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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]

Background: Only a few dental procedures have been reported to cause life-threatening bleeding. All of these cases followed surgical intervention. Material and Methods: In this paper, we report a case of severe bleeding following non-surgical periodontal procedures in a patient treated with a dual anti-platelet regimen post-coronary stent insertion. Results: Her medical history included ischaemic heart disease, hypertension and diabetes mellitus. Haemostasis was achieved at the conclusion of the non-surgical periodontal treatment. However, several hours later, the patient arrived at the emergency room and was diagnosed with hypovolemic shock. Conclusion: This case should raise the clinician's awareness of bleeding complications in non-surgical procedures as well as the risk for bleeding when a dual anti-platelet regimen is administered. The importance of patient monitoring and the use of local haemostatic agents is demonstrated in these cases. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of self-performed mechanical plaque removal in adults with gingivitis using a manual toothbrush with respect to the level of plaque and gingivitis in controlled studies of at least 6 months duration. Search: Medline-PubMed up to and including September 2004. Results: Out of 3223 titles and abstracts, 33 trials were found for data extraction. A meta-analysis was conducted of studies ( n=9) in which, for the manual toothbrush group at baseline, only a professional prophylaxis provided. The weighted mean differences (WMD) between baseline and end-trial for the Quigley & Hein plaque index was 0.28 and 0.21 for the Gingival Index ( p<0.05). Eight studies provided both a professional OHI and prophylaxis at baseline. The WMD for the Silness & Löe Plaque Index was 0.10 (ns). The WMD of the proportion of bleeding sites was 5.84% ( p<0.05). Conclusion: In adults with gingivitis the quality of self-performed mechanical plaque removal is not sufficiently effective and should be improved. Based on studies ⩾6 months of duration, it appears that a single oral hygiene instruction, describing the use of a mechanical toothbrush, in addition to a single professional ‘oral prophylaxis’ provided at baseline, had a significant, albeit small, positive effect on the reduction of gingivitis. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of adjunctive therapies in reducing gingivitis and plaque by means of a systematic review of randomized clinical trials (RCTs). Material and Methods: A search protocol was designed to identify 6‐month RCTs that investigated the efficacy of adjuncts to mechanical plaque control on gingivitis and plaque. Following screening, relevant information was extracted, and quality and potential risk of bias were estimated. Mean treatment differences were calculated to obtain standardized mean differences and weighted mean differences (SMD and WMD) as appropriate. Results: Meta‐analyses included 70 studies of adjunctive antiseptics. Compared with mechanical plaque control alone, adjuncts yielded statistically significant reductions in gingival index (n = 72; SMD = −1.268; 95% CI [−1.489; −1.047]; p <.001; I2 = 96.2%), bleeding (%) (n = 26, WMD=−14.62%; 95% CI [−18.01%; −11.23%]; p <.001; I2 = 95.1%), plaque index (n = 93, SMD = −1.017; 95% CI [−1.194; −0.840]; p <.001; I2 = 95.3%) and plaque (%) (n = 23; WMD = −18.20%; 95% CI [−24.00%; −12.50%]; p <.001; I2 = 96.9%). Mouthrinses resulted in greater reductions in per cent plaque compared with dentifrices (meta‐regression, coefficient = 13.80%; 95% CI [2.40%; 25.10%]; p =.020). The antiseptic agents were similarly effective in reducing gingivitis and plaque in patients with dental plaque‐induced gingivitis (intact periodontium) or previously treated periodontitis with gingival inflammation. Conclusion: Adjunctive antiseptics in mouthrinses and dentifrices provide statistically significant reductions in gingival, bleeding and plaque indices. [ABSTRACT FROM AUTHOR]

Background: Delmopinol is a third-generation anti-plaque agent used as a mouthwash to reduce plaque and alleviate gingivitis. Objective: To create an overview of the anti-plaque efficacy of 0.2% delmopinol as an adjunct to normal oral hygiene measures by meta-analysis of completed clinical trials. Materials and Methods: Eight double-blind, parallel-group studies were identified. Study durations ranged from 8 to 24 weeks. Five studies ( n=913) involved supervised rinsing; three studies ( n=467) involved unsupervised rinsing. These sets of trials were analysed separately and in combination. Efficacy outcomes comprised modified plaque index, modified gingival index (MGI) and gingival bleeding on probing (BOP). Results: Delmopinol 0.2% was superior to placebo for the reduction of plaque scores in both sets of studies. Effects on MGI and BOP were also better with delmopinol 0.2% than with placebo. In most instances, 95% confidence intervals were wholly in favour of delmopinol. Pooled analysis of all eight studies confirmed statistically significant effects of delmopinol 0.2% compared with placebo ( p<0.00001). Delmopinol met the efficacy criteria of the American Dental Association in studies of extended duration. Conclusion: Delmopinol 0.2% mouthwash is effective as an adjunct measure for reducing plaque burden and indices of gingivitis, whether or not it is used under supervision. [ABSTRACT FROM AUTHOR]

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