The Effect of the Bass Intrasulcular Toothbrushing Technique on the Reduction of Gingival Inflammation: A Randomized Clinical Trial

• Published in: The journal of evidence-based dental practice 2019-06, Vol.19 (2), p.106-114
• Main Authors: Ausenda, Federico, Jeong, Natalie, Arsenault, Peter, Gyurko, Robert, Finkelman, Matthew, Dragan, Irina F., Levi, Paul A.
• Format: Article
• Language: English
• Subjects: Bass technique; Dental Plaque Index; Gingival inflammation; Humans; Inflammation; Periodontal Diseases; Single-Blind Method; Toothbrush wear; Toothbrushing; Toothbrushing technique
• ISSN: 1532-3382; 1532-3390
• DOI: 10.1016/j.jebdp.2019.01.004

The primary objective of this randomized controlled clinical trial was to investigate the effect of the Bass Intrasulcular Technique (BIT) on reducing gingival inflammation at 4 and 12 weeks compared with the toothbrushing techniques commonly used. After receiving ethical approval from the Tufts Health Sciences Institutional Review Board, 55 subjects were invited to participate in the study. Only the subjects who presented with bleeding on probing (BoP) were enrolled. The test group (BT) was instructed on how to use the BIT, and the control group (NI) received no brushing technique instructions. Clinical measurements (probing depth, plaque score, BoP) of each tooth were recorded at 4 and 12 weeks. The toothbrushes of all participants were photographed and assessed by two blinded examiners using the ImageJ software. The statistical significance between the cohorts' BoP and their plaque score results was assessed via hierarchical logistic regression. The analyses were performed using the SAS software (version 9.4; SAS Institute, Cary, NC). Forty-eight participants were eligible to participate and were randomly assigned to one of the two groups (N = 24). The BT group showed significantly smaller percentages of BoP than the NI group at 4 (BT = 12.4% and NI = 31.4%) and 12 (BT = 11.6% and NI = 43.8%) weeks. The difference in plaque scores at 12 weeks was statistically significant (P = .0003) between the two groups. At 12 weeks, the Mann-Whitney U Test indicated that the difference between the groups in terms of toothbrush area was statistically significant (P = .043). Within the limitations of this randomized controlled clinical trial, the BIT used by participants in the BT group was significantly more effective in reducing gingival inflammation as determined by BoP than the techniques used by participants who had no instructions on brushing techniques; at 12 weeks, the BT group experienced less toothbrush deformation than the control group. BIT should be recommended particularly to patients exhibiting BoP and periodontal diseases.