Final Report
Dane Robinson
Sky Vision Inc
Tempe, AZ
Laboratory Interproximal Access Efficacy of the
TiFinity and Sonicare Elite Toothbrushes
S. L. Yankell, X. Shi, C.M. Spirgel
Yankell Research Consultants Inc
Moorestown, NJ
April 18, 2007
TiFinityIAE041807
Abstract
Interproximal access efficacy (IAE), or the ability of toothbrush bristles to clean between teeth, has
been evaluated with a laboratory method which uses pressure sensitive paper covered with artificial
plaque wrapped around simulated anterior and posterior teeth. The toothbrushes are tested with both
horizontal and vertical brushing motions. In this study, two toothbrushes were evaluated: TiFinity and
Sonicare Elite (model e9650). Twenty-four tests on each toothbrush group were conducted and
results were statistically analyzed using ANOVA and a two-sample t-test. When data from individual
tests are combined to give an overall IAE value, the TiFinity toothbrush has a significantly (p < 0.001)
higher interproximal access mean than the Sonicare Elite product.
Introduction
Since 1983, the primary in-vitro method used in our laboratory assesses the ability of toothbrush
bristles to penetrate between simulated teeth and remove artificial plaque deposits, i.e. interproximal
access efficacy (IAE), during tooth brushing.1 IAE using both vertical and horizontal brushing motions
is evaluated on simulated anterior and posterior tooth shapes. These values are then combined to
determine overall efficacy of the toothbrush products evaluated. Efficacy in the IAE assay 1-3 has
been correlated with clinical plaque removal. 2,4-6
The purpose of this study was to evaluate two toothbrush products, the TiFinity and the Sonicare Elite
toothbrushes, for efficacy in the IAE procedure. The Sonicare Elite e9650 toothbrush is marketed with
both a standard and compact toothbrush head. The compact toothbrush head was selected for
testing since clinical plaque removal studies have shown superiority of the a Sonicare compact
toothbrush head as compared to a standard Sonicare head7 and the Oral-B Sonic Complete.8
Materials and Methods
Two toothbrush products, TiFinity and Sonicare elite (model e9650), were submitted for evaluation
by Sky Vision Inc, Tempe, AZ. Twenty-four tests were conducted on each toothbrush design. For
the Tifinity product, six different toothbrushes were tested four times; for the Sonicare Elite, four
different compact head brushes were tested using six different handles. The Sonicare Elite was
tested with power on the maximum setting. All toothbrushes were stored in our laboratory at a
temperature of 67-70 oF for more than 72 hours before testing.
The laboratory equipment used was fabricated to the design of Nygaard-Ostby, Edvardsen and
Spydevold 9. The tooth brushing technique involved independent evaluations of each toothbrush in
both a vertical and a horizontal brushing motion, tooth shapes simulating anterior and posterior teeth
and a brushing weight of 250g. The brushing apparatus was set to brush 15 seconds at two strokes
per second with a 50-mm stroke. The maximum width (Interproximal Access Efficacy, IAE) of the
artificial plaque removed after brushing was recorded in cm using vernier calipers on artificial
plaquecovered
pressure-sensitive paper placed around the simulated anterior or posterior teeth. The same
examiner performed all evaluations.
The analysis of variance (ANOVA) was performed on the mean scores comparing the toothbrush
products. Two-sample t-tests were conducted to ascertain the level of statistical significance in the
mean differences in IAE between the two toothbrushes.
Results
IAE results with vertical brushing are presented in Table I.
Table I
Interproximal Access Efficacy on Anterior or Posterior Shaped Teeth
With Vertical Brushing
Tooth Shape TiFinity Sonicare Elite
Mean (SD) cm
Anterior 1.20 (0.06) 1.04 (0.08)
Posterior 1.47 (0.06 ) 1.46 (0.05)
Combined 1.34 (0.14) 1.25 (0.22)
The mean IAE value on anterior tooth shapes, with vertical brushing, is significantly higher (p< 0.001)
for the TiFinity product than for the Sonicare elite toothbrush. The mean IAE on posterior tooth
shapes with vertical brushing is numerically higher for the TiFinity toothbrush than for the Sonicare
elite toothbrush; however, the mean difference is not stastically significant. The combined vertical
mean IAE for the TiFinity toothbrush is statistically higher (p < 0.05) than the Sonicare Elite.
IAE results with horizontal brushing are presented in Table II.
Table II
Interproximal Access Efficacy on Anterior or Posterior Shaped Teeth
With Horizontal Brushing
Tooth Shape TiFinity Sonicare Elite
Mean (SD) cm
Anterior 0.97 (0.08) 0.97 (0.09)
Posterior 1.33 (0.14) 0.84 (0.12)
Combined 1.15 (0.22) 0.91 (0.13)
On anterior tooth shapes, with horizontal brushing, there is no significant difference
between the TiFinity product IAE mean and the mean for the Sonicare Elite toothbrush.
On posterior tooth shapes with horizontal brushing, the mean IAE value is significantly higher
(p< 0.001) for the TiFinity toothbrush than for the Sonicare Elite toothbrush. The combined horizontal
mean IAE is statistically higher (p< 0.001) for the TiFinity product than the Sonicare Elite.
Overall means combining all brushing motions and teeth shapes tested are shown in Table III and in
Figure 1.
Table III
Overall Interproximal Access Efficacy
TiFinity Sonicare Elite increased TiFinity IAE
Mean (SD) cm %
1.24 (0.20) 1.08 (0.25) 15.7
Figure 1. Overall IAE Means
On the overall IAE means there was significant statistical difference (p < 0.001) between the TiFinity
product and the Sonicare elite toothbrush.
References
1. Yankell SL, Nygaard Ostby P: Evaluating cleaning efficiency of different toothbrush designs and
textures. J Soc Cosmet Chem 34:151-157, 1983.
2. Volpe AR, Emling RC, Yankell SL: The toothbrush - a new dimension in design, engineering and
clinical evaluation. J Clin Dent 3: C29-C33, 1992.
3. Yankell SL, Shi X, Emling RC, Blatz B, Biesbrock AR: Laboratory evaluations of two battery powered
toothbrushes and a manual toothbrush for efficacy and safety. J Clin Dent 13:187-190,
2002.
4. Yankell SL, Green PA, Greco PM, Stoller NH, Miller MF: Test procedures and scoring criteria to
evaluate toothbrush effectiveness. Clin Prev Dent 6: 3-8, 1984.
5. Haun J, Williams K, Friesen L, Ferrante A, Walters PA, Bartizek RD, Biesbrock AR: Plaque
removal efficacy of a new experimental battery-powered toothbrush relative to two advance design
manual toothbrushes. J Clin Dent 13:191-197, 2002.
6. Biesbrock AR, Walters PA, Bartizek RD: The relative effectiveness of six powered toothbrushes
for dental plaque removal. J Clin Dent 13:198-202, 2002.
7. Emling RC, DeLaurenti M, Ortbland K, Shi X, Yankell SL: Clinical evaluation of a new small-size
Sonicare toothbrush head. J Dent Res 77:122,1998.
8. Schaeken M, Oliemeulen M: Plaque removal between Sonicare elite e9000 series and Oral-B
Sonic Complete. Data on file, Philips Oral Healthcare, Inc., Snoqualmie WA, 2005.
9. Nygaard Ostby P, Edvardsen S, Spydevold B: Sonicare elite B: Access to interproximal tooth
surfaces by different bristle designs and stiffnesses of toothbrushes. Scand J Dent Res 7:
424-430, 1979
Dane Robinson
Sky Vision Inc
Tempe, AZ
Laboratory Interproximal Access Efficacy of the
TiFinity and Sonicare Elite Toothbrushes
S. L. Yankell, X. Shi, C.M. Spirgel
Yankell Research Consultants Inc
Moorestown, NJ
April 18, 2007
TiFinityIAE041807
Abstract
Interproximal access efficacy (IAE), or the ability of toothbrush bristles to clean between teeth, has
been evaluated with a laboratory method which uses pressure sensitive paper covered with artificial
plaque wrapped around simulated anterior and posterior teeth. The toothbrushes are tested with both
horizontal and vertical brushing motions. In this study, two toothbrushes were evaluated: TiFinity and
Sonicare Elite (model e9650). Twenty-four tests on each toothbrush group were conducted and
results were statistically analyzed using ANOVA and a two-sample t-test. When data from individual
tests are combined to give an overall IAE value, the TiFinity toothbrush has a significantly (p < 0.001)
higher interproximal access mean than the Sonicare Elite product.
Introduction
Since 1983, the primary in-vitro method used in our laboratory assesses the ability of toothbrush
bristles to penetrate between simulated teeth and remove artificial plaque deposits, i.e. interproximal
access efficacy (IAE), during tooth brushing.1 IAE using both vertical and horizontal brushing motions
is evaluated on simulated anterior and posterior tooth shapes. These values are then combined to
determine overall efficacy of the toothbrush products evaluated. Efficacy in the IAE assay 1-3 has
been correlated with clinical plaque removal. 2,4-6
The purpose of this study was to evaluate two toothbrush products, the TiFinity and the Sonicare Elite
toothbrushes, for efficacy in the IAE procedure. The Sonicare Elite e9650 toothbrush is marketed with
both a standard and compact toothbrush head. The compact toothbrush head was selected for
testing since clinical plaque removal studies have shown superiority of the a Sonicare compact
toothbrush head as compared to a standard Sonicare head7 and the Oral-B Sonic Complete.8
Materials and Methods
Two toothbrush products, TiFinity and Sonicare elite (model e9650), were submitted for evaluation
by Sky Vision Inc, Tempe, AZ. Twenty-four tests were conducted on each toothbrush design. For
the Tifinity product, six different toothbrushes were tested four times; for the Sonicare Elite, four
different compact head brushes were tested using six different handles. The Sonicare Elite was
tested with power on the maximum setting. All toothbrushes were stored in our laboratory at a
temperature of 67-70 oF for more than 72 hours before testing.
The laboratory equipment used was fabricated to the design of Nygaard-Ostby, Edvardsen and
Spydevold 9. The tooth brushing technique involved independent evaluations of each toothbrush in
both a vertical and a horizontal brushing motion, tooth shapes simulating anterior and posterior teeth
and a brushing weight of 250g. The brushing apparatus was set to brush 15 seconds at two strokes
per second with a 50-mm stroke. The maximum width (Interproximal Access Efficacy, IAE) of the
artificial plaque removed after brushing was recorded in cm using vernier calipers on artificial
plaquecovered
pressure-sensitive paper placed around the simulated anterior or posterior teeth. The same
examiner performed all evaluations.
The analysis of variance (ANOVA) was performed on the mean scores comparing the toothbrush
products. Two-sample t-tests were conducted to ascertain the level of statistical significance in the
mean differences in IAE between the two toothbrushes.
Results
IAE results with vertical brushing are presented in Table I.
Table I
Interproximal Access Efficacy on Anterior or Posterior Shaped Teeth
With Vertical Brushing
Tooth Shape TiFinity Sonicare Elite
Mean (SD) cm
Anterior 1.20 (0.06) 1.04 (0.08)
Posterior 1.47 (0.06 ) 1.46 (0.05)
Combined 1.34 (0.14) 1.25 (0.22)
The mean IAE value on anterior tooth shapes, with vertical brushing, is significantly higher (p< 0.001)
for the TiFinity product than for the Sonicare elite toothbrush. The mean IAE on posterior tooth
shapes with vertical brushing is numerically higher for the TiFinity toothbrush than for the Sonicare
elite toothbrush; however, the mean difference is not stastically significant. The combined vertical
mean IAE for the TiFinity toothbrush is statistically higher (p < 0.05) than the Sonicare Elite.
IAE results with horizontal brushing are presented in Table II.
Table II
Interproximal Access Efficacy on Anterior or Posterior Shaped Teeth
With Horizontal Brushing
Tooth Shape TiFinity Sonicare Elite
Mean (SD) cm
Anterior 0.97 (0.08) 0.97 (0.09)
Posterior 1.33 (0.14) 0.84 (0.12)
Combined 1.15 (0.22) 0.91 (0.13)
On anterior tooth shapes, with horizontal brushing, there is no significant difference
between the TiFinity product IAE mean and the mean for the Sonicare Elite toothbrush.
On posterior tooth shapes with horizontal brushing, the mean IAE value is significantly higher
(p< 0.001) for the TiFinity toothbrush than for the Sonicare Elite toothbrush. The combined horizontal
mean IAE is statistically higher (p< 0.001) for the TiFinity product than the Sonicare Elite.
Overall means combining all brushing motions and teeth shapes tested are shown in Table III and in
Figure 1.
Table III
Overall Interproximal Access Efficacy
TiFinity Sonicare Elite increased TiFinity IAE
Mean (SD) cm %
1.24 (0.20) 1.08 (0.25) 15.7
Figure 1. Overall IAE Means
On the overall IAE means there was significant statistical difference (p < 0.001) between the TiFinity
product and the Sonicare elite toothbrush.
References
1. Yankell SL, Nygaard Ostby P: Evaluating cleaning efficiency of different toothbrush designs and
textures. J Soc Cosmet Chem 34:151-157, 1983.
2. Volpe AR, Emling RC, Yankell SL: The toothbrush - a new dimension in design, engineering and
clinical evaluation. J Clin Dent 3: C29-C33, 1992.
3. Yankell SL, Shi X, Emling RC, Blatz B, Biesbrock AR: Laboratory evaluations of two battery powered
toothbrushes and a manual toothbrush for efficacy and safety. J Clin Dent 13:187-190,
2002.
4. Yankell SL, Green PA, Greco PM, Stoller NH, Miller MF: Test procedures and scoring criteria to
evaluate toothbrush effectiveness. Clin Prev Dent 6: 3-8, 1984.
5. Haun J, Williams K, Friesen L, Ferrante A, Walters PA, Bartizek RD, Biesbrock AR: Plaque
removal efficacy of a new experimental battery-powered toothbrush relative to two advance design
manual toothbrushes. J Clin Dent 13:191-197, 2002.
6. Biesbrock AR, Walters PA, Bartizek RD: The relative effectiveness of six powered toothbrushes
for dental plaque removal. J Clin Dent 13:198-202, 2002.
7. Emling RC, DeLaurenti M, Ortbland K, Shi X, Yankell SL: Clinical evaluation of a new small-size
Sonicare toothbrush head. J Dent Res 77:122,1998.
8. Schaeken M, Oliemeulen M: Plaque removal between Sonicare elite e9000 series and Oral-B
Sonic Complete. Data on file, Philips Oral Healthcare, Inc., Snoqualmie WA, 2005.
9. Nygaard Ostby P, Edvardsen S, Spydevold B: Sonicare elite B: Access to interproximal tooth
surfaces by different bristle designs and stiffnesses of toothbrushes. Scand J Dent Res 7:
424-430, 1979
TiFinity
Sonicare
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