Comparative Study
COMPARISON OF THE EFFICACY OF PIPES CLEANER AND TUFTED FLOSS IN PATIENTS WITH FIXED ORTHODONTIC APPLIANCES: A COMPARATIVE STUDY
, P. Montagna1 , A. Trevisan2 , N. Tomizioli1 , T.M. Davo1, A. Bertajola1, G. Gandioli1 , J. Stevanin1 , B. Olivato1 , G. Montagna3, G. Colapinto1 1 Head and Neck Department, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Verona, Italy
2 Private practice in Vicenza, Italy
3 Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
Correspondence to:
Private practice,
Vicenza, Italy
European Journal of Musculoskeletal Diseases 2026 September-December 15(3): Ahead of Print
https://doi.org/10.82093/ejmd/2026v15iss3_3
Received: 14 July 2026 Accepted: 7 August 2026
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Abstract
To compare the efficacy of pipe cleaners (PC) and tufted floss (TF) over a one-month period to determine which device is more effective in plaque removal and the reduction of gingival inflammation in orthodontic patients with fixed multi-bracket appliances. This randomized controlled trial compared two study groups: the pipe cleaners’ group (n=10, mean age 12.6 ± 2.02 years) and the tufted floss group (n=10, mean age 12.4 ± 2.88 years). Both groups were evaluated at baseline (T0) and 1 month later (T1). At T0, patients received instruction and motivation regarding Home Oral Hygiene (HOI) and the correct use of their assigned device. The indices recorded at both T0 and T1 were the Bonded Bracket Plaque Index (BBPI), Gingival Bleeding Index (GBI), and Gingival Index (GI). Statistical analysis was performed using independent- and paired-samples t-tests to evaluate clinical improvements and overall outcomes. A statistically significant difference was observed at T1, favoring the pipe cleaners’ group regarding the bleeding index (p = 0.012). No statistically significant differences were found for the other parameters analyzed. Within the limits of this study, it can be concluded that the pipe cleaners reduce gingival bleeding on probing more effectively than tufted floss in patients with fixed orthodontic appliances.
Keywords: bonded brackets plaque index, fixed orthodontics, gingival bleeding index, gingival index, oral hygiene, pipe cleaners, tufted floss