The Science Behind Sonicare

Transcription

1 The Science Behind Sonicare

2 Notes from Dr. Joerg Strate Vice President, Philips Oral Healthcare, Clinical & Scientific Affairs Philips Sonicare has redefined personal oral hygiene once again When we decide to launch a new edition of the clinical proof brochure, the document in your hands, you know we must have a significant reason to do so. Launching two new products and introducing breakthrough technology that s likely to change our perspective on interdental cleaning are indeed significant accomplishments. The clinical and scientific research portfolio summarized in this document provides objective and relevant information about our products, and insights into the way we work. Our clinical credibility and commitment to providing patients and dental professionals with the most advanced solutions for home oral healthcare have resulted in global recognition and professional recommendation of Philips Sonicare products. True innovation at Philips Sonicare follows a simple paradigm that integrates the latest scientific knowledge with an in-depth understanding of today s oral healthcare needs. Adhering to these principles frequently results in solutions and technologies that are ahead of their time, and subsequently lead the industry. The original Sonicare technology was exactly that type of industry-leading innovation it defined a new standard for power toothbrushes. Recently, Sonicare For Kids established a unique solution for the specific oral healthcare needs of children. Now the new Sonicare DiamondClean takes our ambition to the next level with the best clinical performance of any Sonicare to date, thanks to its unique brush head and ergonomic handle design. The requirements for our latest innovation, the entirely new Philips Sonicare AirFloss, could not be matched by existing concepts we had to invent them. The result is a unique device that impresses equally with its convenience of use and its clinical efficacy, which could not exist without the unprecedented AirFloss microburst technology invented by Philips engineers. When you read the following pages, I hope you will agree with me that Sonicare DiamondClean and AirFloss represent a significant next step toward even better, more intuitive solutions for daily oral hygiene exactly what Philips Sonicare is all about.

3 Sonicare AirFloss In vitro evaluation of interproximal biofilm removal with Philips Sonicare AirFloss de Jager M, Hix J, Aspiras M, Schmitt P. Data on file, 2010 To evaluate, in vitro, the additional removal of interproximal plaque biofilm of Philips Sonicare AirFloss when used in combination with Philips Sonicare FlexCare. This study evaluated interproximal biofilm removal of Sonicare FlexCare with or without subsequent use of Sonicare AirFloss. An in vitro tooth model was used to assess the efficacy in removing dental plaque biofilm from the interproximal spaces of molar teeth. The dental plaque model was a multispecies oral biofilm grown on hydroxyapatite discs. In a typodont, the discs with biofilm were located on interproximal sites of molar teeth at a distance of 2-4 mm from the tip of the bristles or the nozzle. The typodont was exposed to the dynamic fluid activity generated by the high-frequency bristle movement from the activated Sonicare FlexCare (15 seconds) and by the high-velocity droplet air spray from Sonicare AirFloss (single shot). An inactivated Sonicare FlexCare was used as a control. Plaque removal efficacy was determined by enumeration of the percentage of viable bacteria removed from the discs as a result of these exposures. Results Sonicare AirFloss in conjunction with Sonicare FlexCare removed 66% (p<0.0001) more interproximal biofilm than the active Sonicare FlexCare alone. Sonicare FlexCare active removed significantly more biofilm than Sonicare FlexCare inactive (p<0.0001). Sonicare AirFloss removed 66% more interproximal plaque biofilm than Sonicare FlexCare alone. Comparison of In Vitro Interproximal Plaque Removal % of Plaque Biofilm Removed % Sonicare FlexCare active plus Sonicare AirFloss Sonicare FlexCare active 1

4 In vitro evaluation of interproximal biofilm removal with power toothbrushes Aspiras M, Elliott N, Nelson R, Hix J, Johnson M, de Jager M. In vitro evaluation of interproximal biofilm removal with power toothbrushes. Compend Contin Educ Dent. 2007; 28 (suppl 1):10-14) Results To compare the removal of interproximal biofilm beyond the reach of the bristles of the Sonicare FlexCare and a rotating-oscillating power toothbrush, using an in vitro model. The ability of the Sonicare FlexCare and Oral-B Triumph to remove biofilm without direct bristle contact was evaluated using a dental plaque model of a multispecies oral biofilm grown on hydroxyapatite discs. In a typodont model, the discs with plaque biofilm were located on interproximal sites of molar teeth at a distance of 2-4 mm from the bristles, and exposed to the fluid dynamic activity generated by the activated brushes. An inactivated Sonicare FlexCare was used as a control. Plaque removal efficacy was determined by enumeration of the percentage of viable bacteria removed from the discs as a result of brushing. The active Sonicare FlexCare toothbrush removed a significantly higher percentage of biofilm bacteria when compared to both the inactive state (p<0.0001) and the active Oral-B Triumph toothbrush (p=0.0001). Moreover, with 73% plaque biofilm removal, the Sonicare FlexCare removed three times the amount of plaque biofilm when compared to the Oral-B Triumph, with 23% removal. Sonicare FlexCare removed significantly more biofilm 2-4 mm beyond the reach of the bristles than the Oral-B Triumph. Removal of biofilm bacteria from HA discs in an interproximal site model % Sonicare FlexCare mean % biofilm removed % Oral-B Triumph Sonicare FlexCare Oral-B Triumph (p=0.0001) 2

5 Interproximal plaque biofilm removal of Sonicare FlexCare, National Doltz and GC Prinia Slim sonic toothbrushes Hix J, Aspiras M, Wei J, de Jager M. Interproximal Biofilm Removal Sonicare, Doltz and Prinia Sonic Toothbrushes. J Dent Res 87 (spec Iss B): 2044, 2008 Results To compare the ability of three sonic toothbrushes in removing interproximal plaque biofilm beyond the reach of the bristles in vitro. Using an in vitro typodont model containing saliva-based multispecies oral biofilms grown on hydroxyapatite discs, two studies were executed, comparing Sonicare FlexCare (with ProResults brush head) against either National Doltz EW1045 (with brush head EW0901) and GC Prinia Slim (handle MI-0002, brush head MI-1013). Discs with biofilms were located on interproximal sites of molar teeth at a distance of 2-4 mm from the bristles, and exposed to the fluid dynamic activity generated by the activated brushes. As control, an inactivated FlexCare "off" was used. Plaque removal efficacy was determined by enumeration of the percentage of viable bacteria removed from the interproximal discs as a result of brushing treatment. The activated Sonicare FlexCare toothbrush removed significantly more interproximal biofilm compared to either Doltz (73.1% vs 37.3%, p=0.0001), Prinia (73.1% vs 18.3%, p<0.0001) or the inactivated FlexCare "off" (p<0.0001). Of the three sonic toothbrushes tested in vitro, the Sonicare FlexCare removed significantly more dental plaque biofilm up to 4 mm beyond the bristles than the National Doltz EW1045 and the GC Prinia Slim. 3

6 Removal of plaque biofilm bacteria from HA discs in an interproximal site model Mean % of Plaque Biofilm Removed % 37.3% Sonicare FlexCare National Doltz 2 Treatment Removal of plaque biofilm bacteria from HA discs in an interproximal site model Mean % of Plaque Biofilm Removed % 18.3% Sonicare FlexCare GC Prinia Slim Treatment 4

7 Effect of the Sonicare FlexCare power toothbrush on fluoride delivery through Streptococcus mutans biofilms Stoodley P, Nguyen D, Longwell M, Nistico L, von Ohle Ch, Milanovich N, de Jager M. Effect of the Sonicare FlexCare power toothbrush on fluoride delivery through Streptococcus mutans biofilms. Compend Contin Educ Dent. 2007;28 (suppl 1):15-22) Results Evaluate the ability of two power toothbrushes, the Sonicare FlexCare and the Oral-B Triumph, to enhance the diffusion of fluoride through a biofilm by fluid dynamic action in vitro. Fluoride diffusion was established by an experimental system that measured the rate of fluoride diffusion through a membrane colonized with a Streptococcus mutans biofilm. In a fluid-filled container, the biofilm colonized membrane was contained in a water tight partition that separated the brushing chamber from the measurement chamber. Brushes were positioned perpendicular to the biofilm at 10 mm distance, then fluoride (1100 ppm NaF) was added to the brushing chamber and the brush activated to enhance fluoride penetration to the measurement chamber through fluid dynamic activity. Penetration of fluoride through the biofilm and membrane was measured with a fluoride electrode over a four minute period, and expressed as the mass transfer coefficient. The mass transfer coefficient (a measure of the rate of delivery of fluoride through the biofilm-colonized membrane)of fluoride generated by powered brushing was significantly greater (p<0.05) than that from passive diffusion alone (no brushing): Sonicare FlexCare increased diffusion by 129% over no brushing. Sonicare FlexCare resulted in a significantly greater (p<0.05) mass transfer coefficient than the Oral-B Triumph by 29%. This study demonstrated that the fluid dynamic action of Sonicare FlexCare enhances the penetration of fluoride through biofilm which may, in turn, help increase the bioavailability of fluoride in residual dental plaque. 5

8 .9.8 Fluoride concentration (mg/l) Time (s) Sonicare FlexCare Oral-B Triumph No brush Mass transfer coefficient (cm/s) 5x10-5 4x10-5 3x10-5 2x10-5 Sonicare FlexCare Oral-B Triumph No brush 1x10-5 Sonicare FlexCare Oral-B Triumph No brush 6

9 In vitro tooth-cleaning efficacy of electric toothbrushes around brackets Schätzle M, Sener B, Schmidlin P, Imfeld T, Attin T. In vitro tooth-cleaning efficacy of electric toothbrushes around brackets. Eur J Orthod, Advance Access published on June 15, 2010; doi: /ejo/cjp166 Test Devices To evaluate the cleaning efficacy of twelve different brush heads of two electric toothbrush actions (side-to-side and oscillating/rotating) around upper incisor brackets mounted on a custom model in a laboratory setting. Oscillating / rotating toothbrushes Oral-B Professional Care 9500 MicroPulse EB 25 Precision Clean Ortho Care Dual Clean Side-to-side (sonic) toothbrushes Oral-B Sonic Complete Sonic CrissCross Sonic Sensitive Philips Sonicare Standard ProResults brush head Compact ProResults brush head WaterPik SenSonic Advanced Brush 2SRB-2WI Small Brush SRSB-2 WaterPik SenSonic SR 800E Standard Brush SRBL-2I Small Brush SR1B-2I Results Standard and Mini Diamond TM brackets were fixed on black-stained model teeth. The model teeth were then coated with white titanium oxide to simulate plaque accumulation and were brushed by a fixed, automated mechanism under constant conditions of load and equivalent duration of exposure. Twelve different brush heads with either side-to-side or oscillating-rotating action were tested. After brushing, the teeth were scanned, the images digitized and the surfaces re-appearing black were assessed utilizing custom software capable to detect gray-scale intensity. The quantification of the reduction of simulated plaque is expressed as a percentage of the total tooth area. ANOVA test was used for individual comparison of the brush types. Bonferroni/Dunn adjustment was applied for multiple testing. The Sonicare power toothbrush with compact ProResults brush head and standard ProResults brush head were statistically significantly better than other brush heads in the test at removing simulated plaque, with 81.7% and 80.8% observed reduction overall, respectively. 7

10 In this in vitro experiment, the Sonicare power toothbrush with the compact ProResults brush head and the standard ProResults brush head provided superior cleaning efficacy of teeth with fixed orthodontic attachments. % of Cleaned Area Percentage of Touched (Cleaned) Tooth Surfaces for the Respective Toothbrushes Horizontal bars: Medians; Boxes: Inter-quartile areas; Error bars: 10th and 90th percentile; Dots: Extreme values Brush Heads: Oral-B MicroPulse EB 25 Oral-B Precision Clean Oral-B Ortho Care Oral-B Dual Clean Oral-B Sonic CrissCross Oral-B Sonic Sensitive Sonicare Standard ProResults Sonicare Compact ProResults WaterPik Advanced Brush 2SRB-2W1 WaterPik Small Brush SRSB-2 WaterPik Standard Brush SRBL-2I WaterPik Small Brush SRIB-2I 8

11 Sonicare Elite Comparison of interproximal plaque removal efficacy of two power toothbrushes using in vitro oral biofilms Hope CK,Wilson M. Am J Dent 2002;15:7B-11B Results To compare, in vitro, the interproximal plaque removal beyond the bristles of two power toothbrushes. A dental plaque model in which a multispecies biofilm was grown on hydroxyapatite discs was used to evaluate the ability of Sonicare Elite and Oral-B 3D to remove biofilm without bristle contact. The dental plaque model was located interproximally at a distance of approximately 2 mm from the bristles and exposed to the fluid dynamic activity generated by the brushes with the motors either activated or inactivated for 5 seconds. In the activated state, both brushes removed a significantly higher percentage of plaque biofilm compared to the inactive brushes.the percentage of plaque bacteria removed by Sonicare Elite (32.2%) beyond the bristles was significantly greater than that removed by Oral-B 3D (9.5%), (p<0.05). Sonicare Elite removed significantly more dental plaque biofilm 2 3 mm beyond the reach of the bristles than Oral-B 3D. % Plaque Bacteria Removal % 9.5% Sonicare Elite Oral-B 3D Sonicare Elite Oral-B 3D (p<0.05) 9