Subgingival Air Polishing Research Articles

A paradigm shift in mechanical biofilm management? Subgingival air polishing: a new way to improve mechanical biofilm management in the dental practice.

In the past few years indications for the use of the air polishing technology have been expanded from supragingival use (airflow) to subgingival air polishing (perioflow) by the development of new low-abrasive glycine-based powders and devices with a subgingival nozzle. Several studies on the subgingival use of air polishing have been completed. On 7 June 2012, during the Europerio 7 Congress in Vienna, a consensus conference on mechanical biofilm management took place aiming to review the current evidence from the literature on the clinical relevance of the subgingival use of air polishing and to make practical recommendations for the clinician. Bernita Bush (Bern), Prof Johannes Einwag (Stuttgart), Prof Thomas Flemmig (Seattle), Carmen Lanoway (Munich), Prof Ursula Platzer (Hamburg), Prof Petra Schmage (Hamburg), Brigitte Schoeneich (Zurich), Prof Anton Sculean (Bern), Dr Clemens Walter (Basel), and Prof Jan Wennström (Gothenburg) discussed under the moderation of Klaus-Dieter Bastendorf and Christian Becker (both ADIC Association for Dental Infection Control) the available clinical studies to reach a consensus on available clinical evidence. This paper summarizes the main conclusions of the consensus conference and points to the clinical relevance of the findings for the dental practitioner.

Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy

The objective was to determine clinical and microbiological effects and perceived treatment discomfort of root debridement by subgingival air polishing compared with ultrasonic instrumentation during supportive periodontal therapy (SPT). The trial was conducted as a split-mouth designed study of 2-month duration including 20 recall patients previously treated for chronic periodontitis. Sites with probing pocket depth (PPD) of 5-8 mm and bleeding on probing (BoP+) in two quadrants were randomly assigned to subgingival debridement by (i) glycine powder/air polishing applied with a specially designed nozzle or (ii) ultrasonic instrumentation. Clinical variables were recorded at baseline, 14 and 60 days post-treatment. Primary clinical efficacy variable was PPD reduction. Microbiological analysis of subgingival samples was performed immediately before and after debridement, 2 and 14 days post-treatment. Both treatment procedures resulted in significant reductions of periodontitis-associated bacterial species immediately and 2 days after treatment, and in significant reduction in BoP, PPD and relative attachment level at 2 months. There were no statistically significant differences between the treatment procedures at any of the examinations intervals. Perceived treatment discomfort was lower for air polishing than ultrasonic debridement. This short-term study revealed no pertinent differences in clinical or microbiological outcomes between subgingival air polishing and ultrasonic debridement of moderate deep pockets in SPT patients.

Subgingival Plaque Removal Using a New Air‐Polishing Device

The purpose of this study is to evaluate the safety, patient acceptance, and short-term microbiologic effect of a new air-polishing device in subjects in maintenance care with residual pockets > or =5 mm. This was an examiner-masked, randomized, split-mouth clinical trial. A new disposable nozzle, allowing the subgingival application of amino acid glycine powder at a limited pressure, was compared to scaling and root planing (SRP) in 50 subjects with residual pockets during the maintenance phase. After removing supragingival deposits, the spray was applied for 4 to 5 seconds in all sites > or =5 mm in the test quadrant, whereas SRP was used in the control quadrant. Microbiologic samples were taken from one treated test and one control site 2 days before and 7 days after treatment. Total bacterial counts and the counts of six periodontal pathogens were determined by real-time polymerase chain reaction. No adverse event was noted in any subject for the test or control treatment. Using a visual analog scale, the patients perceived the test treatment to be significantly less painful/uncomfortable than the hand instrumentation (P <0.001). Significantly less time was used by the operator for the test procedure (P <0.001). The reduction in bleeding on probing was significant for the treated sites in the test and control quadrants (P = 0.019 and P <0.001, respectively), but traditional SRP reduced the bleeding tendency significantly more than air polishing (P = 0.045). The differences in the total bacterial load and the counts of six periodontal pathogens between the test and control sites did not reach statistical significance. The longitudinal reduction was significant in control sites for total bacteria load (P <0.001), Porphyromonas gingivalis (P = 0.01), Treponema denticola (P <0.001), and Tannerella forsythia (previously T. forsythensis) (P <0.001). Subgingival air polishing with a new device was safe (no adverse events were noted), perceived to be more acceptable by the patients, and was more time-efficient than SRP; however, on a microbiologic level, it was not superior to conventional SRP.