Impact of Interdental Brushing On Periapical and Gingival Health in Patients with Multi-Rooted RCT-Treated Teeth

Abstract

High-quality endodontic treatment and good oral hygiene are key factors in the long-term success of root canal treatment (RCT). The aim of the present study was to assess the effects of interdental brushing on periapical health and gingival health of RCT treated multi-rooted teeth. A prospective study was carried out in 170 patients of age group 20–45 years during a period of 6 months in Department of Operative Dentistry and Endodontics. There were two groups of participants: Group A (routine toothbrushing, n = 85) and Group B (routine toothbrushing + interdental brushing daily, n = 85). Gingival health was determined by Gingival Index developed by Löe and Silness (1963) and periapical status was determined by Periapical Index (PAI) developed by Ørstavik, Kerekes and Eriksen (1986) from standardized periapical radiographs. The clinical results at 6 months follow-up showed significant differences between the two groups, with Group B having a mean Gingival Index of 0.64 ± 0.29 versus Group A, which had a mean Gingival Index of 1.21 ± 0.41 (p < 0.001). 81.2% of patients in Group B showed favorable periapical healing (PAI score ≤2) while 67.1% of the patients showed favorable periapical healing in Group A (p = 0.032). The overall plaque reduction was 43.8% with interdental brushing versus 24.6% with toothbrushing only. All data was analyzed statistically with SPSS version 26.0, at the level of significance p < 0.05. The results showed that interdental brushes can be used as an adjunctive treatment to achieve a significant improvement in gingival health and promote periapical healing of multi-rooted RCT treated teeth, and that they are an important part of a routine post-endodontic oral hygiene regimen.