The aim of this randomized clinical trial was to compare the plaque control effectiveness and handling of an interdental brush with a short curved handle and a triangular cross-section of the brush head (IDB) and an interdental brush with a long straight handle in combination with a monotufted brush head (MTB). In a split-mouth design, 110 multibracket patients were randomly assigned to group A using the MTB in the first and third quadrants and the IDB in the second and fourth quadrants or to group B who proceeded the other way around. A crossover was performed after 3 months. The plaque index (PI) was scored every 6 weeks for a period of 24 weeks, and handling was evaluated using visual analogue scales (VAS). Wilcoxon tests were used to determine differences in PI and VAS scores between the two brushes and for PI differences between the different observation periods. Differences concerning personal preference and perceived cleaning efficacy were analysed with chi-square tests. The significance levels used were P < 0.001 and P < 0.01. The PI decreased significantly, but no statistically significant difference was found between the two brushes. Subjects experienced less pain and reported better access behind the archwire with the IDB. The use of an interdental brush reduced the PI irrespective of the design of the brush head. In direct comparison, adolescent patients preferred the IDB. Further trials are required to investigate the effectiveness of the IDB in reducing decalcification during orthodontic treatment.

Gene expression variation can be partitioned into different components (regulatory, genetic and acclimatory effects) but for lichen-forming fungi, the relative importance of each of these effects is unclear. Here, we studied gene expression in the lichen-forming fungus Lobaria pulmonaria in response to thermal stress and parasitism by the lichenicolous fungus Plectocarpon lichenum. Our experimental procedure was to acclimate lichen thalli to 4 °C over three weeks and then expose them to 15 °C and 25 °C for 2 hours each, sampling infected and visually asymptomatic thalli at each temperature. Quantitative Real-Time PCR was utilized to quantify gene expression of six candidate genes, normalizing expression values with two reference genes. We found that two genes encoding heat shock proteins (hsp88 and hsp98), two polyketide synthase genes (rPKS1, nrPKS3) and elongation factor 1-1-α (efa) were upregulated at higher temperatures. Moreover, we observed higher expression of hsp98 at 25 °C in samples infected by P. lichenum than in uninfected samples. Finally, in partial redundancy analyses, most of the explained variation in gene expression was related to temperature treatment; genetic variation and long-term acclimatization to sites contributed far less. Hence, regulatory effects (i.e. direct adjustments of gene expression in response to the temperature change) dominated over genetic and acclimatory effects in the gene expression variability of L. pulmonaria. This study suggests that L. pulmonaria could become a valuable lichen model for studying heat shock protein responses in vivo.