Comparative evaluation of plaque removal and soft tissue trauma after use of manual toothbrushes with different bristle stiffness

Aim: The aim of this study was to evaluate and compare the efficacy of manual toothbrushes of the same type with different bristle stiffness concerning plaque removal, gingivitis development and soft tissue trauma.
Methods: Three groups with forty subjects each used manual toothbrushes with either hard, medium or soft bristle stiffness. The brushing time was set for 2 minutes twice a day. Four and eight weeks after the baseline examination, clinical parameters for plaque removal : Quigley and Hein index (QHI), Modified approximal plaque index (MAPI); gingivitis: Papillary bleeding index (PBI) and soft tissue damage: Danser gingival abrasion index (DI) were recorded again.
Results: QHI and MAPI index scores showed statistically significant reduction in subjects who used hard bristled toothbrushes after 8 weeks(p<0.05 and p<0.001, respectively). In subjects who used hard bristled toothbrushes showed more gingival lesions (p<0.01) and higher PBI scores after 4 and 8 weeks (p<0.001) compared to subjects who used soft or medium bristled toothbrushes.
Conclusion: Manual toothbrushes with hard bristles may better remove plaque but they also result in more soft tissue trauma compared to toothbrushes with softer bristles.