Investigation of the effects of Bipolar Radiofrequency Energy on the Structural Morphology of Dental Plaque

Abstract

Objectives To investigate the effects of radiofrequency (RF) energy, applied through a power toothbrush, on the structural morphology of dental plaque and its bacteria components. Previous studies showed that a toothbrush powered by RF (ToothWave) effectively reduces extrinsic tooth stains, plaque, and calculus. However, the mechanism by which it reduces dental plaque deposits is not fully established.

Materials and Methods Multispecies plaques at sampling time points of 24, 48, and 72 hours were treated with the application of RF using ToothWave with the toothbrush bristles 1 mm above the plaque surface. Groups that underwent the same protocol but without RF treatment served as paired controls. Confocal laser scanning microscope (CLSM) was used to determine cell viability at each time point. Plaque morphology and bacteria ultrastructure were viewed using scanning electron microscope (SEM) and transmission electron microscope (TEM), respectively.

Statistical Analysis Data were analyzed statistically using analysis of variance (ANOVA) and Bonferroni post-tests.

Results At each time, RF treatment significantly (p < 0.05) reduced the viable cells in plaque and caused a substantial disruption of plaque morphology, while the untreated plaque had intact morphology. Cells in treated plaques showed disrupted cell walls, cytoplasmic material, huge vacuoles, and heterogeneity in electron density, while these organelles remained intact in untreated plaques.

Conclusion The application of RF via a power toothbrush can disrupt plaque morphology and kill bacteria. These effects were enhanced by the combined application of RF and toothpaste.

Keywords

dental plaque - power toothbrush - radiofrequency - toothbrushing - ToothWave - bacterial viability

Data Available Statement

The dataset generated and analyzed during the current study are available upon request from Dr. Bennett T. Amaechi ([e-mail]).

Investigate the effects of bipolar radiofrequency (3 W, 3 MHz) applied via a power toothbrush on the structural morphology (chain formation) of periodontal disease-causing biofilm, ultrastructure (cell wall and cell components) of the bacteria, and the thickness of bacteria plaque biofilm.

Publikationsverlauf

Artikel online veröffentlicht:
12. Mai 2023

• References

• 1 Marsh PD. Dental plaque as a biofilm and a microbial community: implications for health and disease. BMC Oral Health 2006; 6 (Suppl 1, Suppl 1): S14
• 2 White DJ. Dental calculus: recent insights into occurrence, formation, prevention, removal and oral health effects of supragingival and subgingival deposits. Eur J Oral Sci 1997; 105 (5, Pt 2): 508-522
• 3 Mira A, Simon-Soro A, Curtis MA. Role of microbial communities in the pathogenesis of periodontal diseases and caries. J Clin Periodontol 2017; 44 (Suppl. 18) S23-S38
• 4 Coventry J, Griffiths G, Scully C, Tonetti M. ABC of oral health: periodontal disease. BMJ 2000; 321 (7252): 36-39
• 5 Digel I, Kern I, Geenen EM, Akimbekov N. Dental plaque removal by ultrasonic toothbrushes. Dent J 2020; 8 (01) 28
• 6 Penick C. Power toothbrushes: a critical review. Int J Dent Hyg 2004; 2 (01) 40-44
• 7 Loe H, Theilade E, Jensen SB. Experimental gingivitis in man. J Periodontol 1965; 36 (36) 177-187
• 8 Rosema NA, Hennequin-Hoenderdos NL, Berchier CE, Slot DE, Lyle DM, van der Weijden GA. The effect of different interdental cleaning devices on gingival bleeding. J Int Acad Periodontol 2011; 13 (01) 2-10
• 9 Yaacob M, Worthington HV, Deacon SA. et al. Powered versus manual toothbrushing for oral health. Cochrane Database Syst Rev 2014; 2014 (06) CD002281
• 10 Aspiras MB, Barros SP, Moss KL. et al. Clinical and subclinical effects of power brushing following experimental induction of biofilm overgrowth in subjects representing a spectrum of periodontal disease. J Clin Periodontol 2013; 40 (12) 1118-1125
• 11 Schmidt JC, Zaugg C, Weiger R, Walter C. Brushing without brushing?–a review of the efficacy of powered toothbrushes in noncontact biofilm removal. Clin Oral Investig 2013; 17 (03) 687-709
• 12 Gorur A, Lyle DM, Schaudinn C, Costerton JW. Biofilm removal with a dental water jet. Compend Contin Educ Dent 2009; 30 (Spec No 1): 1-6
• 13 Robinson PG, Deacon SA, Deery C. et al. Manual versus powered toothbrushing for oral health. Cochrane Database Syst Rev 2005; (02) CD002281
• 14 Amaechi BT, Levi L, Silman Z. et al. Clinical efficacy of a novel radiofrequency toothbrush for tooth stain reduction and tooth whitening: a randomized controlled trial. J Am Dent Assoc 2022; 153 (04) 342-353
• 15 Milleman KR, Levi L, Grahovac TL, Milleman JL. Safety and efficacy of a novel toothbrush utilizing RF energy for the reduction of plaque, calculus and gingivitis. Am J Dent 2020; 33 (03) 151-156
• 16 Papas AS, Martuscelli G, Singh ML. et al. A study to assess the safety and tolerability of three toothbrushes. J Clin Dent 2002; 13 (05) 203-206
• 17 Ng C, Tsoi JKH, Lo ECM, Matinlinna AJP. Safety and design aspects of powered toothbrush: a narrative review. Dent J 2020; 8 (01) 15
• 18 Van der Weijden FA, Campbell SL, Dörfer CE, González-Cabezas C, Slot DE. Safety of oscillating-rotating powered brushes compared to manual toothbrushes: a systematic review. J Periodontol 2011; 82 (01) 5-24
• 19 Gugerli P, Secci G, Mombelli A. Evaluation of the benefits of using a power toothbrush during the initial phase of periodontal therapy. J Periodontol 2007; 78 (04) 654-660
• 20 Dorfer CE, Joerss D, Wolff D. A prospective clinical study to evaluate the effect of manual and power toothbrushes on pre-existing gingival recessions. J Contemp Dent Pract 2009; 10 (04) 1-8
• 21 Deacon SA, Glenny AM, Deery C. et al. Different powered toothbrushes for plaque control and gingival health. Cochrane Database Syst Rev 2010; 2010 (12) CD004971
• 22 Shehadeh S, Levi L, Shamir D. Clinical evaluation of a novel radiofrequency-based toothbrush for teeth whitening and reduction of teeth stains: a pilot study. Clin Exp Dent Res 2021; 7 (06) 1096-1102
• 23 Milleman KR, Grahovac TL, Yoder AL, Levi L, Milleman JL. Safety and efficacy of a novel toothbrush utilizing RF energy for teeth shade whitening and the reduction of teeth stains. Adv Dent Oral Health 2020; 12 (03) 214-220
• 24 Deshmukh J, Vandana KL, Chandrashekar KT, Savitha B. Clinical evaluation of an ionic tooth brush on oral hygiene status, gingival status, and microbial parameter. Indian J Dent Res 2006; 17 (02) 74-77
• 25 Dalziel CF. Electric shock hazard. IEEE Spectr 1972; 9 (02) 41-50
• 26 Popovic Z, Popovic B. The skin effect. In: Introductory Electromagnetics. Upper Saddle River, NJ: Prentice-Hall; 1999: 385
• 27 Parfrey LW, Barbero E, Lasser E. et al. Evaluating support for the current classification of eukaryotic diversity. PLoS Genet 2006; 2 (12) e220
• 28 Dev SR, Birla SL, Raghavan GS, Subbiah J. Microbial decontamination of food by microwave (MW) and radio frequency (RF). In: Microbial Decontamination in the Food Industry. Cambridge: Woodhead Publishing; 2012: 274-299
• 29 Rifna EJ, Singh SK, Chakraborty S, Dwivedi M. Effect of thermal and non-thermal techniques for microbial safety in food powder: recent advances. Food Res Int 2019; 126: 108654
• 30 Rahmati E, Khoshtaghaza MH, Banakar A, Ebadi MT. Decontamination technologies for medicinal and aromatic plants: a review. Food Sci Nutr 2022; 10 (03) 784-799