At a glance
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Assessing the Impact of Interdental Brushing on Gingival Health and Patient-Reported Outcome Measures in Individuals With Fixed Prostheses: A Single-Blind Randomized Controlled Clinical Trial
In Brief
A clinical study evaluating Touch-to-Teach interdental brush instruction and Conventional oral hygiene instruction for Gingivitis and 3 related conditions. Completed, enrolled 32 participants across 1 site.
Detailed Summary
Why is this study being done? People with dental crowns often develop inflamed gums because bacteria accumulate in the tight spaces between teeth that a regular toothbrush cannot reach. Interdental brushes can clean these spaces, but patients frequently use them incorrectly. This study tested whether a personalised, hands-on instructional method called Touch-to-Teach produces healthier gums compared with standard dental hygiene advice. Who participated? 40 adults with at least one porcelain-fused-to-metal crown in the molar region with supragingival margins took part at Thumbay University Hospital, Ajman, UAE. Four participants withdrew; 36 completed the three-month study. What did participants do? All participants received full-mouth scaling and standardised toothbrushing instruction. Group 1 (Touch-to-Teach) additionally received probe-guided, site-specific interdental brush selection and guided in-mouth training, with correctly sized brushes provided for home use. Group 2 (Conventional Instruction) received verbal advice, educational videos, and a model-based demonstration, with brush size selected empirically and no brushes provided for home use. Follow-up visits were conducted at one, two, and three months. What was measured? A blinded examiner recorded gum inflammation, plaque levels, gum pocket depth, and bleeding at each visit. Both groups completed a questionnaire on brush comfort, perceived efficacy, and satisfaction at one and three months. What were the key results? The Touch-to-Teach group showed significantly greater reductions in plaque accumulation, gingival inflammation, and probing depth compared with the control group. Both groups showed meaningful reductions in gingival bleeding over time, with no statistically significant difference between groups at three months. Patient-reported outcomes consistently favoured the Touch-to-Teach group. These findings suggest that calibrated, personalised interdental brush instruction may offer advantages for patients with fixed dental prostheses.
Study Details
Timeline
Arms & Interventions
Participants received standardized oral hygiene instruction (Modified Bass technique) and full-mouth scaling and root surface debridement, plus individualized Touch-to-Teach interdental brush instruction using the Curaprox Chairside System. A color-coded CPS colorimetric probe measured each interproximal space precisely (blue 0.6mm, red 0.7mm, pink 0.8mm, yellow 0.9mm, green 1.1mm). Matching color-coded brushes were prescribed per site. The clinician demonstrated correct technique on a dental model then guided each patient through the procedure in their own mouth until correct insertion, manipulation, and removal were demonstrated at each designated space. Prescribed size-calibrated interdental brushes were provided for home use throughout the 3-month study period
Participants received standardized oral hygiene instruction (Modified Bass technique) and full-mouth scaling and root surface debridement. Conventional guidance comprised verbal instruction, access to European Federation of Periodontology animated patient education videos on interdental cleaning, and chairside hands-on demonstration of interdental brush insertion and manipulation using dental models with error correction. Brush size was selected empirically by the clinician without a calibrated sizing system. No personalized brush prescription, no CPS probe measurement, and no in-mouth guided insertion were provided.
Interventions
Individualized interdental brush care delivered using the Curaprox Chairside System (Curaprox AG) through three structured phases: Diagnostic Phase: CPS colorimetric probe with five autoclavable color-coded tips (blue 0.6mm, red 0.7mm, pink 0.8mm, yellow 0.9mm, green 1.1mm) used to measure precise accessibility diameter of each interproximal space. Prescription Phase: Matching color-coded interdental brush selected per space. Brush correctly sized when fitting snugly without wire bending or forceful insertion required. Training Phase: Clinician demonstrated technique on dental model then guided patient through procedure in their own mouth until proficiency in correct insertion angle, gentle manipulation, and removal was achieved at each space. Prescribed brushes provided for daily home use for 3 months.
Standardized oral hygiene guidance comprising: verbal instruction in Modified Bass toothbrushing technique; access to European Federation of Periodontology patient portal animated education videos demonstrating interdental cleaning techniques; and chairside hands-on demonstration of interdental brush insertion and manipulation using dental models with corrections provided as necessary. Brush size selected empirically without calibrated probe system. No personalized brush prescription, no CPS probe measurement, and no in-mouth guided insertion performed.