Meta-analysis on the effectiveness of powered toothbrushes for orthodontic patients

Introduction: Although powered toothbrushes have been recommended for gingivitis prevention in orthodontic patients, a relevant meta-analysis has been lacking. The aim of this meta-analysis was to compare the effectiveness of powered and manual toothbrushes in reducing gingival inflammation in patients having fixed orthodontic appliance therapy. Methods: Citations of potentially relevant trials published in journals, dissertations, and conference proceedings were located by searching the appropriate databases. In addition, efforts to identify potentially relevant unpublished or ongoing trials were made by searching the databases of research registers. Trials appropriate for inclusion had to be randomized controlled trials fulfilling certain criteria concerning study design, participants' characteristics, intervention characteristics, and principal outcome measures. The weighted mean difference with the 95% confidence interval was used to express the comparative treatment effect. The random effects method for meta-analysis was used to combine treatment effects across studies in each category. Trial quality was evaluated by assessing randomization, allocation concealment, blinding, and handling losses. Results: Five trials were considered appropriate for the meta-analysis. Based on quality assessment and the short experimental period of these trials, current evidence is insufficient to support the comparative efficacy of powered toothbrushes in reducing gingivitis in patients undergoing fixed orthodontic appliance therapy. Conclusions: Any inferences about clinical practice are precluded. Greater standardization of the methodology used is desirable in future trials.