod. 2017 Mar;87(2):279-285. doi: 10.2319/042516-334.1. Epub 2016 Sep 19.


Objective: To compare the effectiveness of a motionless ultrasonic toothbrush to a manual toothbrush in reducing dental plaque, gingival inflammation, and mutans streptococci in patients with fixed orthodontic appliances.

Materials and methods: Twenty-five orthodontic patients were recruited to this crossover study. The patients were randomized into two groups starting with manual or motionless ultrasonic toothbrushes for 30 days. After a 30-day washout period, the patients switched to the other toothbrush type for 30 days. Plaque and gingival indices were evaluated by two calibrated-blinded examiners before and after each 30-day period of brushing. Salivary samples were also collected for quantification of mutans streptococci.

Results: On the bracket side, the motionless ultrasonic toothbrush showed a significantly higher mean plaque index bracket score after 30-day usage than baseline (P = .049), while the manual toothbrush group showed no difference between the before and after brushing periods (P = .10). The changes in plaque index bracket score were significantly more favorable in the manual toothbrush group than in the ultrasonic toothbrush group (P = .04). In contrast, no difference was observed on the nonbracket side. There was no significant difference in the changes of gingival index or the numbers of mutans streptococci between the two groups.

Conclusion: Manual toothbrushing performed better than brushing with the motionless ultrasonic toothbrush in plaque removal on the bracket side in orthodontic patients. However, no difference was observed in terms of gingival status and the numbers of mutans streptococci.

Keywords: Dental plaque removal; Fixed orthodontic appliances; Gingival inflammation; Motionless ultrasonic toothbrush; Mutans streptococci; Powered toothbrush.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Biofilms
  • Cross-Over Studies
  • Dental Plaque / microbiology
  • Dental Plaque / prevention & control*
  • Dental Plaque Index
  • Equipment Design
  • Female
  • Gingivitis / microbiology
  • Gingivitis / prevention & control*
  • Humans
  • Male
  • Orthodontic Appliances*
  • Periodontal Index
  • Saliva / microbiology
  • Single-Blind Method
  • Streptococcus mutans
  • Toothbrushing / instrumentation*
  • Treatment Outcome
  • Ultrasonics*