The efficacy of an oscillating-rotating power toothbrush compared to a high-frequency sonic power toothbrush on parameters of dental plaque and gingival inflammation: A systematic review and meta-analysis.

AIM: To establish the efficacy of oscillating-rotating power toothbrush (OR-PTB) compared to high-frequency sonic power toothbrush (HFS-PTB) on improving parameters of plaque and gingival inflammation. Safety and participants' preference were secondary interests. MATERIALS AND METHODS: MEDLINE-PubMed and Cochrane-CENTRAL databases were searched, up to April 2021. Inclusion criteria were (randomized)controlled clinical trials that evaluated healthy humans brushing with an OR-PTB compared to a HFS-PTB. Evaluation for a minimum of 4 weeks, of one or more of the following parameters: plaque index scores (PI), bleeding scores (BS), number of bleeding sites (NoB) and gingival index scores (GI). RESULTS: Thirty two publications involving 38 comparisons were included after the independent screening. The descriptive analysis showed that in 54% of the comparisons, a significant difference in favour of the OR-PTB was found for PI, BS and GI scores. The Quigley and Hein index showed a significant difference of means (DiffM) between the end scores (DiffM 0.13, 95% CI [0.05;0.21] p < 0.001), as well as for the Rustogi-modified Navy index (DiffM 0.01, 95% CI [0.01;0.03] p = 0.002). This is in line with the meta-analysis for BS (DiffM 0.09, 95% CI [0.03;0.14] p = 0.003), for which the results were in favour of the OR-PTB and considered potentially clinically relevant. NoB showed a significant difference in favour of the OR-PTB for the end scores (DiffM 3.61, 95% CI [2.63;4.58] p < 0.00001). No difference in safety was indicated, 78% of participants preferred the OR-PTB. CONCLUSION: For patients to maintain good plaque control and improve gingival health, there is a small but significant difference based on longer-term studies between OR-PTB and HFS-PTB. This difference is potentially clinically relevant.

The efficacy of a rubber bristles interdental cleaner on parameters of oral soft tissue health-a systematic review.

AIM: This study aimed to establish the efficacy of a rubber bristles interdental cleaner (RBIC) as an adjunct to toothbrushing (TB) compared to that of the adjuvant use of other interdental cleaning devices and TB alone on plaque and gingivitis parameters. Additionally, the safety aspects and panellists' appreciation were evaluated. MATERIALS AND METHODS: Databases were searched for randomized controlled clinical trials (RCTs) evaluating plaque (PI), bleeding (BS), and gingival index (GI) scores, safety assessments, and participants' appreciation. Extracted data were summarized in a descriptive and, if possible, a meta-analysis. RESULTS: The search retrieved 142 unique papers; six studies with 10 comparisons were included in a descriptive analysis. Five RCTs compared RBICs with interdental brushes (IDBs), four with dental floss (DF) and one with manual TB only. No comparisons to wood sticks were retrieved. Using an RBIC resulted in no difference in plaque scores compared to DF and IDBs. For overall bleeding scores, no difference was found. Two studies analysing the accessible sites separately found RBICs to be more favourable than DF and IDBs. Conversely, one study evaluating the efficacy of RBICs compared to IDBs, according to the GI scores, showed that IDBs achieved significantly greater reduction. Moreover, RBICs caused fewer gingival abrasions and were preferred by the study participants. CONCLUSION: Based on a descriptive and a meta-analysis of the available literature, it is synthesized that in gingivitis patients, a weak to very weak certainty exists that a RBIC is indicated for gingivitis and plaque reduction. The evidence supports user safety and participants' preferences.

Dental plaque score reduction with an oscillating-rotating power toothbrush and a high-frequency sonic power toothbrush: a systematic review and meta-analysis of single-brushing exercises.

AIM: To establish the effect of a single-brushing exercise on dental plaque removal using an oscillating-rotating power toothbrush (OR-PTB) as compared to a high-frequency sonic power toothbrush (HFS-PTB). MATERIALS AND METHODS: The MEDLINE-PubMed and Cochrane-CENTRAL databases were searched up to September 2019. The inclusion criteria contained (randomized) controlled clinical trials involving healthy adult participants brushing with an OR-PTB as compared to an HFS-PTB. Plaque index (PI) scores were evaluated after a single-brushing exercise. RESULTS: A total of 15 publications were included, representing 34 comparisons, of which 8 were professional brushing exercises and 26 participant brushing exercises. The potential risk of bias was estimated to be low. In the overall descriptive analysis of 34 comparisons, 19 comparisons showed a statistically significant difference in favour of the OR-PTB and 4 in favour of the HFS-PTB. The meta-analysis using the professional brushing study design showed a significant difference of means (DiffM) in favour of the OR-PTB (PI score) (DiffM 0.19; P < .0001) (95% CI [013; 0.25]). In those studies where the participants brushed themselves, the data were inconclusive. PI scores showed no difference between the two brushes (P = .15), while one plaque index (the Rustogi Modified Navy plaque index) indicated significant favour for the OR-PTB (DiffM 0.06; P = .002) (95% CI [0.02; 0.09]). CONCLUSION: Based on the estimated evidence profile, there is moderate certainty of evidence of a very small but significant beneficial effect on plaque removal after a single-brushing exercise with the OR-PTB over the HFS-PTB.

Tongue coating in relationship to gender, plaque, gingivitis and tongue cleaning behaviour in systemically healthy young adults.

OBJECTIVES: The purpose of this observational study was to investigate the relationship between tongue coating (thickness [Tc] and surface discoloration [Td]) and gender, plaque, gingivitis (bleeding on marginal probing [BOMP] and bleeding on pocket probing [BOPP]) and tongue cleaning behaviour. MATERIALS AND METHODS: A total of 336 participants were screened for this cross-sectional study, from which 268 (150 male, 118 female) were found to be eligible. Aspects of tongue coating were visually assessed. Additionally, BOMP, BOPP and the plaque index (PI) were scored. To ascertain the tongue cleaning behaviour, the Oral Hygiene Behavior questionnaire was used. RESULTS: Most tongue coating was found at the posterior sections of the tongue surface. A thin coating and white discoloration were most prevalent as highest score for both males (92.7%) and females (87.4%), as well as white discoloration for the whole group of participants (50.2%). A gender difference was observed for TC and Td (P < .001). Analysis did not reveal a relationship between Tc and PI and between Td and PI. Also, no relation was detected between tongue cleaning behaviour and Tc or Td. However, tongue cleaning was associated with lower BOMP and BOPP scores. CONCLUSION: BOMP, BOPP or PI score did not appear to be linked to Tc and Td. A significant gender difference was found for Tc and Td. Self-reported tongue cleaning behaviour was associated with slightly lower BOMP and BOPP scores.

The effect on clinical parameters of periodontal inflammation following non-surgical periodontal therapy with ultrasonics and chemotherapeutic cooling solutions: a systematic review.

AIM: To establish the added effect of a chemotherapeutic cooling solution in an ultrasonic device on clinical parameters of periodontal inflammation following non-surgical periodontal therapy. METHODS: The MEDLINE-PubMed, Cochrane-CENTRAL, and the EMBASE databases were searched. Probing pocket depth (PPD) and clinical attachment level (CAL) and their changes were selected as outcome variables. Subgroup analyses were performed according to the following active ingredients: essential oils (EO), povidone-iodine (PVP), and chlorhexidine (CHX). RESULTS: Screening of 100 unique papers resulted in 14 eligible publications, including 16 comparisons. The meta-analysis (MA) showed that when the ultrasonic cooling solution had adjuvant chemotherapeutic properties, the difference of means (DiffM) for end value PPD-0.12 (95% CI: -0.42; 0.18) and for CAL the DiffM+-0.13 (95% CI: -0.39; 0.14). None of these were statistically significant, and the findings were supported by the overall descriptive analysis. Subgroup analysis only revealed a small effect for PVP on the difference (DiffM = -0.23, 95% CI: -0.43; -0.02) with respect to CAL (p = 0.03). CONCLUSIONS: The collective evidence indicates that overall, no additional effects were observed. There is a "very weak" recommendation based on the sub-analysis showing that in conjunction with PVP, a very small gain in CAL may be expected. For the use of CHX or EO, the added effect can be considered to be "zero." Therefore, the strength and direction of the recommendation emerging from this review is against their use.

Can Chemical Mouthwash Agents Achieve Plaque/Gingivitis Control?

Also note that structured abstracts are not allowed per journal style: What is the effect of a mouthwash containing various active chemical ingredients on plaque control and managing gingivitis in adults based on evidence gathered from existing systematic reviews? The summarized evidence suggests that mouthwashes containing chlorhexidine(CHX) and essential oils (EO) had a large effect supported by a strong body of evidence. Also there was strong evidence for a moderate effect of cetylpyridinium chloride(CPC). Evidence suggests that a CHX mouthwash is the first choice, the most reliable alternative is EO. No difference between CHX and EO with respect to gingivitis was observed.