Plaque Biofilm Removal Following Interproximal Cleaning

Objectives:
To evaluate the effect of oral hygiene cleaning modalities on surface and interproximal plaque removal.
Methods:
This IRB approved, randomized, single-blinded parallel-design study was conducted in 199 healthy adults (mean age 44.6years, 145 females/54 males). Eligible subjects were non-smokers, aged 18-65 years, with >0.5 per Rustogi Modified Navy Plaque Index (RMNPI) following a 24+/-4 hour plaque accumulation period. Enrolled subjects received a Baseline RMNPI and Oral Soft Tissue(OST) assessment and were then randomly allocated to use one of the following oral hygiene cleaning modalities in office; manual toothbrush (MTB) alone, MTB plus string floss (SF), MTB plus Sonicare Airfloss with water (AFW), MTB plus Sonicare AirflossPro with water (AFPW) or MTB plus Sonicare AirflossPro with Listerine CoolMint Antiseptic Rinse (AFPR). Subjects then received post-use OST and RMNPI examinations. All subjects then received an MTB for home use for the following 7-10 days. Subjects returned to clinic at Visit2 for contralateral interproximal plaque (IP) sampling before and after product use according to prior randomization assignment. Subjects were then dismissed from the study.
Results:
For RMNPI, Overall LSMeans(SE) pre and post product use outcomes were as follows; for MTB 0.62(0.01) and 0.23(0.01), for SF 0.62(0.01) and 0.19(0.01), for AFW 0.63(0.00) and 0.17(0.01), for AFPW 0.64(0.01) and 0.16(0.01) and for AFPR 0.63(0.01) and 0.11(0.01).

For IP protein residual concentration, LSMeans(SE) pre and post product use outcomes were as follows; for MTB 47.96(4.01) and 42.52(3.17), for SF 51.24(4.01) and 37.47(3.17), for AFW 55.73(4.01) and 39.09(3.18), for AFPW 49.38(4.06) and 41.47(3.21), for AFPR 49.55(4.06) and 37.36(3.21).
Conclusions:
The use of adjunct interproximal cleaning regimens significantly improves surface plaque removal versus MTB alone. Among interproximal modalities, AFPR and AFPW were superior to SF (p-value <0.001). For IP concentration, we observed large variation across treatment groups, which did not allow for statistical differentiation between cleaning modalities.