Professional mechanical plaque removal alone may not be enough to maintain gingival health.

Abstract

The Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase databases. Randomised controlled trials of professional plaque removal with a comparison group of no intervention, oral hygiene instruction only or different frequencies of professional mechanical plaque removal were considered. Independent duplicate data abstraction was carried out by two reviewers. Included studies were assessed with the Cochrane risk of bias tool. Meta-analysis was not conducted because of marked heterogeneity in the included studies. Three studies were included. Risk of bias was unclear or high in all three studies. Three studies compared professional mechanical plaque removal (PMPR) and oral Hygiene Instruction (OHI) versus no treatment and found evidence for PMPR and OHI achieving more favourable changes in plaque and bleeding/inflammation compared with no treatment. There was no available evidence for an effect on pocket depth (PD) or attachment level (AL). Two studies compared PMPR + OHI versus OHI and found evidence suggesting no difference between PMPR + OHI and OHI alone in maintaining or improving plaque and bleeding outcomes. There was no additional information from other intervention comparisons in the three studies. Evidence from the three new studies was considered with existing RCT evidence. Within the limitations of the research, we suggest the following conclusions: low-moderate strength of evidence suggests that in adults, PMPR, particularly if combined with OHI, may achieve greater changes in measures of dental plaque and gingival bleeding/inflammation than no treatment. Moderate strength of evidence suggests there is no additional benefit to plaque and gingival bleeding outcomes from PMPR over that achieved by repeated and thorough oral hygiene instructions, although with no evidence to inform on prevention of periodontitis. Low strength of evidence suggests that more frequent PMPR is associated with improved plaque and bleeding outcomes and possibly less annual attachment loss.