IADR Abstract Archives
Effects of Chemotherapeutic Toothpaste by Orthodontic Patients With Fixed Appliances
Objectives: To systematically analyse, critically appraise and comprehensively synthesize papers which studied the effect of toothpaste with chemical active ingredients(TP-C) compared to regular toothpaste(RTP) concerning plaque scores(PS), gingival scores(GS) and bleeding scores(BS) in orthodontic patients wearing fixed appliances.
Methods: This systematic review was prepared according to the Cochrane Handbook and the guidelines of Transparent Reporting of Systematic Reviews and Meta-Analyses(PRISMA). The MEDLINE-PubMed and Cochrane databases were searched with predefined search terms until December 2022 for (randomized)controlled clinical trials, focusing on the comparison TP-C to RTP by orthodontic patients wearing fixed appliances on clinical parameters of gingival health. The risk of bias of the eligible papers was evaluated, data of interest were extracted, a descriptive analysis was performed. If possible, a meta-analysis and sub-analysis on specific ingredients was conducted. The quality of evidence and the strength of a recommendation was rated.
Results: The search resulted in 418 papers, of which 6 were eligible describing 9 comparisons. Their potential risk of bias was assessed as moderate to high and heterogeneity was considered as substantial. The descriptive analysis indicated no significant difference for PS(77.78%), BS(51.14%), and a significant difference in favour of TP-C for GS(71.43%). The meta-analyses for baseline data showed no significant difference. For the overall end-scores TP-C provided a statistically additional effect on reducing PS(p=0.05) but not for GS(p=0.08) and BS(p=0.11). The sub-analyses on the ingredient chlorhexidine(CHX) also supported these findings (PS:p=0.04;GS:p=0.51;BS:p=0.26). No significant difference was found in sub-analyses specifically on stannous fluoride(PS:p=0.08;BS:p=0.82). The magnitude of the effect of TP-C was graded from very small to medium and the strength of the recommendation was judged as weak.
Conclusions: There is weak certainty for the recommendation, in patients undergoing fixed orthodontic treatment, that the adjunctive use of toothpaste with an active ingredient as CHX can reduce plaque accumulation and gingival inflammation.
Methods: This systematic review was prepared according to the Cochrane Handbook and the guidelines of Transparent Reporting of Systematic Reviews and Meta-Analyses(PRISMA). The MEDLINE-PubMed and Cochrane databases were searched with predefined search terms until December 2022 for (randomized)controlled clinical trials, focusing on the comparison TP-C to RTP by orthodontic patients wearing fixed appliances on clinical parameters of gingival health. The risk of bias of the eligible papers was evaluated, data of interest were extracted, a descriptive analysis was performed. If possible, a meta-analysis and sub-analysis on specific ingredients was conducted. The quality of evidence and the strength of a recommendation was rated.
Results: The search resulted in 418 papers, of which 6 were eligible describing 9 comparisons. Their potential risk of bias was assessed as moderate to high and heterogeneity was considered as substantial. The descriptive analysis indicated no significant difference for PS(77.78%), BS(51.14%), and a significant difference in favour of TP-C for GS(71.43%). The meta-analyses for baseline data showed no significant difference. For the overall end-scores TP-C provided a statistically additional effect on reducing PS(p=0.05) but not for GS(p=0.08) and BS(p=0.11). The sub-analyses on the ingredient chlorhexidine(CHX) also supported these findings (PS:p=0.04;GS:p=0.51;BS:p=0.26). No significant difference was found in sub-analyses specifically on stannous fluoride(PS:p=0.08;BS:p=0.82). The magnitude of the effect of TP-C was graded from very small to medium and the strength of the recommendation was judged as weak.
Conclusions: There is weak certainty for the recommendation, in patients undergoing fixed orthodontic treatment, that the adjunctive use of toothpaste with an active ingredient as CHX can reduce plaque accumulation and gingival inflammation.