Dental Plaque, Orthodontic Patients
Conditions
Keywords
Toothbursh, Miswak, Siwak, Dental plaque, Orthodontic Patients, Braces
Brief summary
This study compares the immediate plaque removal efficacy of the natural Miswak versus a traditional manual toothbrush using the Modified Bass technique among orthodontic patients. The main question it aims to answer is: Are there statistically significant differences in the post-brushing plaque index reduction between the dental arch side cleaned with Miswak and the contralateral side cleaned with a manual toothbrush?
Detailed description
The maintaining of excellent oral hygiene is a significant challenge for patients undergoing orthodontic treatment due to the presence of fixed brackets and archwires, which act as retentive areas for dental biofilm accumulation. While the conventional manual toothbrush is widely prescribed, the natural Miswak (Salvadora persica) serves as a popular traditional oral hygiene tool with documented mechanical and antimicrobial properties. However, there is a lack of split-mouth clinical trials directly evaluating and comparing their immediate mechanical efficacy in the presence of orthodontic appliances. This study utilizes a split-mouth experimental design to minimize inter-individual variability, where each participant serves as their own control. The mouth of each patient is randomized to use the natural Miswak on one side and the conventional manual toothbrush on the contralateral side during a single clinical session with no subsequent follow-up. Aim: To evaluate and compare the immediate efficacy of the natural Miswak versus a manual toothbrush (using the Modified Bass technique) in reducing dental plaque scores among a sample of patients with fixed orthodontic appliances at Al-Hawash Private University.
Interventions
DEVICENatural Miswak (Al-Kureysh, Pakistan)
* Preparation: 1-2 cm of outer bark removed, soaked in water for 10-15 mins, and fibers frayed. * Technique: Vertical strokes (gum to tooth), horizontal on occlusal, focusing around brackets. * Duration: 3 to 5 minutes.
DEVICEManual Toothbrush (Colgate Zig Zag, China)
* Technique: Modified Bass Technique (bristles at 45-degree angle to gingival margin, short vibratory movements) modified to brush above and below orthodontic brackets. * Duration: 3 to 5 minutes.
Sponsors
Al-Hawash Private University
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Split-Mouth Design (Each participant receives both interventions simultaneously on opposite sides of the jaw)
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients aged between 18 and 30 years old. * Presence of fixed orthodontic appliances (brackets and wires) on both upper and lower arches. * Good general systemic health with the absence of any medical conditions that might affect oral health status.
Exclusion criteria
* Presence of advanced or aggressive periodontal diseases. * Current smokers. * Use of antimicrobial or antibacterial mouthwashes within 24 hours prior to the study session. * Systemic antibiotic intake within the past 2 weeks preceding the experiment. * Any physical or motor disability that could hinder the patient's capacity to perform proper tooth brushing.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Modified Quigley-Hein Plaque Index (mQH) Score | Baseline (immediately before brushing) and Post-intervention (immediately after brushing within the same single clinical session). | Mesial, distal, and mid surfaces of facial and lingual aspects were scored. Scoring was as follows: 0 = no plaque/debris 1. = separate flecks of plaque at the cervical margin of the tooth. 2. = a thin continuous band of plaque (up to 1 mm) at the cervical margin of the tooth. 3. = a band of plaque wider than 1 mm but covering less than one third of the crown of the tooth. 4. = plaque covering at least one third but less than two thirds of the crown of the tooth. 5. = plaque covering two thirds or more of the crown of the tooth. * Scores from all evaluated surfaces are summed together and then divided by the total number of sites evaluated to provide an average score for each mouth side per patient. * Plaque is disclosed using a basic fuchsin solution (VISUPLAC, Maquira, Brazil) applied via micro-applicators. |
Countries
Syria
Contacts
STUDY_CHAIRAli Abu Sulaiman
Al-Hawash Private University
PRINCIPAL_INVESTIGATORFida Kaseeh, Ph.D. in Oral Medicine
Al-Hawash Private University
Outcome results
None listed