The effect of intrasulcular brushing on sulcular epithelial permeability.
The purpose of the present study was to determine the effect of intrasulcular toothbrushing on permeability of the sulcular epithelium. Twenty-four dental students were divided into two groups of 12 each. On day 0, subjects in Group I began having the buccal aspects of the maxillary right first and second molars brushed for 30 seconds daily for 49 days by an examiner using an intrasulcular technique while subjects in Group II had the same teeth brushed with an extrasulcular technique. On day 49, clinical evaluation of inflammation was performed and biopsies were taken to evaluate gingival inflammation, sulcular epithelial keratinization and permeability of the sulcular epithelium in vitro using a microperfusion technique. Results indicate that subjects in both groups had attained equally high levels of gingival health. The intrasulcular group demonstrated a significantly higher degree of sulcular epithelial keratinization. However, no relationship was found between the degree of sulcular epithelial keratinization and sulcular epithelial permeability. Thus, the benefits derived from intrasulcular brushing and increasing sulcular epithelial keratinization are questionable.