title: Efficacy of adjunctive anti-plaque chemical agents: a systematic review and network meta-analyses of the Turesky modification of the Quigley and Hein plaque index.
abstract: The aim of this systematic review and network meta-analysis (NMA) was to compare the efficacy of different anti-plaque chemical agents, in 6-month, home-use, randomized clinical trials (RCTs), in terms of plaque index (PlI) changes.
  
  
  
  RCTs assessing PlI were identified, screened, and evaluated for inclusion. Relevant information was extracted, and quality and risk of bias were assessed. Mean differences between baseline-end were calculated to obtain weighted mean differences and 95% confidence intervals. NMA protocols were applied to assess direct and indirect comparisons among products using Turesky PlI.
  
  
  
  Eighty-three papers were included: 49 examined dentifrices, 32 mouthrinses and 2 both. The NMA analysed 51 studies including data from 4242 and 4180 subjects for dentifrices and mouthrinses respectively. For dentifrices, triclosan-copolymer and chlorhexidine showed the greatest effect, with significant differences when compared with stannous fluoride. For mouthrinses, essential oils and chlorhexidine showed the greatest effect, with significant differences when compared with delmopinol, alexidine and cetylpyridinium chloride.
  
  
  
  Within the limitations of this study (including the severe imbalance in the amount of evidence), dentifrices containing triclosan-copolymer or chlorhexidine and mouthrinses containing essential oils or chlorhexidine showed the greatest effect on PlI scores as assessed with NMA.
authors.affiliation: ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Escribano
authors.affiliation: ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Figuero
authors.affiliation: ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
authors.forename: Conchita
authors.initials: C
authors.lastname: Martín
authors.affiliation: Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain.
authors.forename: Aurelio
authors.initials: A
authors.lastname: Tobías
authors.affiliation: ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Serrano
authors.affiliation: ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Roldán
authors.affiliation: ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Herrera
mesh_terms: D000891:Anti-Infective Agents, Local; D003773:Dental Plaque; D003774:Dental Plaque Index; D003802:Dentifrices; D004311:Double-Blind Method; D005891:Gingivitis; D006801:Humans; D010512:Periodontal Index; D014260:Triclosan
chemical_list: D000891:Anti-Infective Agents, Local; D003802:Dentifrices; D014260:Triclosan
keywords: antiseptic; gingivitis; network meta-analyses; plaque index; systematic review