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BLACK BRUSH : WHITE TEETH

A Comparative Study On The Efficacy Of Charcoal Infused Bristles

VsNylon Bristles : A Clinical Study

Department of Periodontics and ImplantologyJaipur Dental College

Jaipur, Rajasthan

Presented by :DrAnirudh S Chauhan

Guided by :

Dr Praveen KudvaDr Syeda T

TabasumDr Monika R

GoswamyDr Sumit SharmaDr Geetha Bhat

PREVENTIVE

STUDY

INTRODUCTION Efficient plaque removal is essential for the

prevention of gingival and periodontal diseases which forms the basis of any good daily oral hygiene routine.

The mechanical method is the most widely accepted method of plaque control.

The manual toothbrush is widely used and is often the sole means of plaque removal for majority.

Various factors such as preset angulations of the brush head, design of the brush, bristle length and material, brush diameter and patient skill determine the plaque control

The conventional bristles available in the market are nylon based.

Currently research is targeted on newer , synthetic materials in combination with traditionally used herbal or natural products.

This study was designed to assess the efficacy of nylon bristles with charcoal infused bristles.

Traditionally charcoal has been used for oral health care with numerous properties such as › Abrasive nature (improves plaque removal)› Sulfur absorbing property ( for treating halitosis)› Whitening effect ( natural bleaching property )

The aim of the study was to compare the efficacy of commercially available nylon bristles with charcoal infused bristles in

controlling plaque and gingivitis.

AIM

OBJECTIVES

INCLUSION CRITERIA

Full complement of teeth present, except third molars.

Age : 18-24 years

Ability to attend the hospital at recall

Good general and oral health

No periodontal therapy during the past 6 months

Moderate gingivitis

Poor manual dexterity

Current orthodontic therapy

Use of drugs that could affect the state of the gingival tissues

Muco-gingival problems

A habit of taking alcohol, smoking or chewing tobacco.

Use of any other supplemental plaque control measures, such as interdental aids or mouthwashes

EXCLUSION CRITERIA

Materials & Methods Dental students were screened for their oral

hygiene using the OHIS index by green and vermillion (1964)

40 dental students having good oral hygeine ranging between 0.8-1.2 were selected for the study.

Students were demonstrated and taught Rolls technique for brushing (1 minute) twice daily.

The samples were stratified and randomized to one of the two brushing groups using the coin toss method by a second examiner who was not involved in the recording of clinical parameters :

› Group A - soft nylon bristle.› Group B - soft charcoal

infused bristle

A commercially available fluoridated dentifrice was provided to the participants for use throughout the study.

The subjects were informed about the study, and their consent to take part in the study was obtained and carried out in accordance with ethical standards of the institutional committee.

Scaling and polishing was done and baseline score made zero.

INDICES USED: Loe and Silness Gingival

Index (1963).

Turesky and Gilmore modification of QuigleyHein plaque index.

The indices were scored at baseline, day 15 and day 30.

The collected data were analyzed and submitted for statistical evaluation using Student’s t-test

Gingival Index Plaque Index P value

Pre-Treatment 1.1 1.4

15 days 0.5 0.6 SIG

30 days 0.4 0.6 SIG

Gingival Index Plaque Index P value

Pre-Treatment 1.2 1.65

15 days 0.4 0.5 SIG

30 days 0.2 0.4 SIG

GROUP A

GROUP -B

Inter-comparison between the 2 groups showed it was statistically non significant in reduction of Gingival Index and Plaque Index at 30 day interval.

Discussion

Mechanical plaque control is the most important strategy to prevent periodontal diseases.

Tooth brushing plays a pivotal role in the defense against plaque and gingivitis.

In the present study gingival status was assessed using Loe & Silness gingival index ( 1963)

Previous studies assessing brushes {Brickmann et al, haesman et al, barnes et al and grossman et al }

There was a decline in the mean gingival index scores in Group A and Group B from baseline to day 30.

Group B gingival index scores showed a lower value compared to group A probably because of added properties of activated charcoal such as of anti inflammatory.

Turesky and Gilmore modification of Quigley-Hein plaque index was used to assess plaque.

This index was taken for scoring because all the teeth can be assessed for plaque and it provides more sensitive and accurate evaluation of brushing effectiveness compared to other indices BAY I, KARDEL KM ,SKOUGAARD MR ( 1967) SCOPP IW ET (1976)

There was a reduction of the mean plaque scores at day 30 in Group A & Group B When compared to baseline scores

This is in line with the studies done by CLAYDON

AND ADDY ( 1996), CLAYDON AND LEECH ( 2002) who concluded that all the subjects removed approximately 50-60% of the accumulated plaque with different bristles and differences observed were of little clinical significance.

The plaque and gingival scores in group B were marginally lower than group A .

A definite and gradual improvement in reduction of plaque and health of gingiva was observed in both the groups.

This could be attributed towards the abrasive property of activated charcoal infused in the bristles.

It has been well demonstrated that accumulation of microbial plaque results in development of inflammation and daily removal of plaque leads to resolution of gingival inflammation as quoted in studies given by CRITCHLEY ET AL ,1978

CONCLUSION

Charcoal infused bristles have showed decrease in values in

gingivitis & periodontitis patients though not statistically

significant.

Future considerations

In future a cross over design study protocol could be done with a larger sample size and longer duration.