{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:54:49Z","timestamp":1791186889286,"version":"4.1.0"},"reference-count":56,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clinic Periodontology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Effective self\u2010performed oral hygiene is fundamental to the prevention and control of dental biofilm\u2010induced gingivitis. While reinforcement strategies and behavioural interventions (including technologies\/digital adjuncts) may improve adherence, advances in oral hygiene devices may enhance the mechanical efficacy of plaque removal. This systematic review evaluated the effects of (1) enhanced oral hygiene instruction, (2) behavioural\/motivational\/technology interventions and (3) oral hygiene devices on gingival inflammation in adults with gingivitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Electronic searches identified randomised controlled trials comparing enhanced versus standard oral hygiene instruction (PICOS 1), behavioural\/motivational\/technological adjuncts versus standard instruction (PICOS 2) and power versus manual toothbrush devices (PICOS 3). Primary outcome was bleeding on probing (BoP) at a minimum of 3\u2009months. Risk of bias was assessed using the Cochrane RoB 2 tool. Random\u2010effects meta\u2010analyses and, where appropriate, network meta\u2010analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010seven randomised controlled trials (RCTs) were included (PICOS 1:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097, PICOS 2:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099, PICOS 3:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921). Enhanced oral hygiene instruction produced a statistically significant but modest reduction in gingival bleeding compared with standard instruction. Behavioural\/motivational\/technological interventions yielded small but statistically significant and consistent benefits, with low\u2010to\u2010moderate heterogeneity. In contrast, powered toothbrushes demonstrated substantially greater reductions in gingival bleeding and plaque compared with manual brushing. Network meta\u2010analysis ranked oscillating\u2010rotating and high\u2010frequency sonic powered toothbrushes as the most effective interventions, with large effect sizes and consistent findings across studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reinforced instruction and behavioural interventions produce meaningful improvements in gingival inflammation. Powered toothbrushes consistently provide improvements in gingival health over manual toothbrushes. While effective powered devices have a strong influence on gingival therapeutic outcomes, the foundation of long\u2010term oral health lies in well\u2010instructed, consistent self\u2010care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpe.70192","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:34:33Z","timestamp":1791185673000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Dental Biofilm\u2010Induced Gingivitis: Oral Hygiene Instruction, Behavioural Strategies and Self\u2010Performed Mechanical Oral Hygiene\u2014A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6526-6235","authenticated-orcid":false,"given":"J.","family":"Suvan","sequence":"first","affiliation":[{"name":"University of Glasgow Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5075-8384","authenticated-orcid":false,"given":"G. A.","family":"Van der Weijden","sequence":"additional","affiliation":[{"name":"Academic Centre for Dentistry Amsterdam (ACTA)  Amsterdam the Netherlands"},{"name":"Clinic for Periodontology Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7234-0037","authenticated-orcid":false,"given":"D. E.","family":"Slot","sequence":"additional","affiliation":[{"name":"Academic Centre for Dentistry Amsterdam (ACTA)  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6656-6934","authenticated-orcid":false,"given":"C.","family":"Valkenburg","sequence":"additional","affiliation":[{"name":"Academic Centre for Dentistry Amsterdam (ACTA)  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8343-4693","authenticated-orcid":false,"given":"D.","family":"Marletta","sequence":"additional","affiliation":[{"name":"UCL Library Services, LCCOS \u2013 Library, Culture, Collections &amp; Open Science University College London (UCL)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9653-5629","authenticated-orcid":false,"given":"S.","family":"Culshaw","sequence":"additional","affiliation":[{"name":"University of Glasgow Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8654-935X","authenticated-orcid":false,"given":"F.","family":"D'Aiuto","sequence":"additional","affiliation":[{"name":"Oral Surgery Unit, Charing Cross Hospital Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"1","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1111\/j.1600-051X.1997.tb01180.x","article-title":"Assessment of the Effect of an Oscillating\/Rotating Electric Toothbrush on Oral Health A 12\u2010Month Longitudinal Study","volume":"24","author":"Ainamo J.","year":"1997","journal-title":"Journal of Clinical Periodontology"},{"issue":"7048","key":"e_1_2_10_3_1","first-page":"41","article-title":"Measurement Error and Correlation Coefficients","volume":"313","author":"Bland J. 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