DOCSLIB.ORG

Jcpe.13275 Publication Date 2020 Document Version Final Published Version Published in Journal of Clinical Periodontology

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Jcpe.13275 Publication Date 2020 Document Version Final Published Version Published in Journal of Clinical Periodontology UvA-DARE (Digital Academic Repository) Mechanical plaque removal of periodontal maintenance patients A systematic review and network meta-analysis Slot, D.E.; Valkenburg, C.; Van der Weijden, G.A. DOI 10.1111/jcpe.13275 Publication date 2020 Document Version Final published version Published in Journal of Clinical Periodontology Link to publication Citation for published version (APA): Slot, D. E., Valkenburg, C., & Van der Weijden, G. A. (2020). Mechanical plaque removal of periodontal maintenance patients: A systematic review and network meta-analysis. Journal of Clinical Periodontology, 47(S22), 107-124. https://doi.org/10.1111/jcpe.13275 General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. UvA-DARE is a service provided by the library of the University of Amsterdam (https://dare.uva.nl) Download date:29 Sep 2021 Received: 29 August 2019 | Revised: 20 January 2020 | Accepted: 10 February 2020 DOI: 10.1111/jcpe.13275 SYSTEMATIC REVIEW Mechanical plaque removal of periodontal maintenance patients: A systematic review and network meta-analysis Dagmar E. Slot1 | Cees Valkenburg1,2 | G.A. (Fridus) Van der Weijden1 1Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Abstract University of Amsterdam and Vrije Aim: This systematic review synthesizes the available clinical evidence concerning Universiteit Amsterdam, Amsterdam, The Netherlands efficacy of mechanical oral hygiene devices in periodontal maintenance patients. 2General dentist and clinical epidemiologist, Material and Methods: Three databases were searched up to October 2019 for clini- Hoevelaken, The Netherlands cal trials conducted in adult patients in periodontal maintenance which evaluated the Correspondence effect of toothbrushes or an interdental device on plaque removal and parameters Dagmar E. Slot, Department of of periodontal diseases. Descriptive analysis and network meta-analysis (NMA) were Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of performed. Amsterdam and VU University Amsterdam, Results: Sixteen eligible publications, including 17 relevant comparisons, were re- Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands. trieved. Four out of five comparisons found no clinical difference between a manual Email: [email protected] and power toothbrush. Of the interdental cleaning devices, the interdental brushes Funding information (IDBs) reduced plaque scores more effectively than a manual toothbrush alone. For This research received no specific grant the oral irrigator, two out of three comparisons indicated a positive effect on gin- from any funding agency in the public, commercial, or non-profit sectors. The work givitis scores, and probing pocket depth. The NMA demonstrated that for plaque for this paper was funded by the regular removal the adjuvant use of IDBs was significantly more effective than the manual academic appointments of Slot and Van der Weijden at the Academic Centre for toothbrush alone. For the reduction of gingival inflammation, no product ranked Dentistry Amsterdam (ACTA). 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 de- vice for patient self-care in periodontal maintenance. KEYWORDS interdental devices, maintenance, supportive periodontal therapy, toothbrush 1 | INTRODUCTION treatment consists of a phase of active periodontal therapy (APT), which is followed by supportive periodontal therapy (SPT) to reduce Periodontitis is a ubiquitous and inflammatory condition that repre- the risk of re-infection and progression of the disease. SPT includes sents a significant public health burden (Chapple et al., 2015). Severe a periodontal re-evaluation and risk assessment and supragingival periodontitis affects over 11% of adults; is a major cause of tooth and subgingival removal of bacterial plaque and calculus. Evaluation loss that negatively impacts speech, nutrition, quality of life and self- of oral hygiene performance and motivation and re-instruction in esteem; and has systemic inflammatory consequences (Kassebaum oral hygiene practices are necessary for the long-term success of et al., 2014). Periodontitis is bacterially induced, and the respond- periodontal treatment (Tonetti, Chapple, Jepsen, & Sanz, 2015; ing chronic inflammatory process results in loss of the connec- Tonetti, Eickholz, et al., 2015). Effective plaque control practices tive tissues and bone that support teeth (Lang, 2014). Periodontal are particularly important for periodontitis patients because they J Clin Periodontol. 2020;47:107–124. wileyonlinelibrary.com/journal/jcpe © 2020 John Wiley & Sons A/S. | 107 Published by John Wiley & Sons Ltd 108 | SLOT ET AL. have demonstrated susceptibility to periodontal inflammation. The importance of self-performed plaque control cannot be properly in- Clinical Relevance ferred from the systematic reviews that are currently available be- Scientific rationale for the study: Daily oral self-care is cause patient motivation and instruction in oral hygiene practices critical to the long-term success of periodontal therapy. were combined with SPT in most of the studies (Sanz et al., 2015). Currently, no synthesis of the available literature is avail- However, substantial periodontal deterioration was observed in the able concerning mechanical oral home care during peri- patients enrolled in a maintenance regimen that was solely based odontal maintenance. on self-performed plaque control without SPT (Sanz et al., 2015; Principal findings: No clinical differences between a power Trombelli, Franceschetti, & Farina, 2015). toothbrush and manual toothbrush were found. There is As plaque is considered the major aetiological factor of peri- some (mainly indirect) evidence that indicates that the ad- odontal diseases, patient cooperation in daily plaque removal is crit- juvant use of interdental brushes is effective for improving ical to the long-term success of dental and periodontal treatment plaque score reduction. (Chapple et al., 2015). With respect to recommendations for oral hy- Practical implications: Periodontal maintenance patients giene practices, there is a wide range of variability between what is can be advised to use either a power or manual tooth- known and what is practised. This may be due to the lack of transla- brush. For interdental cleaning, interdental brushes are the tion of relevant scientific evidence into information that is useful for device of choice. As alternative, an oral irrigator may be the dental care professional and the patient. It is however important considered. that professional recommendations incorporate the best available scientific evidence to maximize successful patient care outcomes. This evidence-based approach improves the quality of health care by assimilating scientific evidence into practice and by reducing vari- ations in practice patterns (Lehane et al., 2018). One concern is that 2.1 | Focused PICOS question most studies on home care products for mechanical plaque control are performed on gingivitis patients (Van der Weijden & Slot, 2015). Based on (randomized) controlled clinical trials (study design), what Even though these studies have demonstrated desired outcomes, is, in periodontal maintenance patients (patient), the effect on the results may not be directly applicable to periodontitis patients plaque removal and parameters of periodontal diseases (outcome) with periodontal pockets. Currently, there has been no systematic of the following: evaluation or significant syntheses of knowledge about the clinical effect of toothbrushes and interdental cleaning devices among peri- 1. Power toothbrushes (PTBs) (intervention) as compared to manual odontitis patients during periodontal maintenance. Therefore, the toothbrushes (MTBs) (control)? aim of this systematic review is to synthesize the available evidence 2. interdental oral hygiene devices (intervention) compared to no in- concerning mechanical oral hygiene devices in periodontal mainte- terdental cleaning (control) as adjunct to toothbrushing? nance patients. 3. Different interdental cleaning devices (intervention/control) as adjunct to toothbrushing 2 | MATERIALS AND METHODS TABLE 1 Search Strategy This systematic review was prepared in accordance with the Search terms used for PubMed–MEDLINE and Cochrane-CENTRAL. Cochrane Handbook for Systematic Reviews of Interventions The search strategy was customized according to the database (Higgins & Green, 2011), and the recommendations for strength- being searched. ening the reporting of systematic reviews and meta-analyses The following strategy
Load more

Recommended publications
  • Comparison of the Plaque Removal Efficacy of Aquajet Water Flosser
    Sarlati F ,et al . J Res Dentomaxillofac Sci http://www.Jrdms.dentaliau.ac.ir e(ISSN): 2383 -2754 Journal of Research in Dental and Maxillofacial Sciences Comparison of the Plaque Removal Efficacy of Aquajet Water Flosser and Dental Floss in Adults After a Single Use. (A Prelimi- Nary Study) Sarlati F1, Azizi A2*,Zokaei N3, Mohaghegh Dolatabadi N3, Hasanzadegan Roudsari M4, Moradi Hajiabadi A5 1 Associate Professor, Periodontics Dept,Dental Branch of Tehran, Islamic Azad University, Tehran, Iran. 2Professor, Oral Medicine Dept, Member of Dental Implant Research Center, Dental Branch of Tehran, Islamic Azad University, Tehran, Iran. 3 General Practitioner. 4 Phd student, Chemical Engineering Dept., Science and Research Branch, Islamic Azad University, Tehran, Iran. 5 Mechanical Engineering Dept., Science and Research Branch, Islamic Azad University, Tehran, Iran. ABSTRACT ARTICLE INFO Article Type Background and Aim: Toothbrushes cannot reach all interdental areas. Interdental Orginal Article cleaning is an important part of oral hygiene care. The purpose of this study was to Article History Received: April 2016 compare the supragingival plaque removal efficacy of an interdental cleaning power Accepted: July 2016 device (Aquajet) and dental floss. ePublished: Oct 2016 Methods and Materials: Thirty subjects were enrolled in this single-blind, split Keywords: mouth clinical trial. All the subjects received both written and verbal instructions and Water flosser, demonstrated proficiency prior to the study. The subjects were asked to abstain from Periodontium, oral hygiene methods for 48 hours prior to the study. The subjects were scored using Plaque index the Proximal/Marginal Plaque Index (PMI). Then, the four oral quadrants were ran- domly assigned to one of two treatment groups: One upper and one lower quadrant: Aquajet and the other two quadrants: dental floss.
    [Show full text]
  • Dental Mechanical Plaque Control In 
    J Clin Periodontol 2015; 42 (Suppl. 16): S92–S105 doi: 10.1111/jcpe.12363 Sonja Salzer€ 1, Dagmar E. Slot2, Efficacy of inter-dental Fridus A. Van der Weijden2 and Christof E. Dorfer€ 1 1Clinic for Conservative Dentistry and mechanical plaque control Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, – Germany; 2Department of Periodontology, in managing gingivitis Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The a meta-review Netherlands Salzer€ S, Slot DE, Van der Weijden FA, Dorfer€ CE. Efficacy of inter-dental mechanical plaque control in managing gingivitis – a meta-review. J Clin Periodontol 2015; 42 (Suppl. 16): S92–S105. doi: 10.1111/jcpe.12363. Abstract 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 gingivi- tis 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 mag- nitude was retrieved that supported dental floss, woodsticks and the oral irrigator to reduce gingivitis in addition to toothbrushing.
    [Show full text]
  • The Efficacy of Power Driven Interdental Tools As an Addition to Tooth-Brushing on Plaque Removal and Gingivitis in Humans
    The efficacy of power driven interdental tools as an addition to tooth-brushing on plaque removal and gingivitis in humans A systematic review of randomized trials HUVUDOMRÅDE: Oral hälsa FÖRFATTARE: Pia Edlund Johansson HANDLEDARE: Agneta Stenebrand JÖNKÖPING 2017/05 0 Summary Objective: To evaluate in humans the efficacy of power driven interdental cleaning tools in addition to tooth-brushing compared to tooth-brushing alone or any non- power driven interdental cleaning tool in addition to tooth-brushing on dental plaque removal and prevention of gingivitis. Introduction: Daily mechanical self-care disruption of dental plaque is considered important for oral health maintenance. Tooth-brushing, which is the most common method for removing dental plaque, has only a marginal effect on the interdental spaces between the teeth. Therefore, special cleaning tools are necessary for plaque removal in these areas. Dental floss has long been considered “the golden standard” of interdental cleaning and is often recommended by dental health professionals. Powered interdental tools are an alternative that in certain studies have proven to be efficient on plaque and bleeding. Method: Two internet sources (PubMed and Cochrane Central) were searched for studies investigating the efficacy of powered interdental tools on the parameters of plaque, gingivitis and bleeding in comparison to tooth-brushing only or tooth- brushing and any non-powered interdental tool. The PRISMA 2009 protocol was adopted and studies included were analysed for results and homogeneity. Bias across studies was estimated according to a protocol by SBU. Results: 14 articles were found relevant to the research question and analysed for data on plaque, gingivitis and bleeding.
    [Show full text]
  • Boekintraoralhygieneevidence.Pdf
    Multi-Disciplinary Management of Periodontal Disease Edited by: PM Bartold, LJ Jin © 2012 Asian Pacific Society of Periodontology Interdental oral hygiene: The evidence 1 Chapter 3 Interdental oral hygiene: The evidence GA Van de Weijden1,2, DE Slot1 1 Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, The Netherlands 2 Clinic for Periodontology, Utrecht, The Netherlands Introduction tissue support (Axelsson 2004, Hujoel et al 2006). There is increasing public awareness of the Interdental plaque control is essential to value of personal oral hygiene. People brush every patient’s self-care program. Several their teeth for a number of reasons: to feel fresh dental conditions result from infrequent or and confident, to have a nice smile, and to ineffective interdental cleaning, including avoid bad breath and disease. Oral cleanliness caries and periodontal diseases. These two, in is important for the preservation of oral health combination, suggest a need for effective as it removes microbial plaque, preventing it interdental cleaning. It is therefore important from accumulating on teeth and gingivae that the effectiveness of these interdental oral (Choo et al 2001). Maintenance of effective hygiene products be assessed and understood. plaque control is the cornerstone of any The present review was undertaken to provide attempt to prevent and control periodontal the dental professional with the available disease. The benefits of optimal home-use scientific evidence. plaque-control measures include the opportunity to maintain a functional dentition Interdental devices throughout life. Self-care has been defined by the World Health Organization as all the There is confusion in the literature with activities that the individual takes to prevent, respect to the definitions of approximal, diagnose and treat personal ill health by self- interproximal, interdental, and proximal sites.
    [Show full text]
  • An Overview of Different Interdental Cleaning Aids and Their Effectiveness
    dentistry journal Review An Overview of Different Interdental Cleaning Aids and Their Effectiveness Ethan Ng 1,2,* and Lum Peng Lim 1 1 Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, 11 Lower Kent Ridge Road, Singapore 119083, Singapore; [email protected] 2 Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore * Correspondence: [email protected] Received: 17 March 2019; Accepted: 5 May 2019; Published: 1 June 2019 Abstract: Optimisation of plaque control is essential for the success of non-surgical and surgical periodontal therapy. This cannot be achieved with brushing alone; hence, there is a need for adjunctive interdental cleaning aids. The aim of this paper is to provide an overview of different interdental cleaning aids and review the literature for consensus on their effectiveness. A literature search of articles in English, up to December 2018, was conducted in Pubmed. High-quality flossing is difficult to achieve, and ineffective routine use of floss may not confer significant benefits over brushing alone. Interdental brushes are more effective than brushing as a monotherapy. They are at least as good if not superior to floss in reducing plaque and gingivitis. Although they are effective for patients regardless of their periodontal status (healthy or active), they are especially indicated in periodontal patients where widened embrasures are common. Added benefits include ease of use, patient acceptance, and recontouring of interdental tissues. Rubberpiks do not demonstrate inferiority to conventional interdental brushes. Wooden interdental aids appear to offer no significant advantage over brushing with respect to plaque removal; they may, however, reduce gingival bleeding.
    [Show full text]
  • Original Article
    Journal of Applied Dental and Medical Sciences NLM ID: 101671413 ISSN:2454-2288 Volume 2 Issue 2 April - June 2016 Original Article Comparative Evaluation of Oral Irrigator and Dental Floss as an adjunct to Tooth Brushing on Reduction of Plaque and Gingivitis- A Randomized, Single Blind Clinical Study of Rural Patients P.K. Sasikumar1, Shankar Shanmugam2, Sakthi Saranya Devi3, M.Kirthika4 1 Reader, Dept of Periodontics,2Reader, Dept of Public Health Dentistry, J.K.K.N Dental College and Hospital, Kumarapalayam, Namakkal 3,4 Dept. of Oral Medicine and Radiology, Dept of Pedodontics,Vinayaka Mission Sankarachariyar Dental College &Hospital, Salem. A R T I C L E I N F O A B S T R A C T Aim: The purpose of this short-term, randomized trial was to assess the efficacy of the addition of daily oral irrigation and dental floss to manual tooth brushing and also compared to determine which regimen had the greatest effect on the reduction of plaque and gingivitis. Material and methods: A parallel clinical study of 70 subjects was performed over a period of four weeks. The subjects in the first group (OIS) were trained in the correct use of oral irrigator, once per day in the evening and the second group (DF) were trained to brush their teeth two times per day, in the morning and evening, with uses of standard dental floss. Pre-scaling baseline data was recorded; subjects were re-evaluated after the scaling regarding their oral hygiene and gingival status in the 2nd and 4th week follow-up. Results: After four weeks, subjects who used oral irrigator associated regular tooth brushing demonstrated that significant decreases (p=<0.001) in papillary bleeding, of 16.80%, with an initial mean PBI value of 0.93 (±0.15) and a final mean PBI value of 0.59 (±0.25).
    [Show full text]
  • Interdental Hygiene Devices for Periodontal Health
    Central JSM Dentistry Review Article *Corresponding author Zuhal Yetkin Ay, Department of Periodontology, Süleyman Demirel University, Faculty of Dentistry, Interdental Hygiene Devices for 32260 Isparta, Turkey, Tel: 90 246 2118798; Fax: 90 246 2370607; Email: Submitted: 15 July 2016 Periodontal Health Accepted: 21 October 2016 Zuhal Yetkin Ay* Published: 24 October 2016 Department of Periodontology, Süleyman Demirel University, Turkey ISSN: 2333-7133 Copyright Abstract © 2016 Ay ZY Although toothbrush is the most effective and widespread tool for the oral hygiene OPEN ACCESS constitution and maintenance, none of the tooth brushing methods is efficient in eliminating the interproximal dental plaque. The interproximal cleaning should be an inseparable part of the Keywords daily plaque removal routine. In this short review, the interdental cleaning devices (dental floss, • Interdental cleaning interdental brushes, single tufted brushes, wooden or plastic tips/interdental stimulators, and • Dental floss oral irrigators) were summarized and reminded. • Interdental brush • Oral irrigators • Periodontal health INTRODUCTION The primary etiologic agent of periodontal diseases is the microorganisms in dental plaque [1]. Dental plaque is the of microbial dental plaque was reported for the prevention of periodontal diseases [8]. The plaque control measurements were recommended in primary, secondary and tertiary prevention organized biofilm matrix comprised of salivary glycoproteins and hard surfaces [2]. from periodontal diseases; in other words not only for the extracellular microbial products on the non-shedding and steady maintenance of the oral health but also for the prevention of the onset of the disease, for the reversibility of the gingivitis status The “Non-specific Plaque Hypothesis”, accepted in 1960’s, to the health status, and for the prevention from recurrence or periodontalstated that thetissue bacteria destruction accumulated [3].
    [Show full text]
  • Attachment 7 Brushing and Flossing Brochure
    ORAL HEALTH INFORMATION FOR ADULTS FLOSSING AND BRUSHING Oral Health and Adults What type of toothbrush? This fact sheet offers practical suggestions about how ■ Soft bristle brush that is small to care for your teeth and gums as well as tips that may enough to reach all areas of make the job easier. Oral health is important for people of your mouth. all ages. A healthy mouth helps people enjoy their food, chew better, eat well, and avoid pain and tooth loss. With What type of floss? good oral hygiene and regular visits to the dentist, you can maintain your oral health for years. ■ Waxed, unwaxed, flavored, or plain floss all do the same thing. Brushing What if it’s hard to floss? Brushing removes dental plaque, a sticky, colorless film of bacteria on tooth surfaces. If plaque is not removed, some ■ If it’s hard to floss, there are of it can harden below the gum line and irritate the gums. flossing tools that can help (see inside page). Flossing Flossing removes dental plaque between teeth where a toothbrush can’t reach. If not removed, dental plaque can build up and cause tooth decay and gum disease. ■ Follow the step-by-step guide (see next page) ■ Use tools that might make flossing easier ■ Floss regularly Flossing Step-by-Step Follow these steps to floss your teeth: ■ Use a string of floss about two feet long. Wrap that piece around the middle finger of each hand. ■ Grip the floss between the thumb and index finger of each hand. ■ Ease the floss gently between the teeth until it reaches the gumline.
    [Show full text]
  • Interdental Cleaning to Prevent and Treat Gum Disease: State of the Evidence
    AN ORAL HEALTH WHITE PAPER SERIES | N° 2 INTERDENTAL CLEANING TO PREVENT AND TREAT GUM DISEASE: STATE OF THE EVIDENCE This paper reviews the relative efficacy of different interdental cleaning methods in preventing and treating gingivitis and periodontitis based upon the latest evidence from randomized controlled studies, systematic reviews and meta-analyses. AN ORAL HEALTH WHITE PAPER SERIES | N° 2 INTERDENTAL CLEANING TO PREVENT AND TREAT GUM DISEASE: STATE OF THE EVIDENCE TABLE OF CONTENTS ABSTRACT 2 PLAQUE AND GUM DISEASE 2 GOOD INTERDENTAL CARE IS 3 ESSENTIAL FOR PLAQUE CONTROL WHICH INTERDENTAL CLEANER 4 IS THE MOST EFFECTIVE? 4 PREVENTION OF PERIODONTAL DISEASE 5 TREATMENT OF PERIODONTAL DISEASE PATIENT PREFERENCE AFFECTS 6 COMPLIANCE WITH TREATMENT SUMMARY OF KEY RESULTS 7 SUMMARY 8 REFERENCES 9 APPENDIXES 11 © Sunstar Europe Sàrl This white paper was produced by Sunstar Europe in order to summarize the literature on interdental cleaning. AN ORAL HEALTH WHITE PAPER SERIES | N° 2 INTERDENTAL CLEANING TO PREVENT AND TREAT GUM DISEASE: STATE OF THE EVIDENCE ABSTRACT Gingivitis affects up to 90% of the world’ population; periodontitis up to 50% of adults worldwide. Appropriate primary and secondary prevention both depend on daily mechanical plaque removal and are the recommended and most affordable ways to reduce the incidence of these diseases. This review of interdental cleaning approaches is based upon the latest evidence base. The relative efficacy of different interdental cleaning methods is provided in accordance with the latest randomized controlled studies (RCTs), and when available, systematic reviews and meta-analyses. Our review indicates that accumulated data unequivocally demonstrates that interdental cleaning plus tooth brushing is better than tooth brushing alone, for both the prevention and treatment of gum disease.
    [Show full text]