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PracticeUpdatePlaque Removal Efficacy of Conventional vs. Waist-Shaped Interdental Brushes Around the Base of Orthodontic Brackets

The incidence of white-spot lesions, caries, and gingivitis is increased by plaque buildup around the bracket undercut areas, but all of these conditions can be avoided with excellent oral hygiene habits. But which toothbrush, and more precisely which interdental brush, should be used?

In a recent multicenter, randomized, examiner-blinded crossover study, researchers compared the efficacy of two types of interdental brushes (IDBs) in plaque removal around brackets in patients with fixed orthodontic appliances. The study found that waist-shaped IDBs significantly outperformed their cylindrical counterparts, particularly in hard-to-reach areas.

HCN Medical Memo
For dental professionals working with orthodontic patients, this study underscores the importance of recommending waist-shaped interdental brushes for more effective plaque removal, especially in hard-to-reach areas around brackets. The findings could be the future for preventing white-spot lesions, caries, and gingivitis in orthodontic patients.

Study Design:
  • Multicenter, randomized, examiner-blinded crossover study with 3 interventions.
  • Involved 20 patients (12 females, 8 males) aged 12-18 with fixed orthodontic devices.
  • Conducted at the Department of Orthodontics, University Medical Center of the Johannes Gutenberg University Mainz, and the Children’s Dental Clinic St. Gallen.
  • Compared a conventional, cylindrically shaped IDB (IDBG-S [IB]) with a waist-shaped IDB (Circum, CDB-8 [CB]).
  • Plaque index (PI) scores assessed before and after cleaning on 8 tooth surfaces around orthodontic brackets.

A waist-shaped IDB has never been tested in patients undergoing orthodontic treatment.

Key Findings:
  • Both IDBs showed plaque removal effects, but the CB was significantly more effective (P = 0.002).
  • CB showed higher plaque removal efficacy at the main areas 1 and 8, which are difficult for toothbrushes to reach.
  • All 20 participants completed the study with no reported side effects or adverse events.

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