Clinical and Biochemical Evaluation of Oral Irrigator Effectiveness in Fixed Orthodontic Treatment: A Randomised Clinical Trial

AIM: This study aimed to compare the clinical and biochemical effectiveness of using an oral irrigator (OI) and an interdental brush (IB) during fixed orthodontic treatment. METHODS: A total of 30 patients with fixed orthodontic treatment were included in the study. All participants were randomly divided into two equal groups: patients using OI (OI-group) and patients using IB (IB-group). The patients were followed regularly; clinical evaluations were performed at 4 different times (baseline, 2nd, 4th, and 8th weeks), and gingival crevicular fluid samples were collected simultaneously. Total and concentration levels of IL-1β, IL-10, MMP-1, and MMP-8 from the collected gingival crevicular fluid samples were evaluated by the ELISA method. Clinical and biochemical differences that occurred at different times between the two groups were statistically examined. RESULTS: The GI and BOP values at the 8th week (p < 0.001) and PI values at the 2nd (p = 0.004), 4th (p = 0.003), and 8th weeks (p < 0.001) were found to be statistically lower in the OI-group. Total IL-1β values in the 2nd week (p = 0.016), and total MMP-8 values in the 4th (p = 0.006) and 8th weeks (p = 0.01) were statistically lower in the OI-group. There were no significant differences in MMP-1 and IL-10 values between the groups at any time interval of the study (p > 0.05). CONCLUSION: This study demonstrated that the use of an oral irrigator in conjunction with a toothbrush resulted in lower levels of gingival inflammation markers and plaque compared to an interdental brush in patients undergoing fixed orthodontic treatment, suggesting that the oral irrigator served as a beneficial tool for supporting periodontal health during orthodontic treatment. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05562986.