Professional mechanical plaque removal for prevention of periodontal diseases in adults--systematic review update.

AIM: To update previous systematic review investigating effect of professional mechanical plaque removal (PMPR) on prevention of periodontal diseases. METHODS: Search for randomized controlled trials: 2004 to April 2014. Screening and data abstraction conducted independently/in duplicate and narrative synthesis. RESULTS: From 1655 titles and abstracts, 24 full-text articles screened and three new studies were eligible. Low-to moderate strength of evidence suggests that in adults, PMPR, particularly if combined with oral hygiene instructions (OHI), may achieve greater changes in measures of dental plaque and gingival bleeding/inflammation than no treatment. Moderate strength of evidence suggests there is no additional benefit to plaque and gingival bleeding outcomes from PMPR over that achieved by repeated and thorough OHI. There is no evidence from RCTs to inform on prevention of periodontitis. Low strength of evidence suggests that more frequent PMPR is associated with improved plaque and bleeding outcomes and possibly less annual attachment loss. CONCLUSIONS: There are insufficient data to inform directly on the effect of PMPR on primary prevention of periodontitis. However, in relation to gingival health, new studies strengthen the evidence that there is little value in providing PMPR without OHI. In fact, repeated, thorough OHI can achieve a similar benefit to repeated PMPR.