Evidence map›Paper›PMID 29520910›Full record

SynthesisJournal of periodontology2018

A network meta-analysis of interproximal oral hygiene methods in the reduction of clinical indices of inflammation.

Georgios A Kotsakis, Qinshu Lian, Andreas L Ioannou, Bryan S Michalowicz, Mike T John, Haitao Chu

Registry-linked trialOpen access · greenAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of periodontology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06515483 (Evaluation of the Efficacy and Safety of a Loop Stretchable Dental Floss in Controlling Gingivitis and Supragingival Plaque Removal During Thirty Days), which is not on this map. Cited by 51 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 5 pooled it
6.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06515483 nacompletednot on this mapstarted 2024, after this paper: background citation

Evaluation of the Efficacy and Safety of a Loop Stretchable Dental Floss in Controlling Gingivitis and Supragingival Plaque Removal During Thirty Days

TypeinterventionalSponsorIndiana UniversityRan2024 to 2024Enrolled64ConditionsGingivitis, Supragingival PlaqueArmsBrushing and Flossing of teeth, Brushing Only
3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 5 syntheses or guidelines pooled it, 92 citations in OpenAlex.

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  18. Effects of an oral hygiene regimen on progression of gingivitis/early periodontitis: A randomized controlled trial.Canadian journal of dental hygiene : CJDH = Journal canadien de l'hygiene dentaire : JCHD · 2021
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Georgios A KotsakisDepartment of Periodontics and Clinical Periodontal Research Laboratory, University of Washington, Seattle, WA, United States.
Qinshu LianDepartment of Biostatistics, University of Minnesota, Minneapolis, MN, United States.
Andreas L IoannouDepartment of Periodontics, University of Texas Health Science Center at Houston, Houston, TX, United States.
Bryan S MichalowiczDepartment of Periodontics, University of Minnesota, Minneapolis, MN, United States.
Mike T JohnDepartment of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, MN, United States.
Haitao ChuDepartment of Biostatistics, University of Minnesota, Minneapolis, MN, United States.
University of Minnesota · USBritish Society of Periodontology · GBThe University of Texas Health Science Center at Houston · USUniversity of Minnesota System · US

Funding

Statistical Methods and Software for Multivariate Meta-analysisR21LM012197 · NLM · UNIVERSITY OF MINNESOTA · PI CHU, HAITAO · 2015 to 2016
$385k
Aiding Effective Decision Making in Dental Research Using Network Meta-analysisR03DE024750 · NIDCR · UNIVERSITY OF MINNESOTA · PI CHU, HAITAO, JOHN, MIKE · 2015 to 2016
$292k
NIDCR NIH HHS R03 DE024750NLM NIH HHS R21 LM012197
6 · The paper itself

Abstract

backgroundA wide selection of Interdental Oral Hygiene (IOH) aids is available to consumers. Recommendations for selection are, however, limited by the lack of direct comparisons in available studies. We aimed to assess the comparative efficacy of IOH aids using Bayesian Network Meta-Analysis (BNMA).

methodsTwo independent reviewers performed a systematic literature review of randomized clinical trials assessing IOH aids, based on a focused question. Gingival inflammation (Gingival Index (GI), Bleeding-on-probing (BOP)) was the primary outcome and plaque and probing depth were secondary outcomes A random-effects arm-based BNMA model was run for each outcome; posterior medians and 95% credible-intervals (CIs) summarized marginal distributions of parameters.

resultsA two-phase selection process identified 22 trials assessing 10 IOH aids as brushing adjuncts. Interdental brushes (IB) yielded the largest reduction in GI (0.23 [95% CI: 0.09, 0.37]) as toothbrushing adjuncts, followed by water-jet (WJ) (0.19 [95% CI: 0.14, 0.24]). Rankings based on posterior probabilities revealed that IB and WJ had the highest probability of being "best" (64.7% and 27.4%, respectively) for GI reduction, whereas the probability for toothpick and floss being the "best" IOH aids was near zero. Notably, except for toothpicks, all IOH aids were better at reducing GI as compared with control.

conclusionsBNMA enabled us to quantitatively evaluate IOH aids and provide a global ranking of their efficacy. Interdental brushes and water-jets ranked high for reducing gingival bleeding, whereas toothpicks and floss ranked last. The patient-perceived benefit of IOH aids is not clear because gingival inflammation measures are physical indicators of periodontal health.

Indexed as

GingivitisOral HygieneBayes TheoremDental Devices, Home CareDental Plaque IndexHumansInflammationToothbrushingdental hygienegingivitismeta-analysisoral hygienesystematic reviews and evidence-based medicine

Identifiers

PMID29520910
PMCPMC5984142
OpenAlexW2791403402

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.