The Accomplishments of KoCVAM in the Development and Implementation of Alternative Methods in Korea.

The Korean Center for the Validation of Alternative Methods (KoCVAM), which promotes the Three Rs principles and the use of alternative methods in Korea, has been operating within the Toxicological Screening and Testing Division of the Ministry of Food and Drug Safety (MFDS) since 2009. KoCVAM has exchanged opinions and information on the development and validation of non-animal alternative test methods as part of the International Cooperation on Alternative Test Methods (ICATM), and provided input into draft OECD Test Guidelines (TGs). Several Korean laws (e.g. the Cosmetics Act) encourage the use of alternative test methods for chemical testing and assessment. To promote and support the use of alternative test methods in the country, KoCVAM has published information and provided training on the national guidelines, which are based on the OECD TGs. In addition, KoCVAM has held annual training workshops on alternative test methods, to help Korean research institutions (including GLP test facilities) to implement them. In addition, by helping to develop and validate alternative test methods that were adopted in OECD TG 442B, TG 492 and TG 439, KoCVAM has contributed to the enhanced competitiveness of Korean industry on the worldwide stage.

Effect of decentration and tilt on the in vitro optical quality of monofocal and trifocal intraocular lenses.

PURPOSE: To evaluate and compare the effect of decentration and tilt on the optical quality of monofocal and trifocal intraocular lenses (IOL). METHODS: Optical quality of a monofocal IOL (AcrySof IQ SN60WF; Alcon Laboratories, Inc., USA) and a trifocal IOL (AcrySof IQ PanOptix; Alcon Laboratories, Inc., USA) was assessed using an in vitro optical bench (OptiSpheric IOL R&D; Trioptics GmbH, Germany). At apertures of 3.0 mm and 4.5 mm, modulation transfer function (MTF) at spatial frequency of 50 lp/mm, MTF curve and the United States Air Force (USAF) resolution test chart of the two IOLs were measured and compared at their focus with different degrees of decentration and tilt. Optical quality at infinity, 60 cm and 40 cm and the through-focus MTF curves were compared when the two IOLs were centered at apertures of 3.0 mm and 4.5 mm. Spectral transmittance of the two IOLs was measured by the UV-visible spectrophotometer (UV 3300 PC; MAPADA, China). RESULTS: The SN60WF and the PanOptix filtered blue light from 400 to 500 nm. Both IOLs at the far focus and the PanOptix at the intermediate focus showed a decrease in optical quality with increasing decentration and tilt. The PanOptix demonstrated enhanced optical quality compared to the previous gradient at the near focus at a decentration range of 0.3-0.7 mm with a 3.0 mm aperture, and 0.5 mm with a 4.5 mm aperture, whereas other conditions exhibited diminished optical quality with increasing decentration and tilt at the focus of both IOLs. When the two IOLs were centered, the SN60WF had better optical quality at infinity, while the PanOptix had better optical quality at 60 cm and 40 cm defocus. The optical quality of the SN60WF exceeded that of the PanOptix at far focus, with a 3 mm aperture decentration up to 0.7 mm and a 4.5 mm aperture decentration up to 0.3 mm; this observation held true for all tilts, irrespective of aperture size. As both decentration and tilt increased, the optical quality of the SN60WF deteriorated more rapidly than that of the PanOptix at the far focal point. CONCLUSIONS: The SN60WF showed a decrease in optical quality with increasing decentration and tilt. Optical quality of the PanOptix at the near focus increased in some decentration conditions and decreased in some conditions, while it showed a decrease at the other focuses with increasing decentration. While tilt only had a negative effect on optical quality. When both IOLs were centered, the PanOptix provided a wider range of vision, while the SN60WF provided better far distance vision. At the far focus, the SN60WF has better resistance to tilt than the PanOptix, but the optical quality degrades more quickly when decentered and tilted.

The larvicidal effect of the supernatant of Lactobacillus acidophilus ATCC 4356 on Toxocara canis.

Human toxocariasis is a parasitic anthropozoonosis that is difficult to treat and control. A previous study carried out with Lactobacillus acidophilus ATCC 4356 revealed that the cell free supernatant (CFS) of this probiotic killed 100% of Toxocara canis larvae in vitro. The present study aimed to investigate the characteristics of the CFS of L. acidophilus ATCC 4356, which may be involved in its larvicidal effects on T. canis. L. acidophilus ATCC 4356 was cultured, and lactic and acetic acids present in the CFS were quantified by high performance liquid chromatography (HPLC). The levels of pH and H2O2 were also analyzed. To assess the larvicidal effect of the CFS, this was tested pure and diluted (1:2 to 1:128) on T. canis larvae. High concentrations of lactic and acetic acids were detected in the CFS. The acidity of the pure CFS was observed at pH 3.8, remaining acidic at dilutions of 1:2 to 1:16. Regarding the in vitro larvicidal effect, 100% death of T. canis larvae was observed using the pure CFS and 1:2 dilution. Based on these results, it can be inferred that the presence of higher concentrations of organic acids and low pH of the medium contributed to the larvicidal activity of the CFS of L. acidophilus ATCC 4356. In addition, the maintenance of the larvicidal effect, even after dilution, suggests a greater chance of the larvicidal effect of this CFS against T. canis in vivo.

Development of natural cosmetic emulsion using the by-product of Lecythis pisonis seed.

Natural products and their biological activities are currently a subject of great interest to the industrial and scientific sector, due to society's awareness of the proper use of biodiversity and economic and sustainability. To promote the sustainable use of biomass the extract of the by-product of the shell seed of Lecythis pisonis was applied to develop a natural cosmetic emulsion. To ensure safety for its topical use the cytotoxic activity of its crude extract was evaluated by the colorimetric method of 3- bromide (4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium, MTT, in cell culture of fibroblasts L929, human keratinocytes HaCat, and human endothelium EA.hy926 cell lines. The triplicate of the cosmetic formulation containing the extract was obtained regarding stability according to the procedures of the Brazilian Health Regulatory Agency (Anvisa). The irritability tests were performed using alternative methods, in vitro, chorioallantoic membrane assay (HET-CAM and CAM-TBS), and hemolysis test (RBC). The crude extract was not cytotoxic, IC50 index >780 mg/mL. The preservative system was effective against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans, and Aspergillus niger. The emulsion was classified as non-irritable. The crude extract of the by-product of sapucaia seeds can be incorporated into a natural emulsion, safe for topical use.

Influences of coexisting aged polystyrene microplastics on the ecological and health risks of cadmium in soils: A leachability and oral bioaccessibility based study.

Whether coexisting microplastics (MPs) affect the ecological and health risks of cadmium (Cd) in soils is a cutting-edge scientific issue. In this study, four typical Chinese soils were prepared as artificially Cd-contaminated soils with/without aged polystyrene (PS). TCLP and in vitro PBET model were used to determine the leachability (ecological risk) and oral bioaccessibility (human health risk) of soil Cd. The mechanisms by which MPs influence soil Cd were discussed from direct and indirect perspectives. Results showed that there was no significant difference in the leachability of soil Cd with/without aged PS. Additionally, aged PS led to a significant decrease in the bioaccessibility of soil Cd in gastric phase, but not in small intestinal phase. The increase in surface roughness and the new characteristic peaks (e.g., Si-O-Si) of aged PS directly accounted for the change in Cd bioaccessibility. The change in organic matter content indirectly accounted for the exceptional increase in Cd bioaccessibility of black soil with aged PS in small intestinal phase. Furthermore, the changes in cation exchange capacity and Cd mobility factor caused by aged PS explained the change in Cd leachability. These results contribute to a deeper understanding about environmental and public health in complicated emerging scenarios.

Adsorption of aflatoxin B1 by different antimycotoxin additives: bentonite, clinoptilolite, and beta-glucans extracted from yeast cell wall.

The present study aims to evaluate and compare antimycotoxin additives (AMAs) composed of bentonite (AMA 1), clinoptilolite (AMA 2), and beta-glucans extracted from yeast cell wall (AMA 3), with respect to their ability to bind Aflatoxin B1 (AFB1) using the isothermal models of Freundlich, Langmuir, and BET. The additives were submitted to an in vitro adsorption experiment with AFB1 (0.05-4 mg L-1), using solutions of pH 3 and pH 6, with an inclusion rate of 0.5%, and analyzed by HPLC-MS/MS. At pH 3, for the seven concentrations evaluated, AMA 1 obtained adsorption rates (99.69 to 99.98%) higher (p < 0. 05) than the other AMAs, which were from 82.97 to 88.72% (AMA 2) and from 79.43 to 89.32% (AMA 3). At pH 6, in concentrations of 1, 2, and 4 mg L-1 of AFB1, AMA 1 obtained higher (p < 0.05) adsorption results (97.86 to 99.86%) than AMA 2 (91.98 to 96.12%) and AMA 3 (87.56 to 93.50%). The Freundlich model best fitted the AMA 1 adsorption data. For the other additives, the Langmuir model obtained the best fit, demonstrating qm of 8.6 mg g-1 at pH 3 and 2.3 mg g-1 at pH 6 for AMA 2; and for AMA 3, with qm of 3.4 mg g-1 at pH 3 and 2.3 mg g-1 at pH 6. The isotherm models work as an effective tool to describe the adsorption process whereas the AMA adsorption capacity varies as a function of product composition, pH, and mycotoxin content.

Early Blood Clot Detection Using Forward Scattering Light Measurements Is Not Superior to Delta Pressure Measurements.

The occurrence of thrombus formation within an extracorporeal membrane oxygenator is a common complication during extracorporeal membrane oxygenation therapy and can rapidly result in a life-threatening situation due to arterial thromboembolism, causing stroke, pulmonary embolism, and limb ischemia in the patient. The standard clinical practice is to monitor the pressure at the inlet and outlet of oxygenators, indicating fulminant, obstructive clot formation indicated by an increasing pressure difference (ΔP). However, smaller blood clots at early stages are not detectable. Therefore, there is an unmet need for sensors that can detect blood clots at an early stage to minimize the associated thromboembolic risks for patients. This study aimed to evaluate if forward scattered light (FSL) measurements can be used for early blood clot detection and if it is superior to the current clinical gold standard (pressure measurements). A miniaturized in vitro test circuit, including a custom-made test chamber, was used. Heparinized human whole blood was circulated through the test circuit until clot formation occurred. Four LEDs and four photodiodes were placed along the sidewall of the test chamber in different positions for FSL measurements. The pressure monitor was connected to the inlet and the outlet to detect changes in ΔP across the test chamber. Despite several modifications in the LED positions on the test chamber, the FSL measurements could not reliably detect a blood clot within the in vitro test circuit, although the pressure measurements used as the current clinical gold standard detected fulminant clot formation in 11 independent experiments.

Effects of post-polymerization conditions on color properties, surface roughness, and flexural strength of 3D-printed permanent resin material after thermal aging.

PURPOSE: To evaluate the color, surface properties, and flexural strength of 3D-printed permanent crown resin subjected to different post-polymerization conditions after artificial aging. MATERIALS AND METHODS: Ninety (10 × 2 mm) disc-shaped specimens were printed by using permanent crown resin with SLA technology. Specimens were divided into nine different groups, subject to post-polymerization conditions at three different times (15, 20, and 30 min) and three different temperatures (40, 60, and 80°C) (n = 10). Color and surface roughness measurements were repeated pre-post thermal aging (5.000 cycles, 5-55°C) and a flexural strength test was carried out. Data were analyzed with Shapiro-Wilk, Kruskal-Wallis, ANOVA, Tukey HSD, and Dunn tests (α < 0.05). RESULTS: ΔE00  values showed results below the acceptable color threshold, except for the 30 min 40°C group (ΔE00 <1.8). No difference was found between the relative translucency parameter and surface roughness values of the 20 min 60°C group recommended by the manufacturer and the other groups. A significant difference was found between the flexural strength values of the groups (p < 0.001). CONCLUSIONS: The color properties, surface topography, and mechanical properties of the printed permanent crown material were affected by different post-polymerization conditions: polymerized at different times and temperatures. Although the flexural strength and color change values showed promising results, more studies are required to evaluate its suitability for clinical use.

Determination of Novel SARS-CoV-2 Inhibitors by Combination of Machine Learning and Molecular Modeling Methods.

INTRODUCTION: Within the scope of the project, this study aimed to find novel inhibitors by combining computational methods. In order to design inhibitors, it was aimed to produce molecules similar to the RdRp inhibitor drug Favipiravir by using the deep learning method. METHOD: For this purpose, a Trained Neural Network (TNN) was used to produce 75 molecules similar to Favipiravir by using Simplified Molecular Input Line Entry System (SMILES) representations. The binding properties of molecules to Viral RNA-dependent RNA polymerase (RdRp) were studied by using molecular docking studies. To confirm the accuracy of this method, compounds were also tested against 3CL protease (3CLpro), which is another important enzyme for the progression of SARS-CoV-2. Compounds having better binding energies and RMSD values than favipiravir were searched with similarity analysis on the ChEMBL drug database in order to find similar structures with RdRp and 3CLpro inhibitory activities. RESULT: A similarity search found new 200 potential RdRp and 3CLpro inhibitors structurally similar to produced molecules, and these compounds were again evaluated for their receptor interactions with molecular docking studies. Compounds showed better interaction with RdRp protease than 3CLpro. This result presented that artificial intelligence correctly produced structures similar to favipiravir that act more specifically as RdRp inhibitors. In addition, Lipinski's rules were applied to the molecules that showed the best interaction with RdRp, and 7 compounds were determined to be potential drug candidates. Among these compounds, a Molecular Dynamic simulation study was applied for ChEMBL ID:1193133 to better understand the existence and duration of the compound in the receptor site. CONCLUSION: The results confirmed that the ChEMBL ID:1193133 compound showed good Root Mean Square Deviation (RMSD), Root Mean Square Fluctuation (RMSF), hydrogen bonding, and remaining time in the active site; therefore, it was considered that it could be active against the virus. This compound was also tested for antiviral activity, and it was determined that it did not delay viral infection, although it was cytotoxic between 5mg/mL-1.25mg/mL concentrations. However, if other compounds could be tested, it might provide a chance to obtain activity, and compounds should also be tested against the enzymes as well as the other types of viruses.

Effect of the Advanced Cranial and Craniofacial Implant Fabrication on Their Degradation Affinity.

Biodegradable craniofacial and cranial implants are a new aspect in terms of reducing potential complications, especially in the long term after surgery. They are also an important contribution in the field of surgical reconstructions for children, for whom it is important to restore natural bone in a relatively short time, due to the continuous growth of bones. The aim of this study was to verify the impact of the technology on biodegradability and to estimate the risk of inappropriate implant resorption time, which is an important aspect necessary to select prototypes of implants for in vivo testing. Prototypes of implants were made using two technologies: 3D printing using a PLDLA: poly(L-co-D,L lactide) (PLDLA) filament containing hydroxyapatite nanoparticles, and injection using PLDLA. After the radiation sterilization process, they were subjected to in vitro degradation under accelerated conditions. As part of this study, the in vitro degradation of newly developed biodegradable implant technologies was assessed in accordance with the guidelines of European standards. It was found that the implant manufacturing process had a significant impact on the degradation time under simulated conditions in various media. Implants made using the injection technique were characterized by lower susceptibility to degradation media compared to the 3D-printed implant under accelerated conditions.

Risk assessment of parabens in a transcriptomics-based in vitro test.

Parabens have been used for decades as preservatives in food, drugs and cosmetics. The majority however, were banned in 2009 and 2014 leaving only methyl-, ethyl-, propyl-, and butyl-derivates available for subsequent use. Methyl- and propylparaben have been extensively tested in vivo, with no resulting evidence for developmental and reproductive toxicity (DART). In contrast, ethylparaben has not yet been tested for DART in animal experiments, and it is currently debated if additional animal studies are warranted. In order to perform a comparison of the four currently approved parabens, we used a previously established in vitro test based on human induced pluripotent stem cells (iPSC) that are exposed to test substances during their differentiation to neuroectodermal cells. EC50 values for cytotoxicity were 906 µM, 698 µM, 216 µM and 63 µM for methyl-, ethyl-, propyl- and butylparaben, respectively, demonstrating that cytotoxicity increases with increasing alkyl chain length. Genome-wide analysis demonstrated that FDR-adjusted significant gene expression changes occurred only at cytotoxic or close to cytotoxic concentrations, for example 1720 differentially expressed genes (DEG) at 1000 µM ethylparaben, 1 DEG at 316 µM, and no DEG at 100 µM or lower concentrations. The highest concentration of ethylparaben that did not induce any cytotoxicity nor DEG was 1670-fold above the highest concentration reported in biomonitoring studies (60 nM ethylparaben in cord blood). In conclusion, cytotoxicity and gene expression alterations of ethylparaben occurred at concentrations of approximately three orders of magnitude above human blood concentrations; moreover, the substance fitted well into a scenario where toxicity increases with the alkyl chain length, and gene expression changes only occur at cytotoxic or close to cytotoxic concentrations. Therefore, no evidence was obtained suggesting that in vivo DART with ethylparaben would lead to different results as the methyl- or propyl derivates.

Evaluation of the antiwear-ability/scratch-resistance efficacy of makeup products by in vitro test method application.

OBJECTIVE: The objective of this study is to propose a method for assessing the antiwear-ability (AW) or surface scratch-resistance (SR) efficacy of makeup products through in vitro experiments. MATERIALS AND METHOD: The method primarily involves measuring the change in weight as a means of evaluating the overall effectiveness. AW/SR effects are evaluated by applying a fixed amount of makeup product on artificial fake skin and comparing the weight difference after simulated friction/scratch. RESULTS: The in vitro results indicate that this method is easy to operate and yields repeatable data. It consistently reflects differences between samples when compared to clinical studies. CONCLUSIONS: This method effectively compares the AW/SR effects of makeup products and demonstrates utility in evaluating product efficacy and difference. It holds great scientific and practical value.

A reliable and replicable test protocol for the mechanical evaluation of synthetic meshes.

Despite the worldwide spread of surgical meshes in abdominal and inguinal surgery repair, the lack of specific standards for mechanical characterization of synthetic meshes, used in hernia repair and urogynecologic surgery, makes performance comparison between prostheses undoubtedly difficult. This consequently leads to the absence of acknowledged specifications about the mechanical requirements that synthetic meshes should achieve in order to avoid patient discomfort or hernia recurrences. The aim of this study is to provide a rigorous test protocol for the mechanical comparison between surgical meshes having the same intended use. The test protocol is composed of three quasi-static test methods: (1) ball burst test, (2) uniaxial tensile test, and (3) suture retention test. For each test, post-processing procedures are proposed to compute relevant mechanical parameters from the raw data. Some of the computed parameters, indeed, could be more suitable for comparison with physiological conditions (e.g., membrane strain and anisotropy), while others (e.g., uniaxial tension at rupture and suture retention strength) are reported as they provide useful mechanical information and could be convenient for comparisons between devices. The proposed test protocol was applied on 14 polypropylene meshes, 3 composite meshes, and 6 urogynecologic devices to verify its universal applicability towards meshes of different types and produced by various manufacturers, and its repeatability in terms of coefficient of variation. The test protocol resulted easily applicable to all the tested surgical meshes with intra-subject variability characterized by coefficient of variations settled around 0.05. Its use within other laboratories could allow the determination of the inter-subject variability assessing its repeatability among users of alternative universal testing machines.

Combined cytotoxicity of ZnO nanoparticles and chlorpyrifos in the rainbow trout, Oncorhynchus mikyss, gonadal cell line RTG-2.

The toxicity of ZnO nanoparticles (ZnO NPs) in aquatic organisms has been extensively studied, but little information is available on the effects associated with their interaction with other contaminants. In this context, the in vitro effects of co-exposure of chlorpyrifos (CPF) and ZnO NPs on fish-derived cells were investigated. A selection of concentrations was tested in single and binary exposures: CPF (0.312 - 75 mg/L) and ZnO NPs (10 - 100 mg/L). Cytotoxicity was measured using commonly used cellular endpoints: Alamar Blue/CFDA-AM for viability and plasma membrane integrity, NRU for lysosomal disruption and MTT for mitochondrial function. In addition, specific mechanisms of toxicity for CPF and ZnO NPs were tested: acetylcholinesterase (AChE) activity and ROS generation, respectively. AChE was by far the most sensitive assay for single exposure to CPF. There was no concentration-response relationship for ROS after single exposure to ZnO NPs, but 10 mg/L produced significant effects only for this cellular endpoint. Co-exposure of CPF with 10 m/L of ZnO NPs produced significant effects in almost all endpoints tested, which were enhanced by co-exposure with 100 mg/L of ZnO NPs. AChE testing of additional co-exposures with bulk ZnO, together with the application of the Independent Action (IA) prediction model, which allowed us to draw more in-depth conclusions on the toxicological behavior of the mixture. Synergism was observed at 0.625 mg/L CPF concentration and antagonism at 5 mg/L CPF in mixtures containing 100 mg/L of both ZnO NPs and bulk ZnO. However, more cases of synergism between CPF and ZnO NPs occurred at intermediate CPF concentrations, demonstrating that nano-sized particles have a more toxic interaction with CPF than bulk ZnO. Therefore it can be argued that in vitro assays allow the identification of interaction profiles of NP-containing mixtures by achieving multiple endpoints with a large number of concentration combinations.

Isolation, functional evaluation of probiotic properties and molecular identification of strains isolated from Iranian poultry's gut.

Background and Objectives: The use of probiotics as an alternative to antibiotics in poultry diets has attracted a lot of interest recently. In this context, the determination of probiotic characteristics was evaluated on several isolates obtained from Iranian poultry's gut. Materials and Methods: Probiotic characteristics such as hemolysis activity, acid, bile, gastric juice tolerate, in vitro adhesion assay, cell surface properties (hydrophobicity, auto-aggregation and co-aggregation) and antibiotic susceptibility test were evaluated. Finally, selected isolates identified molecularly after temperature-salt tolerance and extracellular enzyme activity (amylase, protease and cellulose). Results: Out of 362 strains isolated from native poultry in three geographical regions of Iran, nine strains (belong to Bacillus sp., Enterococcus sp., Pediococcus sp., Lactobacillus sp., Kluyveromyces sp.) showed resistance against gastrointestinal physiological conditions, desirable surface properties, ability to adhere to epithelial intestine cell line and antibiotic susceptibility. Also, these strains were discovered to be temperature-salt tolerant but, only a small number of them were able to produce hydrolase enzymes. Conclusion: According to the results, the selected strains can be introduced as native probiotic candidates for utilization in novel poultry feeds.

Evaluation of the susceptibility to fipronil of Rhipicephalus microplus larvae from egg masses incubated at different times of oviposition.

The objective of this work was to evaluate the susceptibility of R. microplus larvae from different oviposition times to fipronil. The LPT was performed in sextuplicate, at concentrations of 18.75, 37.5, 75, 150 and 300 µg.mL-1. The LC50 found for the egg masses incubated with +7, +14 and +21 days were respectively 105.87, 110.71 and 121.22 µg.mL-1. The larvae originating from egg masses from the same group of engorged females, incubated on different days, presented similar mortality rates compared to the evaluated fipronil concentrations, facilitating the maintenance of laboratory colonies of this tick species.

O objetivo deste trabalho foi avaliar a susceptibilidade de larvas de R. microplus oriundas de diferentes momentos da oviposição frente ao fripronil. O TPL foi realizado em sextuplicata, nas seguintes concentrações 18,75; 37,5; 75; 150; 300 µg.mL-1. Não houve diferença estatística entre as mortalidades das larvas oriundas de posturas incubadas nos dias mais sete, +14 e +21, expostas ao fipronil. As CL50 encontradas para as posturas incubadas com +7, +14 e +21 dias foram respectivamente 105,87; 110,71 e 121,22 µg.mL-1. Observou-se que as larvas oriundas de posturas, do mesmo grupo de fêmeas ingurgitadas, incubadas em dias diferentes apresentam taxas de mortalidade parecidas frente as concentrações de fipronil avaliadas, facilitando a manutenção das colônias laboratorias desta espécie de carrapato.

Cleaning potential of interdental brushes around orthodontic brackets - an in vitro investigation.

This study evaluated the brushing efficacy of different interdental brushes around a multibracket appliance in vitro. In four models displaying misaligned and aligned teeth with and without attachment loss, the brushing capacities of three interdental brushes (IDB) were tested: A waist-shaped IDB with a diameter of 9 mm at both ends and 5 mm in the middle (B1), a cylindrical brush with a diameter of 9 mm (B2) and one with 5 mm (B3). Before cleaning, the black teeth in the respective models were stained white with titanium (IV) oxide and the percentage of cleaned surface was planimetrically assessed. In addition, the forces applied to the IDB were also recorded. The effect of brush and model on expected cleaning performance was examined using an analysis of variance (ANOVA). The cleaning performance of the brushes in decreasing order was B2>B3>B1; no significant differences between the different tooth areas and models were found. With regard to force measurements, significant differences were found with the highest and lowest forces IDB (2) and (1), respectively. There was a significant correlation between force and cleaning performance: The higher the force needed the higher was the cleaning performance. In summary, this study showed that cylindrical interdental brushes achieved a better cleaning performance than the waist-shaped IDB. Given some shortcomings of this first laboratory study, more research is still needed, but IDB may represent a valuable yet still clinically underused tools.