Periodontal evaluation of different toothbrushing techniques in patients with fixed orthodontic appliances

Plaque control is the major consensus during orthodontic treatment to prevent the occurrence of cavities and periodontal inflammation. The mechanic resource of greater effectiveness and frequent use in this control is the oral hygiene. The tooth brushing techniques most used in orthodontic patients are: Ramfjord's method, Modified Stillman technique and Bass method.

Since control studies evaluating the effectiveness of usual tooth brushing techniques do not show clear advantage, the objective of this study was to evaluate the effectiveness of three brushing methods, through periodontal clinical parameters of patients with fixed orthodontic appliances.

Thirty patients were selected, with ages between 14 and 22 years old, with fixed orthodontic appliances. After basic periodontal treatment the following factors were evaluated: 1--Plaque index and 2--Gingival index and each patient was randomly included in one of the three selected groups according to the brushing technique: Group 1--Scrubbing technique; Group 2--Modified Stillman technique and Group 3--Bass technique. Patients were evaluated for 9 months.

The results showed a significant reduction of clinical parameters by the end of this period, however there was a very significant reduction of Gingival index on group 3 (13.6%) when compared to the other groups.

Thus, it can be suggested that the Bass technique can be effective on the reduction of periodontal clinical parameters of Plaque index and Gingival index in patients with fixed orthodontic appliances.