World Journal of Dentistry

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VOLUME 9 , ISSUE 5 ( September-October, 2018 ) > List of Articles


Efficacy of Interdental Brush as an Adjunct to Manual Toothbrush on Gingival Status in Patients undergoing Fixed Orthodontic Therapy: A Clinical Study

Rao Anupama, Shah Seema, Kashyap R Shankar, Rajesh Hosadurga, Vijaya K Kumar, Vinita A Boloor

Keywords : Fixed orthodontic therapy, Interdental brush, Manual toothbrush, Plaque

Citation Information : Anupama R, Seema S, Shankar KR, Hosadurga R, Kumar VK, Boloor VA. Efficacy of Interdental Brush as an Adjunct to Manual Toothbrush on Gingival Status in Patients undergoing Fixed Orthodontic Therapy: A Clinical Study. World J Dent 2018; 9 (5):355-360.

DOI: 10.5005/jp-journals-10015-1562

License: CC BY-NC 4.0

Published Online: 01-10-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Aim: Aim of the study was to evaluate the efficacy of manual toothbrush (STIM® 42 Orthodontic toothbrush) with or without an interdental brush (IDB) (STIM® PROXA-Extra fine) on gingival status in patients undergoing fixed orthodontic therapy. Materials and methods: In a randomized control trial of 60 subjects undergoing orthodontic therapy with Begg's appliance enrolled for the study. They were placed in a maintenance regimen with (STIM® 42 orthodontic toothbrush) after thorough scaling and root planning (SRP) for four weeks before the commencement of the study. This was done to attain uniformity and avoid bias in both the groups at the baseline. At the end of four weeks, subjects were randomly divided into two groups, group I–30 subjects used STIM® 42 Orthodontic toothbrush only and group II–30 subjects used STIM® PROXA-extra fine as an adjunct to STIM® 42 Orthodontic toothbrush for four weeks. Clinical parameters such as bonded bracket plaque index (BBPI), gingival index (GI), and gingival bleeding index (GBI) were recorded at baseline, 1, 2 and 4 weeks. Analysis of data was done using repeated measures analysis of variance (ANOVA) and unpaired student t-test using Statistical Package for the Social Sciences (SPSS) 22 software. Results: Result of the study showed a statistically significant reduction (p < 0.001) in BBPI, GI and GBI in group. II subjects when compared to group. I. Conclusion: Manual orthodontic brush along with IDB proved to be superior, in controlling plaque, gingival inflammation and gingival bleeding in subjects undergoing fixed orthodontic treatment. Clinical significance: Our study supports the use of interdental brushes along with manual toothbrush during fixed orthodontic treatment. It can significantly improve plaque control, thereby improving gingival health. To promote gingival health dentists need to motivate and reinforce this beneficial practice among their patients undergoing fixed orthodontic treatment.

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  1. Cardoso Mde A, Saraiva P P, Maltagliati L Á, Rhoden FK, Costa CC, Normando D. et al. Alterations in plaque accumulation and gingival inflammation promoted by treatment with self-ligating and conventional orthodontic brackets. Dental Press J Orthod 2015;20:35-41.
  2. Naranjo AA, Triviño ML, Jaramillo A, Betancourth M, Botero JE. Changes in the subgingivalmicrobiota and periodontal parameters before and 3 months after bracket placement. Am J Orthod Dentofacial Orthop. 2006;130(3):275.e17-22.
  3. Singh T, Bhatia B, Singh G, Prasad PN. Comparative study of the plaque removal efficacy of three types of toothbrushes in patients with fixed orthodontic appliances J. Ind Orthod Soc. 2011;45(2):61-67.
  4. Bock NC, von Bremen J, Kraft M, Ruf S. Plaque control effectiveness and handling of interdental brushes during multibracket treatment—a randomized clinical trial. European J Orthod. 2010:32(4):408-413.
  5. Imai PH, Hatzimanolakis PC. Encouraging client compliance for interdental care with the interdental brush: The client's perspective. Can J Dent Hyg. 2010;44(2):71-75.
  6. Goh HH. Interspace/interdental brushes for oral hygiene in orthodontic patients with fixed appliances. Cochrane Database Syst Rev. 2007;18(3):CD005410.
  7. Al-Anezi SA, Harradine NW. Quantifying plaque during orthodontic treatment: A systematic review. Angle Orthod. 2012;82(4):748-753.
  8. Löe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963;21:533-51.
  9. Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25(4):229-235.
  10. Armstrong R. A. When to use the Bonferroni correction, Ophthal Physiol. Opt. 2014;34(5): 502-508.
  11. Krishnan V, Ambili R, Davidovitch Z, Murphy NC. Gingiva and orthodontic treatment. Semin Orthod 2007;13:257-271.
  12. Alstad S, Zachrisson BU. Longitudinal study of periodontal condition associated with orthodontic treatment in adolescents. Am J Orthod 1979; 76:277-286.
  13. Kilicoglu H, Yildirim M, Polater H. Comparison of the effectiveness of two types of toothbrushes on oral hygiene of patients undergoing orthodontic treatment with fixed appliances. Am J Orthod Dentofacial Orthop 1997; 111:591-594.
  14. Cantekin K, Celikoglu M, Karadas M, Yildirim H, Erdem A. Effects of orthodontic treatment with fixed appliances on oral health status: A comprehensive study. Journal of Dental Sciences 2011; 6(4):235-238.
  15. Ristic M, Vlahovic Svabic M, Sasic M, Zelic O. Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents. Orthod Craniofac Res 2007; 10:187-195.
  16. Wolff D, Joers D, Rau P, Dörfer CE. In vitro cleaning efficacy and resistance to insertion test of interdental brushes, Clinical Oral Investigations 2006;10:297-304
  17. Poklepovic T, Worthington HV, Johnson TM, Sambungak D, Imai P, Clarkson JE, et al. Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev. 2013;12:CD009857
  18. Jared H, Zhong Y, Rowe M, Ebisutani K, Tanaka T, Takase N. Clinical trial of a novel interdental brush cleaning system. J Clin Dent. 2005;16(2):47-52.
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