Clinical evaluation of air polishing with erythritol powder followed by ultrasonic calculus removal versus conventional ultrasonic debridement and rubber cup polishing for the treatment of gingivitis: A split-mouth randomized controlled clinical trial

Air-polishing followed by ultrasonic calculus removal for the treatment of gingivitis: A 12-month, split-mouth randomized controlled clinical trial

OBJECTIVE

To evaluate the advantages of a novel protocol involving full-mouth erythritol-powder air-polishing followed by ultrasonic calculus removal in the maintenance of patients treated for gingivitis, with a focus on time and comfort.

METHODS

Systemically healthy patients with gingivitis were selected. Following a split-mouth design, quadrants 1-4 and 2-3 were randomly allocated to receive air-polishing followed by ultrasonic calculus removal following a protocol known as Guided Biofilm Therapy (GBT) or traditional full-mouth ultrasonic debridement followed by polishing with a rubber cup and prophylactic paste (US + P). Bleeding on probing (BoP) and the plaque index (PI) were collected at baseline (T0), 2 weeks (T1), 4 weeks (T2), 3 months (T3), and 6 months (T4) and 12 months (T5). Following the same randomization, prophylactic therapy was provided at 3 months (T3) and 6 months (T4). Clinical parameters, treatment time and patient comfort and satisfaction were evaluated.

RESULTS

A total of 41 patients were selected, 39 completed the study. The clinical parameters were clinically satisfactory for both treatments at every time. At 4 months after treatment, GBT maintained significantly lower BoP and PI. GBT protocol required a significantly lower treatment time, especially at T3 and T4, when it saved 24.5% and 25.1% of the time, respectively. Both treatments were rated positively by most patients. However, GBT was perceived as more comfortable, and a higher number of patients preferred it.

CONCLUSION

No significant difference was observed between GBT and conventional ultrasonic debridement and rubber cup polishing in terms of BoP and PI levels. The GBT protocol allowed less time expenditure and higher patients' perceived comfort.

Air powder waterjet technology using erythritol or glycine powders in periodontal or peri-implant prophylaxis and therapy: A consensus report of an expert meeting

OBJECTIVES

To attain a collective expert opinion on the use of air powder waterjet technology (APWT) with erythritol and glycine powders in the prophylaxis and therapy of periodontal and peri-implant diseases.

MATERIAL AND METHODS

In the first step, a modified one-round online Delphi survey including 44 five-point Likert scale questions was conducted among a group of 10 expert clinicians and researchers with thorough knowledge and experience in this topic. In the second step, the single questions and the survey results were discussed during a meeting, and consensus statements were formulated, respectively.

RESULTS

An agreement was reached on most items, especially opinions supporting glycine and erythritol powders as favorable with respect to efficiency, safety, and comfort. More scientific evidence is needed to support the improvement in clinical attachment on teeth and implants, especially when APWT with erythritol is used. In addition, APWT needs more long-term evaluation and studies in terms of microbiome/microbiological effects as well as effects on the inflammatory response on natural teeth and implants, also in light of a guided biofilm therapy concept.

CONCLUSIONS

In line with the expert opinions and supported by the evidence, it was concluded that the use of APWT with erythritol and glycine powders in nonsurgical periodontal and peri-implant therapy and prophylaxis is patient compliant and efficient.

Comparative study on the effects of different polishing methods on tooth surface microstructure and roughness following initial periodontal treatment

OBJECTIVE

To investigate the effects of different polishing methods on the surface microstructure and roughness of teeth following initial periodontal treatment.

METHODS

Teeth were divided into three groups (silica onegloss, polishing disc, and polishing strip) in vitro. Tooth surface microstructure was characterized via scanning electron microscopy. Roughness was measured by profilometry and laser scanning confocal microscopy (LSCM). According to the in vitro results, one group was chosen for further clinical trials. Effects of the chosen polishing method on patient plaque control and satisfaction were assessed via plaque staining and visual analog scale (VAS).

RESULTS

Electron microscopy results revealed that the polishing disc group had smoother roots and crowns than did the other two groups. Roughness analysis revealed that the crown roughness with the polishing disc and silica onegloss was lower, and the root roughness with the polishing disc was the lowest (p < .05) The LSCM results showed that the pigment deposition depth with the polishing disc and silicon onegloss in the crowns and roots were significantly lower than those with the other two methods (p = .000). The polishing effect of the polishing disc was best among the three groups. Clinical trials were performed to verify the polishing disc effects. Plaque staining results showed that the decrease in plaque in the polishing disc group was greater than that of the rubber cup group (p = .020), which was similar to the results of LSCM. The VAS results showed that the polishing disc made teeth feel smoother, similar to the results of the roughness detection, and the procedure was more comfortable (p < .05). However, there was no significant difference between the two groups regarding foreign body sensation during pronunciation (p = .178).

CONCLUSION

Combining in vitro and in vivo evaluations, the use of a polishing disc following periodontal treatment yielded superior polishing effects on teeth and was better accepted by patients.

An Umbrella Review on Low-Abrasive Air Powder Water Jet Technology in Periodontitis and Peri-Implantitis Patients

This umbrella review was conducted to assess the existing literature and scientific evidence on air powder water jet technology (APWJT) in periodontal and peri-implantitis therapy. A systematic literature search for systematic reviews and meta-analyses of the last decade on the use of APWJT in periodontitis and implant patients was performed in the databases of MEDLINE/Ovid, Embase, Cochrane library and Scopus. An additional hand search on PubMed and Google Scholar was conducted. Ten articles that fit the inclusion criteria were selected after the full-text screening. Two systematic reviews, including one with a meta-analysis, investigated the use of APWJT in active periodontal therapy. The use of APWJT as an adjunct to conventional scaling and root planing (SRP) in active periodontal treatment showed improved results in the test group. Six articles, including two with a meta-analysis, reported on the use of APWJT as a stand-alone therapy or as an adjunct in supportive periodontal therapy. Similarly significant improved results were reported for the use of APWJT. Regarding the active treatment of peri-implant mucositis and peri-implantitis, four systematic reviews could not show an improved clinical outcome when APWJT was used as an adjunct to conventional treatment measures. Furthermore, one article investigated APWJT as a stand-alone therapy or as an adjunct in supportive peri-implant mucositis and peri-implantitis therapy. In systematic reviews that also investigated patient perception, APWJT was generally well-tolerated by the patient. Within the limitations of this umbrella review, it can be concluded that the use of APWJT with low-abrasive powders such as glycine, erythritol or trehalose as an adjunct in active periodontitis therapy shows similar clinical results compared to conventional SRP alone. In surgical peri-implantitis treatment, APWJT can be used adjunctively. It could be considered that the use of APWJT in supportive periodontal treatment results in a comparable clinical outcome and an enhanced patient perception, as well as a shorter clinical time.