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document
Direct and indirect effects of interdental hygiene in a clinical trial . Many randomized controlled trials ( RCTs ) in dental research test the efficacy of interventions on more than one outcome variable . Univariate methods , such as the t test or analysis of covariance , can not evaluate the efficacy of interventions on multiple outcomes simultaneously . The aim of this study was to use structural equation modeling ( SEM ) to re-analyze a RCT , comparing the effects of pre-curved interdental brushes and flossing on probing pocket depth ( PPD ) , plaque indices , and bleeding on probing ( BOP ) measured at baseline , intermediate , and final examinations . Results of SEM showed that the observed greater reduction in PPD and BOP in persons using interdental brushing than in those flossing is due mainly to the greater efficiency in plaque removal with the interdental brushes ( indirect effect ) rather than to the compression of the interdental papillae ( direct effect ) . In contrast , smokers showed less BOP at baseline but also less improvement in BOP through direct effects .
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Intervention_Educational
interdental hygiene
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Intervention_Educational
structural equation modeling
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Intervention_Educational
pre-curved interdental brushes and flossing
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Outcome_Physical
PPD
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Outcome_Physical
BOP
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Outcome_Physical
efficiency in plaque removal
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Outcome_Physical
BOP
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Outcome_Physical
BOP
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Participant_Condition
persons using interdental brushing than in those flossing
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Participant_Condition
smokers