PDF(Pubmed)
Abstract：
BACKGROUND: The meaning of the toothbrushing technique for the effectivity of toothbrushing in terms of plaque removal and parameters of gingivitis is unknown. This systematic review and network meta-analysis (NMA) aimed to synthesize evidence from randomized controlled trials (RCTs).
METHODS: We searched MEDLINE (PubMed), the Cochrane Central Register of Controlled Trials, and the Web of Science for RCTs that compared any self-applied manual toothbrushing technique to any other technique or control and assessed plaque after toothbrushing and gingivitis. Where intervention effects were recorded repeatedly, the last post-intervention assessment was treated as the primary outcome date (POD), and the assessment closest to the intervention as the secondary outcome date (SOD). Age restrictions were not imposed. Participants with fixed orthodontic appliances were excluded. The evidence was evaluated using the Confidence in Network Meta-Analyses (CINeMA) approach, which is based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
RESULTS: Thirteen publications, including 15 studies, were identified. Ten studies assessing the Fones, Bass, and Scrub techniques provided data eligible for the NMA. The confidence rating of the evidence varied from very low to high in the case of plaque, and from very low to low in the case of gingivitis. Regarding PODs, Fones probably reduces plaque slightly compared with no training; the evidence is very uncertain that Fones may have little to no effect on gingivitis. Bass may result in little to no difference in plaque; the evidence that Bass may result in a slight increase in gingivitis is very uncertain. The evidence is very uncertain that Scrub may result in little to no difference in plaque at the SOD (no POD-data available) and that it may result in a slight increase in gingivitis.
CONCLUSIONS: There is limited evidence regarding the effects of toothbrushing techniques on plaque after brushing or gingivitis.
METHODS: We searched MEDLINE (PubMed), the Cochrane Central Register of Controlled Trials, and the Web of Science for RCTs that compared any self-applied manual toothbrushing technique to any other technique or control and assessed plaque after toothbrushing and gingivitis. Where intervention effects were recorded repeatedly, the last post-intervention assessment was treated as the primary outcome date (POD), and the assessment closest to the intervention as the secondary outcome date (SOD). Age restrictions were not imposed. Participants with fixed orthodontic appliances were excluded. The evidence was evaluated using the Confidence in Network Meta-Analyses (CINeMA) approach, which is based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
RESULTS: Thirteen publications, including 15 studies, were identified. Ten studies assessing the Fones, Bass, and Scrub techniques provided data eligible for the NMA. The confidence rating of the evidence varied from very low to high in the case of plaque, and from very low to low in the case of gingivitis. Regarding PODs, Fones probably reduces plaque slightly compared with no training; the evidence is very uncertain that Fones may have little to no effect on gingivitis. Bass may result in little to no difference in plaque; the evidence that Bass may result in a slight increase in gingivitis is very uncertain. The evidence is very uncertain that Scrub may result in little to no difference in plaque at the SOD (no POD-data available) and that it may result in a slight increase in gingivitis.
CONCLUSIONS: There is limited evidence regarding the effects of toothbrushing techniques on plaque after brushing or gingivitis.
摘要：
背景：就牙菌斑去除和牙龈炎参数而言，刷牙技术对刷牙有效性的意义尚不清楚。本系统综述和网络荟萃分析（NMA）旨在综合来自随机对照试验（RCTs）的证据。
方法：我们搜索了MEDLINE（PubMed），Cochrane中央受控试验登记册,和WebofScienceforRCT，将任何自行使用的手动刷牙技术与任何其他技术或对照进行比较，并评估刷牙和牙龈炎后的牙菌斑。如果反复记录干预效果，最后一次干预后评估被视为主要结果日期(POD)，和最接近干预的评估作为次要结果日期（SOD）。没有施加年龄限制。固定正畸矫治器的参与者被排除在外。使用网络元分析信心(CINEMA)方法评估证据，这是基于建议评估的分级，开发和评估(等级)方法。
结果：13种出版物，包括15项研究，已确定。十项评估Fones的研究，Bass,和Scrub技术提供了符合NMA要求的数据。在斑块的情况下，证据的置信度从非常低到高不等，在牙龈炎的情况下从非常低到低。关于PODs,与没有训练相比，Fones可能会稍微减少牙菌斑；证据非常不确定，Fones可能对牙龈炎几乎没有影响。Bass可能导致牙菌斑几乎没有差异；Bass可能导致牙龈炎轻微增加的证据非常不确定。证据非常不确定，擦洗可能导致SOD上的牙菌斑几乎没有差异（没有POD数据），并且可能导致牙龈炎的轻微增加。
结论：关于刷牙技术对刷牙或牙龈炎后牙菌斑的影响的证据有限。
方法：我们搜索了MEDLINE（PubMed），Cochrane中央受控试验登记册,和WebofScienceforRCT，将任何自行使用的手动刷牙技术与任何其他技术或对照进行比较，并评估刷牙和牙龈炎后的牙菌斑。如果反复记录干预效果，最后一次干预后评估被视为主要结果日期(POD)，和最接近干预的评估作为次要结果日期（SOD）。没有施加年龄限制。固定正畸矫治器的参与者被排除在外。使用网络元分析信心(CINEMA)方法评估证据，这是基于建议评估的分级，开发和评估(等级)方法。
结果：13种出版物，包括15项研究，已确定。十项评估Fones的研究，Bass,和Scrub技术提供了符合NMA要求的数据。在斑块的情况下，证据的置信度从非常低到高不等，在牙龈炎的情况下从非常低到低。关于PODs,与没有训练相比，Fones可能会稍微减少牙菌斑；证据非常不确定，Fones可能对牙龈炎几乎没有影响。Bass可能导致牙菌斑几乎没有差异；Bass可能导致牙龈炎轻微增加的证据非常不确定。证据非常不确定，擦洗可能导致SOD上的牙菌斑几乎没有差异（没有POD数据），并且可能导致牙龈炎的轻微增加。
结论：关于刷牙技术对刷牙或牙龈炎后牙菌斑的影响的证据有限。
