The aim of this study was to compare the plaque removal efficacy around ball attachments of 4 cleaning aids:
yarn (3 mm diameter), gauze strip, Superfloss®, and end-tufted brush. Thirty-two subjects, aged 60 years and over were
recruited from the list of patients in the His Majesty the King’s 80th Birthday Anniversary Dental Implant Project (December
5th, 2007). All subjects were fully edentulous who had been treated with 2 unsplinted dental implants in the anterior
mandible for mandibular implant overdenture. Each subject was randomly assigned by lucky drawing for the sequence
of using cleaning aids. All subjects had to use each cleaning aid 2 times a day for 4 weeks. The experimental phases were
separated by a 2-week wash-out period. Two weeks prior to each experimental phase, ball attachments were polished to
remove all plaque and a standardized instruction in the use of each cleaning aid was given. The plaque scores, gingival
index scores, and probing depths were determined at baseline and at the end of each experimental period. Overall,
the results of this study demonstrated that 4 cleaning aids significantly reduced plaque scores and gingival index scores
at the 4th week follow-up visits (p < 0.05). The highest percentage of the reductions in probing depths were observed in
the use of yarn and end-tufted brush following the 4-week test period. No significant differences were found with respect
to type of cleaning aid used. It was noted that the decreasing frequency distribution of plaque scores and gingival index
scores were uppermost for yarn but not significantly differences among the 4 cleaning aids. It is concluded that yarn is
an effective means of reducing plaque and gingivitis around dental implants as well as other 3 cleaning aids.