Non-Cochrane · intervention · PM41531192
Clinical Efficacy of Interventions Based on Professional Mechanical Plaque Removal in the Treatment of Dental Biofilm-Induced Gingivitis: A Systematic Review and Meta-Analysis.
Farina Roberto, Simonelli Anna, Trombelli Leonardo, et al. · Journal of clinical periodontology · 2026 · PubMed · doi:10.1111/jcpe.70083
Findings
Population Adults with naturally occurring dental biofilm-induced gingivitis
6 findings
| Professional mechanical plaque removal (scaling) alone | No treatment (continued routine oral hygiene) | Supragingival plaque scores 2-6 weeks | SMD 1.13 [0.60, 1.66] GRADE not reported 2 studies · 71 participants |
| Professional mechanical plaque removal (scaling) alone | No treatment (continued routine oral hygiene) | Gingival inflammation indices (GBS, PBI) at patient level 2-6 weeks | SMD 0.28 [-0.21, 0.77] Low Downgraded: risk of bias, inconsistency 2 studies · 71 participants |
| Professional mechanical plaque removal plus oral hygiene instructions | Oral hygiene instructions alone | Gingival inflammation indices (BOP score, GBS) at patient level 2-6 weeks | SMD 0.25 [0.07, 0.44] Low Downgraded: risk of bias, inconsistency 3 studies · 487 participants |
| Professional mechanical plaque removal plus oral hygiene instructions | Oral hygiene instructions alone | Supragingival plaque scores 2-6 weeks | SMD 0.20 [-0.01, 0.41] GRADE not reported 2 studies |
| Ultrasonic scaling plus air polishing (scaling for calculus only) | Ultrasonic scaling plus rubber cup polishing with prophylaxis paste | Supragingival plaque scores 2-6 weeks | SMD 0.04 [-0.36, 0.44] GRADE not reported 3 studies · 168 participants |
| Ultrasonic scaling plus air polishing (scaling for calculus only) | Ultrasonic scaling plus rubber cup polishing with prophylaxis paste | Gingival inflammation indices (BOP, PBI, SBI, GI, mGI) at patient level 2-6 weeks | SMD 0.02 [-0.38, 0.41] Very low Downgraded: risk of bias, indirectness 3 studies · 168 participants |
Included primary studies 11
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Albonni 2021 Clinical outcomes of using erythritol powder by means of air polishing with ultrasonic debridement in the treatment of initial periodontal… PMID:34013650 | 2021 | this review only | Gingival inflammation indices (BOP, PBI, SBI, GI, mGI) at patient level; Supragingival plaque scores | not extracted yet |
| Assaf 2007 Effect of the diode laser on bacteremia associated with dental ultrasonic scaling: a clinical and microbiological study. PMID:17803380 | 2007 | this review only | not stated | not extracted yet |
| Gaare 1990 Improvement of gingival health by toothbrushing in individuals with large amounts of calculus. PMID:2295706 | 1990 | this review only | Gingival inflammation indices (BOP score, GBS) at patient level | not extracted yet |
| Lim and Davies 1996 Comparison of various modalities of "simple" periodontal therapy on oral cleanliness and bleeding. PMID:8811481 | 1996 | this review only | Gingival inflammation indices (BOP score, GBS) at patient level; Supragingival plaque scores | not extracted yet |
| Mensi 2022 Clinical evaluation of air polishing with erythritol powder followed by ultrasonic calculus removal versus conventional ultrasonic… PMID:34275193 | 2022 | this review only | Gingival inflammation indices (BOP, PBI, SBI, GI, mGI) at patient level; Supragingival plaque scores | not extracted yet |
| Mostafa 2022 The effectiveness of microneedling technique using coconut and sesame oils on the severity of gingival inflammation and plaque… PMID:35856483 | 2022 | this review only | not stated | not extracted yet |
| Narayanan 2020 Clinical Evaluation of Local Drug Delivery of Chlorhexidine and Ornidazole in the Treatment of Gingivitis as an Adjunct to Scaling and… DOI:10.37506/ijfmt.v14i4.12322 | 2020 | this review only | not stated | not extracted yet |
| Patil 2015 A comparative evaluation of plaque-removing efficacy of air polishing and rubber-cup, bristle brush with paste polishing on oral hygiene… PMID:26759798 | 2015 | this review only | Gingival inflammation indices (BOP, PBI, SBI, GI, mGI) at patient level; Supragingival plaque scores | not extracted yet |
| Shi 2020 [Investigation of the clinical effect of 65 μm glycine powder air-polishing(GPAP) after ultrasonic scaling during subgingival polishing]. PMID:33043353 | 2020 | this review only | not stated | not extracted yet |
| Somu 2012 Efficacy of a herbal extract gel in the treatment of gingivitis: A clinical study. PMID:22707865 | 2012 | this review only | Gingival inflammation indices (GBS, PBI) at patient level; Supragingival plaque scores | not extracted yet |
| Tan and Saxton 1978 Effect of a single dental health care instruction and prophylaxis on gingivitis. PMID:278698 | 1978 | this review only | Gingival inflammation indices (GBS, PBI) at patient level; Supragingival plaque scores; Gingival inflammation indices (BOP score, GBS) at patient level | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults with naturally occurring dental biofilm-induced gingival inflammation on an intact or reduced periodontium, no history of periodontitis (CAL <= 3 mm) | Young adults and adults with gingivitis (n=11 studies; 8 to 176 patients per arm) |
| Intervention | Professional mechanical plaque removal (scaling, ultrasonic/sonic/manual instrumentation, air polishing) in single or multiple sessions; for FQ3 with professionally administered local adjuncts | Scaling-based PMPR (ultrasonic, hand); air polishing (sodium bicarbonate, glycine, erythritol-chlorhexidine); diode laser; ornidazole-chlorhexidine gel; coconut or sesame oil infiltration |
| Comparison | FQ1: no treatment or OHI alone; FQ2: any of the PMPR interventions; FQ3: same PMPR without the professionally administered adjunct | No treatment (n=1 RCT with routine hygiene), OHI alone (n=3), scaling alone, scaling plus rubber cup polishing, scaling without adjunct |
| Outcomes | Primary: gingival inflammation at patient level (BOP, gingival index, reversion to health); secondary: plaque scores and treatment invasiveness (adverse events, chair time, costs, patient-reported outcomes) | Gingival indices (BOP, GI, GBS, PBI, SBI, BI), plaque score, treatment time, patient preference, adverse events, tooth stain |
| Study designs | Prospective RCTs or controlled trials, split-mouth or parallel-arm, at least 5 subjects per treatment | 10 RCTs and 1 CT; 5 parallel-arm and 6 split-mouth |
| Timing | Primary outcome assessed 2 to 6 weeks after intervention completion; longer follow-up reported separately | 2 to 6 weeks (primary); also 2, 3, 4 and 6 months in five studies |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Yes | Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: Yes | no |
| 10Funding of included studies reported | Yes | Yes | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: No | NRSI: No · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |