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Aim The aim of this systematic review was to evaluate the efficacy of anti-plaque chemical formulations for managing gingivitis, in 6-month, home-use, randomised clinical trials ( RCTs). Material and Methods A protocol was designed, including inclusion and exclusion criteria to identify RCTs assessing gingival and/or bleeding indices. Electronic and hand-searches identified relevant papers, which were screened and evaluated for inclusion. Full-papers were retrieved and relevant information was extracted (also plaque indices), including quality and risk of bias. Mean treatment effects were calculated to obtain weighted mean differences ( WMD) and 95% confidence intervals. Results After the process of screening and selection, 87 articles with 133 comparisons, were included in the review. The additional effects of the tested products were statistically significant in terms of Löe & Silness gingival index (46 comparisons, WMD −0.217), modified gingival index ( n = 23, −0.415), gingivitis severity index ( n = 26, −14.939%) or bleeding index ( n = 23, −7.626%), with significant heterogeneity. For plaque, additional effects were found for Turesky (66 studies, WMD −0.475), Silness & Löe ( n = 26, −0.109), and plaque severity ( n = 12, −23.4%) indices, with significant heterogeneity. Conclusion Within the limitations of the present study, formulations with specific agents for chemical plaque control provide statistically significant improvements in terms of gingival, bleeding and plaque indices. [ABSTRACT FROM AUTHOR]

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]

Objective Systematically review the scientific evidence for efficiency of anti-inflammatory agents against gingivitis, either as solo treatments or adjunctive therapies. Methods A protocol was developed aimed to answer the following focused question: 'Are anti-inflammatory agents effective in treating gingivitis as solo or adjunct therapies?' RCTs and cohort studies on anti-inflammatory agents against gingivitis studies were searched electronically. Screening, data extraction and quality assessment were conducted. The primary outcome measures were indices of gingival inflammation. A sub-analysis was performed dividing the active agents into anti-inflammatory and other drugs. Results The search identified 3188 studies, of which 14 RCTs met the inclusion criteria. The use of anti-inflammatory or other agents, in general showed a higher reduction in the test than in the control in terms of gingival indexes and bleeding scores. Only two RCTs on inflammatory drugs could be meta-analysed, showing a statistically significant reduction in the GI in the experimental group [ WMD = −0.090; 95% CI (−0.105; −0.074); p = 0.000]. However, the contribution of both studies to the global result was unbalanced (% weight: 99.88 and 0.12 respectively). Conclusions Most of the tested material showed beneficial effect as anti-inflammatory agents against gingivitis, either as a single treatment modality or as an adjunctive therapy. [ABSTRACT FROM AUTHOR]