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首页> 外文期刊>Journal of dentistry >The effectiveness of manual versus powered toothbrushes for dental health: a systematic review.
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The effectiveness of manual versus powered toothbrushes for dental health: a systematic review.

机译：手动与电动牙刷对牙齿健康的有效性：系统评价。

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OBJECTIVES: To compare manual and powered toothbrushes in everyday use, principally in relation to plaque removal and gingival health. Stain, calculus removal, dependability, adverse effects and cost were also considered. METHOD: A systematic review was undertaken in collaboration with the Cochrane Oral Health Group. Five electronic databases were searched to identify randomised controlled trials comparing powered and manual toothbrushes. Trials of less than 28 days duration, or where toothbrushing was supervised, were excluded. Assessment of relevance, data extraction and validity assessment were all undertaken independently and in duplicate by two reviewers. Included studies were grouped according to the mode of action of the powered toothbrush. The primary outcomes were plaque and gingival health with data defined as either short-term (1-3 months) or long-term (greater than 3 months) duration were analysed. Powered brushes were categorised into six groups depending on mode of action. Numerical data extracted were checked by a third reviewer for accuracy and entered into RevMan (version 4.1). RESULTS: The initial search identified 354 studies. Two hundred and fifteen full articles were obtained of which 29 trials fulfilled the inclusion criteria with results, which could be entered in the meta-analysis. Twenty-six trials (1786 participants) reported short-term and 10 trials (798 participants) long-term plaque scores. Twenty-nine trials (2236 participants) reported short-term and 10 trials (798 participants) long-term gingivitis scores. Powered brushes reduced plaque and gingivitis at least as effectively as manual brushing. Rotation oscillation powered brushes statistically significantly reduced plaque and gingivitis in both the short and long-term. For plaque at one to 3 months the standardised mean difference was -0.44 (95% CI: -0.66 to -0.21), for gingivitis SMD -0.45 (95% CI: -0.76, -0.15). These represented an 11% reduction on the Quigley Hein Plaque index and a 6% reduction on the Loe and Silness gingival index. At over 3 months the effects were SMD for plaque -1.15 (95% CI: -2.02, -0.29) and SMD for gingivitis -0.51 (95% CI: -0.76, -0.25). These represented a 7% reduction on the Quigley Hein Plaque Index and a 17% reduction on the Ainamo Bay Bleeding on Probing Gingival Index. Sensitivity analyses revealed the results to be robust when selecting trials of high quality. There was no evidence of any publication bias. No other powered brush designs were consistently superior to manual toothbrushes. In these trials, data on cost, reliability and side effects were inconsistently reported. CONCLUSION: In general there was no evidence of a statistically significant difference between powered and manual brushes. However, rotation oscillation powered brushes significantly reduce plaque and gingivitis in both the short and long-term. The clinical significance of this reduction is not known. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.
机译：目的：比较日常使用的手动牙刷和电动牙刷，主要与去除牙菌斑和牙龈健康有关。还考虑了污渍，牙结石去除，可靠性，不利影响和成本。方法：与Cochrane口腔健康小组合作进行了系统的审查。搜索了五个电子数据库，以确定比较电动牙刷和手动牙刷的随机对照试验。持续时间少于28天或在监督牙刷的情况下排除在外。相关性评估，数据提取和有效性评估均由两名审核员独立进行，一式两份。根据电动牙刷的作用方式将纳入的研究分组。主要结局为牙菌斑和牙龈健康，其数据定义为短期（1-3个月）或长期（大于3个月）。动力刷根据作用方式分为六类。第三位审阅者检查了提取的数值数据的准确性，并将其输入RevMan（4.1版）。结果：初步搜索确定了354项研究。共获得215篇文章，其中29项试验符合纳入标准，并有结果，可以将其输入荟萃分析。二十六项试验（1786名参与者）报告了短期斑块评分，十项试验（798名参与者）报告了长期斑块评分。二十九项试验（2236名参与者）报告了短期牙龈炎评分，十项试验（798名参与者）报告了长期牙龈炎评分。电动刷至少可以像手动刷牙一样有效地减少牙菌斑和牙龈炎。在短期和长期内，旋转振荡动力刷在统计学上均显着减少了牙菌斑和牙龈炎。对于1至3个月的牙菌斑，标准平均差异为-0.44（95％CI：-0.66至-0.21），对于牙龈炎SMD为-0.45（95％CI：-0.76，-0.15）。这些代表了Quigley Hein斑块指数降低了11％，Loe和Silness牙龈指数降低了6％。在超过3个月的时间里，斑块的SMD为-1.15（95％CI：-2.02，-0.29），牙龈炎的SMD为-0.51（95％CI：-0.76，-0.25）。这些代表了Quigley Hein斑块指数降低了7％，而Ainamo Bay探测牙龈指数的出血减少了17％。敏感性分析表明，在选择高质量的试验时，结果是可靠的。没有证据表明有任何出版偏见。没有其他电动刷设计能够始终胜过手动牙刷。在这些试验中，有关成本，可靠性和副作用的数据不一致。结论：一般而言，没有证据表明电动刷和手动刷之间存在统计学上的显着差异。然而，旋转振荡动力刷在短期和长期内均显着减少了牙菌斑和牙龈炎。这种减少的临床意义尚不清楚。观察方法学指导方针和使设计更加标准化将有利于将来的试验和荟萃分析。

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