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Clinical and Experimental Dental... Feb 2023To summarize the available evidence on the efficacy of power-driven interdental cleaning tools (PDICTs) as an adjunct to tooth brushing compared to tooth brushing alone... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To summarize the available evidence on the efficacy of power-driven interdental cleaning tools (PDICTs) as an adjunct to tooth brushing compared to tooth brushing alone or tooth brushing combined with any other non-PDICT in terms of interproximal plaque and gingival bleeding reduction in gingivitis patients.
MATERIAL AND METHODS
A systematic literature search was performed in three databases until March 20, 2022 with the following main eligibility criteria: (1) randomized controlled clinical trials (RCTs) with (2) at least 28 days of follow-up in (3) gingivitis patients. Interproximal plaque and bleeding values were defined as the primary outcome variables and used for pair-wise meta-analyses.
RESULTS
Sixteen RCTs were identified including data from 1258 participants at the final evaluation. Eight studies each investigated the effect of either a liquid-based or mechanical PDICT; one of these studies tested additionally a combined liquid-based and mechanical PDICT. Tooth brushing combined with a liquid-based PDICT compared to tooth brushing alone did not result in better interproximal plaque values but in significantly lower interproximal bleeding values. Tooth brushing combined with either a liquid-based PDICT or with a mechanical PDICT compared to tooth brushing and flossing achieved comparable interproximal plaque and bleeding values. The majority of studies reporting on patient compliance/preference favored the use of a PDICT, and except for a single study, which was reporting soft tissue trauma in two subjects from improper use of a mechanical PDICT, none of the studies reported adverse events.
CONCLUSIONS
Daily use of PDICT as an adjunct to tooth brushing significantly reduces interproximal bleeding. This effect appears comparable to that of flossing, while PDICT may achieve higher patient acceptance/compliance.
Topics: Humans; Dental Devices, Home Care; Toothbrushing; Gingivitis; Dental Plaque; Gingiva
PubMed: 36562267
DOI: 10.1002/cre2.691 -
American Journal of Orthodontics and... Oct 2012The association between dental crowding and dental caries has long been accepted because of increased food accumulation and plaque retention in areas of crowding. The... (Review)
Review
INTRODUCTION
The association between dental crowding and dental caries has long been accepted because of increased food accumulation and plaque retention in areas of crowding. The aim of this review was to evaluate this potential causal relationship systematically.
METHODS
Six electronic databases were accessed, supplemented by manual searching of the references of the relevant retrieved articles, peer-reviewed orthodontic journals, and gray literature. Search terms included caries, decay, crowding, and irregularity. Non-English articles were excluded from the review in the study-selection stage. Data extraction and evaluation of primary studies were performed independently by 2 reviewers.
RESULTS
The initial search retrieved 6914 citations. However, only 18 articles met the inclusion criteria. The qualitative systematic review included 8 studies, with articles of low or moderate quality. No association between crowding and caries was reported in 4 studies, a significant negative correlation was found in 2 studies, 1 study showed a direct and significant relationship, and another study showed a positive association in the mandibular anterior region but an inverse correlation in the maxillary posterior region.
CONCLUSIONS
To date, there are no high-quality studies to resolve the possible association between dental crowding and caries; further high-quality longitudinal studies are needed to clarify this relationship.
Topics: Dental Caries; Dental Plaque; Humans; Malocclusion; Risk Factors
PubMed: 22999666
DOI: 10.1016/j.ajodo.2012.04.018 -
Journal of Clinical Periodontology Apr 2015What is the effect of mechanical inter-dental plaque removal in addition to toothbrushing, on managing gingivitis using various formats of inter-dental self-care in... (Review)
Review
FOCUSED QUESTION
What is the effect of mechanical inter-dental plaque removal in addition to toothbrushing, on managing gingivitis using various formats of inter-dental self-care in adults based on evidence gathered from existing systematic reviews?
MATERIAL & METHODS
Three Internet sources were searched by a strategy designed to include systematic reviews on inter-dental cleaning devices. Plaque and gingivitis scores were the primary parameters of interest. Characteristics of selected papers were extracted. The potential risk of bias was estimated and the acquired evidence was graded.
RESULTS
Screening of 395 papers resulted in six systematic reviews. Two papers evaluated the efficacy of dental floss, two of inter-dental brushes (IDB), one of woodsticks and one of the oral irrigator. Weak evidence of unclear or small magnitude was retrieved that supported dental floss, woodsticks and the oral irrigator to reduce gingivitis in addition to toothbrushing. No concomitant evidence for an effect on plaque emerged. There is moderate evidence that IDBs in combination with toothbrushing reduce both plaque and gingivitis.
CONCLUSION
Evidence suggests that inter-dental cleaning with IDBs is the most effective method for inter-dental plaque removal. The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal. All investigated devices for inter-dental self-care seem to support the management of gingivitis, however, to a varying extend.
Topics: Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Gingivitis; Humans; Periodontal Index; Self Care; Toothbrushing; Treatment Outcome
PubMed: 25581718
DOI: 10.1111/jcpe.12363 -
International Journal of Dental Hygiene Feb 2019To review the effectiveness of antiseptic oral sprays on oral health. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To review the effectiveness of antiseptic oral sprays on oral health.
METHODS AND MATERIALS
Three electronic databases (PubMed, Cochrane Library and Web of Science) were systematically searched to identify relevant studies. Only randomized controlled trials (RCTs) comparing the effect of oral sprays to placebo/control spray or mouthrinse on dental plaque and gingival inflammation were included.
RESULTS
Among a total of 996 papers, 20 effective studies fulfilled the selection criteria, and 8 studies were suitable for inclusion in meta-analyses. A meta-analysis of three studies using a 0.2% chlorhexidine (CHX) spray intervention, without prophylaxis at baseline, showed reductions in Plaque Index (PI) (Silness and Löe) and Gingival Index (GI) (Silness and Löe) scores of 0.74 (95% CI: -1.03 to -0.45) and 0.22 (95% CI: -0.38 to -0.06), respectively. Five studies provided a prophylaxis for subjects before study initiation. Three of these five studies used 0.2% CHX spray. A meta-analysis demonstrated an increase of 0.18 (95% CI: -0.01 to 0.37) in PI (Silness and Löe) scores. Two RCTs compared 0.12% and 0.2% CHX spray, and a meta-analysis showed increases of 1.71 (95% CI: 1.27 to 2.14) and 1.58 (95% CI: 1.23 to 1.93), respectively, in PI (Quigley and Hein) scores. Of the RCTs not amenable to meta-analysis, eight studies reported significant improvements in PI and GI scores.
CONCLUSIONS
Available evidence suggests that oral sprays are an acceptable delivery method for antiseptic agents. Further high-quality studies are warranted to determine the effectiveness of alternative chemotherapeutic agents delivered via oral sprays on oral health.
Topics: Adolescent; Adult; Aged; Anti-Infective Agents, Local; Child; Chlorhexidine; Databases, Bibliographic; Dental Plaque; Dental Plaque Index; Female; Gingivitis; Humans; Male; Middle Aged; Oral Hygiene; Oral Sprays; Periodontal Index; Randomized Controlled Trials as Topic; Young Adult
PubMed: 29405627
DOI: 10.1111/idh.12331 -
Photodiagnosis and Photodynamic Therapy Sep 2022Autofluorescence (AF) spectroscopy is a potent yet non-invasive technique with diagnostic and therapeutic applications. It identifies and characterizes changes occurring... (Review)
Review
BACKGROUND
Autofluorescence (AF) spectroscopy is a potent yet non-invasive technique with diagnostic and therapeutic applications. It identifies and characterizes changes occurring in the human body based on the changes in the fluorescence signatures.
AIM
The primary purpose of this systematic review is to address the question "Is it feasible to detect dental plaque using light-induced auto-fluorescence in adult patients with invisible grade 1 plaque?"
MATERIALS AND METHODS
The literature search was conducted independently MEDLINE, Embase, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies from January 2000 and June 2021, using the following terms in various combinations: detection, dental biofilm, plaque, light, auto-fluorescence, caries, gingivitis, sensitivity and specificity. Studies describing various fluorescence techniques for the detection of plaque, including sensitivity and specificity, were included.
RESULTS
The majority of the studies indicated that AF spectroscopy allows fluorescence-based detection of various diseases, including early-stage dental plaque. While results of conventional plaque detection techniques are inconsistent, the data from the AF technique is reliable and reproducible, which can be used for patient documentation. However, a wide range of non-uniformity existed in these studies. AF spectroscopy, as a non-invasive technique, represents a viable and patient-friendly clinical tool for the early detection of dental biofilm plaque, and its meticulous removal has been directly responsible for the prevention of this disease.
CONCLUSION
Despite the heterogeneity and limitations of studies included in this review, the future for light-induced autofluorescence spectroscopy technologies in diagnostic dentistry certainly presents an accurate and potentially applicable option.
Topics: Adult; Biofilms; Dental Plaque; Gingivitis; Humans; Oral Hygiene; Photochemotherapy
PubMed: 35605925
DOI: 10.1016/j.pdpdt.2022.102916 -
International Journal of Dental Hygiene Feb 2022The purpose of this systematic review was to assess whether flossing before or after influences plaque index reduction. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The purpose of this systematic review was to assess whether flossing before or after influences plaque index reduction.
METHODS
This systematic review was conducted according to the guidelines of the preferred reporting items for systematic reviews and meta-analyses and registered with the International prospective register of systematic reviews under number CRD42019126239. The PICO question was, 'does flossing before or after brushing have any effect on reducing dental plaque?'. An electronic search was performed until April 2020 in the following databases: PubMed/MEDLINE, Scopus Web of Science and Cochrane Library. The initial database search resulted in 9679 references, and after detailed analysis of the titles and abstracts of the selected studies, the inclusion/exclusion criteria were applied, and 06 complete articles were downloaded and selected for further analysis. After the complete 02 articles were selected, 60 patients with a mean age of 23.1 years were studied and compared dental flossing before or after dental brushing.
RESULTS
The results showed that there was no statistical difference between brush-floss and floss-brush in reducing plaque index (p = 0.91, RR: 0.01, 95% CI: -0.16, 0.18).
CONCLUSIONS
Flossing before or after brushing has no significant effect on reducing dental plaque index. However, more clinical studies should be conducted.
Topics: Adult; Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Gingivitis; Humans; Toothbrushing; Young Adult
PubMed: 34402188
DOI: 10.1111/idh.12546 -
The Cochrane Database of Systematic... Dec 2013Effective oral hygiene is a crucial factor in maintaining good oral health, which is associated with overall health and health-related quality of life. Dental floss has... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Effective oral hygiene is a crucial factor in maintaining good oral health, which is associated with overall health and health-related quality of life. Dental floss has been used for many years in conjunction with toothbrushing for removing dental plaque in between teeth, however, interdental brushes have been developed which many people find easier to use than floss, providing there is sufficient space between the teeth.
OBJECTIVES
To evaluate the effects of interdental brushing in addition to toothbrushing, as compared with toothbrushing alone or toothbrushing and flossing for the prevention and control of periodontal diseases, dental plaque and dental caries.
SEARCH METHODS
We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 7 March 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 2), MEDLINE via OVID (1946 to 7 March 2013), EMBASE via OVID (1980 to 7 March 2013), CINAHL via EBSCO (1980 to 7 March 2013), LILACS via BIREME (1982 to 7 March 2013), ZETOC Conference Proceedings (1980 to 7 March 2013) and Web of Science Conference Proceedings (1990 to 7 March 2013). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the metaRegister of Controlled Trials (http://www.controlled-trials.com/mrct/) for ongoing trials to 7 March 2013. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (including split-mouth design, cross-over and cluster-randomised trials) of dentate adult patients. The interventions were a combination of toothbrushing and any interdental brushing procedure compared with toothbrushing only or toothbrushing and flossing.
DATA COLLECTION AND ANALYSIS
At least two review authors assessed each of the included studies to confirm eligibility, assessed risk of bias and extracted data using a piloted data extraction form. We calculated standardised mean difference (SMD) and 95% confidence interval (CI) for continuous outcomes where different scales were used to assess an outcome. We attempted to extract data on adverse effects of interventions. Where data were missing or unclear we attempted to contact study authors to obtain further information.
MAIN RESULTS
There were seven studies (total 354 participants analysed) included in this review. We assessed one study as being low, three studies as being high and three studies as being at unclear risk of bias. Studies only reported the clinical outcome gingivitis and plaque data, with no studies providing data on many of the outcomes: periodontitis, caries, halitosis and quality of life. Three studies reported that no adverse events were observed or reported during the study. Two other studies provided some data on adverse events but we were unable to pool the data due to lack of detail. Two studies did not report whether adverse events occurred. Interdental brushing in addition to toothbrushing, as compared with toothbrushing alone Only one high risk of bias study (62 participants in analysis) looked at this comparison and there was very low-quality evidence for a reduction in gingivitis (0 to 4 scale, mean in control): mean difference (MD) 0.53 (95% CI 0.23 to 0.83) and plaque (0 to 5 scale): MD 0.95 (95% CI 0.56 to 1.34) at one month, favouring of use of interdental brushes. This represents a 34% reduction in gingivitis and a 32% reduction in plaque. Interdental brushing in addition to toothbrushing, as compared with toothbrushing and flossing Seven studies provided data showing a reduction in gingivitis in favour of interdental brushing at one month: SMD -0.53 (95% CI -0.81 to -0.24, seven studies, 326 participants, low-quality evidence). This translates to a 52% reduction in gingivitis (Eastman Bleeding Index). Although a high effect size in the same direction was observed at three months (SMD -1.98, 95% CI -5.42 to 1.47, two studies, 107 participants, very low quality), the confidence interval was wide and did not exclude the possibility of no difference. There was insufficient evidence to claim a benefit for either interdental brushing or flossing for reducing plaque (SMD at one month 0.10, 95% CI -0.13 to 0.33, seven studies, 326 participants, low-quality evidence) and insufficient evidence at three months (SMD -2.14, 95% CI -5.25 to 0.97, two studies, 107 participants very low-quality evidence).
AUTHORS' CONCLUSIONS
Only one study looked at whether toothbrushing with interdental brushing was better than toothbrushing alone, and there was very low-quality evidence for a reduction in gingivitis and plaque at one month. There is also low-quality evidence from seven studies that interdental brushing reduces gingivitis when compared with flossing, but these results were only found at one month. There was insufficient evidence to determine whether interdental brushing reduced or increased levels of plaque when compared to flossing.
Topics: Adult; Dental Caries; Dental Devices, Home Care; Dental Plaque; Gingivitis; Humans; Oral Hygiene; Periodontal Diseases; Randomized Controlled Trials as Topic; Toothbrushing
PubMed: 24353078
DOI: 10.1002/14651858.CD009857.pub2 -
International Journal of Dental Hygiene Nov 2008The aim of this study was to assess systematically the adjunctive effect of both flossing and toothbrushing versus toothbrushing alone on plaque and gingivitis. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this study was to assess systematically the adjunctive effect of both flossing and toothbrushing versus toothbrushing alone on plaque and gingivitis.
MATERIALS
The MEDLINE and Cochrane Central register of Controlled Trials (CENTRAL) databases were searched through December 2007 to identify appropriate studies. The variables of plaque and gingivitis were selected as outcomes.
RESULTS
Independent screening of titles and abstracts of 1166 MEDLINE-Pubmed and 187 Cochrane papers resulted in 11 publications that met the eligibility criteria. Mean values and SD were collected by data extraction. Descriptive comparisons are presented for brushing alone or brushing and flossing. A greater part of the studies did not show a benefit for floss on plaque and clinical parameters of gingivitis. A meta-analysis was performed for the plaque index and gingival index.
CONCLUSIONS
The dental professional should determine, on an individual patient basis, whether high-quality flossing is an achievable goal. In light of the results of this comprehensive literature search and critical analysis, it is concluded that a routine instruction to use floss is not supported by scientific evidence.
Topics: Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Dental Prophylaxis; Gingival Hemorrhage; Gingivitis; Humans; Periodontal Index; Randomized Controlled Trials as Topic; Research Design; Toothbrushing
PubMed: 19138178
DOI: 10.1111/j.1601-5037.2008.00336.x -
International Journal of Dental Hygiene Feb 2023To systematically review the literature about the antiplaque and antigingivitis efficacy of new and worn manual toothbrushes. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically review the literature about the antiplaque and antigingivitis efficacy of new and worn manual toothbrushes.
METHODS
Five databases were searched to identify randomized controlled trials, involving adults, comparing the clinical efficacy of new and worn manual toothbrushes. Experimental groups need to have different usage time in changing their manual toothbrush. Two reviewers performed studies selection, data extraction and risk of bias assessment independently. Meta-analyses were performed comparing the toothbrushes after a single use (antiplaque efficacy) and after multiple uses (antiplaque and antigingivitis efficacy).
RESULTS
Eight studies were included, totalling 344 individuals. In studies with a single-use design, no statistically difference was found between new and worn toothbrushes for antiplaque efficacy (SMD:-0.39; 95%CI:-0.80 to 0.03). Studies with a multiple-use design showed no statistically difference between groups for the antigingivitis efficacy (MD:-0.10; 95%CI:-0.24 to 0.03). However, higher antiplaque efficacy was demonstrated in new toothbrushes in the studies with a multiple-use design (SMD:-0.75; 95%CI:-1.37 to -0.14). The certainty of the evidence ranged from very low (antiplaque) to low (antigingivitis).
CONCLUSION
New and worn toothbrushes presented similar antiplaque and antigingivitis efficacy. However, further randomized controlled trials, with a lower risk of bias, are needed to enhance the certainty of this evidence.
Topics: Humans; Gingivitis; Dental Plaque; Toothbrushing; Dental Plaque Index; Equipment Design
PubMed: 36300684
DOI: 10.1111/idh.12640 -
International Journal of Dental Hygiene Feb 2024This systematic review and meta-analysis tests the effectiveness of dental water jet (DWJ) with manual toothbrushes (MTB) compared to MTB alone in oral health... (Meta-Analysis)
Meta-Analysis Review
The effectiveness of dental water jet in reducing dental plaque and gingival bleeding in orthodontic patients: A systematic review and meta-analysis of randomized clinical trials.
INTRODUCTION
This systematic review and meta-analysis tests the effectiveness of dental water jet (DWJ) with manual toothbrushes (MTB) compared to MTB alone in oral health maintenance in orthodontic patients.
METHODS
Four databases were systematically searched: PubMed, Scopus, Web of Science (WoS) and Cochrane Library until 6 January 2022 using a combination of medical subject heading (MeSH) terms and keywords. Randomized clinical trials (RCTs) were only included and critically appraised using the Cochrane Risk of Bias (ROB) tool. The mean difference (MD) effect measure was calculated using the Mantel-Haenszel statistical test (95% confidence interval [CI]) to compare both study groups (p-value < 0.05).
RESULTS
After reviewing 5881 studies from a systematic search, six were selected for inclusion, with four involved in the quantitative analysis. The risk of bias was low in two studies, moderate in two studies and high in the remaining two studies. The meta-analysis showed a significant improvement in plaque index and bleeding scores in DWJ + MTB group compared MTB alone group in orthodontic patients with generalized gingivitis (MD = -0.75, 95% CI [-1.29, -0.22], p = 0.006) and (MD = -0.17, 95% CI [-0.27, -0.08], p = 0.0003), respectively. However, no significant improvement was detected between both groups in the gingival index.
CONCLUSIONS
The use of DWJ as an adjunctive device in addition to MTB can be an effective strategy for maintaining oral hygiene in orthodontic patients with gingivitis. However, more high-quality RCTs are needed to confirm the findings.
Topics: Humans; Dental Plaque; Water; Randomized Controlled Trials as Topic; Oral Hygiene; Gingivitis; Gingival Hemorrhage; Dental Plaque Index
PubMed: 37694518
DOI: 10.1111/idh.12741