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BMC Oral Health Jul 2020This systematic review of randomized clinical trials aimed to evaluate the available evidence regarding the efficacy of propolis-based mouthwash on dental plaque and...
BACKGROUND
This systematic review of randomized clinical trials aimed to evaluate the available evidence regarding the efficacy of propolis-based mouthwash on dental plaque and gingival inflammation.
METHODS
PubMed, Scopus, and Web of Science databases were searched up to November 2019. Clinical trials that evaluated the efficacy of propolis mouthwashes compared with chlorhexidine (CHX) were included. The primary outcomes comprised dental plaque and/or gingival inflammation. Two authors assessed the risk of bias using the Cochrane tool. Due to marked heterogeneity of the available data, studies were assessed qualitatively, and no metaanalysis was performed.
RESULTS
Nine clinical trials, comprising 333 subjects, fulfilled the eligibility criteria. Most of the included studies showed high risk of bias. Overall, propolis mouthwashes showed good efficacy on plaque and gingivitis in all of the included studies. Out of the eight studies that reported on plaque index, 5 studies found equal efficacy of propolis and CHX in reducing plaque, two studies found superior efficacy in favor of CHX, while one study found superior efficacy in favor of propolis. Six studies assessed gingival inflammation outcome, four of which reported better results with propolis, while two studies reported comparable results.
CONCLUSIONS
The results suggest that propolis-based mouthwashes have potential benefits in reducing plaque and gingival inflammation. However, methodological limitations along with small sample sizes in some of the included studies weaken the strength of the evidence. Therefore, further well-designed clinical trials with large sample sizes and adequate follow-up period are recommended to discern the efficacy of propolis mouthwash on plaque and gingivitis.
Topics: Anti-Infective Agents, Local; Chlorhexidine; Cross-Over Studies; Dental Plaque; Dental Plaque Index; Double-Blind Method; Gingivitis; Humans; Inflammation; Mouthwashes; Propolis; Single-Blind Method
PubMed: 32650754
DOI: 10.1186/s12903-020-01185-5 -
International Journal of Dental Hygiene Feb 2023To establish the efficacy of oscillating-rotating power toothbrush (OR-PTB) compared to high-frequency sonic power toothbrush (HFS-PTB) on improving parameters of plaque... (Meta-Analysis)
Meta-Analysis Review
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.
Topics: Humans; Dental Plaque; Equipment Design; Single-Blind Method; Toothbrushing; Gingivitis; Dental Plaque Index; Inflammation
PubMed: 35535635
DOI: 10.1111/idh.12597 -
Oral Diseases Oct 2022To systematically review the prevalence of bacteraemia, triggered by dental intervention and home oral hygiene practices, in children. The network meta-analysis (NMA)... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To systematically review the prevalence of bacteraemia, triggered by dental intervention and home oral hygiene practices, in children. The network meta-analysis (NMA) quantitatively compared the risk of bacteraemia triggered by dental extractions and home and professional cleaning procedures.
MATERIALS AND METHODS
Clinical trials with the outcome "bacteraemia in children" were searched. The NMA was performed using the frequentist weighted least-squares approach comparing the odds ratios (OR) of different interventions.
RESULTS
Among 11 of 13 studies, dental treatment was performed under general anaesthesia. In 2,381 patients, bacteraemia occurred in 38.7%-56% patients following single-tooth extractions, in 22%-46% after manual toothbrushing (MTB), and in 26%-78% after power toothbrushing (PTB). When MTB was set as the reference (OR 1), rubber cup polishing showed a slightly higher risk (OR 1.26) of bacteraemia. PTB presented a higher risk (OR 1.79-2.27) than with single-tooth extractions (OR 1.55) but lower than that with multiple extractions (OR 2.55).
CONCLUSION
Daily use of MTB and routine professional cleaning were associated with the lowest risk of developing bacteraemia in children with gingivitis, almost as much as with a single-tooth extractions. Improved plaque control with PTB increased the risk of bacteraemia. There is limited evidence on gingivitis-free and systemically-diseased children.
Topics: Bacteremia; Child; Dental Plaque; Gingivitis; Humans; Network Meta-Analysis; Toothbrushing
PubMed: 34245644
DOI: 10.1111/odi.13957 -
International Journal of Dental Hygiene Feb 2022The purpose of the present systematic review and meta-analysis was to assess the available evidence regarding the efficacy of curcumin mouthwashes on plaque and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The purpose of the present systematic review and meta-analysis was to assess the available evidence regarding the efficacy of curcumin mouthwashes on plaque and gingivitis.
METHODS
A comprehensive online search of multiple databases (PubMed, Scopus, Web of Science, and Google Scholar) was performed to identify all relevant studies published up to August 2020, using the following keywords: curcumin, turmeric, gingivitis, periodontal health, and plaque control. All clinical trials that compared the efficacy of curcumin mouthwash with chlorhexidine in controlling dental plaque and gingivitis were included. Data were analysed using Review Manager (RevMan) 5.3 software. The risk of bias was evaluated by two independent reviewers using the Cochrane assessment tool.
RESULTS
Six randomized clinical trials (comprising 320 subjects) fulfilled the eligibility criteria. Five studies showed a high risk of bias and only one study showed a low risk of bias. The pooled data of the six included studies revealed comparable efficacy of curcumin and chlorhexidine in reducing dental plaque (I = 91%; standardized mean difference [SMD]: 0.27, 95% CI: -0.53, 1.07, p = 0. 51) and gingival inflammation (I = 40%; SMD: -0.13, 95% CI: -0.35, 0.09, p = 0.24), with no statistically significant differences between the two groups.
CONCLUSION
The results suggest that curcumin mouthwashes have promising anti-plaque and anti-gingivitis properties. Further clinical trials with adequate sample sizes and standardized methodologies are required to discern the efficacy of curcumin mouthwash in reducing plaque and gingivitis.
Topics: Anti-Infective Agents, Local; Chlorhexidine; Curcumin; Dental Plaque; Dental Plaque Index; Gingivitis; Humans; Mouthwashes
PubMed: 34013606
DOI: 10.1111/idh.12518 -
Journal of Clinical Periodontology Mar 2012The aim of this study was to investigate the robustness of the observations on the influence of oral hygiene, gingival and periodontal status on the development of... (Meta-Analysis)
Meta-Analysis Review
AIM
The aim of this study was to investigate the robustness of the observations on the influence of oral hygiene, gingival and periodontal status on the development of bacteraemia from everyday oral activities (B-EOA), analysing its prevalence, duration, magnitude and bacterial diversity.
MATERIAL AND METHODS
This systematic review/meta-analysis complies with PRISMA reporting guidelines. MEDLINE-PubMed, the Cochrane Library and Embase were explored for detecting studies on B-EOA.
RESULTS
There were 290 potentially eligible articles, of which 12 article on B-EOA fulfilled the inclusion criteria and were processed for data extraction (seven on toothbrushing, one on dental flossing and four on chewing). Evaluating the influence of plaque and gingival indices on the prevalence of bacteraemia following toothbrushing, the pooled odds ratios were 2.61 [95% confidence interval (CI) = 1.45-4.69] and 2.77 (95% CI = 1.50-5.11), respectively. None of five studies on bacteraemia following dental flossing and chewing revealed a statistically significant association between oral hygiene, gingival or periodontal status and the development of bacteraemia.
CONCLUSIONS
Meta-analysis showed that plaque accumulation and gingival inflammation scores significantly increased the prevalence of bacteraemia following toothbrushing. However, systematic review showed no relationship between oral hygiene, gingival and periodontal status and the development of B-chewing, and there is no evidence that gingival and periodontal health status affects B-flossing.
Topics: Bacteremia; Dental Devices, Home Care; Dental Plaque; Gingivitis; Humans; Mastication; Periodontitis; Selection Bias; Toothbrushing
PubMed: 22092606
DOI: 10.1111/j.1600-051X.2011.01784.x -
Advances in Nutrition (Bethesda, Md.) Nov 2015The aim of this systematic review was to identify and summarize evidence of the association between anthropometric measurements and periodontal status in children and... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review was to identify and summarize evidence of the association between anthropometric measurements and periodontal status in children and adolescents. We searched PubMed, Institute for Scientific Information Web of Knowledge, Cochrane Library, and 7 additional databases, following the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, up to December 2014. Observational studies reporting data on the association between anthropometric measurements and periodontal diseases in 2-18-y-old participants were included. An initial search identified 4191 papers; 278 potentially effective studies (k = 0.82) and 16 effective studies (k = 0.83) were included after screening. The mean quality of evidence among the studies was 20.3, according to the Strengthening the Reporting of Observational studies in Epidemiology checklist (k = 0.79). Meta-analyses showed that obesity (measured by body mass index) was significantly associated with visible plaque index (OR: 4.75; 95% CI: 2.42, 9.34), bleeding on probing (OR: 5.41; 95% CI: 2.75, 10.63), subgingival calculus (OR: 3.07; 95% CI: 1.10, 8.62), probing depth (OR: 14.15; 95% CI: 5.10, 39.25) and flow rate of salivary secretion (standardized mean difference: -0.89; 95% CI: -1.18, -0.61). However, various results were reported in the effective studies that were not included in meta-analyses. In conclusion, obesity is associated with some signs of periodontal disease in children and adolescents. Further studies with a comprehensive prospective cohort design and more potential variables are recommended.
Topics: Adolescent; Anthropometry; Body Mass Index; Child; Child, Preschool; Dental Plaque; Energy Intake; Gingivitis; Humans; Inflammation; Obesity; Periodontal Diseases; Periodontal Index; Salivation
PubMed: 26567204
DOI: 10.3945/an.115.010017 -
European Review For Medical and... Apr 2015Chlorhexidine (CHX) is one of the most widely used antiseptic, especially in dentistry. At low concentrations CHX is bacteriostatic and at high concentrations acts... (Review)
Review
OBJECTIVES
Chlorhexidine (CHX) is one of the most widely used antiseptic, especially in dentistry. At low concentrations CHX is bacteriostatic and at high concentrations acts bactericidal causing cell death by cytolysis. In this study, we performed a systematic review of pharmaco-biological activity and application of CHX.
MATERIALS AND METHODS
Articles for inclusion in this review were retrieved from online databases PubMed/Medline. The selected papers were included in the present manuscript according to their relevance for the topic.
RESULTS
Totally 75 papers were enrolled in this research. CHX has strong biocidal activity against Gram-positive bacteria and weaker activity against Gram-negative bacteria. It is also active against yeasts, some dermatophytes and some lipophilic viruses. The most widely application CHX has found in dentistry and antisepsis. Numerous studies have confirmed the beneficial effects of CHX in reducing of plaque accumulation, in tooth caries, gingivitis, periodontitis and in alveolar osteitis. Unfortunately, CHX exhibits cytotoxic activity on human cells, can cause colorization of teeth and fillings, and its activity depends on the pH of the environment and the presence of organic substances.
CONCLUSIONS
CHX play a valuable role in the dentistry and antisepsis. However, it can also cause side effects, limiting its application time.
Topics: Anti-Infective Agents, Local; Antisepsis; Biological Availability; Chlorhexidine; Dental Plaque; Humans
PubMed: 25912596
DOI: No ID Found -
Clinical Oral Investigations Jan 2014To evaluate the effectiveness of natural compounds containing mouthrinse (NCCM) as an adjunct to unsupervised oral hygiene in the management of dental plaque and... (Review)
Review
OBJECTIVES
To evaluate the effectiveness of natural compounds containing mouthrinse (NCCM) as an adjunct to unsupervised oral hygiene in the management of dental plaque and gingivitis.
MATERIALS AND METHODS
An electronic search for clinical studies of NCCMs was conducted in Medline-PubMed, the Cochrane Central Register of Controlled Trials and EMBASE for a period spanning from the earliest available date in each database up to February 2013. Plaque index, gingival index, and gingival bleeding index were selected as primary outcomes. The methodological quality of the studies was assessed according to the "Levels of Evidence" outlined by the Center of Evidence-Based Medicine, and to the Jadad scale.
RESULTS
The screen yielded 2,236 titles and abstracts that met the inclusion criteria. These identified 11 clinical trials testing 13 different NCCMs, and were used for data extraction. Heterogeneity and the limited number of studies on any individual NCCM precluded a formal meta-analysis. Of the 13 NCCMs tested, eight demonstrated positive results, and few reported any adverse effects or events.
CONCLUSIONS
Evidence proving the effectiveness of NCCM as an adjunct to unsupervised oral hygiene for plaque and gingivitis control is still insufficient. However, some natural products (compounds) may have oral health benefits, so further high-quality study is warranted.
CLINICAL RELEVANCE
This review provides an overview of the strength of clinical evidence regarding the effectiveness of natural compounds containing mouthrinses in promoting gingival health.
Topics: Biological Products; Dental Plaque; Gingivitis; Humans; Mouthwashes; Periodontal Index
PubMed: 23860901
DOI: 10.1007/s00784-013-1033-0 -
Journal of Applied Research in... May 2019People with intellectual disabilities (ID) typically have poorer oral health. Oral diseases have a microbiological origin, and thus, dental plaque control (DPC) is key... (Meta-Analysis)
Meta-Analysis
BACKGROUND
People with intellectual disabilities (ID) typically have poorer oral health. Oral diseases have a microbiological origin, and thus, dental plaque control (DPC) is key to safeguard their oral health.
METHODS
A structured search strategy was applied to screen oral health promotion initiatives for DPC among children and adolescents with ID following PRISMA statements. Qualitative and quantitative analyses were performed.
RESULTS
From 1,455 citations, 22 studies informed this review. Seven studies related to mechanical interventions and 13 to chemical interventions. Qualitative analyses found conventional toothbrushes were less effective than modified toothbrushes but quantitative analyses were conflicting. Of the nine studies that compared chlorhexidine to placebos, seven reported chlorhexidine was more effective than placebos. Meta-analysis favoured chlorhexidine to placebos (p < 0.0001, 95% CI 0.34-0.63).
CONCLUSIONS
Both mechanical and chemical interventions are effective for DPC. It is unclear whether they are alternative means for DPC or whether they are best employed together.
Topics: Adolescent; Child; Chlorhexidine; Dental Plaque; Humans; Intellectual Disability; Oral Hygiene
PubMed: 30734986
DOI: 10.1111/jar.12561 -
Journal of Periodontal Research Jun 2023To appraise the literature on the prevalence of the JP2 clone of Aggregatibacter actinomycetemcomitans (A.a.) and on its association with presence and progression of... (Meta-Analysis)
Meta-Analysis Review
To appraise the literature on the prevalence of the JP2 clone of Aggregatibacter actinomycetemcomitans (A.a.) and on its association with presence and progression of periodontitis in different populations. A systematic search of the literature was conducted in Medline, Embase and Cochrane Library for studies reporting data on detection of the JP2 clone of A.a. A total of 56 papers were included in the review, from an initial search of 685 titles. Studies were carried out in populations with a mean age of 26.34 years (range 6.24-53.85 years). Just over 16% of the overall population assessed (n = 13 751) had the JP2 clone detected. Meta-analyses included 16 studies and 1775 patients, and revealed an association between detection of the JP2 clone and diagnosis of periodontitis (RR = 1.86, 95% 1.43-2.42) from saliva and plaque, with high heterogeneity (I = 85%, p < .00001). Meta-analyses included 5 studies and 616 patients, and revealed an association between baseline detection of the JP2 clone and onset of periodontitis over 2 to 5 years (RR = 4.12, 95% 2.42-7.00), with high heterogeneity (I = 81%, p < .0003). From the overall risk of bias score, 29 papers were judged as low risk of bias, whilst the remaining papers were judged to have an overall medium or high risk of bias. Detection of the JP2 clone of A.a. in subgingival plaque and saliva samples is associated with increased odds of diagnosis of periodontitis and may be able to predict onset of periodontitis. This systematic review provides clear evidence that in certain populations, the JP2 clone of A.a. is associated with early-onset periodontitis. Furthermore, detection of this bacterium seems to be predictive of disease onset.
Topics: Humans; Child; Adolescent; Young Adult; Adult; Middle Aged; Aggregatibacter actinomycetemcomitans; Exotoxins; Aggressive Periodontitis; Dental Plaque; Clone Cells
PubMed: 36987541
DOI: 10.1111/jre.13102