The efficacy of an oscillating-rotating power toothbrush compared to a high-frequency sonic power toothbrush on parameters of dental plaque and gingival inflammation: A systematic review and meta-analysis

Aim: To establish the efficacy of oscillating-rotating power toothbrush (OR-PTB) compared to high-frequency sonic power toothbrush (HFS-PTB) on improving parameters of plaque and gingival inflammation. Safety and participants' preference were secondary interests. Materials and methods: MEDLINE-PubMed and Cochrane-CENTRAL databases were searched, up to April 2021. Inclusion criteria were (randomized)controlled clinical trials that evaluated healthy humans brushing with an OR-PTB compared to a HFS-PTB. Evaluation for a minimum of 4 weeks, of one or more of the following parameters: plaque index scores (PI), bleeding scores (BS), number of bleeding sites (NoB) and gingival index scores (GI). Results: Thirty two publications involving 38 comparisons were included after the independent screening. The descriptive analysis showed that in 54% of the comparisons, a significant difference in favour of the OR-PTB was found for PI, BS and GI scores. The Quigley and Hein index showed a significant difference of means (DiffM) between the end scores (DiffM 0.13, 95% CI [0.05;0.21] p < 0.001), as well as for the Rustogi-modified Navy index (DiffM 0.01, 95% CI [0.01;0.03] p = 0.002). This is in line with the meta-analysis for BS (DiffM 0.09, 95% CI [0.03;0.14] p = 0.003), for which the results were in favour of the OR-PTB and considered potentially clinically relevant. NoB showed a significant difference in favour of the OR-PTB for the end scores (DiffM 3.61, 95% CI [2.63;4.58] p < 0.00001). No difference in safety was indicated, 78% of participants preferred the OR-PTB. Conclusion: For patients to maintain good plaque control and improve gingival health, there is a small but significant difference based on longer-term studies between OR-PTB and HFS-PTB. This difference is potentially clinically relevant