Effect of professional mechanical plaque removal performed on a long-term, routine basis in the secondary prevention of periodontitis: a systematic review

Aims To systematically review the evidence evaluating the efficacy of long-term, routine, professional mechanical plaque removal (PMPR) in the prevention of periodontitis progression. Methods A literature search was conducted to identify prospective studies evaluating the effect of PMPR in periodontitis patients undergoing active periodontal therapy and enrolled in a maintenance programme including PMPR for at least 3 years. Results No RCTs evaluating the efficacy of the intervention when compared with no treatment during maintenance were found. Nineteen prospective studies assessing the effect of PMPR as part of the supportive therapy were included. In general, studies reported no to low incidence of tooth loss during follow-up. The weighted mean yearly rate of tooth loss was 0.15 ± 0.14 and 0.09 ± 0.08 for follow-up of 5 years or 12-14 years, respectively, with no significant differences between groups. Mean clinical attachment loss was <1 mm at follow-up ranging from 5 to 12 years. Conclusions Supportive therapy, which encompasses PMPR, may limit the incidence and yearly rate of tooth loss as well as the loss in clinical attachment in patients treated for periodontitis. However, whether and to what extent the intervention may impact on long-term periodontal parameters still needs to be assessed.