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Vandekerckhove et al. [13] reported that powered toothbrushes are effective, safe and comfortable for patients who have undergone rehabilitation with implant prostheses. Wolff et al. [15] demonstrated that sonic brushing is an effective means of dental implant maintenance. On the other hand, Swierkot et al. [16] found no significant differences between manual and sonic-powered toothbrushes regarding plaque removal around dental implants. These results were obtained from subjects without periodontal or peri-implant disease. Talazoparib nmr To the best of our knowledge, no studies have evaluated the effectiveness of sonic-powered toothbrushes for plaque removal in subjects with peri-implant mucositis. The aim of this study was to evaluate the effectiveness of powered toothbrushes, in comparison with manual toothbrushes, for plaque control in patients with peri-implant mucositis. MATERIALS AND METHODS Experimental design This randomized, prospective, controlled, clinical parallel study compared the efficacy of manual toothbrushes (Butler GUM 311, Sunstar, Etoy, Switzerland) and sonic-powered toothbrushes (Sonicare DiamondClean, Philips, Amsterdam, Netherland) for plaque control around dental implants. The sonic-powered toothbrush used in this binedaline study has a frequency of up to 31,000 brush strokes per minute and a two-minute timer to ensure the recommended brushing time. The study protocol was approved by the Institutional Review Board (IRB #CMP13003), Seoul National University Dental Hospital, Seoul, Korea. All patients received a detailed description of the proposed study protocol and provided informed written consent to participate in the study. Subjects were recruited from December 2013 to August 2014. The first procedure was carried out in December 2013, and all one-month follow-up visits were completed by October 2014. A block randomization sequence was used to ensure equal distribution of the subjects to the manual toothbrush group and the sonic-powered toothbrush group. The Dabrafenib in vivo randomization was performed on the day of scaling, using a sealed envelope containing the allocated toothbrush procedure. The sample size was determined to be 20 subjects per group. Wolff et al. [15] demonstrated that a change of 0.1 (��0.1) in the modified sulcus bleeding index (mSBI) around the implant sites was found between baseline and 24 weeks of follow-up. In our study, a difference of 0.3 in the magnitude of mSBI change after two months was considered to be the threshold of clinical relevance when comparing the use of manual and sonic-powered toothbrushes. A total sample size of 36 subjects (18 per group) was found to achieve 81% power in detecting a difference of 0.3 between the mean mSBI values of the manual toothbrush group and the sonic-powered toothbrush group, with a standard deviation of 0.3. The Mann-Whitney U test was used, and P-values
