{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:43:20Z","timestamp":1792291400294,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004515","name":"Universiti Kebangsaan Malaysia","doi-asserted-by":"publisher","award":["DD\u20102024\u2010006"],"award-info":[{"award-number":["DD\u20102024\u2010006"]}],"id":[{"id":"10.13039\/501100004515","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dental Hygiene"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n This study evaluated the efficacy of different manual toothbrush designs in removing extrinsic stains around orthodontic brackets using surface\u2010specific and time\u2010dependent assessments.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Fifty extracted premolars bonded with brackets and archwires were stained and randomly allocated to five toothbrush groups: conventional (CTB), U\u2010shaped (UTB), middle\u2010groove (MTB), V\u2010shaped (VTB) and triple\u2010headed (THB) (\n n<\/jats:italic>\n \u2009=\u200910\/group). Simulated toothbrushing was performed for up to 10,000\u2009cycles. Colour change (\u0394\n E<\/jats:italic>\n ) was quantified using digital image analysis at four time points. Overall and surface\u2010specific (mesiodistal, gingivo\u2010occlusal) \u0394\n E<\/jats:italic>\n values were analysed using generalised estimating equations with Bonferroni correction.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Stain removal increased significantly over time across all groups (\n p<\/jats:italic>\n \u2009<\u20090.001), although perceptible improvement was not consistently observed at early time points. THB demonstrated significantly higher overall \u0394\n E<\/jats:italic>\n values than other designs (\n p<\/jats:italic>\n \u2009<\u20090.001), with differences becoming more pronounced from T2 onwards. Gingivo\u2010occlusal surfaces showed greater stain removal than mesiodistal surfaces in four toothbrush groups (\n p<\/jats:italic>\n \u2009<\u20090.05), whereas no surface difference was observed for THB. Differences between toothbrush designs were confined to mesiodistal surfaces, where THB achieved higher \u0394\n E<\/jats:italic>\n values than all other groups from T2 to T4 (\n p<\/jats:italic>\n \u2009<\u20090.05); whereas no differences were detected at gingivo\u2010occlusal surfaces.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Stain removal around orthodontic brackets is influenced by surface accessibility and brushing duration. Toothbrush design influenced stain removal most clearly under restricted\u2010access conditions and after sufficient brushing time, with no significant differences observed at gingivo\u2010occlusal surfaces. Triple\u2010headed toothbrushes may offer an advantage in stain removal at anatomically restricted regions adjacent to brackets.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/idh.70178","type":"journal-article","created":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:30:32Z","timestamp":1792290632000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surface\u2010Specific and Time\u2010Dependent Stain Removal Around Orthodontic Brackets: An In\u00a0Vitro Comparison of Manual Toothbrush Designs"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9668-2016","authenticated-orcid":false,"given":"Shea Lee","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Family Oral Health, Faculty of Dentistry Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2308-365X","authenticated-orcid":false,"given":"Khairil Aznan Mohamed","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Family Oral Health, Faculty of Dentistry Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8483-7830","authenticated-orcid":false,"given":"Hsu Zenn","family":"Yew","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, Faculty of Dentistry Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3394-369X","authenticated-orcid":false,"given":"Murshida","family":"Marizan Nor","sequence":"additional","affiliation":[{"name":"Department of Family Oral Health, Faculty of Dentistry Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp\u2010journals\u201010024\u20101824"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.51642\/ppmj.v34i01.502"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/26.5.507"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/154405910508400113"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2010.10.003"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1997.0428"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40510\u2010016\u20100158\u20105"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10235638"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3290\/j.ohpd.a37711"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1806\u201083242012000400013"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010023\u201003035\u20106"},{"issue":"3","key":"e_1_2_12_13_1","first-page":"31","article-title":"Evaluation 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