Plaque Removal Efficacy of Three Cleaning Methods for Removable Orthodontic Appliances: A Crossover Randomized Clinical Trial.

Abstract

The mechanical plaque removal methods of removable orthodontic appliances (ROAs) may damage the appliance surface and may not effectively eliminate the entire microbial plaque. This study aimed to compare the efficacy of brushing + denture cleanser tablets, brushing + propolis mouthwash and brushing only for plaque removal from each orthodontic appliance surface. This crossover randomized clinical trial evaluated 32 patients between 7-15 years with ROAs. The patients were randomly assigned to three groups of brushing (control), brushing + denture cleanser tablets (intervention group 1), and brushing + propolis mouthwash (intervention group 2). The plaque removal methods were switched among the groups during three 1-month periods. One month after practicing a certain protocol, the plaque disclosing agent was applied on the surface of the appliance. The photographs of appliances were analyzed by Image J software to calculate the surface area occupied by the residual microbial plaque. The ratio difference of residual plaque surface area to the surface area of the entire appliance was significant between the intervention group1 and control group (p<0.001), while it was not significant in intervention group 2 and control group (p=0.105). Also, this difference between the intervention group1 and 2 was statistically significant (p<0.001). Simultaneous use of toothbrush with denture cleanser tablets decreased the microbial biofilm on the surface of ROAs, compared with brushing alone. Thus, it seems that the use of denture cleaning tablets may be suitable for effective cleaning of ROAs.