title: A systematic review of the effectiveness of self-performed mechanical plaque removal in adults with gingivitis using a manual toothbrush.
abstract: OBJECTIVE
  To assess the effectiveness of self-performed mechanical plaque removal in adults with gingivitis using a manual toothbrush with respect to the level of plaque and gingivitis in controlled studies of at least 6 months duration. SEARCH: Medline-PubMed up to and including September 2004.
  
  
  RESULTS
  Out of 3223 titles and abstracts, 33 trials were found for data extraction. A meta-analysis was conducted of studies (n=9) in which, for the manual toothbrush group at baseline, only a professional prophylaxis provided. The weighted mean differences (WMD) between baseline and end-trial for the Quigley & Hein plaque index was 0.28 and 0.21 for the Gingival Index (p<0.05). Eight studies provided both a professional OHI and prophylaxis at baseline. The WMD for the Silness & Löe Plaque Index was 0.10 (ns). The WMD of the proportion of bleeding sites was 5.84% (p<0.05).
  
  
  CONCLUSIONS
  In adults with gingivitis the quality of self-performed mechanical plaque removal is not sufficiently effective and should be improved. Based on studies > or = 6 months of duration, it appears that a single oral hygiene instruction, describing the use of a mechanical toothbrush, in addition to a single professional 'oral prophylaxis' provided at baseline, had a significant, albeit small, positive effect on the reduction of gingivitis.
authors.affiliation: Department of Periodontology, Academic Centre for Dentistry Amsterdam, The Netherlands. ga.vd.weijden@acta.nl
authors.forename: G A
authors.initials: GA
authors.lastname: van der Weijden
authors.forename: K P K
authors.initials: KP
authors.lastname: Hioe
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000628:therapy*; D003774:Dental Plaque Index; D005891:Gingivitis / Q000628:therapy*; D006801:Humans; D010512:Periodontal Index; D014099:Toothbrushing / Q000295:instrumentation*