Intervention Review
Interventions for cleaning dentures in adults
Editorial Group: Cochrane Oral Health Group
Published Online: 7 OCT 2009
Assessed as up-to-date: 25 MAY 2009
DOI: 10.1002/14651858.CD007395.pub2
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Database Title
Additional Information
How to Cite
de Souza RF, de Freitas Oliveira Paranhos H, Lovato da Silva CH, Abu-Naba'a L, Fedorowicz Z, Gurgan CA. Interventions for cleaning dentures in adults. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD007395. DOI: 10.1002/14651858.CD007395.pub2.
Publication History
- Publication Status: New
- Published Online: 7 OCT 2009
Abstract
Background
Removing denture plaque may be essential for maintaining the oral health of edentulous people. Brushing and soaking in chemical products are two of the most commonly used methods of cleaning dentures.
Objectives
To evaluate the effectiveness and safety of different methods for cleansing removable dentures.
Search methods
We searched the following databases: the Cochrane Oral Health Group Trials Register (to May 2009); CENTRAL (The Cochrane Library 2009, Issue 2); MEDLINE (1965 to May 2009); EMBASE (1980 to May 2009); LILACS (1980 to May 2009); and CINAHL (1997 to May 2009). There were no language restrictions.
Selection criteria
Randomised controlled trials (RCTs) comparing any mechanical method (e.g. brushing or ultrasound) or chemical (e.g. enzymes, sodium hypochlorite, oral rinses or peroxide solutions) in adults over the age of 18 wearing removable partial dentures or complete dentures.
The primary outcomes considered were the health of denture bearing areas (soft tissues, periodontal tissues and teeth) and participants' satisfaction and preference. Secondary outcomes included denture plaque coverage area, indicators of halitosis and microbial counts on abutment teeth, soft tissues or denture base or saliva.
Data collection and analysis
Two independent review authors screened and extracted information from, and independently assessed the risk of bias in the included trials.
Main results
Although six RCTs were included in this review, the wide range of different interventions and outcome variables did not permit pooling of data in a meta-analysis. Isolated reports indicated that chemicals and brushing appear to be more effective than placebo in the reduction of plaque coverage and microbial counts of anaerobes and aerobes on complete denture bases.
Authors' conclusions
There is a lack of evidence about the comparative effectiveness of the different denture cleaning methods considered in this review. Few well designed RCTs were found. Future research should focus on comparisons between mechanical and chemical methods; the assessment of the association of methods, primary variables and costs should also receive future attention.
Plain language summary
Interventions for cleaning dentures in adults
Plaque formed on the surfaces of removable dentures can have a significant impact on oral health, as long as it can lead to infection of denture-supporting mucosa (stomatitis), gum inflammation (gingivitis) and tooth decay. Denture plaque can be removed by several different methods which include: brushing with paste, soaking in chemicals (e.g. effervescent tablets or bleach) and using special devices (a microwave oven or ultrasonic device).
This review found weak evidence in support of soaking of dentures in effervescent tablets or enzymatic solutions and that brushing with paste can remove plaque and kill microbes better than inactive treatments. It is, however, unclear which is the most effective and there is a paucity of data on the use of alternative methods.
Futures studies should aim to provide reliable information about which method is more effective in maintaining oral health of removable denture wearers. The scarce data found was restricted to the cleansing of complete dentures made from an acrylic resin base. Further research should also investigate how removable partial dentures can be cleaned, and in particular on the corrosive effects of cleaners on their metallic components.
摘要
背景
於成人中不同義齒清潔法的效果
去除義齒上的牙菌斑可能是維持無牙患者口腔健康的基本要件。兩種最常用的清潔義齒方式是用刷子刷和浸泡化學產品。
目標
評估不同的活動義齒清潔方法的成效與安全性。
搜尋策略
我們檢索了以下資料庫：the Cochrane Oral Health Group Trials Register(2009.5)、CENTRAL(The Cochrane Library 2009，第2期)、MEDLINE(1965～2009.5)、EMBASE(1980～2009.5)、LILACS(1980～2009.5)、CINAHL(1997～2009.5)。沒有語言限制。
選擇標準
隨機對照試驗(RCTs)比較任何機械性方法(如使用刷子或超音波)或化學方法(如蛋白酵素、漂白水、漱口水或雙氧水)，對象為18歲以上成年人配戴局部活動義齒或全口義齒。評估的主要成效為義齒承載區的健康情形(軟組織、牙周組織及牙齒)、受試者滿意度與偏好。其次評估的包括義齒牙菌斑分佈區、口臭指數與在支台齒(abutment teeth)、軟組織或義齒基底或唾液中的微生物含量。
資料收集與分析
2名評閱者獨立篩選取得資訊，並互不影響地評估納入試驗 的偏誤風險(risk of bias)。
主要結論
雖有6個隨機對照試驗被納入本研究報告，但彼此的清潔方法差異甚多，所評估成效之間的變異也很大, 因此無法聚集資料來進行統合分析(metaanalysis)。個別的報告指出，化學品和刷洗對於減少全口義齒基底的牙菌斑分佈和厭氧、好氧微生物的數量比對照組更為有效。
作者結論
本篇回顧缺乏證據證明不同義齒清潔方式的比較效益。僅發現少數研究設計良好的隨機對照試驗。未來的研究應著重在比較機械性和化學性方法之間的不同，也要評估不同方法合併使用的成效, 主要變因與成本也需要被評估。
翻譯人
本摘要由臺灣大學附設醫院王東美翻譯。
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。
總結
於成人中不同義齒清潔方法的效果：活動義齒表面上形成的牙菌斑對口腔健康有顯著影響，長期會導致義齒承載區的黏膜感染(口炎stomatitis)，牙齦發炎(牙齦炎)和蛀牙。去除義齒上的牙菌斑有幾個不同的方法，其中包括：用牙膏刷洗、浸泡化學藥品(如發泡錠或漂白水)和使用特殊設備(微波爐或超音波儀器)。這項報告發現薄弱的證據支持浸泡義齒於發泡錠或蛋白酵素液與用牙膏刷洗, 比起消極的處理更能去除牙菌斑和殺死微生物。然而尚未清楚何種方式最有效，也缺乏其他替代方式的資料。未來研究應提供可靠的資訊，告訴活動義齒配戴者哪種方式對維持口腔健康最為有效。所找到的少量資料侷限於評估如何清潔以壓克力樹脂製成的全口義齒。進一步的研究也應探討如何將局部活動義齒清潔乾淨，特別是清潔方法對金屬部分是否產生腐蝕的結果。