Comparison of Oral Hygiene and Gingival Outcomes in Children With Special Care Needs Using Powered or Manual Toothbrushes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Aim: This systematic review and meta-analysis (SRMA) compares oral hygiene and gingival outcomes in children with special care needs (CSCNs) using powered or manual toothbrushes. Material and Methods: Two authors searched articles using PubMed and Cochrane library; the search was extended to other databases to include publications until July 2024. RCTs available in English were included. Oral hygiene and gingival outcomes in CSCNs, using powered or manual toothbrushes were: plaque index (PI), Quigley Hein plaque index (QHPI), gingival index (GI), and oral hygiene index simplified (OHI-S). ROB and publication bias was assessed using Cochrane tool and funnel plots, respectively. Meta-analyses were performed using forest plots. GRADE was used for the quality. Results: Twelve studies were included in SR and 11 studies in MA. In relation to GI and in the subgroup analysis of QHPI, powered toothbrushing was superior to manual toothbrushing with SMD −0.681 [95% CI (−0.911 to −0.451)] and SMD −0.85 [95% CI (−1.166 to −0.53)], respectively using REM. Comparisons with other indices exhibited no significant differences. The ROB and publication bias were moderate, quality of evidence was low to moderate GRADE. Conclusion: Powered toothbrushes had favorable outcomes in a few but not all parameters. The overall quality of evidence is low. PROSPERO registration ID: CRD42024579260.