Comparison of Plaque Removal Efficacy of Different Toothbrushes in Clear Aligner Patients

January 26, 2026 updated by: Kübra Arslan Çarpar, Mersin University

Comparison of the Plaque Removal Efficacy of Manual and Powered Toothbrushes in Patients Undergoing Clear Aligner Therapy

This study aims to compare the effectiveness of manual and powered toothbrushes in removing dental plaque in patients undergoing clear aligner orthodontic treatment.

Clear aligner treatment uses attachments bonded to teeth to facilitate tooth movement. These attachments may increase plaque accumulation around the tooth surface. Poor plaque control can lead to dental caries and periodontal problems.

In this study, patients receiving clear aligner treatment will brush their teeth using either a manual or a powered toothbrush. Dental plaque levels around attachments will be evaluated before and after brushing using a modified plaque index.

The results of this study may help determine whether one type of toothbrush is more effective than the other in maintaining oral hygiene during clear aligner therapy.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Dental plaque is a complex biofilm and a primary etiological factor in the development of dental caries and periodontal diseases. Orthodontic treatments may increase plaque accumulation due to the presence of attachments bonded to the tooth surface.

Clear aligner therapy has become increasingly popular due to its esthetic and removable nature. However, attachments used during treatment may compromise oral hygiene by promoting plaque retention, particularly in the gingival region.

This study is designed to evaluate and compare the plaque removal effectiveness of manual and powered toothbrushes in patients undergoing clear aligner orthodontic treatment.

A total of 14 patients receiving clear aligner therapy will be randomly assigned to either a manual toothbrush group or a powered toothbrush group. Dental plaque accumulation around attachments will be assessed before brushing (T0) and after a standardized two-minute brushing period (T1) using the Modified Plaque Index adapted for orthodontic patients.

Plaque scores will be evaluated at multiple tooth surfaces (mesial, distal, occlusal, and gingival) and analyzed both on a patient-based and tooth-based level. Attachments will also be categorized as conventional or optimized, and plaque reduction will be compared between attachment types.

The findings of this study are expected to provide evidence regarding the effectiveness of different toothbrush types in maintaining oral hygiene in patients treated with clear aligners.

Study Type

Interventional

Enrollment (Actual)

14

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Mersin
      • Mersin, Mersin, Turkey (Türkiye), 33150
        • Mersin University, Faculty of Dentistry, Department of Orthodontics

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Age ≥ 18 years
  • Undergoing orthodontic treatment with clear aligners
  • Presence of bonded attachments on teeth
  • No known systemic diseases
  • Not using any regular systemic medications
  • Right-handed individuals (actively using the right hand)

Exclusion Criteria:

  • Age < 18 years
  • Absence of attachments on teeth
  • Presence of any systemic disease
  • Regular use of systemic medications
  • Left-handed or ambidextrous individuals

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Manual Toothbrush Group
Participants brushed their teeth for 2 minutes using a manual toothbrush following standardized oral hygiene instructions during a routine orthodontic visit.
Device: Manual Toothbrush
Use of a manual toothbrush for plaque removal in patients undergoing clear aligner therapy.
Other Names:
  • TePe Select™ Medium
Experimental: Powered Toothbrush Group
Participants brushed their teeth for 2 minutes using a powered toothbrush following standardized oral hygiene instructions during a routine orthodontic visit.
Device: Powered Toothbrush
Use of a powered toothbrush for plaque removal in patients undergoing clear aligner therapy.
Other Names:
  • Oral-B iO 9
  • Electric toothbrush

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Modified Plaque Index (MPI) Score After Toothbrushing
Time Frame: Immediately before and immediately after a single 2-minute toothbrushing session
The primary outcome is the change in dental plaque accumulation measured using the Modified Plaque Index (MPI). Plaque scores will be recorded immediately before toothbrushing (T0) and immediately after a standardized 2-minute toothbrushing session (T1). The difference between T0 and T1 MPI scores will be calculated to assess plaque removal effectiveness.
Immediately before and immediately after a single 2-minute toothbrushing session

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Mersin University

Investigators

  • Principal Investigator: Kübra Arslan Çarpar, DDS, PhD, Mersin University, Faculty of Dentistry, Department of Orthodontics

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 3, 2025

Primary Completion (Actual)

December 31, 2025

Study Completion (Actual)

December 31, 2025

Study Registration Dates

First Submitted

January 26, 2026

First Submitted That Met QC Criteria

January 26, 2026

First Posted (Actual)

February 3, 2026

Study Record Updates

Last Update Posted (Actual)

February 3, 2026

Last Update Submitted That Met QC Criteria

January 26, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2024/1110

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared due to the small sample size of the study and the potential risk of participant re-identification. Additionally, the informed consent obtained from participants did not include provisions for data sharing beyond the scope of the present study.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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