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Plaque Removal by a Powered Toothbrush Versus a Manual Toothbrush in Children: A Systematic Review and Meta-Analysis

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Purpose: The purpose of this study was to determine the relative plaque reduction efficacy of powered versus manual toothbrushes in children. Methods: A systematic review and meta-analysis were conducted based on a literature search that included Medline, Embase, FDA publications, Cochrane Database of Systematic Reviews, Dentistry and Oral Science, and Berman Medical Library, Hebrew University. Studies were chosen that were randomized controlled trials and published between 1980 to 2019 in English that compared plaque reduction with manual and powered toothbrushes in children. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. Results: From a search of 1,502 articles, nine articles were selected for meta-analysis. A statistically significant plaque reduction benefit for a powered toothbrush versus manual toothbrush (P<0.001): combined mean difference (MD) was 0.590 and the 95 percent confidence interval was 0.352 to 0.828 (random-effects model). Two tests revealed considerable heterogeneity (I2 equals 96 percent; Cochran's Q, P<0.001). A low possibility of bias was indicated by Begg-Mazumdar and Egger tests (P>0.1 for both). Evidence quality was given a GRADE score of moderate. Conclusions: Powered toothbrushes were more effective than manual toothbrushes for plaque removal in children.


Document Type: Research Article

Affiliations: 1: Dr. Davidovich is a senior lecturer, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel;, Email: [email protected] 2: Dr. Shafir is a resident, Department of Pediatric Dentistry, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel 3: Dr. Shay is a clinical lecturer, Department of Endodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel 4: Dr. Zini is an associate dean and chair, Department of Community Dentistry, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel

Publication date: July 1, 2020

More about this publication?
  • Pediatric Dentistry is the official publication of the American Academy of Pediatric Dentistry, the American Board of Pediatric Dentistry and the College of Diplomates of the American Board of Pediatric Dentistry. It is published bi-monthly and is internationally recognized as the leading journal in the area of pediatric dentistry. The journal promotes the practice, education and research specifically related to the specialty of pediatric dentistry. This peer-reviewed journal features scientific articles, case reports and abstracts of current pediatric dental research.
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