Air-polishing devices in periodontal treatment
PD Dr. Kristina Bertl, PhD MSc MBA
Air polishing devices have become a firmly established part of periodontal treatment in recent years. But how efficient are they? What applications do they have? What should be considered when using them?
Based on consensus conference findings (Cobb 2017, Sculean 2013) and two reviews (Bühler 2015a,b) on this topic, these questions can be answered as follows:
- Supra- and subgingival use of glycine-based powders is safe and effective.
- In contrast, powders containing sodium bicarbonate should not be used in periodontal treatment, because these powders can cause considerable damage to exposed cementum and dentine and to the gums.
- For pocket probing depths of ≤ 4 mm and of 5–9 mm, removing biofilm with an air polisher is more effective and quicker than conventional methods; however, the clinical outcome is comparable, and no method is clearly superior.
- However, it is essential to note that air-polishing devices cannot ablate deposits of tartar and calculus; here, a combination of (ultra)sonic devices and/or hand instruments must be used.
- The results available so far for powders containing erythritol indicate that they are at least equivalent to or tend to have advantages over glycine-based powders, both in terms of safety during use and effectiveness.
- Patients often find an air-polishing device in conjunction with glycine-based powder more pleasant than conventional methods.
- Cobb CM, Daubert DM, Davis K, Deming J, Flemmig TF, Pattison A, Roulet JF, Stambaugh RV. Consensus Conference Findings on Supragingival and Subgingival Air Polishing. Compend Contin Educ Dent. 2017 Feb;38(2):e1-e4. Bühler J, Amato M, Weiger R, Walter C. A systematic review on the patient perception of periodontal treatment using air polishing devices. Int J Dent Hyg. 2016 Feb;14(1):4-14. doi: 10.1111/idh.12119. Epub 2015a Jan 23. Bühler J, Amato M, Weiger R, Walter C. A systematic review on the effects of air polishing devices on oral tissues. Int J Dent Hyg. 2016 Feb;14(1):15-28. doi: 10.1111/idh.12120. Epub 2015b Feb 17. Sculean A, Bastendorf KD, Becker C, Bush B, Einwag J, Lanoway C, Platzer U, Schmage P, Schoeneich B, Walter C, Wennström JL, Flemmig TF. A paradigm shift in mechanical biofilm management? Subgingival air polishing: a new way to improve mechanical biofilm management in the dental practice. Quintessence Int. 2013 Jul;44(7):475-7. doi: 10.3290/j.qi.a29615.