Ultrasonic Cleaning and its Effects on Denture Biofilm: A Systematic Review.

Abstract

<h4>Introduction and aims</h4>Denture biofilm is associated with various oral and systemic diseases. Therefore, an effective denture-cleaning method should be adopted by denture wearers. This systematic review aimed to evaluate the efficacy of ultrasonic denture cleaning in reducing plaque quantity and microbial load and changing the microbial composition.<h4>Methods</h4>Clinical studies published in English with no restriction on the year of publication that compared ultrasonic denture cleaning with other cleaning methods were included. Literature was searched across 5 electronic databases (PubMed, Embase, Web of Science, Scopus, and Cochrane Central Register for Controlled Trials). An additional search via other methods was performed until June 2025. The Revised Cochrane Handbook risk-of-bias tools (RoB 2) for individually randomised and parallel-group trials, cluster-randomised trials, and crossover trials were employed for the risk of bias assessments. A narrative synthesis of the included studies was generated.<h4>Results</h4>A total of 2,811 articles were identified. Fifteen studies underwent full-text article screening, and an additional 4 articles were added through manual search. Ultimately, 10 randomised controlled clinical trials reporting the efficacy of ultrasonic denture cleaning contributed to this review. All included studies, assessed using the RoB 2, were considered to be of 'some concerns' to a 'high risk' of bias. The present review identified a diverse range of ultrasonic cleaning protocols. From the synthesis of the 10 included studies, positive outcomes were observed in reducing denture plaque quantity and microbial load, particularly when a chemical cleansing method was combined with ultrasonic cleaning.<h4>Conclusion</h4>There was consistent evidence from randomised clinical trials that supported ultrasonic cleaning reduced denture plaque quantity and modified microbial load, particularly when supplemented with an effervescent denture cleanser.<h4>Clinical relevance</h4>Ultrasonic cleaning combined with chemical cleansing should be adopted by older adults to reduce denture plaque coverage and microbial loads.