title: Efficacy of professional hygiene and prophylaxis on preventing plaque increase in orthodontic patients with multibracket appliances: a systematic review.
abstract: BACKGROUND
  Plaque increase is a troubling side-effect of fixed orthodontic therapy. This generally arise as a consequence of long-term difficulty in maintaining adequate oral hygiene while wearing multibracket appliances. Demineralization, also known as white spot, causes particular concern as it spoils the aesthetic outcome of the treatment itself, not to mention the integrity of the enamel.
  
  
  OBJECTIVE
  To collate the existing literature by evaluating the efficacy of dental hygienist intervention on plaque increase in fixed orthodontics patients.
  
  
  METHODS
  A targeted search of the Medline database (Entrez PubMed), EMBASE, and CENTRAL using relevant Medical Subject Headings was performed. The articles selected were all published before June 2013 and comprised randomized clinical trials, prospective longitudinal controlled clinical trials, and before/after studies onto the plaque increase of fixed appliances.
  
  
  RESULTS
  The search strategy yielded 630 articles. Following the application of inclusion and exclusion criteria, 10 articles qualified for the final review.
  
  
  CONCLUSIONS
  The quality of the retrieved researches ranged from low (one study) to high (one study). Six controlled trials were considered at unknown risk of bias. Data showed that regular patient motivation sessions and mechanical tooth cleaning by a professional dental hygienist help maintaining good oral hygiene during fixed orthodontics.
authors.affiliation: *Department of Orthodontics, Genoa University School of Dentistry, marco.migliorati@unige.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Migliorati
authors.affiliation: *Department of Orthodontics, Genoa University School of Dentistry.
authors.forename: Luisa
authors.initials: L
authors.lastname: Isaia
authors.affiliation: *Department of Orthodontics, Genoa University School of Dentistry.
authors.forename: Angela
authors.initials: A
authors.lastname: Cassaro
authors.affiliation: **Epidemiology Service (SSEpi-SeREMI), Azienda Sanitaria Locale Alessandria.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rivetti
authors.affiliation: ***Department of Paedodontics, Genoa University School of Dentistry.
authors.forename: Francesca
authors.initials: F
authors.lastname: Silvestrini-Biavati
authors.affiliation: *Department of Orthodontics, Genoa University School of Dentistry.
authors.forename: Laura
authors.initials: L
authors.lastname: Gastaldo
authors.affiliation: ***Department of Paedodontics, Genoa University School of Dentistry.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Piccardo
authors.affiliation: ****Department of Orthodontics, Dental School, University of Brescia and Doctoral School of "Experimental Medicine and Therapy" - course of "Physiopathology of Stomatognatic Apparatus. Dental Materials", *****Department of Biomedical Sciences and Human Oncology, University of Turin, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Dalessandri
authors.affiliation: *Department of Orthodontics, Genoa University School of Dentistry.
authors.forename: Armando
authors.initials: A
authors.lastname: Silvestrini-Biavati
mesh_terms: D018849:Controlled Clinical Trials as Topic; D003731:Dental Caries / Q000517:prevention & control; D003773:Dental Plaque / Q000517:prevention & control*; D003777:Dental Prophylaxis / Q000379:methods*; D006801:Humans; D009910:Oral Hygiene / Q000379:methods; D016910:Orthodontic Brackets; D016032:Randomized Controlled Trials as Topic