{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:12:46Z","timestamp":1789035166611,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Special Care in Dentistry"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Individuals with Down syndrome (DS) and autism spectrum disorder (ASD) often face challenges in maintaining adequate oral hygiene due to motor, sensory, and behavioral limitations. Toothbrushes with customized handles have been proposed as assistive devices, but clinical evidence of their effectiveness remains limited. This study aimed to evaluate the effectiveness of customized\u2010handle toothbrushes compared with conventional toothbrushes in reducing dental plaque in these populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A non\u2010randomized clinical trial was conducted with 28 individuals diagnosed with DS or ASD. Participants used either customized\u2010handle or conventional toothbrushes and were followed for three weeks. Dental plaque was assessed using the modified Quigley and Hein Plaque Index at baseline, immediately after supervised brushing, and after one and three weeks. Both toothbrush types led to plaque reduction over time in both groups; however, no statistically significant differences were observed between toothbrush types at any evaluation point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Customized\u2010handle toothbrushes showed similar effectiveness compared to conventional toothbrushes in reducing dental plaque in individuals with DS and ASD and may serve as a supportive tool for oral hygiene care, particularly when combined with supervision and caregiver assistance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/scd.70203","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T07:13:59Z","timestamp":1782803639000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Customized Toothbrush Handles in Individuals With Down Syndrome and Autism Spectrum Disorder: A Non\u2010Randomized Clinical Trial"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4467-8601","authenticated-orcid":false,"given":"Mirlena Mansur Dionizio","family":"da Silva","sequence":"first","affiliation":[{"name":"Oral Diagnosis Department, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3740-5127","authenticated-orcid":false,"given":"Daniel Lobato Ferreira","family":"Ferraz","sequence":"additional","affiliation":[{"name":"Oral Diagnosis Department, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0888-8449","authenticated-orcid":false,"given":"Almira Oliveira","family":"Pereira","sequence":"additional","affiliation":[{"name":"Oral Diagnosis Department, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0300-5697","authenticated-orcid":false,"given":"Vanessa Gallego Arias","family":"Pecorari","sequence":"additional","affiliation":[{"name":"Department of Public Health, Pediatric dentistry and Orthodontics, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9796-0283","authenticated-orcid":false,"given":"Brenda Corr\u00eaa","family":"Santos","sequence":"additional","affiliation":[{"name":"Oral Diagnosis Department, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3594-3557","authenticated-orcid":false,"given":"Tamiris Christensen","family":"Bueno","sequence":"additional","affiliation":[{"name":"Oral Diagnosis Department, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1072-8711","authenticated-orcid":false,"given":"Rog\u00e9rio de Andrade","family":"Elias","sequence":"additional","affiliation":[{"name":"Oral Diagnosis Department, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6677-0065","authenticated-orcid":false,"given":"Marcio Ajudarte","family":"Lopes","sequence":"additional","affiliation":[{"name":"Oral Diagnosis Department, Piracicaba Dental School University of Campinas (UNICAMP)  Piracicaba S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/19932820.2022.2116794"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/children12030330"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14061868"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_885_21"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3345\/cep.2021.00479"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/children12030368"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.5409\/wjcp.v14.i3.106778"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpr.2002.120840"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9091130"},{"issue":"7","key":"e_1_2_9_11_1","article-title":"Individually Modeled 3D Printed 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