de Souza Raphael Freitas, de Freitas Oliveira Paranhos Helena, Lovato da Silva Claudia H, Abu-Naba'a Layla, Fedorowicz Zbys, Gurgan Cem A
Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, Av. Do Café, s/n, Ribeirão Preto, São Paulo (SP), Brazil, 14040-050.
Cochrane Database Syst Rev. 2009 Oct 7;2009(4):CD007395. doi: 10.1002/14651858.CD007395.pub2.
Removing denture plaque may be essential for maintaining the oral health of edentulous people. Brushing and soaking in chemical products are two of the most commonly used methods of cleaning dentures.
To evaluate the effectiveness and safety of different methods for cleansing removable dentures.
We searched the following databases: the Cochrane Oral Health Group Trials Register (to May 2009); CENTRAL (The Cochrane Library 2009, Issue 2); MEDLINE (1965 to May 2009); EMBASE (1980 to May 2009); LILACS (1980 to May 2009); and CINAHL (1997 to May 2009). There were no language restrictions.
Randomised controlled trials (RCTs) comparing any mechanical method (e.g. brushing or ultrasound) or chemical (e.g. enzymes, sodium hypochlorite, oral rinses or peroxide solutions) in adults over the age of 18 wearing removable partial dentures or complete dentures.The primary outcomes considered were the health of denture bearing areas (soft tissues, periodontal tissues and teeth) and participants' satisfaction and preference. Secondary outcomes included denture plaque coverage area, indicators of halitosis and microbial counts on abutment teeth, soft tissues or denture base or saliva.
Two independent review authors screened and extracted information from, and independently assessed the risk of bias in the included trials.
Although six RCTs were included in this review, the wide range of different interventions and outcome variables did not permit pooling of data in a meta-analysis. Isolated reports indicated that chemicals and brushing appear to be more effective than placebo in the reduction of plaque coverage and microbial counts of anaerobes and aerobes on complete denture bases.
AUTHORS' CONCLUSIONS: There is a lack of evidence about the comparative effectiveness of the different denture cleaning methods considered in this review. Few well designed RCTs were found. Future research should focus on comparisons between mechanical and chemical methods; the assessment of the association of methods, primary variables and costs should also receive future attention.
去除义齿菌斑对于维护无牙患者的口腔健康可能至关重要。刷牙和浸泡在化学产品中是清洁义齿最常用的两种方法。
评估清洁可摘义齿不同方法的有效性和安全性。
我们检索了以下数据库：Cochrane口腔健康组试验注册库（至2009年5月）；CENTRAL（Cochrane图书馆2009年第2期）；MEDLINE（1965年至2009年5月）；EMBASE（1980年至2009年5月）；LILACS（1980年至2009年5月）；以及CINAHL（1997年至2009年5月）。无语言限制。
比较任何机械方法（如刷牙或超声）或化学方法（如酶、次氯酸钠、口腔含漱液或过氧化物溶液）在18岁以上佩戴可摘局部义齿或全口义齿的成年人中的随机对照试验（RCT）。所考虑的主要结局是义齿承托区（软组织、牙周组织和牙齿）的健康状况以及参与者的满意度和偏好。次要结局包括义齿菌斑覆盖面积、口臭指标以及基牙、软组织或义齿基托或唾液中的微生物计数。
两位独立的综述作者筛选并提取纳入试验的信息，并独立评估其偏倚风险。
尽管本综述纳入了6项RCT，但广泛多样的不同干预措施和结局变量不允许在荟萃分析中合并数据。个别报告表明，在减少全口义齿基托上的菌斑覆盖以及厌氧菌和好氧菌的微生物计数方面，化学方法和刷牙似乎比安慰剂更有效。
关于本综述中所考虑的不同义齿清洁方法的相对有效性，缺乏证据。仅发现少数设计良好的RCT。未来的研究应侧重于机械方法和化学方法之间的比较；方法、主要变量和成本之间关联的评估也应在未来受到关注。
