Five studies were included in this review (n=304), all parallel RCTs. Pooling across brush types was not carried out. Quality appraisal identified particular weaknesses in the reporting of randomisation and lack of intention-to-treat analyses. Allocation concealment was poorly reported in four out of the five trials.
Rotation-oscillation brushes (two trials, n=139) did not appear to offer any significant benefit in gingivitis scores over manual toothbrushes (WMD -0.02, 95% CI -0.08 to 0.05). Trials that assessed ionic or pulsating toothbrushes also reported no significant differences, but a small trial of side-to-side brushes (n=24) found a significant reduction in gingivitis compared with manual brushes (WMD -0.54, 95% CI -0.71 to -0.37). Statistical heterogeneity did not appear to be present for either analysis.