The efficacy of interdental brushes on plaque and parameters of periodontal inflammation: A systematic review

Department of Periodontology, Academic Centre for Dentistry Amsterdam, Louwesweg 1, Amsterdam,The Netherlands.
International Journal of Dental Hygiene (Impact Factor: 1.06). 12/2008; 6(4):253-64. DOI: 10.1111/j.1601-5037.2008.00330.x
Source: PubMed


The aim of the study was to asses the effect of the use of interdental brushes (IDB) in patients as an adjunct to toothbrushing compared with toothbrushing alone or other interdental oral hygiene devices on plaque and the clinical parameters of periodontal inflammation.
MEDLINE-PubMed and the Cochrane Central register of controlled trials (CENTRAL) were searched through November 2007 to identify appropriate studies. Clinical parameters of periodontal inflammation such as plaque, gingivitis, bleeding and pockets were selected as outcome variables.
Independent screening of the titles and abstracts of 218 MEDLINE-PubMed and 116 Cochrane papers resulted in nine publications that met the eligibility criteria. Mean values and standard deviations were collected by data extraction. Descriptive comparisons are presented for brushing alone or brushing and woodsticks; meta-analyses were also performed for the floss comparison.
As an adjunct to brushing, the IDB removes more dental plaque than brushing alone. Studies showed a positive significant difference using IDB with respect to the plaque scores, bleeding scores and probing pocket depth. The majority of the studies presented a positive significant difference in the plaque index when using the IDB compared with floss.

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    • "A systematic review[19] was conducted to assess the effect of the use of interdental brushes in patients, as an adjunct to tooth brushing, compared to tooth brushing alone, or the other interdental oral hygiene devices on plaque and the clinical parameters of periodontal inflammation. It was a systematic review of nine randomized controlled trials with a meta-analysis of some included studies. "
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    ABSTRACT: It is now well established that removal of bacterial plaque can reduce the severity of chronic inflammatory periodontal disease. Periodontal disease is seen to progress faster interdentally and plaque control in these areas is of great importance. Various types of interdental cleaning aids have been developed in recent years. This study was aimed at evaluating the efficacy of a newly developed interdental cleaning aid, BrushPick, in a split mouth randomized clinical trial. This was a split mouth design study where the quadrant on one side of the oral cavity served as the control while another quadrant on the opposite side served as the test sample. Fifty-seven patients with mild-to-moderate periodontitis, presenting with open interdental embrasures, were selected for the study. After non-surgical periodontal therapy, they were asked to use the BrushPick in the embrasures on one side of the arch in a spilt mouth design study and the embrasures on the other side acted as controls. The Rustogi et al. modified Navy plaque index (RMNPI) and interdental bleeding index (IBI) were recorded at baseline, seven days, 14 days, and 28 days. The mean differences between test and control sites were compared using the studentt test. The mean difference was compared between different durations using analysis of variance (ANOVA). The mean RMNPI was significantly different between the test and control sites at P<0.001 on both days 14 and 28. At 28 days the mean IBI was 0.08 (SD=0.02) for the experimental sites and 0.28 (SD=0.11) for the control sites. The difference was statistically significant at P<0.001. ANOVA showed that the mean RMNPI scores and mean IBI scores showed a statistically significant difference when compared at different durations at the test sites (P<0.0001). But, at the control sites there was no significant change. This study suggested that BrushPick reduces plaque and gingival bleeding in open interdental embrasures. Further large sampled clinical trials and comparative studies using gold standard interdental cleaning aids are required to establish the efficacy of this device.
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    ABSTRACT: Objectives The aim of the present review was to analyze the impact of the hydrodynamic effects created by powered toothbrushes on biofilm removal in vitro. Materials and methods A MEDLINE search was performed for publications published by 20 May 2012; this search was complemented by a manual search. The study selection, data preparation, and validity assessment were conducted by two reviewers. Results Sixteen studies were included. The studies differed with respect to the methods of biofilm formation and brushing protocols. Eighteen different powered toothbrush models were evaluated. Toothbrushes with side-to-side action demonstrated biofilm removal without direct bristle contact to biofilms ranging from 38 to 99 %. Most studies found biofilm removal exceeding 50 %. Biofilm reduction using multidimensional toothbrushes was significantly lower than by those with the side-to-side mode. Detachment forces due to hydrodynamic phenomena, passing air–liquid interfaces, and acoustic energy transfer were suggested to cause reduction of the biofilm. Conclusion Noncontact biofilm reduction was obtained by the hydrodynamic effects of some powered toothbrushes in vitro. Clinical relevance Powered toothbrushes may have the potential to simplify self-performed oral hygiene. However, additional beneficial effects of higher amounts of noncontact biofilm removal in vitro have not been shown clinically, yet.
    No preview · Article · Sep 2012 · Clinical Oral Investigations
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