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Aim The aim of this systematic review and network meta-analysis (NMA) was to compare the efficacy of different anti-plaque chemical agents, in 6-month, home-use, randomized clinical trials (RCTs), in terms of plaque index (PlI) changes. Material and Methods RCTs assessing PlI were identified, screened, and evaluated for inclusion. Relevant information was extracted, and quality and risk of bias were assessed. Mean differences between baseline-end were calculated to obtain weighted mean differences and 95% confidence intervals. NMA protocols were applied to assess direct and indirect comparisons among products using Turesky PlI. Results Eighty-three papers were included: 49 examined dentifrices, 32 mouthrinses and 2 both. The NMA analysed 51 studies including data from 4242 and 4180 subjects for dentifrices and mouthrinses respectively. For dentifrices, triclosan-copolymer and chlorhexidine showed the greatest effect, with significant differences when compared with stannous fluoride. For mouthrinses, essential oils and chlorhexidine showed the greatest effect, with significant differences when compared with delmopinol, alexidine and cetylpyridinium chloride. Conclusion Within the limitations of this study (including the severe imbalance in the amount of evidence), dentifrices containing triclosan-copolymer or chlorhexidine and mouthrinses containing essential oils or chlorhexidine showed the greatest effect on PlI scores as assessed with NMA. [ABSTRACT FROM AUTHOR]

Aim To systematically evaluate the efficacy of chlorhexidine ( CHX) mouthrinses on plaque, gingival inflammation and staining in gingivitis patients. Material & Methods Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched through April 2011. Randomized controlled clinical trials comparing CHX to placebo/control mouthrinses or oral hygiene ( OH) ≥4 weeks were included. Results Among 1355 titles, 30 publications fulfilled the selection criteria. Meta-analysis ( MA) showed significant weighted mean differences ( WMD) favouring CHX. This was −0.39 [95% CI: −0.70; −0.08] for the Plaque Index Silness & Löe, −0.67 [95% CI: −0.82; −0.52] for the Plaque-Index Quigley & Hein ( PIQH), −0.32 [95% CI: −0.42; −0.23] for the Gingival Index ( GI), −0.08 [95% CI: −0.10; −0.05] for the bleeding aspect of the GI, −0.21 [95% CI: −0.37; −0.04] for the Papillary BIeeding Index, −0.16 [95% CI: −0.26; −0.07] for Bleeding on Marginal Probing and 0.91 [95% CI: 0.12;1.70] for the Lobene Stain Index. MA of studies with a low risk of author-estimated bias showed a WMD of −0.68 [95% CI: −0.85; −0.51] for the PIQH and −0.24 [95% CI: −0.29; −0.20] for the GI in favour of CHX. Relative to control, the reduction with CHX for plaque was 33% and for gingivitis 26%. CHX rinsing groups demonstrated significantly more staining. Conclusions In gingivitis patients, CHX mouthrinses together with OH versus placebo- or control mouthrinse provide significant reductions in plaque and gingivitis scores, but a significant increase in staining score. [ABSTRACT FROM AUTHOR]