Summary Review/Periodontology
Evidence-Based Dentistry (2007) 8, 5–6. doi:10.1038/sj.ebd.6400507
Stannous fluoride toothpastes reduce the gingival index more than sodium fluoride toothpastes
Are dentifrices containing stannous fluoride effective in reducing gingivitis?
Address for correspondence: S Paraskevas, Department of Periodontology, Academic Centre for Dentistry Amsterdam ACTA, Louwesweg 1, 1066 EA Amsterdam, The Netherlands. s.paraskevas@acta.nl
Richard Niederman DMD1
1Forsyth Institute, Boston, Massachusetts and Boston University Goldman School of Dental Medicine, Boston, Massachusetts, USA
Paraskevas S and van der Weijden GA. A review of the effects of stannous fluoride on gingivitis. J Clin Periodontol 2006; 33:1–13
Abstract
Data sources
Medline and the Cochrane Central Register of Controlled Trials were used to identify sources of data.
Study selection
Title and abstracts were screened independently. Randomised controlled clinical trials of >6 months duration that used gingivitis or plaque levels as outcome measures were selected.
Data extraction and synthesis
The mean values and standard deviations were extracted. In studies where standard errors of the mean were reported, standard deviations were calculated by the authors based on the sample size. Weighted means of baseline and of end of trial were calculated with the software Cochrane Collaboration Review Manager (version 4.2; The Cochrane Collaboration, Oxford, England) using a random-effects model. A meta-analysis for stannous fluoride (SnF) mouth rinse and dentifrice/ mouthrinse formulations was not performed because there were insufficient data.
Results
Fifteen papers were included in the review. For SnF dentifrices, a statistically significant reduction in gingivitis was noted in comparison with control [weighted mean difference (WMD), 0.15 (gingival index) and 0.21 (gingivitis severity index); test for heterogeneity P<0.00001, I2=91.1% and P 50.03, I2= 80.1%, respectively]. There were inconsistent results for plaque reduction. On using the plaque index, no differences were found, whereas meta-analysis of the Turesky index gave a WMD of 0.31 (P 50.01; test for heterogeneity P 0.0001, I2=91.7%).
Conclusions
The use of SnF dentifrices results in greater gingivitis and plaque reduction compared with a conventional dentifrice. The precise magnitude of this effect was difficult to assess because of a high level of heterogeneity in study outcomes.
