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SANZ et al .
Risk of bias Low to unclear.
IDBs are the first choice for periodontal maintenance patients. Six comparisons from four RCTs (162 patients) were identified.
Consistency High.
Risk of bias High to unclear.
Clinical relevance and effect size Considered as clinically relevant.
Consistency High.
Balance of benefit and harm There is a moderate risk of trauma due to the use of interdental brushes, when not used properly. Therefore, individual instruction and adaptation to the individual situation by professionals are cru - cial. In any case, the benefits overweigh the risks by far.
Clinical relevance and effect size Considered as clinically relevant.
Balance of benefit and harm There is a moderate risk of trauma due to the use of interdental brushes or flossing, when not used properly. Therefore, individual instruction and adaptation to the individual situation by profession - als are crucial.
Economic considerations Not considered.
Patient preferences There is clinical evidence supporting that patients with open inter - dental spaces prefer the use of interdental brushes over the use of dental floss. Applicability The guideline can be applied since appropriate quantities and varieties of interdental brushes are available on the European market. R4.7 | What is the value of dental flossing for interdental cleaning in periodontal maintenance patients? Evidence-based recommendation (4.7) We do not suggest flossing as the first choice for interdental cleaning in periodontal maintenance patients. Supporting literature Slot et al. (2020) Quality of evidence Six comparisons from four RCTs (162 patients) with unclear to high risk of bias Grade of recommendation Grade B—↓ Strength of consensus Consensus (5.6% of the group abstained due to potential CoI)
Economic considerations Not considered.
Patient preferences There is clinical evidence supporting that patients with open interdental spaces prefer the use of interdental brushes over the use of dental floss. Applicability The guideline can be applied since appropriate quantities and varieties of interdental brushes are available on the European market. R4.8 | What is the value of other interdental devices for interdental cleaning in periodontal maintenance patients? Expert consensus-based recommendation (4.8) In interdental areas not reachable by toothbrushes, we suggest supplementing tooth brushing with the use of other interdental cleaning devices in periodontal maintenance patients. Supporting literature Slot et al. (2020) Grade of recommendation Grade B—↑ Strength of consensus Consensus (4.1% of the group abstained due to potential CoI)
Background
Background
Intervention See previous sections.
Intervention Other interdental cleaning devices include rubber/elastomeric clean - ing sticks, wood sticks, an oral irrigator or dental floss. Although there are very small and fine interdental brushes available on the market, it must be realized that not all interdental spaces are readily accessible with interdental brushes.
Available evidence The underlying systematic review (Slot et al., 2020) found evidence for a significantly better cleaning effect of interdental brushes than of flossing. Both the descriptive analysis and the NMA indicate that
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