This randomized crossover clinical trial evaluated whether the sequence of powered toothbrushing and dental flossing affects dental plaque removal. Forty-six systemically and periodontally healthy participants were randomly assigned to one of two oral hygiene sequences. In Group 1, participants performed powered toothbrushing followed by dental flossing during the first period and dental flossing followed by powered toothbrushing during the second period. Group 2 performed the same procedures in the opposite order. The two intervention periods were separated by a 15-day washout period, with professional prophylaxis performed to standardize oral hygiene conditions. Dental plaque was assessed before and after the oral hygiene procedures using the Plaque Index (PI) and the Turesky modification of the Quigley-Hein Plaque Index (TQHPI). The study aimed to determine whether performing powered toothbrushing before or after dental flossing results in greater plaque removal.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
46
Participants will perform oral hygiene using a powered toothbrush according to the standardized study protocol. The intervention will be applied as part of the assigned brushing-flossing sequence.
Participants will perform interdental cleaning using dental floss according to the standardized study protocol. The intervention will be applied as part of the assigned brushing-flossing sequence.
Lokman Hekim University Faculty of Dentistry
Ankara, Turkey (Türkiye)
Residual Plaque Index
Residual dental plaque was assessed immediately after completion of the assigned oral hygiene sequence using the Plaque Index (PI). Higher scores indicate greater residual plaque accumulation.
Time frame: Immediately after completion of the assigned oral hygiene sequence following 48 hours of plaque accumulation, in each study period.
Residual Buccal Turesky Modified Quigley-Hein Plaque Index (TQHPI)
Following plaque disclosure, residual plaque on the buccal tooth surfaces was assessed using the Turesky Modified Quigley-Hein Plaque Index (TQHPI), scored from 0 to 5, with higher scores indicating greater residual plaque accumulation.
Time frame: Immediately after completion of the assigned oral hygiene sequence following 48 hours of plaque accumulation, in each study period.
Residual Lingual Turesky Modified Quigley-Hein Plaque Index (TQHPI)
Following plaque disclosure, residual plaque on the lingual tooth surfaces was assessed using the Turesky Modified Quigley-Hein Plaque Index (TQHPI), scored from 0 to 5, with higher scores indicating greater residual plaque accumulation.
Time frame: Immediately after completion of the assigned oral hygiene sequence following 48 hours of plaque accumulation, in each study period.
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