Clinical Efficacy of Interventions Based on Professional Mechanical Plaque Removal in the Treatment of Dental Biofilm-Induced Gingivitis: A Systematic Review and Meta-Analysis

Aim: To evaluate the efficacy of professional mechanical plaque removal (PMPR) for treating naturally occurring dental biofilm–induced gingivitis (i) compared to no treatment or oral hygiene instructions (OHI) (FQ1), (ii) when performed through different modalities (FQ2) or (iii) when combined with professionally administered local adjuncts (FQ3). Materials and Methods: A structured literature search was conducted for randomised or non-randomised controlled trials (RCTs and CTs) assessing gingival inflammation at patient level within 2–6 weeks after treatment in adults with gingivitis. Results: Heterogeneous evidence shows with low certainty that PMPR has no efficacy in patients continuing with ineffective self-performed oral hygiene regimens but enhances OHI outcomes (FQ1; three RCTs, one CT). Split-mouth RCTs consistently indicated with very low certainty that ultrasonic scaling (US) plus air polishing is as effective but less time consuming than US plus polishing with rubber cup and prophylaxis paste. Furthermore, diode laser shows no adjunctive benefit (FQ2; five RCTs). Although some professionally administered local adjuncts have shown positive outcomes in patients receiving PMPR, their broader clinical application is limited due to unresolved clinical issues and uncertain cost effectiveness (FQ3; two RCTs). Conclusions: OHI should be the first-line treatment for dental biofilm–induced gingivitis. Combination of PMPR and OHI provides an adjunctive benefit over OHI alone. Air polishing may be combined with US to reduce the time for PMPR administration.