Int J Dent Hygiene. 2017;1–8. wileyonlinelibrary.com/journal/idh | 1 © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Accepted: 8 September 2017 DOI: 10.1111/idh.12318 ORIGINAL ARTICLE Interdental plaque reduction after use of different devices in young subjects with intact papilla: A randomized clinical trial F Graziani 1,2 | A Palazzolo 1 | S Gennai 1 | D Karapetsa 1 | MR Giuca 1 | S Cei 1 | N Filice 1 | M Petrini 1 | M Nisi 1 1 Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy 2 Periodontology Unit, UCL Eastman Dental Institute, London, UK Correspondence Filippo Graziani, Department of Surgical, Medical, Molecular Pathology and Critical Area Medicine, Unit of Dentistry and Oral Surgery, Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy. Email: filippo.graziani@med.unipi.it Funding information The study was partly funded by the Italian Ministry Health and the Tuscan Region (Grant # GR-2009-1592229) and partly self- supported by the University of Pisa (Grant PRA_2016_26). Abstract Objectives: To determine the efficacy of 4 different oral hygiene regimens involving adjunctive interdental cleaning devices in unsupervised young subjects with intact in- terdental papilla. Material and methods: Sixty periodontally healthy subjects were randomly allocated to 4 groups following different oral hygiene regimens (T-7): use of manual toothbrush alone; manual toothbrush plus dental floss; manual toothbrush plus interdental brushes; and manual toothbrush plus rubber interdental picks. Oral hygiene instruc- tions (OHI) were given. One week after (T0), professional supragingival scaling and polishing was performed, and subjects were then reseen every 2 weeks (T14 and T28). At T-7, T0, T14 and T28, full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS) and angulated bleeding index (AngBI) were taken. Results: During the first week (T-7/T0 unclean phase), FMPS decreased significantly in all groups except the group using dental floss. At T28, a significant decrease in FMPS (P < .001, all groups) and FMBS (P < .05, all groups except the group using floss- ing P < .001) was noted. Interdental FMPS showed significantly lower values in sub- jects treated with interdental brushes or rubber interdental picks vs toothbrushing alone (P < .05). The use of interdental picks was associated with reduced interdental FMBS when compared to flossing (P < .05). Conclusion: In young subjects, with no interdental attachment loss, toothbrushing or toothbrushing and adjunctive interdental cleaning devices such as dental floss, inter- dental brushes or interdental rubber picks can significantly reduce both plaque and gingival inflammation. Use of interdental brushes or rubber picks reduces more inter- dental plaque in comparison with toothbrushing alone. KEYWORDS floss, interdental brushes, interdental picks, toothbrushing 1 | INTRODUCTION Accumulation of dental plaque is undoubtedly the main aetiological factor associated with the most frequent diseases of the oral cav- ity that is caries, gingivitis and periodontitis. It is thus of uttermost importance to be able to manage plaque accumulation especially in young subjects through successful prevention strategies. Studies showed that dental plaque is accumulated differently, in a specific pattern, among the individuals, yet the interproximal areas appear to be consistently associated with higher plaque scores. 1,2