For both the Missing and Unused index tools it is good to remember that these are recommendations. The best tool is properly tuned squishware (that part of the system that exists between your ears).

How many programmers does it take to change a light bulb? None; It's a hardware problem.

How many therapists does it take to change a light bulb. None; The light bulb must change on its own. The therapist is only a guide.

Likewise the missing index tool is a guide.