Hoogteijling Fcr, Hennequin-Hoenderdos N L, Van der Weijden G A, Slot D E
Dental Hygienist practice Mondzorg Soest, Soest, The Netherlands.
Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.
Int J Dent Hyg. 2018 Feb;16(1):3-12. doi: 10.1111/idh.12272. Epub 2017 Feb 7.
This systematic review was performed to establish the effect of a manual toothbrush with tapered toothbrush filaments (TFTBs) compared to a manual toothbrush with end-rounded toothbrush filaments (ERTB) on clinical parameters of dental plaque, gingivitis and gingival abrasion.
MEDLINE-PubMed and Cochrane-CENTRAL databases were searched. The inclusion criteria were (randomized) controlled clinical trials, participants ≥18 years and papers evaluating the effect of a TFTB compared to an ERTB. Data were extracted for dental plaque index (PI), bleeding scores (BS), gingival index scores (GI) and gingival abrasion scores (GA). A descriptive analysis and a meta-analysis were performed when appropriate.
An independent screening of 33 unique papers resulted in seven eligible publications, which included eight comparisons. Meta-analysis did not show a significant difference between TFTB and ERTB with respect to PI scores. The meta-analysis of the GI scores showed a significant mean difference in favour of the TFTB (DiffM=-0.12 [95% CI: -0.17; -0.07]). Of the three comparisons evaluating GA, no differences were found.
With respect to plaque removal, evidence that supports the recommendation for usage of a TFTB over an ERTB is lacking. Regarding GI, there is minimal evidence favouring a TFTB over an ERTB and the clinical relevance of this difference is probably negligible. Therefore, based on the collective evidence emerging from this systematic review, the strength and direction of the recommendation, there appears to be no firm evidence for a dental healthcare professional to advise the use of a TFTB over the use of an ERTB.
本系统评价旨在确定与圆头刷毛手动牙刷(ERTB)相比,锥状刷毛手动牙刷(TFTB)对牙菌斑、牙龈炎和牙龈磨损等临床指标的影响。
检索MEDLINE-PubMed和Cochrane-CENTRAL数据库。纳入标准为(随机)对照临床试验、参与者年龄≥18岁以及评估TFTB与ERTB效果对比的论文。提取牙菌斑指数(PI)、出血评分(BS)、牙龈指数评分(GI)和牙龈磨损评分(GA)的数据。必要时进行描述性分析和荟萃分析。
对33篇独立论文进行筛选,得到7篇符合条件的出版物,包括8项对比研究。荟萃分析显示,TFTB和ERTB在PI评分方面无显著差异。GI评分的荟萃分析显示,TFTB具有显著的平均差异优势(DiffM=-0.12 [95% CI:-0.17;-0.07])。在评估GA的三项对比研究中,未发现差异。
在牙菌斑清除方面,缺乏支持推荐使用TFTB而非ERTB的证据。关于GI,几乎没有证据表明TFTB优于ERTB,且这种差异的临床相关性可能微不足道。因此,基于本系统评价得出的综合证据、推荐的力度和方向,似乎没有确凿证据支持牙科保健专业人员建议使用TFTB而非ERTB。