Gingivitis Models - Relevant Approaches to Assess Oral Hygiene Products.

OBJECTIVES: To review the application of gingivitis prevention and treatment models to assess the efficacy of mechanical and chemotherapeutic oral hygiene interventions following shorter- and longer-term use. METHODS: Representative published clinical trials evaluating the shorter- and longer-term anti-gingivitis efficacy of stannous fluoride dentifrice, cetylpyridinium chloride (CPC) rinse, and oscillating-rotating (O-R) electric rechargeable toothbrushes were reviewed. Key gingivitis indices, including the Löe-Silness Gingival Index (LS), Lobene Modified Gingival Index (MGI), Gingival Bleeding Index (GBI), Papillary Bleeding Index (PIBI), and the Mazza modification of the PIBI (Mazza GI), were evaluated for their relative validity and sensitivity in evaluating prevention and treatment outcomes. RESULTS: Twenty clinical trials were evaluated, including 11 treatment studies and 9 prevention trials. Collectively, the findings demonstrated the efficacy of stabilized stannous fluoride toothpaste, CPC rinses, and O-R electric toothbrushes in improving gingival health both in longer-term prevention and shorter-term treatment models. The studies employed various frequently used gingivitis indices. The indices were sufficiently sensitive to elucidate treatment differences. CONCLUSIONS: Based on the results of this review, gingivitis prevention and treatment studies are valid approaches to show treatment effects, and their utilization is dependent upon whether the intention is to evaluate "reducing the onset of gingivitis" or "reducing the severity of existing gingivitis." Various indices, including the LS, MGI, GBI, PIBI, and Mazza GI indices, provide valid measurements for evaluating gingivitis in treatment and prevention models. Shorter-term treatment models allow for efficient efficacy evaluation in clinically relevant populations with existing disease.