The efficacy of an oscillating‐rotating power toothbrush compared to a high‐frequency sonic power toothbrush on parameters of dental plaque and gingival inflammation: A systematic review and meta‐analysis

Abstract

Aim: To establish the efficacy of oscillating-rotating power toothbrush (OR-PTB) compared to high-frequency sonic power toothbrush (HFS-PTB) on improving parameters of plaque and gingival inflammation. Safety and participants' preference were secondary interests.Materials and methods: MEDLINE-PubMed and Cochrane-CENTRAL databases were searched, up to April 2021. Inclusion criteria were (randomized)controlled clinical trials that evaluated healthy humans brushing with an OR-PTB compared to a HFS-PTB.Evaluation for a minimum of 4 weeks, of one or more of the following parameters: plaque index scores (PI), bleeding scores (BS), number of bleeding sites (NoB) and gingival index scores (GI).Results: Thirty two publications involving 38 comparisons were included after the independent screening. The descriptive analysis showed that in 54% of the comparisons, a significant difference in favour of the OR-PTB was found for PI, BS and GI scores. The Quigley and Hein index showed a significant difference of means (DiffM) between the end scores (DiffM 0.13, 95% CI [0.05;0.21] p < 0.001), as well as for the Rustogi-modified Navy index (DiffM 0.01, 95% CI [0.01;0.03] p = 0.002). This is in line with the meta-analysis for BS (DiffM 0.09, 95% CI [0.03;0.14] p = 0.003), for which the results were in favour of the OR-PTB and considered potentially clinically relevant. NoB showed a significant difference in favour of the OR-PTB for the end scores (DiffM 3.61, 95% CI [2.63;4.58] p < 0.00001). No difference in safety was indicated, 78% of participants preferred the OR-PTB. Conclusion:For patients to maintain good plaque control and improve gingival health, there is a small but significant difference based on longer-term studies between OR-PTB and HFS-PTB. This difference is potentially clinically relevant.

A Meta-analysis Comparing Toothbrush Technologies on Gingivitis and Plaque

“…Whilst some groups have reported little to no efficacy difference between O-R and sonic brushes, including high-frequency models, with respect to plaque or gingivitis reduction, 53 , 54 a large body of independently conducted research supports the superior performance of O-R brushes vs sonic as well as manual brushes. 8 , 9 , 10 , 14 , 16 , 17 The consistently lower plaque effects seen for manual toothbrushes vs electric toothbrushes illustrate that whilst a skilled user can achieve thorough plaque removal with a manual toothbrush, it is difficult to do in practice. 7 …”

“…Evidence shows greater gingivitis and plaque reduction for the latter technology. 8 , 14 , 15 , 16 , 17 A prior meta-analysis assessed the gingivitis- and plaque-reducing effects of O-R vs manual and sonic electric toothbrushes. 15 That analysis focused on 20 randomised controlled trials (RCTs) evaluating plaque and 16 RCTs assessing gingivitis, all of which were conducted between 2007 and 2017.…”

Brushing behaviour changes and plaque removal with an electric toothbrush: A clinical trial

“…Another notable finding is the enhanced plaque removal exhibited by the NG‐OR brush relative to the T‐OR. While both toothbrushes are based on OR technology, which has been shown to provide gingival health advantages over manual and sonic toothbrush controls, 24–28 the novel drive system of the NG‐OR brush eliminates intrinsic losses of energy that are incurred with use of the mechanical drive system in the T‐OR and the NG‐OR brush has a higher frequency of brush rotations. A recent meta‐analysis of 26 RCTs with over 3000 subjects confirms plaque removal and gingival health efficacy advantages for the NG‐OR brush over traditional OR models like the T‐OR brush 29 .…”

Effectiveness of Oscillating and Rotating versus High-Frequency Sonic Powered Toothbrush in Dental Hygiene University Students: A Proof-of-Concept Study

“…After 3 months of OR PTB, the main oral hygiene indexes (NMPS, OHI-S, and PCR) improved so much that they resulted in being significantly better than those detected at T0 in Group 2, albeit from a clinical point of view, this statistically significant difference was not relevant. In the scientific literature, there is still no agreement on this topic, considering that a meta-analysis performed by van der Sluijs et al [44] showed a small but significant difference between the oscillating-rotating power toothbrush and high-frequency sonic toothbrush, confirming a clinically more relevant advantage of oscillating-rotating than using HFS PTB. Moreover, a review of randomized clinical trials by Preda et al [27], taking into account the quality assessment, resulted in being in favor of sonic toothbrushes, reporting greater long-term results for both the gingival and bleeding indices.…”