Design and Efficacy of Custom-Made Cleaning Splints for the Approximal Plaque Removal-A Laboratory Study.

Stefan Rues, Theresa Becker, Valentin Bartha, Marcia Spindler, Sebastian Hetzler, Diana Wolff, Peter Rammelsberg, Andreas Zenthöfer
Author Information
  1. Stefan Rues: Department of Prosthodontics, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany. ORCID
  2. Theresa Becker: Department of Conservative Dentistry, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany.
  3. Valentin Bartha: Department of Conservative Dentistry, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany.
  4. Marcia Spindler: Department of Conservative Dentistry, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany.
  5. Sebastian Hetzler: Department of Prosthodontics, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany.
  6. Diana Wolff: Department of Conservative Dentistry, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany.
  7. Peter Rammelsberg: Department of Prosthodontics, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany.
  8. Andreas Zenthöfer: Department of Prosthodontics, Medical Faculty, Heidelberg University, 69120 Heidelberg, Germany.

Abstract

Cleaning splints (CSs) can facilitate interdental brush (IDB) insertion and guide IDBs during cleaning movement. Cleaning efficacy with and without CSs was to be assessed and compared for a fully dentate (FD) and a partially edentulous (PE) situation. For two maxillary typodont models simulating either an FD situation or a PE situation with every second tooth missing, suitable IDBs were selected and each cleaning splint was designed and fabricated by 3D-printing. Before and after standardized cleaning, model teeth were photographed at three timepoints: (T1) clean surface, (T2) surface coated with artificial plaque, and (T3) after IDB cleaning. For each of the four test groups differing in dental status (FD, PE) and CS use (without, with), n = 10 tests/group were completed. After aligning corresponding photographs, pixel-based color difference ratios (T2-T3)/(T2-T1) were calculated. Approximal cleaning efficacy was set as the mean value over predefined regions of interest. Effects of CS use and dental status were analyzed with two-way ANOVA (α = 0.05). CS use significantly improved mean approximal cleaning efficacy for the PE model ( = 0.001), whereas no difference was found with the FD model ( = 0.381). Improved cleaning efficacy with the PE model was only found in combination with a CS (factor combination model × CS use: = 0.003). Cleaning splints might have the potential to improve interproximal hygiene and can be recommended for clinical use. Clinical studies should validate the results of this in vitro study and clarify if CSs could be beneficial for patients with restricted manual skills.

Keywords

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