The effect of anti-plaque agents on gingivitis

Abstract

Data sourcesAn electronic search was conducted on PubMed Central. References of retrieved papers and previously published systematic reviews were hand searched.Study selectionRandomised controlled trials (RCTs) with at least six months follow-up evaluating the use of test products used in mouthrinses, toothpastes or gels as adjuncts to mechanical oral hygiene (including toothbrushing) were considered.Data extraction and synthesisTwo trained and calibrated reviewers independently assessed the studies for eligibility, with any disagreement being resolved by discussion. Two reviewers under the supervision of a third reviewer extracted data. Risk of bias was evaluated using the Cochrane risk of bias tool and the CONSORT statement. Outcomes were summarised as means and standard deviation (SD) or standard error (SE), the results were pooled and analysed using weighted mean differences (WMD), and heterogeneity among the studies was calculated.ResultsEighty-seven articles with 133 comparisons were included in the review. A majority of the studies (75) were considered to be at high risk of bias, eight at unclear risk and four at low risk. Fifteen different categories of active agent were used in toothpastes and ten in mouthwashes. The additional effects of the tested products were statistically significant for the Loe & Silness gingival index (46 studies), WMD -0.217, the modified gingival index (23 studies) - 0.415, gingivitis severity index (26 studies) - 14.939% or bleeding index (23 studies) - 7.626% with significant heterogeneity. For plaque, additional effects were found for Turesky (66 studies) WMD - 0.0475, Silness & Loe (26 studies) - 0.109 and for plaque severity (12 studies) - 23.4% indices, with significant heterogeneity.ConclusionsWithin the limitations of the present study, formulations with specific agents for chemical plaque control provide statistically significant improvements in terms of gingival, bleeding and plaque indices.