Editorial Type:
Article Category: Review Article
 | 
Online Publication Date: 18 Apr 2025

Effects of chemotherapeutic vs regular toothpastes on dental plaque and gingival inflammation in orthodontic patients with fixed appliances: a systematic review and meta-analysis

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DOI: 10.2319/071824-573.1
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ABSTRACT

Objectives

To analyze, appraise, and synthesize papers in which authors have compared the effects of chemotherapeutic toothpaste (CTP) and regular toothpaste (RTP) on plaque scores (PSs), gingival scores (GSs), and bleeding scores (BSs) in orthodontic patients wearing fixed appliances (FAs).

Materials and Methods

PubMed-MEDLINE, Cochrane-CENTRAL, and Embase databases were searched with predefined search terms until April 2024 for controlled or randomized controlled clinical trials aligning with the aim. In the eligible papers, risk of bias was evaluated, data of interest were extracted, and a descriptive analysis was performed. If possible, meta-analyses and subanalyses on specific factors were conducted. The quality of evidence and strength of the recommendation were rated.

Results

In our search and selection, we obtained five papers describing eight comparisons. Potential risk of bias was assessed as some concerns to high, and heterogeneity was considered substantial. Descriptive analysis revealed no significant difference in PS and BS, with an improvement in GS favoring CTP. Meta-analyses of the end scores showed CTP significantly reduced PS (standardized mean difference [SMD] = −0.26; 95% confidence interval [CI] = −0.52, −0.01; P = .04). However, no significant effects were observed on GS and BS. These findings were supported by the subanalyses on CTP with chlorhexidine (CHX; PS: mean difference [MD] = −5.12; 95% CI = −10.08, −0.15; P = .04). The quality of evidence was graded as very low, and strength of the recommendation was judged as very weak.

Conclusions

For orthodontic patients with FAs, very weak certainty exists in recommending CTP (eg, with CHX) over RTP for use with toothbrushing. CTP may have a very small effect on PS and a small effect on GS.

Copyright: © 2025 by The EH Angle Education and Research Foundation, Inc.
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Contributor Notes

 PhD candidate, DDS, Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands.
 Lecturer, PhD, DDS, Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands.
 Associate professor, PhD, DDS, Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands.
 Professor, PhD, RDH, Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands.
Corresponding author: Dr Dagmar Else Slot, Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands (e-mail: d.slot@acta.nl)

YL contributed to conception and design, search and selection, analysis and interpretation, and drafted and critically revised the manuscript. CV contributed to conception and design, search and selection, analysis and interpretation, and critically revised the manuscript. REGJ contributed to conception and design and critically revised the manuscript. DES contributed to conception and design, search and selection, analysis and interpretation, and critically revised the manuscript. All authors gave final approval and agreed to be accountable for all aspects of work ensuring integrity and accuracy.

Received: 18 Jul 2024
Accepted: 08 Feb 2025
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