-
International Journal of Dental Hygiene Feb 2021To 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... (Meta-Analysis)
Meta-Analysis
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.
Topics: Adult; Dental Plaque; Dental Plaque Index; Equipment Design; Humans; Periodontal Index; Single-Blind Method; Toothbrushing
PubMed: 32940391
DOI: 10.1111/idh.12463 -
Oral Health & Preventive Dentistry Jun 2024To evaluate the efficacy of the adjunctive use of tea tree oil (TTO) for dental plaque control and nonsurgical periodontal treatment (NSPT). (Meta-Analysis)
Meta-Analysis Review
The Effect of Local Application of Tea Tree Oil Adjunctive to Daily Oral Maintenance and Nonsurgical Periodontal Treatment: A Systematic Review and Meta-Analysis of Randomised Controlled Studies.
PURPOSE
To evaluate the efficacy of the adjunctive use of tea tree oil (TTO) for dental plaque control and nonsurgical periodontal treatment (NSPT).
MATERIALS AND METHODS
Three electronic databases were searched from 2003. The reference lists of the included articles and relevant reviews were also manually searched. Randomised controlled trials reporting the clinical outcomes of the topical use of TTO as an adjunct to daily oral hygiene or scaling and root planing (SRP) were included. Regarding the use of TTO as an adjunctive to daily oral hygiene, the primary outcome was plaque index (PI) reduction. Regarding the use of TTO as an adjunctive to SRP, probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were the primary outcomes. The secondary outcomes were adverse events.
RESULTS
Eleven studies were included for qualitative analysis, 9 studies were included for quantitative analysis, and 6 studies were included to examine the application of TTO mouthwash as an adjunctive to daily oral hygiene. In addition, three studies were included to analyse the subgingival use of TTO adjunctive to SRP at selected sites. The results indicated a nonsignificant improvement in PI reduction in the TTO mouthwash group compared with placebo. The incidence of adverse events was statistically significantly greater in the CHX group than in the TTO group. For subgingival use of TTO adjunctive to SRP, beneficial effects were observed in the TTO group compared with SRP alone in terms of PPD and CAL at both three and six months post-treatment. However, an unpleasant taste was reported in three out of four studies.
CONCLUSION
There is a lack of strong evidence to support the beneficial effects of TTO. Studies with larger sample sizes and standardised evaluation criteria are needed to further demonstrate the clinical relevance of TTO.
Topics: Humans; Tea Tree Oil; Randomized Controlled Trials as Topic; Dental Scaling; Mouthwashes; Dental Plaque; Oral Hygiene; Root Planing; Dental Plaque Index; Combined Modality Therapy; Treatment Outcome; Phytotherapy; Periodontal Diseases
PubMed: 38864380
DOI: 10.3290/j.ohpd.b5458585 -
Critical Reviews in Toxicology Aug 2021Intraoral fixed appliances remain in the potentially corrosive environment of the mouth for an average of two years. Over time, corrosion causes the release of metal...
Intraoral fixed appliances remain in the potentially corrosive environment of the mouth for an average of two years. Over time, corrosion causes the release of metal ions, such as nickel and chromium. These metals can become allergenic and cytotoxic, causing different conditions in the human body. The aim of this study therefore is to carry out a systematic review of the available scientific evidence on the accumulation of metal ions, and the genotoxic and cytotoxic effects in oral mucosa cells deriving from short- and long-term exposure to them. The systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary outcome (quantification of metal ion deposits and assessment of their genotoxic and/or cytotoxic effects) and secondary outcome (complementary analysis of cytotoxic and genotoxic effects) were examined. The Cochrane Collaboration tool and Toxicological data Reliability Assessment Tool (ToxRTool) were used for quality assessment. Once the search was performed, a total of seven articles met the inclusion criteria and were included in this study. Two main techniques were used to assess genotoxic effects: alkaline comet assay (6/7) and micronucleus method (1/7). Cytotoxicity was evaluated (4/7) using the trypan blue dye test. Accumulations of nickel (7/7), chromium (5/7), and other metals (zinc, cobalt, iron, manganese, molybdenum, titanium) were also quantified. The results allowed us to conclude that release of metal ions and acute cell and DNA damage in oral mucosa cells takes place in the early stages of treatment. However, more long-term studies are needed to evaluate chronic exposure to metals and DNA damage, as well as cellular capacity to recover DNA integrity.
Topics: Chromium; DNA Damage; Humans; Ions; Mouth Mucosa; Orthodontic Appliances; Reproducibility of Results
PubMed: 34738508
DOI: 10.1080/10408444.2021.1960271 -
Journal of Periodontology Nov 2020The 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions grouped the diseases previously recognized as chronic (CP) or... (Review)
Review
BACKGROUND
The 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions grouped the diseases previously recognized as chronic (CP) or aggressive (AgP) periodontitis under a single category named periodontitis. The rationale for this decision was the lack of specific patterns of immune-inflammatory response or microbial profiles associated with CP or AgP. However, no previous studies have compiled the results of all studies comparing subgingival microbial data between these clinical conditions. Thus, this systematic review aimed to answer the following focused question: "Do patients with AgP periodontitis present differences in the subgingival microbiota when compared with patients with CP?"
METHODS
A systematic review was conducted according to the PRISMA statement. The MEDLINE, EMBASE, and Cochrane databases were searched up to June 2019 for studies of any design (except case reports, case series, and reviews) comparing subgingival microbial data from patients with CP and AgP.
RESULTS
A total of 488 articles were identified and 56 were included. Thirteen studies found Aggregatibacter actinomycetemcomitans elevated in AgP in comparison with CP, while Fusobacterium nucleatum, Parvimonas micra, and Campylobacter rectus were elevated in AgP in a few studies. None of these species were elevated in CP. However, the number of studies not showing statistically significant differences between CP and AgP was always higher than that of studies showing differences.
CONCLUSION
These results suggested an association of A. actinomycetemcomitans with AgP, but neither this species nor the other species studied to date were unique to or could differentiate between CP and AgP (PROSPERO #CRD42016039385).
Topics: Aggregatibacter actinomycetemcomitans; Aggressive Periodontitis; Chronic Periodontitis; Dental Plaque; Firmicutes; Humans; Porphyromonas gingivalis
PubMed: 32233092
DOI: 10.1002/JPER.19-0586 -
Clinical and Experimental Dental... Aug 2021Octenidine dihydrochloride is an antimicrobial cationic surfactant compound. We conducted a systematic review to determine the efficacy of octenidine-based mouthwash on...
OBJECTIVE
Octenidine dihydrochloride is an antimicrobial cationic surfactant compound. We conducted a systematic review to determine the efficacy of octenidine-based mouthwash on plaque formation, gingivitis, and oral microbial growth in subjects with or without periodontal disease.
MATERIALS AND METHODS
PubMed/MEDLINE, ScienceDirect, Google Scholar, and Cochrane Library were searched for relevant studies. The review was conducted per PRISMA guidelines. Only randomized controlled trials and observational studies comparing octenidine with placebo or other mouthwashes in healthy subjects with or without periodontal disease, were considered for this review. The endpoints included percentage reduction in plaque index (PI), gingival index (GI), absolute reduction in the mean number of colony-forming units (CFU/ml [log ]) and adverse effects (AEs; tooth staining/mucosal tolerance).
RESULTS
Ten randomized controlled and six observational studies fulfilled the selection criteria. Twice or thrice daily rinsing with 0.1% octenidine for 30-60 s produced significant reduction in plaque, gingivitis and oral microbial growth. Compared to control mouthwash or baseline, 0.1% octenidine inhibited plaque formation by ~38.7%-92.9%, which was either equal or greater than that of chlorhexidine gluconate. 0.1% octenidine reduced gingivitis by ~36.4%-68.37% versus control mouthwash or baseline and microbial growth by 0.37-5.3 colony-forming units (vs. chlorhexidine: 0.4-4.23 colony-forming units). Additional benefits of 0.1% octenidine were significant reduction in the number of bleeding sites, papilla bleeding index, sulcus bleeding index, and gingival fluid flow.
CONCLUSION
Within the limitations of this study, there exists moderate evidence that 0.1% OCT was found to be an effective antiplaque agent. Octenidine inhibited plaque formation upto 93% and gingivitis upto 68% versus placebo and was either superior or comparable to chlorhexidine. Octenidine was well-tolerated and safe and can be an effective alternative to CHX and other contemporary mouthwashes.
Topics: Chlorhexidine; Dental Plaque; Gingivitis; Humans; Imines; Mouthwashes; Periodontal Diseases; Pyridines
PubMed: 34227746
DOI: 10.1002/cre2.386 -
Special Care in Dentistry : Official... 2023The aim of this systematic review is to compare the effectiveness of a powered (PTB) and a manual (MTB) toothbrush in the hands of people with physical (PD) or...
AIMS
The aim of this systematic review is to compare the effectiveness of a powered (PTB) and a manual (MTB) toothbrush in the hands of people with physical (PD) or intellectual (ID) disabilities or in the hands of a caregiver on parameters of plaque and gingival inflammation.
METHODS
MEDLINE-PubMed, Cochrane-CENTRAL and EMBASE databases were searched from initiation up to February 2022. The inclusion criteria were clinical trials conducted in people with PDs or IDs and comparing the effect of toothbrushing with a PTB to an MTB on plaque removal and gingival health. Data were extracted from the eligible studies and analyzed in four subgroups based firstly on the person performing the toothbrushing, either the participants or a caregiver, not a dental professional, and secondly on the main disability of the participants, either PD or ID. Heterogeneity and risk of bias were assessed, data were extracted from the eligible studies, and a descriptive analysis was performed.
RESULTS
The search yielded 294 unique papers; after selection 16 eligible publications describing 25 comparisons were included: 12 self-brushing and 13 caregiver-brushing comparisons. Considerable clinical and methodological heterogeneity was present; together with limited numerical data, not allowing for a meta-analysis. The descriptive analysis showed, in the majority, no statistically significant difference between PTB and MTB. This applied to self-brushing and caregiver-brushing in both disability groups.
CONCLUSION
This review demonstrates with a low level of evidence that a PTB compared to an MTB in the hands of people with PD or ID or in the hands of their caregivers results in no clinical difference in effectiveness on parameters of plaque and gingival inflammation.
Topics: Humans; Dental Plaque; Dental Plaque Index; Equipment Design; Gingivitis; Inflammation; Intellectual Disability; Single-Blind Method; Toothbrushing
PubMed: 36654213
DOI: 10.1111/scd.12821 -
Journal of the American Dental... Feb 2021The authors conducted a systematic review to assess the efficacy of oscillating rotating (OR) versus side-to-side (SS) powered toothbrushes on plaque and gingival index... (Review)
Review
BACKGROUND
The authors conducted a systematic review to assess the efficacy of oscillating rotating (OR) versus side-to-side (SS) powered toothbrushes on plaque and gingival index reduction.
METHODS
The authors searched 3 electronic databases and the gray literature for randomized clinical trials in which investigators compared OR with SS powered toothbrushes. Two authors independently screened the studies, performed data abstraction, and assessed the risk of bias. The authors used random-effects model meta-analyses to pool results across trials and the Grading of Recommendations Assessment, Development and Evaluation approach to rate the certainty of evidence.
RESULTS
This systematic review included 24 trials in which researchers enrolled a total of 2,998 patients. There was moderate-certainty evidence that SS toothbrushes may result in little to no difference in plaque index reduction from baseline to 4 weeks compared with OR toothbrushes (standardized mean difference, 0.02; 95% confidence interval, -0.46 to 0.42). There was moderate-certainty evidence that SS toothbrushes may result in little to no difference in gingival index reduction from baseline to 4 weeks compared with OR toothbrushes (standardized mean difference, 0.13; 95% confidence interval, -0.47 to 0.22). There was moderate-quality evidence suggesting little to no difference in adverse events.
CONCLUSIONS
The evidence does not suggest the superiority of either OR or SS toothbrushes for plaque or gingival index reduction.
PRACTICAL IMPLICATIONS
Clinicians and patients considering the use of either of these toothbrushes are unlikely to observe more benefits with one type versus the other.
Topics: Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Equipment Design; Gingivitis; Humans; Periodontal Index; Toothbrushing
PubMed: 33358240
DOI: 10.1016/j.adaj.2020.10.002 -
International Journal of Paediatric... Nov 2021Conventional methods of oral health education (OHE) are not suitable for children with visual impairment, as these methods usually involve visual demonstration with... (Review)
Review
BACKGROUND
Conventional methods of oral health education (OHE) are not suitable for children with visual impairment, as these methods usually involve visual demonstration with models or plaque-disclosing dyes.
AIM
To systematically review the literature to support the best approach for providing OHE to children and adolescents with visual impairment.
DESIGN
A systematic search of five electronic databases and grey literature was conducted. Randomized controlled trials that compared different OHE methods in children and adolescents with visual impairment were included. The Cochrane risk-of-bias tool (RoB 2) was used for the risk-of-bias assessment. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was used to determine the certainty of evidence.
RESULTS
Nine randomized controlled trials with a total of 804 participants were included in this review. Seven OHE methods were compared. Seven studies were assessed to be at high risk of bias, one study was assessed to have some concerns, and one study was assessed to be at low risk of bias. The overall certainty of evidence was very low according to GRADE.
CONCLUSION
There was insufficient evidence to recommend a particular method of OHE as more effective in improving the oral hygiene of children with visual impairment, but combination methods may show similar or better results.
Topics: Adolescent; Child; Dental Plaque; Health Education, Dental; Humans; Oral Hygiene; Randomized Controlled Trials as Topic; Vision Disorders
PubMed: 33730385
DOI: 10.1111/ipd.12788 -
BMC Oral Health Mar 2023Ultrasonically-activated irrigation (UAI) is effective in root canal irrigation but may damage canal walls. EDDY is a sonic activation system with flexible working tips... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Ultrasonically-activated irrigation (UAI) is effective in root canal irrigation but may damage canal walls. EDDY is a sonic activation system with flexible working tips that cause no harm to dentinal walls. This review explores the intracanal cleaning efficacy of EDDY compared with UAI in vitro.
METHODS
The systematic review was registered in the PROSPERO database (CRD42021235826). A literature search was conducted in six electronic databases. In vitro studies that compared the removal of smear layer, debris, soft tissue or microbes in root canals between EDDY and UAI were included. Data extraction and quality assessment were performed. Meta-analyses were conducted on smear layer removal and debris elimination with the standardized mean difference (SMD). Heterogeneity was measured using the I test and the Chi test. The random-effect model was used when I > 50%, or p < 0.1, otherwise the fixed-effect model was applied. The level of significance was set at p < 0.05.
RESULTS
19 articles were included in this systematic review and 7 articles were included in meta-analyses. Meta-analyses on smear layer removal showed unimportant differences between EDDY and UAI at any canal third (coronal [SMD = 0.08, 95% confidence interval (95%CI): -0.29 to 0.45; p = 0.44, I = 0%]; middle [SMD = 0.02, 95% CI: -0.44 to 0.47; p = 0.94, I = 0%]; apical [SMD = 0.01, 95%CI: -0.35 to 0.38; p = 0.70, I = 0%]). Meta-analyses on debris removal evaluated by scanning electron microscope (coronal [SMD = 0.03, 95% CI: -0.41 to 0.46; p = 0.27, I = 23%]; middle [SMD = -0.24, 95% CI: -0.83 to 0.35; p = 0.80, I = 0%]; apical [SMD = 0.24, 95%CI: -0.20 to 0.67; p = 0.36, I = 2%]) and micro-CT (SMD = 0.36, 95% CI: -0.67 to 1.40; p = 0.03, I = 70%) both found insignificant differences. No meta-analysis was undertaken on soft-tissue removal and disinfection due to the various study designs, but the qualitative analyses implied that EDDY achieved similar performance to UAI in both aspects.
CONCLUSIONS
Limited evidence indicated that EDDY was comparable to UAI in removing smear layer, debris, soft tissue and microbes ex vivo. Considering UAI may damage canal walls, EDDY might be a substitute for UAI in irrigation activation. But more randomized clinical trials are required to explore the clinical extrapolation of the results in this review.
Topics: Humans; Dental Pulp Cavity; Root Canal Preparation; Smear Layer; Root Canal Irrigants; Therapeutic Irrigation; Microscopy, Electron, Scanning; Sodium Hypochlorite
PubMed: 36932445
DOI: 10.1186/s12903-023-02875-6 -
Brazilian Oral Research 2019The aim was of this study was to determine the current weight of evidence for the existence of specific differences between the microbiota of healthy teeth and healthy...
The aim was of this study was to determine the current weight of evidence for the existence of specific differences between the microbiota of healthy teeth and healthy implants, or of teeth with periodontitis and implants with peri-implantitis. A systematic review was conducted according to the PRISMA statement. The MEDLINE, EMBASE and Cochrane databases were searched up to February 2018 for studies comparing microbiological data of biofilm samples collected from healthy teeth and implants or from teeth with periodontitis and implants with peri-implantitis. The weight of evidence was defined in three categories (strong, moderate and mild/some), according to the difference in number of studies showing statistically significantly higher counts and/or proportions and/or abundance and/or prevalence of microorganisms in health or in disease. Of the 132 articles identified, 8 were included. A wide range of microorganisms were present in different conditions but no microorganisms showed strong, moderate or mild/some evidence for a specific association with either teeth or implants. The results of this systematic review indicated that there is insufficient evidence in the literature to support specific differences between microorganisms colonizing teeth and implants, either in health or in disease.
Topics: Bacteria; Biofilms; Case-Control Studies; Dental Implants; Dental Plaque; Gingiva; Humans; Microbiota; Peri-Implantitis; Periodontitis
PubMed: 31576948
DOI: 10.1590/1807-3107bor-2019.vol33.0064