Exploring the potential of interdental brush in oral cytology: a pilot study on sampling efficiency

Background: With the renewed interest in brush biopsies, particularly for screening oral potentially malignant disorders and cancers, understanding the efficacy of available brush types in oral cytology is crucial. This study aims to compare the effectiveness of interdental brush sampling with commonly used cytology brushes in oral cytology evaluation. Methods: The study design was an observational clinical study. Brush biopsies were collected from the buccal mucosa of 99 healthy volunteers using an Interdental Brush- TePe Original Interdental Brush (TePe, Malmö, Sweden) (Cell sampling-Interdental Brush (CSIB)), Cytobrush Plus GT (Medscand Medical AB, Sweden) (Cell sampling device 1 (CSD1)), and CervexBrush (Rovers, Oss, Netherlands) (Cell sampling device 2 (CSD2)). Samples were evaluated for cellularity, depth of the epithelial layer, and cellular integrity. Results were compared between brush types using the Friedman test, and multiple comparisons were examined using the Dunn test. The significance level was set at p < 0.05. Results: Of the 99 cases, 59.6% were female and 40.4% were male, with a prevalence of smoking and alcohol consumption at 43.4%. The mean age was 24.3 years (± 4.5). There were no significant differences in cellularity between the brush types (p = 0.205). Mild cellularity was observed at rates of 3%, 9.1%, and 9.1% for CSD1, CSIB, and CSD2, respectively. Parabasal/basal layer cells were detected in 1% of samples collected with CSD1 and 4% with CSD2, while CSIB samples contained only superficial/intermediate cells. CSIB produced an inadequate integrity rate of 30.3%, whereas neither CSD2 nor CSD1 yielded samples with inadequate integrity. Conclusions: Interdental brushes may have potential as accessible and practical tools for chairside cytological screening. The CSIB obtained high-cellularity samples; however, it demonstrated low scores in cellular integrity. Future oral cytological studies may explore the modifications in interdental brush design to improve its potential in sampling for cell preservation and integrity.