Assessment of the effectiveness of a rotatable shank toothbrush compared to a conventional handle toothbrush: A multicenter, single-blind, randomized controlled trial.

Abstract

Background: The persistence of dental plaque is attributable to the inaccessibility to all surfaces of the oral cavity. Thus, an integrated team designed an innovative toothbrush comprising a brush head assembly with an upper end and a lower end, and a handle rotatably configured with the lower end of the brush head assembly. The brush head is connected to the handle through a socket-ball joint, which allows the shank and the handle to rotate at any angle between 0° and 360° with respect to one another around an axis. Additionally, the brush head bends toward the handle, maintaining a bending angle of 15°.

Objectives: The aim of the present randomized controlled trial (RCT) was to analyze and assess the effectiveness of a toothbrush with a rotatable shank in comparison to toothbrushes with flexible and straight handles with respect to supragingival plaque and gingival health outcomes. The secondary objective of the study was to evaluate the feedback of individuals who used the rotatable shank toothbrush.

Material and methods: Three toothbrushes - one with a rotatable shank, one with a flexible handle and one with a straight handle - were compared in terms of efficacy in plaque and gingivitis control at 3 clinical centers (a multicenter trial). A total of 270 patients, aged 18-65 years, were included in the study. The collected data was analyzed and compared using the analysis of variance (ANOVA) with Tukey's post hoc test.

Results: All groups demonstrated improvement in gingival health and a reduction in the plaque index (PI) scores. Nonetheless, the improvement was more pronounced in the group that used the toothbrush with a rotatable shank.

Conclusions: The enhanced plaque removal and improved gingival health at all surfaces achieved with the rotatable shank toothbrush are ascribable to the incorporation of 2 features: the ability to rotate the toothbrush neck along its axis; and an inclination that facilitates access to all surfaces.