Clinical Efficacy Comparison of Oscillation/Rotation/Pulsation and Sonic Electric Toothbrushes - Metaanalysis

Background. Continuous assessment of clinical efficacy of plaque removal and gingivitis state is needed. In many studies the efficacy powered versus manual toothbrushes have been compared. Less attention was paid to the differences in clinical effectiveness between powered toothbrushes. Objectives. The metaanalysis to compare the plaque removal and gingivitis efficacy between the oscillating/rotating/pulsating (ORP) and sonic (D) toothbrushes has been done. Plaque removal, especially on proximal region, based on the changes Rustonogi Modification of Navy Plaque Index (RMNPI) and the reduction of extension (GBI acc. Ainamo and Bay) and intensity (MGI acc. Lobene gingival index) of gingivitis in the evaluation of a least one month studies has been compared. Material and Methods. After the review of literature, in the metaanalysis six studies from years 2001-2012 have been included. All of included trails were assessed on the key criteria. A measure of treatment effect was mean differences plaque and gingivitis indices between beginning of toothbrushing and end point of observations. Random effects model in the DerSimonian and Laird was performed for the calculation of cumulative mean difference. Heterogeneity and publication bias assessment have been assessed. Results. There was a significant reduction of whole mouth RMNPI index after 4-12 weeks OPR toothbrushing (D = 0.049 +/- 0.014, p = 0,0003). After using of ORP toothbrushes a significant reduction of approximal RMNPI index (D = 0.082 +/- 0.017, p = 0.0000) have been demonstrated. For ORP toothbrushes it has been found a significant influence on a reduction of MGI index (D = 0.7 +/- 0.03, p = 0.017). There was no significant difference between these toothbrushes in extension gingivitis reduction. Conclusions. A significant advantage of the oscillating/rotating/pulsating over sonic toothbrushes in plaque removal, especially on approximal dental surfaces was demonstrated in the metaanalysis. For gingivitis reduction this advantage is not so clear-cut.