Cochrane · intervention · CD007395

Interventions for cleaning dentures in adults

de Souza, RF, de Freitas Oliveira Paranhos, H, Lovato da Silva, CH, et al. · Cochrane Database of Systematic Reviews · 2009 · Cochrane Library

Oral Health Implants and prosthodontics2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 4 · 15.4%Ungraded 22 · 84.6%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Wearers of complete dentures (CD) or removable partial dentures (RPD) or both (including tooth-supported or retained overdenture) over the age of 18; participants with a history of corticosteroid or antimicrobial treatment within the previous 3 months, and participants with implant-retained prostheses, were excluded	Six studies included; settings and participant characteristics varied extensively (some institutionalised elderly, others former university-clinic patients); all included studies assessed complete denture (CD) wearers only, none assessed RPD wearers
Intervention	Any mechanical method (e.g. brushing or ultrasound) or chemical method (e.g. enzymes, sodium hypochlorite, oral rinses or peroxide solutions); microwave disinfection and the combination of two or more methods also considered	Enzyme cleanser (n=2); Silicone surfactant cleanser (n=1); Brushing (n=4); Effervescent tablets (n=2); Other chemical cleansers (n=1); Association of brushing and effervescent tablets (n=1)
Comparison	These interventions evaluated against each other, sham procedures, or no treatment	Placebo/sham solution (n=2); No treatment (n=2); Distilled water (n=2); Another active method - brushing, effervescent tablets or association (n=3)
Outcomes	Primary: health of denture bearing areas (soft tissues/mucosa; periodontal tissues - bleeding on blunt probing, gingival attachment, tooth mobility; hard tissues/teeth - plaque scores, caries); participants' satisfaction and preference. Secondary: denture plaque coverage area; indicators of halitosis (volatile sulphur compounds); microbial counts on abutment teeth, soft tissues, denture base or saliva. Adverse effects; Costs	Denture plaque/biofilm coverage score (n=4); Microbial counts - fusobacteria, total anaerobes, aerobes, yeasts, hyphae/bacteria (n=4); Improvement on denture cleanliness, caregivers' opinion (n=1)
Study designs	Randomised controlled trials (RCTs)	Randomised controlled trials (parallel-group, Latin-square and cross-over)
Timing	Not reported	48 hours to 12 weeks (follow-up varied across studies)

Search date: May 2009. Databases: Cochrane Oral Health Group Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; LILACS; CINAHL

Questions and results

Current version only

Any denture cleansing method (mechanical or chemical) vs Another method, sham/placebo, or no treatment

Population: Adults (over 18) wearing complete dentures (CD) or removable partial dentures (RPD)

CD007395.PUB2 (current) · 3 questions

Outcome	Effect	Evidence	Status / GRADE
Adverse effects same question in other reviews	Noticeable absence of reports about adverse effects; no included study assessed the extent of adverse effects (for example the aftertaste of sodium hypochlorite, or mechanical or chemical damage to denture materials)…	0 studies	No studies
Outcome NR same question in other reviews	Although six RCTs were included in this review, the wide range of different interventions and outcome variables did not permit pooling of data in a meta-analysis. Isolated reports indicated that chemicals and brushing…	6 studies	Ungraded
Costs same question in other reviews	Noticeable absence of reports about costs of materials associated with denture cleansing methods; no included study assessed costs (Discussion; Implications for research).	0 studies	No studies

Any denture cleansing method (mechanical or chemical) vs Another method, sham/placebo, or no treatment

Population: Wearers of removable partial dentures (RPD), over the age of 18

CD007395.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR same question in other reviews	No included study assessed removable partial denture (RPD) wearers; all six included trials assessed complete denture wearers (Discussion; Implications for research: 'No included study assessed removable partial…	0 studies	No studies

Ultrasonic treatment or microwave disinfection device vs Another method, sham/placebo, or no treatment

Population: Adults (over 18) wearing complete dentures (CD) or removable partial dentures (RPD)

CD007395.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR same question in other reviews	The effectiveness of ultrasonic or microwave devices as an intervention for routine use was not studied according to a randomised controlled trial design (Implications for research).	0 studies	No studies

Enzyme cleanser vs Placebo / sham solution

Population: Institutionalised elderly wearing maxillary complete dentures (CD)

CD007395.PUB2 (current) · 3 questions

Outcome	Effect	Evidence	Status / GRADE
Improvement on denture cleanliness (caregivers' opinion) 12 weeks same question in other reviews	After 12 weeks using an enzyme denture cleanser ('E'), 8 of 18 caregivers perceived some improvement in CD cleanliness. After using a placebo solution ('Plac'), only 2 of 17 perceived some improvement (Analysis 1.1,…	1 study · 35 participants	Ungraded
Microbial counts (hyphae and bacteria) 12 weeks same question in other reviews	Lower hyphal and bacterial scores were also found for 'E' when compared with 'Plac' after 12 weeks. It was not possible to extract adequate data as the investigators did not provide standard deviations.	1 study	Ungraded
Denture plaque (biofilm) score 5 weeks; 3 months same question in other reviews	Both interventions reduced biofilm scores after 2 weeks. However, plaque scores were significantly lower for 'E' after 5 weeks (P < 0.05) and 3 months (P < 0.01), as assessed by Chi2 test. It was not possible to…	1 study	Ungraded

Enzyme cleanser vs Brushing

Population: Wearers of maxillary and mandibular complete dentures (CD)

CD007395.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Denture plaque coverage score same question in other reviews	Standard deviations were not reported for the relevant data so these were not included in the analysis. Reduction of plaque scores was associated with enzyme concentration (ANOVA, P < 0.001). Brushing alone and…	1 study	Ungraded

Silicone surfactant cleanser vs Placebo / sham solution

Population: Complete denture (CD) wearers

CD007395.PUB2 (current) · 2 questions

Outcome	Effect	Evidence	Status / GRADE
Visual plaque score 14 days same question in other reviews	MD -0.88 [-1.00, -0.76]	1 study	Ungraded
Visual plaque score 2 days same question in other reviews	MD -1.02 [-1.13, -0.91]	1 study	Ungraded