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Meta-Analysis
. 2023 Feb;21(1):77-94.
doi: 10.1111/idh.12597. Epub 2022 Jun 25.

The efficacy of an oscillating-rotating power toothbrush compared to a high-frequency sonic power toothbrush on parameters of dental plaque and gingival inflammation: A systematic review and meta-analysis

Eveline van der Sluijs  1 , Dagmar Else Slot  1 , Nienke Lisette Hennequin-Hoenderdos  1 , Cees Valkenburg  1 , Fridus G A van der Weijden  1
Affiliations
Meta-Analysis

The efficacy of an oscillating-rotating power toothbrush compared to a high-frequency sonic power toothbrush on parameters of dental plaque and gingival inflammation: A systematic review and meta-analysis

Eveline van der Sluijs et al. Int J Dent Hyg. 2023 Feb.

Abstract

Aim: To establish the efficacy of oscillating-rotating power toothbrush (OR-PTB) compared to high-frequency sonic power toothbrush (HFS-PTB) on improving parameters of plaque and gingival inflammation. Safety and participants' preference were secondary interests.

Materials and methods: MEDLINE-PubMed and Cochrane-CENTRAL databases were searched, up to April 2021. Inclusion criteria were (randomized)controlled clinical trials that evaluated healthy humans brushing with an OR-PTB compared to a HFS-PTB. Evaluation for a minimum of 4 weeks, of one or more of the following parameters: plaque index scores (PI), bleeding scores (BS), number of bleeding sites (NoB) and gingival index scores (GI).

Results: Thirty two publications involving 38 comparisons were included after the independent screening. The descriptive analysis showed that in 54% of the comparisons, a significant difference in favour of the OR-PTB was found for PI, BS and GI scores. The Quigley and Hein index showed a significant difference of means (DiffM) between the end scores (DiffM 0.13, 95% CI [0.05;0.21] p < 0.001), as well as for the Rustogi-modified Navy index (DiffM 0.01, 95% CI [0.01;0.03] p = 0.002). This is in line with the meta-analysis for BS (DiffM 0.09, 95% CI [0.03;0.14] p = 0.003), for which the results were in favour of the OR-PTB and considered potentially clinically relevant. NoB showed a significant difference in favour of the OR-PTB for the end scores (DiffM 3.61, 95% CI [2.63;4.58] p < 0.00001). No difference in safety was indicated, 78% of participants preferred the OR-PTB.

Conclusion: For patients to maintain good plaque control and improve gingival health, there is a small but significant difference based on longer-term studies between OR-PTB and HFS-PTB. This difference is potentially clinically relevant.

Keywords: dental plaque; gingival health; oscillating-rotating toothbrush; power toothbrush; sonic toothbrush; systematic review.

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Conflict of interest statement

A potential for a COI exists when professional judgement concerning a primary interest, such as patients' welfare or the validity of research, may be influenced by a secondary interest, such as financial gain. Financial relationships are often judged to undermine the credibility of a journal, the authors, or the science itself. Other interests, such as personal relationships or rivalries, academic competition and intellectual beliefs, may also present conflicts. Authors, reviewers, editors and editorial board members of journals in the peer‐review and publication process must, therefore, consider and disclose their relationships and activities when fulfilling their different roles. Transparent and complete disclosures are required to help maintain public trust in the scientific process. In the current systematic review, 14 (45%) publications reported a variety of COIs. Nine papers, , , , , , , were written in conjunction with authors related to industry. The rate of COIs in the present study is much lower than the 76% that was found in a systematic review of RCTs from six dental journals published between January 2011 and March 2012. This difference may be explained by the fact that the included studies in the present review were published over a decade ago when COI reporting was not common.

As presented in the online Appendices S3A,B, 22 of 32 of the included publications reported a source of funding. COIs and funding sources are often reported under the same heading, although these are separate items. Funding does not always indicate a problematic influence, but authors should carefully consider agreements with study sponsors, both for‐profit and non‐profit, and discuss terms such as authors' access to all of the study's data, their ability to analyse and interpret the data and to prepare and publish manuscripts independently, taking into account the principle of academic freedom. From toothpaste trials, it is evident that COIs are not associated with positive conclusions. As toothpaste and toothbrushes are the most recommended products in oral care, the results on COIs and positive conclusions regarding toothpaste can be considered to apply to toothbrush studies as well.

The authors declare that they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Search and selection results. (M)GI, Modified gingival index; (M)Q&H‐PI, modified Quigley & Hein plaque index; (R)MN‐PI, Rustogi Modification of the Navy plaque index; Ang/BOMP, Angular Bleeding index/ Bleeding on marginal probing; BI, Bleeding index; BS, Bleeding scores; GBI, Gingival bleeding index; MGI, Modified gingival Index; NoB, Number of bleeding sites
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