Efficacy of Three Interdental Cleaning Methods for Peri-Implant Health Maintenance of Single Implant-Supported Crowns: A Randomised Clinical Trial.

PURPOSE: To compare the effectiveness of an interproximal brush, a water flosser, and dental floss in removing plaque and reducing inflammation around implant-supported crowns. MATERIALS AND METHODS: A randomised controlled trial was conducted involving 45 participants with implant-supported single crowns. The participants were randomly assigned to three groups: interproximal brush, water flosser, and dental floss. Plaque index scores, gingival index scores, and interleukin-6 (IL-6) levels were assessed at baseline and after a two-week period. Statistical analysis was performed to compare the outcomes among the groups. RESULTS: Following the second visit, improvements in plaque control were observed across all three interdental cleaning methods. The water flosser demonstrated a slight reduction in IL-6 levels (60.17 ± 3.07 vs 58.79 ± 4.04) compared to the initial visit, although this decrease was not statistically significant. Conversely, both the interdental brush and dental floss exhibited a slight increase in IL-6 levels at the second visit (60.73 ± 2.93 and 55.7 ± 10.64, respectively) compared to the mean at the first visit (58.38 ± 3.24 and 54.6 ± 2.22, respectively). Among the groups, only the interproximal brush demonstrated a statistically significant difference in IL-6 levels (p=0.008), while no statistically significant differences were observed in the dental floss and water flosser groups. CONCLUSION: Within the study's limitations, our findings suggest that all three methods of interdental cleaning effectively improve plaque control and reduce gingival inflammation. However, using a water flosser appears to reduce inflammation more effectively, highlighting its potential advantage over the other two methods. Further research is needed to evaluate the long-term efficacy and impact of these methods on implant survival.

The effectiveness of dental water jet in reducing dental plaque and gingival bleeding in orthodontic patients: A systematic review and meta-analysis of randomized clinical trials.

INTRODUCTION: This systematic review and meta-analysis tests the effectiveness of dental water jet (DWJ) with manual toothbrushes (MTB) compared to MTB alone in oral health maintenance in orthodontic patients. METHODS: Four databases were systematically searched: PubMed, Scopus, Web of Science (WoS) and Cochrane Library until 6 January 2022 using a combination of medical subject heading (MeSH) terms and keywords. Randomized clinical trials (RCTs) were only included and critically appraised using the Cochrane Risk of Bias (ROB) tool. The mean difference (MD) effect measure was calculated using the Mantel-Haenszel statistical test (95% confidence interval [CI]) to compare both study groups (p-value < 0.05). RESULTS: After reviewing 5881 studies from a systematic search, six were selected for inclusion, with four involved in the quantitative analysis. The risk of bias was low in two studies, moderate in two studies and high in the remaining two studies. The meta-analysis showed a significant improvement in plaque index and bleeding scores in DWJ + MTB group compared MTB alone group in orthodontic patients with generalized gingivitis (MD = -0.75, 95% CI [-1.29, -0.22], p = 0.006) and (MD = -0.17, 95% CI [-0.27, -0.08], p = 0.0003), respectively. However, no significant improvement was detected between both groups in the gingival index. CONCLUSIONS: The use of DWJ as an adjunctive device in addition to MTB can be an effective strategy for maintaining oral hygiene in orthodontic patients with gingivitis. However, more high-quality RCTs are needed to confirm the findings.