{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:10:45Z","timestamp":1769062245259,"version":"3.49.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T00:00:00Z","timestamp":1688083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T00:00:00Z","timestamp":1688083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100015068","name":"Universidade de Santiago de Compostela","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100015068","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Oral Invest"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To assess the efficacy of a new toothbrush (Balene) for the mechanical removal of dental plaque in patients with acquired brain injury.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material and methods<\/jats:title>\n                <jats:p>The study group consisted of 25 adults with acquired brain injury. The participants underwent 2 sessions of toothbrushing lasting 1\u00a0min, one with a conventional toothbrush and the other with the Balene toothbrush. This new double-headed toothbrush has 6 active sides, which allows for the simultaneous toothbrushing of both alveolar arches, with elastomer bristles angled at 45\u00b0, as well a handle that rotates up to 180\u00b0. Therefore, the user does not need to remove the toothbrush from the oral cavity during the toothbrushing process. Dental plaque accumulation was assessed using the simplified oral hygiene index of Greene and Vermillion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The plaque index was significantly reduced both with the Balene toothbrush (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and with the conventional toothbrush (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The dental plaque removal efficacy was similar with the two toothbrushes. There were also no statistically significant differences in the removal of plaque with the Balene toothbrush between the autonomous and assisted toothbrushing modalities (<jats:italic>p<\/jats:italic>\u2009=\u20090.345).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>For patients with acquired brain injury, the Balene toothbrush was as effective as a conventional toothbrush, regardless of whether the toothbrushing modality was autonomous or assisted.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical relevance<\/jats:title>\n                <jats:p>The Balene\u00ae toothbrush\u2019s efficacy in removing dental plaque is similar to that of conventional toothbrushes, both with the autonomous and assisted toothbrushing modality. Given its particular ergonomics, this toothbrush could be indicated for certain select patients with acquired brain injury (i.e., those whose degree of cooperation allows for toothbrushing, with a sufficient mouth opening, with no substantial abnormalities in the intermaxillary relationship, and with no significant edentulous sections).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00784-023-05106-y","type":"journal-article","created":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T11:01:49Z","timestamp":1688122909000},"page":"4855-4860","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Plaque removal efficacy of a new toothbrush with a double-sided head and rotating handle\u2014a pilot randomized control trial in acquired brain injury patients"],"prefix":"10.1007","volume":"27","author":[{"given":"Eliane Garc\u00eda","family":"Mato","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc\u00eda Sande","family":"L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcio Diniz","family":"Freitas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Teresa Abeleira","family":"Pazos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacobo Limeres","family":"Posse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro Diz","family":"Dios","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berta Rivas","family":"Mundi\u00f1a","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,6,30]]},"reference":[{"key":"5106_CR1","first-page":"357","volume":"54","author":"F Castellanos-Pinedo","year":"2012","unstructured":"Castellanos-Pinedo F, Cid-Gala M, Duque P, Ramirez-Moreno JM, Zurdo-Hern\u00e1ndez JM, GrupoTrabajo de del Plan de Atenci\u00f3n al Da\u00f1o Cerebral Sobrevenido de Extremadura (2012) Da\u00f1o cerebral sobrevenido: propuesta de definicion, criterios diagnosticos y clasificacion [Acquired brain injury: a proposal for its definition, diagnostic criteria and classification]. Rev Neurol 54:357\u2013366 (Spanish)","journal-title":"Rev Neurol"},{"key":"5106_CR2","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.3109\/02699052.2016.1167244","volume":"30","author":"M Kothari","year":"2016","unstructured":"Kothari M, Spin-Neto R, Nielsen JF (2016) Comprehensive oral-health assessment of individuals with acquired brain-injury in neuro-rehabilitation setting. Brain Inj 30:1103\u20131108. https:\/\/doi.org\/10.3109\/02699052.2016.1167244","journal-title":"Brain Inj"},{"key":"5106_CR3","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1080\/02699052.2021.1891289","volume":"35","author":"SF Kothari","year":"2021","unstructured":"Kothari SF, Nascimento GG, De Caxias FP, Jakobsen MB, Nielsen JF, Kothari M (2021) Changes in oral health related quality of life and its associated factors in individuals with brain injury. Brain Inj 35:718\u2013724. https:\/\/doi.org\/10.1080\/02699052.2021.1891289","journal-title":"Brain Inj"},{"key":"5106_CR4","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.oooo.2016.10.024","volume":"123","author":"M Kothari","year":"2017","unstructured":"Kothari M, Pillai RS, Kothari SF, Spin-Neto R, Kumar A, Nielsen JF (2017) Oral health status in patients with acquired brain injury: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 123:205-219.e7. https:\/\/doi.org\/10.1016\/j.oooo.2016.10.024","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"5106_CR5","doi-asserted-by":"publisher","first-page":"714167","DOI":"10.3389\/fneur.2021.714167","volume":"12","author":"SF Kothari","year":"2021","unstructured":"Kothari SF, Nascimento GG, Jakobsen MB, Nielsen JF, Kothari M (2021) Effectiveness of standard oral care plan during hospital stay in individuals with brain injury. Front Neurol 12:714167. https:\/\/doi.org\/10.3389\/fneur.2021.714167","journal-title":"Front Neurol"},{"key":"5106_CR6","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1186\/s12903-022-02446-1","volume":"22","author":"S Huang","year":"2022","unstructured":"Huang S, Liu Y, Li M, Liu Z, Zhao F, Li J, Lu H, Zhou H (2022) Oral health knowledge, attitudes, and practices and oral health-related quality of life among stroke inpatients: a cross-sectional study. BMC Oral Health 22:410. https:\/\/doi.org\/10.1186\/s12903-022-02446-1","journal-title":"BMC Oral Health"},{"key":"5106_CR7","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.jdent.2014.06.005","volume":"43","author":"R Dai","year":"2015","unstructured":"Dai R, Lam OL, Lo EC, Li LS, Wen Y, McGrath C (2015) Asystematic review and meta-analysis of clinical, microbiological, and behavioural aspects of oral health among patients with stroke. J Dent 43:171\u2013180. https:\/\/doi.org\/10.1016\/j.jdent.2014.06.005","journal-title":"J Dent"},{"key":"5106_CR8","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.3390\/jcm11051415","volume":"11","author":"LS SchmalzG","year":"2022","unstructured":"SchmalzG LS, Ziebolz D (2022) Oral health-related quality of life in patients after stroke-a systematic review. J Clin Med 11:1415. https:\/\/doi.org\/10.3390\/jcm11051415","journal-title":"J Clin Med"},{"key":"5106_CR9","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1080\/17483107.2020.1822450","volume":"17","author":"N Gurgel-Juarez","year":"2022","unstructured":"Gurgel-Juarez N, Egan M, Wiseman M, Finestone H, Flowers HL (2022) Technology for maintaining oral care after stroke: considerations for patient-centered practice. Disabil Rehabil Assist Technol 17:916\u2013926. https:\/\/doi.org\/10.1080\/17483107.2020.1822450","journal-title":"Disabil Rehabil Assist Technol"},{"key":"5106_CR10","doi-asserted-by":"publisher","first-page":"S77","DOI":"10.1111\/jcpe.12359","volume":"42","author":"FA Van der Weijden","year":"2015","unstructured":"Van der Weijden FA, Slot DE (2015) Efficacy of homecare regimens for mechanical plaque removal in managing gingivitis a meta review. J Clin Periodontol 42:S77\u2013S91. https:\/\/doi.org\/10.1111\/jcpe.12359","journal-title":"J Clin Periodontol"},{"key":"5106_CR11","doi-asserted-by":"publisher","first-page":"CD003864","DOI":"10.1002\/14651858.CD003864.pub3","volume":"12","author":"P Campbell","year":"2020","unstructured":"Campbell P, Bain B, Furlanetto DL, Brady MC (2020) Interventions for improving oral health in people after stroke. Cochrane Database Syst Rev 12:CD003864. https:\/\/doi.org\/10.1002\/14651858.CD003864.pub3","journal-title":"Cochrane Database Syst Rev"},{"key":"5106_CR12","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1111\/idh.12283","volume":"16","author":"SM Kalf-Scholte","year":"2018","unstructured":"Kalf-Scholte SM, Van der Weijden GA, Bakker E, Slot DE (2018) Plaque removal with triple-headed vs single-headed manual toothbrushes-a systematic review. Int J Dent Hyg 16:13\u201323. https:\/\/doi.org\/10.1111\/idh.12283","journal-title":"Int J Dent Hyg"},{"key":"5106_CR13","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/1741-7015-8-18","volume":"8","author":"KF Schulz","year":"2010","unstructured":"Schulz KF, Altman DG, Moher D, CONSORT Group (2010) CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Medicine 8:18. https:\/\/doi.org\/10.1186\/1741-7015-8-18","journal-title":"BMC Medicine"},{"key":"5106_CR14","doi-asserted-by":"publisher","unstructured":"Greene JC,Vermillion JR (1964) The simplified oral hygiene index. J Am Dent Assoc 68:7\u201313. https:\/\/doi.org\/10.14219\/jada.archive.1964.0034","DOI":"10.14219\/jada.archive.1964.0034"},{"key":"5106_CR15","first-page":"106","volume":"7","author":"SL Yankell","year":"1996","unstructured":"Yankell SL, EmlingRC PB (1996) A six-month clinical evaluation of the Dentrust toothbrush. J Clin Dent 7:106\u2013109","journal-title":"J Clin Dent"},{"key":"5106_CR16","first-page":"115","volume":"38","author":"E Sauvetre","year":"1995","unstructured":"Sauvetre E, Rozow A, de Meel H, Richebe A, Abi-Khalil M, Demeure F (1995) Comparison of the clinical effectiveness of a single and a triple-headed toothbrushes in a population of mentally retarded patients. Bull Group Int Rech Sci Stomatol Odontol 38:115\u2013119","journal-title":"Bull Group Int Rech Sci Stomatol Odontol"},{"key":"5106_CR17","first-page":"362","volume":"117","author":"I Miolin","year":"2007","unstructured":"Miolin I, Kulik EM, Weber C, Meyer J (2007) Clinical effectiveness of two different toothbrushes in the elderly. Schweiz Monatsschr Zahnmed 117:362\u2013367","journal-title":"Schweiz Monatsschr Zahnmed"},{"key":"5106_CR18","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.3390\/antibiotics11101296","volume":"11","author":"I Z\u00fa\u00f1iga","year":"2022","unstructured":"Z\u00fa\u00f1iga I, Iniesta M, Virto L, Ribeiro-Vidal H, Alonso-Espa\u00f1ol A, Hern\u00e1ndez F, Cardona JJ, Maher-Lavandero A, Alonso B, Sanz M, Herrera D (2022) Dental biofilm removal and bacterial contamination of a new doubled-side thermoplastic polyurethane-based toothbrush: a crossover study in healthy volunteers. Antibiotics (Basel) 11:1296. https:\/\/doi.org\/10.3390\/antibiotics11101296","journal-title":"Antibiotics (Basel)"},{"key":"5106_CR19","first-page":"100","volume":"115","author":"N Scheidegger","year":"2005","unstructured":"Scheidegger N, Lussi A (2005) Tooth cleaning with different children\u2019s toothbrushes A clinical study. Schweiz Monatsschr Zahnmed 115:100\u2013106","journal-title":"Schweiz Monatsschr Zahnmed"},{"key":"5106_CR20","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1080\/00016350410010054","volume":"62","author":"AA Do\u011fanMC","year":"2004","unstructured":"Do\u011fanMC AA, A\u015fici N, Odaba\u015f M, Seydao\u011flu G (2004) Clinical evaluation of the plaque-removing ability of three different toothbrushes in a mentally disabled group. Acta Odontol Scand 62:350\u2013354. https:\/\/doi.org\/10.1080\/00016350410010054","journal-title":"Acta Odontol Scand"},{"key":"5106_CR21","first-page":"65","volume":"6","author":"I Kaschke","year":"2005","unstructured":"Kaschke I, Jahn K, Zeller A (2005) The effectiveness of different toothbrushes for people with special needs. J Disabil Oral Health 6:65\u201371","journal-title":"J Disabil Oral Health"},{"key":"5106_CR22","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1111\/j.1754-4505.2012.00311.x","volume":"33","author":"M Yitzhak","year":"2013","unstructured":"Yitzhak M, Sarnat H, Rakocz M, Yaish Y, Ashkenazi M (2013) The effect of toothbrush design on the ability of nurses to brush the teeth of institutionalized cerebral palsy patients. Spec Care Dentist 33:20\u201327. https:\/\/doi.org\/10.1111\/j.1754-4505.2012.00311.x","journal-title":"Spec Care Dentist"}],"container-title":["Clinical Oral Investigations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-023-05106-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00784-023-05106-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-023-05106-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T06:27:11Z","timestamp":1691648831000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00784-023-05106-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,30]]},"references-count":22,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["5106"],"URL":"https:\/\/doi.org\/10.1007\/s00784-023-05106-y","relation":{},"ISSN":["1436-3771"],"issn-type":[{"value":"1436-3771","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,30]]},"assertion":[{"value":"6 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 June 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study\u2019s protocol was approved by the Ethics Committee of the University of Santiago de Compostela, Spain (registration number 2021\/27).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The participants, or their legal guardians (if necessary), completed and signed a specific informed consent for study participation.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}