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Gheorghe DN, Bennardo F, Silaghi M, Popescu DM, Maftei GA, Bătăiosu M, Surlin P. Subgingival Use of Air-Polishing Powders: Status of Knowledge: A Systematic Review. J Clin Med 2023; 12:6936. [PMID: 37959401 PMCID: PMC10647465 DOI: 10.3390/jcm12216936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/07/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Effective subgingival biofilm removal is crucial for achieving positive and stable outcomes in periodontal therapy, forming an indispensable part of any periodontal treatment approach. The development of air-polishing tools has emerged as a promising alternative to hand and ultrasonic scalers for dental biofilm removal. The objective of this systematic review was to assess existing literature regarding the subgingival use of various types of air-polishing powders, as an effective method of subgingival biofilm control. For this, 55 articles on this subjected were sourced from searched databases and subjected to an evaluation process of their contained information, which was subsequently structured and compiled into this manuscript. The existing literature acknowledges that good subgingival biofilm control is essential for the success of periodontal therapy, including through subgingival air-polishing, as an adjunctive procedure. This approach has the potential to enhance patient comfort during and after subgingival mechanical plaque removal, thereby mitigating damage to periodontal structures. Consequently, it may lead to improved healing capabilities within the periodontal tissues and the formation of a more stable reparative gingival junctional epithelium.
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Affiliation(s)
- Dorin Nicolae Gheorghe
- Department of Periodontology, Research Center of Periodontal-Systemic Interactions, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.-M.P.); (P.S.)
| | - Francesco Bennardo
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
| | - Margarita Silaghi
- Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Dora-Maria Popescu
- Department of Periodontology, Research Center of Periodontal-Systemic Interactions, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.-M.P.); (P.S.)
| | - George-Alexandru Maftei
- Department of Dento-Alveolar Surgery and Oral Pathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
| | - Marilena Bătăiosu
- Department of Pedodontics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Petra Surlin
- Department of Periodontology, Research Center of Periodontal-Systemic Interactions, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.-M.P.); (P.S.)
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Nong Z, Ya Z, Zheng J, Yong X, Tao R. The efficacy of subgingival air polishing and subgingival debridement in periodontal support therapy: a meta-analysis. Evid Based Dent 2023; 24:142-143. [PMID: 37433921 DOI: 10.1038/s41432-023-00910-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/30/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE To assess whether there is sufficient evidence of a difference in efficacy between subgingival air polishing (SubAP) and subgingival debridement as periodontal support treatment. The systematic review protocol was registered in the PROSPERO database under no. CRD42020213042. METHODS A comprehensive search was conducted using eight online databases to develop straightforward clinical questions and search strategies, from their inception to 27 January 2023. The references of identified reports were also retrieved for inclusion in the analysis. The risk-of-bias of the included studies was evaluated using the Revised Cochrane Risk-of-Bias tool (RoB 2). A meta-analysis was performed on five clinical indicators using the Stata 16 software. RESULTS Twelve randomized controlled trials were ultimately included, and most included studies had varying degrees of risk-of-bias. The results of the meta-analysis indicated that there was no significant difference between SubAP and subgingival scaling in terms of improving probing depth (PD), clinical attachment loss (CAL), plaque index (PLI), and bleeding on probing% (BOP%). The results of the visual analogue scale score analysis indicated that SubAP produced less discomfort than did subgingival scaling. DISCUSSION SubAP can provide better treatment comfort than subgingival debridement. There was no significant difference in the efficacy of the two modalities in improving PD, CAL, and BOP% in supportive periodontal therapy. CONCLUSION Currently, evidence for assessing the difference in the efficacy of SubAP and subgingival debridement in improving the PLI is insufficient, and further high-quality clinical studies are needed.
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Affiliation(s)
- Zuwei Nong
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
| | - Zuke Ya
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China.
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China.
| | - Jiali Zheng
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
| | - Xiangzhi Yong
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
| | - Renchuan Tao
- Department of Periodontal and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, P.R. China
- Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Nanning, P.R. China
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Hihara H, Izumita K, Iwatsu M, Sato T, Tagaino R, Shobara K, Shinohara Y, Hatakeyama T, Kayaba C, Sato M, Tokue A, Sugawara T, Ashino K, Ikeda K, Aida J, Sasaki K. Clinical Trial for Evaluating the Effectiveness and Safety of a New Dental Plaque Removal Device: Microscale Mist Unit. Antibiotics (Basel) 2022; 11:antibiotics11060825. [PMID: 35740231 PMCID: PMC9219637 DOI: 10.3390/antibiotics11060825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 12/10/2022] Open
Abstract
This study evaluates the effectiveness and safety of a microscale mist unit (MSM-UNIT) that sprays high-speed fine water droplets to remove dental plaque adhering to the oral mucosa (tongue and palate) and tooth surface. Fifteen patients who had difficulty self-managing sufficient oral care were included in this study. Effectiveness was evaluated for at least five patients' tongues, palate mucosas, and tooth surfaces, and safety evaluation was conducted at all three sites for all patients. Effectiveness was evaluated using the rate of degree of dental plaque removal. Safety was evaluated using a numerical rating scale (NRS) for pain and symptoms of inflammation. An operator who performed treatment and an evaluator who evaluated effectiveness and safety were designated. In addition, an image judgment committee judged effectiveness. Although evaluation of the tongue varied between the evaluators and the image judgment committee, the rates of degree for all plaque removal increased in all regions. In addition, low pain NRS results and minimal symptoms of inflammation were observed and within an acceptable range. The MSM-UNIT can be used effectively and safely for removing oral plaque not only from teeth, but also from the oral mucosa.
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Affiliation(s)
- Hiroki Hihara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
- Correspondence: ; Tel.: +81-22-717-8369
| | - Kuniyuki Izumita
- Perioperative Oral Health Management, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan;
| | - Misato Iwatsu
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| | - Tomoya Sato
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| | - Ryo Tagaino
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
- Perioperative Oral Health Management, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan;
| | - Kenta Shobara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| | - Yuta Shinohara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| | - Takanori Hatakeyama
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
| | - Chie Kayaba
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Mariko Sato
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Ayako Tokue
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Tomoko Sugawara
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Kanamai Ashino
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Koji Ikeda
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (C.K.); (M.S.); (A.T.); (T.S.); (K.A.); (K.I.)
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan;
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; (M.I.); (T.S.); (R.T.); (K.S.); (Y.S.); (T.H.); (K.S.)
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Divnic-Resnik T, Pradhan H, Spahr A. The efficacy of the adjunct use of subgingival air-polishing therapy with erythritol powder compared to conventional debridement alone during initial non-surgical periodontal therapy. J Clin Periodontol 2022; 49:547-555. [PMID: 35373340 PMCID: PMC9321595 DOI: 10.1111/jcpe.13623] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/19/2022] [Accepted: 03/24/2022] [Indexed: 01/12/2023]
Abstract
Aim To assess the efficacy of the adjunct use of a subgingival erythritol powder air‐polishing device (EPAP) in comparison to conventional subgingival instrumentation alone during initial non‐surgical periodontal therapy. Materials and Methods Twenty‐one patients with generalized Stages 2 and 3 grade B periodontitis were included in this single centre, single blinded, split‐mouth, randomized clinical trial. Teeth on the control side were treated with conventional hand and ultrasonic instrumentation, while those on the contralateral test side was treated using EPAP as adjunct to conventional subgingival instrumentation with hand and ultrasonic instruments. Three months after initial instrumentation, persisting pockets of ≥4 mm were re‐treated, in both control and test sides, again with the respective treatment approach—subgingival instrumentation alone on control, and subgingival instrumentation + EPAP on test side. Clinical parameters such as probing pocket depth (PPD), bleeding on probing, and relative attachment level were recorded at baseline and 3 and 6 months following the initial instrumentation. Subgingival plaque samples were collected at baseline, immediately post surgery, as well as at 1 week, 1 month, 3 months, and 6 months after initial instrumentation. Results In the test group after 6 months, a significantly larger number of initially deep pockets (PPD ≥ 5.5 mm) were reduced to shallow (PPD ≤ 3.4 mm), and a larger attachment gain was observed. No statistically significant microbiological differences could be found between test and control group. Conclusions The results of the present study indicate that the adjunct use of subgingival airflow therapy with EPAP during initial non‐surgical periodontal therapy might be beneficial in initially deep pockets (PPD ≥ 5.5 mm).
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Affiliation(s)
- Tihana Divnic-Resnik
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Harold Pradhan
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Axel Spahr
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Tan SL, Grewal GK, Mohamed Nazari NS, Mohd-Dom TN, Baharuddin NA. Efficacy of air polishing in comparison with hand instruments and/or power-driven instruments in supportive periodontal therapy and implant maintenance: a systematic review and meta-analysis. BMC Oral Health 2022; 22:85. [PMID: 35321688 PMCID: PMC8944123 DOI: 10.1186/s12903-022-02120-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Supportive periodontal therapy (SPT) is the key for a stable periodontal health following active treatment. Likewise, implant maintenance is crucial following implant placement. This systematic review aimed to assess clinical outcomes, patients' perception, and cost-effectiveness of repeated periodontal therapy with air polishing devices (APDs) in comparison with hand instruments and/or power-driven instruments (conventional interventions) in SPT and implant maintenance. METHODS Electronic search for randomised controlled clinical trials with minimum 6 months follow-up for SPT and implant maintenance programme was conducted for data published from 01 January 2000 to 30 April 2020 using multiple databases and hand searching. Risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (RoB 2). RESULTS A total of 823 articles were screened. 4 SPT and 2 implant maintenance studies were eligible for inclusion. For SPT, repeated APDs interventions revealed no statistically significant difference when compared to the conventional interventions (weighted mean difference [WMD] 0.11 mm, p = 0.08). Likewise, no statistical difference was noted in terms of percentage of bleeding on probing (BOP) and clinical attachment level (CAL) gain. APDs were associated with lower pain score (based on Visual Analogue Scale) and higher patient acceptance in SPT studies. For implant maintenance, APDs resulted in reduction in PPD and percentage of BOP. However, CAL gain was comparable between the two groups. In terms of patient reported outcomes, no implant maintenance studies recorded any forms of patient reported outcomes. In addition, no studies reported on economic evaluation of APDs in both SPT and implant maintenance. CONCLUSION Within the limitations of this systematic review and meta-analysis, repeated subgingival debridement using APDs in SPT resulted in similar clinical outcomes but better patients' comfort when compared to the conventional interventions. For implant maintenance, there is limited evidence to show that repeated application of APDs leads to improved clinical outcomes when compared to conventional treatments.
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Affiliation(s)
- Shiuan Lee Tan
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Galvinderjeet Kaur Grewal
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Nor Shafina Mohamed Nazari
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Tuti Ningseh Mohd-Dom
- Department of Family Oral Health Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nor Adinar Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
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Abdulbaqi HR, Shaikh MS, Abdulkareem AA, Zafar MS, Gul SS, Sha AM. Efficacy of erythritol powder air-polishing in active and supportive periodontal therapy: A systematic review and meta-analysis. Int J Dent Hyg 2021; 20:62-74. [PMID: 34318577 DOI: 10.1111/idh.12539] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This systematic review aimed to analyse available evidence to answer two focused questions about the efficacy of erythritol powder air-polishing (EPAP) (i) as an adjunctive during active periodontal therapy (APT) and (ii) as an alternative to hand/ultrasonic instrumentation during supportive periodontal therapy (SPT). Additionally, microbiological outcomes and patient's comfort/perceptions were assessed as secondary outcomes. METHODS PubMed, Cochrane and Medline were searched for relevant articles published before February 2021 following PRISMA guidelines. The search was conducted by three independent reviewers, and the agreement was measured by Cohen's kappa score. Out of 1043 articles, eight randomized clinical trials were selected for systematic review and quantitative synthesis. Only periodontal parameters, such as clinical attachment level (CAL), probing pocket depth (PPD) and bleeding on probing (BoP), showed homogeneity and, thus, were selected for meta-analysis. RESULTS The improvement in PPD and BoP scores after using EPAP was comparable with hand/ultrasonic instrumentation during both APT and SPT. Significant CAL gain was achieved with EPAP during APT (0.16 mm, p < 0.02) compared with hand/ultrasonic instrumentation at the end point, whereas non-significant CAL gain was achieved during SPT. No differences were observed regarding microbiological outcomes between the two treatment modalities. However, EPAP inflicted less pain and was better perceived by the patients. CONCLUSION Erythritol powder air-polishing can substitute hand/ultrasonic instrumentation for SPT, and CAL gain is significantly improved when EPAP is used as an adjunct during APT. For microbiological outcomes, no significant differences were observed between the two approaches; however, EPAP was better tolerated by the patients than hand/ultrasonic instrumentation. CLINICAL RELEVANCE Erythritol powder air-polishing can be used as an adjunct during APT and as an alternative to conventional mechanical debridement during SPT.
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Affiliation(s)
- Hayder R Abdulbaqi
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Ali A Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Muhammad S Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Medina, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
| | - Sarhang S Gul
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Aram M Sha
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq.,Smart Health Tower, Sulaimani, Iraq
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