Impact of toothbrush head configuration and dentifrice abrasivity on non-carious cervical lesions in-vitro

Lina Alzahrani; Giovanna C Denucci; Frank Lippert; Laila Al Dehailan; Surya S Bhamidipalli; Anderson T Hara

doi:10.1016/j.jdent.2023.104798

Impact of toothbrush head configuration and dentifrice abrasivity on non-carious cervical lesions in-vitro

J Dent. 2024 Jan:140:104798. doi: 10.1016/j.jdent.2023.104798. Epub 2023 Dec 2.

Authors

Lina Alzahrani¹, Giovanna C Denucci², Frank Lippert², Laila Al Dehailan³, Surya S Bhamidipalli⁴, Anderson T Hara⁵

Affiliations

¹ Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Oral Health Research Institute, 415 Lansing Street, Indianapolis, IN 46202, USA; Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P. O. Box 1982, Dammam 31441, Saudi Arabia.
² Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Oral Health Research Institute, 415 Lansing Street, Indianapolis, IN 46202, USA.
³ Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P. O. Box 1982, Dammam 31441, Saudi Arabia.
⁴ Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, USA.
⁵ Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Oral Health Research Institute, 415 Lansing Street, Indianapolis, IN 46202, USA. Electronic address: ahara@iu.edu.

PMID: 38043721
DOI: 10.1016/j.jdent.2023.104798

Abstract

Objective: To investigate the effect of toothbrush head configuration and dentifrice slurry abrasivity on the development of simulated non-carious cervical lesions (NCCLs) in vitro.

Methods: Extracted premolars were randomly allocated into 15 groups (n = 16) generated by the association between toothbrush head configuration (flat-trimmed, rippled, cross-angled/multilevel/rubbers added, cross-angled/multilevel/flex head, feathered) and dentifrice slurry abrasivity (low/medium/high). Teeth were mounted on acrylic blocks and had their roots partially covered with acrylic resin, leaving 2-mm root surfaces exposed. Toothbrushing was performed for 35,000 and 65,000 double-strokes. Specimens were analyzed using non-contact profilometry for dental volume loss (mm³) and lesion morphology. Data was analyzed using ANOVA with pairwise comparisons and Kruskal-Wallis tests.

Results: The two-way interaction between toothbrush head configuration and slurry abrasivity was significant (p = 0.02). At 35,000 strokes, the flat-trimmed and cross-angled/multilevel/rubbers added toothbrushes caused the highest loss, when associated to the high-abrasive slurry (p<0.05); whereas cross-angled/multilevel/flex head showed the least loss, when associated to the low-abrasive (p<0.05). At 65,000, more dental loss was observed for all toothbrushes when associated to the high-abrasive slurry, with flat-trimmed causing the highest loss (p < 0.05). Lower dental loss rates were observed for cross-angled/multilevel/flex head associated to the low-abrasive slurry when compared to the other toothbrushes (p < 0.05), except to feathered (p = 0.14) and rippled (p = 0.08). Flat lesions (mean internal angle ± standard-deviation: 146.2°± 16.8) were mainly associated with low-abrasive slurry, while wedge-shaped lesions (85.8°± 18.8) were more frequent with medium- and high-abrasive slurries.

Conclusion: The development, progression and morphology of simulated NCCLs were modulated by both toothbrush head configuration and dentifrice abrasivity.

Clinical significance: Dental professionals should consider both the type of toothbrush and dentifrice abrasivity in the management plan of patients at risk of developing NCCLs.

Keywords: Abrasion; Dentifrice; Non-carious cervical lesion; Profilometry; Toothbrush.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bicuspid / pathology
Dentifrices* / adverse effects
Humans
Tooth Abrasion* / etiology
Tooth Abrasion* / pathology
Toothbrushing / adverse effects
Toothpastes

Substances

Dentifrices
Toothpastes