Mechanical Plaque Removal of Periodontal-Maintenance-Patients: Systematic-Review and Network Meta-Analysis

Objectives: Objective:
This systematic review synthesizes the available clinical evidence concerning the efficacy of mechanical oral hygiene devices in periodontal maintenance patients.



Methods: Methods:
Two databases were searched up to June 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 health. Descriptive analysis and network-meta-analysis (NMA) was performed.


Results: Results:
Thirteen eligible publications, including 17 relevant comparisons, were retrieved. The majority [DES1] of five comparisons found no clinical differences for a manual or powered toothbrush. Of the interdental cleaning devices, the interdental brushes reduced plaque scores more effectively than a manual toothbrush alone. Two out of the three comparisons indicated a positive effect on gingivitis-scores, and PPD for the oral irrigator. 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.


Conclusions: Conclusion:
Due to the scarcity of studies that met 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.
Funding: No funding was received for this review.
Protocol registration: PROSPERO number 137441