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Meta-Analysis
. 2023 Feb;9(1):3-16.
doi: 10.1002/cre2.691. Epub 2022 Dec 23.

Efficacy of power-driven interdental cleaning tools: A systematic review and meta-analysis

Pia Edlund  1 , Kristina Bertl  1   2 , Nikolaos Pandis  3 , Andreas Stavropoulos  1
Affiliations
Meta-Analysis

Efficacy of power-driven interdental cleaning tools: A systematic review and meta-analysis

Pia Edlund et al. Clin Exp Dent Res. 2023 Feb.

Abstract

Objectives: To summarize the available evidence on the efficacy of power-driven interdental cleaning tools (PDICTs) as an adjunct to tooth brushing compared to tooth brushing alone or tooth brushing combined with any other non-PDICT in terms of interproximal plaque and gingival bleeding reduction in gingivitis patients.

Material and methods: A systematic literature search was performed in three databases until March 20, 2022 with the following main eligibility criteria: (1) randomized controlled clinical trials (RCTs) with (2) at least 28 days of follow-up in (3) gingivitis patients. Interproximal plaque and bleeding values were defined as the primary outcome variables and used for pair-wise meta-analyses.

Results: Sixteen RCTs were identified including data from 1258 participants at the final evaluation. Eight studies each investigated the effect of either a liquid-based or mechanical PDICT; one of these studies tested additionally a combined liquid-based and mechanical PDICT. Tooth brushing combined with a liquid-based PDICT compared to tooth brushing alone did not result in better interproximal plaque values but in significantly lower interproximal bleeding values. Tooth brushing combined with either a liquid-based PDICT or with a mechanical PDICT compared to tooth brushing and flossing achieved comparable interproximal plaque and bleeding values. The majority of studies reporting on patient compliance/preference favored the use of a PDICT, and except for a single study, which was reporting soft tissue trauma in two subjects from improper use of a mechanical PDICT, none of the studies reported adverse events.

Conclusions: Daily use of PDICT as an adjunct to tooth brushing significantly reduces interproximal bleeding. This effect appears comparable to that of flossing, while PDICT may achieve higher patient acceptance/compliance.

Keywords: bleeding; gingivitis; interdental cleaning device; meta-analysis; plaque; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the inclusion process of studies for the systematic review
Figure 2
Figure 2
Forest plot for interproximal plaque
Figure 3
Figure 3
Forest plot for interproximal bleeding
See this image and copyright information in PMC

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