Antimicrobial Impact of Different Air-Polishing Powders in a Subgingival Biofilm Model.

Johannes-Simon Wenzler,Felix Krause,Andreas Braun,Sarah Böcher,Axel Birkenmaier,Georg Conrads,Wolfgang Falk

doi:10.3390/antibiotics10121464

Johannes-Simon Wenzler, Felix Krause + Show 5 more

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https://doi.org/10.3390/antibiotics10121464

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Abstract

Subgingival air-polishing devices (SAPD) can reduce bacterial biofilms and thus support periodontal healing. The authors of this study evaluated the effectiveness of the glycine-based and trehalose-based air-polishing powders in removing pathogenic bacteria in a subgingival biofilm model. We treated 56 subgingival pockets in porcine jaws with SAPD. Subgingival air polishing was performed in three groups of 13 pockets each: I, glycine-based powder; II, trehalose-based powder; and III, water alone. Another group (IV) served as untreated controls. Prior to air polishing, inoculated titanium bars were inserted into the pockets containing periopathogenic bacteria such as Porphyromonas gingivalis and Tannerella forsythia. Remaining bacteria were evaluated using real-time PCR. The numbers of remaining bacteria depended on the treatment procedure, with the lowest number of total bacteria in group I (median: 1.96 × 106 CFU; min: 1.46 × 105; max: 9.30 × 106). Both polishing powders in groups I and II (median: 1.36 × 107 CFU; min: 5.22 × 105; max: 7.50 × 107) showed a statistically significantly lower total bacterial load in comparison to both group IV (median: 2.02 × 108 CFU; min: 5.14 × 107; max: 4.51 × 108; p < 0.05) and group III (median: 4.58 × 107 CFU; min: 2.00 × 106; max: 3.06 × 108; p < 0.05). Both subgingival air-polishing powders investigated can reduce periopathogenic bacteria and thus support antimicrobial therapy approaches in periodontal treatment regimens.

Highlights

The authors of this study evaluated the effectiveness of the glycine-based and trehalose-based air-polishing powders in removing pathogenic bacteria in a subgingival biofilm model
Periodontitis is an inflammatory disease of the tissue surrounding the teeth caused by bacteria in the plaque biofilm resulting in pocket formation in the gum tissue, loss of attachment, bone destruction, and tooth loss
Because new biofilm forms rapidly on treated root surfaces after subgingival instrumentation [6,37], following the pretreatment composition of the subgingival microflora [6,38], repeated subgingival debridement as part of supportive periodontal therapy appears to be necessary in order to maintain long-term stable conditions [6,39]

Summary

Introduction

Periodontitis is an inflammatory disease of the tissue surrounding the teeth caused by bacteria in the plaque biofilm resulting in pocket formation in the gum tissue, loss of attachment, bone destruction, and tooth loss. The main goal in periodontitis therapy is to reduce or eliminate infection, with major clinical objectives such as reducing the probing depth (PD) and increasing the clinical attachment level (CAL) [1]. Mechanical treatment such as subgingival debridement (SD), which attempts to achieve infection-free conditions by removing bacterial deposits in the supragingival and subgingival biofilm, is still the most important part of periodontal treatment [2]. The primary goal of subgingival debridement is to remove subgingival biofilm and calculus, the long-term objective is and should always be to maintain stable periodontal conditions by preventing the recurrence or progression of periodontal disease through the constant removal of emerging biofilm [3,4]. Undesirable side effects that have been reported include emphysema in the soft tissue, abrasive effects on root cement and exposed dentin [15,16,17], gingival irritation [18], and possible recessions on exposed tooth necks [8,19]

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