A systematic review of professional mechanical plaque removal for prevention of periodontal diseases.
OBJECTIVE
To investigate the effect of professional mechanical plaque removal (PMPR) on the prevention of periodontal diseases.


METHODS
We searched for randomized controlled trials, controlled clinical trials and cohort studies from 1950 to October 2004. Screening and data abstraction were conducted independently and in duplicate. Critical appraisal of studies was based on objective criteria and evidence tables were constructed.


RESULTS
From 2179 titles and abstracts, 132 full-text articles were screened and 32 studies were relevant. Evidence exists that PMPR in adults, particularly in combination with oral hygiene instruction (OHI), may be more effective than no treatment judged by surrogate measures. The evidence for a benefit of PMPR+OHI over OHI alone is less clear. The optimum frequency of PMPR has not been investigated although more frequent PMPR is associated with improved markers of health. The strength of evidence for these results ranges from weak to moderate due to risk of bias, inconsistent results, lack of appropriate statistics and small sample size.


CONCLUSIONS
There appears to be little value in providing PMPR without OHI. In fact, repeated OHI might have a similar effect as PMPR. Some forms of PMPR might achieve greater patient satisfaction. There is little difference in beneficial or adverse effects of different methods of PMPR.
Needleman
Ian
I
International Centre for Evidence-Based Oral Health, Eastman Dental Institute, UCL, London, UK. i.needleman@eastman.ucl.ac.uk
Suvan
Jean
J
Moles
David R
DR
Pimlott
Jean
J
D000328:Adult; D015331:Cohort Studies; D018849:Controlled Clinical Trials as Topic; D003773:Dental Plaque / Q000628:therapy*; D003777:Dental Prophylaxis; D006267:Health Education, Dental; D006801:Humans; D009910:Oral Hygiene / Q000193:education*; D009911:Oral Hygiene Index; D010510:Periodontal Diseases / Q000517:prevention & control*; D010512:Periodontal Index