Rajwani Andrea Rani, Hawes Sophia Nancy Diana, To Amanda, Quaranta Alessandro, Rincon Aguilar Julio C
Oral Health Prev Dent. 2020 Oct 2;18(4):843-854. doi: 10.3290/j.ohpd.a45354.
Currently, there is no consensus on recommendations for manual toothbrushing techniques between dentists, oral health therapists and dental companies. The aim of this systematic review is to identify and assess the quality of evidence of the effectiveness of manual toothbrushing techniques in the existing literature.
A broad search was conducted on the electronic databases Medline via Ovid, PubMed and EBSCO Dentistry & Oral Sciences. Included studies examined manual toothbrushing technique efficiency. Articles were assessed utilising the Cochrane Collaboration's tool for assessing risk of bias. Thirteen studies met the inclusion criteria and were included in this review. These included five randomised controlled trials (RCT), seven experimental non-randomised control studies and one in vitro study.
Of the 3190 articles identified, 40 were relevant to manual toothbrushing and 13 were included in the final review. Studies indicating statistically significantly superior plaque removal for a given technique were Bass (one), modified Bass (one), Charter's (two), Fones (two), scrub (two), roll (one), modified Stillman (one), toothpick method (one). Four studies exhibited no statistically significant difference in effectiveness of plaque removal. Unfortunately, considerable variation was found between studies, making a definitive conclusion impossible in terms of an ideal manual toothbrushing technique that would promote plaque removal and reduce gingivitis.
There is still insufficient evidence for suggesting that one toothbrushing method is more effective than another in plaque removal and reduction of gingivitis. Excessive variability in many aspects of the design and methodology of the selected studies hinder conclusions on an ideal manual toothbrushing technique. Experimental randomised controlled trials that follow the CONSORT guidelines are required to provide adequate-quality evidence and make any definitive conclusions on the relative effectiveness of manual toothbrushing techniques.
目前，牙医、口腔健康治疗师和牙科公司之间对于手动刷牙技术的建议尚未达成共识。本系统评价的目的是识别和评估现有文献中手动刷牙技术有效性的证据质量。
通过Ovid、PubMed和EBSCO牙科学与口腔科学数据库对电子数据库Medline进行广泛检索。纳入的研究考察了手动刷牙技术的效率。使用Cochrane协作网评估偏倚风险的工具对文章进行评估。13项研究符合纳入标准并被纳入本评价。其中包括5项随机对照试验（RCT）、7项非随机对照实验研究和1项体外研究。
在识别出的3190篇文章中，40篇与手动刷牙相关，13篇被纳入最终评价。表明特定技术在统计学上具有显著更好的牙菌斑清除效果的研究有巴斯刷牙法（1项）、改良巴斯刷牙法（1项）、查特尔刷牙法（2项）、方斯刷牙法（2项）、擦洗法（2项）、旋转法（1项）、改良史迪曼刷牙法（1项）、牙签法（1项）。4项研究在牙菌斑清除效果上没有显示出统计学上的显著差异。遗憾的是，研究之间存在相当大的差异，就促进牙菌斑清除和减少牙龈炎的理想手动刷牙技术而言，无法得出明确结论。
仍没有足够的证据表明一种刷牙方法在清除牙菌斑和减少牙龈炎方面比另一种更有效。所选研究在设计和方法的许多方面存在过度变异性，阻碍了关于理想手动刷牙技术的结论。需要遵循CONSORT指南的实验性随机对照试验来提供高质量证据，并就手动刷牙技术的相对有效性得出任何明确结论。
