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The use of medium bristle toothbrushes is associated with the incidence of gingival fissures

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Abstract

Objectives

The objective of this study was to compare the incidence of gingival fissures (GF) associated with the use of soft and medium bristle toothbrushes over three months.

Material and methods

A blind randomized crossover clinical trial was conducted with 20 high school students (14 females, 14–24 years old) using both toothbrushes type (soft and medium bristle) during 3 months each. Periodontal examinations and photographs of premolars and molars were recorded on days 0, 30, 60, and 90 of 1st phase. Following a 10-day washout period, the 2nd phase was carried out with the participants changing the assigned brush type. Toothbrushing perception was evaluated at the end of study through a questionnaire. A calibrated and blind examiner analyzed the photographs for GF presence. Differences in the GF incidence between toothbrushes type were analyzed by McNemar test, while factors associated with GF incidence were investigated by Poisson regression.

Results

Sixty-five percent (n = 13) of participants had at least one GF throughout the study, with 40% (n = 8) of them while using medium brushes only (p = 0.039). GF occurrence was significantly associated with medium brushes (IRR, 3.582; 95% CI 1.459–8.795; p = 0.005). 58.8% of participants reported gingival soreness or bleeding with medium brushes.

Conclusions

Both toothbrushes led to the GF occurrence. Nonetheless, medium bristles toothbrushes determined a 3.58 times greater risk of developing these lesions.

Clinical relevance

The use of medium bristle brush is associated with greater incidence of gingival fissures. The presence of gingival fissures should be considered by the clinician when evaluating the toothbrushing habits of patients.

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Funding

The authors financially supported the study.

Author information

Authors and Affiliations

  1. Graduate Program in Dentistry - Periodontics, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil

    Douglas Romitti & Adriane V. Fagundes

  2. Department of Conservative Dentistry, Periodontics, School of Dentistry, Federal University of Rio Grande Do Sul, Rua Ramiro Barcelos 2492/106. Bairro Santa Cecília, Porto Alegre, RS, 90003-035, Brazil

    Patrícia D. M. Angst, Sabrina C. Gomes & Rui V. Oppermann

  3. Graduate Program in Dentistry, School of Health Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Maximiliano S. Gomes

Authors
  1. Douglas Romitti
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  2. Adriane V. Fagundes
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  6. Rui V. Oppermann
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by D Romitti, AV Fagundes, and PDM Angst. Analysis, guidance, and supervision were performed by PDM Angst, MS Gomes, SC Gomes, and RV Oppermann. The first draft of the manuscript was written by D Romitti and RV Oppermann, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Rui V. Oppermann.

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Ethics approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. The Ethics Committee of the Federal University of Rio Grande do Sul approved the study protocol (#CAAE 80127117.9.0000.5347).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Romitti, D., Fagundes, A.V., Angst, P.D.M. et al. The use of medium bristle toothbrushes is associated with the incidence of gingival fissures. Clin Oral Invest 26, 1657–1666 (2022). https://doi.org/10.1007/s00784-021-04138-6

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  • DOI: https://doi.org/10.1007/s00784-021-04138-6

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