In Vitro Analysis of Enamel Abrasion Using a Novel Manual Nano-Bristle Toothbrush: An Atomic Force Microscopy Study

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2025 Jan 7

PMID 39764310

Authors

Mohan Prasad

Prem Blaisie Rajula

Ravishankar Pl

Sunanda Rao

Gayathri K

Mounika V

Murali Venkata Rama Mohan Kodali

Kalaivani V

Gracelin Soloman

Nelofar Nisha

Affiliations

Soon will be listed here.

Abstract

Introduction: To evaluate the enamel abrasion effects of soft, ultra-soft, and nano-bristle toothbrushes using atomic force microscopy (AFM) to guide toothbrush selection for optimal enamel preservation.

Methods: This in vitro study involved 45 extracted human teeth (central and lateral incisors), randomly assigned to three groups (n=15 each): Group I (nano-bristle), Group II (ultra-soft bristle), and Group III (soft bristle). Each specimen underwent 10,000 brushing cycles with a standardized 2 N force to simulate one year of brushing. A slurry of commercially available toothpaste mixed with saline was applied, and brushing was performed with a mechanical brushing simulator. AFM analysis measured enamel surface roughness before and after brushing.

Results: Nano-bristle toothbrushes caused a minimal increase in surface roughness (mean change: 4 nm; p = 0.001), significantly less than the increases seen with soft (mean change: 14.08 nm; p = 0.001) and ultra-soft (mean change: 14.86 nm; p = 0.001) bristle toothbrushes. AFM analysis confirmed that both soft and ultra-soft bristles caused greater enamel abrasion compared to nano-bristles, with no significant difference between soft and ultra-soft bristle groups.

Conclusion: Nano-bristle toothbrushes demonstrated the least enamel abrasion in this study, suggesting they may provide a gentle alternative for preserving enamel integrity.

References

Wiegand A, Kuhn M, Sener B, Roos M, Attin T . Abrasion of eroded dentin caused by toothpaste slurries of different abrasivity and toothbrushes of different filament diameter. J Dent. 2009; 37(6):480-4. DOI: 10.1016/j.jdent.2009.03.005. View

Finke M, Parker D, Jandt K . Influence of soft drinks on the thickness and morphology of in situ acquired pellicle layer on enamel. J Colloid Interface Sci. 2005; 251(2):263-70. DOI: 10.1006/jcis.2002.8428. View

Kirkham J, Brookes S, Shore R, Bonass W, Smith D, Wallwork M . Atomic force microscopy studies of crystal surface topology during enamel development. Connect Tissue Res. 2000; 38(1-4):91-100; discussion 139-45. DOI: 10.3109/03008209809017025. View

Loe H, THEILADE E, Jensen S . EXPERIMENTAL GINGIVITIS IN MAN. J Periodontol (1930). 1965; 36:177-87. DOI: 10.1902/jop.1965.36.3.177. View

Kumar S, Singh S, Gupta A, Roy S, Sareen M, Khajuria S . A Profilometric Study to Assess the Role of Toothbrush and Toothpaste in Abrasion Process. J Dent (Shiraz). 2015; 16(3 Suppl):267-73. PMC: 4623835. View

Sgan-Cohen H, Vered Y . A clinical trial of the meridol toothbrush with conical filaments: evaluation of clinical effectiveness and subjective satisfaction. J Clin Dent. 2006; 16(4):109-13. View

Turssi C, Binsaleh F, Lippert F, Bottino M, Eckert G, Moser E . Interplay between toothbrush stiffness and dentifrice abrasivity on the development of non-carious cervical lesions. Clin Oral Investig. 2019; 23(9):3551-3556. DOI: 10.1007/s00784-018-2776-4. View

Addy M . Tooth brushing, tooth wear and dentine hypersensitivity--are they associated?. Int Dent J. 2005; 55(4 Suppl 1):261-7. DOI: 10.1111/j.1875-595x.2005.tb00063.x. View

Zanatta F, Bergoli A, Werle S, Antoniazzi R . Biofilm removal and gingival abrasion with medium and soft toothbrushes. Oral Health Prev Dent. 2011; 9(2):177-83. View

10.

FINKE , Jandt , Parker . The Early Stages of Native Enamel Dissolution Studied with Atomic Force Microscopy. J Colloid Interface Sci. 2000; 232(1):156-164. DOI: 10.1006/jcis.2000.7200. View

11.

Vas N, Varghese R . An In Vitro Study of the Abrasive Potential of Various Toothbrushes on the Surface of Aligner Attachments. Cureus. 2024; 16(3):e55911. PMC: 11003860. DOI: 10.7759/cureus.55911. View

12.

Tellefsen G, Liljeborg A, Johannsen A, Johannsen G . The role of the toothbrush in the abrasion process. Int J Dent Hyg. 2011; 9(4):284-90. DOI: 10.1111/j.1601-5037.2011.00505.x. View

13.

Al Shammari A, Farook F, Fallatah A, Aldosari S, Ababneh K, Aleissa B . A Randomized Clinical Study of the Plaque Removal Efficacy of a Novel Manual Toothbrush With Micro-Pulse Bristles on Fixed Orthodontic Patients. Cureus. 2022; 14(8):e28453. PMC: 9510717. DOI: 10.7759/cureus.28453. View

14.

Faul F, Erdfelder E, Buchner A, Lang A . Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009; 41(4):1149-60. DOI: 10.3758/BRM.41.4.1149. View

15.

AlShehab A, AlHazoom A, Alowa M, AlAli H, Abdulmohsen A, Farooq I . Effect of bristle stiffness of manual toothbrushes on normal and demineralized human enamel-An in vitro profilometric study. Int J Dent Hyg. 2018; 16(2):e128-e132. DOI: 10.1111/idh.12332. View

16.

Vahabi S, Nazemi Salman B, Javanmard A . Atomic force microscopy application in biological research: a review study. Iran J Med Sci. 2013; 38(2):76-83. PMC: 3700051. View

17.

Kumari N, Johnson L, Yadav H, Das A, Umrao B, Gera R . Effect of Hand and Ultrasonic Scaling-Root Planing Methods on Tooth Surface Topography: An In-Vitro Atomic Force Microscopy Study. Cureus. 2023; 15(10):e46925. PMC: 10640483. DOI: 10.7759/cureus.46925. View

18.

Bizhang M, Riemer K, Arnold W, Domin J, Zimmer S . Influence of Bristle Stiffness of Manual Toothbrushes on Eroded and Sound Human Dentin--An In Vitro Study. PLoS One. 2016; 11(4):e0153250. PMC: 4829200. DOI: 10.1371/journal.pone.0153250. View

19.

Dyer D, Addy M, Newcombe R . Studies in vitro of abrasion by different manual toothbrush heads and a standard toothpaste. J Clin Periodontol. 2000; 27(2):99-103. DOI: 10.1034/j.1600-051x.2000.027002099.x. View

20.

Toshniwal S, Reche A, Bajaj P, Maloo L . Status Quo in Mechanical Plaque Control Then and Now: A Review. Cureus. 2022; 14(8):e28613. PMC: 9523496. DOI: 10.7759/cureus.28613. View