Comparative Evaluation of the Effectiveness of Different Orthodontic Toothbrushes in Maintaining Periodontal Health: A Randomized Clinical Trial
DOI:
https://doi.org/10.48165/ajm.2026.9.02.10Keywords:
Fixed orthodontic treatment, Electric toothbrush, Single-tuft toothbrushAbstract
Background: Fixed orthodontic appliances increase plaque retention by creating additional retentive areas around brackets and wires, thereby compromising oral hygiene and increasing the risk of gingival inflammation and periodontal disease. Appropriate toothbrush selection plays a pivotal role in maintaining periodontal health during orthodontic treatment. However, limited evidence exists regarding the comparative effectiveness of different orthodontic toothbrushes. Aim: To compare the effectiveness of manual orthodontic, electric, and single-tuft toothbrushes in maintaining periodontal health among patients undergoing fixed orthodontic treatment. Materials and Methods: This randomized clinical trial included 90 patients aged 15–30 years undergoing fixed orthodontic treatment. Participants were randomly allocated into three groups (n = 30 each): Group I used a manual orthodontic toothbrush, Group II used an electric toothbrush, and Group III used a single-tuft toothbrush as an adjunct to a manual orthodontic toothbrush. Standardized oral hygiene instructions were provided to all participants. Periodontal parameters, including Plaque Index (Silness and Löe), Gingival Index (Löe and Silness), Bleeding on Probing, and Probing Pocket Depth, were recorded at baseline, 1 month, and 3 months. Statistical analysis was performed using one-way ANOVA with Tukey's post hoc test for intergroup comparisons and repeated-measures ANOVA for intragroup comparisons. A p-value<0.05 was considered statistically significant. Results: All three groups demonstrated significant improvements in periodontal parameters over the study period. The electric toothbrush group showed significantly greater reductions in plaque accumulation, gingival inflammation, and bleeding on probing than the manual orthodontic and single-tuft toothbrush groups. The single-tuft toothbrush also demonstrated superior plaque control and gingival health compared with the manual orthodontic toothbrush. No significant intergroup differences were observed in probing pocket depth, although all groups showed slight improvements over time. Conclusion: All toothbrushes evaluated effectively improved periodontal health in patients undergoing fixed orthodontic treatment. However, electric toothbrushes demonstrated superior plaque removal and gingival health, while the adjunctive use of a single-tuft toothbrush also provided significant
clinical benefits. Incorporating advanced toothbrush designs into oral hygiene protocols may improve periodontal outcomes during orthodontic therapy.
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