title: Evaluation of the effectiveness of a pre-brushing rinse in plaque removal: a meta-analysis.
abstract: OBJECTIVE
  A meta-analysis technique was used to pool data from studies to assess the effectiveness of the pre-brushing rinse PLAX on existing plaque and gingivitis.
  
  
  METHODS
  Studies were identified using MEDLINE and other sources, and grouped according to whether PLAX was used in short- or long-term treatment. The quality of trials was assessed by 2 independent readers. The DerSimonian and Laird random effects model was used. Meta-analyses were performed according to duration and type of PLAX treatment. In "1-day" studies, the effect of PLAX after rinsing and after rinsing and brushing was evaluated, whereas in longitudinal studies, this was done at several follow-up times.
  
  
  RESULTS
  A total of 19 studies were included and mean quality scores ranged from 0.13 to 0.60, for the study protocol from 0.18 to 0.70 and for data analysis and presentation from 0.05 to 0.53. In "1-day" studies, PLAX significantly reduced plaque after rinsing (difference=0.143; 95% CI=0.02-0.27;p=0.022), whereas no significant reduction was observed in post-brushing measures. In "longitudinal" studies, plaque was significantly reduced at 1-2 (difference=0.168; 95% CI=0.09-0.24; p<0.0001), 3-4 (difference=0.179; 95% CI=0.01-0.35; p=0.043), 12 (difference=0.288; 95% CI=0.21-0.37; p<0.0001) and 24 (difference=0.377; 95% CI=0.19-0.57; p=0.0001) weeks. The meta-analysis that evaluated gingivitis showed a significant reduction in inflammation with PLAX treatment at 12 (difference=0.209; 95% CI=0.17-0.25; p<0.0001) and 24 (difference=0.257; 95% CI=0.22-0.29; p<0.0001) weeks follow-up.
  
  
  CONCLUSIONS
  Although PLAX use appears to offer some benefit in plaque and gingivitis reduction, the clinical magnitude of the difference and the benefit on oral health are likely to be small.
authors.affiliation: Department of Hygiene, Medical School, University of Catanzaro Magna Graecia, Catanzaro, Italy. angelillo@unicz.it
authors.forename: Italo F
authors.initials: IF
authors.lastname: Angelillo
authors.forename: Carmelo G A
authors.initials: CG
authors.lastname: Nobile
authors.forename: Maria
authors.initials: M
authors.lastname: Pavia
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D001565:Benzoates / Q000008:administration & dosage / Q000627:therapeutic use*; D016001:Confidence Intervals; D003773:Dental Plaque / Q000628:therapy*; D003774:Dental Plaque Index; D004311:Double-Blind Method; D005500:Follow-Up Studies; D005891:Gingivitis / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D008137:Longitudinal Studies; D009067:Mouthwashes / Q000627:therapeutic use*; D010512:Periodontal Index; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D012967:Sodium Dodecyl Sulfate / Q000008:administration & dosage / Q000627:therapeutic use*; D013223:Statistics as Topic; D014099:Toothbrushing; D014260:Triclosan / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000891:Anti-Infective Agents, Local; D001565:Benzoates; D009067:Mouthwashes; D010919:Placebos; C070868:Plax; D012967:Sodium Dodecyl Sulfate; D014260:Triclosan