DATA SOURCES: The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase and the US National Institutes of Health Trials Register. STUDY SELECTION: Randomised controlled trials (RCTs) of parallel or crossover design, (with a sufficient wash-out period) of at least six months duration, and irrespective of language or publication status. DATA EXTRACTION AND SYNTHESIS: Study assessment and data extraction were carried out independently by at least two reviewers. Meta-analysis was conducted using random-effects models when there were at least four studies (fixed-effect models when fewer than four studies), reporting mean differences (MD) for continuous data and risk ratios (RR) for dichotomous data. RESULTS: Thirty studies involving 14,835 patients were included. Ten studies were considered to be a low risk of bias, nine at high risk and the remaining 11 were assessed as at unclear risk. After six to seven months use of triclosan/copolymer toothpaste there was a statistically significant reduction in plaque in favour of triclosan/copolymer of 22% (20 studies, 2675 patients, moderate-quality evidence).There was also a statistically significant reduction in plaque severity of 41% (13 studies, 1850 patients, moderate-quality evidence). Triclosan/copolymer toothpaste also reduced gingival inflammation statistically significantly by 22% after six to nine months of use (20 studies, 2743 patients, moderate-quality evidence). After 36 months of use there was no evidence of a difference between triclosan/copolymer toothpaste and control in the development of periodontitis (attachment loss) (RR 0.92, 95% CI 0.67 to 1.27, one study, 480 patients, low-quality evidence). After 24 to 36 months of use, triclosan/copolymer toothpaste slightly reduced coronal caries by about 5% (four studies, 9692 patients, high-quality evidence). One study (1357 patients, moderate-quality evidence) suggested that after 36 months of use triclosan/copolymer toothpaste probably reduced root caries.After six months of use triclosan/copolymer toothpaste may have reduced the mean total calculus by about 15%. There were no data available for meta-analysis regarding adverse effects, but 22 studies (73%) reported that there were no adverse effects caused by either the experimental or control toothpaste.There was considerable heterogeneity present in the meta-analyses for plaque, gingivitis and calculus. Plaque and gingivitis showed such consistent results that it did not affect our conclusions, but the reader may wish to interpret the results with more caution. CONCLUSIONS:
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