Clinical Oral Investigations

, Volume 23, Issue 9, pp 3551–3556 | Cite as

Interplay between toothbrush stiffness and dentifrice abrasivity on the development of non-carious cervical lesions

  • Cecilia P. Turssi
  • Fahad Binsaleh
  • Frank Lippert
  • Marco C. Bottino
  • George J. Eckert
  • Elizabeth A.S. Moser
  • Anderson T. HaraEmail author
Original Article



This study investigated the effect of toothbrush stiffness and dentifrice slurry abrasivity on the development and progression of simulated non-carious cervical lesions (NCCLs).

Materials and methods

Human maxillary premolars were allocated to 12 groups generated by the association between toothbrushes, soft, medium, and hard stiffness, and simulated dentifrice slurries, lower, medium, and higher; deionized water (DI) served as negative control. Teeth were mounted on acrylic blocks, and their root surfaces partially covered with acrylic resin to simulate gingiva, leaving a 2-mm area apical to the cemento-enamel junction exposed to toothbrushing. Specimens were brushed with the test slurries for 35,000 and 65,000 double strokes. Impressions taken at baseline and after both brushing periods were scanned by a 3D optical profilometer. Dentin volume loss (mm3) was calculated by image subtraction. Data were analyzed using three-way ANOVA and Fisher’s PLSD tests.


All toothbrushes caused higher volume loss when associated to higher abrasive slurry, compared to medium- and lower-abrasive slurries. Medium caused more volume loss than lower-abrasive slurry, which led to more volume loss than DI. Hard and medium toothbrushes were not different when used with medium- or higher-abrasive slurries. There were no differences among toothbrushes when used with DI and lower-abrasive slurry. Overall, 35,000 brushing strokes resulted in significantly less volume loss than 65,000.


Toothbrush stiffness was an important factor on NCCL development, especially when brushing with medium- and higher-abrasive slurries.

Clinical relevance

Medium and hard toothbrushes associated with medium- and high-abrasive toothpastes can yield more severe NCCLs.


Non-carious cervical lesions Toothbrush Toothpaste Dentifrice Abrasivity Dentin 



This research was part of Fahad Binsaleh’s thesis submitted in partial fulfillment of the MSD in Operative Dentistry degree awarded in 2016 from Indiana University School of Dentistry (IUSD). The authors would like to thank Dr. Norman Blaine Cook and Dr. Kim E. Diefenderfer for their insightful comments and feedback.


This study was supported by the Dental Erosion-Abrasion Program of the Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN, USA.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Cariology and Restorative DentistrySão Leopoldo Mandic Institute and Dental Research CenterCampinasBrazil
  2. 2.Department of Cariology, Operative Dentistry and Dental Public HealthIndiana University School of DentistryIndianapolisUSA
  3. 3.Department of Cariology, Restorative Sciences and EndodonticsUniversity of Michigan School of DentistryAnn ArborUSA
  4. 4.Department of BiostatisticsIndiana University School of MedicineIndianapolisUSA

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