Intervencije za čišćenje zubnih proteza u odraslih
Abstract
Background
Removing denture plaque may be essential for maintaining the oral health of edentulous people. Brushing and soaking in chemical products are two of the most commonly used methods of cleaning dentures.
Objectives
To evaluate the effectiveness and safety of different methods for cleansing removable dentures.
Search methods
We searched the following databases: the Cochrane Oral Health Group Trials Register (to May 2009); CENTRAL (The Cochrane Library 2009, Issue 2); MEDLINE (1965 to May 2009); EMBASE (1980 to May 2009); LILACS (1980 to May 2009); and CINAHL (1997 to May 2009). There were no language restrictions.
Selection criteria
Randomised controlled trials (RCTs) comparing any mechanical method (e.g. brushing or ultrasound) or chemical (e.g. enzymes, sodium hypochlorite, oral rinses or peroxide solutions) in adults over the age of 18 wearing removable partial dentures or complete dentures.
The primary outcomes considered were the health of denture bearing areas (soft tissues, periodontal tissues and teeth) and participants' satisfaction and preference. Secondary outcomes included denture plaque coverage area, indicators of halitosis and microbial counts on abutment teeth, soft tissues or denture base or saliva.
Data collection and analysis
Two independent review authors screened and extracted information from, and independently assessed the risk of bias in the included trials.
Main results
Although six RCTs were included in this review, the wide range of different interventions and outcome variables did not permit pooling of data in a meta‐analysis. Isolated reports indicated that chemicals and brushing appear to be more effective than placebo in the reduction of plaque coverage and microbial counts of anaerobes and aerobes on complete denture bases.
Authors' conclusions
There is a lack of evidence about the comparative effectiveness of the different denture cleaning methods considered in this review. Few well designed RCTs were found. Future research should focus on comparisons between mechanical and chemical methods; the assessment of the association of methods, primary variables and costs should also receive future attention.
PICO
Plain language summary
Intervencije za čišćenje zubnih proteza u odraslih
Naslage nakupljene na površinama zubnih proteza mogu imati značajan učinak na oralno zdravlje jer mogu dovesti do infekcija sluznice koja podupire protezu (stomatitis), upalu desni (gingivitis) i zubni karijes. Naslage sa zubnih proteza mogu se ukloniti s pomoću nekoliko različitih metoda, koje uključuju: četkanje pastom, namakanje u kemikalijama (primjerice pjenušave/šumeće tablete ili izbjeljivači) i uporabom posebnoga sredstva (mikrovalna peć ili ultrazvučni uređaj).
Ovaj sustavni pregled pronašao je slabe dokaze u korist namakanja proteza u otopinama šumećih tableta ili enzimatskim otopinama, kao i to da četkanje pastom može ukloniti plak i ubiti mikrobe bolje od neaktivnih tretmana. Međutim, nejasno je što je najučinkovitije, a postoji i pomanjkanje podataka o uporabi alternativnih metoda.
Buduće studije trebale bi imati cilj osigurati pouzdane informacije o tome koja je metoda učinkovitija u održavanju oralnoga zdravlja pojedinaca koji nose zubne proteze. Pronađeni podaci su oskudni i ograničeni na čišćenje totalnih proteza načinjenih od akrilatnih smola. Dodatna istraživanja trebala bi također istražiti kako se mogu čistiti djelomične proteze, osobito u odnosu na korozivno djelovanje sredstava za čišćenje na njihove metalne komponente.
