12 February 2020

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Peri-implant mucositis: which toothbrush is better to choose?

Alessandra Abbà

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Peri-implant mucositis is an inflammation of the mucosa around dental implant. Clinically, it is characterized by mucosal bleeding on peri-implant probing. It’s a reversible condition, in fact early intervention with effective removal of the microbial biofilm helps in preventing further progression to peri-implantitis with additional bone loss. Managing of mucositis is exclusively non-surgical and depends on good oral hygiene. Biofilm removal is typically performed by mechanical means using manual or powered toothbrush. Dental floss and interdental cleansing devices are recommended for daily plaque control too. Powered toothbrushes have advantages compared to other oral hygiene appliances as they provide patients with an easy plaque control technique, especially those with counter-rotational and oscillating-rotating brushes.

The aim of this randomized, prospective, controlled, parallel study, published on Journal of Periodontal & impact Science in 2015, was to evaluate the effectiveness of powered toothbrushes in comparison with the manual one for plaque control in patients with peri-implant mucositis.

Matherials and Methods
40 volunteers (age from 39 to 75 years) with bleeding on probing and no sign of peri-implantitis were selected for the study from the patients of Seoul National University Dental Hospital. They were dived into two groups, manual and powered toothbrush, and instructed to brush their teeth and implants three times a day for two minutes. Clinical parameters, including the modified plaque index (mPI) and the modified sulcus bleeding index (mSBI) were recorded at baseline and at one-month and two-month follow-up visits. Finally they completed a questionnaire describing their oral hygiene habits, including duration and frequency of toothbrush.  

Results
The daily frequency of brushing in the manual toothbrush group was significantly higher than in the powered toothbrush group; Similarly the duration of brushing in the powered toothbrush group was significantly longer than in the manual toothbrush group at one and two months of follow-up. On the contrary, no statistically significant differences were found relating to other oral hygiene habits. In the manual toothbrush group, the mean±SD mPI scores at the baseline, one month, and two months were 1.85±0.62, 1.18±0.98, and 1.09±0.95, respectively. In the powered toothbrush group, the corresponding mPI values were 1.70±0.65, 0.63±0.72, and 0.43±0.68, respectively. A significant difference in the mPI values of the manual and powered toothbrush groups was found at two months of follow-up.  

Conclusions
Powered toothbrush may help patients with peri-implant mucositis in plaque control.        

For additional informations: 
Efficacy of sonic-powered toothbrushes for plaque removal in patients with peri-implant mucositis