Comparison of triclosan and stannous fluoride dentifrices on parameters of gingival inflammation and plaque scores: a systematic review and meta-analysis.

OBJECTIVE

To systematically review the literature to compare the efficacy of triclosan (Tcs) and stannous fluoride (SnF) dentifrices on parameters of gingivitis and plaque scores.

MATERIALS AND METHODS

Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched up to March 2013 to identify appropriate studies. Studies regarding self-performed manual brushing by adults with a minimum 4 weeks of follow-up were included. Primary outcomes were parameters of gingivitis. Secondary outcome was plaque score.

RESULTS

Of 55 publications, 11 met the eligibility criteria. Additionally, four unpublished papers were added after contacting the manufacturers of the leading brands. In total, 15 studies [10 medium term and five long term (>6 months)] were processed for data analysis. There was no difference in gingival index (or its modification) between the two types of dentifrice [DiffM-0.04, 95% confidence interval CI (-0.11; 0.04); P = 0.34]. The change in the average gingival bleeding score was significantly in favour of SnF [DiffM0.02, 95% CI (0.01; 0.02); P < 0.00001]. Plaque scores demonstrated a statistical significant difference in favour of Tcs, according to Quigley-Hein Plaque Index (Q&H PI; DiffM-0.29, 95% CI [-0.45; -0.13]; P = 0.0004), but there was no difference according to Rustogi Modified Navy Plaque Index (RMNPI) [DiffM-0.09, 95% CI (-0.01; 0.18); P = 0.07]. Long-term results supported these findings.

CONCLUSIONS

In the context of inconclusive results for the primary outcome variable of gingival health, it can be concluded that there was a minor and most likely clinically insignificant difference between Tcs- and SnF-containing dentifrices. Meta-analysis of plaque score reduction was also inconclusive; whereas Tcs was more effective when assessed by the Q&H PI, it was not when scored with the RMNPI.