The Efficacy of Powered Oscillating Heads vs. Powered Sonic Action Heads Toothbrushes to Maintain Periodontal and Peri-Implant Health: A Narrative Review

Int J Environ Res Public Health. 2021 Feb 4;18(4):1468. doi: 10.3390/ijerph18041468.


Objectives: To compare the efficacy of rotating-oscillating heads (ORHs) VS sonic action heads (SAHs) powered toothbrushes on plaque accumulation and gingival inflammation.

Methods: An electronic (MEDLINE, Embase, Inspec, PQ SciTech and BIOSIS) and a complementary manual search were made to detect eligible studies. RCTs meeting the following criteria were included: final timepoint longer than 15 days; year of publication after 2000; patients without orthodontic appliances or severe systemic/psychiatric diseases. Studies comparing two or more different types of sonic/roto-oscillating toothbrushes were excluded. Selection of articles, extraction of data, and assessment of quality were made independently by several reviewers.

Results: 12 trials (1433 participants) were included. The differences between ORHs and SAHs toothbrushes were expressed as weighted mean differences (WMD) and 95% confidence intervals (CI). The heterogeneity of data was evaluated. Concerning Plaque Index, both toothbrushes obtained comparable results. Six trials of up to 3 months and at an unclear risk of bias provided significant outcomes in terms of gingival inflammation in favor of ORHs toothbrush. Evidence resulting from three trials of up to 6 months and at a high/low risk of bias stated SAHs toothbrush superiority in gingival inflammation.

Conclusions: Both ORHs and SAHs toothbrushes improved the outcomes measured from the baseline. In most of the good quality trials included, SAHs toothbrush showed statistical better long-term results. Due to the shortage of investigations, no further accurate conclusions can be outlined with reference to the superiority of a specific powered toothbrush over the other.

Keywords: domiciliary oral hygiene; electric toothbrushes; home care; rotating oscillating heads (ORHs); sonic action heads (SAHs).

Publication types

  • Review

MeSH terms

  • Equipment Design
  • Gingivitis*
  • Humans
  • Orthodontic Appliances
  • Prostheses and Implants
  • Single-Blind Method
  • Toothbrushing*

Grants and funding

The authors were funded by their own institutions.