Abstract
Objective
The aim of this randomized controlled trial was to evaluate the interproximal cleaning efficacy of waist-shaped compared with straight soft interdental brushes in patients undergoing nonsurgical periodontal therapy.
Materials and methods
Ten patients diagnosed with periodontitis stage II or III were scheduled for nonsurgical periodontal therapy. Baseline plaque control record (PCR), modified approximal plaque index (API), papillary bleeding index (PBI), probing pocket depth (PPD), and bleeding on probing (BOP) were evaluated. Four interdental spaces of equal sizes were determined, and baseline plaque indices (PI) were assessed on eight surfaces of the respective adjacent teeth, resulting in 640 measuring positions. Interdental brushes with a straight or waist-shaped design were randomly allocated to the right or left side, and patients received oral hygiene instructions. Follow-up measurements including PCR, API, PBI, and site-specific PI were performed during initial nonsurgical periodontal therapy sessions and reevaluation which was undertaken 8 weeks afterwards.
Results
PCR, API, and PBI decreased significantly compared with baseline at each time point (p < 0.001).
PPD (waist-shaped, baseline 4 mm (range, 2–9 mm) vs. reevaluation 3 mm (range, 1–6 mm); p < 0.001; straight, baseline 4 mm (range, 2–10) vs. reevaluation 3 mm (range, 1–6) mm; p < 0.001) and BOP (p = 0.008) showed significant reduction in both groups. Sub-analysis of site-specific areas including line angles and interproximal areas revealed no significant reduction of plaque during the observation period between both brush designs. No difference between straight and waist-shaped brushes regarding PPD or BOP decrease was found.
Conclusion
The efficacy of both interdental brush designs concerning plaque control in patients undergoing nonsurgical periodontal therapy was similar.
Clinical relevance
The use of interdental brushes is essential for biofilm removal in patients during initial periodontal therapy, regardless of brush design.
Clinical trial registration
ISRCTNregistry (#ISRCTN24498365), http://www.isrctn.com/ISRCTN24498365
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References
Chapple IL, Van der Weijden F, Doerfer C et al (2015) Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol 42(Suppl 16):S71–S76
Valen H, Scheie AA (2018) Biofilms and their properties. Eur J Oral Sci 126(Suppl 1):13–18
Hajishengallis G (2014) The inflammophilic character of the periodontitis-associated microbiota. Mol Oral Microbiol 29:248–257
Ji S, Choi YS, Choi Y (2015) Bacterial invasion and persistence: critical events in the pathogenesis of periodontitis? J Periodontal Res 50:570–585
Lang NP, Cumming BR, Löe H (1973) Toothbrushing frequency as it relates to plaque development and gingival health. J Periodontol 44:396–405
Axelsson PA (2014) Commentary: periodontitis is preventable. J Periodontol 85:1303–1307
Costa FO, Costa AA, Cota LOM (2020) The use of interdental brushes or oral irrigators as adjuvants to conventional oral hygiene associated with recurrence of periodontitis in periodontal maintenance therapy: a 6-year prospective study. J Periodontol 91:26–36
Murakami S, Mealey BL, Mariotti A, Chapple ILC (2018) Dental plaque-induced gingival conditions. J Periodontol 89(Suppl 1):S17–S27
Magnusson I, Lindhe J, Yoneyama T, Liljenberg B (1984) Recolonization of a subgingival microbiota following scaling in deep pockets. J Clin Periodontol 11:193–207
Lang NP, Cumming BR, Löe HA (1977) Oral hygiene and gingival health in Danish dental students and faculty. Community Dent Oral Epidemiol 5:237–242
Caton JG, Blieden TM, Lowenguth RA, Frantz BJ, Wagener CJ, Doblin JM, Stein SH, Proskin HM (1993) Comparison between mechanical cleaning and an antimicrobial rinse for the treatment and prevention of interdental gingivitis. J Clin Periodontol 20:172–178
Poklepovic T, Worthington HV, Johnson TM et al (2013) Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev 18(12):CD009857
Sälzer S, Slot DE, Van der Weijden FA, Dörfer CE (2015) Efficacy of inter-dental mechanical plaque control in managing gingivitis--a meta-review. J Clin Periodontol 42(Suppl 16):S92–S105
Jordan RA, Hong HM, Lucaciu A, Zimmer S (2014) Efficacy of straight versus angled interdental brushes on interproximal tooth cleaning: a randomized controlled trial. Int J Dent Hyg 12:152–157
Larsen HC, Slot DE, Van Zoelen C, Barendregt DS, Van der Weijden GA (2017) The effectiveness of conically shaped compared with cylindrically shaped interdental brushes - a randomized controlled clinical trial. Int J Dent Hyg 15:211–218
Chongcharoen N, Lulic M, Lang NP (2012) Effectiveness of different interdental brushes on cleaning the interproximal surfaces of teeth and implants: a randomized controlled, double-blind cross-over study. Clin Oral Implants Res 23:635–640
Schnabl D, Goebel G, Kadletz A et al (2019) Cleansing efficacy of waist-shaped interdental brushes. A randomized-controlled crossover study. J Clin Periodontol 47(1):30–35
Rösing CK, Daudt FA, Festugatto FE, Oppermann RV (2006) Efficacy of interdental plaque control aids in periodontal maintenance patients: a comparative study. Oral Health Prev Dent 4:99–103
Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, Mealey BL, Papapanou PN, Sanz M, Tonetti MS (2018) A new classification scheme for periodontal and peri-implant diseases and conditions - introduction and key changes from the 1999 classification. J Periodontol 89(Suppl 1):S1–S8
O'Leary TJ, Drake RB, Naylor JE (1972) The plaque control record. J Periodontol 43:38
Silness J, Loe H (1964) Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22:121–135
Research Randomizer. Available at: https://www.randomizer.org
Bakdash B (1994) Oral hygiene and compliance as risk factors in periodontitis. J Periodontol 65(Suppl 5S):539–544
Christou V, Timmerman MF, Van der Velden U, Van der Weijden FA (1998) Comparison of different approaches of interdental oral hygiene: interdental brushes versus dental floss. J Periodontol 69:759–764
Worthington HV, MacDonald L, Poklepovic Pericic T et al (2019) Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries. Cochrane Database Syst Rev 4:CD012018
Serino G, Rosling B, Ramberg P, Socransky SS, Lindhe J (2001) Initial outcome and long-term effect of surgical and non-surgical treatment of advanced periodontal disease. J Clin Periodontol 28:910–916
Rosling B, Serino G, Hellström MK, Socransky SS, Lindhe J (2001) Longitudinal periodontal tissue alterations during supportive therapy. Findings from subjects with normal and high susceptibility to periodontal disease. J Clin Periodontol 28:241–249
Turesky S, Gilmore ND, Glickman I (1970) Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol 41:41–43
Wolff D, Joerss D, Dörfer CE (2006) In vitro-cleaning efficacy of interdental brushes with different stiffness and different diameter. Oral Health Prev Dent 4:279–285
Baumgartner G, Wiedemeier DB, Hofer D, Sener B, Attin T, Schmidlin PR (2019) In vitro cleaning potential of waist-shaped interdental brushes. Swiss Dent J 129:360–367
Parodontale Therapie – das Würzburger Konzept. Available at: https://www.bzb-online.de/bzb_0611.htm
Acknowledgments
This study was supported by Topcaredent®, Zurich, Switzerland (provision of waist-shaped interdental brushes).
Funding
This study was supported by the Medical University of Vienna.
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All procedures performed in studies involving human participants were approved by the Ethics Committee of the Medical University of Vienna (Nr. 1670/2016) and 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.
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Wehner, C., Husejnagic, S., Laky, B. et al. Effect of interdental brush design on plaque during nonsurgical periodontal therapy. Clin Oral Invest 25, 87–94 (2021). https://doi.org/10.1007/s00784-020-03337-x
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DOI: https://doi.org/10.1007/s00784-020-03337-x