title: Effectiveness of different interdental brushes on cleaning the interproximal surfaces of teeth and implants: a randomized controlled, double-blind cross-over study.
abstract: OBJECTIVE
  To compare the interproximal cleansing efficacy of the novel, waist-shaped Circum brush (Topcaredent, Switzerland; CB) with that of a straight soft interdental brush (IB) (TePe, Sweden; SB) on posterior surfaces.
  
  
  METHODS
  Eight patients after completion of initial periodontal therapy abolished oral hygiene for 3 days. Baseline plaque scores (PlI, Silness & Löe ) 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 2-week recovery, patients abolished oral hygiene practices for another 3 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 with 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 favour 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Implant Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Nardnadda
authors.initials: N
authors.lastname: Chongcharoen
authors.forename: Martina
authors.initials: M
authors.lastname: Lulic
authors.forename: Niklaus P
authors.initials: NP
authors.lastname: Lang
mesh_terms: D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D015921:Dental Implants; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D010512:Periodontal Index; D014099:Toothbrushing / Q000295:instrumentation*
chemical_list: D015921:Dental Implants