ABSTRACT

Objective

To determine if an adjunct proteolytic pre-rinse along with contemporary methods of dental cleaning may more effectively remove visual plaque in subjects with fixed orthodontic appliances.

Materials and Methods

Forty-three orthodontic subjects, ages 10 to 25, completed this single site, double-blind, crossover clinical trial. Subjects randomly received bromelain enzyme or a powdered-sugar placebo pre-rinse, followed by manual tooth brushing and use of a Waterpik. Subjects received the alternate pre-rinse during the subsequent visit. Baseline and residual plaque accumulation were recorded via disclosing tablet and digital photography. A single, blinded examiner scored visual plaque scores from randomized photographs. Treatment effects on composite plaque score were evaluated using repeated-measures analysis of variance. A 5% significance level was used for all tests.

Results

No significant differences in plaque scores were noted at baseline or post-rinse between the enzyme and placebo. The changes from baseline to post-rinse (P = .190), post-brushing (P = .764), and post-Waterpik (P = .882) were not significantly different between interventions. Significant reduction in plaque scores were observed in both arms of the study after brushing (P < .01) and waterjet use (P < .01). Neither age (P = .220) nor gender (P = .449) impacted plaque scores.

Conclusions

Use of a bromelain enzyme pre-rinse alone did not significantly enhance plaque removal. A significant reduction in retained plaque was observed with the application of brushing and or Waterpik.

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Author notes

a

Resident, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, IN, USA.

b

Associate Professor and Department Chair, Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine (MBRU), Dubai, UAE.

c

Associate Research Professor, Director of Remineralization Research Program, Oral Health Research Institute, Indianapolis, IN, USA.

d

Director of Dental Hygiene & Clinical Assistant Professor, Indiana University School of Dentistry, Indianapolis, IN, USA.

e

Biostatistician, Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.

f

Associate Professor, Chair, & Program Director, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, IN, USA.