• Scott A Deacon, Anne-Marie Glenny, Chris Deery, Peter G Robinson, Mike Heanue, A Damien Walmsley, and William C Shaw.
• South West Cleft Unit, Frenchay Hospital, Frenchay Park Road, Bristol, UK, BS16 1LE.
• Cochrane Db Syst Rev. 2010 Dec 8; 2010 (12): CD004971CD004971.

BackgroundPowered brushes were first introduced commercially in the 1960s. A recent systematic review suggested the superiority of certain modes of powered over manual toothbrushing for plaque and gingivitis reduction. That review did not allow for direct comparison between different modes of powered toothbrush.ObjectivesTo compare different modes of powered toothbrushing against each other for plaque reduction and the health of the gingivae. Other factors to be assessed were calculus and stain removal, cost, dependability and adverse effects.Search StrategyThe following databases were searched: Cochrane Oral Health Group's Trials Register (to 26 July 2010); Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 3); MEDLINE via OVID (1950 to 26 July 2010); EMBASE via OVID (1980 to 26 July 2010); CINAHL via EBSCO (1982 to 26 July 2010). There were no language restrictions.Selection CriteriaTrials were considered for inclusion with the following criteria: random allocation of participants; no compromised manual dexterity; unsupervised powered toothbrushing for at least 4 weeks. The primary outcomes were the plaque and gingivitis scores after powered toothbrush use during trial period.Data Collection And AnalysisData extraction was performed independently and in duplicate. The authors of trials were contacted to provide missing data where possible. The effect measure for each meta-analysis was the standardised mean difference (SMD) with 95% confidence intervals (CI) using the random-effects model. Potential sources of heterogeneity were assessed.Main ResultsThe review included data from 15 trials with 1015 participants. Due to the dearth of trials assessing the same mode of action, no definitive conclusions can be stated regarding the superiority of one mode of powered toothbrush over any other. Only minor and transient side effects were reported. Cost, dependability were not reported.Authors' ConclusionsFurther trials of good quality are required to establish if any mode of action has superiority over the other modes of action for powered toothbrushes.

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