Little value in providing professional mechanical plaque removal without oral hygiene instruction: What is the effect of professional mechanical plaque removal (PMPR) on clinical and patient centred outcomes related to the prevention of periodontal diseases in adults?

Data Sources Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Old Medline, Embase and bibliographies of previously published review articles. Searching was limited to English languageStudy SelectionRandomized controlled trials (RCTs), controlled clinical trials (CCTs) and cohort studies with comparison groups were considered. Both parallel arm and split mouth treatment studies were eligible for inclusion and all durations of follow-up were includedData Extraction and SynthesisScreening and data abstraction were conducted independently and in duplicate. Critical appraisal of studies was based on objective criteria and evidence tables were constructed and data stratified according to study typeResultsFrom 2179 titles and abstracts, 132 full-text articles were screened and 32 studies were relevant. Evidence exists that PMPR in adults, particularly in combination with oral hygiene instruction (OHI), may be more effective than no treatment judged by surrogate measures. The evidence for a benefit of PMPR + OHI over OHI alone is less clear. The optimum frequency of PMPR has not been investigated although more frequent PMPR is associated with improved markers of health. The strength of evidence for these results ranges from weak to moderate due to risk of bias, inconsistent results, lack of appropriate statistics and small sample size. Conclusions There appears to be little value in providing PMPR without OHI. In fact, repeated OHI might have a similar effect as PMPR. Some forms of PMPR might achieve greater patient satisfaction. There is little difference in beneficial or adverse effects of different methods of PMPR.