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G A Van Der Weijden - One of the best experts on this subject based on the ideXlab platform.
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mechanical Plaque Removal of periodontal maintenance patients a systematic review and network meta analysis
Journal of Clinical Periodontology, 2020Co-Authors: D E Slot, Cees Valkenburg, G A Van Der WeijdenAbstract:Aim This systematic review synthesizes the available clinical evidence concerning efficacy of mechanical oral hygiene devices in periodontal maintenance patients. Material and methods Three databases were searched up to October 2019 for clinical trials conducted in adult patients in periodontal maintenance which evaluated the effect of toothbrushes or an interdental device on Plaque Removal and parameters of periodontal diseases. Descriptive analysis and network meta-analysis (NMA) were performed. Results Sixteen eligible publications, including 17 relevant comparisons, were retrieved. Four out of five comparisons found no clinical difference between a manual and power toothbrush. Of the interdental cleaning devices, the interdental brushes (IDBs) reduced Plaque scores more effectively than a manual toothbrush alone. For the oral irrigator, two out of three comparisons indicated a positive effect on gingivitis scores, and probing pocket depth. The NMA demonstrated that for Plaque Removal the adjuvant use of IDBs was significantly more effective than the manual toothbrush alone. For the reduction of gingival inflammation, no product ranked higher than the manual toothbrush. Conclusion Due to the scarcity of studies that met the inclusion criteria for each of the oral hygiene devices and the low certainty of the resultant evidence, no strong "evidence-based" conclusion can be drawn concerning any specific oral hygiene device for patient self-care in periodontal maintenance.
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Plaque Removal with triple headed vs single headed manual toothbrushes a systematic review
International Journal of Dental Hygiene, 2018Co-Authors: S M Kalfscholte, G A Van Der Weijden, Eric W P Bakker, D E SlotAbstract:Objective The aim of this systematic review was to establish the effectiveness of brushing with a triple-headed manual toothbrush compared to a single-headed manual toothbrush on Plaque Removal. Materials and methods The MEDLINE-PubMed and Cochrane-CENTRAL databases were searched. The inclusion criteria were clinical trials conducted with humans without fixed orthodontic appliances who were not dental care professionals. Papers that evaluated the effect of toothbrushing with a triple-headed manual toothbrush compared to a single-headed manual toothbrush on Plaque Removal were included. Data were extracted from the eligible studies, and a descriptive analysis was performed. Result The search retrieved 15 eligible publications including 18 relevant comparisons. Heterogeneity was most obvious with respect to the person who performed the brushing, either the participants themselves or a caregiver responsible for daily oral hygiene. Additionally, participant characteristics such as age and individual disabilities varied. A lack of appropriate data and a variation in the indices used allowed only a descriptive analysis. Of the 14 comparisons with self-performed brushing by the participants, the majority showed no difference between triple-headed and single-headed toothbrushes, with a few favouring the triple-headed. In the comparisons in which a caregiver performed the brushing, three of the four showed that the triple-headed toothbrush performed significantly better on the reduction in Plaque scores. Conclusion From this review emerges the recommendation that the use of a triple-headed manual toothbrush instead of a single-headed manual toothbrush might be favorable with respect to Plaque Removal in case a care-dependent individual is brushed by a caregiver.
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prebrushing rinse with water on Plaque Removal a split mouth design
International Journal of Dental Hygiene, 2017Co-Authors: E Van Der Sluijs, Dagmar E Slot, N L Hennequinhoenderdos, Mpc Van Leeuwen, G A Van Der WeijdenAbstract:Objective The aim was to evaluate whether there is an additional beneficial effect on dental Plaque Removal of rinsing the oral cavity with water before toothbrushing. Method In total, 48 non-dental, systemically healthy participants ≥18 years were included in this randomized controlled clinical trial using a split-mouth design. The participants were requested to refrain from any form of oral hygiene for 48 h. First dental Plaque scores (PI) were assessed full mouth. Two randomly assigned contra-lateral quadrants were brushed. Next the participant rinsed for 1 min with 15 ml water. Subsequently, the opposite two contra-lateral quadrants were brushed. Brushing was performed without toothpaste. Subsequently the second full-mouth PI assessment was performed. The brushing and rinsing procedure was performed under supervision and brushing time was tracked by a timer, each quadrant was brushed for 30 s. For the buccal, lingual, and approximal surfaces and tooth type, a subanalysis was performed. Results At baseline there was no statistically significantly difference between the two sets of contra-lateral quadrants. When a water rinse was used before toothbrushing the PI-score was reduced by 58%. If water rinse was used post-brushing the PI-score reduced by 57%. The difference of 0.04 in mean Plaque index score reduction between the two brushing regimens was not significant(P = 0.162). Conclusion When a 2 min brushing exercise was performed, on average more than 55% dental Plaque was removed. Prerinsing with water did not contribute significantly to toothbrush efficacy.
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Plaque Removal by young children using old and new toothbrushes
Journal of Dental Research, 2006Co-Authors: W H Van Palenstein Helderman, G A Van Der Weijden, M M Kyaing, M T Aung, W Soe, N A M Rosema, M A Van T HofAbstract:There is inconclusive evidence about the relationship between toothbrush wear and Plaque Removal. This randomized cross-over clinical trial aimed to validate or invalidate non-inferiority in the Plaque-Removal efficacy of old vs. new toothbrushes in the hands of 7- and 8-year-old children. The lower limit for non-inferiority was set a priori as a difference in Plaque score<15%. Children (n=101) brushed, in the first session, with either their 14-month-old toothbrush or a new one, and in the second session vice versa. The mean Quigley-Hein Plaque score, before and after children brushed with old brushes, was 2.9 and 2.4, and with new brushes 2.8 and 2.1. The Plaque score after they brushed with the new toothbrush was 10.9% lower (p<0.001) than after they brushed with the old toothbrush. The confidence interval of 7.6%-13.9% was within the acceptance band (<15%), and non-inferiority of old toothbrushes in the hands of these children was validated.
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a systematic review of the effectiveness of self performed mechanical Plaque Removal in adults with gingivitis using a manual toothbrush
Journal of Clinical Periodontology, 2005Co-Authors: G A Van Der Weijden, K P K J HioeAbstract:Objective: To assess the effectiveness of self-performed mechanical Plaque Removal in adults with gingivitis using a manual toothbrush with respect to the level of Plaque and gingivitis in controlled studies of at least 6 months duration. Search: Medline-PubMed up to and including September 2004. Results: Out of 3223 titles and abstracts, 33 trials were found for data extraction. A meta-analysis was conducted of studies (n=9) in which, for the manual toothbrush group at baseline, only a professional prophylaxis provided. The weighted mean differences (WMD) between baseline and end-trial for the Quigley & Hein Plaque index was 0.28 and 0.21 for the Gingival Index (p<0.05). Eight studies provided both a professional OHI and prophylaxis at baseline. The WMD for the Silness & Loe Plaque Index was 0.10 (ns). The WMD of the proportion of bleeding sites was 5.84% (p<0.05). Conclusion: In adults with gingivitis the quality of self-performed mechanical Plaque Removal is not sufficiently effective and should be improved. Based on studies 6 months of duration, it appears that a single oral hygiene instruction, describing the use of a mechanical toothbrush, in addition to a single professional ‘oral prophylaxis’ provided at baseline, had a significant, albeit small, positive effect on the reduction of gingivitis.
Roberto Farina - One of the best experts on this subject based on the ideXlab platform.
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efficacy of alternative or additional methods to professional mechanical Plaque Removal during supportive periodontal therapy a systematic review and meta analysis
Journal of Clinical Periodontology, 2020Co-Authors: Leonardo Trombelli, Roberto Farina, Alexander Pollard, Nicholas C A Claydon, Giovanni Franceschetti, Iftekhar Khan, Nicola X WestAbstract:Aims To systematically review the literature addressing the following focused questions: "What is the efficacy of either (#1) alternative or (#2) additional methods to professional mechanical Plaque Removal (PMPR) on progression of attachment loss during supportive periodontal therapy (SPT) in periodontitis patients?". Methods A systematic search for randomized clinical trials was performed. Change in clinical attachment level (CAL) from baseline was the primary outcome. Results Routine PMPR performed with either a combination of ultrasonic/hand instruments or Er:Yag laser showed similarly effective in preventing CAL loss. Moreover, a routine SPT regimen based on PMPR led to stability of CAL irrespective of a daily sub-antimicrobial doxycycline dose (SDD). Finally, an adjunctive photodynamic therapy (PDT) did not enhance the magnitude of CAL gain when sites with probing depth ≥4 mm were repeatedly treated. After pooling all data, the results of the meta-analysis showed no statistical differences in CAL change from baseline: mean overall CAL change was -0.233 mm (95% confidence interval: -1.065, 0.598; p = .351). Conclusions Weak evidence indicate that in treated periodontitis patients enrolled in a 3-4 month SPT based on PMPR, Er:Yag laser (as alternative), SDD and PDT (as additional) do not produce a greater clinical effect on periodontal conditions compared to PMPR.
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effect of professional mechanical Plaque Removal performed on a long term routine basis in the secondary prevention of periodontitis a systematic review
Journal of Clinical Periodontology, 2015Co-Authors: Leonardo Trombelli, Giovanni Franceschetti, Roberto FarinaAbstract:Aims To systematically review the evidence evaluating the efficacy of long-term, routine, professional mechanical Plaque Removal (PMPR) in the prevention of periodontitis progression. Methods A literature search was conducted to identify prospective studies evaluating the effect of PMPR in periodontitis patients undergoing active periodontal therapy and enrolled in a maintenance programme including PMPR for at least 3 years. Results No RCTs evaluating the efficacy of the intervention when compared with no treatment during maintenance were found. Nineteen prospective studies assessing the effect of PMPR as part of the supportive therapy were included. In general, studies reported no to low incidence of tooth loss during follow-up. The weighted mean yearly rate of tooth loss was 0.15 ± 0.14 and 0.09 ± 0.08 for follow-up of 5 years or 12–14 years, respectively, with no significant differences between groups. Mean clinical attachment loss was <1 mm at follow-up ranging from 5 to 12 years. Conclusions Supportive therapy, which encompasses PMPR, may limit the incidence and yearly rate of tooth loss as well as the loss in clinical attachment in patients treated for periodontitis. However, whether and to what extent the intervention may impact on long-term periodontal parameters still needs to be assessed.
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effect of professional mechanical Plaque Removal on secondary prevention of periodontitis and the complications of gingival and periodontal preventive measures consensus report of group 4 of the 11th european workshop on periodontology on effective prevention of periodontal and peri implant diseases
Journal of Clinical Periodontology, 2015Co-Authors: Mariano Sanz, Philip M. Preshaw, Roberto Farina, Amelie Baumer, Nurcan Buduneli, Henrik Dommisch, Eija Kononen, Gerard J Linden, Joerg Meyle, Marc QuirynenAbstract:Background and Aims The scope of this working group was to review: (1) the effect of professional mechanical Plaque Removal (PMPR) on secondary prevention of periodontitis; (2) the occurrence of gingival recessions and non-carious cervical lesions (NCCL) secondary to traumatic tooth brushing; (3) the management of hypersensitivity, through professionally and self administered agents and (4) the management of oral malodour, through mechanical and/or chemical agents. Results and Conclusions Patients undergoing supportive periodontal therapy including PMPR showed mean tooth loss rates of 0.15 ± 0.14 teeth/year for 5-year follow-up and 0.09 ± 0.08 teeth/year (corresponding to a mean number of teeth lost ranging between 1.1 and 1.3) for 12-14 year follow-up. There is no direct evidence to confirm tooth brushing as the sole factor causing gingival recession or NCCLs. Similarly, there is no conclusive evidence from intervention studies regarding the impact of manual versus powered toothbrushes on development of gingival recession or NCCLs, or on the treatment of gingival recessions. Local and patient-related factors can be highly relevant in the development and progression of these lesions. Two modes of action are used in the treatment of dentine hypersensitivity: dentine tubule occlusion and/or modification or blocking of pulpal nerve response. Dentifrices containing arginine, calcium sodium phosphosilicate, stannous fluoride and strontium have shown an effect on pain reduction. Similarly, professionally applied prophylaxis pastes containing arginine and calcium sodium phosphosilicate have shown efficacy. There is currently evidence from short-term studies that tongue cleaning has an effect in reducing intra-oral halitosis caused by tongue coating. Similarly, mouthrinses and dentifrices with active ingredients based on Chlorhexidine, Cetylpyridinium chloride and Zinc combinations have a significant beneficial effect.
Aaron R Biesbrock - One of the best experts on this subject based on the ideXlab platform.
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a clinical evaluation of the Plaque Removal efficacy of five manual toothbrushes
The Journal of clinical dentistry, 2010Co-Authors: N C Sharma, J Qaqish, J M Grender, Patricia A Walters, Aaron R BiesbrockAbstract:OBJECTIVE To assess and compare the Plaque Removal efficacy of five different Oral-B manual toothbrushes: CrossAction Pro-Health (CAPH), CrossAction (CA), Exceed (EX), Advantage 123 (ADV 123), and Indicator (IND). METHODS This was a single-use, five-treatment, examiner-blind, randomized, five-period (visit) crossover study, with 10 different treatment sequences (groups) that determined the order in which the five toothbrushes were assigned at study visits. Three toothbrushes had an advanced CrissCross bristle design (CAPH, CA, EX), while two had more standard designs with straight bristles (ADV 123 and IND). At the first visit, subjects disclosed their Plaque with disclosing solution, and an examiner performed a baseline Plaque examination using the Rustogi, et al. Modification of the Navy Plaque Index (RMNPI). Subjects brushed for one minute with their assigned toothbrush under supervision, after which they again disclosed their Plaque and were given a second Plaque examination. The same procedure was followed for each of the visits in turn. RESULTS All five manual toothbrushes showed a statistically significant (p < 0.0001) reduction in Plaque from baseline for the whole mouth (84% to 93%), gingival margin (74% to 88%), and approximal surfaces (95% to 99%). For pair-wise treatment comparisons for all three Plaque measures, CAPH, CA, and EX demonstrated statistically significantly better Plaque Removal than ADV 123 and IND (all p < 0.018). No other treatment comparisons were statistically significant. CONCLUSION All five manual toothbrushes showed highly effective Plaque reduction for whole mouth, gingival margin, and approximal surfaces. Comparisons between brushes showed consistent advantages for CAPH, CA, and EX compared to ADV 123 and IND for all three Plaque measures, indicating that advances in toothbrush design can further enhance Plaque Removal.
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clinical evaluation of brushing time and Plaque Removal potential of two manual toothbrushes
International Journal of Dental Hygiene, 2008Co-Authors: Geza T. Terezhalmy, Aaron R Biesbrock, Pat Walters, J M Grender, Robert D BartizekAbstract:: Aim: To compare Plaque Removal efficacy of Oral-B CrossAction (CA) used for 1 min with an American Dental Association (ADA) manual toothbrush used for 2 or 5 min in an examiner-blind, three-treatment, six-period crossover study. Materials and methods: After refraining from all oral hygiene procedures for 23–25 h, subjects were randomly assigned to one of nine possible six-period (visit) treatment sequences. Plaque was assessed at baseline (Rustogi Modified Navy Plaque Index). Post-brushing scores were recorded after brushing with a marketed dentifrice and the assigned toothbrush for the specified duration. The same procedure was followed at each of six subsequent visits. Clinical measurements were carried out by the same examiner. Results: Forty subjects completed the study. All three treatments effectively removed Plaque from the whole mouth, along the gingival margin and from approximal surfaces. Whole mouth and gingival margin Plaque Removal scores with CA for 1 min did not differ significantly from scores with the ADA toothbrush used for 2 min. The ADA brush used for 5 min showed significantly greater whole mouth (P < 0.001) and gingival margin (P < 0.001) Plaque reduction than the two other treatments. Approximal Plaque Removal scores did not differ between the three treatments. Conclusions: Efficient Plaque Removal can be achieved after 1 min of brushing with CA. The amount of Plaque removed did not differ significantly from that achieved with the ADA brush after 2 min of brushing. Greater whole mouth and gingival margin Plaque Removal scores were seen with the ADA brush after 5 min.
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Plaque Removal efficacy of an advanced rotation oscillation power toothbrush versus a new sonic toothbrush
American Journal of Dentistry, 2008Co-Authors: Aaron R Biesbrock, Robert D Bartizek, C R Goyal, Patricia A Walters, J QaqishAbstract:PURPOSE To evaluate the Plaque Removal efficacy and safety of an advanced rotation-oscillation power toothbrush relative to a newly-introduced sonic toothbrush. METHODS This study used a randomized, examiner-blind, two-treatment, four-period, four-sequence crossover design. Subjects received both toothbrushes (Oral-B Triumph and Sonicare FlexCare) and a standard dentifrice from the study site and used each toothbrush at home during an acclimation phase prior to their Plaque measurement visits. After abstaining from all oral hygiene for 24 hours, subjects returned to the study site and were assessed with the Rustogi Modified Navy Plaque Index. They then brushed for 2 minutes with their first randomly-assigned toothbrush and post-brushing Plaque scores were recorded. This procedure was followed for three additional study visits, with subjects using their normal at-home toothbrush and dentifrice for the 2- to 5-day washout periods between visits. Subjects always abstained from all oral hygiene for 24 hours prior to their visits. RESULTS 45 subjects completed the study. Both brushes were found to be safe and both significantly reduced Plaque after a single brushing. Oral-B Triumph was statistically significantly (P < 0.0001) more effective in Plaque Removal than Sonicare FlexCare for whole mouth Plaque scores, gingival marginal Plaque scores and interproximal Plaque scores. Compared to Sonicare FlexCare, the adjusted mean Plaque reduction scores for Oral-B Triumph were 21%, 23% and 22% greater for whole mouth, marginal and interproximal areas, respectively.
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Plaque Removal efficacy of four types of dental floss
Journal of Periodontology, 2008Co-Authors: Geza T. Terezhalmy, Robert D Bartizek, Aaron R BiesbrockAbstract:Background: Effective Plaque Removal is essential for gingival health, and dental floss is used to augment Plaque Removal achieved with a toothbrush.Methods: This randomized, controlled, examiner-masked, five-period crossover study examined Plaque Removal in 25 subjects following single use with an American Dental Association reference manual toothbrush alone and in combination with four floss products: three traditional (unwaxed, woven, and shred-resistant) and one powered flosser. Plaque was scored before and after brushing for 1 minute. The Rustogi modified Navy Plaque index was used to focus scores on tooth areas contacted during the proper use of dental floss.Results: Mean Plaque reductions (baseline minus postbrushing) in floss contact areas were as follows: 0.181 with the toothbrush alone; 0.228, 0.217, and 0.210 for the toothbrush in combination with the three traditional flosses, unwaxed, woven, and shred-resistant, respectively; and 0.252 for the toothbrush plus powered flosser. No statistically...
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comparative Plaque Removal efficacy of a dual action power toothbrush and a manual tooth effects by tooth type
American Journal of Dentistry, 2006Co-Authors: Svetlana Farrell, Robert D Bartizek, Geza T. Terezhalmy, Aaron R BiesbrockAbstract:PURPOSE To evaluate the Plaque Removal efficacy of a dual action power toothbrush (Crest SpinBrush Pro Clean) relative to an ADA reference manual toothbrush. In addition to overall Plaque Removal, emphasis was put on Plaque reduction around the gingival margin, interproximal areas of the tooth and in the posterior segment of the dentition. METHODS The study was a randomized, examiner-blind, two-treatment, four-period, crossover design. After an informed consent, 50 healthy volunteers were randomized to four treatment sequences and used each toothbrush twice according to their assigned treatment sequence. At every visit, Plaque Removal was assessed at baseline and after a single brushing using the Rustogi-modified Navy Plaque Index that allows estimation of interproximal Plaque and Plaque at the gingival margin. Self-reported and examiner-observed adverse events were collected at every visit. Mean Plaque Index (MPI) scores were calculated for the whole mouth, gingival region, interproximal region and different areas of the dentition using an analysis of covariance for crossover design with baseline Plaque score as the covariate. RESULTS 49 subjects provided complete data and were included in the analysis. Baseline MPI scores were not significantly different between the groups for any investigated tooth region or dentition area. Following a single brushing, the power toothbrush provided a reduction of 43% (P< 0.001) for the whole mouth MPI, 43% (P< 0.001) for the gingival margin MPI and 65% (P< 0.001) for the interproximal MPI relative to a manual brush. Use of the power toothbrush resulted in a significant reduction of whole-mouth and gingival margin MPI across all areas of the dentition compared to a manual toothbrush (P< 0.001). The power toothbrush also had superior interproximal Plaque Removal efficacy compared to the manual toothbrush for molars (P< 0.001, with 118% greater Removal score). Both brushes were well tolerated.
D E Slot - One of the best experts on this subject based on the ideXlab platform.
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mechanical Plaque Removal of periodontal maintenance patients a systematic review and network meta analysis
Journal of Clinical Periodontology, 2020Co-Authors: D E Slot, Cees Valkenburg, G A Van Der WeijdenAbstract:Aim This systematic review synthesizes the available clinical evidence concerning efficacy of mechanical oral hygiene devices in periodontal maintenance patients. Material and methods Three databases were searched up to October 2019 for clinical trials conducted in adult patients in periodontal maintenance which evaluated the effect of toothbrushes or an interdental device on Plaque Removal and parameters of periodontal diseases. Descriptive analysis and network meta-analysis (NMA) were performed. Results Sixteen eligible publications, including 17 relevant comparisons, were retrieved. Four out of five comparisons found no clinical difference between a manual and power toothbrush. Of the interdental cleaning devices, the interdental brushes (IDBs) reduced Plaque scores more effectively than a manual toothbrush alone. For the oral irrigator, two out of three comparisons indicated a positive effect on gingivitis scores, and probing pocket depth. The NMA demonstrated that for Plaque Removal the adjuvant use of IDBs was significantly more effective than the manual toothbrush alone. For the reduction of gingival inflammation, no product ranked higher than the manual toothbrush. Conclusion Due to the scarcity of studies that met the inclusion criteria for each of the oral hygiene devices and the low certainty of the resultant evidence, no strong "evidence-based" conclusion can be drawn concerning any specific oral hygiene device for patient self-care in periodontal maintenance.
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Plaque Removal with triple headed vs single headed manual toothbrushes a systematic review
International Journal of Dental Hygiene, 2018Co-Authors: S M Kalfscholte, G A Van Der Weijden, Eric W P Bakker, D E SlotAbstract:Objective The aim of this systematic review was to establish the effectiveness of brushing with a triple-headed manual toothbrush compared to a single-headed manual toothbrush on Plaque Removal. Materials and methods The MEDLINE-PubMed and Cochrane-CENTRAL databases were searched. The inclusion criteria were clinical trials conducted with humans without fixed orthodontic appliances who were not dental care professionals. Papers that evaluated the effect of toothbrushing with a triple-headed manual toothbrush compared to a single-headed manual toothbrush on Plaque Removal were included. Data were extracted from the eligible studies, and a descriptive analysis was performed. Result The search retrieved 15 eligible publications including 18 relevant comparisons. Heterogeneity was most obvious with respect to the person who performed the brushing, either the participants themselves or a caregiver responsible for daily oral hygiene. Additionally, participant characteristics such as age and individual disabilities varied. A lack of appropriate data and a variation in the indices used allowed only a descriptive analysis. Of the 14 comparisons with self-performed brushing by the participants, the majority showed no difference between triple-headed and single-headed toothbrushes, with a few favouring the triple-headed. In the comparisons in which a caregiver performed the brushing, three of the four showed that the triple-headed toothbrush performed significantly better on the reduction in Plaque scores. Conclusion From this review emerges the recommendation that the use of a triple-headed manual toothbrush instead of a single-headed manual toothbrush might be favorable with respect to Plaque Removal in case a care-dependent individual is brushed by a caregiver.
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efficacy of homecare regimens for mechanical Plaque Removal in managing gingivitis a meta review
Journal of Clinical Periodontology, 2015Co-Authors: Fridus Van Der Weijden, D E SlotAbstract:Focused question Based on evidence as presented in systematic reviews what is the efficacy and safety of available homecare toothbrush regimens for mechanical Plaque Removal on Plaque and gingivitis in adults? Material & Methods Three Internet sources were used (up to and including August 2014) to search for appropriate papers that satisfied the study purpose. Plaque scores and gingivitis scores were considered to be the primary parameter of interest. Safety was considered an important facet in relation to efficacy. Data and conclusions as presented in the selected papers were extracted. The potential risk of bias was estimated and the emerging evidence was graded. Results Independent screening of 176 unique reviews resulted in 10 published and eligible systematic reviews. They were categorized into one review evaluating the effect of an oral hygiene instruction with a toothbrush on Plaque and gingivitis scores, five evaluating the efficacy of manual and power toothbrushes and three reviews evaluating toothbrush safety and one evaluating toothbrush contamination. Conclusion Tooth brushing is effective in reducing levels of dental Plaque. With respect to gingivitis power toothbrushes have a benefit over manual toothbrushes. The greatest body of evidence was available for oscillating–rotating brushes. Tooth brushing generally can be considered safe for the teeth and their investing tissues.
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efficacy of inter dental mechanical Plaque control in managing gingivitis a meta review
Journal of Clinical Periodontology, 2015Co-Authors: Sonja Salzer, D E Slot, Fridus Van Der Weijden, Christof E DorferAbstract: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.
Leonardo Trombelli - One of the best experts on this subject based on the ideXlab platform.
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efficacy of alternative or additional methods to professional mechanical Plaque Removal during supportive periodontal therapy a systematic review and meta analysis
Journal of Clinical Periodontology, 2020Co-Authors: Leonardo Trombelli, Roberto Farina, Alexander Pollard, Nicholas C A Claydon, Giovanni Franceschetti, Iftekhar Khan, Nicola X WestAbstract:Aims To systematically review the literature addressing the following focused questions: "What is the efficacy of either (#1) alternative or (#2) additional methods to professional mechanical Plaque Removal (PMPR) on progression of attachment loss during supportive periodontal therapy (SPT) in periodontitis patients?". Methods A systematic search for randomized clinical trials was performed. Change in clinical attachment level (CAL) from baseline was the primary outcome. Results Routine PMPR performed with either a combination of ultrasonic/hand instruments or Er:Yag laser showed similarly effective in preventing CAL loss. Moreover, a routine SPT regimen based on PMPR led to stability of CAL irrespective of a daily sub-antimicrobial doxycycline dose (SDD). Finally, an adjunctive photodynamic therapy (PDT) did not enhance the magnitude of CAL gain when sites with probing depth ≥4 mm were repeatedly treated. After pooling all data, the results of the meta-analysis showed no statistical differences in CAL change from baseline: mean overall CAL change was -0.233 mm (95% confidence interval: -1.065, 0.598; p = .351). Conclusions Weak evidence indicate that in treated periodontitis patients enrolled in a 3-4 month SPT based on PMPR, Er:Yag laser (as alternative), SDD and PDT (as additional) do not produce a greater clinical effect on periodontal conditions compared to PMPR.
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effect of professional mechanical Plaque Removal performed on a long term routine basis in the secondary prevention of periodontitis a systematic review
Journal of Clinical Periodontology, 2015Co-Authors: Leonardo Trombelli, Giovanni Franceschetti, Roberto FarinaAbstract:Aims To systematically review the evidence evaluating the efficacy of long-term, routine, professional mechanical Plaque Removal (PMPR) in the prevention of periodontitis progression. Methods A literature search was conducted to identify prospective studies evaluating the effect of PMPR in periodontitis patients undergoing active periodontal therapy and enrolled in a maintenance programme including PMPR for at least 3 years. Results No RCTs evaluating the efficacy of the intervention when compared with no treatment during maintenance were found. Nineteen prospective studies assessing the effect of PMPR as part of the supportive therapy were included. In general, studies reported no to low incidence of tooth loss during follow-up. The weighted mean yearly rate of tooth loss was 0.15 ± 0.14 and 0.09 ± 0.08 for follow-up of 5 years or 12–14 years, respectively, with no significant differences between groups. Mean clinical attachment loss was <1 mm at follow-up ranging from 5 to 12 years. Conclusions Supportive therapy, which encompasses PMPR, may limit the incidence and yearly rate of tooth loss as well as the loss in clinical attachment in patients treated for periodontitis. However, whether and to what extent the intervention may impact on long-term periodontal parameters still needs to be assessed.