Abstract
BackgroundInterdental rubber picks (IRP) have become a frequent and convenient alternative for interdental cleaning. However, only little evidence exists supporting the effectiveness of newer designs available on the market. Therefore, a new in vitro model was evaluated to measure the experimental cleaning efficacy (ECE), as well as the force needed for insertion and during the use of IRP, with high reproducibility.MethodsFive different sizes of commercially marketed IRP with elastomeric fingers (IRP-F) (GUM SOFT-PICKS® Advanced, Sunstar Deutschland GmbH, Schönau, Germany) or slats (IRP-S) (TePe EasyPick™, TePe D-A-CH GmbH, Hamburg, Germany) were tested. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre−/post brushing situations at interdental areas (standardized cleaning, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. Forces were registered with a load cell [N].ResultsIRP-F have to be inserted with significant higher forces of 3.2 ± 1.8 N compared to IRP-S (2.0 ± 1.6 N; p < 0.001) independent of the size and type of artificial interdental area. During cleaning process IRP-S showed significantly lower values for pushing/pulling (1.0 ± 0.8 N/0.5 ± 0.4 N) compared to IRP-F (1.6 ± 0.8 N/0.7 ± 0.3 N; p < 0.001) concomitant to significantly lower ECE (19.1 ± 9.8 vs. 21.7 ± 10.0%, p = 0.002). Highest ECE was measured with largest size of IRP-F/IRP-S independent the morphology of interdental area.ConclusionsNew interdental cleaning aids can be tested by the new experimental setup supported by 3D printing technology. Within the limitations of an in vitro study, IRP-F cleaned more effectively at higher forces compared to IRP-S.
Highlights
Interdental rubber picks (IRP) have become a frequent and convenient alternative for interdental cleaning
Experimental setup In this in vitro study, two different designs of interdental rubber picks were tested in all available sizes (Fig. 1a); the IRP with elastomeric fingers (IRP-F) with elastomeric fingers in small (ISO 1), regular (ISO 2) and large size (ISO 4) (GUM SOFTPICKS® Advanced, Sunstar Deutschland GmbH, Schönau, Germany) and the other one IRP-S with elastomeric slats in extra-small/small (ISO 1-4) and medium-large/ large (ISO 3-6) (TePe D-A-CH GmbH, Hamburg, Germany)
We found the highest experimental cleaning efficacy (ECE) for the isosceles triangle interdental morphology (31.1 ± 7.8%; p < 0.001), the biggest gap size of artificial interdental area (1.3 mm; 24.5 ± 8.6%; p < 0.001), as well as for the largest tested interdental rubber picks (Large; 24.0 ± 8.3%; p < 0.001), respectively (Table 1)
Summary
Interdental rubber picks (IRP) have become a frequent and convenient alternative for interdental cleaning. Beside a lot of efforts developing better toothbrushes, up to date their bristles do not reach the interproximal surfaces of teeth efficiently [1]. This seems important as interdental sites present the highest risk of plaque accumulation and the highest prevalence of caries and infrabony pockets in an adult population [2]. It’s not surprising that a currently published Cochrane review did not find any difference by very low-certainty evidence for interdental brushes or flossing versus interdental rubber picks [6]. The authors of this review concluded [6] that the available evidence for interdental rubber picks is limited and inconsistent
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