Effectiveness of different interdental brushes to cleaning the interproximal areas: a randomized controlled,double-blind cross-over study

Abstract

Background: Biofilms form readily on interproximal surfaces. Oral hygiene tends to neglect those surfaces. Hence, the promotion of interdental brushes (IB) for oral hygiene is important. However, only limited evidence of the efficacy of IB exists.

Objectives: - to compare the interproximal cleansing efficacy of the novel, waist-shaped Circum? brush (Topcaredent, Switzerland; CB) with that of a straight soft IB (TePe?, Sweden; SB) on posterior surfaces.

Material & methods: Eight patients after completion of initial periodontal therapy abolished oral hygiene for three days. Baseline plaque scores (PlI, Silness & L?e 1964) were assessed on eight surfaces of all premolars and molars. Subsequently, an instructed nurse applied at random one of the two IB, three times per interdental space. Following this, registration of the PlI was repeated by the same blinded examiner. After a two-week recovery, subjects abolished oral hygiene practices for another three days.

Again, pre-and post-brushing PlI were recorded by the same examiner. The second IB was now applied.

Results: Patient mean PlI and site PlI were evaluated before and after application of the SB or CB, respectively. Paired t-tests were performed to yield statistically significant differences. The reduction of biofilm from before to after the use of the IB on a subject basis was highly significant (p<0.0001). The mean PlI after the use of the CB was significantly lower than after the use of the SB (p<0.0001). Comparing the PlI of the line angles (MB, ML, DB, DL), significantly more biofilm had been removed by applying CB compared to SB (p<0.0001). Moreover, comparing the PlI of the buccal (MB, DB) or the lingual line angles (DL, ML) yielded a significantly higher reduction of biofilm in favor of the CB (p<0.0001). The reduction of the PlI in the mid-interproximal portion, both mesially and distally did not differ significantly between CB and ST. No biofilm reduction was seen on the buccal sites with either IB.

Conclusion: The application of the waist-shaped Circum? IB resulted in significantly lower PlI scores than the use of a straight IB. This was predominantly due to the higher cleansing effect of the waist-shaped CB on the buccal and lingual line angles.