Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Int J Dent Hyg. 2020 Feb;18(1):17-26. doi: 10.1111/idh.12401. Epub 2019 Jul 23.
In adult participants, what is, following a single brushing exercise, the efficacy of a powered toothbrush (PTB) as compared to a manual toothbrush (MTB) on plaque removal?
MEDLINE-PubMed and Cochrane-CENTRAL were searched from inception to February 2019. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects ≥18 years of age, in good general health and without periodontitis, orthodontic treatment, implants and/or removable prosthesis. Papers evaluating a PTB compared with a MTB in a single brushing exercise were included. When plaque scores were assessed according to the Quigley-Hein plaque index (Q&HPI) or the Rustogi modified Navy plaque index (RMNPI). From the eligible studies, data were extracted. A meta-analysis and subanalysis for brands and mode of action being oscillating-rotating (OR) and side-to-side (SS) were performed when feasible.
Independent screening of 3450 unique papers resulted in 17 eligible publications presenting 36 comparisons. In total, 28 comparisons assessed toothbrushing efficacy according to the Q&HPI and eight comparisons used the RMNPI. Results showed a significant effect in favour of the PTB. The difference of Means (DiffM) was -0.14 (P < 0.001; 95%CI [-0.19; -0.09]) for the Q&HPI and -0.10 (P < 0.001; 95%CI [-0.14; -0.06]) for the RMNPI, respectively. The subanalysis on the OR mode of action showed a DiffM -0.16 (P < 0.001; 95%CI [-0.22, -0.10]) for the Q&HPI. For the SS mode of action using RMNPI, the DiffM showed -0.10 (P < 0.001; 95%CI [-0.15; -0.05]). The subanalysis for brands showed for the P&G OR PTB using the Q&HPI a DiffM of -0.15 (P < 0.001; 95%CI [-0.22; -0.08]) and the Colgate SS for RMNPI showed a DiffM of -0.15 (P < 0.001; 95%CI [-0.18; -0.12]).
There is moderate certainty that the PTB was more effective than the MTB with respect to plaque removal following a single brushing exercise independent of the plaque index scale that was used.
在成年参与者中，单次刷牙后，与手动牙刷（MTB）相比，电动牙刷（PTB）在去除牙菌斑方面的效果如何？
从建库到 2019 年 2 月，我们在 MEDLINE-PubMed 和 Cochrane-CENTRAL 上进行了检索。纳入标准为：在≥18 岁的健康成年人中进行的（随机）对照临床试验，且无牙周炎、正畸治疗、种植体和/或可摘义齿。纳入了评估 PTB 与 MTB 在单次刷牙时效果的研究。当使用 Quigley-Hein 菌斑指数（Q&HPI）或 Rustogi 改良海军菌斑指数（RMNPI）评估菌斑评分时。从合格的研究中提取数据。当可行时，对品牌和作用模式（振荡-旋转（OR）和左右（SS））进行荟萃分析和亚分析。
对 3450 篇独特论文进行独立筛选后，有 17 篇符合条件的文献纳入了 36 项比较。共有 28 项比较根据 Q&HPI 评估了刷牙效果，8 项比较使用了 RMNPI。结果显示，PTB 有显著的优势。Q&HPI 的差异均值（DiffM）为-0.14（P<0.001；95%CI [-0.19；-0.09]），RMNPI 的 DiffM 为-0.10（P<0.001；95%CI [-0.14；-0.06]）。对 OR 作用模式的亚分析显示，Q&HPI 的 DiffM 为-0.16（P<0.001；95%CI [-0.22，-0.10]）。对于 SS 作用模式，使用 RMNPI 的 DiffM 为-0.10（P<0.001；95%CI [-0.15；-0.05]）。品牌亚分析显示，使用 Q&HPI 的 P&G OR PTB 的 DiffM 为-0.15（P<0.001；95%CI [-0.22；-0.08]），而 Colgate SS 的 DiffM 为 RMNPI 为-0.15（P<0.001；95%CI [-0.18；-0.12]）。
有中等确定性证据表明，与手动牙刷相比，在单次刷牙后，PTB 在去除牙菌斑方面更有效，而与使用的菌斑指数无关。
