Satish Kumar1. 1. Division of Periodontology, Diagnostic Sciences & Dental Hygiene, Ostrow School of Dentistry of USC, Los Angeles, CA, USA.
Abstract
DATA SOURCES: Medline, the Cochrane Central Register of Controlled Trials and Embase. STUDY SELECTION: Randomised, controlled trials (RCTs) or controlled clinical trials (CCTs) in adults ≥17 years of age involving either triclosan or stannous-fluoride-containing dentifrices and self-performed manual brushing with a minimum four' weeks of follow-up were considered. DATA EXTRACTION AND SYNTHESIS: Study quality was assessed by two reviewers and meta-analysis performed where using fixed or random effects models as appropriate. RESULTS: Fifteen RCTs including four unpublished trials from one manufacturer met the criteria.No differences in the gingival index were seen between the two dentifrices [Diff-0.04, 95% confidence interval CI (-0.11; 0.04); P = 0.34]. However the change in the average gingival bleeding score was significantly in favour of SnF [DiffM0.02, 95% CI (0.01; 0.02); P < 0.00001]. Plaque scores demonstrated a statistically significant difference in favour of TCS, according to the Quigley-Hein Plaque Index (Q&H PI; Diff-0.29, 95% CI [-0.45; -0.13]; P = 0.0004), but there was no difference according to Rustogi Modified Navy Plaque Index (RMNPI) [Diff-0.09, 95% CI (-0.01; 0.18); P = 0.07]. CONCLUSIONS: In the context of inconclusive results for the primary outcome variable of gingival health, it can be concluded that there was a minor and most likely clinically insignificant difference between Tcs- and SnF-containing dentifrices. Meta-analysis of plaque score reduction was also inconclusive; whereas TCS was more effective when assessed by the Q&H PI, it was not when scored with the RMNPI.
DATA SOURCES: Medline, the Cochrane Central Register of Controlled Trials and Embase. STUDY SELECTION: Randomised, controlled trials (RCTs) or controlled clinical trials (CCTs) in adults ≥17 years of age involving either triclosan or stannous-fluoride-containing dentifrices and self-performed manual brushing with a minimum four' weeks of follow-up were considered. DATA EXTRACTION AND SYNTHESIS: Study quality was assessed by two reviewers and meta-analysis performed where using fixed or random effects models as appropriate. RESULTS: Fifteen RCTs including four unpublished trials from one manufacturer met the criteria.No differences in the gingival index were seen between the two dentifrices [Diff-0.04, 95% confidence interval CI (-0.11; 0.04); P = 0.34]. However the change in the average gingival bleeding score was significantly in favour of SnF [DiffM0.02, 95% CI (0.01; 0.02); P < 0.00001]. Plaque scores demonstrated a statistically significant difference in favour of TCS, according to the Quigley-Hein Plaque Index (Q&H PI; Diff-0.29, 95% CI [-0.45; -0.13]; P = 0.0004), but there was no difference according to Rustogi Modified Navy Plaque Index (RMNPI) [Diff-0.09, 95% CI (-0.01; 0.18); P = 0.07]. CONCLUSIONS: In the context of inconclusive results for the primary outcome variable of gingival health, it can be concluded that there was a minor and most likely clinically insignificant difference between Tcs- and SnF-containing dentifrices. Meta-analysis of plaque score reduction was also inconclusive; whereas TCS was more effective when assessed by the Q&H PI, it was not when scored with the RMNPI.
Authors: Beverley J Shea; Jeremy M Grimshaw; George A Wells; Maarten Boers; Neil Andersson; Candyce Hamel; Ashley C Porter; Peter Tugwell; David Moher; Lex M Bouter Journal: BMC Med Res Methodol Date: 2007-02-15 Impact factor: 4.615