Efficacy of dental floss with ellipsoidal knots vs conventional dental floss for plaque removal: A split‐mouth randomized trial

Objectives To compare clinical efficacy for plaque removal between dental floss with soft ellipsoidal knots and conventional floss. Materials and Methods We studied 33 university students (29 females and 4 males, 13 of them undergraduate/postgraduate students of dentistry), including regular and sporadic (less once/wk) users of dental floss, with interproximal spaces ≤1 mm, who used floss with and without knots in a randomized manner following a split‐mouth design. The Modified Navy Plaque Index (RMNPI) by Rustogi et al. was applied to determine the total removed plaque (TPI) and that removed in the gingival area (GPI) and interproximal spaces (IPI). Results The reduction in GPI was greater with the knotted vs conventional floss in all cases (14.77 ± 12.38; 64.79% vs 17.38 ± 13.66; 57.51%) and especially among no floss users (12.469 ± 10.98; 68.02% vs 15.833 ± 11.88; 58.55%). No statistically significant difference between floss types was found in TPI and IPI (globally or by floss utilization frequency) or in the mean GPI of floss users. Conclusion Floss with ellipsoidal knots showed similar efficacy to remove plaque in patients with less experience of flossing (but without statistically significant differences) compared with flossing themselves with conventional floss, and it may be an optimal solution for patients starting to use dental floss and for those with a lesser or only sporadic history of floss utilization.