Abstract
Objectives: In adult participants, what is, following a single brushing exercise, the efficacy of a powered toothbrush (PTB) as compared to a manual toothbrush (MTB) on plaque removal?. Methods: MEDLINE-PubMed and Cochrane-CENTRAL were searched from inception to February 2019. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects ≥18 years of age, in good general health and without periodontitis, orthodontic treatment, implants and/or removable prosthesis. Papers evaluating a PTB compared with a MTB in a single brushing exercise were included. When plaque scores were assessed according to the Quigley-Hein plaque index (Q&HPI) or the Rustogi modified Navy plaque index (RMNPI). From the eligible studies, data were extracted. A meta-analysis and subanalysis for brands and mode of action being oscillating-rotating (OR) and side-to-side (SS) were performed when feasible. Results: Independent screening of 3450 unique papers resulted in 17 eligible publications presenting 36 comparisons. In total, 28 comparisons assessed toothbrushing efficacy according to the Q&HPI and eight comparisons used the RMNPI. Results showed a significant effect in favour of the PTB. The difference of Means (DiffM) was −0.14 (P < 0.001; 95%CI [−0.19; −0.09]) for the Q&HPI and −0.10 (P < 0.001; 95%CI [−0.14; −0.06]) for the RMNPI, respectively. The subanalysis on the OR mode of action showed a DiffM −0.16 (P < 0.001; 95%CI [−0.22, −0.10]) for the Q&HPI. For the SS mode of action using RMNPI, the DiffM showed −0.10 (P < 0.001; 95%CI [−0.15; −0.05]). The subanalysis for brands showed for the P&G OR PTB using the Q&HPI a DiffM of −0.15 (P < 0.001; 95%CI [−0.22; −0.08]) and the Colgate SS for RMNPI showed a DiffM of −0.15 (P < 0.001; 95%CI [−0.18; −0.12]). Conclusion: There is moderate certainty that the PTB was more effective than the MTB with respect to plaque removal following a single brushing exercise independent of the plaque index scale that was used.
| Original language | English |
|---|---|
| Pages (from-to) | 17-26 |
| Number of pages | 10 |
| Journal | International Journal of Dental Hygiene |
| Volume | 18 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Feb 2020 |
Funding
Funding information The first author received a personal educational grant by the Stichting Nederlandse Vereniging voor Parodontologie (NVvP) as the Foundation of the Dutch Society for Periodontology. Slot, Rosema and Van der Weijden have formerly received external advisor fees, lecturer fees or research grants from companies that produce manual and powered toothbrushes. Among these were Colgate, Dentaid, GABA, Lactona, Oral-B, Philips, Procter & Gamble, Sara Lee, Tepe, Sunstar, Waterpik and Unilever. The authors wish to acknowledge their gratitude to Joost Bouwman, head librarian of the ACTA library and Laura Wiggelinkhuizen, for their help to retrieve papers used in this study. They are also grateful to the following authors for their response, time and effort to search for additional data: Dr. D. Augustini for the Re (2016) study; Dr. N.A.M. Rosema, Prof. P.A. Heasman, Dr. W.J. Killoy, Dr. P. Renton Harper, Dr. D. Lyle for the Sharma (2006) study; and L. Sagel and Dr. J.M. Grender for the Klukowska (2012), Sharma (2011) and Kurtz (2016) studies. Em. Prof. dr. J.A. De Boever for the Lazarescu (2003) study and Dr. D. Bachteler for the Nathoo (2012, 2014) studies. The authors thank the Stichting Nederlandse Vereniging voor Parodontologie (NVvP) for providing a personal educational grant for the first author.
| Funders | Funder number |
|---|---|
| Joost Bouwman | |
| Philips | |
| Procter & Gamble, Sara Lee | |
| Stichting Nederlandse Vereniging voor Parodontologie | |
| Dutch Society for Periodontology | |
| NVVP |
