4.4 Review

Efficacy of oscillating rotating versus side-to-side powered toothbrushes on plaque and gingival index reduction A systematic review

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AMER DENTAL ASSOC
DOI: 10.1016/j.adaj.2020.10.002

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Toothbrushing; plaque; gingivitis; preventative dentistry

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After conducting a systematic review of 24 trials, researchers concluded that there is no clear superiority between oscillating rotating and side-to-side powered toothbrushes in reducing plaque or gingival index.
Background. The authors conducted a systematic review to assess the efficacy of oscillating rotating (OR) versus side-to-side (SS) powered toothbrushes on plaque and gingival index reduction. Methods. The authors searched 3 electronic databases and the gray literature for randomized clinical trials in which investigators compared OR with SS powered toothbrushes. Two authors independently screened the studies, performed data abstraction, and assessed the risk of bias. The authors used random-effects model meta-analyses to pool results across trials and the Grading of Recommendations Assessment, Development and Evaluation approach to rate the certainty of evidence. Results. This systematic review included 24 trials in which researchers enrolled a total of 2,998 patients. There was moderate-certainty evidence that SS toothbrushes may result in little to no difference in plaque index reduction from baseline to 4 weeks compared with OR toothbrushes (standardized mean difference, 0.02; 95% confidence interval, -0.46 to 0.42). There was moderate-certainty evidence that SS toothbrushes may result in little to no difference in gingival index reduction from baseline to 4 weeks compared with OR toothbrushes (standardized mean difference, 0.13; 95% confidence interval, -0.47 to 0.22). There was moderate-quality evidence suggesting little to no difference in adverse events. Conclusions. The evidence does not suggest the superiority of either OR or SS toothbrushes for plaque or gingival index reduction. Practical Implications. Clinicians and patients considering the use of either of these toothbrushes are unlikely to observe more benefits with one type versus the other.

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