title: Mechanical and chemical plaque control in the simultaneous management of gingivitis and caries: a systematic review.
abstract: OBJECTIVE
  To report the evidence on the effect of mechanical and/or chemical plaque control in the simultaneous management of gingivitis and caries.
  
  
  METHODS
  A protocol was designed to identify randomized (RCTs) and controlled (CCTs) clinical trials, cohort studies and prospective case series (PCS), with at least 6 months of follow-up, reporting on plaque, gingivitis and caries. Relevant information was extracted from full papers, including quality and risk of bias. Meta-analyses were performed whenever possible.
  
  
  RESULTS
  After the screening of 1,373 titles, 15 RCTs, 10 CCTs and 2 PCS were included. Low to moderate evidence support that combined professional and self-performed mechanical plaque control significantly reduces standardized plaque index [n = 4; weighted mean difference (WMD) = 1.294; 95% CI (0.445; 2.144); p = 0.003] and gingivitis scores [n = 4; WMD = 1.728; 95% CI (0.631; 2.825); p = 0.002]. The addition of fluoride to mechanical plaque control is relevant for caries management [n = 5; WMD = 1.159; 95% CI (0.145; 2.172); p = 0.025] while chlorhexidine rinses are relevant for gingivitis.
  
  
  CONCLUSIONS
  Mechanical plaque control procedures are effective in reducing plaque and gingivitis. The addition of fluoride to mechanical plaque control is significant for caries management. Chlorhexidine rinse has a positive effect on gingivitis and inconclusive role in caries.
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: Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
authors.forename: Diego F
authors.initials: DF
authors.lastname: Nóbrega
authors.affiliation: ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: García-Gargallo
authors.affiliation: Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
authors.forename: Livia M A
authors.initials: LM
authors.lastname: Tenuta
authors.affiliation: ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Herrera
authors.affiliation: Faculty of Medicine and Dentistry, Catholic University of Louvain, Brussels, Belgium.
authors.forename: Joana C
authors.initials: JC
authors.lastname: Carvalho
mesh_terms: D003731:Dental Caries / Q000150:complications / Q000517:prevention & control*; D003773:Dental Plaque / Q000150:complications / Q000517:prevention & control*; D005459:Fluorides / Q000627:therapeutic use; D005891:Gingivitis / Q000150:complications / Q000628:therapy*; D006801:Humans; D055595:Mechanical Phenomena
chemical_list: D005459:Fluorides
keywords: 
  DMF
  ; caries; chemical plaque control; gingival index; gingivitis; mechanical plaque control; meta-analyses; plaque index; systematic review