• bleeding;
  • gingivitis;
  • manual toothbrush;
  • meta-analysis;
  • oral hygiene;
  • plaque;
  • systematic review;
  • triclosan

Abstract:  Objective:  To assess the effectiveness of self-performed mechanical plaque control with triclosan (5-chloro-2-(2,4 dichlorophenoxy)phenol) containing dentifrice.

Search strategy:  An electronic search of the National Library of Medicine, Washington DC (Medline-PubMed; up to and including March 2005) was performed using specific search terms to identify clinical trials of ≥6 months in duration, which assessed the effect of various forms of plaque control in gingivitis subjects. In those trials the manual toothbrush group (frequently the control group) served to provide data for the assessment of the effectiveness of self-performed mechanical plaque control with a triclosan-containing dentifrice. The data were analysed depending on the (baseline) intervention, being either a professional oral hygiene instructions, a prophylaxis, or both.

Data collection and analysis:  Two reviewers extracted information (KPKJH and GAW). Where appropriate plaque and gingivitis data for baseline and end-trial were used to calculate weighted mean differences (WMD) with the appropriate 95% confidence intervals (CI) using a random effect models.

Main results:  Of 105 titles and abstracts, 18 trials were found suitable for clinical data were extracted. Meta-analysis were conducted. In studies (n = 9) evaluating a triclosan/copolymer dentifrice, plaque control [Quigley and Hein (1962) Journal of American Dental Association, Vol. 65: pp. 26–29] was significantly improved compared with a control fluoride dentifrice, with a WMD of −0.48 (95% CI: −0.73 to −0.24). For gingival inflammation as assessed with the gingival index [Löe and Silness (1963) Acta Odontologica Scandinavica, Vol. 21: pp. 533–551] a significant WMD of −0.24 (95% CI: −0.35 to −0.13) was found. From studies (n = 6) evaluating the Triclosan zinc/citrate dentifrices a small but significant WMD for plaque control [Silness and Löe (1964) Acta Odontologica Scandinavica, Vol. 22: pp. 121–135] was observed in favour of the test group as compared with the standard fluoride dentifrice formulations (WMD −0.07, 95% CI: −0.10 to 0.05). While at baseline the proportion of bleeding was comparable, at the end of the studies a significant −10.81% WMD (95% CI: −12.69 to −8.93) in favour of the triclosan/zinc citrate dentifrice was observed.

Conclusion:  This systematic review indicates, based on studies ≥6 months of duration in adults with gingivitis, that the effectiveness of self-performed mechanical plaque control with a triclosan-containing dentifrice, had a significant albeit small positive effect on the reduction of plaque and gingivitis.